ABSTRACT
Pachyonychia congenital (PC) is a rare autosomal dominant genodermatosis characterized hyperkeratosis affecting the nails and palmoplantar areas, oral leukokeratosis, and cystic lesions. A 39-year-old woman with PC type 1 (Jadassohn-Lewandowsky syndrome) and B-cell lymphoma is described. No similar disorders or parental consanguinity were found in her family. Typical features of PC developed since her early childhood and the diagnosis of B-cell lymphoma was established seven years ago, without a clear causal relation between these entities. Despite inherent limitations of a single case, this report may contribute to PC understanding.
Subject(s)
Lymphoma, B-Cell/complications , Pachyonychia Congenita/complications , Adult , Diagnosis, Differential , Female , Humans , Lymphoma, B-Cell/diagnosis , Magnetic Resonance Imaging , Pachyonychia Congenita/diagnosis , Tomography, X-Ray ComputedABSTRACT
Descreve-se o caso de uma mulher de 36 anos etários com declínio de função renal em virtude de nefrite intersticial aguda, confirmada por biopsia, depois do uso de mesalazina para tratar sua doença do Crohn. Não houve comprovação clínica nem histopatológica de vasculite no presente estudo de caso. A melhora da função renal ocorreu depois da suspensão da mesalazina, substituída por corticosteroides. Nefrotoxicidade tem sido associada com o uso de 5-aminosalicilatos em doenças inflamatórias intestinais; porém, os exatos mecanismos da patogênese dessa condição pouco descrita permanecem desconhecidos. A escala de avaliação de Naranjo revelou um provável efeito adverso da droga. Relatos de caso poderiam contribuir para melhor conhecimento a respeito de entidades clínicas possivelmente subinformadas.
We describe the case of a 36-year-old woman with renal function decline due to acute interstitial nephritis, confirmed by biopsy, after the use of mesalazine to treat Crohn?s disease. Improvement of renal function occurred after discontinuation of mesalazine and administration of corticoids. There was neither clinical nor histopathological evidence of vasculitis in the present case study. Nephrotoxicity has been associated with the use of 5-aminosalicylates in inflammatory bowel diseases; however, the exact pathogenic mechanisms of this rarely described condition remain unknown. The Naranjo scale score revealed a probable drug-adverse effect of mesalazine. Case reports may contribute to increase the knowledge about possibly unreported clinical entities.
ABSTRACT
A 76-year-old male with adenocarcinoma on the right lung underwent five cycles of chemotherapy with pemetrexed disodium, cisplatin, and dexamethasone. Imaging studies of control showed a node in a cavitary lesion on the left lung, and the main hypothesis was Aspergillus infection. PCR was utilized and contributed to establish the early diagnosis in this patient with invasive aspergillosis. Furthermore, the species Aspergillus fumigatus was characterized by its growing at 50 °C but not at 10 °C, typical culture features, and presence of subclavate vesicles. Diagnosis criteria for Aspergillus pulmonary infection include characteristic clinical and imaging findings, elevated C-reactive protein and erythrocyte sedimentation rate, positive specific serological test, and isolation of Aspergillus from bronchoalveolar cultures. Molecular methods, as PCR, have been useful to complement the conventional microbiological investigations in immunocompromised people with invasive fungal infections. The patient was successfully treated with a schedule of voriconazole 4 mg/kg intravenous infusion every 12 h for 21 days and then switched to oral administration of 200 mg twice a day. He has been comfortable, maintaining normal vital signs, and the results of the periodical microbiologic tests of control are negative. Pathogenesis of invasive aspergillosis in patients with lung cancer is not completely understood. Case studies may contribute to a better knowledge about Aspergillus infection in this setting.
