ABSTRACT
Wilson's Disease (WD) is an autosomal recessive disorder of copper metabolism resulting in a pathological accumulation of this metal, initially in the liver and later in other organs, mainly brain. Treatment with copper chelating agents and zinc salts results in a depletion of copper deposits and prevents or reverses the clinical manifestations. Copper deficiency may cause haematological and neurological changes, the latter principally being polyneuropathy and myelopathy. We report a patient with WD who developed a myelopathy associated with a deficiency of copper following prolonged treatment with D-penicillamine and zinc salts (AU)
La enfermedad de Wilson (EW) es una enfermedad autosómica recesiva del metabolismo del cobre que provoca la acumulación patológica de este metal, primero en el hígado y posteriormente en otros órganos, principalmente el cerebro. El tratamiento con agentes quelantes del cobre y sales de zinc conduce al agotamiento de los depósitos de cobre y previene o revierte las manifestaciones clínicas de esta enfermedad. El déficit de cobre puede causar alteraciones hematológicas y neurológicas, entre estas últimas principalmente polineuropatía y mielopatía. Se presenta un paciente con EW que ha desarrollado una mielopatía asociada con la deficiencia de cobre tras un tratamiento prolongado con D-penicilamina y sales de zinc (AU)
Subject(s)
Humans , Spinal Cord Diseases/etiology , Copper/deficiency , Hepatolenticular Degeneration/complications , Chelating Agents/adverse effects , Risk FactorsABSTRACT
Wilson's Disease (WD) is an autosomal recessive disorder of copper metabolism resulting in a pathological accumulation of this metal, initially in the liver and later in other organs, mainly brain. Treatment with copper chelating agents and zinc salts results in a depletion of copper deposits and prevents or reverses the clinical manifestations. Copper deficiency may cause haematological and neurological changes, the latter principally being polyneuropathy and myelopathy. We report a patient with WD who developed a myelopathy associated with a deficiency of copper following prolonged treatment with D-penicillamine and zinc salts.
Subject(s)
Chelating Agents/adverse effects , Chelation Therapy/adverse effects , Copper/deficiency , Hepatolenticular Degeneration/complications , Penicillamine/adverse effects , Polyneuropathies/chemically induced , Spinal Cord Diseases/chemically induced , Zinc/adverse effects , Ceruloplasmin/analysis , Chelating Agents/therapeutic use , Copper/pharmacokinetics , Copper/urine , Female , Gait Disorders, Neurologic/chemically induced , Hepatolenticular Degeneration/drug therapy , Hepatolenticular Degeneration/metabolism , Humans , Magnetic Resonance Imaging , Middle Aged , Neurologic Examination , Penicillamine/therapeutic use , Polyneuropathies/diagnosis , Reflex, Abnormal , Sensation Disorders/chemically induced , Spinal Cord Diseases/diagnosis , Zinc/pharmacokinetics , Zinc/therapeutic useABSTRACT
La reactivación de la infección por el VHB en pacientes con infección resuelta se detecta en pocas ocasiones, usualmente asociado a un tratamiento inmunosupresor y conlleva una morbilidad y mortalidad altas. Se ha publicado en la literatura médica algunos casos de reactivación de la infección por el VHB asociada al empleo de rituximab y nosotros presentamos otro paciente, con un linfoma no Hodgkin B, que tras recibir quimioterapia en combinación con rituximab sufrió una reactivación seguida de fallo hepático. Se revisa y comenta la literatura más reciente en relación a este tema (AU)
Reactivation of hepatitis B virus infection in patients with resolved infection is rare and is usually associated with immunosuppressive therapy. Morbidity and mortality are high. Some cases of hepatitis B reactivation associated with the use of rituximab have previously been published. We present the case of a patient with B-cell non-Hodgkin lymphoma receiving combination chemotherapy with rituximab who showed hepatitis B reactivation followed by liver failure. The most recent literature on this topic is reviewed and discussed (AU)
Subject(s)
Humans , Male , Aged, 80 and over , Hepatitis B Antibodies/blood , Hepatitis B Core Antigens/immunology , Hepatitis B , Hepatitis B, Chronic/complications , Immunologic Factors/adverse effects , Immunotherapy/adverse effects , Virus Activation , Virus Activation/immunology , Fatal Outcome , Hepatitis B Surface Antigens/blood , Hepatitis B Antibodies/immunology , Hepatitis B, Chronic/drug therapy , Hepatitis B, Chronic/virology , Immunologic Factors/administration & dosageABSTRACT
Reactivation of hepatitis B virus infection in patients with resolved infection is rare and is usually associated with immunosuppressive therapy. Morbidity and mortality are high. Some cases of hepatitis B reactivation associated with the use of rituximab have previously been published. We present the case of a patient with B-cell non-Hodgkin lymphoma receiving combination chemotherapy with rituximab who showed hepatitis B reactivation followed by liver failure. The most recent literature on this topic is reviewed and discussed.