Subject(s)
Alzheimer Disease/diagnosis , Hallucinations/etiology , Recognition, Psychology , Aged , Alzheimer Disease/physiopathology , Alzheimer Disease/psychology , Diagnosis, Differential , Disease Progression , Electroencephalography , Female , Hallucinations/psychology , Humans , Magnetic Resonance Imaging , Reflex, Abnormal , Severity of Illness IndexABSTRACT
Subacute thyroiditis (SAT) is an extremely rare complication of influenza vaccination. Several infectious agents have been related with SAT. It is also well known the association between HLA-B35 and the development of SAT. We describe a case of subacute thyroiditis and dyserythropoesis occurring shortly after administration of an influenza vaccine in a 55-year-old man with history of diabetes and psoriasis, family history of autoimmunity without clinical evidence of acute viral infection prior to the onset of symptoms. We propose that, the events occurring in the patient may be explained as result of complex interactions between the individual genetic background and environmental exposure to infectious agents that generated a pro-inflammatory status, where the vaccine was the trigger for the subsequent alterations in thyroid and bone marrow. These findings highlight the importance of immunogenetic factors involved in response to vaccination that is the central theme in the growing field of 'vaccinomics'.
Subject(s)
Anemia/etiology , Diabetes Mellitus, Type 2/complications , HLA-B35 Antigen/analysis , Influenza Vaccines/adverse effects , Thyroiditis, Autoimmune/etiology , Thyroiditis, Subacute/etiology , Anemia/immunology , Autoantibodies/blood , Bone Marrow/pathology , Cytokines/biosynthesis , Diabetes Mellitus, Type 2/immunology , GATA1 Transcription Factor/biosynthesis , Genetic Predisposition to Disease , Goiter, Nodular/complications , HLA-B35 Antigen/genetics , Humans , Inflammation , Male , Middle Aged , Psoriasis/complications , Psoriasis/immunology , Thyroiditis, Autoimmune/immunology , Thyroiditis, Autoimmune/pathology , Thyroiditis, Subacute/immunology , Thyroiditis, Subacute/pathology , Vaccination , Vaccines, Attenuated/adverse effectsABSTRACT
The prevalence of concomitant thyroid carcinoma with Grave's disease has been reported to range from 0 to 10%. Many controversies exist in the literature regarding the diagnostic workup and management in these types of patients. We are reporting a case of a 31 year old woman who had Graves' disease, a palpable thyroid nodule, and results from a thyroid scan revealed a "hot" nodule. Interestingly, an ultrasound guided FNA of the "hot" nodule showed papillary thyroid microcarcinoma. Finally, a total thyroidectomy showed multilobar tumor involvement. The diagnostic tools employed to establish the proper management strategy for this patient were based on data in the literature that is full of discrepancies. The fact that Grave's disease occurs concomitantly with thyroid cancer, specifically the papillary type, is an indisputably rare combination. One rare feature on our clinical case was the reported malignancy of a papillary carcinoma within a "hot" nodule which usually is much less that 1%. Many studies describe an increasing incidence of Grave's disease patients with concomitant papillary thyroid carcinoma. One possible explanation for these findings could be improvements in medical technology of screening tools. We propose that, thyroid ultrasonography should be integrated in the diagnostic workup in patients presenting with Graves' disease, especially in those presenting with palpable nodules. Fine needle biopsy should not be restricted to cold nodules.
Subject(s)
Hyperthyroidism/complications , Thyroid Neoplasms/complications , Thyroid Nodule/complications , Adult , Female , HumansABSTRACT
El dolor oseo es el síntoma principal del paciente joven con osteoma osteoide. Este tumor debe ser debidamente diagnosticado y clasificado para que el tratamiento adecuado -en este caso, extirpación quirúrgica del nido -pueda ser instituido y así aliviar esta dolorosa condición. Escintigrafía de hueso es una técnica excelente para detectar el tumor, (aún cuando las radiografías sean normales para localizar el nido y planear el abordaje quirúrgico; para guiar el proceso de curetaje y determinar cuando el nido ha sido disecado en su totalidad; y para seguimeniento del caso postoperatorio para detectar recurrencias. Ninguna otra técnica conocida puede contribuir tanto al diagnóstico y manejo de esta enfermedad
Subject(s)
Child , Humans , Male , Femoral Neoplasms , Osteoma, Osteoid , Femoral Neoplasms/surgery , Osteoma, Osteoid/surgery , Pain/etiologyABSTRACT
El sangrado gastrointestinal de un divertículo de Meckel es una entidad clínica muy difícil de diagnosticar con técnicas endoscópicas o radiografías rutinarias, necesitándose a veces la angiografía. El escintigrama con pertecnetato de tecnecio 99m resulta una alternativa viable para el diagnóstico de esta condición
Subject(s)
Humans , Gastrointestinal Hemorrhage , Meckel Diverticulum/diagnosis , Technetium , Meckel Diverticulum , Urinary BladderABSTRACT
El drenaje anómalo del ducto biliar común a la tercera porción del duodeno es un hallazgo raro que se había descrito previamente en autopsias y colangiografias operatorias. Aquí reportamos el primer caso de esta variante identificada por escintigrafía del sistema hepatobiliar utilizando técnicas de medicina nuclear
Subject(s)
Middle Aged , Humans , Male , Ampulla of Vater , Ampulla of Vater/abnormalities , Common Bile Duct Diseases , Duodenum , Duodenum/abnormalities , Liver , Renal Insufficiency, Chronic/complications , Bile Ducts, Intrahepatic , Common Bile Duct Diseases/complicationsABSTRACT
Se describe una técnica nuclear simple y no invasiva para el diagnóstico de tromboflebitis profunda de las extremidades inferiores. Esta envuelve la marcación de las células rojas del paciene con Tecnesio-90m. Imágenes del sistema venoso profundo pueden obtenerse con muy buena resolución. La exactitud de la prueba es de 92%
Subject(s)
Middle Aged , Humans , Male , Erythrocytes , Thrombophlebitis , Perna/blood supply , TechnetiumABSTRACT
La otitis externa maligna es una enfermedad seria y potencialmente fatal de envejecientes diabéticos y debilitados, usualmente causada por Pseudomona aeruginosa. Si no es controlada pronto, una otitis por pseudomonas tiende a regarse a la base del cráneo y a las estructuras de tejido blando en la vecinidad. La escintigrafía de hueso emerje como una prueba excelente para la identificación temprana de osteomielitis de la base del cráneo, ayudando también a determinar la extensión y el manejo apropiado de la condición. La utilización de escintigrafía ósea es recomendada en esta enfermedad
