RESUMEN
La calcifilaxis se caracteriza por una intensa deposición de calcio en pequeños vasos sanguíneos, piel y otros órganos, descripta principalmente en pacientes con insuficiencia renal crónica, trasplante renal o disfunción paratiroidea. Hasta la fecha, solo hay siete casos descriptos en la literatura de calcifilaxis que imita arteritis de células gigantes (ACG). En esta revisión presentamos el octavo caso documentado patológicamente.
Calciphylaxis is characterized by intense deposition of calcium in small blood vessels, skin, and other organs, described mainly in patients with chronic renal insufficiency, renal transplant of parathyroid dysfunction. To date, there are only seven cases described in literature of calciphylaxis mimicking giant cell arteritis (GCA). In this review, we present the eighth case pathologically documented.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Arterias Temporales/patología , Arteritis de Células Gigantes/diagnóstico , Calcifilaxia/diagnóstico , Calcifilaxia/patología , Diagnóstico DiferencialRESUMEN
La policondritis recidivante (RP) es un trastorno autoinmune sistémico poco frecuente que se caracteriza por episodio y deterioro progresivo de la inflamación del cartílago. Aproximadamente el 30% de los pacientes con RP tienen enfermedad concurrente. Sin embargo, hay tres casos previos reportados de RP relacionado con enfermedad relacionada con la inmunoglobulina G4 (IgG4-RD). Nosotros presentamos otro caso de una mujer de 37 años que desarrolló RP aproximadamente 1 año antes del diagnóstico de IgG4-RD. La asociación entre ER-IgG4 y RP sigue sin estar clara.
Relapsing polychondritis (RP) is a rare systemic autoimmune disorder characterized by the episodic and progressive deterioration of cartilage inflammation. Approximately 30% patients with RP have concurrent disease. However, there are three cases reports of RP complicated by immunoglobulin G4-related disease (IgG4-RD). Here we report another case of a 37-year-old female who developed RP approximately 1 years before IgG4-RD diagnosis. The association between IgG4-RD and RP remains unclear.
Asunto(s)
Policondritis Recurrente , Diagnóstico , Enfermedad Relacionada con Inmunoglobulina G4 , InflamaciónRESUMEN
La policondritis recidivante (RP) es un trastorno autoinmune sistémico poco frecuente que se caracteriza por episodio y deterioro progresivo de la inflamación del cartílago. Aproximadamente el 30% de los pacientes con RP tienen enfermedad concurrente. Sin embargo, hay tres casos previos reportados de RP relacionado con enfermedad relacionada con la inmunoglobulina G4 (IgG4-RD). Nosotros presentamos otro caso de una mujer de 37 años que desarrolló RP aproximadamente 1 año antes del diagnóstico de IgG4-RD. La asociación entre ER- IgG4 y RP sigue sin estar clara.
Relapsing polychondritis (RP) is a rare systemic autoimmune disorder characterized by the episodic and progressive deterioration of cartilage inflammation. Approximately 30% patients with RP have concurrent disease. However, there are three cases reports of RP complicated by immunoglobulin G4-related disease (IgG4-RD). Here we report another case of a 37-year-old female who developed RP approximately 1 years before IgG4-RD diagnosis. The association between IgG4-RD and RP remains unclear
Asunto(s)
Humanos , Femenino , Policondritis Recurrente , Enfermedad Relacionada con Inmunoglobulina G4 , InflamaciónRESUMEN
La calcifilaxis ha sido definida como una sensibilidad a la calcificación de los tejidos, descrita primariamente en pacientes con insuficiencia renal crónica, trasplante renal o disfunción de glándulas paratiroides. Existen pocos casos descritos de pacientes con artritis reumatoide, sin insuficiencia renal, ni disfunción paratiroidea. Nosotros presentamos otro caso en una mujer con artritis reumatoide inactiva (AU)
Calciphylaxis has been defined as tissue sensitivity to calcification, described mainly in patients with chronic renal insufficiency, renal transplant, or parathyroid dysfunction. There are few cases described in patients with rheumatoid arthritis that do not suffer from renal failure or hyperparathyroidism. Another case is presented of calciphylaxis in a woman with inactive rheumatoid arthritis (AU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/tratamiento farmacológico , Calcinosis/complicaciones , Calcinosis/tratamiento farmacológico , Necrosis/complicaciones , Necrosis/tratamiento farmacológico , Vasculitis/tratamiento farmacológico , Metotrexato/uso terapéutico , Prednisona/uso terapéutico , Biopsia/métodos , Úlcera por Presión/complicaciones , Úlcera por Presión/diagnóstico , Vasculitis/complicaciones , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/diagnóstico , Úlcera por Presión/tratamiento farmacológico , Calcio/uso terapéutico , Vitamina D/uso terapéuticoRESUMEN
Calciphylaxis has been defined as tissue sensitivity to calcification, described mainly in patients with chronic renal insufficiency, renal transplant, or parathyroid dysfunction. There are few cases described in patients with rheumatoid arthritis that do not suffer from renal failure or hyperparathyroidism. Another case is presented of calciphylaxis in a woman with inactive rheumatoid arthritis.
Asunto(s)
Artritis Reumatoide/complicaciones , Calcifilaxia/etiología , Calcifilaxia/diagnóstico , Femenino , Humanos , Persona de Mediana EdadRESUMEN
An 82-year-old woman came to consultation with sudden visual loss in her left eye. Fifteen days before, she complained of diplopia. She had doubtful symptoms of giant cell arteritis and showed a normal physical exam. Lab results showed erythrosedimentation rate (ESR) = 62 mm/1°h; uremia = 0.56 g/dl (normal <0.45); serum creatinine = 1.7 mg% (normal <1.4); low calcium and phosphorus; and normal urine calcium and serous PTH. Fundus exam and brain magnetic resonance imaging (MRI) showed normality of optic nerves, chiasma, retrochiasmatic area, ocular muscles, eyeballs, lacrimal glands, periorbital fat, cavernous sinuses, and occipital cortex. A temporal arteritis was suspected; therefore, a biopsy was carried on. It showed the presence of large calcium deposits in the artery's tunica media and internal elastic lamina, with narrowing of the lumen, with no inflammation and multinuclear giant cells. Histological diagnosis is calciphylaxis. Although calciphylaxis is a well-described entity that occurs in end-stage renal patients, many cases are due to non-uremic causes. To date, there are only six cases described in literature of calciphylaxis mimicking GCA.