RESUMO
OBJECTIVE: To assess serum interleukin-6 (IL-6)level in patients with systemic sclerosis (SSc) and its correlations with European Scleroderma Study Group activity score (EUSTAR), Scleroderma Assessment Questionnaire (SAQ), disability index and cardiopulmonary involvement. METHODS: Twenty SSc patients and 10 matched healthy controls were included. Serum IL-6 was measured in patients and controls. Disease activity, status,and disability were assessed.Cardiopulmonary involvement was evaluated by pulmonary function tests (PFTs), six minute walk test, echocardiography, and high resolution computed tomography (HRCT) of chest. RESULTS: Serum level of IL-6 was significantly higher in patients with SSc (6.3± 1.4pg/ml) versus healthy controls (3.2± 0.4pg/ml) (P=0.002). IL-6 level showed positive correlations with disease duration (r=0.49, P=0.03), EUSTAR score (r=0.64, P=0.002), Index of Respiratory Status "IRS" (r=0.46, P=0.001), Index of Musculoskeletal Status "IMSS" (r=0.45, P=0.049), Index of Vascular Status "IVS" (r=0.39, P=0.04), mean and peak of pulmonary artery pressure (r=0.44 & 0.55, P=0.02 & 0.002 respectively). Negative correlations of IL-6 level with DLCO% (r=-0.49, P=0.006),six minute walk distance (6MWD) (r=-0.52, P= 0.003) and right ventricle fraction area change (r=-0.48, P=0.03) were found, while there were strong positive correlations with HRCT-ground glass score (r=0.77, P=0.0001) and HRCT-fibrosis score (r=0.62, P=0.003). CONCLUSION: IL-6 level is increased in patients with SSc and significantly correlates with EUSTAR score, IRS, DLCO, 6MWD, HRCT scores, and echocardiographic abnormalities of the right side of the heart. These results support the role of IL-6 in the disease activity and in the development of cardiopulmonary manifestations in SSc patients.
Assuntos
Doenças Cardiovasculares/sangue , Sistema Cardiovascular/fisiopatologia , Interleucina-6/sangue , Pneumopatias/sangue , Pulmão/fisiopatologia , Escleroderma Sistêmico/sangue , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Sistema Cardiovascular/diagnóstico por imagem , Estudos de Casos e Controles , Avaliação da Deficiência , Ecocardiografia Doppler , Teste de Esforço , Tolerância ao Exercício , Feminino , Hemodinâmica , Humanos , Pulmão/diagnóstico por imagem , Pneumopatias/diagnóstico , Pneumopatias/etiologia , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Valor Preditivo dos Testes , Estudos Prospectivos , Respiração , Testes de Função Respiratória , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/diagnóstico , Escleroderma Sistêmico/fisiopatologia , Índice de Gravidade de Doença , Inquéritos e Questionários , Regulação para Cima , Adulto JovemAssuntos
Angiografia/métodos , Doenças da Aorta/complicações , Doenças da Aorta/diagnóstico por imagem , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Tomografia Computadorizada por Raios X/métodos , Úlcera/complicações , Úlcera/diagnóstico por imagem , Idoso , Doenças da Aorta/cirurgia , Diagnóstico Diferencial , Humanos , Masculino , Derrame Pericárdico/cirurgia , Úlcera/cirurgiaRESUMO
Castleman's disease is a rare form of lymph node hyperplasia most commonly presenting as a solitary hypervascular mediastinal mass. Surgical resection is the treatment of choice, but this can be associated with significant blood loss due to its hypervascularity. We report two cases with a preoperative diagnosis of mediastinal Castleman's disease in whom preoperative embolization with Trisacryl gelatin microspheres (Biosphere Medical, Rockland, MA) was performed. Compared with the literature, a decrease in the amount of perioperative bleeding was noted in both cases.
Assuntos
Hiperplasia do Linfonodo Gigante/terapia , Embolização Terapêutica/instrumentação , Cuidados Pré-Operatórios/métodos , Adolescente , Aortografia , Biópsia , Hiperplasia do Linfonodo Gigante/diagnóstico , Feminino , Seguimentos , Humanos , Microesferas , Pessoa de Meia-Idade , Toracotomia/métodos , Tomografia Computadorizada por Raios XRESUMO
Finger ischemia due to embolic occlusion of digital arteries resulting from trauma to the palmar ulnar artery has been termed hypothenar hammer syndrome (HHS). In HHS, arterial thrombosis and/or aneurysm formation with embolization to the digital arteries causes symptoms of ischemia. We describe a patient in whom the initial diagnosis was made on multidetector computed tomographic angiography (CTA), as well as his endovascular and surgical management.
Assuntos
Angiografia , Dedos/irrigação sanguínea , Isquemia/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Arteriopatias Oclusivas/complicações , Arteriopatias Oclusivas/diagnóstico por imagem , Humanos , Isquemia/etiologia , Isquemia/cirurgia , Masculino , Pessoa de Meia-Idade , Artéria Ulnar/diagnóstico por imagemRESUMO
Renal arteriovenous fistulas (AVFs) are rare abnormal communications between the arterial and venous circulations that can be congenital or acquired. We describe the multidetector computed tomography angiography (MDCTA) appearance of 2 cases of renal AVF, one with the cirsoid and one with the aneurysmal subtype, and the impact of these findings on therapeutic decision making and treatment follow-up.
