RESUMO
A case is presented of a woman with a long history of sarcoidosis who developed diffuse histoplasmosis. Although association between these two entities has been described before, there are only a few case reports of histoplasmosis among sarcoid patients. Diagnosis was finally established by bone marrow biopsy which saved the patient's life.
Assuntos
Histoplasmose/complicações , Sarcoidose Pulmonar/complicações , Adulto , Medula Óssea/microbiologia , Feminino , Histoplasma/isolamento & purificação , Histoplasmose/diagnóstico , HumanosRESUMO
Human immunodeficiency virus (HIV) infection has been associated with several renal disorders. Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) were also described in several patients with overt AIDS. We describe a patient who presented with HUS and only subsequent investigation to find the cause of HUS led to the diagnosis of HIV infection. HIV infection should be suspected in patients presenting with microangiopathic renal failure.
Assuntos
Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome Hemolítico-Urêmica/diagnóstico , Síndrome da Imunodeficiência Adquirida/complicações , Adulto , Diagnóstico Diferencial , Síndrome Hemolítico-Urêmica/etiologia , Síndrome Hemolítico-Urêmica/terapia , Humanos , Masculino , Plasmaferese , TrombocitopeniaRESUMO
OBJECTIVE: To describe a patient with ifosfamide-induced nonconvulsive status epilepticus. CASE SUMMARY: A 71-year-old woman with a history of malignant mixed mesodermal tumor involving the uterus, cervix, and vagina was admitted because of local recurrence. After receiving 3 doses of ifosfamide/mesna, she was found to be unresponsive. Physical examination and laboratory data revealed no significant changes. An electroencephalogram was consistent with the diagnosis of nonconvulsive status epilepticus. The patient's mental status returned to baseline after treatment with intravenous phenytoin and discontinuation of ifosfamide therapy. DISCUSSION: Central nervous system (CNS) toxicity has been described with ifosfamide, with most cases reported in the pediatric population. Among CNS toxicities, generalized tonic-clonic seizures have been reported in both children and adults. This represents the first report of nonconvulsive status epilepticus induced by ifosfamide. CONCLUSIONS: There was a temporal relationship between the onset of nonconvulsive status epilepticus and initiation of ifosfamide infusion. No other identifiable factor contributed to the unresponsiveness.
