RESUMO
Benign mucous membrane pemphigoid is a rare autoimmune disorder affecting the upper aero-digestive tract and conjunctivae. This is a case presentation of benign mucous membrane pemphigoid affecting the oral mucosa, pharynx, oesophagus and larynx, leading to cicatricial lesions in the pharynx and larynx, causing dysphagia, hoarseness and stridor. The alternative forms of management for laryngeal scarring due to this disease are explained. The patient was later diagnosed with advanced renal cell carcinoma, raising the possibility of cicatricial pemphigoid manifesting as a paraneoplastic syndrome of underlying renal cell carcinoma.
Assuntos
Carcinoma de Células Renais/complicações , Neoplasias Renais/complicações , Síndromes Paraneoplásicas/etiologia , Penfigoide Mucomembranoso Benigno/etiologia , Doenças Respiratórias/patologia , Idoso , Evolução Fatal , Humanos , Masculino , Síndromes Paraneoplásicas/tratamento farmacológico , Equipe de Assistência ao Paciente , Penfigoide Mucomembranoso Benigno/tratamento farmacológico , Doenças Respiratórias/tratamento farmacológicoRESUMO
The timing of insertion of a cochlear implant (CI) in post-meningitic sensorineural hearing loss is, in spite of recent advances in the understanding of the pathogenesis of the condition, still controversial. The danger of labyrinthitis ossificans allows only a little time to decide whether to implant a CI or not. On the other hand the clinician needs to be certain that no residual hearing is present and whether or not the patient will benefit from conventional amplification. A well-documented case of early spontaneous recovery of a profound post-meningitic sensorineural hearing loss in a child is presented and the relevant literature reviewed.
Assuntos
Perda Auditiva Neurossensorial/fisiopatologia , Meningite Meningocócica/complicações , Recuperação de Função Fisiológica/fisiologia , Pré-Escolar , Implantes Cocleares , Feminino , Auxiliares de Audição , Perda Auditiva Neurossensorial/microbiologia , Perda Auditiva Neurossensorial/terapia , Humanos , Remissão EspontâneaRESUMO
A case of pharyngeal (Zenker's) pouch in a patient suffering from polymyositis is presented. Although dysphagia is a recognized manifestation of polymyositis, in this unique case it was caused by a pharyngeal pouch. The aetiology of Zenker's diverticulum is discussed in the light of this unexpected association.
Assuntos
Polimiosite/complicações , Divertículo de Zenker/etiologia , Meios de Contraste , Transtornos de Deglutição/diagnóstico por imagem , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Polimiosite/diagnóstico por imagem , Polimiosite/fisiopatologia , Radiografia , Divertículo de Zenker/diagnóstico por imagem , Divertículo de Zenker/fisiopatologiaRESUMO
A case of cutaneous T-cell lymphoma is presented in which the diagnosis was obscured by a concomitant granulomatous infiltrate. A working diagnosis of tuberculosis delayed appropriate treatment for several months over which time rapid progression of the disease was seen. Inclusion of overlying skin in the repeat biopsies yielded the histological information to establish the correct diagnosis and there was rapid regression on completion of a course of radiotherapy.
