RESUMO
Fluorosis is thought to be rare in Pakistan but endemic in various parts of the world, especially in India and China. In Pakistan only a few cases have been reported from Thar, Sibbi and Manga Mandi, with probability of fluorosis on MRI findings, supported by high drinking waterfluoride content. Neurological manifestations of skeletal fluorosis may vary from radiculo-myelopathy to neuropathy. A case of 26 years old female from Thul, Sindh, who presented with paraplegia, is reported here. Her MRI showed extensive classical degenerative changes throughout the spine, consistent with fluorosis, leading to cord compression at multiple levels. No such case with confirmed fluorosis has been previously reported from Pakistan.
Assuntos
Doenças Ósseas , Exposição Ambiental/efeitos adversos , Fluoretos/efeitos adversos , Paraplegia , Compressão da Medula Espinal , Adulto , Doenças Ósseas/induzido quimicamente , Doenças Ósseas/complicações , Doenças Ósseas/diagnóstico , Doenças Ósseas/fisiopatologia , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Paraplegia/diagnóstico , Paraplegia/etiologia , Paraplegia/fisiopatologia , Radiografia/métodos , Medula Espinal/diagnóstico por imagem , Medula Espinal/patologia , Compressão da Medula Espinal/complicações , Compressão da Medula Espinal/diagnóstico , Compressão da Medula Espinal/fisiopatologiaRESUMO
Patients with reactive thrombocytosis are generally asymptomatic and platelet counts of up to 1,000,000/microL are seen in this disorder. However, in a small proportion of cases platelet counts may be in the range generally seen in Clonal Thrombocytosis (CT). In elderly patients or those with symptomatic atherosclerosis or thrombotic disease or immobility, thrombosis may occur even with reactive thrombocytosis. We report a case of a rare presentation of Reactive Thrombocytosis with digital gangrene in an elderly lady. She was evaluated for thrombocytosis and was given supportive treatment after which she clinically improved.
