RESUMO
BACKGROUND: The prevalence of iron, folic acid and vitamin B12 deficiencies and their role in the development of recurrent oral ulcerations is not well known. The aim of this study was to determine the prevalence of these deficiencies in our patients. PATIENTS AND METHODS: Iron, folic acid and vitamin B12 levels were studied in 80 patients with recurrent oral ulcerations (ROU) and the results were compared with a control group of 29 patients with different oral diseases. RESULTS: In the recurrent oral ulcers patients, deficiencies were detected in 21/80 patients (26.2%). In 18 cases they were pure: iron (4), folic acid (10) and vitamin B12 (4). In 3 patients, combined deficiencies were detected, being secondary to pernicious anaemia in two patients. In the control group, deficiencies were observed in 4/29 cases (13.7%). In three cases they were isolated (one case suffered from ferropenic anaemia and two patients of pernicious anaemia). CONCLUSIONS: Patients with recurrent oral ulcerations have more frequently iron, folic acid and vitamin B12 deficiencies than those with other diseases of oral mucosa. However, there were not significant differences when the frequency of deficiency of each one of such elements were taken into account separately.
Assuntos
Deficiências de Ferro , Estomatite Aftosa/etiologia , Deficiência de Vitamina B 12/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Ferropriva/complicações , Anemia Perniciosa/complicações , Criança , Interpretação Estatística de Dados , Feminino , Ácido Fólico/sangue , Deficiência de Ácido Fólico/complicações , Humanos , Ferro/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva , Estomatite Aftosa/sangue , Vitamina B 12/sangueRESUMO
Acquired cutis laxa (ACL) is an uncommon elastolytic disorder of unknown aetiology. In rare instances, ACL has been reported in association with autoimmune diseases and dermal deposit of immunoglobulins, suggesting that destruction of elastic tissue may be immunologically mediated. We report a 35-year-old man with generalized acquired cutis laxa (GACL) associated with a persistent papular erythematous eruption that histopathologically showed some resemblance to dermatitis herpetiformis. A marked reduction and degeneration of dermal elastic fibres was noted in biopsies from loose-hanging skin. Direct immunofluorescence from non-inflammatory loose skin revealed granular immunoglobulin A (IgA) deposits at the basement membrane zone and fibrillar IgA deposits in the dermal papillae. IgA deposits were also observed on the elastic fibres of the reticular dermis. Electron microscopy of skin from the submammary fold revealed fragmented elastic fibres, partial absence of peripheral microfibrils and abundant neutrophils, some of which were degranulated and adjacent to elastic fibres. Immunoelectron microscopy of an erythematous papule revealed IgA deposits around dermal elastic fibres. Antigliadin, antireticulin and antiendomysium antibodies were present. Jejunal biopsies showed a gluten-sensitive enteropathy. A possible IgA-mediated immune mechanism for the development of GACL in our patient is suggested.
Assuntos
Doença Celíaca/complicações , Síndrome de Ehlers-Danlos/complicações , Tecido Elástico/imunologia , Imunoglobulina A/análise , Pele/imunologia , Adulto , Doença Celíaca/imunologia , Síndrome de Ehlers-Danlos/imunologia , Fácies , Humanos , MasculinoRESUMO
Pancreatic tuberculosis is rare and may present differential diagnostic problems, specially with cancer of the pancreas. An immunocompetent patient with a pancreatic tuberculous abscess whose clinical manifestations were epigastric pain and a toxic syndrome of one month of evolution is presented. A cystic mass was detected on computerized axial tomography in the tail of the pancreas suggestive of irresectable carcinoma because of vascular invasion with negative percutaneous cytologic puncture for malignant cells. The patient was surgically treated with no histologic confirmation of malignancy. A second laparotomy was performed at 6 months since spontaneous size reduction, external pancreatic fistula with miliary peritoneal dissemination and biopsy compatible with tuberculous granulomas was found. Staining for resistant acid-alcohol bacilli were always negative. Medical treatment achieved complete disappearance of the pancreatic tumor in one year.
Assuntos
Abscesso/diagnóstico , Pancreatopatias/diagnóstico , Tuberculose/diagnóstico , Abscesso/tratamento farmacológico , Abscesso/cirurgia , Idoso , Antituberculosos/uso terapêutico , Diagnóstico Diferencial , Seguimentos , Humanos , Masculino , Pancreatopatias/tratamento farmacológico , Pancreatopatias/cirurgia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Tuberculose/tratamento farmacológico , Tuberculose/cirurgiaAssuntos
Hemorragia Gastrointestinal/tratamento farmacológico , Somatostatina/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Avaliação de Medicamentos , Feminino , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/tratamento farmacológico , Distribuição Aleatória , Ranitidina/uso terapêutico , Gastropatias/complicaçõesAssuntos
Peso Corporal , Febre de Causa Desconhecida/etiologia , Doença de Whipple/diagnóstico , Adulto , Doença de Crohn/diagnóstico , Diagnóstico Diferencial , Humanos , Absorção Intestinal , Neoplasias Intestinais/diagnóstico , Linfoma/diagnóstico , Síndromes de Malabsorção/diagnóstico , Masculino , Doença de Whipple/complicações , Doença de Whipple/fisiopatologiaRESUMO
A case of hepatic fascioliasis is reported in which the diagnosis was made by direct visualization of the parasite by means of percutaneous transhepatic cholangiography. The peculiar radiological image should be included in the differential diagnosis of biliary tract pathology.