RESUMO
Left ventricular remodelling plays an important pathogenetic role in progressive circulatory insufficiency both in dilated cardiomyopathy (DCMP) and in ischemic heart disease with postinfarction cardiosclerosis. In terminal cardiac failure structural changes (changed geometry of the left ventricle, in particular) become stereotypic. The dobutamin test in DCMP reveals low functional reserve of the total and segmentary contractility compared to ischemic cardiomyopathy. This may help in echocardiographic diagnostic difficulties.
Assuntos
Cardiomiopatia Dilatada/diagnóstico , Cardiomiopatia Dilatada/fisiopatologia , Ventrículos do Coração/fisiopatologia , Infarto do Miocárdio/diagnóstico , Adulto , Doença Crônica , Progressão da Doença , Ecocardiografia/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Clinicoendoscopic and immunological evaluation of periodic disease patients shows that the disease-related inflammation of the colon is pathogenetically coupled with secretory IgA hypoproduction and abnormal intestinal eubiotic microflora. These facts should be allowed for when making differential diagnosis between periodic disease and gastrointestinal inflammations.
Assuntos
Colite/diagnóstico , Febre Familiar do Mediterrâneo/diagnóstico , Imunoglobulina A Secretora/análise , Imunoglobulina G/análise , Peritonite/diagnóstico , Adolescente , Adulto , Colite/complicações , Colite/imunologia , Colo/imunologia , Colonoscopia , Diagnóstico Diferencial , Febre Familiar do Mediterrâneo/complicações , Febre Familiar do Mediterrâneo/imunologia , Humanos , Mucosa Intestinal/imunologia , Laparoscopia , Pessoa de Meia-Idade , Peritonite/complicações , Peritonite/imunologiaRESUMO
The authors describe a rare case of amyloidosis in a female patient suffering from periodic disease (PD) for 18 years without any clinico-laboratory signs of renal impairment but with marked clinical, (malabsorption, cachexia), endoscopic, x-ray and other manifestations of gastrointestinal amyloidosis. This case is of interest since patients suffering from amyloidosis due to PB develop malabsorption very rarely, namely in 2-3% of cases. As a rule, it develops in patients with pronounced chronic renal failure on hemodialysis or with a history of kidney transplantation. In this particular case, the patient demonstrated selective marked damage to the gastrointestinal tract, with the kidneys remaining practically intact. A possibility of the indicated variety of amyloidosis should be considered in specification of the genesis of persistent diarrhea in PB patients.
Assuntos
Amiloidose/diagnóstico , Febre Familiar do Mediterrâneo/diagnóstico , Gastroenteropatias/diagnóstico , Rim/fisiologia , Adolescente , Amiloidose/etiologia , Doença Crônica , Diarreia/diagnóstico , Diarreia/etiologia , Febre Familiar do Mediterrâneo/complicações , Feminino , Gastroenteropatias/etiologia , HumanosRESUMO
The reported and the authors' data are provided on the pathogenesis, morphofunctional characteristics and clinical manifestations of acute and chronic gastroenteropathies in patients suffering from periodic disease with and without amyloidosis. Under discussion is the significance of changes in the gastrointestinal tract for the diagnosis of periodic disease, its association with other diseases and early recognition of amyloidosis.
Assuntos
Amiloidose/complicações , Febre Familiar do Mediterrâneo/complicações , Gastroenteropatias/etiologia , Amiloide/metabolismo , Amiloidose/diagnóstico , Amiloidose/metabolismo , Febre Familiar do Mediterrâneo/diagnóstico , Febre Familiar do Mediterrâneo/metabolismo , Gastroenteropatias/diagnóstico , Gastroenteropatias/metabolismo , HumanosAssuntos
Amiloidose/diagnóstico , Túnica Conjuntiva/irrigação sanguínea , Febre Familiar do Mediterrâneo/diagnóstico , Adulto , Amiloidose/etiologia , Amiloidose/patologia , Biópsia , Duodeno/patologia , Febre Familiar do Mediterrâneo/complicações , Febre Familiar do Mediterrâneo/patologia , Mucosa Gástrica/patologia , Histocitoquímica , Humanos , Mucosa Intestinal/patologia , Microcirculação/fisiopatologia , Pessoa de Meia-IdadeRESUMO
The results obtained during radioimmunoassay, biochemistry and morphological studies in patients with periodic disease point to the development of hypoparathyroid hormonemia, reduction of the substrate of the parathyroid parenchyma, responsible for the synthesis of parathyroid hormone. These alterations became aggravated in the course of the development of amyloidosis. The latter is not always related to amyloidosis of the parathyroid glands themselves.
Assuntos
Febre Familiar do Mediterrâneo/metabolismo , Glândulas Paratireoides/metabolismo , Adolescente , Adulto , Febre Familiar do Mediterrâneo/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Glândulas Paratireoides/patologia , Hormônio Paratireóideo/deficiênciaRESUMO
Based on clinico-endoscopic, x-ray, immunological and immunohistochemical studies the authors demonstrate the role of disorders in the components of humoral and cellular immunity in the development of intestinal inflammation and amyloidosis in patients with periodical disease. Circulatory disorders, congestive hyperemia, edema of the intestinal mucosa, and spasmodic intestinal dyskinesia that develop during an attack of periodical disease are the initial components in the pathogenesis of inflammatory intestinal lesions seen during periodical disease.
Assuntos
Febre Familiar do Mediterrâneo/imunologia , Intestino Grosso/imunologia , Amiloidose/etiologia , Amiloidose/imunologia , Amiloidose/patologia , Formação de Anticorpos , Colite/etiologia , Colite/imunologia , Colite/patologia , Febre Familiar do Mediterrâneo/etiologia , Febre Familiar do Mediterrâneo/patologia , Histocitoquímica , Humanos , Imunidade Celular , Enteropatias/etiologia , Enteropatias/imunologia , Enteropatias/patologia , Intestino Grosso/diagnóstico por imagem , Intestino Grosso/patologia , RadiografiaRESUMO
Neutral glycolipids of blood constituted four main fractions both in healthy persons and in patients with hypertension. An increase in di- and trihexosylceramides in blood plasma and in monohexosylceramides from erythrocytes occurred simultaneously with elevation of total blood glycolipids in hypertension.
Assuntos
Glicolipídeos/sangue , Hipertensão/sangue , Eritrócitos/análise , Glicoesfingolipídeos/sangue , Humanos , Valores de ReferênciaRESUMO
On a model of caseine amyloidosis in 52 rabbits it was shown that in the preamyloid phase the humoral immunity was stimulated, but as soon as the first deposits of amyloid appeared, it was inhibited. The cellular immunity was inhibited starting from the 20th day of the experiment. On the 40th day of the experiment the cellular immunity was found to be less inhibited in the animals with initial deposits of amyloid as compared with the animals with no amyloidosis; on the 60--80th day in progressing of amyloidosis differences in the degree of inhibition of the cellular immunity were obliterated. The degree of fixation of IgG in amyloid was directly dependent on its content in the blood serum and on the "age" of amyloid.