RESUMO
Tuberous sclerosis complex manifests predominantly as a neurocutaneous disorder Lung involvement was considered rare. Lymphangioleiomyomatosis which occurs mainly in women of childbearing age is the major pulmonary disorder seen in tuberous sclerosis. Multifocal micronodular pneumocyte hyperplasia has also been described in tuberous sclerosis. The case of a 51-year old female diagnosed with tuberous sclerosis is described after she presented with progressive shortness of breath and was found to have interstitial lung disease. Tuberous sclerosis should be considered as a differential in patients with interstitial lung disease especially in association with cutaneous lesions.
Assuntos
Hiperplasia/patologia , Pneumopatias/etiologia , Pulmão/patologia , Esclerose Tuberosa/patologia , Dor no Peito/diagnóstico , Progressão da Doença , Dispneia/diagnóstico , Feminino , Humanos , Hiperplasia/diagnóstico , Pneumopatias/diagnóstico , Pneumopatias/patologia , Pessoa de Meia-Idade , Dermatopatias/etiologia , Esclerose Tuberosa/complicações , Esclerose Tuberosa/diagnósticoRESUMO
Tuberous sclerosis complex manifests predominantly as a neurocutaneous disorder Lung involvement was considered rare. Lymphangioleiomyomatosis which occurs mainly in women of childbearing age is the major pulmonary disorder seen in tuberous sclerosis. Multifocal micronodular pneumocyte hyperplasia has also been described in tuberous sclerosis. The case of a 51-year old female diagnosed with tuberous sclerosis is described after she presented with progressive shortness of breath and was found to have interstitial lung disease. Tuberous sclerosis should be considered as a differential in patients with interstitial lung disease especially in association with cutaneous lesions.
El complejo de esclerosis tuberosa se manifiesta predominantemente como un desorden neurocutáneo. El compromiso pulmonar era considerado raro. La linfangioleiomiomatosis que se presenta principalmente en mujeres en estado de gestación, es el principal trastorno observado en la esclerosis tuberosa. La hiperplasia micronodular pneumocítica ha sido también descrita en la esclerosis tuberosa. Se describe el caso de una mujer de 51 años a quien se le diagnosticó esclerosis tuberosa, luego de que se presentara con disnea y se hallara que padecía la enfermedad intersticial del pulmón. La esclerosis tuberosa deber ser considerada como un diagnóstico diferencial en pacientes con la enfermedad intersticial del pulmón, especialmente cuando se encuentra asociada con lesiones cutáneas.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Esclerose Tuberosa/patologia , Hiperplasia/patologia , Pneumopatias/etiologia , Pulmão/patologia , Dermatopatias , Progressão da Doença , Dispneia/diagnóstico , Dor no Peito/diagnóstico , Esclerose Tuberosa/complicações , Esclerose Tuberosa/diagnóstico , Hiperplasia/diagnóstico , Pneumopatias/diagnóstico , Pneumopatias/patologiaRESUMO
The colon responds monomorphically to a variety of insults thus making it difficult to differentiate invasive amoebic colitis and inflammatory bowel disease (IBD). The authors present a case with chronic dysentery, haematochezia, anaemia and hypoproteinaemia. The endoscopic findings were suggestive of IBD. The stool examination was negative for trophozoites or cysts of parasites. The recto-colonic biopsy specimens showed mucosal inflammation with exudates containing amoebic trophozoites. The patient was successfully treated with metronidazole and iodoquinol. He recovered within two weeks and repeat colonoscopy four weeks after the treatment showed a normal rectum and colon. Clinicians should have a high level of suspicion for amoebic colitis in cases of colitis especially in regions where amoebiasis is still present. Efforts should be made to find the amoebic trophozoites in multiple stool and colonic biopsy specimens.
Assuntos
Disenteria Amebiana/diagnóstico , Adulto , Amebicidas/uso terapêutico , Diagnóstico Diferencial , Quimioterapia Combinada , Disenteria Amebiana/tratamento farmacológico , Humanos , Doenças Inflamatórias Intestinais/diagnóstico , Iodoquinol/uso terapêutico , Masculino , Metronidazol/uso terapêuticoRESUMO
The colon responds monomorphically to a variety of insults thus making it difficult to differentiate invasive amoebic colitis and inflammatory bowel disease (IBD). The authors present a case with chronic dysentery, haematochezia, anaemia and hypoproteinaemia. The endoscopic findings were suggestive of IBD. The stool examination was negative for trophozoites or cysts of parasites. The recto-colonic biopsy specimens showed mucosal inflammation with exudates containing amoebic trophozoites. The patient was successfully treated with metronidazole and iodoquinol. He recovered within two weeks and repeat colonoscopy four weeks after the treatment showed a normal rectum and colon. Clinicians should have a high level of suspicion for amoebic colitis in cases of colitis especially in regions where amoebiasis is still present. Efforts should be made to find the amoebic trophozoites in multiple stool and colonic biopsy specimens
El colon responde de manera monomórfica a una variedad de insultos, lo cual hace difícil distinguir entre la colitis amebiana invasiva y la enfermedad intestinal inflamatoria (EII). Los autores presentan un caso con disentería crónica, hematoquexia, anemia e hipoproteinemia. Los resultados endoscópicos apuntaban a una EII. El análisis de las heces fecales arrojó resultados negativos en cuanto a presencia de trofozoitos o quistes de parásitos. Esto condujo a un diagnóstico erróneo y el paciente fue tratado por una EII. Sin embargo, los especímenes de la biopsia rectocolónica mostraron una inflamación mucosal con exudados en los que se hallaban presentes trofozoitos amebianos. El paciente tuvo un tratamiento exitoso con metronidazol y iodoquinol. Se recuperó en dos semanas, y se le repitió la colonoscopia cuatro semanas después de que el tratamiento mostró un recto y colon normales. Los clínicos debían mostrar un alto nivel de sospecha ante la colitis amebiana, especialmente en aquellas regiones donde la amebiasis todavía está presente. Deben hacerse esfuerzos por encontrar trofozoitos amebianos en múltiples especímenes de heces fecales y biopsia colónica.
Assuntos
Humanos , Masculino , Adulto , Disenteria Amebiana/diagnóstico , Amebicidas/uso terapêutico , Diagnóstico Diferencial , Disenteria Amebiana/tratamento farmacológico , Doenças Inflamatórias Intestinais/diagnóstico , Iodoquinol/uso terapêutico , Metronidazol/uso terapêutico , Quimioterapia CombinadaRESUMO
This paper reports the case of a 21-year-old Afro-Caribbean pregnant woman with hyperthyroidism and hypokalaemic quadriparesis and reviews the literature on the topic. Thyrotoxic periodic paralysis is a very rare condition in the Caribbean. This case reminds West Indian physicians to consider this rare condition in any patient that presents with paralysis.
Assuntos
Hipopotassemia/etiologia , Paralisia/etiologia , Complicações na Gravidez/diagnóstico , Tireotoxicose/complicações , Adulto , Antitireóideos/uso terapêutico , População Negra , Carbimazol/uso terapêutico , Feminino , Humanos , Hipopotassemia/tratamento farmacológico , Potássio/uso terapêutico , Gravidez , Complicações na Gravidez/tratamento farmacológico , Tireotoxicose/diagnóstico , Tireotoxicose/tratamento farmacológicoRESUMO
This paper reports the case of a 21-year-old Afro-Caribbean pregnant woman with hyperthyroidism and hypokalaemic quadriparesis and reviews the literature on the topic. Thyrotoxic periodic paralysis is a very rare condition in the Caribbean. This case reminds West Indian physicians to consider this rare condition in any patient that presents with paralysis