RESUMO
We report a case of an allergic hypersensitivity reaction on azathioprine presenting with colitis. Allergic reactions on azathioprine are common in patient with inflammatory bowel disease. The clinic of the allergic reaction on azathioprine in our patient was atypical in the way it mimicked an acute exacerbation of inflammatory bowel disease. The pathogenesis of the allergic reaction is still unclear. Although re-challenge can be life-threatening and should always be done with precautions, it may definitively proof the causal association with the drug and decide for definitive cessation In allergic reactions there is no link with TPMT activity but other genetically predispositions are proposed.
Assuntos
Azatioprina/efeitos adversos , Colite/induzido quimicamente , Hipersensibilidade a Drogas/etiologia , Imunossupressores/efeitos adversos , Doença de Crohn/tratamento farmacológico , Doença de Crohn/fisiopatologia , Feminino , Seguimentos , Humanos , Ileíte/tratamento farmacológico , Ileíte/fisiopatologia , Pessoa de Meia-IdadeRESUMO
A 76-year-old female, presented with a recurrent cough and haemoptysis after an aspiration of a 'grain de Valls'. Chest radiography and computed tomography demonstrated an atelectasis of the medial segment of the right middle pulmonary lobe. Bronchoscopy was negative for any malignancy but the onco-PET-scan showed a pathologic hypermetabolic lesion in the right middle lobe. A lobectomy was performed and pathology revealed a 'destroyed lung' with images of foreign body reactions and microabscesses without any sign of malignancy. Postoperatively, clinical improvement with complete resolution of the symptoms was observed. With this case report we demonstrate the irritative and clastogenic characteristics of phenolphtalein, the main active ingredient of the 'grain de Valls'. This case also illustrates an example of a false positive PET-scan.
Assuntos
Catárticos/intoxicação , Reação a Corpo Estranho , Exposição por Inalação , Pulmão/patologia , Fenolftaleína/intoxicação , Abscesso/etiologia , Idoso , Reações Falso-Positivas , Feminino , Reação a Corpo Estranho/diagnóstico por imagem , Humanos , Tomografia por Emissão de Pósitrons , Radiografia TorácicaRESUMO
Two cases of reversible cholestatic hepatitis after treatment with an amoxycillin/clavulanic acid preparation (Augmentin) are described.
Assuntos
Amoxicilina/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Colestase Intra-Hepática/induzido quimicamente , Ácidos Clavulânicos/efeitos adversos , Amoxicilina/uso terapêutico , Bronquite/tratamento farmacológico , Doença Hepática Induzida por Substâncias e Drogas/patologia , Colestase Intra-Hepática/etiologia , Colestase Intra-Hepática/patologia , Ácidos Clavulânicos/uso terapêutico , Combinação de Medicamentos , Feminino , Humanos , Pessoa de Meia-Idade , Otite/tratamento farmacológicoRESUMO
A case, which is clinically characterized by a subacute vertebrobasilar syndrome, is presented. The necropsy reveals multiple infarcts in brainstem, cerebellum and left cerebral hemisphere, due to tumoural emboli of a non-detected primary tumour. It is postulated that the latter has to originate in the lungs in order to produce this unique type of cerebral arterial embolism.
Assuntos
Neoplasias das Glândulas Suprarrenais/complicações , Artéria Basilar , Isquemia Encefálica/patologia , Embolia e Trombose Intracraniana/complicações , Neoplasias Renais/complicações , Artéria Vertebral , Neoplasias das Glândulas Suprarrenais/patologia , Glândulas Suprarrenais/patologia , Artéria Basilar/patologia , Encéfalo/patologia , Capilares/patologia , Infarto Cerebral/patologia , Humanos , Rim/patologia , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Artéria Vertebral/patologiaAssuntos
Neoplasias Mandibulares/diagnóstico por imagem , Melanoma/diagnóstico por imagem , Tumores Odontogênicos/diagnóstico por imagem , Feminino , Humanos , Lactente , Neoplasias Mandibulares/patologia , Neoplasias Mandibulares/cirurgia , Melanoma/patologia , Melanoma/cirurgia , Tumores Odontogênicos/patologia , Tumores Odontogênicos/cirurgia , RadiografiaRESUMO
A 20-month-old mentally retarded girl developed an acute upper respiratory infection, followed by breathing difficulties, leading to death. Picorna virus-like particles were demonstrated in a mildly affected quadriceps femoris muscle biopsy, while the necropsy findings demonstrated an acute polymyositis with predominant diaphragm involvement. The mental retardation was due to micropolygyria of the brain. Initial respiratory difficulties are an unknown feature of polymyositis. In this case the upper respiratory infection, possibly caused by a Coxsackie B2, is evoked as responsible for this unusual distribution of the acute viral polymyositis.
