RESUMO
Arteriosclerosis is an alteration of the blood vessels whose walls calcify, lose their elasticity and thicken. The result is a decrease in circulating blood flow and ischemic manifestations. Calcification of the arteries is a physiological phenomenon in the elderly but young subjects may also be affected. Indeed, certain risk factors can favor the formation of plaques at the level of the vessels. These include classic cardiovascular risk factors, as well as systemic inflammatory diseases, connective tissue diseases, chronic hypercalcemia We report the case of a 26-year-old female patient with diffuse arteriosclerosis discovered accidentally, and whose exhaustive etiological investigation remained negative.
Assuntos
Artérias/patologia , Arteriosclerose/diagnóstico , Arteriosclerose/etiologia , Adulto , Calcinose/complicações , Calcinose/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Achados Incidentais , Fatores de RiscoRESUMO
Seizures are one of the most serious neuropsychiatric manifestations of systemic lupus erythematous (SLE). This descriptive and retrospective study aims at describing clinical and paraclinical features and therapeutic approach of seizures in patients with SLE. The characteristics of the seizure group was compared to those of a control group (patients with LES who had not presented seizures). A total of 177 patients were included in these analyses. Among them, 14 (8 %) developed seizures before, at or after the SLE diagnosis. The age of occurrence of seizures was younger than for other complications of the disease. There was no significant association with the antiphospholipid syndrome. Disease activity in these patients was significantly higher than in the control group. During the follow up, the subjects being under anticonvulsants and/or corticosteroids and/or immunosuppressive therapy, we observed good outcomes (n=5), re-occurence of seizures (n=4), cognitive impairment (n=3 ) and death (n=2). Our study shows that seizures tend to occur early in the course of SLE, in the context of important disease activity and other serious clinical manifestations and in younger individuals. Seizures portend a negative impact on the overall long-term prognosis and quality of life in patients with SLE.
La comitialité est une des manifestations neurologiques les plus sévères du lupus érythémateux systémique (LES). Notre objectif est de décrire les caractéristiques des épilepsies chez les patients lupiques. Dans une étude rétrospective descriptive, les données cliniques et paracliniques des patients lupiques présentant une épilepsie ont été comparées à celles des patients lupiques n'ayant pas présenté de crises convulsives. Nous avons recensé 177 patients lupiques dont 14 (8 %) avaient présenté une épilepsie avant, au moment ou après le diagnostic de LES. L'âge de survenue des épilepsies était plus jeune que celui des autres manifestations. L'association à un syndrome des antiphospholipides n'était pas significative. Les patients lupiques présentant une épilepsie avaient un score d'activité de la maladie lupique (SLEDAI) significativement plus élevé que celui du groupe contrôle. L'évolution était marquée par la disparition des crises convulsives (n=5), la récidive (n=4), l'installation de troubles cognitifs (n=3 ) et le décès (n=2). Cette étude montre que la comitialité tend à survenir de façon précoce au cours du LES, aggravant alors le pronostic fonctionnel et vital. Elle associe un SLEDAI assez élevé ainsi qu'un âge de survenue plus jeune.
Assuntos
Lúpus Eritematoso Sistêmico/complicações , Convulsões/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
Vertebral primary malignant germ cell tumors are rarely located in thoracic spine. We report the case of a 44-year-old female, in which a symptomatology including dorsal rachidial pain, intercostal neuralgia, straight and transit disorder revealed a thoracic vertebral primary malignant germ cell tumor. The sole location of a vertebral primary malignant germ cell tumor in adult, exceptionally reported in the literature, prompted us to relate this observation.
