RESUMO
Complete heart block associated with Wegener's granulomatosis (WG) is rare especially in the limited form of the disease. We describe a case of a 43-year-old woman with a limited form of WG who developed a complete heart block. Prompt treatment with steroids and cyclophosphamide led to temporary regression of complete heart block. Further involvement of lung was treated successfully by tumor necrosis factor-alpha inhibitor infliximab. Cardiac rhythm abnormalities should always be kept in mind both in diagnosis and follow-up of WG.
Assuntos
Granulomatose com Poliangiite/diagnóstico , Bloqueio Cardíaco/terapia , Adulto , Anticorpos Monoclonais/farmacologia , Anticorpos Monoclonais/uso terapêutico , Ciclofosfamida/farmacologia , Ciclofosfamida/uso terapêutico , Feminino , Humanos , Infliximab , Pulmão/patologia , Esteroides/farmacologia , Esteroides/uso terapêutico , Tomografia Computadorizada por Raios X , Fator de Necrose Tumoral alfa/metabolismoRESUMO
We report an episode of bacterial meningitis in a 45 year-old woman, who was treated with infliximab for Wegener's granulomatosis. This patient presented with the classic clinical presentation of acute meningitis: the triad of fever, neck stiffness, and an altered mental state that appeared 6 months after the infliximab initiation. A computed tomographic (CT) scan of the head showed cerebral edema and Streptococcus pneumoniae was isolated from blood and CSF cultures. Prompt diagnosis and early treatment improved the outcome of this patient.
