Assuntos
Síndrome de Cushing/metabolismo , Lipomatose/induzido quimicamente , Tecido Adiposo/metabolismo , Adulto , Criança , Relação Dose-Resposta a Droga , Feminino , Humanos , Transplante de Rim , Lipomatose/diagnóstico , Lipomatose/diagnóstico por imagem , Masculino , Mediastino/diagnóstico por imagem , Pessoa de Meia-Idade , Complicações Pós-Operatórias/tratamento farmacológico , Radiografia , Ombro , Esteroides/efeitos adversos , Esteroides/uso terapêutico , Transplante HomólogoRESUMO
A 26 year-old male presented with a spontaneous pathological fracture of the right femur caused by an osteolytic lesion. A chest X-ray demonstrated the coexistence of interstitial pulmonary fibrosis. Fibrocaseous tuberculosis and widespread malignancy were ruled out by appropriate investigations. The differential diagnosis, as based on the histological examination of the bone tumour, rested between hyperparathyroidism complicated by pulmonary disease and eosinophilic granuloma with lung manifestations. Hyperparathyroidism was ruled out by the absence of clinical and biochemical evidence of a disturbance of calcium metabolism. The diagnosis of histiocytosis-X was established by the histological appearance of the lung biopsy.
Assuntos
Doenças Ósseas/diagnóstico , Granuloma Eosinófilo/diagnóstico , Pneumopatias/diagnóstico , Adulto , Doenças Ósseas/metabolismo , Neoplasias Ósseas/diagnóstico , Cálcio/metabolismo , Diagnóstico Diferencial , Granuloma Eosinófilo/diagnóstico por imagem , Granuloma Eosinófilo/metabolismo , Humanos , Pneumopatias/diagnóstico por imagem , Pneumopatias/metabolismo , Masculino , Fibrose Pulmonar/complicações , RadiografiaRESUMO
Four adult recipients of cadaveric renal homografts acquired Pneumocystis carinii infections from which they subsequently died. The disease in adults under immunosuppressive therapy runs a course different from the disease observed in newborns. The clinical course is rapidly progressive and early diagnosis by means of aggressive diagnostic procedures is mandatory. To prevent a fatal outcome, treatment even on suspicion is suggested. Epidemiologically, a person-to-person spread seems possible and isolation of the patient is necessary.