[Symmetric multiple lipomatosis. A case report with an unusual onset]. / Lipomatosi multipla simmetrica. Descrizione di un caso clinico con inusuale insorgenza.

The authors report a case of symmetric multiple lipomatosis in a young woman with chronic liver disease caused by previous alcohol abuse whose onset occurred three years after the suspension of the toxic agent. The introduction includes a review of the latest literature, focusing in particular on the most probable etiopathogenetic causes, the most common clinical presentations and therapeutics choices. After a description of this particular case, the authors discuss the unusual presentation of the syndrome caused by the rapid onset of lipid accumulation a long time after the suspension of alcohol abuse.

Platelet aggregation in presence of anticoagulants dependent pseudothrombocytopenia.

We report a case of pseudothrombocytopenia anticoagulants dependence in a healthy woman. Platelet count was performed on the automated impedance haematological analyzer utilizing peripheral blood samples anticoagulated with ethylene diamine tetra-acetate, heparin and sodium citrate. We pointed out that the severe thrombocytopenia was principally time and ethylene diamine tetra-acetate dependent. As regard both the temperature (37 degrees C) and the other anticoagulants (heparin, sodium citrate), the phenomenon was variable. The phenomenon "in vitro" was confirmed by the normal aggregation, moreover we showed that the platelets of a normal subject aggregated with plasma and ethylene diamine tetra-acetate of pseudothrombocytopenic subject. We report this case because often, in a healthy subject, it is possible to make a mistake in diagnosis and to employ more sophisticated and expansive investigations. Moreover it is very important to point out the pseudothrombocytopenia in case of heparinic therapy because it is possible to have a dilated thrombocytopenia.

[Acquired idiopathic sideroblastic anemia with cyclic hypereosinophilia of unclear significance. A case report]. / Anemia sideroblastica idiopatica acquisita con ipereosinfolia ciclica di non chiaro significato. Descrizione di un caso.

We considered the case of an eighty-three-years-old woman who was admitted to Somma Lombardo Hospital, because of the presence of an acquired sideroblastic idiopathic anaemia accompanied by a cyclic hypereosinophilia of undefined significance. The case is reported both because references about sideroblastic idiopathic anaemia with hypereosinophilia of undefined significance are rare in the literature and because it may support the hypothesis that hypereosinophilia ensues from the myelodysplastic syndrome. Therefore it is possible that when diagnosing acquired sideroblastic idiopathic anaemia, not only thrombocytopenia, but hypereosinophilia has to be considered as an unfavourable prognostic marker for early appearance of acute non-lymphoid leukemia.

[The diagnosis of chronic pyelonephritis in internal medicine]. / La diagnosi di pielonefrite cronica in medicina interna.

All those clinical, laboratory, radiological and radioisotopic elements of importance in the diagnosis of chronic pyelonephritis in internal medicine have been examined. Anamnestic indications of chronic pyelonephritis include previous infections episodes of the urinary ways, pain in the lumbar and suprapubic region and micturition disturbances. Less significant are objective findings such as pain at percussion of the lumber region, hypertension and possible signs of renal insufficiency. Important diagnostically among laboratory examinations are leucocyturia higher than 1,000.000 in 24 hours, a findings of leucocyte cylinders, bacteriuria higher than 100.000 per cc of urine and the observation of immunoantibodies covering bacteria isolated from the urine. X-ray and radioisotopic examinations are recognised as having considerable diagnostic usefulness. None of the clinical, laboratory, X-ray or radioisotopic findings is, however, strictly specific. Confirmation of a diagnostic suspicion is only possible when scrupulous accumulation of the most typical subjective and objective findings regarding the disease is accompanied by the positivity of diagnostic tests. The results of these tests must in all cases be assessed critically in the context of the clinical picture for, taken singly, they have no decisive value.