RESUMO
Disseminated intestinal and cutaneous thromboangiitis (Kohlmeier-Degos' syndrome) is a rare syndrome of unknown etiology, which is characterized by cutaneous and visceral involvement. Two (cutaneous and visceral) stages are identified. A fatal outcome is inevitable although there may be a long (8-20-year) course of the disease during a benign process. The causes of death are peritonitis, central nervous system impairments, pleurisy, pericarditis. The paper describes a case of disseminated intestinal and cutaneous thromboangiitis (Kohlmeier-Degos' syndrome) in a 32-year-old female patient who has died from intoxication due to severely impaired permeability of the epithelial barrier mainly of the large bowel (diphtheritic inflammation of the mucosa, severe inflammatory edema of the submucous layer, and fibrinous impregnation of the serous membrane).
Assuntos
Antibacterianos/uso terapêutico , Transfusão de Eritrócitos/métodos , Glucocorticoides/uso terapêutico , Papulose Atrófica Maligna/diagnóstico , Adulto , Diagnóstico Diferencial , Ecocardiografia , Endoscopia Gastrointestinal , Evolução Fatal , Feminino , Humanos , Laparoscopia , Papulose Atrófica Maligna/terapia , Síndrome , Tomografia Computadorizada por Raios XRESUMO
The noninvasive method of oscillovasometry, devised previously, was applied to the estimation of arterial pressure, effective radius of large arterial vessels, a number of indices showing elastic vessel properties and change in tone of the vessels on the right upper limb just before sublingual administration of nitroglycerin (0.5 mg) to the patients and 4-5 min after it. A group of 96 patients with different levels of arterial pressure were examined. It was found that all the patients showed a pressure decrease and tachycardia, but about a half of them had a passive response in large arterial vessels in the form of a decrease in the vessel volume, while others showed a decrease in arterial vessel tone (vasodilation), i.e. an active vascular response. From the data we drew the conclusion that there are two types of vascular response (active and passive) and they do not depend on the initial level of arterial pressure. Nitroglycerin probably acts more effectively on large arteries with a high initial tone. The possible mechanism of this phenomenon is discussed.
