RESUMO
CASO CLÍNICO: Se presenta el caso de una mujer de 31 años con pérdida brusca de visión de un ojo debido a una oclusión de arteria ciliorretiniana. En la exploración presentaba hepatomegalia y en la analítica los niveles séricos de hierro, saturación de transferrina y ferritina estaban elevados. Los perfiles de autoinmunidad y de hipercoagulabilidad fueron normales. El estudio doppler-ultrasónico de los troncos supraaórticos fue anodino, pero la ecografía cardíaca evidenció una miocardiopatía con calcificación subendocárdica. El estudio genético para la hemocromatosis fue positivo. DISCUSIÓN: La calcificación subendocárdica secundaria a hemocromatosis puede ser la causa de la oclusión embólica de la arteria ciliorretiniana. El cuadro embólico ocular fue la forma de presentación de la hemocromatosis en nuestra paciente
CLINICAL CASE: We report a case of a 31 year-old woman with a sudden visual loss due to a cilioretinal artery occlusion. The physical examinination showed hepatomegaly. Serum iron and ferritin and transferrin saturation were unusually high. The doppler scan of carotid arteries showed no relevant signs of atheromatous disease. Dilated cardiomiopaty was revealed in the B-scan with subendocardial calcium deposits. Genetic tests were positive for hemochromatosis. DISCUSSION: Subendocardial calcification due to hemochromatosis could be the embolic source in our patient. This embolic ocular disease is the first presentation of hemochromatosis in this patient
Assuntos
Feminino , Humanos , Oclusão da Artéria Retiniana/metabolismo , Oclusão da Artéria Retiniana/patologia , Hemocromatose/metabolismo , Hemocromatose/patologia , Hepatomegalia/metabolismo , Hepatomegalia/patologia , Ferro/administração & dosagem , Cardiomiopatias/diagnóstico , Diabetes Mellitus/genética , Oclusão da Artéria Retiniana/complicações , Oclusão da Artéria Retiniana/diagnóstico , Hemocromatose/diagnóstico , Hemocromatose/genética , Hepatomegalia/complicações , Hepatomegalia/diagnóstico , Ferro/provisão & distribuição , Cardiomiopatias/metabolismo , Diabetes Mellitus/diagnósticoRESUMO
We recently demonstrated that the mucosa of the small intestine of the rat expresses reelin and some components of its signaling system. The current study evaluates whether reelin affects the intestinal gene expression profile using microarray analysis and reeler mice, a natural mutant in which reelin is not expressed. The effect of the mutation on body weight and intestinal morphology is also evaluated. The mutation reduces body and intestinal weight during the first 2 months of age and modifies the morphology of the crypts and villi. For the microarray assays, total RNA was obtained from either isolated epithelial cells or intact small intestine. Of the 45,101 genes present in the microarray the mutation significantly alters the expression of 62 genes in the isolated epithelial cell samples and of 84 in the intact small intestine. The expression of 83% of the genes tested for validation was substantiated by reverse transcriptase polymerase chain reaction. The mutation notably up-regulates genes involved in intestinal metabolism, while it down-regulates genes related with immune response, inflammation, and tumor development. Genes involved in cell proliferation, differentiation, apoptosis, membrane transport and cytoskeleton are also differently expressed in the reeler mice as compared with the control. This is the first report showing that the lack of reelin modifies intestinal morphology and gene expression profile and suggests a role for reelin in intestinal epithelium homeostasis (AU)
