RESUMO
We report a case of thalassaemia intermedia complicated during two consecutive pregnancies by two episodes of spastic paraparesis due to compression of the spinal cord by extramedullary paravertebral masses. The patient was successfully treated by hypertransfusion and local irradiation. Compression of vital organs by the extramedullary masses must always be considered in chronic haemolytic anaemias during periods of increased haemopoietic demands like pregnancy. As relapses can not be excluded, a closer follow-up is needed. A dose of irradiation preventing from recurrences in the same anatomical area, seems necessary.
Assuntos
Hematopoese Extramedular/fisiologia , Paraparesia Espástica/etiologia , Talassemia/complicações , Adulto , Feminino , Hematopoese Extramedular/efeitos da radiação , Humanos , Imageamento por Ressonância Magnética , Paraparesia Espástica/radioterapia , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/terapia , Recidiva , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/radioterapia , Talassemia/terapiaRESUMO
Anaerobic arthritis due to Bacteroides fragilis was diagnosed in a 33-year-old patient with prolonged fever suffering from sickle cell/thalassaemia. The causative agent was isolated from blood and purulent synovial fluid from both knee joints. A combination of chloramphenicol plus metronidazole treatment proved effective. Anaerobic arthritis has not previously been described in patients with sickle cell disease, and may reflect the well-known susceptibility of these patients to pathogens.
