RESUMO
BACKGROUND: Thrombangiitis obliterans or Buerger's disease is a segmental inflammatory disease affecting small and medium-sized veins and arteries, which most often affects young smokers leading to thrombophlebitis and acral ischaemic syndromes, inducing high amputation rates. Based on positive results of a former pilot study we report on our results of immunoadsorption (IA) in clinical routine care, where IA was offered as a treatment option. PATIENTS AND METHODS: The uncontrolled course of 12 consecutive TAO-patients treated by IA on a series of 5 consecutive days was observed. Follow-up period was 14.1 (ranging from 1-26) months. RESULTS: Eight patients were treated with one, four patients completed 2 IA-series. In 9 patients an early onset and lasting clinical improvement and an improvement of ischaemia was noted. The intake of pain-relievers (especially opioids) sank drastically. Eight patients returned to work. Retrospectively, in two out of three treatment failures the correct diagnosis of TAO was questionable. CONCLUSION: IA seems to be a promising treatment option for patients suffering from TAO which should be further evaluated in controlled clinical trials.
Assuntos
Técnicas de Imunoadsorção , Tromboangiite Obliterante/terapia , Adulto , Estudos de Coortes , Feminino , Dedos/irrigação sanguínea , Seguimentos , Pé/irrigação sanguínea , Humanos , Isquemia/etiologia , Isquemia/terapia , Masculino , Pessoa de Meia-Idade , Doença de Raynaud/terapia , Dedos do Pé/irrigação sanguíneaRESUMO
We describe a patient with Wegener's granulomatosis whose disease presented as pseudotumor of the orbit and a breast mass. Both findings were misinterpreted and errors in diagnosis resulted, despite the availability of rapid and accurate diagnostic tests for this disease. We report this case to emphasize the more unusual presentations of Wegener's granulomatosis.
