RESUMO
PURPOSE: The purpose of this article is to report the first case of primary vitreoretinal lymphoma in a patient with sarcoid uveitis. MATERIAL AND METHODS: A 63-year-old woman with biopsy-proven sarcoid uveitis diagnosed 7 years ago was presented for a 6-month history of bilateral intermediate uveitis and gait disturbance with cerebral magnetic resonance imaging suggestive of neurosarcoidosis. Because of corticoids resistance, a vitrectomy and a cerebral biopsy were performed. The final diagnosis was primary central nervous system diffuse lymphoma. Patient died despite the chemotherapy with an initial improvement of visual and neurological features. CONCLUSION: Ophthalmologists should know that patient followed up with sarcoid uveitis can develop a primary vitreoretinal diffuse large B-cell lymphoma.
Assuntos
Doenças do Sistema Nervoso Central/complicações , Linfoma Intraocular/etiologia , Retina/patologia , Neoplasias da Retina/etiologia , Sarcoidose/complicações , Uveíte/complicações , Corpo Vítreo/patologia , Biópsia , Encéfalo/diagnóstico por imagem , Doenças do Sistema Nervoso Central/diagnóstico , Feminino , Humanos , Linfoma Intraocular/diagnóstico , Linfoma Difuso de Grandes Células B , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias da Retina/diagnóstico , Sarcoidose/diagnóstico , Tomografia de Coerência Óptica/métodos , Uveíte/diagnósticoRESUMO
Whipple's disease (WD) is a rare chronic and systemic infection caused by the ubiquitous actinomycete Tropheryma whipplei. A case of localized infection with mesenteric adenopathy associated with a prolonged unexplained fever is reported herein. Screening by PCR on saliva and stool was positive, and T. whipplei was formally identified by specific PCR on duodenal and mesenteric adenopathy biopsies. Histological analysis did not demonstrate periodic acid-Schiff-positive macrophages or positive T. whipplei immunochemistry in either the duodenal mucosa or mesenteric nodes. Treatment with hydroxychloroquine and doxycycline allowed a rapid resolution of symptoms, and subsequent saliva and stool PCR results were negative.
Assuntos
Linfadenite Mesentérica/diagnóstico , Reação em Cadeia da Polimerase/métodos , Doença de Whipple/diagnóstico , Adulto , Biópsia , Feminino , Humanos , Linfadenite Mesentérica/tratamento farmacológico , Doença de Whipple/tratamento farmacológicoRESUMO
We describe the case of four patients consulting for headache and tachycardia of brutal onset. Their biological data were compatible with primary hyperthyroidism with low TSH and high T4 serum levels. Serum thyroglobulin level was low and Tc-scintigraphy showed decreased uptake with a homogenous pattern. These results allowed to conclude a thyrotoxicosis caused by thyroid hormones intake. History taking revealed consumption of beef neck meat containing all or parts of the bovine thyroid gland. Evolution was favourable with beta-blockers. A literature review of « hamburger thyrotoxicosis ¼ is presented.
