Assuntos
Neoplasias Colorretais Hereditárias sem Polipose/genética , Mutação , Idoso , Feminino , Humanos , Proteína Homóloga a MRE11/genética , Pessoa de Meia-Idade , Proteína 1 Homóloga a MutL/genética , Proteínas Proto-Oncogênicas B-raf/genética , Síndrome , Proteínas Supressoras de Tumor/genética , Ubiquitina-Proteína Ligases/genéticaAssuntos
Pólipos Adenomatosos/diagnóstico , Neoplasias do Colo/diagnóstico , Neoplasias Duodenais/diagnóstico , Ganglioneuroma/diagnóstico , Síndrome do Hamartoma Múltiplo/diagnóstico , Pólipos Intestinais/diagnóstico , Adenoma/cirurgia , Pólipos Adenomatosos/genética , Pólipos Adenomatosos/patologia , Adulto , Neoplasias do Colo/genética , Neoplasias do Colo/patologia , Colonoscopia , Diagnóstico Diferencial , Neoplasias Duodenais/genética , Neoplasias Duodenais/patologia , Éxons/genética , Ganglioneuroma/genética , Ganglioneuroma/patologia , Gastroscopia , Síndrome do Hamartoma Múltiplo/complicações , Síndrome do Hamartoma Múltiplo/genética , Síndrome do Hamartoma Múltiplo/patologia , Humanos , Hiperpigmentação/etiologia , Pólipos Intestinais/genética , Pólipos Intestinais/patologia , Masculino , Megalencefalia/etiologia , Neoplasia Endócrina Múltipla Tipo 2a/diagnóstico , Mutação de Sentido Incorreto , PTEN Fosfo-Hidrolase/genética , Doenças do Pênis/etiologia , Mutação Puntual , Neoplasias da Glândula Tireoide/cirurgia , TireoidectomiaRESUMO
Mixed cryoglobulinemia (MC) is a small-vessel systemic vasculitis characterized by the presence of cryoglobulins, immunoglobulin complexes that precipitate at low temperatures ( < 37 ºC) inducing the inflammatory process. The most frequent etiology is hepatitis C infection (HCV) (1). Rituximab (RTX), an anti-CD20 monoclonal antibody, has recently emerged as the treatment of choice for severe MC (2). We present a case of severe hepatitis C virus-induced MC that was controlled and maintained in remission with RTX for 26 months, a remarkable prolonged period of time.
Assuntos
Anticorpos Monoclonais Murinos/uso terapêutico , Antivirais/uso terapêutico , Crioglobulinemia/tratamento farmacológico , Crioglobulinemia/etiologia , Hepacivirus , Hepatite C Crônica/complicações , Hepatite C Crônica/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , RituximabAssuntos
Erros de Diagnóstico , Endometriose/diagnóstico , Doenças do Colo Sigmoide/diagnóstico , Neoplasias do Colo Sigmoide/diagnóstico , Adulto , Biópsia , Colectomia , Pólipos do Colo/diagnóstico , Colonoscopia , Diagnóstico Diferencial , Endometriose/epidemiologia , Endometriose/patologia , Endometriose/cirurgia , Feminino , Humanos , Obstrução Intestinal/etiologia , Doenças do Colo Sigmoide/epidemiologia , Doenças do Colo Sigmoide/patologia , Doenças do Colo Sigmoide/cirurgiaRESUMO
OBJECTIVES: To evaluate the patient characteristics, outcome, and prognosis of upper gastrointestinal haemorrhage in the elderly. MATERIAL AND METHODS: A prospective study was conducted on 103 patients aged 80 years and over, admitted to a Gastrointestinal Bleeding Unit after an episode of upper gastrointestinal bleeding. We analysed the personal history, the characteristics of the bleeding event, and whether an urgent diagnostic or therapeutic endoscopy was performed, in order to identify clinical data and endoscopic findings that may have an influence on the outcome of the haemorrhage. RESULTS: The major cause of the haemorrhage was peptic ulcer in 65.1%, and 60.2% of patients were on chronic treatment with non-steroidal anti-inflammatory drugs. An urgent diagnostic endoscopy was performed in all of them, identifying the source of bleeding in 94.2%, and treatment was carried out on 28.2%. The likelihood of rebleeding was 8%, and 4.9% of patients underwent emergency surgery, with an overall mortality rate of 5.8%. CONCLUSIONS: The performance of urgent endoscopy and the application of endoscopic haemostasis are safe and effective in stopping upper gastrointestinal bleeding in the elderly. This has significantly reduced the need for emergency surgery, improving the survival of the bleeding elderly patient and preventing recurrent bleeding.