RESUMO
Cerebral sinus thrombosis (CST) is an uncommon condition in children with a variable clinical presentation which has rarely been described in the setting of diabetic ketoacidosis. We present the case of 14-year-old child in whom lateral sinus thrombosis was caused by dehydration complicating ketoacidosis in a previously undiagnosed type 1 diabetes. The diagnosis of the CST was established during the autopsy due to the rapidity of the neurological deterioration. The cause of death was tonsillar herniation due to diffuse cerebral edema secondary to CST. This is the first published report of a CST in association with new onset type 1 diabetes in a child diagnosed at the postmortem examination.
Assuntos
Edema Encefálico , Diabetes Mellitus Tipo 1 , Cetoacidose Diabética , Trombose dos Seios Intracranianos , Humanos , Criança , Adolescente , Cetoacidose Diabética/complicações , Cetoacidose Diabética/diagnóstico , Diabetes Mellitus Tipo 1/complicações , Trombose dos Seios Intracranianos/complicações , Trombose dos Seios Intracranianos/diagnóstico , Edema Encefálico/etiologia , EncefaloceleRESUMO
BACKGROUND: The positive diagnosis of MPM is based on morphologic features coupled with immunohistochemical findings. Many antibodies have been published especially in order to differentiate between malignant tumors and atypical mesothelial hyperplasia. BAP-1 is a BRCA1-binding protein whose loss of expression was frequently reported in MPM. Our aim was to assess the diagnostic value of this antibody in comparison to the most sensitive diagnostic antibody represented by the calretinin antibody. METHODS: We performed a meta-analysis using the Meta-Disc software 5.1.32. RESULTS: According to our inclusion criteria, 19 studies with 11 studies dealing with BAP1 antibody and 8 studies dealing with calretinin antibody were included. The SEN of BAP 1 and calretinin antibodies was respectively estimated to 54.6% and 86.5%. The SPE reached respectively 95.7% and 76.6%. The dOR was estimated respectively to 23.664 and 38.8. The I-square revealed a heterogeneity of the parameters studied. The metaregression analysis revealed as covariates the amplification system and the histologic subtype as causing effects of heterogeneity for BAP1 antibodies and histologic subtype and chromogene as causing effects of heterogeneity for calretinin antibody. CONCLUSION: This meta-analysis revealed that BAP1 antibody should be associated with more sensitive antibodies in order to assess the diagnosis.
