RESUMO
BACKGROUND: Caplan's syndrome, also known as rheumatoid pneumoconiosis (RP), is a rare disease associating pneumoconiosis with rheumatoid arthritis (RA). This is one of the rare cases evaluating the effect of Rituximab, which was used initially for the treatment of RA, on pneumoconiosis Case Presentation: In this case report, we described a 21-year long-standing history of pneumoconiosis and its association with RA. A 67-year-old man diagnosed with pneumoconiosis presented with morning stiffness and symmetrical polyarthritis. Laboratory investigations showed high titers of rheumatoid factor (RF) and anti-citrullinated protein antibodies. The diagnosis of RA was established and the patient was put on leflunomide. Then, he was treated with Rituximab, as he did not respond to leflunomide. The patient showed marked improvement as pain and swelling decreased. More importantly, Caplan's nodules stabilized on chest-computed tomography. CONCLUSION: The use of rituximab in pneumoconiosis does not alter the evolution of the pulmonary nodules. More trials are needed to establish a treatment consensus for RP.
Assuntos
Artrite Reumatoide , Síndrome de Caplan , Pneumoconiose , Masculino , Humanos , Idoso , Síndrome de Caplan/diagnóstico , Rituximab/uso terapêutico , Leflunomida , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Pneumoconiose/diagnóstico , Pneumoconiose/tratamento farmacológicoRESUMO
Brown tumours (BTs) are focal bone lesions encountered in patients with uncontrolled hyperparathyroidism (HPT). They are due to a proliferation of multinucleated giant cells in osteolytic lesions. Because of early screening of bone metabolism disorders, BTs are rare bone manifestations. More importantly, they scarcely reveal the disease. We demonstrate through these two cases reports unusual locations of BT complicating the course of HPT due to parathyroid hyperplasia.
Assuntos
Hiperparatireoidismo Primário , Neoplasias , Osteíte Fibrosa Cística , Osteólise , Humanos , Osteíte Fibrosa Cística/etiologia , Osteíte Fibrosa Cística/complicações , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/diagnóstico , Diagnóstico Diferencial , Neoplasias/complicações , Neoplasias/diagnósticoRESUMO
Tuberculosis arthritis of the ankle accounts for 10% of all cases of osteoarticular tuberculosis (OT). Because of its rarity and insidious symptoms, diagnosing it may be challenging. Furthermore, its imaging findings mimic those of other diseases. The case of ankle tuberculosis arthritis misdiagnosed as talus necrosis is reported. The difficulties faced by clinicians when confronting such situations are also illustrated.