RESUMO
INTRODUCTION: Ocular siderosis is a rare but severe complication of open globe trauma with intraocular retention of a metallic foreign body. CASE STUDY: We report a case of recurrent uveitis in a 37-year-old patient. The ophthalmic examination revealed poor vision in the left eye, lid edema, limbal scleromalacia, hyphema and severe ocular hypertension. Orbital CT showed the presence of a radio-opaque IOFB between the crystalline lens and vitreous body. An aqueous humor sample was obtained for iron and ferritin levels. The results came back 100 and 2000 times higher, respectively, than the serum reference values. DISCUSSION: The very high iron content is the result of a sustained release from the metallic INFB and is responsible for ocular siderosis in our patient. The extremely high ferritin level would be the result of in situ synthesis by the various cells of the ocular structures in order to preserve the components of the eye. Measurement of these two levels would improve the diagnosis, prognosis and treatment of metallic IOFBs.
Assuntos
Oftalmopatias/diagnóstico , Oftalmopatias/etiologia , Corpos Estranhos no Olho/complicações , Olho/metabolismo , Ferritinas/metabolismo , Siderose/diagnóstico , Adulto , Olho/patologia , Oftalmopatias/metabolismo , Corpos Estranhos no Olho/diagnóstico , Ferimentos Oculares Penetrantes/complicações , Ferimentos Oculares Penetrantes/diagnóstico , Ferimentos Oculares Penetrantes/metabolismo , Humanos , Ferro , Masculino , Siderose/etiologia , Siderose/metabolismoAssuntos
Telangiectasia Hemorrágica Hereditária/diagnóstico , Telangiectasia Hemorrágica Hereditária/terapia , Abdome/diagnóstico por imagem , Dieta Hipossódica , Diuréticos/uso terapêutico , Humanos , Ferro/uso terapêutico , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Radiografia Torácica , UltrassonografiaAssuntos
Síndrome Antifosfolipídica/complicações , Insuficiência de Múltiplos Órgãos/etiologia , Acidente Vascular Cerebral/etiologia , Adulto , Anticorpos Antifosfolipídeos , Síndrome Antifosfolipídica/patologia , Humanos , Lúpus Eritematoso Sistêmico/complicações , Masculino , Tomografia Computadorizada por Raios XAssuntos
Países em Desenvolvimento , Deficiências do Desenvolvimento/genética , Leucodistrofia Metacromática/genética , Transtornos Psicomotores/genética , Encéfalo/patologia , Cerebrosídeo Sulfatase/sangue , Consanguinidade , Deficiências do Desenvolvimento/diagnóstico , Diagnóstico Diferencial , Dominância Cerebral/fisiologia , Feminino , Humanos , Lactente , Leucodistrofia Metacromática/diagnóstico , Imageamento por Ressonância Magnética , Transtornos Psicomotores/diagnósticoAssuntos
Acantose Nigricans/etiologia , Adenocarcinoma/diagnóstico , Neoplasias da Vesícula Biliar/diagnóstico , Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Evolução Fatal , Feminino , Neoplasias da Vesícula Biliar/tratamento farmacológico , Humanos , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/secundário , Pessoa de Meia-IdadeRESUMO
The scapula is an uncommon site for a chondroma. We report the case of a chondroma in the left acromion, which presented as a painful shoulder in a 19-year-old teenager. The diagnosis was suspected on radiographs and CT scan and confirmed by histological findings.
Assuntos
Acrômio/patologia , Neoplasias Ósseas/diagnóstico , Condroma/diagnóstico , Adulto , Biópsia , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Condroma/patologia , Condroma/cirurgia , Humanos , Masculino , Tomografia Computadorizada por Raios X , Resultado do TratamentoAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Pulmonares/diagnóstico por imagem , Pneumotórax/diagnóstico por imagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Biópsia , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prednisolona/administração & dosagem , Radiografia , Vincristina/administração & dosagemRESUMO
INTRODUCTION: Cryoglobulins are immunoglobulins that persist in the serum, precipitate at the cold temperature and resolubilise when rewarmed. There are three categories, the type I, II and III, with neurological symptoms. Those are dominated by peripheral neuropathy, the central nervous system is generally saved. We reported the case of a cryoglobulinemia of the type I having generated a ischemic cerebrovascular accident (CVA), a seldom described situation. CASE REPORT: A 62 years old man, without noteworthy past. He allowed for was occurred the functional impotence of the left hemicorp with a discrete left hemiparesis. The cerebral IRM has evoked subacute ischemic cerebrovascular accident. The cardiovascular check-up was normal. The Horton disease was isolated after biopsy of the left temporal artery. The biological check-up objectified indices in favor of a cryoglobulinemia, this one was identified and classified type I. A monoclonal gammopathy of undetermined significance (MGUS) was associated to him. DISCUSSION: The cutaneous, articular and renal manifestations are the most frequent complications of the cryoglobulinemia, the neurological complications are described, but with a less degree and are dominated by peripheral neuropathy. The attack of the central nervous system remains exceptional and is seen primarily with type I. Its correct assumption of responsibility requires to identify the cryoglobulinemic etiology. Association type I cryoglobulinemia and monoclonal gammapathy reinforced the chances for a central attack. CONCLUSION: In front of all CVA, it would be judicious to seek a cryoglobulin systematically. A hemopathy is often associated to type I, a electrophoretic exploration of serum proteins is not to be neglected to seek a possible origin of the cryoglobulinemia.
Assuntos
Isquemia Encefálica/etiologia , Crioglobulinemia/complicações , Acidente Vascular Cerebral/etiologia , Arterite de Células Gigantes/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Paraproteinemias/complicações , Paresia/etiologiaRESUMO
AIM: To investigate the rate, risk factors, clinical course, and treatment outcomes of endophthalmitis following glaucoma drainage implant (GDI) surgery. METHODS: A computerised relational database search was conducted to identify all patients who were implanted with Ahmed glaucoma valve (AGV) and developed endophthalmitis following surgery at the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, between 1 January 1994 and 30 November 2003. Only medical records of the patients who developed endophthalmitis were retrospectively reviewed. RESULTS: 542 eyes of 505 patients who were on active follow up were included in the study. Endophthalmitis developed in nine (1.7%) eyes; the rate was five times higher in children than in adults. Delayed endophthalmitis (developed 6 weeks after surgery) occurred in eight of nine eyes. Conjunctival erosion overlying the AGV tube was present in six of nine eyes. Common organisms isolated in the vitreous included Haemophilus influenzae and Streptococcus species. Multiple regression analysis revealed that younger age and conjunctival erosion over the tube were significant risk factors associated with endophthalmitis. CONCLUSION: Endophthalmitis is a rare complication of GDI surgery that appears to be more common in children. Conjunctival dehiscence over the GDI tube seems to represent a major risk factor for endophthalmitis. Prompt surgical revision of an exposed GDI tube is highly recommended.
Assuntos
Endoftalmite/etiologia , Implantes para Drenagem de Glaucoma/efeitos adversos , Infecções Relacionadas à Prótese/microbiologia , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Endoftalmite/microbiologia , Infecções Oculares Bacterianas/etiologia , Feminino , Cirurgia Filtrante , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Retrospectivos , Fatores de Risco , Deiscência da Ferida Operatória/complicações , Resultado do Tratamento , Acuidade VisualRESUMO
Dermatofibrosarcoma protubans of Darier-Ferrand is observed in about 0.1% of al malignant skin tumors. Head and face localization in uncommon, estimated to account for about 1 to 10% of all lesions. Relapse is frequent and metastasis in uncommon. Diagnosis is often made late. Surgery is the basic treatment. We report two cases of dermatofibrosarcoma of Darier-Ferrand with head and face localizations. In one case, the tumor extended inside the skull and spread to the superior longitudinal sinus. This is the only such reported case found in the literature. CT scan is more useful for studying the bony tables and the cranial content. MRI provides precision for soft tissue tumors and angio-MRI is particularly useful for analysing with accuracy vascular relations of the tumor.
Assuntos
Dermatofibrossarcoma/diagnóstico , Neoplasias Faciais/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Cutâneas/diagnóstico , Neoplasias Cranianas/diagnóstico , Adulto , Idoso , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
We report a case of congenital dermoid cyst of the conus medullaris without associated dysraphic lesion treated surgically. An 18-year-old man had a one-year history of bladder sphincter disorders and more recent acute renal failure with urinary tract infection. The diagnosis of intramedullary tumor was provided by myelo CT and MRI confirmed by histology. At 10-month follow-up, the postoperative course was good.