RESUMO
Wilson's Disease (WD) is an autosomal recessive disorder of copper metabolism resulting in a pathological accumulation of this metal, initially in the liver and later in other organs, mainly brain. Treatment with copper chelating agents and zinc salts results in a depletion of copper deposits and prevents or reverses the clinical manifestations. Copper deficiency may cause haematological and neurological changes, the latter principally being polyneuropathy and myelopathy. We report a patient with WD who developed a myelopathy associated with a deficiency of copper following prolonged treatment with D-penicillamine and zinc salts.
Assuntos
Quelantes/efeitos adversos , Terapia por Quelação/efeitos adversos , Cobre/deficiência , Degeneração Hepatolenticular/complicações , Penicilamina/efeitos adversos , Polineuropatias/induzido quimicamente , Doenças da Medula Espinal/induzido quimicamente , Zinco/efeitos adversos , Ceruloplasmina/análise , Quelantes/uso terapêutico , Cobre/farmacocinética , Cobre/urina , Feminino , Transtornos Neurológicos da Marcha/induzido quimicamente , Degeneração Hepatolenticular/tratamento farmacológico , Degeneração Hepatolenticular/metabolismo , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Exame Neurológico , Penicilamina/uso terapêutico , Polineuropatias/diagnóstico , Reflexo Anormal , Transtornos de Sensação/induzido quimicamente , Doenças da Medula Espinal/diagnóstico , Zinco/farmacocinética , Zinco/uso terapêuticoRESUMO
Reactivation of hepatitis B virus infection in patients with resolved infection is rare and is usually associated with immunosuppressive therapy. Morbidity and mortality are high. Some cases of hepatitis B reactivation associated with the use of rituximab have previously been published. We present the case of a patient with B-cell non-Hodgkin lymphoma receiving combination chemotherapy with rituximab who showed hepatitis B reactivation followed by liver failure. The most recent literature on this topic is reviewed and discussed.