RESUMO
Bladder outlet obstruction is a common aetiology of lower urinary tract symptoms in adult men and several treatment options are available. We report on a case of a 73-year-old man with a complicated soft tissue infection due to an urinoma after laser prostatectomy. He was treated by several surgical interventions and long-term antibiotic therapy.
Assuntos
Antibacterianos/administração & dosagem , Terapia a Laser , Complicações Pós-Operatórias , Próstata , Infecções dos Tecidos Moles , Obstrução do Colo da Bexiga Urinária , Urinoma , Idoso , Fasciotomia/métodos , Humanos , Terapia a Laser/efeitos adversos , Terapia a Laser/métodos , Masculino , Tamanho do Órgão , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/terapia , Próstata/patologia , Próstata/cirurgia , Doenças Prostáticas/complicações , Doenças Prostáticas/cirurgia , Reoperação/métodos , Infecções dos Tecidos Moles/etiologia , Infecções dos Tecidos Moles/fisiopatologia , Infecções dos Tecidos Moles/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Obstrução do Colo da Bexiga Urinária/etiologia , Obstrução do Colo da Bexiga Urinária/fisiopatologia , Obstrução do Colo da Bexiga Urinária/cirurgia , Fístula Urinária/complicações , Fístula Urinária/terapia , Urinoma/complicações , Urinoma/fisiopatologiaRESUMO
Graves' disease (GD) is an autoimmune disease that involves aberrant B and T lymphocyte responses. Detailed knowledge about lymphocyte subpopulation composition will therefore enhance our understanding of the pathogenesis of GD and might support the development of new immunomodulatory treatment approaches. The aim of this study was to gain detailed insight into the composition of the peripheral blood lymphocyte compartment in GD before and during anti-thyroid drug therapy. Major B and T lymphocyte subpopulations were investigated by flow cytometry in peripheral blood from newly diagnosed GD patients (n = 5), GD patients treated with anti-thyroid drugs (n = 4), patients with recurrent GD (n = 7) and healthy controls (HC; n = 10). In GD patients, numbers of activated T lymphocytes [human leucocyte antigen D-related (HLA-DR)⺠and CD25âº] were increased. The B lymphocyte compartment in GD was characterized by significantly higher numbers of transitional (CD38(high) CD27â», P < 0.03) and pre-naive mature (CD38(low) CD27â» IgD⺠CD5âº, P < 0.04) B lymphocytes, while memory populations were slightly decreased. The increased numbers of CD5âº, transitional and pre-naive mature B lymphocytes correlated positively with fT4 plasma levels. GD is associated with increased numbers of activated T lymphocytes and transitional and pre-naive mature CD5⺠B lymphocytes within the peripheral blood. The increase in CD5⺠B lymphocytes was due mainly to an increase in transitional and pre-naive mature B lymphocytes. Increased fT4 plasma levels might be associated with this increase in transitional and pre-naive mature CD5⺠B lymphocytes.