RESUMO
Patients affected by type 1 Gaucher disease (an autosomal recessive inheritance lysosome storage disorder) develop nodular splenomegaly in 20 to 30% of cases where imiglucerase therapy proves ineffective. The lack of response to imiglucerase therapy on spleen nodules could be an indication of the existence or development of a malignant spleen. We report a 47-year-old man with Gaucher disease who presented with a voluminous splenic nodule, in whom therapy was delayed. Regular monitoring of patients is the most important factor to predict and therefore prevent morbidity.
Assuntos
Doença de Gaucher/diagnóstico , Esplenomegalia/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Baço/patologiaRESUMO
A 24-year-old man returning from a trip to Mali was hospitalized for acute encephalitis and fever in association with acute primary infection by Schistosomiasis mansoni. Bilharziasis was suspected from the epidemiological context and presence of eosinophilia. Diagnosis was confirmed by serological testing. Specific treatment using praziquantel and corticotherapy was successful. Central nervous system involvement attributable to embolization of eggs or ectopic migration of adult worms has been reported in association with chronic Schistosomiasis by S. japonicum or S. mansoni. There have been few reports of acute neuroschistosomiais during the acute primary phase of infestation by S. mansoni. Etiology probably involves immunoallergic mechanisms.
Assuntos
Encefalite/parasitologia , Esquistossomose mansoni/diagnóstico , Corticosteroides/uso terapêutico , Adulto , Animais , Anti-Helmínticos/uso terapêutico , Anticorpos Anti-Helmínticos/sangue , Humanos , Imageamento por Ressonância Magnética , Masculino , Mali , Praziquantel/uso terapêutico , Schistosoma mansoni/imunologia , Esquistossomose mansoni/tratamento farmacológico , ViagemRESUMO
Involvement of the temporal arteries, considered to be the hallmark of giant cell arteritis, is rather rare in other pathologic processes. We describe a patient with lymphoma involving temporal artery. A 68-year-old man has been followed closely without therapy since 1989 for a low-grade non-Hodgkin lymphoma. He presented in 1995 with asymptomatic nodules on the temporal artery with preservation of the pulse. Temporal artery biopsy showed periarterial infiltration of mononuclear cells in keeping with follicular mixed cell lymphoma. The differential diagnosis of temporal arteritis must therefore, include other vasculitides, light chain amyloidosis but also lymphoma and emphasize the need for a temporal artery biopsy.