RESUMO
We report 2 patients who presented with vasomotor symptoms and severe thrombocytopenia following rattlesnake bites. These symptoms persisted in spite of treatment with antivenin and transfusion of multiple doses of platelets. Thrombocytopenia is a common occurrence in moderate to severe crotaline envenomation. Algorithms suggested for the treatment of rattlesnake envenomation with crotaline-specific antivenin may not reverse the associated thrombocytopenia. The precise mechanism of venom-induced thrombocytopenia (VIT), even in the absence of significant coagulopathy, is unknown. Our experience suggests that, unless spontaneous bleeding occurs, repeated transfusion of fresh frozen plasma and/or platelets may not be indicated.
Assuntos
Venenos de Crotalídeos/intoxicação , Crotalus , Mordeduras de Serpentes/complicações , Trombocitopenia/induzido quimicamente , Adulto , Animais , Antivenenos/uso terapêutico , Humanos , Fragmentos Fab das Imunoglobulinas , Fragmentos de Imunoglobulinas/uso terapêutico , Masculino , Transfusão de Plaquetas , Mordeduras de Serpentes/patologia , Mordeduras de Serpentes/terapia , Trombocitopenia/patologia , Trombocitopenia/terapiaRESUMO
BACKGROUND: Epithelioid leiomyosarcoma arising from the uterine cervix is extremely rare, with only three cases reported in the world literature. We present the case report of a 14-cm epithelioid leiomyosarcoma arising from the uterine cervix. CASE: A 47-year-old female presented with a 1-year history of worsening menorrhagia and was found to have a large pelvic mass extending into and filling the upper vagina. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, revealing a 14 x 10 x 9 cm cervical epithelioid leiomyosarcoma. CONCLUSION: Although exceedingly rare, leiomyosarcoma is able to arise primarily from the uterine cervix. Given its extreme rarity, management of cervical LMS must be extrapolated from the currently accepted management for uterine LMS.