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1.
Intern Med ; 62(15): 2273-2277, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37532515

RESUMO

Generalized subcutaneous edema is rare in dermatomyositis. We herein report an 82-year-old woman with dermatomyositis who presented with generalized subcutaneous edema. Three weeks before admission, she first noticed facial edema, and the symptoms exacerbated, with limb edema occurring. On admission, muscle weakness in the limbs and skin rash were noted. Her muscle enzyme levels were elevated, and serum anti-transcriptional intermediary factor 1-γ antibody was detected. She was diagnosed with dermatomyositis and treated with corticosteroids and tacrolimus, which improved her muscle weakness, muscle enzymes, and edema. Thus, generalized subcutaneous edema can occur during dermatomyositis, with facial edema as the initial symptom.


Assuntos
Angioedema , Dermatomiosite , Exantema , Feminino , Humanos , Idoso de 80 Anos ou mais , Dermatomiosite/complicações , Dermatomiosite/diagnóstico , Dermatomiosite/tratamento farmacológico , Edema/etiologia , Edema/diagnóstico , Debilidade Muscular
2.
4.
Int J Infect Dis ; 98: 297-298, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32562847

RESUMO

Adenosine deaminase (ADA) in cerebrospinal fluid (CSF) is considered to be a useful biomarker in differentiating tuberculous meningitis (TBM) from other meningitis in non-HIV patients. However, its specificity decreases in patients with HIV, and other diseases such as cytomegalovirus encephalitis, toxoplasmosis or meningeal lymphomatosis can also elevate ADA in CSF. We here report a rare case of retroviral rebound syndrome in a HIV patient, whose ADA in CSF was elevated.


Assuntos
Adenosina Desaminase/líquido cefalorraquidiano , Infecções por HIV/complicações , Tuberculose Meníngea/diagnóstico , Tuberculose Meníngea/enzimologia , Adulto , Biomarcadores/líquido cefalorraquidiano , Infecções por HIV/líquido cefalorraquidiano , Humanos , Masculino , Tuberculose Meníngea/líquido cefalorraquidiano , Tuberculose Meníngea/etiologia
5.
Am J Trop Med Hyg ; 100(3): 700-702, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30675838

RESUMO

Praziquantel is widely used for treating parasitic infections globally, especially in countries with endemic schistosomiasis. However, severe hypersensitivity to praziquantel has rarely been reported. We report the case of a 30-year-old Japanese man who developed acute generalized exanthematous pustulosis (AGEP), which is a rare and severe cutaneous reaction usually triggered by drugs, after taking praziquantel. During medical examination, eggs of Diphyllobothrium nihonkaiense were found in his stool. He took praziquantel 600 mg for 1 day and developed skin rashes and fever the next day. Pruritic generalized maculopapular erythematous eruptions were observed over the entire body. He had elevated white blood cell count, liver enzymes, and C-reactive protein level. We prescribed acetaminophen, fexofenadine hydrochloride, loxoprofen sodium, and topical ointments including difluprednate and hydrocortisone. Over the next 3 days, he developed pinhead-sized, non-follicular pustules on his diffusely erythematous skin. Histological findings of the pustular lesion showed spongiform subcorneal pustules with perivascular inflammatory cells. Approximately 8 days after taking praziquantel, the pustules resolved with desquamation. He became afebrile on day 9 and his laboratory parameters returned to normal levels on day 16. He was diagnosed with AGEP caused by praziquantel. Physicians need to be aware that praziquantel could cause AGEP, although it is generally considered a safe drug.


Assuntos
Pustulose Exantematosa Aguda Generalizada/patologia , Anti-Helmínticos/efeitos adversos , Praziquantel/efeitos adversos , Pustulose Exantematosa Aguda Generalizada/tratamento farmacológico , Adulto , Animais , Anti-Helmínticos/uso terapêutico , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Difilobotríase/tratamento farmacológico , Diphyllobothrium/isolamento & purificação , Fezes/parasitologia , Humanos , Masculino , Praziquantel/uso terapêutico
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