RESUMO
Pulmonary arterial hypertension (PAH) and cor pulmonale were found in a patient with paroxysmal nocturnal hemoglobinuria (PNH). Autopsy revealed widespread thromboses in pulmonary microvasculature. Vascular thromboses attributed to hypercoagulability have been found in PNH in many organs, including the lungs. PAH has not been reported, however. This disease should then be considered a rare cause of PAH.
Assuntos
Hemoglobinúria Paroxística/complicações , Hipertensão Pulmonar/etiologia , Doença Crônica , Feminino , Hemoglobinúria Paroxística/diagnóstico , Hemoglobinúria Paroxística/patologia , Humanos , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/patologia , Pessoa de Meia-Idade , Artéria Pulmonar/patologia , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiologia , Embolia Pulmonar/patologiaRESUMO
The reactive hemophagocytic syndrome is a condition characterized by systemic proliferation of benign hemophagocytic histiocytes, fever, cytopenia, abnormal liver function, and frequently coagulopathy and hepatosplenomegaly. Its occurrence has been documented in association with viral, bacterial, fungal and parasitic infections; a wide spectrum of malignant neoplasms; some miscellaneous disorders; and phenytoin. Disseminated strongyloidiasis is reported in a patients with systemic lupus erythematosus treated with corticosteroids in whom a reactive hemophagocytic syndrome developed and who finally died. This reactive hemophagocytic syndrome is reported for the first time in strongyloidiasis and may not have been recognized in former patients.
Assuntos
Histiocitose de Células não Langerhans/etiologia , Estrongiloidíase/complicações , Adulto , Feminino , Histiocitose de Células não Langerhans/patologia , Humanos , Lúpus Eritematoso Sistêmico/complicações , Linfonodos/patologia , Estrongiloidíase/parasitologiaRESUMO
Acute mitral insufficiency, originated from rupture of mitral chordae tendineae secondary to nonpenetrating thoracic trauma, is an unusual condition. This diagnosis is difficult to establish because physical examination, electrocardiogram, and cardiac enzymes are neither sensitive nor specific. The diagnosis of rupture must be quickly established because this disorder may be fatal. This paper reports the case of a patient with acute mitral insufficiency secondary to a mitral valve chord rupture a week after a nonpenetrating thoracic trauma.
Assuntos
Cordas Tendinosas/lesões , Insuficiência da Valva Mitral/etiologia , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicações , Adulto , Cordas Tendinosas/diagnóstico por imagem , Cordas Tendinosas/cirurgia , Ecocardiografia Doppler , Ecocardiografia Transesofagiana , Eletrocardiografia , Seguimentos , Humanos , Masculino , Insuficiência da Valva Mitral/diagnóstico , Insuficiência da Valva Mitral/cirurgia , Ruptura , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/cirurgia , Ferimentos não Penetrantes/diagnóstico , Ferimentos não Penetrantes/cirurgiaRESUMO
The transjugular intrahepatic protosystemic shunt (TIPS) is a nonsurgical method with low mortality which does not interfere with subsequent liver transplantation. We describe the case of an old male patient with chronic hepatopathy who was admitted because of an episode of variceal bleeding. Due to the failure of the medical treatment and sclerotherapy, coronarian stomachic vein was embolized with a coil and a TIPS was performed during the acute episode of variceal bleeding. He evolved favorably and after a year of the procedure remains asymptomatic.
Assuntos
Varizes Esofágicas e Gástricas/cirurgia , Hemorragia Gastrointestinal/cirurgia , Hipertensão Portal/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Varizes Esofágicas e Gástricas/complicações , Hemorragia Gastrointestinal/complicações , Humanos , Hipertensão Portal/complicações , MasculinoRESUMO
Antiphospholipid syndrome is characterized by recurrent fetal loss, arterial and venous thromboses, thrombocytopenia and circulating antiphospholipid antibodies. Few patients have a rapidly progressive, fatal outcome. We report two young patients with systemic lupus erythematosus and antiphospholipid antibodies who died after a short course of disease. Although clinical and laboratory findings differed in both patients--small vessel thromboses and microangiopathic hemolytic anemia mimicking thrombotic thrombocytopenic purpura predominated in one of the patients while small and medium size vessel thromboses without hemolysis were present in the other case--autopsy revealed widespread visceral thromboses in both of them, features consistent with a diagnosis of catastrophic antiphospholipid syndrome. This syndrome has not been reported to occur in association with Pneumocistis carinii pneumonia as we describe in one of our patients.