RESUMEN
We describe the case of a 62-year-old woman who presented with insidious onset and slowly progressive neurological complaints. This case illustrates the diagnostic challenges clinicians face because the lack of specific symptomatology and numerous complementary exams. The broad differential diagnosis of this disease requires a diagnostic strategy to be developed. Clinical reasoning is based on clinical, biological and radiological information and highlights the importance of an interdisciplinary approach to patient care.
Nous décrivons le cas clinique d'une patiente de 62 ans se présentant avec des symptômes neurologiques d'apparition progressive et lentement évolutifs. Ce cas illustre un défi diagnostique étant donné l'absence de spécificité des symptômes et des divers examens complémentaires à disposition. Le large diagnostic différentiel de cette affection requiert une stratégie diagnostique élaborée. Le raisonnement clinique se fonde sur des informations cliniques, biologiques et radiologiques et nécessite une approche multidisciplinaire pour finalement accéder au diagnostic.
Asunto(s)
Meningitis , Diagnóstico Diferencial , Femenino , Humanos , Meningitis/diagnóstico , Meningitis/etiología , Persona de Mediana EdadRESUMEN
We describe a patient with interstitial granuloma annulare associated with subcutaneous injection therapy (SIT) for desensitization to a type I allergy. Asymptomatic, erythematous, violaceous annular patches were located at the injection sites on both her arms. Medical history revealed perennial rhinoconjonctivitis treated with SIT (Phostal Stallergen® cat 100% and D. pteronyssinus/D.farinae 50%:50%).
Asunto(s)
Alérgenos/efectos adversos , Conjuntivitis Alérgica/terapia , Desensibilización Inmunológica/efectos adversos , Granuloma Anular/etiología , Rinitis Alérgica Perenne/terapia , Adulto , Alérgenos/administración & dosificación , Alérgenos/uso terapéutico , Animales , Antígenos Dermatofagoides/administración & dosificación , Antígenos Dermatofagoides/efectos adversos , Antígenos Dermatofagoides/uso terapéutico , Gatos , Erupciones por Medicamentos/diagnóstico , Eosinófilos/patología , Eritema Crónico Migrans/diagnóstico , Femenino , Granuloma Anular/diagnóstico , Humanos , Inyecciones SubcutáneasRESUMEN
Although most delayed drug hypersensitivity reactions are mild and show rapid improvement after drug discontinuation, there are severe systemic and/or cutaneous drug reactions which may be life-threatening. These entities are discussed here, namely DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms), acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson syndrome and toxic epidermal necrolysis (TEN). Early detection of warning signs and symptoms may help to take appropriate measures precociously.