RESUMO
A case of a 32 years old woman with fever and exudative ascites is described. Tuberculous peritonitis was confirmed by abdominal laparoscopy, peritoneal biopsy and Lowënstein culture. A serum CA 125 level was 861 U/ml before therapy. The CA 125 level decreased a 30% after three weeks of antituberculous treatment. This tumor marker may be used to follow disease activity in tuberculous ascites.
Assuntos
Antituberculosos/uso terapêutico , Antígeno Ca-125/sangue , Peritonite Tuberculosa/sangue , Peritonite Tuberculosa/tratamento farmacológico , Adulto , Ascite/etiologia , Biomarcadores/sangue , Feminino , HumanosRESUMO
The mesothelioma is a rare tumor, especially in its peritoneal location (20%). Most of these cases are related to an exposition to asbestos long time age. We present a patient with long-evolution ascites and without any other clinical manifestations. The study of the ascitic fluid, the imaging techniques and the peritoneoscopy did not allow the diagnosis in the first place. Only after one year of follow-up and when the patient recalled, in a directed interrogation, her occupational contact with asbestos thirty years age, the diagnosis could be established.
Assuntos
Ascite/etiologia , Mesotelioma/complicações , Neoplasias Peritoneais/complicações , Doença Crônica , Feminino , Humanos , Mesotelioma/patologia , Pessoa de Meia-Idade , Neoplasias Peritoneais/patologiaRESUMO
OBJECTIVE: To value the effects of megestrol acetate wer the weight and the body composition (fat, lean and body water) in patients with AIDS associated cachexia, by bioelectric impedance analysis. SUBJECTS: 25 patients between 23 and 57 years of age, with confirmed HIV infection and prior weight lost of 7.96 +/- 4.6 kg in relation to their habitual weight in the previous months. All the patients were under antiretroviral therapy. METHOD: Basal determination, before the beginning of the antianorexic treatment and at the end of it, using bioelectric impedance analysis by Maltron BF 905 analyzer, calculating fat, lean and total body water in relation to weight, height, age and sex. Oral administration of 320 mg/day megestrol acetate for three consecutive months. Statistical comparation (RSIGMA and SPSS) by paired t-test of the mean weight, body mass index, fat, lean and total body water. RESULTS: During the three months treatment the mean basal body weight of the patients increased 3.54 Kg (p < 0.001) at the expense of an increase of 2.24 kg in the total body lean (p < 0.01), while the increment of the body fat (1.2 kg) was not statistically significant. The total body water increased 1.48 L (p < 0.001) and the body mass index in 1.22 kg/m2 (p < 0.001). CONCLUSION: Treatment with megestrol acetate results in a substained and very significant increase of the weight and body mass index in patients with AIDS related cachexia. This increment in weight is at the expense of body lean.