RESUMO
CASE REPORT: The case is presented of a young man with an atypical haemolytic-uraemic syndrome (aHUS), complicated with bilateral serous retinal detachment, cotton wool spots, and a branch artery occlusion. Treatment with plasmapheresis, haemodialysis and systemic eculizumab led to the blood and urine parameters returning to normal, as well as resolution of the retinal anomalies. Genetic analysis show both mutations in complement factor H and C3. DISCUSSION: Haemolytic-uraemic syndrome (HUS) is a thrombotic microangiopathy characterised by microangiopathic haemolytic anaemia, thrombocytopenia, and acute renal failure. Atypical HUS is caused by genetic mutation of complement system. Ocular involvement is an unusual manifestation of this rare syndrome.
Assuntos
Síndrome Hemolítico-Urêmica Atípica/complicações , Oftalmopatias/etiologia , Adulto , Oftalmopatias/diagnóstico por imagem , Humanos , MasculinoAssuntos
Óculos , Medicina nas Artes , Pinturas/história , Óculos/história , História do Século XVII , Espanha , SimbolismoAssuntos
Cegueira , Manuscritos como Assunto/história , Medicina nas Artes , Punição/história , História Medieval , Humanos , EspanhaAssuntos
Cegueira , Drama , Oftalmopatias , Literatura Moderna , Medicina na Literatura , História do Século XIX , EspanhaRESUMO
PURPOSE: To determine, by means of immunohistochemistry, tumoral expression of collagenase-3, a matrix metalloproteinase linked to cancer and to basal cell and squamous cell carcinomas of the eyelid. MATERIAL AND METHOD: Retrospective review of 23 basal cell carcinomas and 25 squamous cell carcinomas of the eyelid treated at different hospitals during the last five years. We evaluated collagenase-3 expression and the possible relationship to patient and tumour characteristics which included age, sex, histological type, tumour location and surgical margins status. RESULTS: 65% of the basal cell carcinomas and 88% of the squamous cell carcinomas of the eyelids stained positively for collagenase-3. In both cases, the immunostaining was localized in the cytoplasm of the malignant cells and, occasionally in the surrounding stromal cells. CONCLUSIONS: Statistical analysis showed no significant association between collagenase-3 immunostaining and patients or tumour characteristics but the expression of this protein was more intense in the epithelial tumoral cells located at the invading front which could explain the aggressive behaviour of this kind of tumours.
Assuntos
Carcinoma Basocelular/enzimologia , Carcinoma de Células Escamosas/enzimologia , Colagenases/biossíntese , Neoplasias Palpebrais/enzimologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/patologia , Neoplasias Palpebrais/patologia , Feminino , Humanos , Masculino , Metaloproteinase 13 da Matriz , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
CASE REPORT: A young female patient with systemic lupus erithematosus, inactive for a long period, is described. She develops bilateral serous detachments of the retinal pigment epithelium and neurosensory retina after corticosteroid therapy for a residual nephritis. DISCUSSION: This unusual chorioretinopathy has been reported in association with systemic lupus erithematosus and during corticosteroid therapy in many disorders. This patient, with low activity erithematosus lupus, develops serous retinal detachments after receiving corticosteroid therapy that damage the coriocapillary-pigment epithelium barrier, disordered in lupus patients.