RESUMO
This report describes a 37-year-old man presenting with a gait disturbance due to spastic paraparesis. Physical findings showed typical features of Albright's hereditary osteodystrophy, including short stature, obesity, brachydactyly and dental hypoplasia. He was diagnosed as having pseudohypoparathyroidism type Ia, on the basis of his hypocalcaemia, hyperphosphataemia, increased plasma level of parathyroid hormone (PTH), and the unresponsiveness to exogenous PTH loading of his urinary excretion of both nephrogenous cyclic adenosine monophosphate and phosphate. Magnetic resonance imaging and myelographic computed tomographic scans clearly demonstrated severe compression of the spinal cord at T 9/10 by tumour-like ossifications of the paravertebral ligaments. Neurosurgical decompression therapy was, therefore, performed to alleviate his spastic paraparesis. This was a rare case of pseudohypoparathyroidism complicated with spinal cord compression caused by ectopic ossification of the ligaments.
Assuntos
Ossificação Heterotópica/complicações , Pseudo-Hipoparatireoidismo/complicações , Compressão da Medula Espinal/complicações , Adulto , Cálcio/sangue , AMP Cíclico/urina , Humanos , Imageamento por Ressonância Magnética , Masculino , Ossificação Heterotópica/diagnóstico , Paraparesia Espástica Tropical/complicações , Hormônio Paratireóideo/sangue , Fosfatos/sangue , Fosfatos/urina , Pseudo-Hipoparatireoidismo/diagnóstico , Compressão da Medula Espinal/diagnóstico , Tomografia Computadorizada por Raios XAssuntos
Contratura/etiologia , Dedos/fisiopatologia , Doenças Musculares/complicações , Sarcoidose/complicações , Contratura/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Doenças Musculares/patologia , Doenças Musculares/cirurgia , Sarcoidose/patologia , Sarcoidose/cirurgia , Resultado do TratamentoRESUMO
The synovium of three patients with chronic spontaneous hemarthrosis was examined by light and electron microscopy and roentgenographic electron microanalysis. The synovium showed hyperplastic villous processes with proliferation of synovioblasts (B cells) and synovial macrophages (A cells). Erythrophagocytosis was observed in synovial macrophages but not in synovioblasts. Synovioblasts, however, had more numerous siderosomes than did synovial macrophages. Ferritin granules were identified in the cytoplasms of synovial macrophages and synovioblasts as well as in the intercellular space. It was noted that the longer the interval following the hemorrhagic episode, the fewer the siderosomes and erythrophagosomes in synovial macrophages. Therefore, it is likely that synovioblasts take up ferritin and/or inorganic iron released from synovial macrophages in chronic local iron overload.