Assuntos
Aneurisma Infectado/diagnóstico , Blefaroptose/etiologia , Doenças das Artérias Carótidas/diagnóstico , Artéria Carótida Interna , Trombose do Corpo Cavernoso/diagnóstico , Aneurisma Intracraniano/diagnóstico , Infecções Estreptocócicas/diagnóstico , Adolescente , Aneurisma Infectado/complicações , Doenças das Artérias Carótidas/complicações , Trombose do Corpo Cavernoso/complicações , Humanos , Aneurisma Intracraniano/complicações , Angiografia por Ressonância Magnética , Masculino , Infecções Estreptocócicas/complicações , Streptococcus milleri (Grupo)/isolamento & purificaçãoRESUMO
In the past decade, there has been evolution in the diagnosis, management, and long-term care of patients with infective endocarditis and its complications. This includes the relatively new but contentious prophylactic antibiotic regimen. However, these cases still continue to pose a challenge in the adult and pediatric populations. We present a case of a teenager with hypertrophic cardiomyopathy that had an atypical presentation of infective endocarditis.
Assuntos
Cardiomiopatia Hipertrófica/complicações , Endocardite Bacteriana/tratamento farmacológico , Endocardite Bacteriana/etiologia , Guias de Prática Clínica como Assunto , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus gordonii/isolamento & purificação , Adolescente , American Heart Association , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Cardiomiopatia Hipertrófica/fisiopatologia , Quimioterapia Combinada , Ecocardiografia Doppler/métodos , Endocardite Bacteriana/diagnóstico por imagem , Feminino , Seguimentos , Gentamicinas/uso terapêutico , Humanos , Penicilinas/uso terapêutico , Infecções Estreptocócicas/diagnóstico , Resultado do Tratamento , Estados UnidosRESUMO
OBJECTIVE: In NOD.H2h4 mice, high dietary iodine intake has been known to cause iodine-accelerated spontaneous autoimmune thyroiditis (ISAT) via an unknown mechanism. The aim of the study was to examine whether the NOD.H2h4 genetic background predisposes to enhanced iodine organification in thyroglobulin (Tg), a target autoantigen in ISAT. DESIGN: To avoid issues associated with an ongoing anti-Tg antibody response, we assessed Tg iodination levels in iodine-fed, B-cell deficient NOD.H2h4 mice. Additionally, we tested whether humoral or cellular immune responses of iodine-fed NOD.H2h4 mice are preferentially directed to Tg with increased iodine content (I-Tg) or known pathogenic Tg peptides that contained iodine. RESULTS: The iodine content of Tg was not significantly different between control (9.0 +/- 2.7 I atoms per monomer) and iodine-fed mice (10.9 +/- 0.3 I atoms per monomer). Furthermore, in iodine-fed NOD.H2h4 mice developing ISAT, strong but equivalent serum IgG responses were detected to both Tg or I-Tg, whereas their lymphoid cells were stimulated weakly but equally well by Tg or I-Tg in vitro and did not show reactivity against a panel of five pathogenic Tg peptides that contained iodine. CONCLUSIONS: The results suggest that development of ISAT in NOD.H2h4 mice is not associated with enhanced iodine organification or differential B- or T-cell responses to iodinated determinants in Tg.