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1.
Neurol Sci ; 43(8): 4841-4845, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35482157

RESUMO

BACKGROUND: Autoimmune autonomic ganglionopathy is a rare, immune-mediated disorder associated with anti-ganglionic α3-subunit nicotinic acetylcholine receptor (anti-α3gAChR) antibodies, which bind to acetylcholine receptor in autonomic ganglia (parasympathetic and sympathetic) leading to autonomic failure. This disorder is mostly associated with viral infections, but it can also be associated with systemic malignancies. Here, we report the case of a paraneoplastic autonomic ganglionopathy as the first symptom of bladder cancer. METHOD: Case report. RESULTS: A 47-year-old man, without medical history of interest, stated to the emergency department for progressive blurry vision with eye and mouth dryness, constipation, and dizziness upon standing for the last 2 weeks. Orthostatic hypotension was demonstrated by a drop in 13.3 mmHg mean blood pressure (BP) from supine (100/60 mmHg) to 45° reclining sitting position (80/50 mmHg). Blood tests, chest X-ray, brain MRI, and electroneuronography were unremarkable. Electrochemical skin conductance was reduced. Serological examination was positive for anti-α3gAChR antibodies. A full-body CT scan revealed a bladder tumor, which was treated by transurethral bladder resection. The pathologic study demonstrated a low-grade non-muscle-invasive bladder urothelial carcinoma. After tumor resection, and treatment with intravenous immunoglobulins and corticoids, a gradually improvement was observed. Today, the patient remains asymptomatic. CONCLUSION: Subacute panautonomic failure can be the first symptom for systemic malignancies. This case reports a paraneoplastic autonomic ganglionopathy as the first symptom of bladder cancer. This case highlights the importance of a systemic study to rule out the presence of cancer when autoimmune autonomic ganglionopathy is present.


Assuntos
Doenças Autoimunes do Sistema Nervoso , Doenças Autoimunes , Doenças do Sistema Nervoso Autônomo , Carcinoma de Células de Transição , Doenças do Sistema Nervoso Periférico , Neoplasias da Bexiga Urinária , Autoanticorpos , Doenças Autoimunes/complicações , Doenças Autoimunes/patologia , Doenças Autoimunes do Sistema Nervoso/complicações , Doenças Autoimunes do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso Autônomo/complicações , Doenças do Sistema Nervoso Autônomo/etiologia , Carcinoma de Células de Transição/complicações , Carcinoma de Células de Transição/patologia , Gânglios Autônomos/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso Periférico/complicações , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/patologia
2.
Actas Esp Psiquiatr ; 50(2): 125-0, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35312999

RESUMO

Cerebellar cognitive affective syndrome (CCAS) is characterized by alterations at the cognitive level (dysexecutive syndrome, visuospatial deficit, language ...), associated with affective / emotional changes.


Assuntos
Doenças Cerebelares , Transtornos Cognitivos , Doenças Cerebelares/complicações , Doenças Cerebelares/psicologia , Cognição , Transtornos Cognitivos/complicações , Humanos , Idioma , Serotonina
3.
BMJ Open ; 9(6): e025574, 2019 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-31221869

RESUMO

OBJECTIVES: To analyse the association between aminosalicylate-treated inflammatory bowel disease (IBD) and Parkinson's disease (PD) at population level. DESIGN: Cross-sectional study. SETTING: The study was performed based on electronic drug prescription and dispensation records of the Andalusian Public Health System. PARTICIPANTS: All individuals aged ≥50 years with at least one drug dispensation during December 2014 were identified from the records. PRIMARY AND SECONDARY OUTCOME MEASURES: Groups were formed: 'possible PD' group, including all who received an anti-Parkinson agent; 'possible IBD' group, those treated with mesalazine and/or derivatives (5-aminosalicylic acid (5-ASA)); and 'possible PD and IBD', including those receiving both anti-Parkinson agent and 5-ASA. Prevalence of possible PD was determined among those with possible IBD and among those without this condition. The age-adjusted and sex-adjusted OR was calculated. RESULTS: We recorded 2 020 868 individuals (68±11 years, 56% female), 19 966 were included in possible PD group (75±9 years, 53% female) and 7485 in possible IBD group (64±10 years, 47% female); only 56 were included in both groups (76±8 years, 32% female). The prevalence of possible PD was 0.7% among those with possible IBD and 1% among those without this condition (adjusted OR=0.94; 95% CI 0.72 to 1.23; p=0.657). OR was 0.28 in individuals aged ≤65 years (95% CI 0.10 to 0.74; p=0.01) and 1.17 in older individuals (95% CI 0.89 to 1.54; p=0.257). CONCLUSIONS: Within the limitations of this study, the results suggest a protective role for IBD and/or 5-ASA against PD development, especially among under 65-year olds. Further studies are warranted to explore this association given its scientific and therapeutic implications.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Doenças Inflamatórias Intestinais/tratamento farmacológico , Mesalamina/uso terapêutico , Doença de Parkinson/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Proteção , Fatores de Risco , Distribuição por Sexo , Espanha/epidemiologia
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