Assuntos
Anticorpos Monoclonais/uso terapêutico , Antígenos CD20/imunologia , Linfócitos B/imunologia , Infecções por Vírus Epstein-Barr/complicações , Leucemia-Linfoma de Células T do Adulto/terapia , Transtornos Linfoproliferativos/terapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Adolescente , Feminino , HumanosRESUMO
BACKGROUND: Severe central nervous system diseases, such as encephalitis, have been reported in association with Mycoplasma pneumoniae infections. CASE REPORT: After an ENT infection, a 9-year-old boy with Down's syndrome developed encephalitis revealed by an acute alteration in consciousness. Head computed tomography showed, after 2 weeks, an infiltration in the basal ganglia region. The diagnosis of Mycoplasma pneumoniae encephalitis was made; recovery was complete in a few weeks. CONCLUSION: Mycoplasma pneumoniae infection should be considered in all cases of acute encephalopathy; yet the pathogenesis of the disorder is unknown and the treatment uncertain.
Assuntos
Meningoencefalite/diagnóstico , Meningoencefalite/microbiologia , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/microbiologia , Mycoplasma pneumoniae , Doença Aguda , Criança , Coma/microbiologia , Diagnóstico Diferencial , Síndrome de Down/complicações , Humanos , Masculino , Prognóstico , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Sinus histiocytosis with massive cervical lymphadenopathy (Rosai-Dorfman disease) is a non-neoplastic lymphoproliferative disorder. Extranodal involvement, especially of the nervous system, is unusual. We report a case revealed by neurological symptoms. CASE REPORT: A 10-year-old girl presented with paraparesis due to a dural extramedullary mass on magnetic resonance imaging. Massive cervical lymphadenopathy appeared secondarily. Radiological investigations showed mediastinal, paranasal sinus and lower eyelid involvement. The diagnosis of Rosai-Dorfman disease was established histologically and by immunohistochemical studies of nodal lesions by the demonstration of characteristic sinus histiocytosis with sheets of S-100 protein and CD-68 positive large histiocytes displaying lymphocyte phagocytosis. A dramatic response occurred with complete resolution of all clinical findings after treatment with corticosteroids and etoposide, although neurological lesions were unchanged on magnetic resonance imaging. CONCLUSION: Despite its rarity, this case underlines the unknown pathogenesis of this disease (immune dysfunction?) and the difficulties of treatment (choice of chemotherapeutic agents, duration).
Assuntos
Histiocitose Sinusal/diagnóstico , Paraplegia/etiologia , Corticosteroides/uso terapêutico , Criança , Dura-Máter , Etoposídeo/uso terapêutico , Feminino , Histiocitose Sinusal/complicações , Histiocitose Sinusal/tratamento farmacológico , Humanos , Imageamento por Ressonância Magnética , Inibidores da Síntese de Ácido Nucleico/uso terapêutico , Paraplegia/diagnóstico , Doenças da Medula Espinal/diagnóstico , Doenças da Medula Espinal/etiologiaRESUMO
We report a case of congenital cervical rhabdoid tumor with association of a medulloblastoma in a brother. The immunohistochemical features of this tumor are compatible with a neuroectodermal differentiation (MIC 2+, Leu 7+). Extrarenal rhabdoid tumors share a common morphology but do not represent a single entity with only one histogenesis. Most of them are now considered to be of neuroectodermal origin. In our case, the association with a medulloblastoma in a brother seems to confirm this concept.