Assuntos
Infecções por Coronavirus/prevenção & controle , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Dermatoses Faciais/etiologia , Formaldeído/efeitos adversos , Máscaras/efeitos adversos , Assistentes de Enfermagem , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Betacoronavirus , COVID-19 , Feminino , Humanos , SARS-CoV-2RESUMO
Case presentation We report three cases of vitamin B12 and/or folic acid deficiencies presenting with non-immune hemolytic anemia and thrombocytopenia. This presentation, with features of a thrombotic microangiopathy (TMA), has earlier been described as 'pseudo-TMA'.
Assuntos
Deficiência de Ácido Fólico , Microangiopatias Trombóticas , Deficiência de Vitamina B 12 , Diagnóstico Diferencial , Deficiência de Ácido Fólico/complicações , Deficiência de Ácido Fólico/diagnóstico , Humanos , Microangiopatias Trombóticas/diagnóstico , Microangiopatias Trombóticas/etiologia , Vitamina B 12/uso terapêutico , Deficiência de Vitamina B 12/complicações , Deficiência de Vitamina B 12/diagnósticoRESUMO
We discuss a case of a young woman, presenting a constellation of clinical and biochemical features meeting the current case definition of multisystem inflammatory syndrome in adults (MIS-A), 18 days after receiving her first dose of the Oxford/AstraZeneca vaccine. Therapy by means of intravenous immunoglobulins was initiated, leading to clinical and biochemical recovery. Although a relationship between MIS-A and the preceding vaccination cannot be confirmed, it can also not be excluded, given the temporal association and the fact that there were no indicators of a preceding SARS-CoV-2 infection.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Síndrome de Resposta Inflamatória Sistêmica , Adulto , Vacinas contra COVID-19/efeitos adversos , Feminino , Humanos , SARS-CoV-2 , Síndrome de Resposta Inflamatória Sistêmica/induzido quimicamente , VacinaçãoRESUMO
BackgroundSystemic lupus erythematosus (SLE) is a rheumatological disorder with a heterogeneous clinical presentation and disease course. Case presentationWe report a case concerning a young woman with pleuropneumonia, non-responsive to conventional antibiotic therapy, who was, upon further inquiry and passage of time, diagnosed with SLE. Key pointsBy means of this case, we would like to emphasize the clinical implications and prognostic significance of lymphopenia in patients with SLE. Moreover, we attempt to make the reader aware of some of the protean manifestations of SLE and we would like to raise suspicion of acute lupus pneumonitis by demonstrating a case of a young female with non-resolving pneumonia.
Assuntos
Lúpus Eritematoso Sistêmico , Pneumonia , Antibacterianos/uso terapêutico , Feminino , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Pneumonia/diagnóstico , Pneumonia/etiologiaRESUMO
In this study, we investigated serum epidermal growth factor (EGF) in an oncological population of head- and neck and pulmonary neoplasms and whether serum EGF could serve as a prognostic marker of survival and as a predictive marker for treatment response to platinum-based chemotherapy. A total of 59 oncological patients and a control group of age- and sex-matched healthy volunteers were included in this study. Pre-treatment serum EGF from both groups was determined. Patient's and tumour characteristics and mortality were recorded during a 5-year follow up period. Baseline serum EGF significantly differed between the oncological patients and the healthy volunteers (p<0.001). Serum EGF was associated with lymph node metastasis (p = 0.004) but not with sex (p = 0.753), age (p = 1.00), TNM stage (p = 0.191) or tumour size (p = 0.077). Neither serum EGF (p = 0.81) nor age (p = 0.55) showed an effect on the patient's survival. Tumour location was significantly associated with overall 5-year survival (p = 0.003). The predictive capacity of serum EGF of response to chemotherapy was limited (AUC = 0.606), a sensitivity of 80% and a specificity of 56% was observed resulting in a likelihood ratio of a positive and negative test equal to 1.81 and 0.36, respectively. In conclusion, serum EGF levels are 5.5 times higher in an oncological population compared to a control group. Within the oncological population, low serum EGF values are associated with the presence of lymph node metastasis. Further investigation is necessary to determine if the serum EGF levels could serve as a diagnostic biomarker.
Assuntos
Biomarcadores Tumorais/sangue , Fator de Crescimento Epidérmico/sangue , Neoplasias de Cabeça e Pescoço/sangue , Adulto , Idoso , Antineoplásicos/uso terapêutico , Feminino , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Compostos de Platina/uso terapêutico , Análise de SobrevidaRESUMO
Head and neck neoplasms have a poor prognosis because of their late diagnosis. Finding a biomarker to detect these tumors in an early phase could improve the prognosis and survival rate. This literature review provides an overview of biomarkers, covering the different -omics fields to diagnose head and neck neoplasms in the early phase. To date, not a single biomarker, nor a panel of biomarkers for the detection of head and neck tumors has been detected with clinical applicability. Limitations for the clinical implementation of the investigated biomarkers are mainly the heterogeneity of the study groups (e.g., small population in which the biomarker was tested, and/or only including high-risk populations) and a low sensitivity and/or specificity of the biomarkers under study. Further research on biomarkers to diagnose head and neck neoplasms in an early stage, is therefore needed.