Assuntos
Doença Celíaca/complicações , Histiocitose de Células não Langerhans/complicações , Síndromes Paraneoplásicas/complicações , Adenocarcinoma/complicações , Idoso , Doença Celíaca/diagnóstico , Doença Celíaca/terapia , Feminino , Histiocitose de Células não Langerhans/diagnóstico , Histiocitose de Células não Langerhans/terapia , Humanos , Neoplasias Ovarianas/complicações , Síndromes Paraneoplásicas/diagnóstico , Síndromes Paraneoplásicas/terapia , Resultado do TratamentoRESUMO
INTRODUCTION: Motor neuron diseases are always lethal. Other curable causes of neurologic disorders have to be sought. We report an example. EXEGESIS: A 72-year-old man presented a distal weakness and atrophy of the upper extremities. Electromyography showed thenar and hypothenar denervation, without fasciculation. Hypercalcemia led to the discovery of a primary hyperparathyroidism. Five months after parathyroid surgery, there was no worsening. CONCLUSION: Von Recklinghausen and Vical were the first to describe neuromuscular involvement in primary hyperparathyroidism. Faced with symptoms mimicking motor neuron diseases, calcium and phosphorus levels have to be measured because hyperparathyroidism can be cured and neurologic disorders disappear after surgery.
Assuntos
Esclerose Lateral Amiotrófica/diagnóstico , Hiperparatireoidismo/diagnóstico , Adenoma/diagnóstico , Adenoma/cirurgia , Idoso , Cálcio/sangue , Diagnóstico Diferencial , Eletromiografia , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/etiologia , Hiperparatireoidismo/sangue , Hiperparatireoidismo/etiologia , Masculino , Neoplasias das Paratireoides/diagnóstico , Neoplasias das Paratireoides/cirurgia , Paratireoidectomia , Fósforo/sangueRESUMO
A testicular tumour could be diagnosed by the occurrence of a Raynaud's phenomenon complicated by severe digital arteritis. The arteritis rapidly regressed under prostacyclin therapy. Such vascular manifestations are frequent in testicular carcinoma, but they usually develop after chemotherapy. To our knowledge, this is the first case where they preceded the diagnosis and specific treatment of a tumour of the testis.
Assuntos
Disgerminoma/complicações , Epoprostenol/uso terapêutico , Doença de Raynaud/etiologia , Neoplasias Testiculares/complicações , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Disgerminoma/tratamento farmacológico , Disgerminoma/cirurgia , Epoprostenol/administração & dosagem , Humanos , Infusões Intravenosas , Masculino , Necrose , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Doença de Raynaud/tratamento farmacológico , Neoplasias Testiculares/tratamento farmacológico , Neoplasias Testiculares/cirurgiaRESUMO
Mycosis fungoides was observed in a 71-year-old male with Mediterranean lymphoma, a B-cell malignancy. It is proposed that this association is not incidental since hypergammaglobulinaemia and even monoclonal gammopathies have repeatedly been described in cutaneous T-cell lymphomas. Mediterranean lymphoma might have resulted from (a) helper cell activities of tumor T-lymphocytes, (b) common antigenic stimuli, or (c) deranged T-B cooperation due to concomitant mycosis fungoides.