RESUMO
Buckling of the brachiocephalic artery is an important cause of unusual chest x-ray findings which resemble those of a mediastinal tumor. The possibility of a vascular anomaly should be kept in mind whenever a chest x-ray demonstrates an abnormal mediastinal opacity, especially in elderly female patients with hypertension.
RESUMO
Subepithelial haemorrhage of the renal pelvis is a rare cause of haematuria and can be diagnosed based on radiographic findings. This haemorrhage often appears as a non-enhancing hyperdense mass in the renal pelvis on computed tomography, which sometimes results in unnecessary nephrectomy because it can mimic renal neoplasms. It can be managed conservatively, and its prognosis is generally benign. We report a case of renal pelvic haemorrhage complicating emphysematous pyelonephritis that needed emergent nephrectomy. Our case highlights the importance of careful observation for complications of urinary tract infection, although complications are rare. LEARNING POINTS: Renal pelvic haemorrhage is an uncommon cause of haematuria. It can mimic renal neoplasms, which sometimes results in unnecessary nephrectomy.Although the prognosis of renal pelvic haemorrhage is generally benign, careful observation for complications of urinary tract infection is important.
Assuntos
Antirreumáticos , Artrite Reumatoide , Tuberculose Miliar , Humanos , Tuberculose Miliar/diagnóstico , Tuberculose Miliar/tratamento farmacológico , Tuberculose Miliar/patologia , Fator de Necrose Tumoral alfa , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Infliximab/efeitos adversos , Fatores Imunológicos/uso terapêutico , Antirreumáticos/efeitos adversosRESUMO
Schnitzler syndrome (SchS) is a rare, acquired, autoinflammatory disease that is sometimes associated with a fever of unknown origin (FUO). Elevated alkaline phosphatase (ALP) stemming from abnormal bone remodeling is a characteristic laboratory finding of SchS and is included in the diagnostic criteria. However, its utility as a clue to the diagnosis of SchS has been under-emphasized. We herein report a case of SchS presenting with a FUO and highly elevated ALP concentration, which led to repeated, unnecessary liver biopsies.
Assuntos
Febre de Causa Desconhecida , Síndrome de Schnitzler , Humanos , Síndrome de Schnitzler/complicações , Síndrome de Schnitzler/diagnóstico , Síndrome de Schnitzler/tratamento farmacológico , Febre de Causa Desconhecida/diagnóstico , Febre de Causa Desconhecida/etiologia , Fosfatase AlcalinaAssuntos
Amiloidose , Insulina , Humanos , Insulina/uso terapêutico , Amiloidose/diagnóstico , HipoglicemiantesRESUMO
A 49-year-old man presented with gradually progressive aphasia one month after being diagnosed with acquired immunodeficiency syndrome (AIDS). Brain magnetic resonance imaging showed multiple brain lesions with punctate and linear enhancement. A polymerase chain reaction detected Epstein-Barr virus (EBV) in the patient's cerebrospinal fluid. A diagnosis of isolated central nervous system lymphomatoid granulomatosis (CNS-LYG) was made based on the brain biopsy findings. The complete remission of CNS-LYG was achieved by anti-retroviral therapy (ART) alone. In the present case, the development of AIDS-associated CNS-LYG was considered to have been initiated by the reactivation of EBV in the CNS under immunosuppressive conditions. The patient's condition improved with the reconstitution of the patient's immune system.