RESUMEN
CASE REPORT: The following case shows corneal crystal formation in a patient in whom thee systemic work-up led to the diagnosis of a monoclonal gammopathy with increased monoclonal immunoglobulin G (IgG). We present the corneal signs and subsequent haematological investigations undertaken to establish this important association. DISCUSSION: Systemic work-up of a patient with corneal deposits showed a monoclonal gammopathy with increased monoclonal immunoglobulin (IgG-type kappa). Corneal crystals, a rare, but significant, clinical finding, may be the initial presentation in a patient with monoclonal gammopathy.
Asunto(s)
Opacidad de la Córnea/diagnóstico , Cadenas kappa de Inmunoglobulina/análisis , Paraproteinemias/complicaciones , Paraproteínas/análisis , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Proteína de Bence Jones/orina , Terapia Combinada , Opacidad de la Córnea/etiología , Opacidad de la Córnea/patología , Cristalización , Ciclofosfamida/administración & dosificación , Diagnóstico Diferencial , Trasplante de Células Madre Hematopoyéticas , Humanos , Fallo Renal Crónico/etiología , Lenalidomida , Masculino , Melfalán/administración & dosificación , Persona de Mediana Edad , Paraproteinemias/diagnóstico , Paraproteinemias/terapia , Paraproteinemias/orina , Facoemulsificación , Complicaciones Posoperatorias/diagnóstico , Prednisona/administración & dosificación , Lámpara de Hendidura , Talidomida/administración & dosificación , Talidomida/análogos & derivadosRESUMEN
PURPOSE: To analyse and provide the tools to answer three questions that must be asked about a clinical trial on treatments: evaluation of validity (internal validity, so that results are not biased); clinical importance of these results and their application to individual patients. We provide simple statistics tools, clinical trial design, and clinical epidemiology for the evaluation and analysis of clinical trials on treatments. METHODS: Review of the medical literature. RESULTS: For the evaluation of papers on treatment and for using a treatment efficiently, we need to know if the clinical trials that support it are trustworthy, if the treatment has clinical importance and if it can be applied to my patients. CONCLUSIONS: It is of paramount importance to check that the sample of the clinical assay has been correctly randomized, because randomization is necessary to comply with mathematical laws of application of statistical tests. Follow-up of patients must be complete in order to measure precision of results and evaluate the efficacy of treatment.