RESUMEN
Pachydermoperiostosis or the Touraine-Soulente-Golé syndrome is a rare monogenetic disorder characterized by pachydermia, periostosis and digital clubbing accounts for approximately 3â¼5% of all patients with hypertrophic osteoarthropathy. Missense mutations in SLCO2A1 and HPGD genes could plausibly underlie the pathogenesis of pachydermoperiostosis. Patients have usually a favorable outcome with very few cases associated with cancer. Herein, we report the first case of a patient with pachydermoperiostosis associated with bladder cancer.
Asunto(s)
Osteoartropatía Hipertrófica Primaria/complicaciones , Neoplasias de la Vejiga Urinaria/complicaciones , Adulto , Humanos , Masculino , Osteoartropatía Hipertrófica Primaria/diagnóstico por imagen , RadiografíaAsunto(s)
Cardiopatías/etiología , Lupus Eritematoso Sistémico/complicaciones , Femenino , Humanos , MasculinoAsunto(s)
Lupus Eritematoso Sistémico/complicaciones , Peritonitis/etiología , Adulto , Ascitis/etiología , Quimioterapia Combinada , Femenino , Humanos , Inmunosupresores/uso terapéutico , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Peritonitis/diagnóstico , Peritonitis/tratamiento farmacológico , Recurrencia , Inducción de Remisión , Factores de Riesgo , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Fármacos Gastrointestinales/uso terapéutico , Hemorragia Gastrointestinal/etiología , Octreótido/uso terapéutico , Enfermedad de von Willebrand Tipo 2/tratamiento farmacológico , Anciano , Angiodisplasia/diagnóstico , Estenosis de la Válvula Aórtica/diagnóstico , Hemorragia Gastrointestinal/tratamiento farmacológico , Humanos , Masculino , Síndrome , Enfermedad de von Willebrand Tipo 2/diagnósticoAsunto(s)
Cardiomegalia/diagnóstico por imagen , Aneurisma Coronario/etiología , Lupus Eritematoso Sistémico/complicaciones , Tuberculosis Pulmonar/complicaciones , Adulto , Factores de Confusión Epidemiológicos , Aneurisma Coronario/diagnóstico , Aneurisma Coronario/diagnóstico por imagen , Angiografía Coronaria , Diagnóstico Diferencial , Ecocardiografía , Femenino , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/terapia , Humanos , Pulmón/diagnóstico por imagen , Pulmón/patología , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/terapiaRESUMEN
A 71-year-old woman on warfarin (2.5 mg daily) developed severe low back pain with reduced touch sensation and weakness of the lower limbs that progressed to complete paralysis within 28 to 30 hours. Imaging revealed bleeding at the D4 through D11 level, however the patient refused emergency laminectomy. No recovery was observed and the patient was discharged to a rehabilitation facility. Only few other cases of hematomyelia linked to anticoagulant therapy have been reported. Early diagnosis, appropriate management and immediate intervention are needed to prevent irreversible neurological sequelae. The elusive clinical features at presentation may cause an important diagnostic delay.
Asunto(s)
Anticoagulantes/efectos adversos , Diagnóstico Tardío , Parálisis/etiología , Enfermedades Vasculares de la Médula Espinal/inducido químicamente , Enfermedades Vasculares de la Médula Espinal/diagnóstico , Warfarina/efectos adversos , Anciano , Antifibrinolíticos/uso terapéutico , Femenino , Humanos , Dolor de la Región Lumbar/etiología , Parálisis/rehabilitación , Plasma , Enfermedades Vasculares de la Médula Espinal/complicaciones , Vitamina K/uso terapéuticoRESUMEN
INTRODUCTION: This article deals with the description and diagnosis of a new nosographic syndrome, which received the eponym of "Cugini's syndrome" by the name of the Author who discovered its clinical picture. This syndrome is characterized by the binomial: "minimal target organ damage associated to monitoring prehypertension". CLINICAL HISTORY AND DIAGNOSIS: Between the years 1997 and 2002, the Author published a series of investigations regarding some office normotensives who inexplicably showed incipient signs of target organ damage (TOD). Investigated via ambulatory (A) blood (B) pressure (P) monitoring (M), these subjects were surprisingly found not to be hypertensive. Neverthless, the office normotensives with TOD exibited the daily mean level of their systolic (S) and diastolic (D) BP (DMLSBP/DBP) significantly more elevated as compared to true normotensives. Because of these ABPM findings, the Author realized that the investigated subjects were false normotensives whose TOD was associated with a monitoring prehypertension (ABPM-diagnosable prehypertension alias monitoring prehypertension alias masked prehypertension). The year after the last Cugini's investigation, the INC-7 Reports introduced the term: "prehypertension" in its classification of arterial hypertension, as an office sphygmomanometric condition in between office normotension and office hypertension. The ABPM cut-off upper limits for a differential diagnosis between monitoring normotension, prehypertension and hypertension are reported, as calculated by the Author in its collection of ABPMs. The eponym of "Cugini's syndrome" was assigned in 2007 and confirmed in 2009. CONCLUSIVE REMARKS: The monitoring prehypertension is a further condition of discrepancy between office sphygmomanometry and ABPM, as per a masked prehypertension, whose diagnosis has to be immediately diagnosed, for preventing the onset of a TOD. There are reported the present investigations dealing with the possible need for an early antihypertensive treatment of prehypertension. A pharmacological treatment seems to be especially justified in the presence of a Cugini's syndrome.
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Hipertensión/diagnóstico , Hipertensión/historia , Monitoreo Ambulatorio de la Presión Arterial , Historia del Siglo XX , Humanos , Hipertensión/terapia , ItaliaRESUMEN
INTRODUCTION: Proton pump inhibitors (PPIs) have been linked to clinically symptomatic hypomagnesemia. AREAS COVERED: We searched Medline database in all languages using 'proton-pump inhibitors, magnesium, hypomagnesemia and hypomagnesemic hypoparathyroidism' as search terms and other articles were identified through searches of the files of the authors and reference lists from relevant articles. All patients presented with hypomagnesemic hypoparathyroidism, however, they rarely had life-threatening conditions such as malignant ventricular arrhythmias associated with prolonged QT interval, tetany and generalized seizures. Hypomagnesemia was seen with different PPIs, which could suggest a class effect, and was refractory to Mg replacement until PPIs were stopped. Hypomagnesemia may recur after re-challenge with the same or a different PPI and is not clearly dose-related. Mechanisms are poorly understood but PPI-induced hypochlorhydria does not seem involved. Carriers of TRPM6/7 mutations could be at risk. EXPERT OPINION: Although mechanism and incidence rate remain unclear, there seems little doubt that PPIs may cause hypomagnesemia. We should obtain blood Mg levels prior to initiation of PPIs when patients are expected to be on treatment for long period of time and in those with other potential causes of hypomagnesemia. Use of H2-blockers may be an appropriate alternative.
Asunto(s)
Hipercalciuria/inducido químicamente , Deficiencia de Magnesio/inducido químicamente , Nefrocalcinosis/inducido químicamente , Inhibidores de la Bomba de Protones/efectos adversos , Inhibidores de la Bomba de Protones/uso terapéutico , Defectos Congénitos del Transporte Tubular Renal/inducido químicamente , Humanos , Hipercalciuria/sangre , Magnesio/sangre , Deficiencia de Magnesio/sangre , Nefrocalcinosis/sangre , Defectos Congénitos del Transporte Tubular Renal/sangreAsunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Erupciones por Medicamentos/etiología , Eosinofilia/inducido químicamente , Espondiloartritis/tratamiento farmacológico , Sulfasalazina/efectos adversos , Erupciones por Medicamentos/diagnóstico , Eosinofilia/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Índice de Severidad de la EnfermedadAsunto(s)
Ácidos Heptanoicos/efectos adversos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Miositis/inducido químicamente , Pirroles/efectos adversos , Músculo Cuádriceps/efectos de los fármacos , Anciano de 80 o más Años , Antiinflamatorios/administración & dosificación , Atorvastatina , Biopsia , Femenino , Glucocorticoides/administración & dosificación , Humanos , Imagen por Resonancia Magnética , Fatiga Muscular/efectos de los fármacos , Fuerza Muscular/efectos de los fármacos , Miositis/tratamiento farmacológico , Miositis/inmunología , Miositis/patología , Miositis/fisiopatología , Necrosis , Prednisona/administración & dosificación , Músculo Cuádriceps/inmunología , Músculo Cuádriceps/patología , Músculo Cuádriceps/fisiopatología , Resultado del Tratamiento , Extremidad SuperiorAsunto(s)
Péptido 1 Similar al Glucagón/análogos & derivados , Pancreatitis/inducido químicamente , Enfermedad Aguda , Anciano , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Péptido 1 Similar al Glucagón/efectos adversos , Péptido 1 Similar al Glucagón/uso terapéutico , Humanos , Liraglutida , MasculinoAsunto(s)
2-Piridinilmetilsulfinilbencimidazoles/efectos adversos , Hipoparatiroidismo/inducido químicamente , Deficiencia de Magnesio/inducido químicamente , Omeprazol/efectos adversos , Inhibidores de la Bomba de Protones/efectos adversos , Tetania/etiología , Biomarcadores/sangre , Femenino , Humanos , Hipoparatiroidismo/complicaciones , Hipoparatiroidismo/diagnóstico , Magnesio/sangre , Deficiencia de Magnesio/sangre , Deficiencia de Magnesio/complicaciones , Deficiencia de Magnesio/diagnóstico , Persona de Mediana Edad , PantoprazolAsunto(s)
Inhibidores de la Ciclooxigenasa 2/efectos adversos , Síndrome Hepatorrenal/inducido químicamente , Pirazoles/efectos adversos , Sulfonamidas/efectos adversos , Anciano , Celecoxib , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Enfermedad Hepática Inducida por Sustancias y Drogas/fisiopatología , Femenino , Estudios de Seguimiento , Síndrome Hepatorrenal/fisiopatología , HumanosAsunto(s)
Lipoma/diagnóstico , Intensificación de Imagen Radiográfica , Síndrome de la Vena Cava Superior/diagnóstico , Neoplasias Vasculares/diagnóstico , Vena Cava Superior , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Angiografía/métodos , Análisis Químico de la Sangre , Medios de Contraste , Diagnóstico Diferencial , Servicio de Urgencia en Hospital , Estudios de Seguimiento , Humanos , Lipoma/cirugía , Masculino , Persona de Mediana Edad , Enfermedades Raras , Síndrome de la Vena Cava Superior/cirugía , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Ultrasonografía Doppler , Neoplasias Vasculares/cirugía , Procedimientos Quirúrgicos Vasculares/métodosRESUMEN
BACKGROUND: Granulomatous peritonitis may indicate a number of infectious, malignant, and idiopathic inflammatory conditions. It is a very rare postoperative complication, which is thought to reflect a delayed cellmediated response to cornstarch from surgical glove powder in susceptible individuals. This mechanism, however, is much more likely to occur with open abdominal surgery when compared with the laparoscopic technique. METHODS: We report a case of sterile granulomatous peritonitis in an 80-y-old female after a laparoscopic cholecystectomy. Management was conservative, and no relapse was observed after over 1-y of follow-up. DISCUSSION: We propose that peritoneal exposure to bile acids during the laparoscopic removal of the gallbladder was the trigger of granulomatous peritonitis in this patient. Severe complications, such as peritoneal adhesions, intestinal obstruction, and fistula formation, were observed, but no fatalities were reported. CONCLUSION: We should be aware of this rare cause of peritonitis in the surgical setting.