Subject(s)
Myositis/complications , Purpura, Hyperglobulinemic/complications , Anti-Inflammatory Agents/therapeutic use , Diagnosis, Differential , Female , Humans , Leg/pathology , Middle Aged , Myositis/diagnosis , Myositis/drug therapy , Myositis/pathology , Purpura, Hyperglobulinemic/diagnosis , Purpura, Hyperglobulinemic/drug therapy , Purpura, Hyperglobulinemic/pathology , Steroids/therapeutic useSubject(s)
Plasma Cells/pathology , Purpura, Hyperglobulinemic/diagnosis , Skin Diseases/diagnosis , Waldenstrom Macroglobulinemia/diagnosis , Adult , Humans , Macroglobulins/metabolism , Male , Purpura, Hyperglobulinemic/metabolism , Skin Diseases/metabolism , Waldenstrom Macroglobulinemia/metabolismABSTRACT
Hypergammaglobulinemic purpura of Waldenström is a rare syndrome that includes recurrent episodic purpura occurring mainly on the lower extremities and dorsum of the feet. The hallmark of this condition is polyclonal hypergammaglobulinemia primarily composed of IgG. Although the condition generally is benign, it may herald an underlying connective tissue disease or hematologic malignancy. We report a case of a 47-year-old woman with episodic purpura of 3 years' duration associated with Raynaud phenomenon.
Subject(s)
Immunoglobulin G/blood , Purpura, Hyperglobulinemic/immunology , Raynaud Disease/complications , Female , Follow-Up Studies , Humans , Middle Aged , Purpura, Hyperglobulinemic/diagnosis , Purpura, Hyperglobulinemic/etiologyABSTRACT
A 43-year-old healthy patient developed disseminated flat skin-colored to red-brown papules over a few months. These papules were the result of cutaneous IgM deposits representing the first symptom of a hitherto undiagnosed IgM paraproteinemia. This extremely rare skin manifestation of IgM paraproteinemia e. g. possibly incipient Waldenström macroglobulinemia should be included in the histopathological differential of eosinophilic dermal deposits.
Subject(s)
Immunoglobulin M/immunology , Paraproteinemias/diagnosis , Paraproteinemias/therapy , Purpura, Hyperglobulinemic/diagnosis , Purpura, Hyperglobulinemic/therapy , Adult , Diagnosis, Differential , Humans , Macroglobulins , Male , Paraproteinemias/immunology , Purpura, Hyperglobulinemic/immunology , Treatment OutcomeABSTRACT
A woman presented at 25 weeks gestation in her first pregnancy with severe preeclampsia and an intrauterine death. It later emerged that she had Waldenstrom's benign hypergammaglobulinemic purpura. We discuss the implications of this diagnosis in pregnancy and explore possible management options during subsequent pregnancies.
Subject(s)
Pregnancy Complications, Cardiovascular/diagnosis , Pregnancy Complications, Hematologic/diagnosis , Purpura, Hyperglobulinemic/diagnosis , Adult , Female , Fetal Death , Humans , Pre-Eclampsia/etiology , Pregnancy , Purpura, Hyperglobulinemic/complicationsABSTRACT
Visceral leishmaniasis may present with cytopenias along with the formation of many autoantibodies and, rarely, with the presence of mixed cryoglobulinemia, type II, resembling an autoimmune disease. The syndrome of mixed cryoglobulinemia is characterized by the triad of purpura, arthralgias, and asthenia, in conjunction with cryoglobulins in the serum. In this article mixed cryoglobulinemia, type II, was diagnosed in a negative for hepatitis B or C patient suffering from visceral leishmaniasis. Antimicrobial therapy against leishmania eliminated the cryoglobulin titer, as well as the clinical manifestations of cryoglobulinemia. The role of the immune system and the type of immune response for the formation of cryoglobulins are discussed.
Subject(s)
Cryoglobulinemia/diagnosis , Leishmaniasis, Visceral/diagnosis , Purpura, Hyperglobulinemic/diagnosis , Aged, 80 and over , Amphotericin B/therapeutic use , Antiprotozoal Agents/therapeutic use , Bone Marrow/parasitology , Bone Marrow/pathology , Cryoglobulinemia/parasitology , Humans , Leishmaniasis, Visceral/complications , Liposomes , Male , Purpura, Hyperglobulinemic/parasitology , Treatment OutcomeABSTRACT
La neurocisticercosis es una afectación del sistema nervioso central por las larvas de la Taenia solium. Aunque en nuestro país su diagnóstico era excepcional, en los últimos años se ha observado un notable incremento en el número de casos diagnosticados, debido al fenómeno de la inmigración desde países donde la enfermedad es endémica. La forma de presentación más frecuente de la neurocisticercosis es la crisis epiléptica, seguida de la cefalea. Para el diagnóstico de sospecha debemos valorar los datos epidemiológicos y la clínica y confirmarlo mediante los estudios de neuroimagen e inmunológicos. El tratamiento de elección debe ser farmacológico, principalmente con albendazol, y reservar la cirugía para los casos en el que el primero falla. Las medidas higiénico-sanitarias y el tratamiento de los pacientes con teniasis son de suma importancia. La neurocisticercosis ha dejado de ser uno de esos diagnósticos excepcionales y dado el previsible aumento de su incidencia en nuestro medio, los profesionales sanitarios debemos conocer dicha enfermedad e incluirla en niveles más altos de los algoritmos de diagnóstico diferencial (AU)