Subject(s)
Aged , Humans , Male , Abdomen , Pneumatosis Cystoides Intestinalis , Radiography, Abdominal , Pneumatosis Cystoides IntestinalisSubject(s)
Humans , Female , Middle Aged , Hyperthyroidism , Lupus Erythematosus, Systemic , Neutropenia , Peritonitis , Fatal Outcome , Hyperthyroidism , Lupus Erythematosus, Systemic , Neutropenia , PeritonitisSubject(s)
Humans , Female , Middle Aged , Neutropenia/complications , Hyperthyroidism/complications , Lupus Erythematosus, Systemic/complications , Peritonitis/complications , Neutropenia/pathology , Hyperthyroidism/pathology , Lupus Erythematosus, Systemic/pathology , Peritonitis/pathology , Fatal OutcomeABSTRACT
Antiphospholipid syndrome is characterized by recurrent fetal loss, arterial and venous thromboses, thrombocytopenia and circulating antiphospholipid antibodies. Few patients have a rapidly progressive, fatal outcome. We report two young patients with systemic lupus erythematosus and antiphospholipid antibodies who died after a short course of disease. Although clinical and laboratory findings differed in both patients--small vessel thromboses and microangiopathic hemolytic anemia mimicking thrombotic thrombocytopenic purpura predominated in one of the patients while small and medium size vessel thromboses without hemolysis were present in the other case--autopsy revealed widespread visceral thromboses in both of them, features consistent with a diagnosis of catastrophic antiphospholipid syndrome. This syndrome has not been reported to occur in association with Pneumocistis carinii pneumonia as we describe in one of our patients.
Subject(s)
Antiphospholipid Syndrome/complications , Lupus Erythematosus, Systemic/complications , Adult , Antibodies, Antiphospholipid/immunology , Antiphospholipid Syndrome/pathology , Endocarditis, Bacterial/complications , Fatal Outcome , Female , Humans , Lupus Erythematosus, Systemic/pathology , Pneumonia, Pneumocystis/diagnosis , Thrombosis/complicationsABSTRACT
Antiphospholipid syndrome is characterized by recurrent fetal loss, arterial and venous thromboses, thrombocytopenia and circulating antiphospholipid antibodies. Few patients have a rapidly progressive, fatal outcome. We report two young patients with systemic lupus erythematosus and antiphospholipid antibodies who died after a short course of disease. Although clinical and laboratory findings differed in both patients--small vessel thromboses and microangiopathic hemolytic anemia mimicking thrombotic thrombocytopenic purpura predominated in one of the patients while small and medium size vessel thromboses without hemolysis were present in the other case--autopsy revealed widespread visceral thromboses in both of them, features consistent with a diagnosis of catastrophic antiphospholipid syndrome. This syndrome has not been reported to occur in association with Pneumocistis carinii pneumonia as we describe in one of our patients.
ABSTRACT
The transjugular intrahepatic protosystemic shunt (TIPS) is a nonsurgical method with low mortality which does not interfere with subsequent liver transplantation. We describe the case of an old male patient with chronic hepatopathy who was admitted because of an episode of variceal bleeding. Due to the failure of the medical treatment and sclerotherapy, coronarian stomachic vein was embolized with a coil and a TIPS was performed during the acute episode of variceal bleeding. He evolved favorably and after a year of the procedure remains asymptomatic.
Subject(s)
Esophageal and Gastric Varices/surgery , Gastrointestinal Hemorrhage/surgery , Hypertension, Portal/surgery , Portasystemic Shunt, Transjugular Intrahepatic , Acute Disease , Aged , Aged, 80 and over , Esophageal and Gastric Varices/complications , Gastrointestinal Hemorrhage/complications , Humans , Hypertension, Portal/complications , MaleABSTRACT
Acute mitral insufficiency, originated from rupture of mitral chordae tendineae secondary to nonpenetrating thoracic trauma, is an unusual condition. This diagnosis is difficult to establish because physical examination, electrocardiogram, and cardiac enzymes are neither sensitive nor specific. The diagnosis of rupture must be quickly established because this disorder may be fatal. This paper reports the case of a patient with acute mitral insufficiency secondary to a mitral valve chord rupture a week after a nonpenetrating thoracic trauma.
Subject(s)
Chordae Tendineae/injuries , Mitral Valve Insufficiency/etiology , Thoracic Injuries/complications , Wounds, Nonpenetrating/complications , Adult , Chordae Tendineae/diagnostic imaging , Chordae Tendineae/surgery , Echocardiography, Doppler , Echocardiography, Transesophageal , Electrocardiography , Follow-Up Studies , Humans , Male , Mitral Valve Insufficiency/diagnosis , Mitral Valve Insufficiency/surgery , Rupture , Thoracic Injuries/diagnosis , Thoracic Injuries/surgery , Wounds, Nonpenetrating/diagnosis , Wounds, Nonpenetrating/surgeryABSTRACT
The reactive hemophagocytic syndrome is a condition characterized by systemic proliferation of benign hemophagocytic histiocytes, fever, cytopenia, abnormal liver function, and frequently coagulopathy and hepatosplenomegaly. Its occurrence has been documented in association with viral, bacterial, fungal and parasitic infections; a wide spectrum of malignant neoplasms; some miscellaneous disorders; and phenytoin. Disseminated strongyloidiasis is reported in a patients with systemic lupus erythematosus treated with corticosteroids in whom a reactive hemophagocytic syndrome developed and who finally died. This reactive hemophagocytic syndrome is reported for the first time in strongyloidiasis and may not have been recognized in former patients.
Subject(s)
Histiocytosis, Non-Langerhans-Cell/etiology , Strongyloidiasis/complications , Adult , Female , Histiocytosis, Non-Langerhans-Cell/pathology , Humans , Lupus Erythematosus, Systemic/complications , Lymph Nodes/pathology , Strongyloidiasis/parasitologyABSTRACT
A case of a 35-year-old woman presenting infratentorial CNS lymphoma is reported. In 1990 she complained of diplopia, blurred vision and left horizontal nistagmus. An MRI disclosed a lesion in the medulla, pons, and cerebellar vermis and peduncles. Although no treatment was administered, a later RMI showed less extension of the tumor. One year after clinical diagnosis, she received corticosteroids; during the second year a stereotaxic biopsy of the cerebellar lesion was done showing a diffuse B cell non-Hodgkin's lymphoma. A whole brain irradiation was given (50 Gy). She did well for five years, and remains alive (79 months).