ABSTRACT
INTRODUCTION: Eosinophilic ulcer (EU) is a rare pathology and its etiology is still slightly known. It is a benign lesion characterized by fast-growing ulceration with elevated and indurated borders, most commonly affecting the tongue. CASE REPORT: The authors describe a case of EU on a lingual border that was initiated and had its clinical behavior altered by the psychological stress the patient was experiencing. DISCUSSION: This paper discusses the stress effects that alter the individual's immunologic response, thus attracting mast cells and eosinophils towards the mucosal epithelium, which are involved in eosinophilic ulcer. The authors make an association between eosinophilic ulcer and atopic dermatitis, two diseases that appear to have a similar, though not fully defined, etiology. The psychological stress factor was considered a predisponent factor for eosinophilic ulcer etiology and its interference in the etiology and evolution of this disease should be considered.
Subject(s)
Eosinophilia/psychology , Oral Ulcer/psychology , Stress, Psychological/immunology , Tongue Diseases/psychology , Abdominal Pain/immunology , Abdominal Pain/psychology , Adult , Carcinoma, Squamous Cell/diagnosis , Diagnosis, Differential , Eosinophilia/immunology , Follow-Up Studies , Humans , Male , Oral Ulcer/immunology , Psychoneuroimmunology , Tongue Diseases/immunology , Tongue Neoplasms/diagnosisABSTRACT
Hypocomplementemic urticarial vasculitis syndrome (HUVS) is an uncommon immune complex-mediated entity characterized by urticaria with persistent acquired hypocomplementemia. First described in 1973, HUVS is associated with several systemic findings including leukocytoclastic vasculitis, severe angioedema, laryngeal edema, pulmonary involvement, arthritis, arthralgia, glomerulonephritis, and uveitis. These manifestations should be present for at least 6 months. Laboratory findings include low complement levels of classical pathway, namely C1q, C2, C3, and C4. The disease marker is the serum presence of anti-C1q antibodies. Treatment, based on disease severity, involves corticosteroids and other immunosuppressive agents that have demonstrated some success. Patients may have significant morbidity and mortality, most commonly caused by chronic obstructive pulmonary disease and acute laryngeal edema.
Subject(s)
Abdominal Pain/immunology , Complement System Proteins/deficiency , Edema/immunology , Urticaria/immunology , Vasculitis/immunology , Abdominal Pain/diagnosis , Abdominal Pain/drug therapy , Complement System Proteins/analysis , Edema/diagnosis , Edema/drug therapy , Humans , Syndrome , Urticaria/diagnosis , Urticaria/drug therapy , Vasculitis/diagnosis , Vasculitis/drug therapyABSTRACT
Introducción: La insuficiencia suprarrenal primaria (ISRP) es producida por diversas etiologías, congénitas o adquiridas. Su sintomatología es poco específica, exigiendo un alto índice de sospecha. Objetivo: Presentación de dos casos clínicos y revisión de ISRP. Casos Clínicos: Dos niños de 9 y 6 años, ambos con astenia y adinamia, dolor abdominal, baja de peso y vómitos, con avidez por la sal, con mal estado general, lipotimia, hiperpigmentación de piel y mucosas. Se confirmó el diagnóstico de ISRP con compromiso en la secreción de cortisol, y mineralocorticoides. Ambos tuvieron anticuerpos antiadrenales positivos. Conclusiones: La ISRP es poco frecuente en pediatría, sin embargo, es potencialmente de riesgo vital, de manera que reconocer precozmente sus síntomas permitirá realizar un diagnóstico y tratamiento oportuno.