RESUMO
Few cases have been reported to date, in which a massive rhabdomyolysis causes a cardiac arrest in a male adult suffering from undiagnosed McArdle disease. Veno-arterial extracorporeal membrane oxygenation and cytokine adsorption filter (CytoSorb®) were required to reach a complete and successful recovery.
Assuntos
Oxigenação por Membrana Extracorpórea , Doença de Depósito de Glicogênio Tipo V , Parada Cardíaca , Adulto , Masculino , Humanos , Doença de Depósito de Glicogênio Tipo V/complicações , Doença de Depósito de Glicogênio Tipo V/diagnóstico , Parada Cardíaca/etiologia , Parada Cardíaca/terapiaRESUMO
PURPOSE: To assess the clinical value of paratracheal lymph nodes (PLNs) as a novel sonographic finding in autoimmune thyroiditis (AT). METHODS: A total of 309 consecutive patients underwent sonographic examinations of the thyroid between 1998 and 2003. A single radiologist assessed the sonographic findings of AT and PLNs. All patients underwent serological tests for antimicrosomal antibodies (AMAs). Patients with clinical, cytological, or laboratory findings of thyroiditis formed the AT group with a positive AMA test (n = 199). Controls were patients with no signs of nodular thyroid disease, normal thyrotropin, negative AMA, and benign cytology (n = 110). RESULTS: PLNs were seen in 184 of 199 patients in the AT group and in 28 of 110 controls (P < 0.001) (sensitivity of 93.4%, specificity of 74.5% in the diagnosis of AT). PLNs in controls were fewer (2.8 +/- 1.5 versus 4.7 +/- 2.6; P < 0.001) and smaller (8.2 +/- 2.4 mm versus 10.7 +/- 3.3 mm; P < 0.001) than in the AT group. CONCLUSION: PLNs are often present in patients with AT and are detectable with sonography. Radiologists should be aware of the importance of including the paratracheal region in the evaluation of the thyroid gland.
Assuntos
Linfonodos/diagnóstico por imagem , Tireoidite Autoimune/diagnóstico por imagem , Traqueia/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoanticorpos/sangue , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Tireoidite Autoimune/sangue , Tireoidite Autoimune/patologia , Tireotropina/sangue , Ultrassonografia , Adulto JovemRESUMO
Schnitzler's syndrome is a rare combination of chronic urticaria, fever of unknown origin, disabling bone pain, and monoclonal gammopathy. We report a case with an unusual radiological manifestation as a solitary sclerotic lesion of the right iliac bone. Its main features on conventional radiography, computed tomography, and magnetic resonance imaging are described, and the main radiological differential diagnoses are discussed to help with the characterization of this syndrome, which requires a combination of clinical, laboratory, and radiological data. On the other hand, although our patient had an excellent clinical response to anakinra, the sclerotic lesion remained unchanged on follow-up X-ray examinations.
