RESUMO
INTRODUCTION: Paraneoplastic syndromes are a rare cancer complication with a frequent subacute evolution. OBSERVATION: A 62-year-old man was admitted presenting with a cerebellar syndrome and orthostatic hypotension with dysautonomia. Anti-Hu antibody research was positive. A subcarinal adenopathy biopsy found out a small cell lung carcinoma. Despite a treatment with immunoglobulin and chemotherapy, the patient died suddenly, after a raise of dysautonomia symptoms. CONCLUSION: Sudden death observations represent exceptional complications of paraneoplastic syndrome. They might be secondary to arrhythmias, ictal asystol or laryngospasm. Systematic research of paroxystic heart arrhythmias with holter-ECG in paraneoplastic syndrome may prevent sudden deaths.
Assuntos
Morte Súbita/etiologia , Proteínas ELAV/imunologia , Neoplasias Pulmonares/diagnóstico , Degeneração Paraneoplásica Cerebelar/etiologia , Síndromes Paraneoplásicas do Sistema Nervoso/etiologia , Síndrome de Shy-Drager/etiologia , Carcinoma de Pequenas Células do Pulmão/diagnóstico , Anticorpos/sangue , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Vaccination guidelines in patients with cystic fibrosis associate the usual vaccination schedule with specific recommendations concerning influenza, Pneumococcus, viral hepatitis A and B and varicella. Live attenuated vaccines are not contra-indicated but must be administered before pulmonary transplantation. Clinical studies evaluating vaccine efficacy in this population are still necessary. Development of new vaccines against respiratory infections (Staphylococcus aureus, Pseudomonas aeruginosa and Syncitial Respiratory Virus in particular) is an important challenge for the medical management of these patients.