RESUMO
Osteoarticular pathology in leprosy is common and described at all stages, but rarely as the most evident clinical manifestation. We report a case of borderline lepromatous leprosy with initial and disabling hands edema. The swollen hands syndrome is probably due to chronic Mycobacterium leprae tenosynovitis.
Assuntos
Edema/etiologia , Traumatismos da Mão/etiologia , Hanseníase Virchowiana/diagnóstico , Sinovite/etiologia , Adulto , Antibacterianos/uso terapêutico , Dapsona/uso terapêutico , Humanos , Masculino , Mycobacterium leprae , Rifampina/uso terapêutico , Síndrome , Sinovite/microbiologiaRESUMO
INTRODUCTION: Central diabetes insipidus is most frequently reported to occur after a trauma from surgery or accident. However, between 30 and 50% of cases are considered idiopathic. It's a rare complication of myelodysplastic syndrome. CASE REPORT: A 61-year-old patient presented central diabetes insipidus revealing, 17 months before, chronic myelomonocytic leukemia. Cytogenetics studies revealed monosomy 7. Acute myeloid leukemia appears 3 months after training rapid patient's death. DISCUSSION: Blood examination is necessary before to conclude idiopathic central diabetes insipidus. The discovery of chronic myelomonocytic leukemia implicates a rapid managing before its possible acute myeloid leukemia transformation. Indeed, prognosis of central diabetes insipidus and acute myeloid leukemia associated, in presence of monosomy 7, is very poor.
Assuntos
Diabetes Insípido/diagnóstico , Leucemia Mielomonocítica Crônica/diagnóstico , Cromossomos Humanos Par 7/genética , Diagnóstico Diferencial , Evolução Fatal , Humanos , Leucemia Mieloide Aguda/diagnóstico , Masculino , Pessoa de Meia-Idade , Monossomia/diagnóstico , Monossomia/genéticaRESUMO
INTRODUCTION: In France, except in the overseas departments and territories, pulmonary eosinophilia rarely has a parasitic cause except among subjects who have traveled to tropic areas. CASE: A 19-year-old man was hospitalized for incidentally discovered hypereosinophilia. The thoracic CT scan showed several hyperdense nodules that suggested bilateral interstitial alveolar lesions. Diagnosis was finally based on serologic results positive for toxocariasis. A 14-day course of albendazole led to regression of the eosinophilia and of the radiographic images. DISCUSSION: The frequency of toxocariasis or visceral larva migrans syndrome is probably underestimated. In adults, the symptoms can be atypical and possibly serious. Albendazole, for 14 days, is the reference treatment.
Assuntos
Eosinofilia Pulmonar/parasitologia , Toxocaríase/diagnóstico , Adulto , Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , França , Humanos , Masculino , Eosinofilia Pulmonar/tratamento farmacológico , Toxocaríase/tratamento farmacológicoRESUMO
Based on their experience in managing Grave's disease at the Bouffard Army Hospital Center within the local health care context in Djibouti, the authors advocate surgery as the first line treatment. Medical and economical factors supporting this preference are discussed so that readers can adapt them to his own local context.