RESUMO
In this report the authors present the case of a highly malignant non-Hodgkin lymphoma in a young operated patient. They call attention to the gastrointestinal form which is difficult to diagnose. In this case the lymphoma was detected only by laparotomy. The prognosis of secondary generalized lymphoma is poor. In most cases just like in the on described above--it ends with sepsis and death.
Assuntos
Abdome Agudo/etiologia , Linfoma de Células B/complicações , Linfoma de Células B/diagnóstico , Adolescente , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Laparotomia , Linfoma de Células B/cirurgia , Masculino , Estadiamento de NeoplasiasRESUMO
A patient with two diseases, based presumably on different immunopathological mechanisms, hereditary angioedema (HAE) and Crohn's disease, was followed for 8 years. For more than three years of this observation period, detailed laboratory data were also available and could be analyzed. Both diseases had severe courses requiring chronic treatment with danazol and sulfasalazine, respectively. During exacerbation of Crohn's disease, the levels of C4 was found to be significantly lower than during the periods free of symptoms of both diseases. This drop was probably due to an impaired C1-inhibitor activity. HAE attacks and acute exacerbation of Crohn's disease never occurred simultaneously. This finding may be a mere chance but may also indicate that the different immunopathological processes underlying HAE and Crohn's disease influence each other.
Assuntos
Angioedema/complicações , Doença de Crohn/complicações , Adulto , Angioedema/imunologia , Angioedema/patologia , Proteínas Inativadoras do Complemento 1/deficiência , Complemento C4/análise , Via Clássica do Complemento , Doença de Crohn/imunologia , Doença de Crohn/patologia , Humanos , Estudos Longitudinais , MasculinoRESUMO
Hereditary C1 esterase inhibitor deficiency is often associated with immunpathologic disorders. The authors present a case of the rare coincidence of hereditary angioedema (HAE) and Crohn's disease. The history of the patient is analysed along with the familial occurrence of the disease. Characteristic abdominal manifestations of C1 esterase inhibitor deficiency are compared to the clinical signs of Crohn's disease. Differential diagnostic pitfalls are described along with efficatious therapeutic options.