RESUMO
Inflammatory pseudotumor (IP) is a disorder that constitutes a differential diagnosis of a series of clinical conditions due to a large spectrum of manifestations in presentation since it can involve any organ of the human body. Its basic characteristic is the appearance of inflammatory masses whose symptoms depend on their location. We describe two cases of IP that clearly illustrate this diversity of presentation and we review the diagnostic and therapeutic strategies for such a condition.
RESUMO
O HTLV-1 foi o primeiro retrovírus humano a ser associado às doenças malignas leucemia e linfoma de células T do adulto (LLTA). Ele está relacionado também a uma doença inflamatória crônica do sistema nervoso central (SNC) conhecida como paraparesia espástica tropical/mielopatia associada ao HTLV-1 (PET/MAH). O HTLV-1 tem sido implicado na patogênese de várias doenças auto-imunes, tais como: diabetes, esclerose múltipla, dermatite infectiva, uveíte e artropatia. Ao longo dos anos, a infecção retroviral tem assumido um importante papel na patogênese das doenças reumáticas auto-imunes. Partículas semelhantes aos retrovírus têm sido identificadas em tecidos de pacientes com artrite reumatóide (AR), síndrome de Sjõgren, lúpus eritematoso sistêmico (LES) e polimiosite. A síndrome de Sjõgren e a AR têm sido as doenças reumáticas mais encontradas nos pacientes infectados pelo HTLV-1, sendo a freqüência mais elevada nos pacientes com mielopatia. A alta prevalência de síndrome de Sjõgren e de AR entre os indivíduos com mielopatia sugere que a carga viral e a resposta inflamatória exacerbada, que concorrem para o desenvolvimento da mielopatia, devem também influenciar no desenvolvimento das doenças reumáticas auto-imunes.
The HTLV-1 was the first human retrovirus associated with adult T-cell leukemia/lymphoma (LLTA). The virus also causes a chronic inflammatory disease of the central nervous system named HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP). HTLV-1 has been implicated in the pathogenesis of many autoimmune diseases, such as diabetes, multiple sclerosis, infective dermatitis, uveitis and arthropathy. It has long been suggested that retroviral infection may play a role in the pathogenesis of autoimmune rheumatic diseases. Particles resembling retroviruses have been reported in tissue from patients with rheumatoid arthritis (RA), Sjõgren's syndrome, systemic lupus erythematosus (SLE) and polymyositis. Sjõgren's syndrome and RA have been the most frequent rheumatic diseases in patients infected with HTLV-1, being more prevalent in patients with myelopathy. The high prevalence of Sjõgren's syndrome and RA in individuals with myelopathy, suggests that the viral burden and exacerbated inflammatory response may play a role not only in the development of myelopathy, but may also influence the outcome of autoimmune rheumatic diseases.
