RESUMO
Amyloidosis, a disease with extracellular tissue deposition of fibrils, results in clinical manifestations based on deposition of these fibrils in multiple organ systems. Usual manifestations include nephrotic-range proteinuria, cardiac failure, hepatosplenomegaly, and skin manifestations. Common neurological manifestations include peripheral and autonomic neuropathies. Cranial neuropathy has been seldom reported and is an unusual clinical feature of amyloidosis. Here, we report an older man who presented with cranial nerve palsies along with other clinical features, including heart failure, proteinuria, weight loss, anorexia and distal symmetric polyneuropathy and was diagnosed with immunoglobulin light-chain (AL) amyloidosis.
RESUMO
Rapidly progressive dementia (RPD) is a challenging clinical problem in the elderly. It encompasses a wide range of diseases. Thorough clinical examination and a systematic approach is essential to find the cause of RPD. Early recognition of causes of RPD is important for early treatment and reversal of the pathology. We report a case of RPD due to portosystemic encephalopathy secondary to a large portosystemic shunt with preserved liver functions, in a previously healthy elderly male. He had pallidal hyperintensities on MRI brain that can be the clue to the diagnosis of portosystemic shunt and chronic liver disease in patients with RPD.
Assuntos
Circulação Colateral , Demência/etiologia , Malformações Vasculares/diagnóstico , Idoso de 80 Anos ou mais , Progressão da Doença , Junção Esofagogástrica/irrigação sanguínea , Humanos , Masculino , Transtornos Psicóticos/etiologiaAssuntos
Calciofilaxia/diagnóstico por imagem , Diabetes Mellitus , Falência Renal Crônica/terapia , Úlcera da Perna/diagnóstico por imagem , Radiografia/métodos , Adulto , Calciofilaxia/etiologia , Celulite (Flegmão)/etiologia , Evolução Fatal , Humanos , Falência Renal Crônica/complicações , Úlcera da Perna/etiologia , Masculino , Diálise Renal , Sepse/etiologia , Coxa da Perna/diagnóstico por imagemRESUMO
The use of neem-based products is widespread in the Indian Subcontinent. Neem-based pesticides obtained from neem kernels are considered natural and safe. The toxic effects of ingestion and overdose of this pesticide in adults have not been described in this literature. We report the case of a 35-year-old lady who had consumed Azadirachtin in an attempt of deliberate self-harm. The patient had features of neurotoxicity because of Azadirachtin requiring intensive medical care with mechanical ventilation. The patient survived the overdose with no long-lasting side effects of the toxin.
