RESUMO
Hepatitis C virus (HCV) infection is common in the general population and may coincide with disease in the central and peripheral nervous system. Interferon-alpha (IFN-alpha) is used as treatment for HCV infection. The therapeutic benefit is assumed to result from activation of natural killer cells and CD8+ T cells. Despite its beneficial effects, it has been associated with a number of autoimmune disorders, such as chronic inflammatory demyelinating polyneuropathy and multiple sclerosis. Several clinical reports including magnetic resonance imaging exist, but neuropathological confirmation of MS associated with IFN-alpha therapy and HCV infection is lacking. We report a case of a female patient with chronic HCV infection who developed ;acute MS'-like demyelinating disease after IFN-alpha administration, with extensive lesions throughout brain and thoracic spinal cord. The patient died after a disease duration of 6 months. Brain autopsy revealed Baló-like demyelinating plaques with positive HCV sequences within florid lesions. The development of fulminant demyelinating disease after administration of IFN-alpha suggests that autoimmune mechanisms such as T cell mediated tissue damage might be initiated or aggravated by IFN-alpha therapy. Additionally, the presence of HCV RNA within the demyelinated lesion indicates a possible role in triggering or propagating disease.
Assuntos
Antivirais/efeitos adversos , Doenças Desmielinizantes/induzido quimicamente , Hepacivirus/isolamento & purificação , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/efeitos adversos , Doença Aguda , Adulto , Biópsia , Doenças Desmielinizantes/patologia , Feminino , Hepacivirus/genética , Hepatite C Crônica/patologia , Humanos , RNA Viral/isolamento & purificação , Índice de Gravidade de DoençaRESUMO
A case of a benign cystic peritoneal mesothelioma is reported. A 25-year-old woman presented a 8-year history of recurrent tumor and five operations because of that. On the basis of this case and of 18 cases proved by electron microscopy reported by others, the clinicopathological features and the problems of differential diagnosis are discussed. The ultrastructural examination is essential for the diagnosis of cystic mesothelioma.
Assuntos
Mesotelioma/patologia , Neoplasias Peritoneais/patologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Mesotelioma/diagnóstico , Mesotelioma/ultraestrutura , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/ultraestruturaRESUMO
A case of benign cystic peritoneal mesothelioma is reported. A 25-year-old woman presented a 8-year history of recurrent tumor and five operations because of the same. On the basis of this case and of 18 cases proved by electron microscopy reported by others the clinicopathological features and the problems of differential diagnosis are discussed. The ultrastructural examination is essential for the diagnosis of cystic mesothelioma.