RESUMO
Renal paraneoplastic vasculitis (RNPV) is rare. It can be revealed by glomerulonephritis, microaneurysms or renal failure. RPNV may precede the onset of the primary tumor, and treatment and prognosis depend on the etiology (primary tumor). A 54-year-old man who had a primary lung adenocarcinoma was admitted for nephrotic syndrome. The investigations revealed RNPV. The patient was treated with corticosteroids at high dose and cyclophosphamide with improvement of the renal condition; however, the patient died from worsening of his pulmonary neoplasia.
Assuntos
Adenocarcinoma/complicações , Rim/irrigação sanguínea , Neoplasias Pulmonares/complicações , Síndromes Paraneoplásicas/etiologia , Vasculite/etiologia , Adenocarcinoma/diagnóstico , Adenocarcinoma de Pulmão , Corticosteroides/uso terapêutico , Biópsia , Evolução Fatal , Humanos , Imunossupressores/uso terapêutico , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Síndrome Nefrótica/etiologia , Síndromes Paraneoplásicas/diagnóstico , Síndromes Paraneoplásicas/tratamento farmacológico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Vasculite/diagnóstico , Vasculite/tratamento farmacológicoAssuntos
Candida tropicalis , Candidíase/complicações , Endocardite/microbiologia , Adulto , Candida tropicalis/isolamento & purificação , Candidíase/diagnóstico , Candidíase/cirurgia , Procedimentos Cirúrgicos Cardíacos , Endocardite/diagnóstico , Endocardite/cirurgia , Humanos , Masculino , Insuficiência da Valva Mitral/microbiologia , Insuficiência da Valva Mitral/cirurgiaAssuntos
Adenoma/metabolismo , Síndromes Endócrinas Paraneoplásicas , Neoplasias Hipofisárias/metabolismo , Tireotropina/metabolismo , Adenoma/diagnóstico , Hormônio do Crescimento Humano/metabolismo , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Síndromes Endócrinas Paraneoplásicas/diagnóstico , Neoplasias Hipofisárias/diagnóstico , Prolactina/metabolismoAssuntos
Corticosteroides/uso terapêutico , Aneurisma/tratamento farmacológico , Azatioprina/uso terapêutico , Síndrome de Behçet/tratamento farmacológico , Artéria Pulmonar , Adulto , Aneurisma/complicações , Síndrome de Behçet/complicações , Humanos , Masculino , Artéria Pulmonar/patologia , Indução de RemissãoAssuntos
Lúpus Eritematoso Sistêmico/complicações , Psoríase/complicações , Corticosteroides/uso terapêutico , Adulto , Antirreumáticos/uso terapêutico , Feminino , Humanos , Hidroxicloroquina/uso terapêutico , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Psoríase/diagnóstico , Psoríase/tratamento farmacológicoAssuntos
Amiloidose/diagnóstico , Pneumopatias/diagnóstico , Mixoma/diagnóstico , Neoplasias Pélvicas/diagnóstico , Sarcoidose/diagnóstico , Amiloidose/complicações , Cardiomiopatias/complicações , Cardiomiopatias/diagnóstico , Diagnóstico Diferencial , Humanos , Pneumopatias/complicações , Masculino , Pessoa de Meia-Idade , Mixoma/complicações , Mixoma/patologia , Invasividade Neoplásica , Neoplasias Pélvicas/complicações , Neoplasias Pélvicas/patologia , Sarcoidose/complicações , Sialadenite/complicações , Sialadenite/diagnóstico , Síndrome de Sjogren/complicações , Síndrome de Sjogren/diagnósticoRESUMO
BACKGROUND: Takayasu's disease is a chronic inflammatory arteritis involving large vessels in young women. AIM: To assess the clinical, laboratory, and radiological features and course of Takayasu arteritis in Tunisia. METHODS: This retrospective study analyzed 11 patients with Takayasu arteritis between 1999 and 2010 who met the criteria for inclusion proposed by the American College of Rheumatology (ACR). RESULTS: The file review identified 11 women, with a mean age at diagnosis of 29.1 years (range: 17-50 years). Our series included involvement of the aortic arch and its branches in 8 cases, while only 3 cases of the abdominal aorta. Arterial hypertension due to stenosis of the renal arteries was noted in 4 cases. Aortic insufficiency and pulmonary hypertension were noted in one case. In all, 3 patients had type I disease, 3 type V and one type IV. In all, 4 patients had glucocorticoid treatment, and one needed immunosuppressive therapy. Three patients required surgical intervention. Our patients were followed for a mean period of 67.5 months. Disease remained stable in all patients. CONCLUSION: Despite the small number of our patients, the clinical manifestations, angiographic data and course in our study were similar to those in other reported series.
Assuntos
Arterite de Takayasu/diagnóstico , Arterite de Takayasu/terapia , Adolescente , Adulto , Insuficiência da Valva Aórtica/etiologia , Feminino , Humanos , Hipertensão/etiologia , Hipertensão Pulmonar/etiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Arterite de Takayasu/classificação , Adulto JovemRESUMO
BACKGROUND: Corticosteroids are widely prescribed products in the elderly particularly in systemic diseases. Corticosteroids were indispensable in controlling a variety of disease states. Various complications associated with this drug class warrant caution and monitoring with each formulation especially with old population. AIM: To evaluate the frequency and type of side effects and complications of long-term corticosteroid therapy in the elderly. METHODS: We conducted a retrospective study of 23 patients aged 65 and older hospitalized in the internal medicine department of the Habib Thameur hospital during January 2000 to December 2004. Corticoid adverse effects were recorded throughout the follow up period. RESULTS: There are 20 women and 3 men aged 66 to 87 years with a mean age of 75.7 years. The diagnoses were 8 cases of temporal arteritis, 7 cases of rheumatoid arthritis, 3 cases of multiple myeloma, 2 scleroderma, 1 case of systemic lupus erythematosus, 1 case of retroperitoneal fibrosis and 1 case of psoriatic arthritis. We selected 66 complications. Infectious complications were found in 26 cases (39.3%), 11 cases (16.7%) of iatrogenic diabetes, arterial hypertension in 9 cases (13%), skeletal complications in both cases,psychiatric complications in two cases, ophthalmologic complications in one case. CONCLUSION: Despite lifestyle rules and adjunctive therapy, complications seem to be frequent. To minimize the disadvantages of prolonged corticosteroid treatment, regular monitoring and careful screening is imperative for the support and time.