RESUMO
Congenital adrenal hyperplasia (CAH) is an uncommon condition. Its clinical presentation with hypertension is rare. Deficiency of the steroid 11-beta-hydroxylase accounts for less than 10% of CAH. We report a case of a 19-year-old patient who presents with hypertension with ambiguous genitalia secondary to adrenal steroidogenesis dysfunction. We also discuss the defects in adrenal steroidogenesis and clinical phenotypes of CAH.
Assuntos
Hiperplasia Suprarrenal Congênita/diagnóstico , Transtornos do Desenvolvimento Sexual/diagnóstico , Hipertensão/diagnóstico , Hiperplasia Suprarrenal Congênita/complicações , Hiperplasia Suprarrenal Congênita/tratamento farmacológico , Transtornos do Desenvolvimento Sexual/complicações , Transtornos do Desenvolvimento Sexual/tratamento farmacológico , Glucocorticoides/uso terapêutico , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Masculino , Adulto JovemAssuntos
Antibacterianos/uso terapêutico , Doxiciclina/uso terapêutico , Linfo-Histiocitose Hemofagocítica/complicações , Tifo por Ácaros/complicações , Tifo por Ácaros/tratamento farmacológico , Adulto , Medula Óssea/patologia , Ensaio de Imunoadsorção Enzimática , Humanos , Imunoglobulina M , Linfo-Histiocitose Hemofagocítica/patologia , Masculino , Orientia tsutsugamushi/isolamento & purificação , Tifo por Ácaros/diagnóstico , Resultado do TratamentoRESUMO
Melioidosis, which is mainly prevalent in Thailand and Australia, has shown an increasing trend in India in the last few years. We carried out a retrospective study of 25 culture-proven adult cases of melioidosis who were admitted to a tertiary care hospital in southern India during June 2001 to September 2007. There was a six-fold increase in the number of cases in 2006 and 2007 as compared to 2001. Diabetes mellitus was the predisposing factor in 68% of cases, followed by alcoholism (28%). The clinical presentations were fever (80%), pneumonia and/or pleural effusion (48%), hepatomegaly (56%), joint involvement, and/or osteomyelitis (48%), splenomegaly (40%), splenic abscess (24%) and septicemia (28%). The organism, Burkholderia pseudomallei, was sensitive to co-amoxiclav, cotrimoxazole, ceftazidime, and carbapenem. The study suggests that melioidosis is an emerging infectious disease in the southwestern coastal belt of India, and it is likely to happen at much higher incidence.
