RESUMO
Cyanosis, clubbing, and arterial oxygen desaturation may occur in patients with liver disease, and are attributed to the presence of pulmonary or peripheral arterio-venous shunting. Cardiac catheterisation and angiocardiography in a patient with a normal heart did not demonstrate the presence of abnormal arterio-venous anastomoses. Pulmonary shunting was proved when intravenous technetium-labelled macroaggregated albumin, normally held up in capillary networks, was passed quickly through the lungs and immediately detected in high systemic blood flow organs. The opening of peripheral and pulmonary anastomoses in patients with liver disease may be owing to the presence of a vasodilatory substance such as ferritin, which was found to be abnormally increased in the patient's blood.
Assuntos
Fístula Arteriovenosa/etiologia , Cirrose Hepática/complicações , Artéria Pulmonar , Veias Pulmonares , Adolescente , Fístula Arteriovenosa/diagnóstico por imagem , Feminino , Humanos , Cintilografia , Albumina Sérica , Tecnécio , Agregado de Albumina Marcado com Tecnécio Tc 99mRESUMO
Acute suppurative thyroiditis in children is very rare and has been reported in only six cases. We describe a 4 1/2 year old girl who presented with acute suppurative thyroiditis of the left lobe. All thyroid function tests were normal but the radioisotope scan showed decreased activity over the upper pole of the left lobe. The child was treated with massive doses of antibiotics and gradually recovered. Three years later she presented with exactly the same findings in the left lobe of the thyroid. Thyroid function tests were again normal but repeated radioisotopic scan showed decreased activity over the left upper pole. Again she recovered gradually under massive antibiotic treatment. A follow up scan showed great improvement with almost complete recovery of activity in the left lobe.