RESUMO
Lytic and blastic lesions have been associated to malignant tumours, such as solid cancer (breast cancer, renal cancer, prostate cancer, malignant melanoma or thyroid tumours). Although a mixed pattern with lytic and blastic lesions is due to metastatic tumour, this is not the only possible origin. The following case shows a systematic. This case report shows the number of tests that were made in order to discover the origin of osteolytic and osteoblastic lesions and it is notable that there is not an occult neoplasia on every occasion.
Assuntos
Neoplasias Ósseas/secundário , Mastocitose Sistêmica/diagnóstico , Mastocitose Sistêmica/fisiopatologia , Osteólise/etiologia , Idoso , Anemia/complicações , Dor nas Costas/etiologia , Conservadores da Densidade Óssea/uso terapêutico , Diagnóstico Diferencial , Difosfonatos/uso terapêutico , Feminino , Humanos , Hipertensão/complicações , Imidazóis/uso terapêutico , Fatores Imunológicos/uso terapêutico , Interferon-alfa/uso terapêutico , Imageamento por Ressonância Magnética , Mastocitose Sistêmica/tratamento farmacológico , Osteólise/tratamento farmacológico , Osteoporose/complicações , Osteoporose/tratamento farmacológico , Cintilografia , Ácido ZoledrônicoRESUMO
Concern exists about the risk of nephrotoxicity using tenofovir (TDF) in HIV-infected patients. We performed a retrospective case-control study including 122 consecutive TDF-naive patients who started treatment with TDF-containing regimens and 194 patients receiving antiretroviral therapy with other antiretroviral drugs. During a 12-month observation period 5 (4.1%) patients in the TDF group versus 1 (0.5%) in the control group developed grade 1 or higher serum creatinine elevations (p = 0.018). Only 2 (1.6%) patients discontinued TDF treatment as a result of serum creatinine level elevations. In 4 of the 5 patients developing creatinine elevations TDF was combined with lopinavir-ritonavir. The use of TDF in clinical practice during a 12-month period is associated with low risk of mild renal failure. Further studies to assess long-term renal safety of this drug are needed.