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1.
Cardiovasc Pathol ; 40: 68-71, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30928813

RESUMO

Enterocolic lymphocytic phlebitis (ELP) is a rare enteropathy characterized by lymphocytic phlebitis of the mesenteric veins without arteritis. Idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) is a rare disease similar to ELP, characterized by myointimal hyperplasia that constricts the lumen of veins, causing mucosal injury. A 62-year-old man with chief complaint of abdominal pain was treated by partial resection of the ileum after 3 months of conservative therapy. The pathologic diagnosis was ELP with prominent myointimal hyperplasia. Histologically, the lesion consisted of lymphocytic infiltration into the vein accompanied by prominent myointimal hyperplasia and perivenous concentric fibrosis, which are characteristics shared by ELP and IMHMV. The observations in this case suggest that some of ELP and IMHMV may belong to the same disease spectrum. Furthermore, perivascular concentric fibrosis was a remarkable observation that may contribute to differential diagnosis between ELP and "true" IMHMV.


Assuntos
Linfócitos T CD4-Positivos/patologia , Enteropatias/patologia , Veias Mesentéricas/patologia , Flebite/patologia , Túnica Íntima/patologia , Biópsia , Angiografia por Tomografia Computadorizada , Diagnóstico Diferencial , Fibrose , Humanos , Hiperplasia , Imuno-Histoquímica , Enteropatias/diagnóstico por imagem , Enteropatias/cirurgia , Masculino , Veias Mesentéricas/diagnóstico por imagem , Veias Mesentéricas/cirurgia , Pessoa de Meia-Idade , Flebite/diagnóstico por imagem , Flebite/cirurgia , Flebografia/métodos , Valor Preditivo dos Testes , Resultado do Tratamento , Túnica Íntima/diagnóstico por imagem , Túnica Íntima/cirurgia
2.
Rev. esp. patol ; 51(4): 224-231, oct.-dic. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-179167

RESUMO

Introducción: La enfermedad relacionada con inmunoglobulina G4 (IgG4) ha sido reconocida durante la última década. Es una condición fibroinflamatoria con capacidad de comprometer casi cualquier órgano. El diagnóstico requiere la confirmación histológica, clínica y paraclínica. En Colombia, este es el estudio con mayor número de casos. Objetivo: Describir las características clínicas e histopatológicas de los pacientes diagnosticados con enfermedad relacionada con IgG4 en la Fundación Valle del Lili. Métodos: Estudio observacional descriptivo retrospectivo. Se revisaron los registros clínicos y patológicos de pacientes a quienes se les diagnosticó enfermedad relacionada con IgG4 en la institución. Se utilizó estadística descriptiva. Resultados: Entre 2013 y 2016 se diagnosticaron 16 pacientes. La mediana de edad fue 44 años, rango intercuartílico 30-58 y 10 (62,5%) fueron mujeres. La presentación clínica más común fue la asociación de masa+síntomas constitucionales+síntomas relacionados con el sitio de localización 43,8% (n=7). No hubo predominancia por algún órgano. En la histopatología todos presentaron infiltrado linfoplasmocitario y fibrosis estoriforme, el 75% flebitis obliterante; en todos los casos se evidenció≥10 células/CAP de IgG4+ y el 81% tuvieron una razón de IgG4+/IgG+>50%. Conclusión: Dada la baja sospecha y el amplio espectro clínico, se cree que existe un subdiagnóstico de la enfermedad. De acuerdo a nuestros hallazgos se recomienda que ante la presencia de infiltrado linfoplasmocitario, fibrosis estoriforme o flebitis obliterante en la evaluación histológica, se solicite inmunohistoquímica para IgG e IgG4, cuya positividad deberá ser correlacionada con estudios complementarios para la confirmación diagnóstica


Introduction: Immunoglobulin G4 (IgG4)-related disease has been described in the last decade. It is a fibro-inflammatory condition capable of affecting almost every organ and diagnosis requires both clinical and paraclinical confirmation. We present the largest study to date in Colombia. Objective: To describe the clinical and histopathological characteristics of patients diagnosed with IgG4-related disease at the Fundación Valle del Lili. Methods: Observational-descriptive retrospective study. The clinical and pathological records of patients diagnosed with IgG4-related disease at the Fundación Valle del Lili were reviewed and a descriptive statistical analysis made. Results: From 2013-2016, 16 patients were diagnosed. Median age was 44 years (RIC 30-58) and 10 (62.5%) were women. The most common clinical presentation was a combination of a tumefactive mass, constitutional symptoms and site-related symptoms (43.8%) (n=7). No preference for any organ was seen. Histopathology revealed all cases had dense lymphoplasmacytic infiltrate and storiform-type fibrosis; 75% also had obliterative phlebitis. In all cases≥10 cells/HPF of IgG4+ were found and 81% had a ratio of IgG4+/IgG+>50%. Conclusion: IgG4-related disease appears to be underdiagnosed, probably due to its broad clinical spectrum as well as a low index of awareness among clinicians. We recommend that, when dense lymphoplasmacytic infiltrates, storiform-type fibrosis or obliterative phlebitis are found, immunohistochemistry for IgG and IgG4should be requested. Positive results then must be correlated with complementary studies to confirm the disease


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hipergamaglobulinemia/patologia , Pancreatite/imunologia , Doenças Autoimunes/patologia , Estudos Retrospectivos , Colômbia/epidemiologia , Flebite/patologia , Imuno-Histoquímica/métodos
3.
Transplant Proc ; 50(8): 2545-2547, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30316395

RESUMO

PURPOSE: Renal transplant patients with vascular rejection type acute T cell-mediated rejection (ATCMR) grade II have a poor prognosis. Vascular lesions in those cases are thought to randomly occur, thus we searched for a novel pathological marker related to vascular rejection in kidney transplantation. METHODS: We determined pathological characteristics in 14 ATCMR grade II patients treated during an acute phase from 2004 to 2013. We then examined whether those findings appeared in transplant kidney biopsy specimens, except for cases of vascular rejection, in patients examined from 2010 to 2014. RESULTS: In 9 of the 14 ATCMR grade II patients, phlebitis was accompanied by inflammatory cells that formed polypoid projections in the venous lumen and partial disappearance of vascular endothelium. Further investigation showed those inflammatory cells to be T cells and macrophages. Histological findings revealed coexisting phlebitis in 2 of 13 patients with ATCMR grade I, 3 of 24 with borderline changes, and none with normal findings. Phlebitis occurred at a significantly greater rate than the other findings in cases of vascular rejection (P < .05). However, there was no significant difference in regard to graft survival between patients with and without phlebitis (P = .1829). CONCLUSION: Our results suggest severe phlebitis as a novel finding associated with the pathology of vascular rejection in patients with a renal allograft.


Assuntos
Rejeição de Enxerto/imunologia , Rejeição de Enxerto/patologia , Transplante de Rim/efeitos adversos , Flebite/complicações , Adulto , Feminino , Sobrevivência de Enxerto/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Flebite/patologia , Linfócitos T/imunologia , Transplante Homólogo
4.
Rev Esp Patol ; 51(4): 224-231, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-30269773

RESUMO

INTRODUCTION: Immunoglobulin G4 (IgG4)-related disease has been described in the last decade. It is a fibro-inflammatory condition capable of affecting almost every organ and diagnosis requires both clinical and paraclinical confirmation. We present the largest study to date in Colombia. OBJECTIVE: To describe the clinical and histopathological characteristics of patients diagnosed with IgG4-related disease at the Fundación Valle del Lili. METHODS: Observational-descriptive retrospective study. The clinical and pathological records of patients diagnosed with IgG4-related disease at the Fundación Valle del Lili were reviewed and a descriptive statistical analysis made. RESULTS: From 2013-2016, 16 patients were diagnosed. Median age was 44 years (RIC 30-58) and 10 (62.5%) were women. The most common clinical presentation was a combination of a tumefactive mass, constitutional symptoms and site-related symptoms (43.8%) (n=7). No preference for any organ was seen. Histopathology revealed all cases had dense lymphoplasmacytic infiltrate and storiform-type fibrosis; 75% also had obliterative phlebitis. In all cases≥10 cells/HPF of IgG4+ were found and 81% had a ratio of IgG4+/IgG+>50%. CONCLUSION: IgG4-related disease appears to be underdiagnosed, probably due to its broad clinical spectrum as well as a low index of awareness among clinicians. We recommend that, when dense lymphoplasmacytic infiltrates, storiform-type fibrosis or obliterative phlebitis are found, immunohistochemistry for IgG and IgG4should be requested. Positive results then must be correlated with complementary studies to confirm the disease.


Assuntos
Doença Relacionada a Imunoglobulina G4/patologia , Adulto , Doenças Autoimunes/epidemiologia , Colômbia/epidemiologia , Comorbidade , Feminino , Fibrose , Humanos , Hipersensibilidade/epidemiologia , Doença Relacionada a Imunoglobulina G4/epidemiologia , Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Flebite/etiologia , Flebite/patologia , Plasmócitos/patologia , Estudos Retrospectivos , Avaliação de Sintomas , Centros de Atenção Terciária/estatística & dados numéricos
5.
Avian Pathol ; 46(6): 623-643, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28609139

RESUMO

Wooden Breast Disease (WBD), a myopathy that frequently affects modern broiler chickens, is a disorder that has been associated with significant economic losses in the poultry industry. To examine tissue changes associated with the onset and early pathogenesis of this disorder, a time-series experiment was conducted using chickens from a high-breast-muscle-yield, purebred commercial broiler line. Birds were raised for up to seven weeks, with a subset of birds sampled weekly. Breast muscle tissues were extracted at necropsy and processed for analysis by light microscopy and transmission electron microscopy. Histologic presentation indicated localized phlebitis with lipogranulomas in Week 1, focal single-myofibril degeneration in Week 2 preceding an inflammatory response that started in Week 3. Lesions in Week 4 were characterized by multifocal to diffuse muscle fibre degeneration, necrosis, interstitial oedema accompanied by increased lipid and inflammatory cell infiltration. Lesions in Weeks 5-7 revealed diffuse muscle degeneration, necrosis, fibrosis and fatty infiltration with lipogranulomas. Ultrastructural examination showed myofibrillar splitting and degeneration, irregular, displaced and degenerated Z-lines, mitochondrial degeneration and interstitial fibrosis with dense regular collagen fibres. This study, therefore, demonstrates that WBD exhibits an earlier onset in modern broilers than when detectable by clinical examination. Further, this study shows that the disease assumes a progressive course with acute vasculitis, lipid deposition and myodegeneration occurring in the earlier stages, followed by a chronic fibrotic phase.


Assuntos
Doenças Mamárias/veterinária , Galinhas , Metabolismo dos Lipídeos , Doenças Musculares/veterinária , Flebite/veterinária , Doenças das Aves Domésticas/patologia , Animais , Animais Recém-Nascidos , Doenças Mamárias/patologia , Progressão da Doença , Análise de Séries Temporais Interrompida , Masculino , Doenças Musculares/patologia , Músculos Peitorais/patologia , Fenótipo , Flebite/patologia , Distribuição Aleatória
6.
Zhonghua Bing Li Xue Za Zhi ; 46(3): 166-169, 2017 Mar 08.
Artigo em Chinês | MEDLINE | ID: mdl-28297756

RESUMO

Objective: To observe the histopathological changes and immunohistochemical expression of IgG4 in Riedle thyroiditis (RT) and to study the relationship between RT and IgG4-related diseases (IgG4-RD). Methods: A total of 5 RT patients were collected from the Department of Pathology, Peking Union Medical College Hospital during April 2012 to August 2014. The clinical and immunohistochemical features were analyzed in the 5 patients. Histopathologic analysis was performed on hematoxylin and eosin-stained sections. Results: There were one male and four female patients, aged 52 to 78 years (median 59 years). Five cases were characterized by multiple nodules of thyroid, which increased year by year. All patients were found to have surrounding tissue compression symptoms and signs. Two female patients were found to have hypothyroidism. The serum concentration of IgG was elevated in 2 cases, and the serum concentration of IgG was not tested before operation in the remaining patients. By ultrasound, all presented as low echo or medium low echo. Strong echo occasionally appeared in hypoechoic nodules. Microscopically, fibrous tissue hyperplasia was infiltrated with varying numbers of lymphocytes and plasma cells. The occlusion of phlebitis was found in 4 cases and eosinophils were found in 3 cases. IgG4 counts and IgG4/IgG ratios in 5 cases were 20/HPF, 16%; 60/HPF, 82%; 22/HPF, 28%; 400/HPF, 266% and 33/HPF, 71%, respectively. Conclusions: With the similar pathological manifestations between RT and IgG4-RD, immunohistochemical staining shows that the number of IgG4 positive plasma cells and IgG4/IgG ratio of RT are increased in varying degrees. Some cases meet the diagnostic criteria of IgG4-RD, and speculate that some cases of RT belong to IgG4-RD.


Assuntos
Imunoglobulina G/metabolismo , Flebite/patologia , Plasmócitos/patologia , Tireoidite/patologia , Adulto , Idoso , Eosinófilos/patologia , Feminino , Humanos , Imunoglobulina G/sangue , Imuno-Histoquímica , Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Tireoidite/diagnóstico
7.
Rev Esp Enferm Dig ; 108(12): 821-826, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26901337

RESUMO

Diseases causing colonic ischemia may be mistaken with other causes of segmental colitis such as inflammatory bowel disease, especially in young patients. The authors present the case of a 47-year-old male with severe proctosigmoiditis. Assessment excluded infectious causes, thrombophilia and systemic vasculitis. The initial histological specimen was suggestive of inflammatory bowel disease and therapy was initiated with intravenous steroids and, at day 5, infliximab, with no response. The patient was proposed for surgery. Pathological examination of the surgical specimen revealed an idiopathic myointimal hyperplasia of mesenteric veins, a rare entity exhibiting necrotizing phlebitis with rapid progression to segmental necrosis in the rectosigmoid colon. In this paper the authors discuss the differential diagnosis of proctosigmoiditis in young ages and the approach to this exceptionally rare ischemic entity.


Assuntos
Colite/etiologia , Veias Mesentéricas/patologia , Biópsia , Colite/diagnóstico , Colite/cirurgia , Humanos , Hiperplasia , Masculino , Veias Mesentéricas/cirurgia , Pessoa de Meia-Idade , Necrose , Flebite/etiologia , Flebite/patologia , Flebite/cirurgia
8.
Neuropathology ; 36(1): 88-92, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26198847

RESUMO

Primary angiitis of the central nervous system is a rare condition, usually with an insidious onset. There is a wide variety of histological types (granulomatous, lymphocytic or necrotizing vasculitis) and types of vessel involved (arteries, veins or both). Most cases are idiopathic. We describe a first case of idiopathic granulomatous central nervous system phlebitis with additional limited involvement of the heart and lung, exclusively affecting small and medium sized veins in a 22-year-old woman, presenting as a sub acute headache. The reasons for this peculiar limitation of inflammation to the veins and the involvement of the heart and lungs are unknown.


Assuntos
Doenças do Sistema Nervoso Central/patologia , Granuloma/patologia , Pulmão/patologia , Miocárdio/patologia , Flebite/patologia , Autopsia , Edema Encefálico/etiologia , Edema Encefálico/patologia , Veias Cerebrais/patologia , Evolução Fatal , Feminino , Granuloma/complicações , Cefaleia/etiologia , Humanos , Flebite/etiologia , Vasculite do Sistema Nervoso Central/complicações , Vasculite do Sistema Nervoso Central/patologia , Adulto Jovem
9.
Zhonghua Bing Li Xue Za Zhi ; 44(10): 729-33, 2015 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-26702531

RESUMO

OBJECTIVE: To study the prevalence of IgG4-positive plasma cells in Rosai-Dorfman disease and to assess the association between Rosai-Dorfman disease and IgG4-related sclerosing disease (IgG4-SD). METHODS: The clinicopathologic features of 12 tissue samples of Rosai-Dorfman disease (11 extranodal and one nodal) from nine patients were reviewed. The degree of fibrosis and occlusive phlebitis was studied by HE staining. The expression of IgG4 and IgG in plasma cells were studied by immunohistochemistry (EnVision) and quantitatively analyzed by medical image analysis system. RESULTS: Nine tissue samples showed different degree of fibrosis (four tissue samples were mild, one tissue sample was moderate and four tissue samples were severe) and two tissue samples showed occlusive phlebitis in the lesional tissue. Immunohistochemical study showed marked infiltration by IgG4-positive plasma cells (> 50 per high-power field) in four tissue samples, moderate infiltration (30 to 50 per high-power field) in two tissue samples, mild (10 to 29 per high-power field) in three cases and negative infiltration (< 10 per high-power field) in three tissue samples (P < 0.01). Three tissue samples fulfilled the diagnostic criteria of IgG4-SD (> 50 IgG4-positive plasma cells per high-power field and IgG4-to-IgG ratio > 40%), including one tissue sample each of Rosai-Dorfman disease in the left facial skin, above the left eye socket, and in the right parotid. CONCLUSIONS: Some cases of Rosai-Dorfman disease fulfill the diagnostic criteria and show the histologic features of IgG4-SD. They may represent members of the IgG4-SD spectrum. The detection of IgG4-positive plasma cells in the lesional tissues of Rosai-Dorfman disease may have clinical pathological significance.


Assuntos
Histiocitose Sinusal/diagnóstico , Imunoglobulina G/química , Plasmócitos/química , Fibrose , Histiocitose Sinusal/imunologia , Humanos , Imuno-Histoquímica , Flebite/patologia
10.
J Zoo Wildl Med ; 46(4): 938-40, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26667556

RESUMO

Umbilical disorders, including omphalophlebitis, omphaloarteritis, external umbilical abscesses, urachal abscesses, patent urachus, and umbilical hernias, represent a significant challenge to the health and well-being of a neonate. The three neonatal giraffe (Giraffa camelopardalis) in this report were evaluated for umbilical swellings. Two developed omphalophlebitis, and one had an uncomplicated umbilical hernia. Omphalophlebitis is an inflammation and/or infection of the umbilical vein. Giraffe calves with a failure of passive transfer may be predisposed and should be thoroughly evaluated for the condition. Umbilical hernias result from a failure of the umbilical ring to close after parturition or from malformation of the umbilical ring during embryogenesis. These problems were surgically corrected for all three individuals, although one died due to postsurgical complications. The risks involved include anesthetic complications, surgical dehiscence, and maternal rejection. Early detection and surgical intervention are recommended for the correction of omphalophlebitis and umbilical hernias in neonatal giraffe.


Assuntos
Animais Recém-Nascidos , Antílopes , Hérnia Umbilical/veterinária , Flebite/veterinária , Veias Umbilicais/patologia , Animais , Hérnia Umbilical/patologia , Hérnia Umbilical/cirurgia , Masculino , Peritonite/veterinária , Flebite/patologia , Flebite/cirurgia , Veias Umbilicais/cirurgia
11.
Medwave ; 15(8): e6258, 2015 Sep 08.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-26485344

RESUMO

We present the case of a 50-year-old man who comes to the emergency department of Dos de Mayo Hospital, Lima, Peru, with fever, abdominal pain, diarrhea and jaundice. An intestinal infection arises as initial diagnosis. He is referred to the area of Internal Medicine where various laboratory tests and imaging studies were conducted, including an abdominal computerized tomography scan. The scan confirmed the diagnosis of pylephlebitis; treatment with antibiotics and anticoagulant therapy was immediately established. Response and evolution were favorable.


Assuntos
Dor Abdominal/etiologia , Febre/etiologia , Flebite/diagnóstico , Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Flebite/tratamento farmacológico , Flebite/patologia , Veia Porta/patologia , Tomografia Computadorizada por Raios X
13.
Rev. Rol enferm ; 38(4): 9-13, abr. 2015. ilus, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-137126

RESUMO

En el presente artículo se exponen algunas de las complicaciones asociadas a la terapia endovenosa por vía periférica y se describen las características de un catéter de sistema cerrado, que consigue mejorar la seguridad tanto de los pacientes como de los profesionales sanitarios. El catéter dispone en su interior de una membrana antirreflujo que mejora su manipulación, y un novedoso sistema de conexión, con una gran plataforma de fijación, que reduce las complicaciones relacionadas con una sujeción deficiente. Además, está dotado de un dispositivo de seguridad de activación automática que protege de forma inmediata y eficaz, lo que elimina el riesgo de pinchazos accidentales (AU)


This article explains some complications associated with peripheral intravenous venipuncture and also describes the characteristics of a closed system catheter providing an improved safety, both for patient and health care professional. The catheter is designed with a multi-access septum providing a closed-system and with a new hub including a stabilisation platform for better fixation in order to reduce any complication resulting from insufficient fixation. Additionally it is a passive safety device that automatically protects from the risk of needle stick injuries (AU)


Assuntos
Feminino , Humanos , Masculino , Punções/ética , Punções/instrumentação , Cateterismo Periférico/classificação , Cateterismo Periférico/métodos , Flebite/metabolismo , Flebite/patologia , Infiltração/métodos , Lesão por Pressão/metabolismo , Punções/métodos , Punções/enfermagem , Cateterismo Periférico/instrumentação , Cateterismo Periférico , Flebite/diagnóstico , Flebite/enfermagem , Infiltração/classificação , Lesão por Pressão/complicações
15.
Lancet ; 385(9976): 1460-71, 2015 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-25481618

RESUMO

IgG4-related disease is a protean condition that mimics many malignant, infectious, and inflammatory disorders. This multi-organ immune-mediated condition links many disorders previously regarded as isolated, single-organ diseases without any known underlying systemic condition. It was recognised as a unified entity only 10 years ago. Histopathology is the key to diagnosis. The three central pathology features of IgG4-related disease are lymphoplasmacytic infiltration, storiform fibrosis, and obliterative phlebitis. The extent of fibrosis is an important determinant of responsiveness to immunosuppressive therapies. IgG4-related disease generally responds to glucocorticoids in its inflammatory stage, but recurrent or refractory cases are common. Important mechanistic insights have been derived from studies of patients treated by B-cell depletion. Greater awareness of this disease is needed to ensure earlier diagnoses, which can prevent severe organ damage, disabling tissue fibrosis, and even death. Identification of specific antigens and T-cell clones that drive the disease will be the first steps to elucidate the pathogenesis of IgG4-related disease.


Assuntos
Doenças do Sistema Imunitário/patologia , Imunoglobulina G/imunologia , Feminino , Fibrose/patologia , Glucocorticoides/uso terapêutico , Humanos , Doenças do Sistema Imunitário/diagnóstico , Doenças do Sistema Imunitário/tratamento farmacológico , Linfócitos/patologia , Masculino , Flebite/patologia , Plasmócitos/patologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-24972181

RESUMO

A 23-year-old woman with history of headaches and auditory changes presented with acute-onset visual field loss in the right eye. The combination of multiple retinal branch artery occlusions of the right eye on funduscopic examination, characteristic white matter lesions in the corpus callosum on magnetic resonance imaging, and hearing loss on audiometric testing led to a diagnosis of Susac's syndrome. Ultra-widefield fluorescein angiography revealed involvement of the retinal veins, which has not been previously reported with this condition. Additionally, ultra-widefield indocyanine green angiography demonstrated changes in the choroidal circulation, which are controversial in this syndrome.


Assuntos
Angiofluoresceinografia/métodos , Flebite/patologia , Doenças Retinianas/patologia , Síndrome de Susac/complicações , Doenças da Coroide/patologia , Feminino , Humanos , Flebite/etiologia , Doenças Retinianas/etiologia , Adulto Jovem
20.
Angiol Sosud Khir ; 20(2): 90-6, 2014.
Artigo em Russo | MEDLINE | ID: mdl-24961330

RESUMO

UNLABELLED: Venous hypertension combined with other pathogenetic links of the development of chronic venous insufficiency creates conditions for activation of an inflammatory process. Chronization of inflammation leads to alterations in the histological structure of the vascular wall and perivasal tissues, which is reflected by changes in their physical properties (elasticity or compressibility), which may be studied by means of ultrasound elastography (USEG). OBJECTIVE: The study was aimed at exploring the possibility of using ultrasound elastography for monitoring efficacy of conservative treatment of varicose disease of lower extremities with an agent containing a micronized purified flavonoid fraction (MPFF). MATERIAL AND METHODS: we examined a total of 19 patients (38 limbs) presenting with varicose disease of clinical class C2 according to the CEAP classification. The standard ultrasound examination and USEG were carried out using the unit of expert-class "Toshiba" (Japan) with a multi-frequency linear transducer 5-12 Hz. We examined the great saphenous vein in the area of the femur and crus, its tributaries, and the small saphenous vein. All examinations were performed with the patient in the supine, prone and standing positions from the standard approaches in the second half of the day prior to treatment with a phlebotrophic agent containing MPFF (Detralex) and three months after taking the drug at a dose of 1,000 mg/day. RESULTS: at baseline, according to the findings of USEG the intact veins of the lower limbs had a homogeneous pattern of the elastogram in the perivasal area. The presence of varicose transformation was associated with an inhomogeneous elastographic picture. On the background of treatment with MPFF, all patients showed a positive clinical effect in the form of decreased intensity of manifestations of complaints or complete disappearance thereof. According to the findings of ultrasound examination, there was a tendency towards a decrease in the wall thickness and diameter of the examined veins. USEG demonstrated an increase in the perivasal zones of elastographic homogeneity of tissues. The USEG-revealed alterations were more pronounced in large-diameter vessels. On the background of treatment with Detralex there was a trend towards normalization of the elastographic pattern of the vessel as a whole. CONCLUSION: the obtained findings confirm feasibility of using the technique of ultrasound elastography for identification of objective markers of treatment response to MPFF in varicose disease.


Assuntos
Diosmina , Técnicas de Imagem por Elasticidade/métodos , Flavonoides , Hesperidina , Veia Safena , Varizes , Disponibilidade Biológica , Diosmina/administração & dosagem , Diosmina/farmacocinética , Combinação de Medicamentos , Monitoramento de Medicamentos/métodos , Elasticidade/efeitos dos fármacos , Elasticidade/fisiologia , Estudos de Viabilidade , Feminino , Flavonoides/administração & dosagem , Flavonoides/química , Flavonoides/farmacocinética , Flavonoides/farmacologia , Hesperidina/administração & dosagem , Hesperidina/farmacocinética , Humanos , Extremidade Inferior/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Flebite/patologia , Flebite/fisiopatologia , Veia Safena/diagnóstico por imagem , Veia Safena/efeitos dos fármacos , Veia Safena/fisiopatologia , Índice de Gravidade de Doença , Resultado do Tratamento , Varizes/diagnóstico , Varizes/tratamento farmacológico , Varizes/fisiopatologia , Insuficiência Venosa/patologia , Insuficiência Venosa/fisiopatologia
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