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1.
Curr Cardiol Rep ; 23(7): 90, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34081219

RESUMO

PURPOSE OF REVIEW: Coronavirus disease 2019 (COVID19) involves the heart, including pericardium. This article reviews the possible pathophysiological mechanisms in pericardial involvement in COVID19 and pericardial manifestations of COVID19. It also summarizes the patients with pericarditis secondary to COVID19 and outlines the contemporary treatment strategies in this patient population. RECENT FINDINGS: A high degree of suspicion is required to identify the pericardial involvement in COVID19 patients. It is proposed that an underlying hyperinflammatory reaction in COVID19 leads to pericardial inflammation. Acute pericarditis with or without myocardial involvement is diagnosed on clinical presentation, serum inflammatory markers, electrocardiogram, and echocardiogram. Multimodality imaging may also have an additional diagnostic value. Patients are usually managed medically, but some patients develop a life-threatening pericardial tamponade necessitating pericardial drainage. Pericardial involvement is an important clinical manifestation of COVID19 requiring a proper workup. Timely diagnosis and a specific management plan based on the presentation and concomitant organ involvement usually lead to a complete recovery.


Assuntos
COVID-19 , Tamponamento Cardíaco , Derrame Pericárdico , Pericardite , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Humanos , Pericardite/diagnóstico por imagem , Pericardite/terapia , Pericárdio/diagnóstico por imagem , SARS-CoV-2
2.
Am J Kidney Dis ; 77(5): 796-809, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33771393

RESUMO

Since maintenance hemodialysis (HD) first became available in the United States in 1962, there has been tremendous growth in the population of patients with kidney failure. HD has become a routine treatment carried out in outpatient clinics, hospitals, nursing facilities, and in patients' homes. Although it is a complex procedure, HD is quite safe. Serious complications are uncommon due to the use of modern HD machines and water treatment systems as well as the development of strict protocols to monitor various aspects of the HD treatment. The practicing nephrologist must be knowledgeable about life-threatening complications that can occur during HD and be able to recognize, manage, and prevent them. This installment in the AJKD Core Curriculum in Nephrology reviews the pathogenesis, management, and prevention of 9 HD emergencies. The HD emergencies covered include dialyzer reactions, dialysis disequilibrium syndrome, uremic/dialysis-associated pericarditis, air embolism, venous needle dislodgement, vascular access hemorrhage, hemolysis, dialysis water contamination, and arrhythmia episodes.


Assuntos
Emergências , Falência Renal Crônica/terapia , Diálise Renal/efeitos adversos , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/fisiopatologia , Arritmias Cardíacas/terapia , Edema Encefálico , Descontaminação , Soluções para Diálise/normas , Embolia Aérea/etiologia , Embolia Aérea/fisiopatologia , Embolia Aérea/terapia , Deslocamentos de Líquidos Corporais , Hemólise , Hemorragia/etiologia , Hemorragia/fisiopatologia , Hemorragia/terapia , Humanos , Hipersensibilidade/etiologia , Hipersensibilidade/fisiopatologia , Hipersensibilidade/terapia , Rins Artificiais/efeitos adversos , Agulhas , Nefrologia , Pericardite/etiologia , Pericardite/fisiopatologia , Pericardite/terapia , Falha de Prótese , Esterilização , Uremia/complicações , Purificação da Água/normas
3.
Am J Cardiol ; 145: 151-159, 2021 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-33460602

RESUMO

Despite the monumental advances in the diagnoses and therapeutics of malignancy, several cancer patients have presented with pericardial involvement, including acute pericarditis, constrictive pericarditis, and pericardial effusion. Multiple factors can contribute to acute pericarditis, including direct metastasis to the heart, pericardial hemorrhage, infections due to immunosuppression, and cancer therapies that include chemotherapy, immunotherapy, and radiation. Pericardial effusion, either due to cancer invasion or cancer treatment, is one of the most common incidental findings in cancer patients, which significantly worsens morbidity and mortality. If left untreated, pericardial effusion is known to cause complications such as pericardial tamponade. Constrictive pericarditis can be due to radiation exposure, chemotherapy, or is a sequela of a previous episode of acute pericarditis. In conclusion, early detection, prompt treatment, and understanding of pericardial diseases are necessary to help improve the quality of life of cancer patients, and we aim to summarize the knowledge of pericardial involvement in patients with cancer.


Assuntos
Antineoplásicos/efeitos adversos , Hemorragia/fisiopatologia , Neoplasias/terapia , Derrame Pericárdico/fisiopatologia , Pericardite Constritiva/fisiopatologia , Lesões por Radiação/fisiopatologia , Radioterapia/efeitos adversos , Hemorragia/diagnóstico , Hemorragia/etiologia , Hemorragia/terapia , Humanos , Hospedeiro Imunocomprometido , Infecções/etiologia , Infecções/imunologia , Infecções/fisiopatologia , Metástase Neoplásica , Neoplasias/complicações , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/etiologia , Derrame Pericárdico/terapia , Pericardite/diagnóstico , Pericardite/etiologia , Pericardite/fisiopatologia , Pericardite/terapia , Pericardite Constritiva/diagnóstico , Pericardite Constritiva/etiologia , Pericardite Constritiva/terapia , Pericárdio , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Lesões por Radiação/terapia
4.
Am J Case Rep ; 22: e928188, 2021 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-33423035

RESUMO

BACKGROUND Pleuropericarditis after pacemaker (IPG) implantation is a rare post-cardiac injury syndrome (PCIS) condition. Pericarditis is one of the complications following insertion of a IPG; it affects 2-5% of patients within 5-21 days after IPG implementation and is associated with screw-in (active fixation) atrial lead positioning. Usually, pericarditis following IPG implantation is benign and has a self-limiting course. The mechanism of this complication remains unclear. It could involve a direct irritation of pericardium by minimally protruding electrodes, low bleeding, and autoimmune and inflammatory responses. The frequency of pleuropericarditis is not well defined. The etiopathogenesis is presumed to be the same as for pericarditis, yet there are no standardized criteria for the diagnosis, and treatment is based on the empirical anti-inflammatory therapy used in pericarditis. CASE REPORT A 71-year-old woman was admitted due to syncope. Sinus arrests with escape atrioventricular rhythm were observed during hospitalization; therefore, a dual-chamber pacemaker (IPG) was implanted with 2 active fixation (screw-in) electrodes. On the first day after implantation, a slight pericardial hemorrhage occurred with resorption in the following days, and an inflammatory reaction with pericardial and left pleural effusion occurred later. The first-line treatment was ineffective. However, prednisolone with colchicines with longer use than suggested by pericarditis recommendations was effective. CONCLUSIONS Patients with even mild pericardial effusion after IPG insertion should be followed closely due to the risk of pleuropericarditis, with consideration of anti-inflammatory treatment for longer than in pericarditis.


Assuntos
Marca-Passo Artificial , Derrame Pericárdico , Pericardite , Derrame Pleural , Idoso , Feminino , Humanos , Marca-Passo Artificial/efeitos adversos , Pericardite/diagnóstico , Pericardite/etiologia , Pericardite/terapia , Pericárdio
7.
JAMA Cardiol ; 5(7): 819-824, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32219357

RESUMO

Importance: Virus infection has been widely described as one of the most common causes of myocarditis. However, less is known about the cardiac involvement as a complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Objective: To describe the presentation of acute myocardial inflammation in a patient with coronavirus disease 2019 (COVID-19) who recovered from the influenzalike syndrome and developed fatigue and signs and symptoms of heart failure a week after upper respiratory tract symptoms. Design, Setting, and Participant: This case report describes an otherwise healthy 53-year-old woman who tested positive for COVID-19 and was admitted to the cardiac care unit in March 2020 for acute myopericarditis with systolic dysfunction, confirmed on cardiac magnetic resonance imaging, the week after onset of fever and dry cough due to COVID-19. The patient did not show any respiratory involvement during the clinical course. Exposure: Cardiac involvement with COVID-19. Main Outcomes and Measures: Detection of cardiac involvement with an increase in levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin T, echocardiography changes, and diffuse biventricular myocardial edema and late gadolinium enhancement on cardiac magnetic resonance imaging. Results: An otherwise healthy 53-year-old white woman presented to the emergency department with severe fatigue. She described fever and dry cough the week before. She was afebrile but hypotensive; electrocardiography showed diffuse ST elevation, and elevated high-sensitivity troponin T and NT-proBNP levels were detected. Findings on chest radiography were normal. There was no evidence of obstructive coronary disease on coronary angiography. Based on the COVID-19 outbreak, a nasopharyngeal swab was performed, with a positive result for SARS-CoV-2 on real-time reverse transcriptase-polymerase chain reaction assay. Cardiac magnetic resonance imaging showed increased wall thickness with diffuse biventricular hypokinesis, especially in the apical segments, and severe left ventricular dysfunction (left ventricular ejection fraction of 35%). Short tau inversion recovery and T2-mapping sequences showed marked biventricular myocardial interstitial edema, and there was also diffuse late gadolinium enhancement involving the entire biventricular wall. There was a circumferential pericardial effusion that was most notable around the right cardiac chambers. These findings were all consistent with acute myopericarditis. She was treated with dobutamine, antiviral drugs (lopinavir/ritonavir), steroids, chloroquine, and medical treatment for heart failure, with progressive clinical and instrumental stabilization. Conclusions and Relevance: This case highlights cardiac involvement as a complication associated with COVID-19, even without symptoms and signs of interstitial pneumonia.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Miocardite/virologia , Pericardite/virologia , Pneumonia Viral/complicações , Disfunção Ventricular Esquerda/virologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Miocardite/diagnóstico por imagem , Miocardite/terapia , Pandemias , Pericardite/diagnóstico por imagem , Pericardite/terapia , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/terapia
8.
BMC Cardiovasc Disord ; 20(1): 28, 2020 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-32209051

RESUMO

BACKGROUND: In the workup of a pediatric patient with pericarditis we found evidence of a pseudo-aneurysm of the left ventricle, which is a rare complication of purulent pericarditis. CASE PRESENTATION: We present a case of a six-year-old girl who was diagnosed with pericarditis and a fistula between the pericardial and the intra-luminal space of the left ventricle of the heart. She was successfully treated with antibiotics and cardio-thoracic surgery. We found 23 published cases (21 with follow-up) of infectious pseudo-aneurysm of the heart, of which 19 underwent surgery, 5 had fatal outcome, and 2 who refused surgery survived. The majority of cases were associated with Staphylococcus aureus. The exact mechanisms of this rare complication remain unknown. CONCLUSIONS: A pseudo-aneurysm of the left ventricle is a rare and not well understood complication of a purulent pericarditis most commonly caused by Staphylococcus aureus infection. Because of risk of rupture, surgical intervention is advised.


Assuntos
Falso Aneurisma/microbiologia , Aneurisma Infectado/microbiologia , Neoplasias Cardíacas/microbiologia , Osteomielite/microbiologia , Pericardite/microbiologia , Infecções Estafilocócicas/microbiologia , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/terapia , Aneurisma Infectado/diagnóstico por imagem , Aneurisma Infectado/terapia , Antibacterianos/uso terapêutico , Procedimentos Cirúrgicos Cardíacos , Criança , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/terapia , Humanos , Osteomielite/complicações , Osteomielite/diagnóstico , Osteomielite/terapia , Pericardite/diagnóstico por imagem , Pericardite/terapia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/terapia , Resultado do Tratamento
9.
Am J Case Rep ; 21: e921633, 2020 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-32107365

RESUMO

BACKGROUND Acute bacterial pericarditis is rare, and the incidence numbers have been declining in the modern antibiotic era. Purulent bacterial pericarditis is a fatal disease in which mortality rates can reach 100% if left untreated. CASE REPORT We present a case of primary purulent bacterial pericarditis with polymicrobial growth including Micromonas micro, Prevotella intermedia and Fusobacterium species, all of which are anaerobic flora of the oral cavity. Constant re-accumulation of the purulent pericardial effusion led the patient to have recurrent echocardiographic and clinical cardiac tamponade requiring recurrent pericardiocentesis' and eventually a pericardial window. CONCLUSIONS Although rare, bacterial pericarditis has been noted to lead to clinical and echocardiographic tamponade. Early diagnosis and treatment are necessary for improving clinical outcomes. It is important to have a suspicion for purulent pericarditis, due to its high level of mortality, in patients who present with non-specific symptoms and pleuritic chest pain.


Assuntos
Bactérias Anaeróbias/efeitos dos fármacos , Tamponamento Cardíaco/microbiologia , Tamponamento Cardíaco/terapia , Pericardite/microbiologia , Pericardite/terapia , Adulto , Antibacterianos/uso terapêutico , Fusobacterium/efeitos dos fármacos , Humanos , Masculino , Pericardiocentese , Prevotella intermedia/efeitos dos fármacos , Doenças Raras
11.
J Am Coll Cardiol ; 75(1): 76-92, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31918837

RESUMO

Pericarditis refers to the inflammation of the pericardial layers, resulting from a variety of stimuli triggering a stereotyped immune response, and characterized by chest pain associated often with peculiar electrocardiographic changes and, at times, accompanied by pericardial effusion. Acute pericarditis is generally self-limited and not life-threatening; yet, it may cause significant short-term disability, be complicated by either a large pericardial effusion or tamponade, and carry a significant risk of recurrence. The mainstay of treatment of pericarditis is represented by anti-inflammatory drugs. Anti-inflammatory treatments vary, however, in both effectiveness and side-effect profile. The objective of this review is to summarize the up-to-date management of acute and recurrent pericarditis.


Assuntos
Anti-Inflamatórios/uso terapêutico , Gerenciamento Clínico , Pericardite/diagnóstico por imagem , Pericardite/terapia , Doença Aguda , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/fisiopatologia , Tamponamento Cardíaco/terapia , Ecocardiografia/métodos , Eletrocardiografia/métodos , Humanos , Pericardite/fisiopatologia , Recidiva , Literatura de Revisão como Assunto , Tomografia Computadorizada por Raios X/métodos
13.
JAAPA ; 33(1): 16-22, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31880644

RESUMO

Pericarditis is the most common form of pericardial disease and may be associated with significant morbidity and mortality. Management of idiopathic pericarditis includes pharmacologic therapies, non-pharmacologic therapies, and surgery. This article describes the diagnosis and management of idiopathic causes of pericarditis, incorporating recommendations included in the European Society of Cardiology guidelines.


Assuntos
Corticosteroides/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Colchicina/uso terapêutico , Imunossupressores/uso terapêutico , Técnicas de Janela Pericárdica , Pericardite/terapia , Moduladores de Tubulina/uso terapêutico , Doença Aguda , Aspirina/uso terapêutico , Azatioprina/uso terapêutico , Gerenciamento Clínico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Fatores Imunológicos/uso terapêutico , Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico , Pericardite/diagnóstico por imagem , Guias de Prática Clínica como Assunto , Recidiva
14.
Ter Arkh ; 92(12): 10-18, 2020 Dec 15.
Artigo em Russo | MEDLINE | ID: mdl-33720567

RESUMO

AIM: To analyze the register of pericarditis in a therapeutic clinic, to evaluate their nosological spectrum, to optimize approaches to diagnosis and treatment. MATERIALS AND METHODS: For the period 20072018, the register includes 76 patients with the diagnosis of pericarditis (average age 53.115.7 years, 2085 years, 46 female). Patients with hydropericardium were not included in the register. Diagnostic puncture of pericardium was carried out in 5 patients, pleural puncture in 11 patients. Morphological diagnostics included endomyocardial/ intraoperative biopsy of myocardium (n=4/2), thoracoscopic/intraoperative biopsy of pericardium (n=1/6), pleural puncture (n=5), transbronchial (n=1), thoracoscopic biopsy of intrathoracic lymph nodes (n=2), lung (n=1), supraclavicular lymph node biopsy (n=1), salivary gland (n=1), subcutaneous fat and rectum biopsy per amyloid (n=6/1). The genome of cardiotropic viruses, level of anti-heart antibodies, C-reactive protein, antinuclear factor, rheumatoid factor (antibodies to cyclic citrullinized peptide), antibodies to neutrophil cytoplasm were determined, extractable nuclear antigens (ENA), protein immunoelectrophoresis, diaskin test, computed tomography of lungs and heart, cardiac magnetic resonance imaging, oncologic search. RESULTS: The following forms of pericarditis were verified: tuberculosis (14%, including in combination with hypertrophic cardiomyopathy HCM), acute / chronic viral (8%) and infectious immune (38%), including perimyocarditis in 77%, pericarditis associated with mediastinum lymphoma/sarcoma (4%), sarcoidosis (3%), diffuse diseases of connective tissue and vasculitis (systemic lupus erythematosus, rheumatoid arthritis, diseases of Horton, Takayasu, Shegren, Wegener, 12%), leukoclastic vasculitis, Loefflers endomyocarditis, AL-amyloidosis, thrombotic microangiopathy (1% each), HCM (8%), coronary heart disease (constriction after repeated punctures and suppuration; postinfection and immune, 4%), after radiofrequency catheter ablation and valve prosthetics (2%). Tuberculosis was the main causes of constrictive pericarditis (36%). Treatment included steroids (n=39), also in combination with cytostatics (n=12), anti-tuberculosis drugs (n=9), acyclovir/ganclovir (n=14), hydroxychloroquine (n=23), colchicine (n=13), non-steroidal anti-inflammatory drugs (n=21), L-tyroxine (n=5), chemotherapy (n=1). In 36 patients different types of therapy were combined. Treatment results observed in 55 patients. Excellent and stable results were achieved in 82% of them. Pericardiectomy/pericardial resection was successfully performed in 8 patients. Lethality was 13.2% (10 patients) with an average follow-up 9 [2; 29.5] months (up to 10 years). Causes of death were chronic heart failure, surgery for HCM, pulmonary embolism, tumor. CONCLUSION: During a special examination, the nature of pericarditis was established in 97% of patients. Morphological and cytological diagnostics methods play the leading role. Tuberculosis pericarditis, infectious-immune and pericarditis in systemic diseases prevailed. Infectious immune pericarditis is characterized by small and medium exudate without restriction and accompanying myocarditis. Steroids remain the first line of therapy in most cases. Hydroxychloroquine as well as colchicine can be successfully used in moderate / low activity of immune pericarditis and as a long-term maintenance therapy after steroid stop.


Assuntos
Derrame Pericárdico , Pericardite Constritiva , Pericardite Tuberculosa , Pericardite , Feminino , Humanos , Pessoa de Meia-Idade , Pericardiectomia , Pericardite/diagnóstico , Pericardite/etiologia , Pericardite/terapia
15.
Expert Rev Cardiovasc Ther ; 17(11): 817-826, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31709840

RESUMO

Introduction: Acute pericarditis is frequently complicated with recurrences, which represent a diagnostic and therapeutic challenge for the physician, a bothersome trouble for patients. An incorrect treatment of pericarditis may cause further recurrence of symptoms, while an incorrect diagnosis may cause either a prolonged symptoms course with a possible risk of chronic constriction, or useless and potentially harmful treatments.Areas covered: This review will focus on the most useful and recent diagnostic tools for recurrent pericarditis. Medline/Pubmed Library were screened with specific key search: 'recurrent AND pericarditis'. The research was restricted to papers published in the last 5 years (2015-2019) and papers in English language, in order to appraise the latest advances in diagnostic assessment.Expert opinion: An accurate diagnosis of recurrent pericarditis is critical to provide timely and appropriate treatment of symptoms and prevention of further episodes. Diagnosis is made in case of recurrent symptoms associated with a documented evidence of pericardial inflammation. Further studies are needed to develop newer diagnostic tools aimed at identification of a predominant auto-inflammatory of auto-immune mechanism, which is essential to tailor the treatment.


Assuntos
Pericardite/terapia , Pericárdio/patologia , Humanos , Pericardite/diagnóstico , Recidiva
17.
Curr Cardiol Rep ; 21(9): 107, 2019 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-31376028

RESUMO

Identification of the etiology of pericardial disease is challenging because the accessibility to pericardial fluid and tissue is limited and there is a relatively low yield of fluid and tissue analysis. Pericardial disease is associated with various systemic diseases and is frequently a first manifestation of other systemic diseases. Detecting the cause of pericarditis and minimizing the subsequent inflammatory process can possibly prevent long-term complications. PURPOSE OF REVIEW: To review the clinical utility of [18F]-2-deoxy-2-fluoro-D-glucose positron emission tomography/computed tomography ([18F]FDG-PET/CT) in the diagnosis and treatment of pericardial disease. RECENT FINDINGS: [18F]FDG-PET/CT can visualize the hypermetabolic tissues of both malignancy and inflammation. Distribution of [18F]FDG-PET/CT uptake can provide information for neoplastic disease. If malignancy is ruled out, high uptake of pericardium is associated with active inflammation of the pericardium, and thus response to anti-inflammatory agents can also be predicted with [18F]FDG-PET/CT imaging. [18F]FDG-PET/CT can be helpful for diagnosing and establishing prognosis and for planning for anti-inflammatory treatment in pericardial disease.


Assuntos
Pericardite/diagnóstico por imagem , Pericardite/terapia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Fluordesoxiglucose F18 , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/secundário , Humanos , Inflamação/diagnóstico por imagem , Inflamação/terapia , Pericardite/etiologia , Prognóstico , Compostos Radiofarmacêuticos
18.
Curr Cardiol Rep ; 21(9): 97, 2019 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-31352541

RESUMO

PURPOSE OF REVIEW: This review highlights the literature related to pericardial injury following radiation for oncologic diseases. RECENT FINDINGS: Radiation-associated pericardial disease can have devastating consequences. Unfortunately, there is considerably less evidence regarding pericardial syndromes following thoracic radiation as compared to other cardiovascular outcomes. Pericardial complications of radiation may arise acutely or have an insidious onset several decades after treatment. Transthoracic echocardiography is the screening imaging modality of choice, while cardiac magnetic resonance imaging further characterizes the pericardium and guides treatment decision-making. Cardiac CT can be useful for assessing pericardial calcification. Ongoing efforts to lessen inadvertent cardiac injury are directed towards the revision of radiation techniques and protocols. As survival of mediastinal and thoracic malignancies continues to improve, radiation-associated pericardial disease is increasingly relevant. Though advances in radiation oncology demonstrate promise in curtailing cardiotoxicity, the long-term effects pertaining to pericardial complications remain to be seen.


Assuntos
Cardiotoxicidade/diagnóstico por imagem , Derrame Pericárdico/diagnóstico por imagem , Pericardite/diagnóstico por imagem , Pericárdio/diagnóstico por imagem , Cardiotoxicidade/etiologia , Cardiotoxicidade/prevenção & controle , Cardiotoxicidade/terapia , Relação Dose-Resposta à Radiação , Humanos , Neoplasias/radioterapia , Derrame Pericárdico/etiologia , Derrame Pericárdico/prevenção & controle , Derrame Pericárdico/terapia , Pericardite/etiologia , Pericardite/prevenção & controle , Pericardite/terapia , Pericárdio/lesões , Pericárdio/efeitos da radiação , Lesões por Radiação/diagnóstico por imagem , Lesões por Radiação/etiologia , Lesões por Radiação/prevenção & controle , Lesões por Radiação/terapia , Fatores de Risco
19.
BMJ Case Rep ; 12(6)2019 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-31167769

RESUMO

Petrified pinna refers to the calcification or ossification of the external auricular cartilage. It is an uncommon clinical entity and is most often associated with local trauma, frostbite or inflammation. Auricular calcification may be the exclusive cutaneous marker of underlying endocrinopathy. It has been most commonly associated with adrenal insufficiency and other endocrine conditions like diabetes mellitus, hypothyroidism and acromegaly. We present a 47-year-old Caucasian manwho presented with acute pericarditis with tamponade physiology, who was found to have petrified pinnae as a telltale sign of the underlying autoimmune polyendocrine syndrome type 2.


Assuntos
Calcinose/etiologia , Pavilhão Auricular/patologia , Pericardite/etiologia , Poliendocrinopatias Autoimunes/diagnóstico , Insuficiência Adrenal/tratamento farmacológico , Diagnóstico Diferencial , Síndrome da Sela Vazia/diagnóstico por imagem , Humanos , Hipotireoidismo/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Pericardiocentese/métodos , Pericardite/diagnóstico por imagem , Pericardite/terapia , Poliendocrinopatias Autoimunes/complicações , Poliendocrinopatias Autoimunes/imunologia , Resultado do Tratamento
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