Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 528
Filtrar
1.
J Clin Neurosci ; 79: 169-171, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33070890

RESUMO

COVID-19 is the disease caused by Novel Coronavirus (SARS-CoV-2) infection and world current main public health problem, due to its easy transmissibility and multiple clinical presentations. The main symptoms reported worldwide are dry cough, dyspnea, and fever, as well as anosmia and ageusia. COVID-19 diagnosis is made with RT-PCR, but many other complementary exams may be used to guide clinical practice, such as Chest Computerized Tomography (CT), showing ground glass opacities; increase in inflammatory markers, as C-Reactive Protein and Erythrocyte Sedimentation Rate; hemogram might show hypoalbuminemia, thrombocytopenia. Severe cases may evolve to thromboembolic and atheroembolic events, leading to stroke, myocardial infarction, pulmonary thromboembolism. Male, 28 years old, went for neurological appointment after presenting episode of intense headache, dysarthria, deviation of lip rhyme on appointment's eve. Previously healthy, no comorbidities or risk factors. Underwent brain MRI and serum serological analysis. SARS-CoV-2 capacity of affecting brain homeostasis by breaking blood-brain barrier, makes it easier to develop ischemic or inflammatory damage, and invading central nervous system. Neurological symptoms and syndromes are the main consequences of COVID-19 pandemic and must be prevented through adequate clinical management.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/etiologia , Vasculite/diagnóstico por imagem , Vasculite/etiologia , Adulto , Humanos , Imagem por Ressonância Magnética , Masculino , Imagem Multimodal , Pandemias , Tomografia Computadorizada por Raios X
3.
Orv Hetil ; 161(20): 829-838, 2020 05 01.
Artigo em Húngaro | MEDLINE | ID: mdl-32364657

RESUMO

Introduction: Large-vessel vasculitis has non-specific clinical symptoms, which can delay the diagnosis. Early recognition and treatment of the disease can help to avoid late complications. 18 F-FDG-PET can detect the inflammation of the vessel wall in the early stage of the disease with high sensitivity. CT is used to localize vasculitis. Aim: To examine the performance of 18F-FDG-PET/CT in patients with suspected large-vessel vasculitis, during relapse and remission, focusing on disease activity and extent. Method: 43 patients were evaluated. They were classified according to the clinical questions: steroid-naive suspected vasculitis, suspected vasculitis on steroid treatment, patients with relapse and in remission. We examined 10 cancer patients in control. We carried out visual and quantitative analysis of the 18F-FDG uptake of vessel walls. During quantitative evaluation, we determined standardised uptake values (SUVmax) of vessel wall segments compared to liver. Results: We found active disease in 5 patients examined for primary diagnosis, moreover, in 5 patients with relapse. The disease involved 3 or more vessel segments in fifty percent of the active cases. In the visually active group, the SUVmax was significantly lower in patients on steroid treatment than in steroid-naive cases (1.17 ± 0.11 vs. 1.43 ± 0.29; p = 0.005). We confirmed remission in 2 cases after therapy. In the inactive group, we found other types of inflammatory disorders in 8 cases. Conclusion: 18F-FDG-PET/CT is an effective diagnostic tool for large-vessel vasculitis, and can be used to determine the activity and extent of the disease. Steroid treatment influences the 18F-FDG-uptake of vessel wall. Orv Hetil. 2020; 161(20): 829-838.


Assuntos
Fluordesoxiglucose F18/administração & dosagem , Arterite de Células Gigantes/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos/administração & dosagem , Vasculite/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Estudos Prospectivos
4.
Br J Radiol ; 93(1113): 20200103, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32356457

RESUMO

Since its introduction into clinical practice, 2-deoxy-2-[18F]flu-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) has become firmly established in the field of oncological imaging, with a growing body of evidence demonstrating its use in infectious and inflammatory vascular pathologies. This pictorial review illustrates the utility of FDG PET/CT as a diagnostic tool in the investigation of vascular disease and highlights some of the more common incidental vascular findings that PET reporters may encounter on standard oncology FDG PET/CTs, including atherosclerosis, large vessel vasculitis, complications of vascular grafts, infectious aortitis and acute aortic syndromes.


Assuntos
Fluordesoxiglucose F18 , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Doenças Vasculares/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças da Aorta/diagnóstico por imagem , Aortite/diagnóstico por imagem , Aterosclerose/diagnóstico por imagem , Prótese Vascular/efeitos adversos , Feminino , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico por imagem , Infecções Relacionadas à Prótese/diagnóstico por imagem , Vasculite/diagnóstico por imagem
5.
Clin Nucl Med ; 45(7): e327-e328, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32433175

RESUMO

We present a case of a 38-year-old woman who complained with cough, fever, and back pain with a weight loss. F-FDG PET/CT to search fever origin revealed uptake in the tracheobronchial and the left auricular cartilage and wall of the thoracic aorta. She underwent biopsy of the left auricle and was diagnosed with relapsing polychondritis (RP) complicating vasculitis. After steroid therapy, FDG PET/CT demonstrated regression of inflammation, showing decreases in the uptakes. Vasculitis should be considered in case of RP with systemic manifestations. Our case demonstrated the utility of FDG PET/CT in evaluation of RP lesions including aortitis.


Assuntos
Fluordesoxiglucose F18 , Policondrite Recidivante/complicações , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Vasculite/complicações , Vasculite/diagnóstico por imagem , Adulto , Feminino , Humanos , Recidiva
6.
Radiol Clin North Am ; 58(4): 765-779, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32471543

RESUMO

Vasculitides are a complex group of diseases sharing the defining feature of inflamed vessel walls. Vasculitides can be classified depending on the size of the predominantly affected vessels. Modern cross-sectional imaging methods have become a cornerstone in the diagnosis of vasculitis and may help in narrowing down differential diagnoses. This review presents the most important imaging modalities and typical findings in large and medium size vasculitis, implementing current imaging recommendations.


Assuntos
Vasculite/diagnóstico por imagem , Adulto , Idoso , Vasos Sanguíneos/anatomia & histologia , Criança , Angiografia por Tomografia Computadorizada , Feminino , Arterite de Células Gigantes/diagnóstico por imagem , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Síndrome de Linfonodos Mucocutâneos/diagnóstico por imagem , Tamanho do Órgão , Poliarterite Nodosa/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Arterite de Takayasu/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adulto Jovem
7.
Radiol Clin North Am ; 58(4): 831-839, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32471547

RESUMO

A variety of nonatherosclerotic diseases affect the arteries of the pelvis and lower extremities. Chronic repetitive traumatic conditions, such as popliteal entrapment and external iliac artery fibroelastosis, vasculitis and connective tissue diseases, and noninflammatory vascular diseases, are a few of the more commonly encountered nonatherosclerotic peripheral vascular diseases. Ultrasound, computed tomography angiography, and magnetic resonance angiography are essential in the initial assessment and management of patients with peripheral vascular disease.


Assuntos
Doenças Vasculares Periféricas/diagnóstico por imagem , Adulto , Doenças do Tecido Conjuntivo/complicações , Feminino , Fibrose/diagnóstico por imagem , Humanos , Artéria Ilíaca/diagnóstico por imagem , Artéria Ilíaca/patologia , Masculino , Pessoa de Meia-Idade , Artéria Poplítea/diagnóstico por imagem , Vasculite/complicações , Vasculite/diagnóstico por imagem , Adulto Jovem
8.
Pediatrics ; 145(5)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32291346

RESUMO

We describe an atypical pediatric case of immunoglobulin A vasculitis (IgAV), also referred to as Henoch-Schönlein purpura, in which formation of spontaneous hematoma of the paraspinal muscles developed. Spontaneous or unprovoked hematomas rarely occur in IgAV. These manifestations have not been described specifically in the pediatric literature as coinciding with IgAV. These findings are alarming for nonaccidental trauma, particularly in a patient without underlying blood dyscrasia. Our objective for this report is to highlight the possible association of muscular hematoma formation with IgAV and to help providers consider this association when trauma and hemophilia has been ruled out.


Assuntos
Hematoma/diagnóstico por imagem , Imunoglobulina A , Músculo Esquelético/diagnóstico por imagem , Púrpura de Schoenlein-Henoch/diagnóstico por imagem , Vasculite/diagnóstico por imagem , Pré-Escolar , Diagnóstico Diferencial , Hematoma/sangue , Humanos , Imunoglobulina A/sangue , Masculino , Púrpura de Schoenlein-Henoch/sangue , Vasculite/sangue
9.
Am J Case Rep ; 21: e921299, 2020 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-32284523

RESUMO

BACKGROUND Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibody production leading to inflammation in multiple organs; it commonly affects young women in their child-bearing years. Clinical manifestations are diverse and range from mild arthritis to diffuse alveolar hemorrhage (DAH). DAH is a rare and devastating complication of SLE that carries a mortality rate of up to 50%, despite aggressive therapy. CASE REPORT A 21-year-old primigravida at 16 weeks gestation presents with a productive cough, rash, sore throat, and high-grade fever. Chest x-ray suggested multifocal pneumonia. Patient deteriorated despite antibiotics and intravenous (IV) fluids. She developed worsening anemia, leukopenia, and thrombocytopenia. Autoimmune workup was positive for Coombs, antinuclear antibody, anti-smith antibody, and hypocomplementemia. Skin biopsy was consistent with SLE. SLE vasculitis was suspected. She required mechanical intubation for rapid respiratory deterioration, with CT thorax suggesting ARDS. Bronchoscopy was done and confirmed DAH. Her course was further complicated with retinopathy and acute pancreatitis associated with SLE. She was treated with IV steroids, IV cyclophosphamide, and plasmapheresis, with significant clinical improvement and successful extubation. She delivered a healthy baby at 32 weeks gestation. CONCLUSIONS Early recognition and initiation of treatment is critical to survival in DAH and requires a high index of clinical suspicion. Treatment includes high-dose steroids, cyclophosphamide, and plasma exchange. Pregnancy increases the risk of adverse outcome in SLE. Seven cases of DAH in pregnant patients with SLE have been reported. Here, we report a catastrophic presentation of DAH, acute pancreatitis, and retinopathy in a pregnant patient with newly diagnosed SLE.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Insuficiência de Múltiplos Órgãos/etiologia , Complicações na Gravidez/etiologia , Vasculite/etiologia , Feminino , Hemorragia/diagnóstico por imagem , Hemorragia/etiologia , Hemorragia/terapia , Humanos , Pneumopatias/diagnóstico por imagem , Pneumopatias/etiologia , Pneumopatias/terapia , Lúpus Eritematoso Sistêmico/terapia , Insuficiência de Múltiplos Órgãos/terapia , Gravidez , Complicações na Gravidez/diagnóstico por imagem , Complicações na Gravidez/terapia , Alvéolos Pulmonares/diagnóstico por imagem , Alvéolos Pulmonares/patologia , Vasculite/diagnóstico por imagem , Vasculite/terapia , Adulto Jovem
10.
Eur Radiol ; 30(2): 1041-1044, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31529250

RESUMO

OBJECTIVES: To assess the value of a T1-3D black-blood turbo spin echo (TSE) sequence for the diagnosis of abdominal large vessel vasculitis (LVV). MATERIALS AND METHODS: The study included 20 patients with abdominal LVV and 17 controls, who underwent a 3T-MRI scan using a modified T1-3D volumetric isotropic TSE acquisition and a segmented T1-3D turbo field echo sequence (T1-mVISTA/T1-eTHRIVE). Two radiologists independently analyzed the aorta for concentric contrast enhancement, concentric wall thickening, image quality, and flow artifact intensity (CCE/CWT/IQ/FAI; 4-point scales). The mean aortic wall thickness (MAWT) in post-contrast T1-mVISTA was compared between patients and controls. RESULTS: IQ of T1-mVISTA was rated good to excellent in 91.5% of 282 evaluated vessel segments with no or minor FAI present in 85.5%. The inter-observer reproducibility for the identification of CCE/CWT on T1-mVISTA was 0.92 and 0.93 (p < 0.001). The distribution of segmental inflammation in T1-mVISTA significantly correlated with T1-eTHRIVE (CCE, κ = 0.768; CWT, κ = 0.715; p < 0.001), resulting in a sensitivity, specificity, and positive predictive value of 100%, 81.3%, and 83.3%. The MAWT significantly differed between patients and controls (3.29 ± 0.81 vs. 2.24 ± 0.45 mm; p < 0.001). CONCLUSIONS: T1-mVISTA enables the evaluation of the MAWT and allows the detection of abdominal LVV. KEY POINTS: • 3D T1w-mVISTA accurately depicted the large abdominal vessels. • 3D T1w-mVISTA enables accurate measurements of the abdominal aortic wall thickness. • 3D T1w-mVISTA is useful for the detection of abdominal LVV.


Assuntos
Imagem por Ressonância Magnética/métodos , Vasculite/diagnóstico por imagem , Abdome/irrigação sanguínea , Abdome/diagnóstico por imagem , Adulto , Idoso , Aorta Abdominal/diagnóstico por imagem , Aortite/diagnóstico por imagem , Artefatos , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
11.
Chest ; 157(3): 612-635, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31704148

RESUMO

We propose an algorithmic approach to the interpretation of diffuse lung disease on high-resolution CT. Following an initial review of pertinent lung anatomy, the following steps are included. Step 1: a preliminary review of available chest radiographs, including the "scanogram" obtained at the time of the CT examination. Step 2: a review of optimal methods of data acquisition and reconstruction, emphasizing the need for contiguous high-resolution images throughout the entire thorax. Step 3: initial uninterrupted scrolling of contiguous high-resolution images throughout the chest to establish the quality of examination as well as an overview of the presence and extent of disease. Step 4: determination of one of three predominant categories - primarily reticular disease, nodular disease, or diseases associated with diffuse alteration in lung density. Based on this determination, one of the three following Steps are followed: Step 5: evaluation of cases primarily involving diffuse lung reticulation; Step 6: evaluation of cases primarily resulting in diffuse lung nodules; and Step 7: evaluation of cases with diffuse alterations in lung density including those with diffusely diminished lung density vs those with heterogenous or diffusely increased lung density, respectively. It is anticipated that this algorithmic approach will substantially enhance initial interpretations of a wide range of pulmonary disease.


Assuntos
Algoritmos , Pneumopatias/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Alveolite Alérgica Extrínseca/diagnóstico por imagem , Amiloidose/diagnóstico por imagem , Bronquiolite/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Fibrose Pulmonar Idiopática/diagnóstico por imagem , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Transtornos Linfoproliferativos/diagnóstico por imagem , Pneumoconiose/diagnóstico por imagem , Edema Pulmonar/diagnóstico por imagem , Radiografia Torácica , Sarcoidose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Vasculite/diagnóstico por imagem
12.
Magn Reson Imaging Clin N Am ; 28(1): 55-73, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31753237

RESUMO

MR enterography is frequently ordered for patients with suspected small bowel disorders. In this article, disease-causing malabsorption, vasculitides, and some of the less common small bowel diseases are reviewed. The clinical presentations, diagnostic criteria, and imaging findings of these diseases are discussed. Because the imaging findings in several small bowel diseases are nonspecific and/or overlap, radiologists must correlate clinical data with imaging to develop a narrower differential diagnosis. The unique or characteristic findings in certain diseases are also emphasized.


Assuntos
Enteropatias/diagnóstico por imagem , Intestino Delgado , Imagem por Ressonância Magnética/métodos , Síndromes de Malabsorção/diagnóstico por imagem , Vasculite/diagnóstico por imagem , Meios de Contraste , Diagnóstico Diferencial , Humanos , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos
15.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 38(5): 280-289, sept.-oct. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-189255

RESUMO

OBJETIVO: Comparar la PET/TC con 18F-FDG y la angioTC en el diagnóstico de la afectación extracraneal en pacientes con sospecha de vasculitis de grandes vasos (VGV). MATERIAL Y MÉTODO: Estudio retrospectivo en 59 pacientes con sospecha clínica de VGV, estudiados con PET/TC con 18F-FDG y angioTC. En 55 pacientes la PET/TC y angioTC se realizaron simultáneamente en la misma máquina y en 4 pacientes en un intervalo<1 mes. La PET/TC se valoró cualitativamente y cuantitativamente (cociente SUVmáx 18F-FDG vaso/SUVmáx hígado). En la angioTC se valoró el engrosamiento mural, el realce de contraste en la pared del vaso y las complicaciones vasculares. RESULTADOS: La PET/TC con 18F-FDG y la angioTC mostraron una elevada especificidad (97,2%) para el diagnóstico de VGV, con una excelente sensibilidad para la PET/TC con 18F-FDG (95,6%) y menor para la angioTC (60,9%), un alto valor predictivo negativo para la PET/TC con 18F-FDG (97,2%) y una alta tasa de falsos negativos para angioTC (39,1%). Se obtuvo una concordancia entre PET/TC con 18F-FDG y angioTC del 70% (índice Kappa 0,70+/-0,095) (p < 0,001). CONCLUSIÓN: Los resultados demuestran un mayor potencial de la PET/TC con 18F-FDG para la detección y extensión de la VGV. La PET/TC con 18F-FDG debe considerarse como la exploración de primera línea en el diagnóstico extracraneal de VGV y su posible asociación con la polimialgia reumática. La angioTC podría estar más indicada en pacientes con arteritis de Takayasu y en vasculitis de larga duración y/o severas, al detectar las posibles complicaciones vasculares


OBJECTIVE: Compare 18F-FDG PET/CT and CTangio in the diagnosis of extracraneal large vessel involvement in patients with suspicion of large vessel vasculitis (LVV). MATERIAL AND METHODS: A retrospective database reviewed 59 patients with clinical suspicion of LVV undergoing 18F-FDG PET/CT and CTangio. In 55 patients PET/TC and CTangio were done simultaneously in the same machine and in 4 patients with a scan interval of<1 month. PET/CT analyses included qualitatively and quantitative analysis (ratio SUVmax 18F-FDG vessel/SUVmax liver). CTangio was assessed for concentric mural thickening, contrast wall enhancement and structural vascular changes as potential complications of vasculitis. RESULTS: 18F-FDG PET/CT and CTangio show high specificity (97.2%) for LVV diagnosis, with an excellent sensitivity for 18F-FDG PET/CT (95.6%) and lower for CTangio (60.9%), which leads to a high negative predictive value for 18F-FDG PET/CT (97.2%) and a high false negative rate for CTangio (39.1%). A 70% concordance between 18F-FDG PET/CT and CTangio was obtained (Kappa index 0.70+/- 0.095 (P<.001). CONCLUSION: The results show the greater potential of 18F-FDG PET/CT for the detection and extension of LVV. Therefore, 18F-FDG PET/CT should be exploited to the maximum and consider as the first line imaging technique in the extracranial diagnosis of LVV and its possible association with polymyalgia rheumatica. The addition of CTangio could be more indicated in patients with Takayasu arteritis and in long-standing and/or severe vasculitis since it increases the accuracy in the detection of possible vascular complications


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Angiografia por Tomografia Computadorizada , Fluordesoxiglucose F18 , Tomografia Computadorizada por Raios X , Compostos Radiofarmacêuticos , Vasculite/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons , Imagem Multimodal , Tomografia Computadorizada por Raios X/métodos , Estudos Retrospectivos
16.
Contrast Media Mol Imaging ; 2019: 9157637, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31531005

RESUMO

18F-Fluorodeoxyglucose positron-emission tomography (18F-FDG-PET) with computed tomography (CT) is effective for diagnosing large vessel vasculitis, but its usefulness in accurately diagnosing suspected, unselected vasculitis remains unknown. We evaluated the feasibility of 18F-FDG-PET/CT in real-life cohort of patients with suspicion of vasculitis. The effect of the dose and the timing of glucocorticoid (GC) medication on imaging findings were in special interest. 82 patients with suspected vasculitis were evaluated by whole-body 18F-FDG-PET/CT. GC treatment as prednisolone equivalent doses at the scanning moment and before imaging was evaluated. 38/82 patients were diagnosed with vasculitis. Twenty-one out of 38 patients had increased 18F-FDG accumulation in blood vessel walls indicating vasculitis in various sized vessels. Vasculitis patients with a positive vasculitis finding in 18F-FDG-PET/CT had a significantly shorter duration of GC use (median = 4.0 vs 7.0 days, P=0.034), and they used lower GC dose during the PET scan (median dose = 15.0 mg/day vs 40.0 mg/day, p=0.004) compared to 18F-FDG-PET/CT-negative patients. Vasculitis patients with a positive 18F-FDG-PET/CT result had significantly higher C-reactive protein (CRP) than patients with a negative 18F-FDG-PET/CT finding (mean value = 154.5 vs 90.4 mg/L, p=0.018). We found that 18F-FDG-PET/CT positivity was significantly associated with a lower dose and shorter duration of GC medication and higher CRP level in vasculitis patients. 18F-FDG-PET/CT revealed clinically significant information in over half of the patients and was effective in confirming the final diagnosis.


Assuntos
Radioisótopos de Flúor , Fluordesoxiglucose F18 , Glucocorticoides/administração & dosagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Vasculite/diagnóstico por imagem , Imagem Corporal Total/métodos , Adulto , Idoso , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/sangue , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/diagnóstico por imagem , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/tratamento farmacológico , Vasos Sanguíneos/diagnóstico por imagem , Proteína C-Reativa/análise , Relação Dose-Resposta a Droga , Esquema de Medicação , Estudos de Viabilidade , Feminino , Fluordesoxiglucose F18/farmacocinética , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Compostos Radiofarmacêuticos/farmacocinética , Sensibilidade e Especificidade , Vasculite/sangue , Vasculite/tratamento farmacológico
18.
Fukushima J Med Sci ; 65(2): 55-60, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31327803

RESUMO

Vasculitis in Behçet's disease, termed "vasculo-Behçet's disease," is a major cause of mortality and morbidity. We report a case of vasculo-Behçet's disease complicated by conversion disorder, in which 18F-fluoro-deoxy-glucose positron emission tomography combined with computed tomography (FDG PET/CT) was useful for the diagnosis. A twenty-two-year-old woman recently diagnosed with tonsillitis presented with fever, right foot pain, left equinovarus foot, and numbness in both hands and feet. Laboratory data showed elevated levels of c-reactive protein (CRP). The patient was positive for HLA B51; pathergy testing was also positive. Nerve conduction velocity and electromyography were normal. MRI showed swelling of the left crural muscle group. PET/CT showed intense FDG uptake in the left popliteal artery, demonstrating active vasculitis. The patient was diagnosed with vasculo-Behçet's disease and treated with corticosteroids, colchicine, and infliximab, which led to obvious improvement of the MRI findings and reduction in CRP. However, left equinovarus foot and numbness in the extremities persisted. She also developed aphonia. They were attributed to psychogenic dystonia and conversion disorder, and psychiatric treatment was effective in relieving those symptoms. We suggest that PET/CT may be useful for the early diagnosis of medium-sized vessel vasculitis in patients with Behçet's disease.


Assuntos
Síndrome de Behçet/diagnóstico por imagem , Transtorno Conversivo/complicações , Fluordesoxiglucose F18 , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Vasculite/diagnóstico por imagem , Adulto , Feminino , Humanos
19.
BMC Surg ; 19(1): 73, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266494

RESUMO

BACKGROUND: Diagnosis and management of acute abdomen secondary to systematic lupus erythematosus (SLE) has always been a clinical challenge. CASE PRESENTATION: A 21-year-old lady, with BMI 17.7, presented to our department with acute abdomen. Laparoscopy was carried out to exclude surgical emergency when conservative regimen failed. The patient revealed a history of purpuric changes and lupus test was positive for SLE. CONCLUSION: Based on our experience, early laparoscopy to alleviate acute abdomen has shown to improve the prognosis of the patient.


Assuntos
Abdome Agudo/diagnóstico , Abdome Agudo/cirurgia , Ascite/etiologia , Lúpus Eritematoso Sistêmico/complicações , Mesentério/irrigação sanguínea , Vasculite/cirurgia , Abdome Agudo/tratamento farmacológico , Abdome Agudo/etiologia , Administração Intravenosa , Administração Oral , Antirreumáticos/administração & dosagem , Ascite/diagnóstico por imagem , Ascite/tratamento farmacológico , Ascite/cirurgia , Feminino , Glucocorticoides/administração & dosagem , Humanos , Hidroxicloroquina/administração & dosagem , Laparoscopia , Mesentério/diagnóstico por imagem , Metilprednisolona/administração & dosagem , Prognóstico , Vasculite/diagnóstico por imagem , Vasculite/tratamento farmacológico , Vasculite/etiologia , Adulto Jovem
20.
Pediatrics ; 144(2)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31320468

RESUMO

Behçet disease (BD) is a multisystemic autoinflammatory disorder characterized by recurrent mucocutaneous, ocular, musculoskeletal, gastrointestinal, central nervous system, and vascular manifestations. Pulmonary arterial involvement (PAI) of BD is probably the most severe form of vasculitis, at least in children. PAI has a high mortality, morbidity, and recurrence rate. There are limited data regarding treatment and outcomes of pediatric patients with BD with PAI. Herein, we report 2 pediatric patients with BD presented with hemoptysis and support our data with a systematic review. These patients were given immunosuppressive therapy, which covered pulse methylprednisolone followed by oral prednisolone, intravenous cyclophosphamide every 3 weeks for a total of 6 cycles, and interferon-α2a concomitantly. These are the first reported cases in the literature successfully treated with this treatment modality in a complication with 50% mortality. These patients have been followed up for a period of at least 4 years without any vascular recurrence. Pediatricians should be aware that patients with BD may not present with full diagnostic criteria. They should consider BD in a child with PAI to avoid diagnostic delay and start life-saving accurate immunosuppressive treatment.


Assuntos
Síndrome de Behçet/diagnóstico por imagem , Síndrome de Behçet/tratamento farmacológico , Imunossupressores/administração & dosagem , Pneumopatias/diagnóstico por imagem , Pneumopatias/tratamento farmacológico , Adolescente , Ciclofosfamida/administração & dosagem , Quimioterapia Combinada , Humanos , Masculino , Metilprednisolona/administração & dosagem , Vasculite/diagnóstico por imagem , Vasculite/tratamento farmacológico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...