RESUMEN
The purpose of the study was to elucidate characteristics of depression in Parkinson's disease (PD). Fifty-eight PD patients were evaluated with Zung's Self-Rating Depression Scale (SDS) and the Unified Parkinson's Disease Rating Scale (UPDRS). Scores for "suicidal ideation" on the SDS correlated with posture and gait disturbances on the UPDRS. Twenty-six patients with spinocerebellar degeneration (SCD) were also evaluated with the SDS. SDS scores for "indecisiveness" and "constipation" were significantly higher in PD patients than SCD patients. Our results suggest that depression is common in disabled persons but PD patients might have a characteristic clinical presentation.
Asunto(s)
Depresión/etiología , Depresión/fisiopatología , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/psicología , Escalas de Valoración Psiquiátrica , Anciano , Depresión/clasificación , Femenino , Humanos , Masculino , Degeneraciones Espinocerebelosas/complicaciones , Degeneraciones Espinocerebelosas/psicologíaRESUMEN
The intravenous immunoglobulin infusion therapy (IVIg) has recently acquired an important role in the treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Some patients, however, require repetitive infusions to maintain the improvement. We planned a one-day therapy with 0.4 g/kg of IVIg in every 7 or 10 days for two CIDP patients who had required a 5-day course of IVIg in every month because of frequent exacerbations. Serum levels of IgG in both patients were kept as high as 2,000 mg/dl resulting in maintaining the improvement without any side effects.
Asunto(s)
Inmunoglobulinas Intravenosas/administración & dosificación , Polirradiculoneuropatía Crónica Inflamatoria Desmielinizante/terapia , Esquema de Medicación , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Prevención SecundariaRESUMEN
A 63-year-old woman had anti-Hu-associated paraneoplastic encephalomyelitis (anti-Hu syndrome) caused by esophageal small cell carcinoma (SCC). The patient developed bilateral limbic encephalitis, followed by myelitis, brain stem encephalitis, and autonomic failure. Extensive examination demonstrated SCC of the abdominal lymph nodes that was retrospectively diagnosed as metastasis of esophageal SCC on autopsy. The neuropathological findings were characterized by widespread neuronal loss and gliosis in the central nervous system, as well as patchy loss of myelin and axons in the spinal nerve roots with perivascular lymphocytic infiltration. This is the first detailed clinical and neuropathological report of anti-Hu syndrome caused by esophageal SCC.
Asunto(s)
Anticuerpos Antiidiotipos/sangre , Carcinoma de Células Pequeñas/complicaciones , Proteínas ELAV/inmunología , Neoplasias Esofágicas/complicaciones , Síndromes Paraneoplásicos del Sistema Nervioso/etiología , Síndromes Paraneoplásicos del Sistema Nervioso/inmunología , Autopsia , Axones/metabolismo , Axones/patología , Carcinoma de Células Pequeñas/patología , Proteína 4 Similar a ELAV , Neoplasias Esofágicas/patología , Resultado Fatal , Femenino , Humanos , Metástasis Linfática/patología , Persona de Mediana Edad , Vaina de Mielina/metabolismo , Síndromes Paraneoplásicos del Sistema Nervioso/patologíaRESUMEN
Platelet-derived microparticle (PDMP) levels were measured using an enzyme-linked immunosorbent assay (ELISA) to elucidate the role of platelet activation in patients with polymyositis or dermatomyositis (PM/DM). PDMP levels in active PM/DM patients (median 13.3 U/ml, interquartile range 9.9-20.7 U/ml, n = 16) and those in patients undergoing treatment (12.1 U/ml, 7.4-16.7 U/ml, n = 12) were significantly higher than in controls (6.5 U/ml, 5.0-8.4 U/ml, n = 26, vs. active, P = 0.0001; vs. treatment, P = 0.004). In a paired sampling study, PDMP decreased significantly after glucocorticoid treatment (P = 0.04). PDMP in the active PM/DM patients correlated significantly with serum C-reactive protein levels (r(s) = 0.67, P = 0.01). These results suggest that platelets may play an important role in the inflammatory process, and that PDMP level could be a useful marker of inflammatory activity in PM/DM patients. Muscle Nerve 39: 586-590, 2009.