[Mucha-Habermann disease and orthotopic heart transplant. Case report]. / Enfermedad de Mucha-Habermann y trasplante ortotópico de corazón. Informe de un caso clínico.

BACKGROUND: Mucha-Habermann disease is a cutaneous clinical manifestation of unknown etiology that frequently appears in young patients. The aim was to present Mucha-Habermann disease that occurred in an old man who had a heart transplant. CLINICAL CASE: a 62 year-old male, heart transplant recipient, who four years after that transplantation procedure presented with papular lesions in neck, thoracic members of which extended to all body surfaces and that evolved vesicles and pustular lesions. A skin biopsy was performed and Mucha-Habermann disease was diagnosed. The patient was treated with steroids and antimicrobial therapy with favorable response. After two years there are no skin lesions. CONCLUSIONS: Mucha-Habermann disease is a low frequency disease and it requires skin biopsy to confirm diagnose. This is an uncommon case due to the age and kind of patient.

Introducción: la enfermedad de Mucha-Habermann es la afección cutánea de etiología desconocida más frecuente en los pacientes jóvenes. Se caracteriza por la erupción aguda de lesiones papulares que evolucionan a vesículas, pústulas y cicatrices deprimidas hiperpigmentadas de aspecto varioliforme. Su curso habitual es subagudo o crónico. El objetivo es describir la enfermedad de Mucha-Habermann en un hombre con trasplante ortotópico de corazón. Caso clínico: hombre de 62 años de edad que cuatro años después de recibir trasplante de corazón presentó lesiones papulares diseminadas en cuello y miembros torácicos, las cuales se extendieron al resto del cuerpo y evolucionaron a vesículas y pústulas. Se obtuvo biopsia de piel y se conformó el diagnóstico de enfermedad de Mucha-Habermann. El paciente recibió tratamiento con esteroide y antimicrobiano, al que respondió favorablemente. Al momento de este informe, las lesiones habían desaparecido. Conclusiones: la enfermedad de Mucha-Habermann es poco frecuente y requiere confirmación mediante biopsia de piel para tratarla adecuadamente. El caso que se describe es poco común por el tipo de paciente y la edad en que se manifestó la enfermedad.

Pleomorphic malignant histiocytoma of pulmonary arteries presenting as pulmonary aneurysms.

Pulmonary aneurysms and primary neoplasms of the great vessels are very rare entities; pulmonary aneurysms are commonly associated with congenital heart diseases, and less frequently in atherosclerosis, medial cystic necrosis, trauma, infection, and inflammatory processes. Many patients have pulmonary hypertension, most frequently resulting from pulmonary artery sarcomas mimicking pulmonary thromboembolism. Symptoms are vague. In 30% of cases, rupture and death occur, related to pulmonary aneurysms. We present the case of a patient with a diagnosis of pulmonary artery pleomorphic malignant histiocytoma that presented as a right pulmonary aneurysm thrombosis and a contained rupture of a left pulmonary aneurysm.

[Distant heart procurement for transplantation]. / Procuración a distancia de corazóncon fines de trasplante.

BACKGROUND: The low availability of organ donors is a serious hindrance to heart transplantation. Long-distance organ procurement has been accepted as an option despite longer ischemic time for the heart. METHODS: Long-distance procurement from outside Mexico City in adult patients with terminal heart failure submitted to orthotopic heart transplantation between February 1st 2011, and January 31st 2012, was assessed. Ischemic time, distance from Mexico City, and perioperative and short-time mortality were determined. RESULTS: There were 14 orthotopic heart transplants during the analyzed period. In 12 cases long-distance heart procurement was required. Mean age of recipients was 42.7 years (range between 17 and 61 years). Seven patients were male and five female. Mean ischemic time was 228.58 minutes. The longest distance of procurement for land and air travel was 2,319 km; and the lowest, 22.5 km. Perioperative mortality was 8.33% (one patient), and there were 2 short-term deaths due to non-cardiac complications. In this series we included a case of heart-kidney transplantation from same donor. CONCLUSION: At our hospital, long-distance procurement for heart transplantation is a useful procedure with good results.