Assuntos
Fasciite Necrosante , Infecções dos Tecidos Moles , Humanos , Infecções dos Tecidos Moles/epidemiologia , Estudos Retrospectivos , Celulite (Flegmão)/tratamento farmacológico , Pele , Extremidade Inferior , Fasciite Necrosante/epidemiologia , Fasciite Necrosante/tratamento farmacológico , Antibacterianos/uso terapêuticoRESUMO
OBJECTIVE: Ulcerative colitis (UC) is a chronic inflammatory condition. Previous reports suggested that UC may have a worse prognosis when associated with auto-immune diseases. We compared characteristics at diagnosis and natural history of the disease between classical ulcerative colitis (CUC) and UC associated with auto-immune diseases (CAI) in children. MATERIAL AND METHODS: In this study, 67 children followed for UC at Nancy University Hospital between 1993 and 2012 were included: 45 patients in the CUC group and 22 in the CAI group. RESULTS: Median follow-up was 4.8 years. Median age at diagnosis was 11.6 years in the CAI group and 9.8 years in the CUC group. Time between symptoms onset and diagnosis was broadly similar in the two groups (<3 months) and there were no significant differences regarding biological and histological findings. At 5 years, the need for corticosteroids and azathioprine did not differ between the CAI and the CUC groups. There was also no significant difference between the two groups regarding infliximab use at 1 and 5 years. CONCLUSIONS: In this pediatric study, CAI had similar characteristics at baseline as CUC. The course of CAI does not seem to be influenced by the presence of concomitant auto-immune diseases.
Assuntos
Doenças Autoimunes/complicações , Doenças Autoimunes/patologia , Colite Ulcerativa/complicações , Colite Ulcerativa/patologia , Adolescente , Corticosteroides/uso terapêutico , Doenças Autoimunes/tratamento farmacológico , Azatioprina/uso terapêutico , Criança , Pré-Escolar , Colite Ulcerativa/tratamento farmacológico , Progressão da Doença , Endoscopia , Feminino , Seguimentos , Humanos , Imunossupressores/uso terapêutico , Lactente , Infliximab/uso terapêutico , Estimativa de Kaplan-Meier , Masculino , Prognóstico , Estudos Retrospectivos , Resultado do TratamentoAssuntos
Produtos Biológicos/efeitos adversos , Doença de Crohn/tratamento farmacológico , Infliximab/efeitos adversos , Síndrome de Melkersson-Rosenthal/microbiologia , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Cutânea/microbiologia , Tuberculose Pulmonar/microbiologia , Adolescente , Antituberculosos/uso terapêutico , Biópsia , Colonoscopia , Doença de Crohn/diagnóstico , Doença de Crohn/imunologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Síndrome de Melkersson-Rosenthal/diagnóstico , Síndrome de Melkersson-Rosenthal/tratamento farmacológico , Síndrome de Melkersson-Rosenthal/imunologia , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/imunologia , Fatores de Risco , Índice de Gravidade de Doença , Resultado do Tratamento , Tuberculose Cutânea/diagnóstico , Tuberculose Cutânea/tratamento farmacológico , Tuberculose Cutânea/imunologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/imunologia , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/imunologiaAssuntos
Doença de Crohn , Microbioma Gastrointestinal , Criança , Dieta , Humanos , Intestino DelgadoRESUMO
Thermal burns can occur during seizure. This diagnosis can be difficult in case of atypical lesions, even more if the epilepsy is unknown and in case of seizures with loss of consciousness and/or an unwitnessed epileptic attack. We report two cases of cutaneous bullous lesions initially misdiagnosed as severe acute cutaneous adverse reactions (generalized bullous fixed drug eruption and Stevens-Johnson syndrome). In the two cases, the clinical aspect, necrotic evolution, and absence of obvious attributable medication allowed to revert to the diagnosis of burns due to boiling water revealing previously unknown epilepsy. For both, surgical management with skin graft was performed, and antiepileptic treatment was introduced. Facing unexplained burns, occult epilepsy should be investigated. Questioning of patient and relatives is crucial.
Assuntos
Queimaduras/etiologia , Queimaduras/terapia , Epilepsia/complicações , Água , Adolescente , Idoso de 80 Anos ou mais , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Feminino , Humanos , Masculino , Diagnóstico Ausente , Transplante de Pele , Síndrome de Stevens-Johnson/diagnósticoRESUMO
BACKGROUND: Kaposi sarcoma is a vascular tumor related to herpesvirus-8 and is promoted by immunosuppression. For the last 15 years, human immunodeficiency virus (HIV) patients have had access to organ transplantation. The dual immunosuppression of HIV and immunosuppressive treatments might increase the risk and severity of Kaposi sarcoma. METHODS: We conducted a multicentric retrospective study by collecting cases from French databases and society members of transplanted patients, among which 7 HIV-infected patients who subsequently developed Kaposi sarcoma were included. RESULTS: In the CRISTAL database (114 511 patients) and the DIVAT (Données Informatisées et VAlidées en Transplantation) database (19 077 patients), the prevalence of Kaposi sarcoma was 0.18% and 0.46%, respectively, in transplanted patients; these values compare with 0.66% and 0.50%, respectively, in transplanted patients with HIV. The median time from HIV infection to Kaposi sarcoma was 20 years. Kaposi sarcoma occurred during the first year after transplantation in most cases, whereas HIV viral load was undetectable. Only 2 patients had visceral involvement. Five patients were treated with conversion of calcineurin inhibitor to mammalian target of rapamycin inhibitor, and 5 patients were managed by decreasing immunosuppressive therapies. At 1 year, 4 patients had a complete response, and 3 had a partial response. CONCLUSIONS: In our study, Kaposi sarcoma in transplanted patients with HIV did not show any aggressive features and was treated with the usual posttransplant Kaposi sarcoma management protocol.