RESUMO
INTRODUCTION: Several mechanisms may explain the aggravation of atheroma lesions in patients receiving corticosteroid treatments. CASE: This 68-year-old man, a smoker with high cholesterol levels and a history of two transient ischemic attacks, also had severe Horton disease (giant cell arteritis) requiring treatment by corticosteroids and azathioprine. After a new transient ischemic accident, clopidogrel treatment was initiated. Ten months later, severe carotid stenosis was observed. Endarterectomy removed a recent thrombus and the pathology examination showed necrotic lesions complicated by hemorrhage with inflammatory infiltrate. DISCUSSIONS: This patient's atheromatous disease was aggravated by intraplaque hemorrhage, caused by several factors include his corticosteroid therapy and platelet aggregation inhibition treatment.
Assuntos
Aterosclerose/induzido quimicamente , Aterosclerose/patologia , Estenose das Carótidas/diagnóstico , Glucocorticoides/efeitos adversos , Inibidores da Agregação Plaquetária/efeitos adversos , Prednisona/efeitos adversos , Ticlopidina/análogos & derivados , Idoso , Estenose das Carótidas/patologia , Estenose das Carótidas/cirurgia , Clopidogrel , Endarterectomia , Arterite de Células Gigantes/tratamento farmacológico , Glucocorticoides/uso terapêutico , Humanos , Inflamação , Masculino , Necrose , Inibidores da Agregação Plaquetária/uso terapêutico , Prednisona/uso terapêutico , Ticlopidina/efeitos adversos , Ticlopidina/uso terapêuticoRESUMO
Langerhans' cell histiocytosis is a disorder in children or young adults, characterized by clonal proliferation of histiocytic cells, staining for CD1a, with uni or multifocal organ involvement. It's a rare condition in adults. We report a case of Langerhans' cell histiocytosis in an adult with sclerosing cholangitis which rapidly progressed to fatal liver failure and progressive cerebellar atrophy. Langerhans cell histiocytosis is a rare cause of sclerosing cholangititis in adults.
Assuntos
Cerebelo/patologia , Colangite Esclerosante/etiologia , Histiocitose de Células de Langerhans/diagnóstico , Idoso , Atrofia/etiologia , Colangite Esclerosante/complicações , Evolução Fatal , Humanos , Falência Hepática/etiologia , MasculinoRESUMO
INTRODUCTION: Drugs are at the origin of around 10% of the cases of vasculitis involving the small vessels. Recent cases report vasculitis related to the administration of nonsteroidal antiinflammatory selective inhibitors of cyclo-oxygenase 2. CASE: Vasculitis associated with ketoprofen appeared in a 76 year-old man: the symptoms disappeared when treatment stopped. A few weeks later, during treatment with rofecoxib, a relapse appeared, including purpura. The diagnosis of rofecoxib-induced cutaneous vasculitis was confirmed by regression of all symptoms when treatment stopped. DISCUSSION: Coxibs, like other nonsteroidal antiinflammatory drugs, may cause vasculitis, at an as-yet undetermined frequency.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Inibidores de Ciclo-Oxigenase/efeitos adversos , Toxidermias/etiologia , Lactonas/efeitos adversos , Sulfonas/efeitos adversos , Vasculite/induzido quimicamente , Idoso , Anti-Inflamatórios não Esteroides/administração & dosagem , Artrite/tratamento farmacológico , Inibidores de Ciclo-Oxigenase/administração & dosagem , Humanos , Lactonas/administração & dosagem , Masculino , Púrpura/induzido quimicamente , Sulfonas/administração & dosagem , Fatores de TempoAssuntos
Neoplasias Duodenais/diagnóstico , Pólipos Intestinais/diagnóstico , Linfoma de Célula do Manto/diagnóstico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Ciclofosfamida/uso terapêutico , Diagnóstico Diferencial , Doxorrubicina/uso terapêutico , Neoplasias Duodenais/tratamento farmacológico , Neoplasias Duodenais/patologia , Duodeno/patologia , Endoscopia , Humanos , Pólipos Intestinais/patologia , Linfoma de Célula do Manto/tratamento farmacológico , Linfoma de Célula do Manto/patologia , Masculino , Prednisona/uso terapêutico , Indução de Remissão , Vincristina/uso terapêuticoRESUMO
An 82-year-old patient complained of diarrhea due to a rectal endocrine intermediate-cell carcinoma. Histology displayed a neuron-specific enolase and CD56 immunoreactive tumor. Hepatic metastases developed rapidly and the tumor was briefly reactive to radiotherapy and chemotherapy. These tumors are rare and have a poor prognosis. We focus on the recent classification of gastrointestinal endocrine tumors.