RESUMO
In the past several years, the coronavirus pandemic has introduced multiple medical disciplines to various new forms of disease previously unknown and has shown us a unique presentation of already existing diseases. We continue to understand the long-term effects of the pandemic on the population's health and continue to find new unique features previously unknown. This paper presents the unique feature of lung uptake abnormalities discovered on nuclear stress testing for cardiac perfusion defects, a consistent finding in multiple individuals with recent COVID-19 or ongoing infection.
Assuntos
COVID-19 , Humanos , Teste de Esforço , Pulmão/diagnóstico por imagem , SARS-CoV-2RESUMO
Lymphocytic hypophysitis (LH) is a rare but increasingly recognized inflammatory disorder of the pituitary, usually associated with pregnancy. Knowledge of this condition is largely anecdotal; the cause, incidence, and natural history are unknown. Cases are usually discovered at biopsy and surgical intervention for a presumptive pituitary neoplasm. Here we describe two cases of lymphocytic hypophysitis. In the first case the patient underwent surgery for presumptive adenoma, and pathology at resection established the diagnosis of lymphocytic hypophysitis. The second case was strongly suspicious for LH by history, endocrine profile, and imaging, and was managed nonoperatively. Though magnetic resonance imaging (MRI) features are not diagnostic, knowledge of imaging features together with clinical history may permit avoidance of surgery.
Assuntos
Doenças Autoimunes/diagnóstico , Doenças da Hipófise/diagnóstico , Hipófise/patologia , Adulto , Doenças Autoimunes/fisiopatologia , Diagnóstico Diferencial , Feminino , Humanos , Hipopituitarismo/diagnóstico , Hipopituitarismo/fisiopatologia , Inflamação/diagnóstico , Inflamação/etiologia , Linfócitos/patologia , Linfocitose/diagnóstico , Linfocitose/fisiopatologia , Imageamento por Ressonância Magnética , Doenças da Hipófise/fisiopatologia , Hipófise/irrigação sanguínea , Hormônios Hipofisários/deficiência , Neoplasias Hipofisárias/diagnósticoRESUMO
At times, infection of pacemaker leads can be difficult to confirm even with transesophageal echocardiography. We describe a patient with pacemaker lead infection where the transesophageal echocardiogram was nondiagnostic, and intracardiac echocardiography made the diagnosis by demonstrating the vegetation on the pacemaker lead. This illustrates a potential role for intracardiac echocardiography in infective endocarditis when transesophageal echocardiography is nondiagnostic.