RESUMEN
The MRI findings of amyloid arthropathy associated with primary amyloidosis are presented here possibly for the first time in the literature. Two types of lesions are noted: (1) capsular and tendon lesions; these regions are thickened, hypointense and enhanced by gadolinium (Gd) on T1 weighted imaging (T1WI), and hyperintense on T2 weighted imaging (T2WI), and (2) periarticular and osseous lesions; these regions appear to be tumor-forming and hypointense on both T1WI and T2WI and are not enhanced by Gd. It is necessary to differentiate these findings from other diseases such as chondrosarcoma, rhabdomyosarcoma and chronic inflammatory lesions such as tuberculosis.
Asunto(s)
Amiloidosis/diagnóstico , Artritis/diagnóstico , Imagen por Resonancia Magnética , Amiloidosis/complicaciones , Artritis/etiología , Diagnóstico Diferencial , Femenino , Humanos , Cápsula Articular/patología , Persona de Mediana Edad , Pronóstico , Articulación del Hombro/patología , Tendones/patologíaRESUMEN
Takayasu's arteritis and temporal arteritis share many clinical and pathological features. The most discriminatory feature between the two diseases is the age at onset; the mean age at onset of the disease was reported as being 26 years for Takayasu's arteritis and 69 years for temporal arteritis. Here we report a 69-year-old woman who presented with a weak right radial artery pulse. The ethnic background and the presence of vascular insufficiency of the right upper extremity and the absence of clinical signs such as shoulder stiffness and tender scalp indicate that her diagnosis is Takayasu's arteritis. It must be emphasized that the two conditions could be differentiated based on the clinical findings even in a patient as old as 69 years old.
Asunto(s)
Arteritis de Células Gigantes/diagnóstico , Arteritis de Takayasu/diagnóstico , Edad de Inicio , Anciano , Aortografía , Diagnóstico Diferencial , Femenino , Antígenos HLA/análisis , Humanos , Arteritis de Takayasu/sangreRESUMEN
Two patients with polymyositis (PM) or dermatomyositis (DM) complicated with massive pleural effusion are reported here. Both patients presented a high-grade fever, pleural effusion prominent on the right, and good response to steroid therapy. In a 50-year-old woman with PM, combined process of pleural inflammation, cardiomyopathy and coexisting hypothyroidism were considered to be responsible for the accumulation of the massive pleural effusion. However, in a 34-year-old man with DM, pleural inflammation associated with interstitial pneumonia or pleural microvasculopathy in DM was considered to be responsible for the accumulation of the massive pleural effusion.
Asunto(s)
Dermatomiositis/complicaciones , Derrame Pleural/etiología , Polimiositis/complicaciones , Adulto , Dermatomiositis/tratamiento farmacológico , Diuréticos/uso terapéutico , Femenino , Fiebre/diagnóstico por imagen , Fiebre/tratamiento farmacológico , Fiebre/etiología , Estudios de Seguimiento , Furosemida/uso terapéutico , Glucocorticoides/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Derrame Pleural/diagnóstico por imagen , Derrame Pleural/tratamiento farmacológico , Polimiositis/tratamiento farmacológico , Prednisolona/uso terapéutico , Radiografía Torácica , Tomografía Computarizada por Rayos XRESUMEN
A case of Henoch-Schönlein purpura with chronic thyroiditis associated with pregnancy is reported. A 27-year-old woman had a struma since age 14. She felt easily fatigable along with enlargement of the struma after the delivery of her first child, and was diagnosed as having chronic thyroiditis. She developed hematuria between the first delivery and the second pregnancy. The hematuria continued during the second pregnancy and in the postpartum period. Immediately after the delivery of her second child, she developed purpura followed by arthralgia and melena. Renal biopsy revealed focal segmental and global type Henoch-Schönlein nephritis. We reviewed five cases of Henoch-Schönlein purpura associated with pregnancy and found that our case is the first in which purpura developed immediately after delivery. Our patient would have developed Henoch-Schönlein nephritis between the first delivery and the second pregnancy. She developed Henoch-Schönlein purpura possibly due to rebound activation of immune response in the postpartum period after the disappearance of dramatic suppression of both humoral and cell-mediated immunity in the pregnant period.
Asunto(s)
Vasculitis por IgA/complicaciones , Complicaciones del Embarazo , Tiroiditis/complicaciones , Adulto , Enfermedad Crónica , Femenino , Humanos , EmbarazoRESUMEN
A 51-year-old female with an ependymal cyst in the left occipital lobe presented with headache, vomiting, dizziness, and right incomplete homonymous hemianopsia. Following a cyst-ventricular communication and cyst-peritoneal shunting procedure, the visual field loss improved markedly. On the basis of the visual field symptoms, computed tomographic findings, and intraoperative observations, the cyst was considered to have developed in the vicinity of the body and posterior horn of the left lateral ventricle, extending to the left occipital lobe.