RESUMEN
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Asunto(s)
Humanos , Síndrome de Fatiga Crónica/etiología , Enfermedades Raras/diagnóstico , Grupo de Atención al Paciente/tendencias , Investigación Interdisciplinaria , Herpesvirus Humano 4/patogenicidad , Síndrome de Fatiga Crónica/diagnóstico , Síndrome de Fatiga Crónica/epidemiologíaRESUMEN
A cohort of 148 consecutive patients with hepatitis C virus infection were studied at the rheumatology out-patient clinic of a tertiary care teaching hospital. The diagnosis of hepatitis C virus infection was supported by detection of HCV RNA in the serum. Cryoglobulin screening was done in all patients and the presence of a monoclonal component was investigated when the cryocrit was higher than 1%. Patients with lymphoproliferative disorders were further investigated. Four patients had a B lymphoproliferative disorder, which represents a prevalence of 2.7% in this cohort of patients with hepatitis C virus infection. Mixed cryoglobulinemia (MC), with cryocrit higher than 1%, was found in 16 of 148 patients (11%). It was type III MC in 13 patients and type II MC in 3. All patients who developed a B lymphoproliferative disorder had mixed cryoglobulinemia, with a monoclonal component (type II MC) in two patients and without a monoclonal component (type III MC) in the other two. The incidence of B-lymphoproliferative disorders among this cohort of patients with hepatitis C virus infection seems to be significantly increased. However, the high frequency of asymptomatic, undiagnosed HCV infection among the apparently healthy general population may decrease the true significance of this association. Systematic screening of cryoglobulin production in patients with hepatitis C virus infection might clarify whether the risk of B lymphoproliferative disorders increases when type II or type III mixed cryoglobulinemia is present.
Asunto(s)
Hepacivirus/aislamiento & purificación , Hepatitis C/complicaciones , Trastornos Linfoproliferativos/etiología , Linfocitos B/patología , Humanos , Trastornos Linfoproliferativos/patología , PrevalenciaRESUMEN
Reflex sympathetic dystrophy syndrome (RSDS) is a rare entity of unknown etiopathogenesis, associated to different precipitating factors such as malignant tumors of several localizations. A new clinical variety has been recently described which has been denominated palmar fasciitis and polyarthritis syndrome. We present here two patients with RSDS associated to breast cancer: one case presenting fasciitis and polyarthritis and another case also associated to polymyalgia rheumatica. We emphasize the importance of reducing the tumor mass in the treatment of this syndrome, as well as including it in the gammagraphic differential diagnosis of bone metastasis.