RESUMO
We report a secretory paraganglioma in an eleven-year-old Trinidadian girl of East Indian descent who presented with malignant hypertension, proteinuria and modest elevation of urinary vanillylmandelic acid levels. The extra-adrenal mass was surgically removed without complications. The patient has been normotensive without evidence of recurrence of disease but with persistent visual sequel two years later. This case reinforces the observation that extraadrenal retroperitoneal paragangliomas can be functionally very active and early computed tomography or other imaging procedure is necessary for rapid noninvasive evaluation, timely surgery and prevention of permanent morbidity.
Assuntos
Hipertensão Maligna/etiologia , Paraganglioma/complicações , Neoplasias Retroperitoneais/complicações , Transtornos da Visão/etiologia , Criança , Feminino , Humanos , Hipertensão Maligna/cirurgia , Paraganglioma/cirurgia , Neoplasias Retroperitoneais/cirurgia , Ácido Vanilmandélico/urina , Acuidade VisualRESUMO
We report a secretory paraganglioma in an eleven-year-old Trinidadian girl of East Indian descent who presented with malignant hypertension, proteinuria and modest elevation of urinary vanillylmandelic acid levels. The extraadrenal mass was surgically removed without complications. The patient has been normotensive without evidence of recurrence of disease but with persistent visual sequel two years later. This case reinforces the observation that extraadrenal retroperitoneal paragangliomas can be functionally very active and early computed tomography or other imaging procedure is necessary for rapid noninvasive evaluation, timely surgery and prevention of permanent morbidity.(Au)
Assuntos
Criança , Relatos de Casos , Feminino , Humanos , Paraganglioma/complicações , Hipertensão Maligna/etiologia , Neoplasias Retroperitoneais/complicações , Transtornos da Visão/etiologia , Trinidad e Tobago , Hipertensão Maligna/cirurgia , Paraganglioma/cirurgia , Neoplasias Retroperitoneais/cirurgia , Ácido Vanilmandélico/urina , Acuidade VisualRESUMO
A sixty-eight-year-old woman with documented sick sinus syndrome was found to have, five year later, florid clinical features of systemic amyloidosis which only then led to recognition of an underlying IgA, Kappa paraproteinaemia. The literature on this association is outlined. Underlying plasma cell dyscrasias should be excluded in cases of unexplained sick sinus syndrome.
Assuntos
Amiloidose/complicações , Síndrome do Nó Sinusal/diagnóstico , Amiloidose/patologia , Autopsia , Cardiomiopatias/complicações , Cardiomiopatias/patologia , Eletrocardiografia , Feminino , Humanos , Pessoa de Meia-Idade , Síndrome do Nó Sinusal/etiologia , Síndrome do Nó Sinusal/patologiaRESUMO
A sixty-eight-year-old woman with documented sick sinus syndrome was found to have, five years later, florid clinical features of systemic amyloidosis which only then led to recognition of an underlying IgA, Kappa paraproteinaemia. The literature on this association is outlined. Underlying plasma cell dyscrasias should be excluded in cases of unexplained sick sinus syndrome.
Assuntos
Humanos , Pessoa de Meia-Idade , Feminino , Amiloidose/diagnóstico , Amiloidose/terapia , Síndrome do Nó Sinusal/etiologia , Síndrome do Nó Sinusal/terapia , Paraproteinemias/terapia , Trinidad e TobagoRESUMO
A sixty-eight-year-old woman with documented sick sinus syndrome was found to have, five years later, florid clinical features of systemic amyloidosis which only then led to recognition of an underlying IgA, Kappa paraproteinaemia. The literature on this association is outlined. Underlying plasma cell dyscrasias should be excluded in cases of unexplained sick sinus syndrome.(AU)
Assuntos
Humanos , Pessoa de Meia-Idade , Feminino , Síndrome do Nó Sinusal/etiologia , Síndrome do Nó Sinusal/terapia , Amiloidose/diagnóstico , Amiloidose/terapia , Trinidad e Tobago , Paraproteinemias/terapiaRESUMO
The clinical histopathological and serological findings in three patients who developed yellow fever after entering the Guayaguayare forest in south-east Trinidad in January and February 1979 are described in this report. The patients were all previously healthy young males and the clinical features of the disease varied from fulminant viral hepatitis with hepato-renal failure to a self-limiting anicteric viral illness. The first patient died, and histopathological examination of the liver was done post-mortem. Needle biopsy of the liver was done on case 2 which presented with the clinical picture of infective hepatitis, and on case 3 with the features of an anicteric viral illness. The histopathological hallmarks of midzonal necrosis, granular eosinophilic degeneration (Councilman bodies) and fatty change in the parenchymal cells of the liver were seen in three cases. The electron microscopic study demonstrated the presence of the yellow fever virus in the liver of the patient who died (AU)
Assuntos
Humanos , Adulto , Masculino , Febre Amarela/patologia , Fígado/patologia , Trinidad e TobagoRESUMO
A pre-menopausal patient with a six-year history of symptoms of the metastatic carcinoid syndrome leading to progressively worsening carcinoid heart disease is described. The failure of anti-oestrogenic therapy (sequential bilateral oophorectomy and Tamoxifen therapy) to halt progression of disease was documented. Death resulted from right ventricular failure associated with pulmonary and tricuspid valvular disease.
Assuntos
Síndrome do Carcinoide Maligno/tratamento farmacológico , Tamoxifeno/uso terapêutico , Biópsia , Feminino , Humanos , Síndrome do Carcinoide Maligno/diagnóstico , Síndrome do Carcinoide Maligno/patologia , Pessoa de Meia-Idade , Tamoxifeno/administração & dosagemRESUMO
A pre-menopausal patient with a six-year history of symptoms of the metastatic carcinoid syndrome leading to progressively worsening carcinoid heart disease is described. The failure of anti-oestrogenic therapy (sequential bilateral oophorectomy and Tamoxifen therapy) to halt progression of disease was documented. Death resulted from right ventricular failure associated with pulmonary and tricuspid valvular disease
Assuntos
Humanos , Pessoa de Meia-Idade , Feminino , Tamoxifeno/uso terapêutico , Síndrome do Carcinoide Maligno/tratamento farmacológico , Tamoxifeno/efeitos adversos , Biópsia , Síndrome do Carcinoide Maligno/diagnóstico , Síndrome do Carcinoide Maligno/patologiaRESUMO
A pre-menopausal patient with a six-year history of symptoms of the metastic carcinoid syndrome leading to progressively worsening carcinoid heart disease is described. The failure of anti-oestrogenic therapy (sequential bilateral oophorectomy and Tamoxifen therapy) to halt progression of disease was documented. Death resulted from right ventricular failure associated with pulmonary and tricuspid valvular disease (AU)