RESUMO
The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) was first introduced in 2011 to provide a more precise syndromic characterization of clinical manifestations observed in patients exposed to adjuvant substances such as biopolymers and silicone, among others. The clinical spectrum of this entity is variable, ranging from local involvement to potentially fatal immune-mediated systemic involvement. The interest in ASIA has grown in recent years, reinforcing diagnostic criteria and deepening the understanding of its pathophysiological behavior. This case report highlights a distinct range of clinical symptoms, such as general symptoms, advanced-stage chronic kidney disease, persistent hypercalcemia with suppressed parathyroid hormone (PTH), bilateral nephrocalcinosis, cutaneous calcinosis, and the presence of positive autoantibodies, emphasizing the significance of understanding this condition.
RESUMO
La isquemia medular (IM) es una emergencia meÌdica causada por hipoperfusioÌn o embolismo de la arteria espinal. El inicio de los siÌntomas es abrupto, y su presentacioÌn cliÌnica y gravedad es amplia, dependiendo del segmento medular comprometido. Entre las causas maÌs frecuentes estaÌn la enfermedad ateroescleroÌtica, las cirugiÌas vasculares aoÌrticas y, menos comuÌnmente, la diseccioÌn aoÌrtica (DA). La IM conlleva secuelas graves y alta mortalidad. Este artiÌculo describe el caso de un paciente con infarto medular agudo como primera manifestacioÌn de un hematoma intramural (HIM) en un aneurisma de aorta toraÌcica.
Spinal cord ischemia is a medical emergency due to hypoperfusion or embolization of the spinal artery. The onset of symptoms is abrupt and the clinical presentation depends on the medullary territory involved. The most frequent causes are atherosclerotic disease, aortic surgery and less commonly, aortic dissection, which is associated with serious complications and greatest risk of mortality. This article describes the case of a patient with an acute spinal infarction as the first manifestation of an intramural hematoma in a thoracic aortic aneurysm.