RESUMO
Resumen Se reporta una paciente en tratamiento con cloroquina para una artritis reumatoidea de aproximadamente diez años de evolución, con una importante dosis acumulada y en quien se documentó deterioro progresivo de la función renal, proteinuria en rango no nefrótico y compromiso muscular proximal en extremidades. En la biopsia renal se encontró a nivel de podocitos cuerpos de cebra. Se descartó enfermedad de Fabry. Se concluyó fosfolipidosis inducida por medicamentos en este caso por cloroquina. Este reporte de caso nos recuerda la importancia de conocer los posibles efectos colaterales de los medicamentos. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2192).
Abstract This is the report of a patient being treated with chloroquine for an approximately 10-year history of rheumatoid arthritis, with a significant cumulative dose and documented progressive kidney function deterioration, non-nephrotic proteinuria and involvement of the proximal muscles of the extremities. The kidney biopsy showed zebra bodies in the podocytes. Fabry disease was ruled out. Medication-induced phospholipidosis was diagnosed, in this case due to chloroquine. This case report reminds us of the importance of being aware of the possible side effects of medications. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2192).
RESUMO
Oxysterols are 27-carbon atom molecules resulting from autoxidation or enzymatic oxidation of cholesterol. They are present in numerous foodstuffs and have been demonstrated to be present at increased levels in the plasma of patients with cardiovascular diseases and in atherosclerotic lesions. Thus, their role in lipid disorders is widely suspected, and they might also be involved in important degenerative diseases such as Alzheimer's disease, osteoporosis, and age-related macular degeneration. Since atherosclerosis is associated with the presence of apoptotic cells and with oxidative and inflammatory processes, the ability of some oxysterols, especially 7-ketocholesterol and 7beta-hydroxycholesterol, to trigger cell death, activate inflammation, and modulate lipid homeostasis is being extensively studied, especially in vitro. Thus, since there are a number of essential considerations regarding the physiological/pathophysiological functions and activities of the different oxysterols, it is important to determine their biological activities and identify their signaling pathways, when they are used either alone or as mixtures. Oxysterols may have cytotoxic, oxidative, and/or inflammatory effects, or none whatsoever. Moreover, a substantial accumulation of polar lipids in cytoplasmic multilamellar structures has been observed with cytotoxic oxysterols, suggesting that cytotoxic oxysterols are potent inducers of phospholipidosis. This basic knowledge about oxysterols contributes to a better understanding of the associated pathologies and may lead to new treatments and new drugs. Since oxysterols have a number of biological activities, and as oxysterol-induced cell death is assumed to take part in degenerative pathologies, the present review will focus on the cytotoxic activities of these compounds, the corresponding cell death signaling pathways, and associated events (oxidation, inflammation, and phospholipidosis).