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Id: biblio-1115784
Autor: Reyes S, Pablo; Andreu, Daniel; Toledo, Camila.
Título: Hipofisitis linfocitaria primaria. Caso clínico / Primary lymphocytic hypophysitis. Report of one case
Fonte: Rev. méd. Chile;148(2):258-262, feb. 2020. graf.
Idioma: es.
Resumo: Primary lymphocytic hypophysitis is an autoimmune disease characterized by lymphocytic infiltration of the pituitary gland, with a higher incidence during late pregnancy and the postpartum period. It causes glandular destruction, mass effect and symptoms such headache, visual field defects, ophthalmoplegia and symptoms of hypopituitarism. We report a 38-year-old postpartum woman who, after giving birth presented decreased left visual acuity associated with a non ictal headache. Magnetic resonance imaging demonstrated a sellar mass associated with decreased free thyroxine and cortisol levels. Suspecting a primary lymphocytic hypophysitis, she was treated with prednisone 60 mg/day and hormonal replacement therapy. One month later, size of the pituitary gland decreased, and the visual field defect improved. Steroidal treatment was maintained for 36 months and progressively tapered. After two years of follow-up, the imaging studies show a normal sized pituitary gland.
Descritores: Doenças da Hipófise
Hipofisite Autoimune
Hipopituitarismo
-Prednisona
Imagem por Ressonância Magnética
Limites: Humanos
Feminino
Gravidez
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1156600
Autor: Miró Jiménez, Yuslier; Nápoles Pérez, Mailyn; Bacallao Prado, Yasnay.
Título: Artritis séptica de la rodilla como forma de presentación de mieloma múltiple / Septic Arthritis of the Knee as a Presentation of Multiple Myeloma
Fonte: Rev. cuba. ortop. traumatol;34(2):e278, jul.-dic. 2020. ilus.
Idioma: es.
Resumo: RESUMEN Introducción: El mieloma múltiple constituye una proliferación maligna de las células plasmáticas derivadas de un solo clon. El tumor, sus productos y la respuesta del paciente ocasionan diversos trastornos funcionales orgánicos y síntomas como dolores óseos o fracturas, insuficiencia renal, predisposición a infecciones, anemia, hipercalcemia y, en ocasiones, trastornos de la coagulación, síntomas neurológicos y manifestaciones vasculares de hiperviscosidad. Objetivo: Presentar un caso infrecuente teniendo en cuenta que la infección aguda como forma de presentación inicial de mieloma es poco usual. Presentación del caso: Se presenta un caso de un paciente de 61 años de edad, ingresado en el servicio de ortopedia en tres ocasiones diferentes y operado de artritis séptica de la rodilla izquierda en estas tres oportunidades. Se mantuvieron los elementos inflamatorios locales a nivel de la articulación, fiebre recurrente, anemia y eritrosedimentación acelerada. Conclusiones: Los estudios hematológicos específicos confirmaron el diagnóstico de mieloma múltiple. Se comenzó tratamiento de inducción a la remisión para esta enfermedad con melfalán y prednisona; se logró mejoría del cuadro infeccioso al concluir el primer ciclo de esta intervención terapéutica(AU)

ABSTRACT Introduction: Multiple myeloma constitutes a malignant proliferation of plasma cells derived from a single clone. The tumor, its products, and the patient's response cause various organic functional disorders and symptoms such as bone pain or fractures, kidney failure, predisposition to infections, anemia, hypercalcemia, and sometimes coagulation disorders, neurological symptoms, and vascular manifestations of hyperviscosity. Objective: To present a rare case, taking into account that acute infection as the initial presentation of myeloma is unusual. Case report: We report a case of a 61-year-old patient, admitted to the orthopedic service on three different occasions and operated on for septic arthritis of the left knee, in every occasions. The local inflammatory elements at the joint level, recurrent fever, anemia and accelerated erythrocyte sedimentation were still present. Conclusions: Specific hematological studies confirmed the diagnosis of multiple myeloma. Induction-to-remission treatment for this disease was started with melphalan and prednisone; improvement of the infection was achieved at the conclusion of the first cycle of this therapeutic intervention(AU)
Descritores: Prednisona/uso terapêutico
Artrite Infecciosa/cirurgia
Joelho
Melfalan/uso terapêutico
Mieloma Múltiplo/tratamento farmacológico
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: CU1.1 - Biblioteca Médica Nacional


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Vega, Jorge
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Id: biblio-1004339
Autor: Aránguiz, Natalia; Vega, Jorge.
Título: Evolución de un linfoma no Hodgkin "triple expresor" en un paciente trasplantado renal con quimioterapia DA-R-EPOCH. Caso clínico / Triple expressor lymphoma in a kidney transplant patient
Fonte: Rev. méd. Chile;147(2):247-250, Feb. 2019.
Idioma: es.
Resumo: Patients transplanted from solid organs have an increased risk of cancer, especially lymphomas. Lymphomas correspond to 4 to 5% of malignant neoplasms in the general population and in solid organ transplant patients it reaches an incidence of 21%. The incidence of non-Hodgkin lymphomas is 10 times higher than in the non-transplanted population. We report the case of a 68-year-old man with a kidney transplant who 6 years after transplantation, developed a non-Hodgkin diffuse large cells B lymphoma with lymph node and pulmonary involvement, with markers of very poor prognosis (triple MYC expressor, BCL2 and BCL6). and its evolution with chemotherapy with DA R EPOCH.
Descritores: Linfoma não Hodgkin
Linfoma Difuso de Grandes Células B/genética
-Vincristina/uso terapêutico
Linfoma não Hodgkin/etiologia
Linfoma não Hodgkin/tratamento farmacológico
Prednisona/uso terapêutico
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Doxorrubicina/uso terapêutico
Biomarcadores Tumorais/genética
Genes myc/genética
Linfoma Difuso de Grandes Células B/etiologia
Linfoma Difuso de Grandes Células B/tratamento farmacológico
Transplante de Rim/efeitos adversos
Proteínas Proto-Oncogênicas c-bcl-2/genética
Ciclofosfamida/uso terapêutico
Proteínas Proto-Oncogênicas c-bcl-6/genética
Etoposídeo/uso terapêutico
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1004347
Autor: Cardemil, Daniela; León, Pilar; Peña, Camila; Valladares, Ximena; Cabrera, María Elena.
Título: Macroglobulinemia de Waldenström: experiencia de 15 años en el Hospital del Salvador, Santiago, Chile / Waldenström macroglobulinemia: experience in 31 patients
Fonte: Rev. méd. Chile;147(3):275-280, mar. 2019. tab, graf.
Idioma: es.
Resumo: Background: Waldenström macroglobulinemia (WM) is an uncommon indolent B-cell lymphoma, due to the proliferation of lymphoplasmacytic cells, and secretion of a monoclonal IgM protein. Aim: To evaluate the clinical characteristics, management and results of treatment of patients with WM at a public hospital in Chile. Patients and Methods: Review of medical records of 31 patients aged 43 to 85 years (16 males) with WM diagnosed between 2002 and 2017. Clinical features and survival were recorded. Results: All patients had bone marrow compromise, and 31%, extranodal involvement. According to the International Prognostic Score System for WM (IPSSWM) 16, 58 and 26% were at low, intermediate and high risk, respectively. Twenty-five patients (81%) were treated, 32% with plasmapheresis and 36% with rituximab. Four cases (16%) achieved complete remission. Median follow up was 35 months (range 6-159). Estimated overall survival (OS) at 5 and 10 years was 74% and 53%, respectively. According to IPSSWM, the estimated five-year OS was 80, 92 and 39%, for low, intermediate and high-risk patients, respectively. Conclusions: OS was similar to that reported abroad, except for low risk patients, probably due to the low number of cases and short follow up. An improved survival should be expected with the routine use of immunochemotherapy.
Descritores: Macroglobulinemia de Waldenstrom/diagnóstico
-Vincristina
Biópsia
Medula Óssea/patologia
Prednisona/uso terapêutico
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Chile/epidemiologia
Taxa de Sobrevida
Estudos Retrospectivos
Resultado do Tratamento
Macroglobulinemia de Waldenstrom/mortalidade
Macroglobulinemia de Waldenstrom/tratamento farmacológico
Ciclofosfamida/uso terapêutico
Rituximab/uso terapêutico
Antineoplásicos Imunológicos/uso terapêutico
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1004361
Autor: Contreras-Olea, Oscar; Goecke-Hochberger, Carola; Rumié-Carmi, Hana Karime; Lobo-Avilés, Rosendo; Mellado-Sagredo, Cecilia; Avila-Smirnow, Daniela.
Título: Fibrodisplasia osificante progresiva plus por una variante patogénica del gen ACVR1: caso clínico / Fibrodysplasia ossificans progressiva: report of one case
Fonte: Rev. méd. Chile;147(3):384-389, mar. 2019. tab, graf.
Idioma: es.
Resumo: Fibrodysplasia ossificans progressiva (FOP) or myositis ossificans, is a genetic disease, with a prevalence of 1 in 2.000.000. It is caused by pathogenic variants in ACVR1 gene and characterized by soft tissue heterotopic ossification, starting in the second decade of life. It is associated to early mortality caused by respiratory complications. It evolves in flare-ups, triggered by soft tissue injuries; therapy is symptomatic, using analgesia, steroids and diphosphonates. We report a 12-year-old female with left renal agenesis, hallux valgus and intellectual disability, presenting with a six months history of thoracic kyphosis, tender nodules in the thorax, and rigidity of right elbow and left knee. Clinical examination revealed dysmorphic facial features. A magnetic resonance showed heterotopic ossification nodules, which was confirmed with spinal radiography. These findings prompted the diagnosis of FOP. Pain treatment was started, and prednisone was used during flare-ups. The ACVR1 gene was analyzed and a pathogenic variant, p. Arg206His, was found, confirming the diagnosis of FOP.
Descritores: Miosite Ossificante/diagnóstico por imagem
-Prednisona/uso terapêutico
Imagem por Ressonância Magnética
Chile
Ossificação Heterotópica/genética
Ossificação Heterotópica/tratamento farmacológico
Ossificação Heterotópica/diagnóstico por imagem
Anti-Inflamatórios/uso terapêutico
Miosite Ossificante/genética
Miosite Ossificante/tratamento farmacológico
Limites: Humanos
Feminino
Criança
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1127613
Autor: Contreras E, Ilse; Andrade P, Rosa.
Título: Hemosiderosis pulmonar idiopática (HPI): presentación de un caso y revisión de la literatura / Idiopathic pulmonary hemosiderosis (IPH): a case report and review of the literature
Fonte: Neumol. pediátr. (En línea);15(3):406-410, sept. 2020. ilus.
Idioma: es.
Resumo: We present the case-report of a one-month-old infant, admitted to the Emergency Department with hypovolemic shock secondary to pulmonary hemorrhage who required life-support measures, including vasoactive drugs and methylprednisolone pulses. She was discharged from the hospital after 13 days of evolution and then readmitted 5 days later for a new episode of hemoptysis with hemodynamic compromise. Fiberoptic bronchoscopy was performed 4 days after the first episode showed a normal anatomy, without active bleeding, with 20% of hemosiderophages in bronchoalveolar lavage. Diffuse infiltrates were found on the chest radiograph. Differents studies were performed for check-out infection, heart disease, immune disease, thrombophilia, celiac disease, swallowing disorder, vascular abnormalities and allergy to cow's milk protein were negative, which led to Idiopathic Pulmonary Hemosiderosis (IPH). It was managed with amino acid formula, daily oral prednisone until 6 months of age and then every other day, and permanent inhaled fluticasone. In subsequent controls, normal growth and development were found, with no recurrences up to the time of this report, at 1 year of age. The favorable evolution in this case is attributed to early diagnosis and timely treatment with systemic corticosteroids. A review of the topic of IPH in pediatrics is presented, and study and treatment algorithms are proposed.

Se presenta el caso de una lactante de un mes de edad, que se presentó en el Servicio de Urgencia con shock hipovolémico secundario a hemorragia pulmonar. Necesitó medidas de soporte vital, incluyendo drogas vasoactivas y pulsos de metilprednisolona. Egresó del hospital a los 13 días de evolución y reingresó 5 días después por nuevo episodio de hemoptisis con compromiso hemodinámico. La fibrobroncoscopía efectuada a los 4 días de evolución del primer episodio mostró una anatomía normal, sin sangrado activo, con 20% de hemosiderófagos en el lavado broncoalveolar. En la radiografía de tórax se encontró infiltrados difusos. Los estudios en busca de infección, cardiopatía, enfermedad inmunológica, trombofilia, enfermedad celíaca, trastorno de deglución, anomalías vasculares y alergia a la proteína de la leche de vaca resultaron negativos, por lo que se planteó una Hemosiderosis Pulmonar Idiopática (HPI). Se manejó con fórmula aminoacídica, prednisona oral diaria hasta los 6 meses de edad y después en días alternos y fluticasona inhalada permanente. En controles posteriores se constató crecimiento y desarrollo normal, sin recidivas hasta el momento de este reporte, con 1 año de edad. La evolución favorable en este caso se atribuye al diagnóstico precoz y tratamiento oportuno con corticoides sistémicos. Se presenta una revisión del tema de HPI en pediatría y se proponen algoritmos de estudio y tratamiento.
Descritores: Hemossiderose/tratamento farmacológico
Hemossiderose/diagnóstico por imagem
-Metilprednisolona
Prednisona
Radiografia Torácica
Corticosteroides/uso terapêutico
Fluticasona
Hemoptise/etiologia
Hemossiderose/complicações
Limites: Humanos
Feminino
Recém-Nascido
Tipo de Publ: Relatos de Casos
Revisão
Responsável: CL1.1 - Biblioteca Central


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Texto completo
Id: biblio-1004362
Autor: Tagle, Rodrigo; Arancibia, Trinidad; Fischman, Alexandra; Vázquez, Sebastián; Chahuán, Javier; Méndez, Gonzalo P; Huidobro E, Juan Pablo.
Título: Recurrencia de Síndrome de Goodpasture con negativización de anticuerpos anti-membrana basal glomerular: caso clínico / Recurrence of goodpasture syndrome with negative antiglomerular basement antibodies: report of one case
Fonte: Rev. méd. Chile;147(3):390-394, mar. 2019. graf.
Idioma: es.
Resumo: Goodpasture Syndrome is described as a single episode disease entity. It is diagnosed with the demonstration of antiglomerular basement (anti-GBM) antibodies in plasma or renal tissue. Although the recurrence of anti-GBM disease is rare, it has been reported in up to 3% of cases. Recurrence with negative anti-GBM antibodies in plasma is even less frequent We report a 63 years old male in whom anti-GBM disease recurred without detectable anti-GBM antibodies in plasma, despite having positive antibodies at the onset.
Descritores: Autoanticorpos/análise
Doença Antimembrana Basal Glomerular/patologia
-Recidiva
Biópsia
Prednisona/uso terapêutico
Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
Imunofluorescência
Doença Antimembrana Basal Glomerular/tratamento farmacológico
Doença Antimembrana Basal Glomerular/diagnóstico por imagem
Ciclofosfamida/uso terapêutico
Nefropatias/patologia
Glomérulos Renais/patologia
Antibacterianos/uso terapêutico
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1148118
Autor: Camoirano, Juliana.
Título: Tratamiento con esteroides de las reagudizaciones de la enfermedad pulmonar obstructiva crónica en personas con diabetes / Steroid treatment for exacerbations of chronic obstructive pulmonary disease in individuals with diabetes
Fonte: Evid. actual. práct. ambul;19(4):126-127, 2016. ilus.
Idioma: es.
Descritores: Esteroides/uso terapêutico
Diabetes Mellitus Tipo 2/complicações
Pneumopatias Obstrutivas/tratamento farmacológico
-Prednisona/administração & dosagem
Diabetes Mellitus Tipo 2/dietoterapia
Diabetes Mellitus Tipo 2/tratamento farmacológico
Hiperglicemia/induzido quimicamente
Metformina/uso terapêutico
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: AR2.1 - Biblioteca Central


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Id: biblio-1146304
Autor: Melo, Edielle de Sant'Anna; Oshiro, Fernanda Sayuri; Veloso, Patrícia Maquinêz; Terêncio, Andréia Sevestrin; Szarf, Gilberto; Siqueira, Maria Eduarda Menezes.
Título: Linfoma Não Hodgkin com Acometimento Cardíaco: Uma Causa Rara de Insuficiência Cardíaca Aguda ­ Relato de Caso / Non-Hodgkin's Lymphoma with Heart Disease as a Rare Cause of Acute Heart Failure: A Case Report
Fonte: ABC., imagem cardiovasc;33(4):eabc114, 20200000.
Idioma: pt.
Descritores: Linfoma Difuso de Grandes Células B/terapia
Linfoma Difuso de Grandes Células B/diagnóstico por imagem
Disfunção Ventricular Esquerda/patologia
Insuficiência Cardíaca/complicações
-Alta do Paciente
Fatores de Tempo
Dexametasona/administração & dosagem
Prednisona/administração & dosagem
Ecocardiografia/métodos
Espectroscopia de Ressonância Magnética/métodos
Radiografia Torácica/métodos
Tomografia Computadorizada por Raios X/métodos
Metotrexato/administração & dosagem
Pulsoterapia/enfermagem
Rituximab/administração & dosagem
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos
Limites: Humanos
Feminino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: BR44.1 - Serviço de Biblioteca, Documentação Científica e Didática Prof. Dr. Luiz Venere Décourt


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Id: biblio-961287
Autor: Vidal Tallet, Lázaro Arturo; Porto Álvarez, Godetia; Claro Moya, Lianetzi; Montell Hernández, Oscar Antonio; Rodríguez Rodríguez, Belkis; Díaz Estévez, Lidia Maria.
Título: Fiebre periódica con estomatitis aftosa, faringitis, y adenitis / Periodical fever with aphthous stomatitis, pharyngitis, and adenitis (PFAPA syndrome)
Fonte: Rev. medica electron;40(4):1155-1162, jul.-ago. 2018. ilus.
Idioma: es.
Resumo: RESUMEN Se presenta un caso de fiebre periódica con estomatitis aftosa, faringitis, y adenitis síndrome de fiebre periódica con estomatitis aftosa, faringitis, y adenitis, entidad aparentemente infrecuente de la cual no se recoge reporte en el país. La etiología no es todavía bien comprendida, se observa con mayor frecuencia entre los 2 y 5 años, aunque se han descrito casos en adultos. Se caracteriza por fiebre periódica con estomatitis aftosa, faringitis, y adenitis de carácter periódica con una dramática respuesta al uso de esteroide en la mayoría de los casos. El caso que se presenta es un paciente de 5 años de edad, sexo masculino, con cuadros de fiebre periódica asociado a amigdalitis con exudado, adenitis y lesiones aftosas, con respuesta en la fase aguda a la prednisona y con respuesta al tratamiento de mantenimiento con cimetidina. En la actualidad lleva 11 meses en remisión (AU).

ABSTRACT We present a case of periodical fever with aphthous stomatitis, pharyngitis and adenitis (PFAPA syndrome), entity that is apparently infrequent and its report in the country was not found. Its etiology is not still clearly understood. It appears with higher frequency in the ages between 2 and 5 years, though it has been described in adult population. It is characterized by periodical fever with aphthous stomatitis, pharyngitis and adenitis of periodical character, with a dramatic answer to the use of steroids in most of the cases. The case that is presented is the one of a male patient aged 5 years with reiterative periodical fever associated to tonsillitis with exudate, adenitis and aphthous lesions, with answer, in the acute phase, to prednisone, and to cimetidine at the maintenance therapy. Nowadays, he is already 11 months in remission (AU).
Descritores: Estomatite Aftosa/epidemiologia
Febre/complicações
-Prednisona/administração & dosagem
Faringite/diagnóstico
Cimetidina/administração & dosagem
Linfadenite/diagnóstico
Limites: Humanos
Masculino
Criança
Tipo de Publ: Relatos de Casos
Responsável: CU424.1 - Centro Provincial de Información de Ciencias Médicas



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