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Id: lil-636751
Autor: Toro Gutiérrez, Carlos-Enrique; Quintana Duque, Mario Andrés; Escobar, María Fernanda; Cañas Dávila, Carlos Alberto; Iglesias Gamarra, Antonio; Restrepo, José Félix.
Título: Enfermedad reumatológica y embarazo / Rheumatic diseases and pregnancy
Fonte: Rev. colomb. reumatol;14(1):54-65, ene. 2007. ilus.
Idioma: es.
Resumo: La presencia de enfermedad reumatológica en el embarazo no es infrecuente. Este hecho se favorece por la mayor prevalencia de enfermedades reumáticas en mujeres en edad fértil. El efecto del embarazo en la enfermedad reumatológica varía de acuerdo a la enfermedad; en algunos casos se tiende a exacerbar la patología de base, mientras que en otros tiende a remitir. Independiente de cuál sea la situación, la enfermedad reumática en el embarazo siempre representa un desafío importante para el equipo médico tratante. El tratamiento de cada condición difiere del estándar porque muchos medicamentos poseen efectos adversos para el embarazo y adicionalmente, en los estudios clínicos con frecuencia se excluye a la población obstétrica por lo que muchas de las recomendaciones en este grupo de pacientes provienen de observaciones clínicas. El conocimiento preciso del problema y la inclusión del médico reumatólogo en el equipo de tratamiento son pasos fundamentales para obtener un mejor resultado materno-fetal. En este artículo analizamos las enfermedades reumáticas más frecuentes y su relación con el embarazo.

The association between rheumatic diseases and pregnancy is not uncommon. This is due to the high prevalence of the rheumatic diseases among young women. The effect of pregnancy on any rheumatic disease is unique to each rheumatologic condition; in some cases pregnancy is the trigger for a flare-up, while in other cases the disease tends to go to remission. Independent to the clinical scenario, rheumatic diseases on a pregnant women is always a challenge for the medical team. Treatment for each condition differs from the standard of care, because many drugs may have serious side effects on pregnancy. Besides, obstetric population is commonly excluded from clinical trials, so most recommendations are made by expert opinion and clinical observations. The precise understanding of this situation and the participation of a rheumatologist in the medical team are essential elements to achieve the best outcomes. In this paper we review the most frequents rheumatic diseases and its relation with pregnancies.
Descritores: Gravidez
Doenças Reumáticas
-Patologia
Terapêutica
Gestantes
Efeitos Adversos de Longa Duração
Limites: Humanos
Feminino
Gravidez
Responsável: CO356.9


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Id: lil-636756
Autor: Medina, Yimy F; Restrepo, José Félix; Iglesias, Antonio; Ojeda, Paulina; Matiz, Carlos.
Título: Enfermedad pulmonar intersticial asociada a enfermedades de tejido conectivo / An interstitial lung disease (ILD) belongs to a group of diffuse parenchymal lung diseases
Fonte: Rev. colomb. reumatol;14(2):115-127, jun. 2007. ilus, tab.
Idioma: es.
Resumo: La enfermedad pulmonar intersticial pertenece al grupo de la enfermedad pulmonar parenqui-matosa difusa. Debe ser diferenciada de otras patologías entre las que están las neumonías intersticiales (NII) asociadas a enfermedad de tejido conectivo (ETC) y las idiopáticas. Se han originado nuevos conceptos en los últimos años y se las ha clasificado en siete subgrupos bien definidos y se ha descrito la asociación de cada uno de estos subgrupos con las ETC. Su historia natural y otros aspectos de su tratamiento no se conocen completamente. Para su diagnóstico completo se requieren criterios clínicos, imagenológicos y de histopatología. La biopsia pulmonar ocupa un lugar esencial. Es importante promover y estimular la subclasificación de cada subgrupo con el fin de conocer su historia natural, dirigir el tratamiento y mejorar su pronóstico.

It should be differentiated from other pathologies among those are idiopathic and ILD associated to connective tissue diseases (CTD). New concepts have been developed in the last years, and they have been classified in seven defined subgroups. It has been described the association of each one of these subgroups with CTD. Natural History and other aspects of its treatment is not known completely. For complete diagnose it is required clinical, image, and histopathologic approaches. The biopsy lung plays an essential role. It is important to promote and to stimulate the subclasification of each subgroup with the purpose of, knowing their natural history, directing the treatment and to improve their outcome.
Descritores: Associação
Tecido Conjuntivo
Pneumopatias
-Patologia
Terapêutica
Diagnóstico
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CO356.9


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Id: lil-636727
Autor: López Rengifo, Diana Milena; Contreras Zúñiga, Eduardo; Osio, Luis Fernando.
Título: Síndrome de Churg Strauss / Churg Strauss Syndrome
Fonte: Rev. colomb. reumatol;14(3):237-240, sep. 2007. ilus, tab.
Idioma: es.
Resumo: El síndrome de Churg Strauss, también llamado angeítis y granulomatosis alérgica, es un síndrome multisistémico caracterizado por rinitis alérgica, asma y eosinofilia importante en el extendido periférico. El órgano más comúnmente comprometido es el pulmón, seguido de la piel. Sin embargo, el síndrome de Churg Strauss puede afectar cualquier órgano sistema, incluyendo el sistema cardiovascular, el gastrointestinal, el renal y el sistema nervioso central.

The Churg-Strauss syndrome, also called allergic granulomatosis and angiitis, is a multisystem disorder characterized by allergic rhinitis, asthma, and prominent peripheral blood eosinophilia. The most common organ involved is the lung, followed by the skin. The Churg-Strauss syndrome, however, can affect any organ system, including the cardiovascular, gastrointestinal, renal, and central nervous systems.
Descritores: Vasculite
Síndrome de Churg-Strauss
-Patologia
Sinais e Sintomas
Terapêutica
Impactos na Saúde
Limites: Humanos
Masculino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CO356.9


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Id: lil-636733
Autor: Saavedra Ramírez, Publio Giovanni; Ramírez Palacios, Iván; Cardona Tapias, Alejandro.
Título: Hipercalcemia recurrente en un paciente con sarcoidosis aguda / Recurrent Hypercalcemia in a patient with acute sarcoidosis
Fonte: Rev. colomb. reumatol;14(4):310-319, dic. 2007. ilus.
Idioma: es.
Resumo: La sarcoidosis es una condición granulomatosa crónica, de causa desconocida y que se caracteriza histológicamente por la presencia de granulomas epitelioides no caseificantes que pueden aparecer en cualquier órgano del cuerpo humano. Esta patología puede ser aguda o subaguda y autolimitada o tomar un curso crónico, caracterizado por exacerbaciones y remisiones. La hipercalcemia se puede encontrar entre el 10 y el 20% de los pacientes con la enfermedad. La causa de esta reside en que los monocitos y macrófagos activados presentes en el granuloma sobreexpresan el receptor de la vitamina D y la enzima 25-hidroxivitamina D 1-α hidroxilasa de una manera resistente a la inhibiciσn normal por niveles elevados de calcio sérico. Esta actividad enzimática autónoma conlleva a una sobreproducción de calcitriol, que a su vez, incrementa la absorción intestinal del calcio de la dieta y la actividad de los osteoclastos con aumento en la reabsorción ósea y consecuentemente produciendo hipercalcemia. Presentamos el caso de un hombre de 49 años de edad, raza negra, con parotidomegalia bilateral, múltiples adenopatías mediastinales, hipercalcemia severa recurrente y falla renal aguda en quien se documentó sarcoidosis como causa de sus síntomas.

Sarcoidosis is a chronic granulomatous disease of unknown etiology characterized by the presence of noncaseating epithelioid granulomas that can take place in every organ or system of the human body. This disease can be acute or sub acute and self limited in presentation or can have a chronic course characterized by exacerbations and remi-ssions. Hypercalcemia can be detected in 10 to 20 percent of the patients with the disease. It is caused by the over expression of vitamin D-receptor and 25-hydroxyvitamin D 1-α hydroxilase enzyme in monocytes and activated macrophages within the granuloma in a way that is resistant to the natural inhibition driven by high serum calcium levels. This autonomous enzymatic activity leads to the overproduction of calcitriol which increase intestinal absorption of the calcium present in the diet and also increase the activity of osteoclast with consequent high bone turnover and hypercalcemia. In this report we present the case of a 49 years old man, black race, bilateral parotid gland enlar-gement, bilateral hilar lymphadenopathy, severe recurrent hypercalcemia and acute renal failure in who sarcoidosis was documented as the cause of his symptoms.
Descritores: Sarcoidose
Hipercalcemia
-Patologia
Associação
Causalidade
Corpo Humano
Granuloma
Doença Granulomatosa Crônica
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Revisão
Responsável: CO356.9


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Id: lil-553371
Autor: Campos, Antônio Hugo José Fróes Marques.
Título: Análise do perfil de expressão gênica em amostras de linfoma de Hodgkin clássico: estudo da patogênese com ênfase no papel da infecção pelo vírus de Epstein-Barr / Gene expression analysis in classical Hodgkin lymphoma: a pathogenetic study emphasizing the role of Epstein-Barr virus infection.
Fonte: São Paulo; s.n; 2009. 108 p. ilus, tab.
Idioma: pt.
Tese: Apresentada a Fundação Antônio Prudente para obtenção do grau de Doutor.
Resumo: O linfoma de Hodgkin clássico é uma neoplasia linfóide monoclonal caracterizada pela presença de raras células de Hodgkin e Reed-Sternberg em meio a um infiltrado inflamatório abundante constituído por linfócitos, eosinófilos, plasmócitos, macrófagos e neutrófilos. Aspectos específicos da patogênese desta neoplasia, particularmente as alterações que impedem a entrada das células neoplásicas em apoptose, não são ainda totalmente conhecidos... Material e métodos. Foram utilizadas 3 linhagens celulares negativas para o EBV (L428, L1236 e KM-H2) e uma linhagem positiva (L591), gentilmente cedidas pelo Prof. Dr. Harald Stein, e 10 amostras de tecido fresco congelado envolvidas por linfoma de Hodgkin clássico, fornecidas pelo Banco de Tumores do Hospital A C Camargo... Blocos de parafina contendo material conservado em formalina de 148 casos de LHC foram selecionados do arquivo do Departamento de Patologia do Centro de Tratamento e Pesquisa Hospital A C Camargo, São Paulo, Brasil, no período de 1970 a 2005... Resultados. Foi observada expressão diferencial de 756 genes, que após análise funcional se agruparam em diversos grupos relevantes, incluindo os grupos de genes relacionados à sinalização célula-célula, ao desenvolvimento do sistema imune, envolvidos na regulação da via de NFkB, e quimiotaxia... Conclusões. Os resultados do presente estudo sugerem a capacidade das CHRS de explorarem diversas vias de sinalização para alterar seu ciclo-celular e controle mitótico, assim como evadir ao sistema de imunovigilância do organismo...

Background. Classical Hodgkin lymphoma is a monoclonal lymphoid neoplasm whose hallmark is the Reed-Sternberg cell and its variants, which are surrounded by an inflamatory background. Although extensively studied, many aspects of its pathogenesis, especially those involving the programmed cell death pathway, are still not understood. The role of Epstein-Barr virus (EBV), which is detected in approximately 50% of Hodgkin lymphomas, is also not well established. Although data on EBV association with clinical outcome of Hodgkin lymphoma patients are controversial, some studies suggest that the cases in which EBV is detected follow a different pathway leading to apoptosis blockage.This can stimulate the search for new treatments based on the presence or absence of EBV. Studies employing differential gene expression techniques can add new information to help solving these questions. Objective. This study analyzed the gene expression pattern of Hodgkin cell lines and tissues involved by classical Hodgkin lymphoma, comparing the differences related to the presence or absence of Epstein-Barr virus infection. Additionally, a Tissue Microarray containing cases of classical Hodgkin lymphoma was constructed to validate the protein expression of some of the genes observed in the analysis, comparing the results with Epstein-Barr status and clinical outcome of the patients. Materials and methods. Three EBV-negative Hodgkin cell lines (L428, L1236 e KM-H2), one EBV-positive Hodgkin cell line (L591), and 10 classical Hodgkin lymphoma frozen tissue samples were used in the gene expression analysis study. Following total RNA extraction, cRNA probes were hybridized in oligoarray glass slides. Data from the image acquisition were submitted to quality control pre-analysis prior to bioinformatic statistical analysis for gene clustering experiments and functional analysis. Paraffin-blocks from 148 retrospective cases of classical Hodgkin Lymphoma, diagnosed between 1970 and 2005, were retrieved from the archives of the Department of Pathology. Cases without enough formalin-fixed and paraffin-embedded tissue to run the immunohistochemical (IHC) reactions, relapse biopsies and HIVassociated HL were excluded. Histological diagnosis was revised, with the use of immunostains when necessary. A tissue microarray was built and immunostains performed with antibodies against Aurora-B, Caspase-1, Caveolin-1, CCL20, CDC2, MMP9 and LMP-1. Cases were also tested for EBV using "in situ" hybridization for "EBV early RNAs" (EBER-1). The reactions were analyzed and the results submitted to statistical analysis. Results. We observed that 756 genes are differentially expressed between EBV-positive and EBV-negative Hodgkin cell lines. These genes are functionally related to many relevant groups, such as cell-cell signaling, immune system development, NFkB regulation and chemotaxis. Some genes belonging to these groups were selected for immunoistochemical validation (Aurora-B, Caspase-1, Caveolin-1, CCL20, CDC2 and MMP9), whose protein expression was detected in 58,78%, 38,51%, 25,68%, 49,32%, 75,68% e 52,03% of the cases, respectively. CCL20 protein expression was specifically associated with EBV-infection (p<0,0001). Disease-specific survival rates of patients between 15 and 45 years who expressed Caspase-1 and MMP9 in neoplastic cells were significantly lower than those who did not express these markers. The expression of MMP9 by neoplastic cells was an independent prognostic factor is this group of patients. Conclusions. The results of this study suggest the ability of Hodgkin-ReedSternberg cells to explore different signaling pathways to control their cell-cycle and mitotic activity, as well as evade immunosurveillance, regulating different genes according to EBV infection status. CCL20 protein expression is associated with EBV infection in Hodgkin lymphoma cases. We also observed the expression of new proteins by Hodgkin-Reed-Sternberg cells, such as Caspase-1 and Caveolin-1. The expression of Caspase-1 and MMP9 by Hodgkin-Reed-Sternberg cells associates with a poor outcome in Hodgkin lymphoma patients between 15 and 45 years. MMP9 expression by neoplastic cells is an independent prognostic factor in this group of patients.
Descritores: Células de Reed-Sternberg
Doença de Hodgkin
Doença de Hodgkin/diagnóstico
Expressão Gênica
HERPESVIRUS HUMANO ABBREVIATIONS AS TOPIC
Patologia
-Imuno-Histoquímica
Apoptose
Limites: Humanos
Responsável: BR30.1 - Biblioteca
BR30.1


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Id: lil-636765
Autor: Mejía-Vallejo, Jimy; Román, Mauricio; Amador, José; Calixto, Luis Fernando; Iglesias-Gamarra, Antonio; Restrepo, José Félix.
Título: Artritis séptica bilateral de rodillas asociada a injerto vascular en paciente inmunocompetente / No presenta
Fonte: Rev. colomb. reumatol;15(1):50-53, ene.-mar. 2008. ilus, graf, tab.
Idioma: es.
Resumo: Se presenta un caso de artritis séptica de rodillas en un paciente inmunocompetente por meticilino sensible con antecedentes de injerto vascular femoropoplíteo izquierdo postraumático; el comportamiento clínico no habitual del caso, la inclusión entre las alternativas diagnósticas de oligoartritis y la emergencia reumatológica y ortopédica motiva su información.

We report a case of bilateral knee septic arthritis caused by Methicillin-sensitive Staphylococcus aureus in an immucompetent patient, who had a history of posttraumatic left femoropopliteal graft. The unusual clinical course, the importance of include this pathology in the differential diagnosis of oligoarthritis as well as the orthopedic and rheumatologic emergence motivate its report.
Descritores: Artrite Infecciosa
Enxerto Vascular
-Patologia
Comportamento
Diagnóstico Diferencial
Informação
Joelho
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: CO356.9


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Id: lil-636776
Autor: Rúa Marín, Catalina; Díaz, James; Cardona, Alejandro; Ramírez, Luis Alberto.
Título: Traqueomegalia y artririts reumatoide / Traqueomegalia and rheumatoid arthritis
Fonte: Rev. colomb. reumatol;15(3):207-209, jul.-sep. 2008. ilus, tab.
Idioma: es.
Resumo: La traqueo-broncomegalia es una rara condición de etiología desconocida que ha sido descrita en asociación con enfermedades del tejido conectivo ocasionalmente. Presentamos un caso de traqueomegalia en una paciente con artritis reumatoide de larga evolución. Este es el segundo caso reportado en la literatura médica hasta ahora. La asociación entre estas patologías es incierta y no se puede establecer una clara relación fisiopatológica debido a la rareza de su ocurrencia y el inicio tardío de los síntomas.

Tracheobronchomegaly is a rare condition of unknown etiology that has been described in association with connective tissue diseases. We present a case of tracheomegaly in a patient with a long evolution rheumatoid arthritis. This is the second case reported in the medical literature until now. Association between these pathologies is uncertain and we can not establish a clear pathophysiological link due to the rarity of its occurrence and the late onset of symptoms.
Descritores: Artrite Reumatoide
Associação
Traqueobroncomegalia
-Patologia
Sinais e Sintomas
Doença
Limites: Humanos
Feminino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: CO356.9


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Id: lil-636779
Autor: Miranda, David; Ramírez, Jorge; Rueda, Liliana; García, Jenny; Wolf, Germán; Lugo A, Luz Helena.
Título: Validación del "Michigan Hand Outcomes Questionnaire" para población colombiana / No presenta
Fonte: Rev. colomb. reumatol;15(4):271-290, oct.-dic. 2008. tab.
Idioma: es.
Resumo: Propósito: validar el "Michigan Hand Outcomes Questionnaire" para el uso en población clínica colombiana, obtener una versión en español que tenga equivalencia trans-lingüística y evaluar la fiabilidad, sensibilidad al cambio, validez de contenido y de constructo del instrumento traducido y adaptado al español. Métodos: estudio observacional de validación de una escala en 205 pacientes colombianos con patología de mano asistentes a las consultas de cirugía plástica, rehabilitación y reumatología en un Hospital Universitario de referencia regional. Resultados: el análisis de componentes principales mostró seis dominios. A pesar de tener el mismo número de dominios, el contenido de algunos de ellos fue diferente a las subescalas originales. Se evaluó la consistencia interna incluyendo los 37 ítems de la escala original y se obtuvo un valor de Alfa de Cronbach de 0,92. Todas las subescalas tenían buena reproducibilidad prueba-reprueba excepto dolor. Al evaluar los resultados de la escala, tres y seis meses después de su primera aplicación, se pudo observar que había diferencias estadísticamente significativas en la puntuación total y en la de cada una de las subescalas. Conclusiones: la versión en español para Colombia del “Michigan Hand Outcomes Questionnaire” tiene buena confiabilidad, validez y sensibilidad al cambio. La evaluación de consistencia interna indicó que la escala podría ser acortada y posiblemente mejoren aún más sus propiedades psicométricas.

Purpose: to validate the Michigan Hand Outcomes Questionnaire for its use in Colombian clinical population: to translate and adapt the scale in order to obtain a cross-linguistically equivalent version in Spanish, and to assess the reliability, sensitivity to change, and content and construct validity of the Colombian Spanish version. Methods: observational study to validate a scale in 205 Colombian patients of plastic surgery, rehabilitation, and rheumatology in a University Hospital, who had a hand disorder. Results: the principal component analysis showed six domains, as in the original questionnaire, but the content of some of them differed from the original MHQ scales. We assessed internal consistency of the entire 37-item original scale, and Cronbach's alpha was of 0,92. All scales had good test-retest reproducibility, except for the Pain scale. Upon evaluation of the results of the scale three and six months after its first application, significant differences could be observed in the total score as well as in the scores for each of the scales. Conclusions: the Colombian Spanish version of Michigan Hand Outcomes Questionnaire has good reliability, validity, and sensitivity to change. Assessment of internal consistency indicated that the scale could be reduced and its psychometric properties would possibly improve.
Descritores: Características da População
Michigan
Inquéritos e Questionários
Colômbia
-Patologia
População
Sensibilidade e Especificidade
Linguística
Limites: Humanos
Responsável: CO356.9


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Id: lil-636789
Autor: Mejía-Vallejo, Jimi; Calvo, Enrique; Restrepo, José Félix; Iglesias-Gamarra, Antonio.
Título: Enfermedades osteocondensantes: una nueva visión clínico-radiológica soportada en la genética y la inmunoosteología / Osteocondensant diseases: A new clinical-radiological vision supported in genetics and osteoimmunology
Fonte: Rev. colomb. reumatol;16(1):46-60, ene.-mar. 2009. ilus, tab.
Idioma: es.
Resumo: Las alteraciones en el remodelado óseo llevan al incremento o disminución de la masa ósea, generando daño de la microarquitectura ósea, lo cual incrementa el riesgo de fractura. Las patologías con incremento de la densidad conducen a diversos procesos osteocondensantes genéticamente dirigidos. La osteocondensación es explicada actualmente por alteración en la función del osteoclasto asociada a una deficiente función de la resorción ósea, alteración en la función del osteoblasto que genera un incremento anormal en la formación ósea, o un imbalance homeostático entre los dos procesos; la expresión clínica y radiológica de estas entidades puede darse en etapas tempranas del desarrollo o en la vida adulta dependiendo del componente autosómico recesivo o dominante respectivamente. En esta revisión, se discute la clasificación basada en el desorden funcional de las células óseas y las principales características clínicas y radiológicas que permiten un abordaje diagnóstico sencillo y aplicable en la práctica clínica.

The alterations in osseous remodeling lead to the increase or decrease of the osseous mass, generating damage to the osseous micro-architecture, which increases the risk of fracture. The pathologies with increase in osseous density lead to different genetically directed osteocondensing processes. The osteocondensing is currently explained by alteration in the function of the osteoclast, associated with a deficient function of the osseous resorption, an alteration in the osteoblast function, which generates an abnormal increase in the osseous formation, or a homeostatic imbalance between the two processes; the clinical and radiological expression of these diseases can take place in early stages of the development, or in the adult life, depending on the recessive or dominant autosomic component, respectively. In this review, the classification based on the functional disorder of the bone cell is discussed, as well as the main clinical and radiological characteristics than permit a simple and applicable diagnostic approach in the clinical practice.
Descritores: Osteosclerose
Patologia
Hiperostose
Doença
Diagnóstico
-Arquitetura
Fraturas Ósseas
Genética
Limites: Humanos
Responsável: CO356.9


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Id: lil-636796
Autor: Restrepo, José Félix; Rondón H, Federico; Colegial G, Carlos H; Quintana L, Gerardo; Iglesias-Gamarra, Antonio.
Título: Vasculitis linfomonocítica primaria de inicio tardío, estrictamente de nervio periférico / Primary Lymphocytic Vasculitis of late onset, Limited to the Peripheral Nerve
Fonte: Rev. colomb. reumatol;16(2):138-145, jun. 2009. ilus, tab.
Idioma: es.
Resumo: En este artículo presentamos los hallazgos de vasculitis estrictamente de nervio periférico en seis pacientes. Los hallazgos corresponden a una vasculitis que ocasiona una polineuropatía sensitivo-distal en guantes y medias cuyo infiltrado es de tipo linfo-monocítico, ausencia de necrosis fibrinoide, con un buen pronóstico, pocas recaídas y buena respuesta al tratamiento. Planteamos que esta patología debe tenerse en cuenta en el diagnóstico diferencial de las polineuropatías y mononeuritis múltiple. Se hace una revisión de la literatura.

We present the finding of strictly peripheral nerve vascultis in six cases. The finding are secondary to a vasculitis that produce a stocking-glove sensitive-motor polyneuropathy, with an limphomonocytic infiltrate, absence of fibrinoid necrosis, good prognosis, low recurrences and an excellent response to treatment. We propose that this condition should be considered in the differential diagnosis of polyneuropathies and multiplex mononeuritis. A literature review is made.
Descritores: Vasculite
Traumatismos dos Nervos Periféricos
-Patologia
Nervos Periféricos
Polineuropatias
Terapêutica
Mononeuropatias
Diagnóstico Diferencial
Neuropatia de Pequenas Fibras
Limites: Humanos
Responsável: CO356.9



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