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Development of the Waterhouse-Friderichsen syndrome after infection with SARS-CoV-2 in a patient with rheumatoid arthritis and secondary AA-adrenal amyloidosis 类风湿性关节炎伴继发性aa肾上腺淀粉样变患者感染SARS-CoV-2后Waterhouse-Friderichsen综合征的发生

Klinicheskaia praktika Pub Date : 2023-09-13 DOI: 10.17816/clinpract472056

Olga Альпидовская

{"title":"Development of the Waterhouse-Friderichsen syndrome after infection with SARS-CoV-2 in a patient with rheumatoid arthritis and secondary AA-adrenal amyloidosis","authors":"Olga Альпидовская","doi":"10.17816/clinpract472056","DOIUrl":"https://doi.org/10.17816/clinpract472056","url":null,"abstract":"The COVID-19 pandemic has also affected rheumatic diseases. A clinical case of the development of the Waterhouse-Friderichsen syndrome after SARS-CoV-2 infection in a patient with secondary AA - adrenal amyloidosis is presented. Description of the case. Patient G.G., 57 years old, was hospitalized for several hours on May 20, 2023 at the Cheboksary Regional Hospital with a diagnosis of severe viral interstitial pneumonia. Secondary AA adrenal amyloidosis. Acute adrenal insufficiency. She was admitted with complaints of an increase in body temperature up to 38.20C. Computed tomography of the chest organs showed signs of bilateral viral interstitial pneumonia (the percentage of lung damage was 74%). The diagnosis of COVID-19 was based on a positive PCR test in nasopharyngeal swabs. Blood pressure - 80 / 40 mm Hg. Art. D - dimer - 786 ng / ml (not higher - 243 ng / ml). Despite treatment, the patient died. At autopsy in the lungs, dystelectasis, hyaline membranes, intraalveolar edema. In the adrenal glands - the deposition of amyloid masses, foci of necrosis of the cortical layer and hemorrhage. Signs of DIC - syndrome. Conclusion. The peculiarity of the case is the development of the Waterhouse-Frideriksen syndrome without signs of sepsis.","PeriodicalId":34156,"journal":{"name":"Klinicheskaia praktika","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135689850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Myasthenic syndrome of Lambert-Eaton on the background of thyroid cancer (clinical case) 甲状腺癌背景下Lambert-Eaton肌无力综合征(临床一例)

Klinicheskaia praktika Pub Date : 2023-09-13 DOI: 10.17816/clinpract119952

Elena Khozhenko

{"title":"Myasthenic syndrome of Lambert-Eaton on the background of thyroid cancer (clinical case)","authors":"Elena Khozhenko","doi":"10.17816/clinpract119952","DOIUrl":"https://doi.org/10.17816/clinpract119952","url":null,"abstract":"Lambert-Eaton myasthenic syndrome, G 73.1 according to ICD-10, is a rare autoimmune disease associated with presynaptic impairment of neuromuscular transmission due to the production of antibodies to voltage-gated calcium channels. The disease is characterized by variable muscle weakness of the proximal limbs, mainly the gluteal and femoral muscles, ptosis of the eyelids, diplopia, dysarthria and peripheral paresthesia, and decreased tendon reflexes. The peculiarity of the Lambert-Eaton myasthenic syndrome is manifested in a combination of increased muscle weakness and fatigue with the phenomenon of \"working in\" - an increase in muscle strength against the background of muscle load after a short-term maximum contraction. At the same time, the patient shows normal response of tendon reflexes. Myasthenic Lambert-Eaton syndrome is often associated with small cell lung cancer and very rarely develops with tumors of other localization. We observed an 80-year-old patient with complaints of weakness and pain in the hips, shoulders, pelvic region, half-ptosis of the eyelids. For half-ptosis of the eyelids, a differential diagnosis was made with myasthenia gravis. Stimulation electromyography revealed the M-response increment, i.e. the phenomenon of working in, which is typical for this syndrome. The examination revealed papillary thyroid cancer, which later was undergoing surgical treatment. This case illustrates Lambert-Eaton's paraneoplastic myasthenic syndrome, a rare tumor form associated with thyroid cancer. Key words: LambertEaton myasthenic syndrome, paraneoplastic syndrome, thyroid cancer.","PeriodicalId":34156,"journal":{"name":"Klinicheskaia praktika","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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