RESUMO
The reactive airway dysfunction syndrome (RADS) is a type of occupational asthma without any period of latency and induced by irritants of low molecular weight. It is a clinical illness diagnosed with scarce information of prevalence in our medical service, that is why it receives a deficient treatment with more morbidity. A clinical case of a 60 year old patient is reported with a sudden, intense and long exposure to clorhidric acid and the consequent development of RADS. We performed a complete study of her signs and symptoms as well as some diagnostic tests, such as respiratory function tests and a positive test to the clorhidric acid. Once the diagnosis was confirmed, the patient was treated with high doses of corticosteroids and bronchodilators of long action for a period of three months. She had complete remission of symptoms, with normal respiratory tests and return to her every day work activities. It is important to consider that this illness in patients with respiratory symptoms and exposed to irritants should receive an appropriate treatment, which makes a better prognosis of it.
Assuntos
Asma/induzido quimicamente , Ácido Clorídrico/efeitos adversos , Doenças Profissionais/induzido quimicamente , Asma/diagnóstico , Asma/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/fisiopatologia , SíndromeRESUMO
AIMS: It has been reported that some patients with cancer present auto-immune phenomenon mediated by auto-antibodies, suggesting a relationship between auto-immunity and cancer. Our interest was to determine the frequency of association of rheumatoid factor and breast cancer. MATERIAL AND METHOD: Fifty patients were studied, 3 on stage 111 and 19 on stage IV. Rheumatoid factor was measured in all of them. Auto-antibodies were measured by ELISA. The clinical files of all the patients were reviewed to determine the presence of metastases (osseous, pulmonary, CNS and hepatic) as well as the histological type of the cancer to correlate the expression of the rheumatoid factor with the patients' clinical status. RESULTS: Four (12.9%) out of the 31 patients on stage 111 had positive rheumatoid factor, while 9 (47.3%) out of 19 patients on stage IV had positive rheumatoid factor. The mean age of the patients on stage 111 with positive rheumatoid factor was 48 years, while the mean age of the patients on stage IV with positive rheumatoid factor was 53 years. Patients on stage 111 with positive rheumatoid factor only had local-regional metastases while patients on stage IV with positive rheumatoid factor had distant metastases. The predominant histological type was adenocarcinoma. CONCLUSION: In this study it is shown that breast cancer on the most advanced stages have higher expression of rheumatoid factor, and more clinical derangement with higher levels of rheumatoid factor expression. The proposal of auto-antibodies as predictors of the severity of the cancer requires further studies on several types of cancer.
Assuntos
Neoplasias da Mama/sangue , Fator Reumatoide/sangue , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de NeoplasiasRESUMO
The hyper IgE syndrome is characterized by recurrent abscess on the skin, and airways and itching dermatitis. The data acquired in the lab is hypergammaglobulinemy, eosinophil in blood, tissue, sputum, with fagocitos, and quimiotaxis defect. Since 1972 it has been reported 150 cases in the world without no geographic difference and 2:1 relation with the masculine gender. The therapeutic ways are even controversial. The therapy with interferon alpha 2 beta is the alternative treatment so diminish the dermis inflammation as the seric IgE reduction. This case shows a patient with the classic clinic data and seric IgE levels who didn't present response to the habitual therapy, because of this. He was the switch to the interferon alpha 2 beta. Later on the therapy it wasesented clinical changes over the symptomatology with reduction in the over seric IgE.