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M C Amigo

Publications and source records attributed to M C Amigo.

At least 37 records · Page 2Linked to original sources
PubMed1996

Valvular heart disease in primary antiphospholipid syndrome (PAPS): clinical and morphological findings.

PURPOSE: To describe clinically and pathologically the valvular lesion of the primary antiphospholipid syndrome (PAPS). PATIENTS AND METHODS: We studied six patients with PAPS and valvulopathy. Four of them died and had autopsy and two had valvular replacement. The study comprised 18 heart valves, 16 from autopsy and two, one mitral and one aortic, resected at surgery. RESULTS: Murmurs and echocardiographic findings kept correlation with gross pathology. Abnormalities were found in one or more valves in all patients including two of five aortic, two of five mitral, one of four pulmonary and two of four tricuspid. Co-existence of new and old lesions was observed. Pathologic findings included intravalvular thrombosis with focal necrosis, and hemorrhage, vascular proliferation, mild histiocytic/fibroblastic infiltration, laminated and verrucous fibrin deposits, laminated and/or nodular fibrosis, and focal calcification. CONCLUSION: The PAPS valvular lesion consists mainly of superficial or intravalvular fibrin deposits and its subsequent organization: vascular proliferation, fibroblast influx, fibrosis and calcification. This results in valve thickening, fusion and rigidity leading to functional abnormalities. Inflammation is not a prominent feature of this lesion.

Adult↗
PubMed1996

Primary antiphospholipid syndrome presenting as chronic thromboembolic pulmonary hypertension. Treatment with thromboendarterectomy.

Pulmonary hypertension may occur in the antiphospholipid syndrome as a result of recurrent pulmonary embolism or microthrombosis of pulmonary vessels. We describe 3 cases of primary antiphospholipid syndrome (APS) and cor pulmonale that fulfilled the criteria for chronic major vessel thromboembolic pulmonary hypertension. Pulmonary thromboendarterectomy was performed in all 3 patients and it was successful in 2. One patient died in the immediate postoperative period from hemorrhagic pulmonary edema. Chronic thromboembolic pulmonary hypertension should be added to the list of pulmonary vascular complications of primary APS. Despite its risk, pulmonary thromboendarterectomy represents a treatment option for this otherwise lethal condition.

Adult↗
PubMed1995

Ocular vaso-occlusive disease in primary antiphospholipid syndrome.

PURPOSE: To evaluate the ocular involvement in patients with the primary antiphospholipid syndrome. METHODS: The authors performed a cross-sectional ophthalmologic study of 17 patients with the primary antiphospholipid syndrome. Retinal fluorangiography was performed in 13 patients. RESULTS: Visual symptoms were described by ten patients. Visual acuity was markedly decreased in five eyes. Conjunctival telangiectases and microaneurysms, in addition to single instances of bilateral episcleritis and limbal keratitis, were the anterior segment findings. Fundus abnormalities were present in 15 patients. Venous tortuosity was the most common finding but there were instances of optic disc edema, vitreous hemorrhages, cotton-wool spots, vitreous bands, serous detachment of the macula, and retinal capillary abnormalities. Fluorangiography showed vaso-occlusive retinopathy in six eyes (5 patients, 29%). Choriocapillary vessel occlusion was observed in two eyes (1 patient) and binocular reticular degeneration of pigmentary epithelium was present in another case. CONCLUSION: The eye is frequently involved in the primary antiphospholipid syndrome, and serious ocular damage may occur. Detailed ophthalmologic evaluation is warranted in these patients.

Adult↗
PubMed1993

Acute rheumatic fever.

The diagnosis of acute rheumatic fever has become difficult. A growing number of diseases that were not recognized in the past could fulfill its diagnostic criteria. We emphasize its changing incidence, current knowledge of its pathogenesis, and lesser known clinical features such as pneumonitis, encephalitis and glomerulonephritis.

Humans↗
PubMed1992

Renal involvement in primary antiphospholipid syndrome.

Our objective was to define the renal involvement in primary antiphospholipid syndrome (APS). We studied 20 patients with primary APS. Fourteen were women, mean age 34.4 years. None met ARA criteria for systemic lupus erythematosus. All patients underwent complete renal function studies. The presence of hypertension was also investigated. Renal disease was found in 5 patients, and was characterized by proteinuria, hypertension and renal failure. Kidney biopsy was performed in these 5 patients, showing thromboses of the microvasculature, mesangiolysis, mesangial interposition, electron lucent subendothelial material and ischemic obsolescence of glomeruli. Arterioles showed luminal narrowing due to medial hypertrophy, mucoid thickening of the intima, thrombosis and fibrosis. We found renal disease in 25% of our patients with primary APS. Biopsy findings were consistent with a thrombotic microangiopathy involving both arterioles and glomerular capillaries.

Adolescent↗
PubMed1991

High prevalence of significant heart valve lesions in patients with the 'primary' antiphospholipid syndrome.

A prospective echocardiographic study was carried out on 55 patients with the recently described 'primary' antiphospholipid syndrome derived from three university medical centres. The prevalence of valvular lesions in patients with this syndrome was 38% compared with 4% in a control group of 55 healthy volunteers (P < 0.001). Mean age of patients with valve abnormalities was 42 +/- 12 years and of those without, 30 +/- 10 years (P < 0.05). One patient had a morphologic echocardiographic pattern suggestive of non-infective verrucous mitral endocarditis. Twenty patients had a two-dimensional or Doppler echocardiographic pattern of significant valvular dysfunction--either regurgitation or stenosis--without evidence of vegetations. Mitral and aortic regurgitation were the most common lesions in these patients. During follow-up of patients with valvular disease, haemodynamically significant clinical valve disease developed in four and surgery was required in one. Eleven patients had cerebrovascular occlusions. Thus, valvular heart disease, particularly affecting the mitral and aortic valves, is common in patients with the 'primary' antiphospholipid syndrome, especially in those over 40 years old.

Adult↗
PubMed1989

Connective tissue disease features after thallium poisoning.

We present 5 patients in whom thallium poisoning (1) mimicked systemic lupus erythematosus (SLE) with positive antinuclear antibodies; (2) caused a SLE-like illness with positive antinuclear antibodies and rheumatoid factor that was followed by a persistent chronic polyarthritis; (3) mimicked SLE with negative antinuclear antibodies and no residual disease; (4) caused arthralgia, Raynaud's phenomenon and palmar erythema with negative antinuclear antibodies followed by keratoconjunctivitis sicca; and (5) triggered the onset of SLE with diffuse proliferative glomerulonephritis. Although the notion exists that thallium poisoning may simulate seronegative SLE, these associations between connective tissue diseases and thallium poisoning have not been previously recorded.

Adult↗
PubMed1984

Coexistent gout and hypertrophic osteoarthropathy in patients with cyanotic heart disease.

We describe 2 adult patients with cyanotic congenital heart disease whom, as a complication of their cardiopathy, had 2 different rheumatic syndromes: gout and hypertrophic osteoarthropathy. The coexistence of these arthropathies in the same patient, to our knowledge, has not been previously reported. We discuss the possible pathogenic mechanisms that may link these syndromes to cyanotic heart disease.

Adult↗
PubMed1980

[Behçet's disease: report of ten cases and of a new clinical manifestation (portal vein thrombosis) (author's transl)].

Ten patients (seven males and three females) with the diagnostic criteria for Behçet's disease are reported. Symptoms began between ages 14 and 37 (mean age 27.9 years), and the time of evolution of the disease varied between one and 23 years (mean 5.7 years). Initial presentation was aphthous stomatitis (three cases), ocular inflammation (three cases), erythema nodosum (one case), arthritis (one case), thrombophlebitis (one case), and hemorrhagic proctocolitis (one case). During the course of the disease the commonest clinical manifestations were oral and genital ulcerations (100%) and ocular (70%), cutaneous (70%), articular (40%), neurological (40%), venous (40%), gastrointestinal (40%) and arterial (10%) involvement. Increased erythrocyte sedimentation rate was a constant feature in all patients. HLA-B5 antigen was determined in four patients, being positive in two of them. Cerebrospinal fluid alterations were present in the four patients with neurological involvement even though three of them never had meningeal symptoms. One patient developed portal hypertension secondary to portal vein thrombosis, and its clinical manifestations are described.

Adolescent↗
PubMed1980

[Cytomorphology of the cerebrospinal fluid. I. Tumors of the central nervous system (author's transl)].

A cytomorphological study of the cerebrospinal fluid corresponding to 42 patients with tumors of the central nervous system has been performed. The group of 31 patients with primary tumors accounted for an overall cytological positivity of 32.2 percent; according to the type of tumor cytological positivities were as follows: glioblastoma multiforme (44.4 percent); grade I/III astrocytoma (33.3 percent); oligodendroglioma (33.3 percent); ependymoma (25 percent), and meningioma (16.6 percent). In the group of 11 patients with metastatic tumors, neoplastic cells were observed in two cases (cytological positivity 18.1 percent). Cytological study of the cerebrospinal fluid is a useful diagnostic method for some primary and secondary neoplasms of the central nervous system.

Brain Neoplasms↗
PubMedDate not supplied

[Disseminated encephalic cryptococcosis as a form of presentation of idiopathic T-CD4 lymphocytopenia].

INTRODUCTION: The term idiopathic T-CD4 lymphocytopenia is used to describe a new syndrome, defined as reduced T-CD4 lymphocytes in persons with no evidence of HIV infection or other causes which would explain the immunosuppression (secondary to neoplasties, immunosuppressive treatment, hereditary immunodeficiencies, infections, etc.). The reduced number of T-CD4 lymphocytes leads to deterioration in cellular immunity and therefore this leads to a predisposition to develop tumors and opportunist infections in patients with such defects. CLINICAL CASE: We describe a case of depletion of T-CD4 lymphocytes, associated with disseminated encephalic cryptococcosis (multiple cortical, capsulo-ganglionar, thalamic and cerebellar cryptococcomas) in a patient with no evidence of HIV infection. The case we present fulfilled diagnostic criteria for idiopathic T-CD4 lymphocytopenia, a clinical condition seldom described in this country. We discuss the pathogenic mechanisms of cryptococcosis, the different varieties of Cryptococcus neoformans and their different roles as the cause of opportunist infections in humans. CONCLUSIONS: In view of the neurotrophism of this fungus, the neurological signs and symptoms should make one suspect the presence of Cryptococcus neoformans infection in non-HIV carriers with cellular immunity defects such as those present in idiopathic T-CD4 lymphocytopenia.

Adult↗
PubMedDate not supplied

[Primary anti-phospholipid syndrome. Clinical experience at the Ignacio Chávez National Institute of Cardiology].

This paper describes 15 patients who had elevated IgG antibodies reactive with cardiolipin. Outstanding clinical features were: recurrent venous and/or arterial thrombosis--often extensive and severe--in 9 cases. Thrombocytopenia, in 11 cases and spontaneous recurrent fetal loss in 8 out of 10 females with marital life. In addition there were vasospastic/thrombotic features such as livedo reticularis, Raynaud's phenomenon and leg ulcers. Involvement of central and/or peripheral nervous system was present in 10 cases. Valvular heart disease was conspicuous, 10 out of 15 patients (66%) had organic lesions in both sides of the heart. There were also laboratory abnormalities such as prolonged partial thromboplastin time, false positive V.D.R.L., plasmatic anticoagulant activity and low incidence of antinuclear antibodies and rheumatoid factors. The clinical syndrome seems to be related to the presence of antibodies reactive with anionic phospholipids, although there is not formal proof of a direct cause effects relationship. Recognition of these distinct clinical entity is important, the use of simple anti aggregating agents like aspirine and careful anticoagulant therapy may modify the course of this newly recognized autoimmune condition.

Adult↗