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Mittermayer B Santiago

Publications and source records attributed to Mittermayer B Santiago.

6 recordsLinked to original sources

Rare association of antiphospholipid syndrome and Takayasu arteritis.

The antiphospholipid syndrome (APS) is characterized by obstetric and thrombotic complications in the presence of antiphospholipid antibodies. It can happen in an isolated way or in association with diffuse connective tissue diseases, mainly systemic lupus erythematosus. The association of APS with Takayasu arteritis (TA) is rarely described in the literature. We described a case of primary APS in a female patient who developed obstruction in large-size arteries, in spite of the use of oral anticoagulant, and increase of erythrocyte sedimentation rate, suggesting TA. The favorable response to prednisone treatment and later to infliximab reinforced the diagnosis of TA. The present report illustrates the existence of APS associated to TA, whose recognition is very important once the therapeutic strategy is radically different.

Adult↗

Lipodermatosclerosis in patients with diffuse connective tissue diseases.

Lipodermatosclerosis (LDS) is a clinical condition characterized by the appearance of hardened, painful, and hyperchromic plaques on the legs. We describe three patients with diffuse connective tissue diseases (DCTD) who developed this clinical condition. The first one was a systemic lupus erythematosus patient with secondary antiphospholipid syndrome; the second patient had a superposition of DCTD (rheumatoid arthritis, Sjögren's syndrome, morphea); and the last one had been diagnosed with CREST 10 years earlier but had more recently developed primary biliary cirrhosis. Although its etiopathogenesis is unknown, LDS has been frequently seen in association with venous insufficiency. Its recognition by professionals who deal with DCTD is very relevant since it is characterized by thickening of the skin, similar to scleroderma. Its identification can avoid the inadvertent use of medications such as penicillamine and immunosuppressants, which have potentially serious side effects.

Journal Article↗

Inflammatory pseudotumor: A diagnostic dilemma.

Inflammatory pseudotumor (IP) is a disorder that constitutes a differential diagnosis of a series of clinical conditions due to a large spectrum of manifestations in presentation since it can involve any organ of the human body. Its basic characteristic is the appearance of inflammatory masses whose symptoms depend on their location. We describe two cases of IP that clearly illustrate this diversity of presentation and we review the diagnostic and therapeutic strategies for such a condition.

Journal Article↗

[Primary hyperparathyroidism in a patient with systemic lupus erythematosus].

Primary hyperparathyroidism (PHP) is a metabolic illness that results from autonomous secretion of parathyroid hormone and is one of the most common causes of hypercalcemia. We present the case of a 47-year-old female with a previous diagnosis of systemic lupus erythematosus (SLE) in whom clinical (diffuse bone pain, emotional lability, jaw tumor) and laboratory features (calcium= 13.5 mg/dL, phosphate= 1.8 mg/dL, alkaline phosphatase= 3028 U/L, PTH intact= 1472 pg/dL) prompted the diagnosis of PHP secondary to parathyroid adenoma as demonstrated by the anatomopathology. After treatment with calcitonin spray 400 UI per day, IV pamidronate 90 mg/week, and subtotal parathyroidectomy, the patient status improved with normal laboratory tests. This is the second report to describe the coexistence of these two disorders in a single patient. Although the pathophysiology of the association of PHP and SLE is not known, the recognition of this association has a practical implication since the therapeutical strategy is completely different.

Female↗

Ureteral stenosis secondary to granulomatous vasculitis.

Vasculitic syndromes are a group of disorders characterized by inflammation of the blood vessels. They include polyarteritis nodosa (PAN), Churg-Strauss syndrome (CS), and Wegener granulomatosis (WG) that differ on type, size, and location of the involved vessels. We report a rare case of granulomatous vasculitis leading to ureteral stenosis in the absence of other systemic manifestations of the disease. The patient was a 56-year-old woman who began to complain of left lumbar pain, nocturia, and dysuria. Computed tomography scan demonstrated a large abdominal mass with ureteral compression. A tissue specimen obtained by laparotomy revealed the presence of a chronic inflammatory process with fibrosis, granulomatous reaction, extravascular eosinophilia, and prominent vasculitis. She was put on corticosteroids and azathioprine with a decrease of the tumoral mass. This incompletely classified vasculitis was an unexpected cause of the abdominal mass.

Churg-Strauss Syndrome↗