Browsing by Author "Malcata, AB"
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- Amenorreia induzida por ciclofosfamida em doentes pré-menopausicas com Lúpus Eritematoso SistémicoPublication . Cunha, I; Saavedra, MJ; Pereira da Silva, JA; Malcata, ABOBJECTIVES: To determine the frequency of ovarian failure in pre-menopausal women after cyclophosphamide (cyc) treatment for systemic lupus erythematosus (SLE); identify risk factors for this complication; estimate the occurrence and viability of pregnancy during and after treatment. METHODS: Review of the data of women treated with intravenous cyc in the department of Rheumatology of Hospitais da Universidade de Coimbra, updated by interview. Information on demographic features; gynaecologic and obstetrical history; characteristics of the disease; duration and side effects of treatment were obtained. Ovarian failure was defined as a lack of menses for, at least, four months and the diagnosis was confirmed by hormonal measurements. RESULTS: Nineteen pre-menopausal women were treated with intravenous cyc in our department. The mean age at the time of cyc initiation was 28.4 years. Lupus nephritis was the most common indication for cyc treatment (89.5%). The mean number of pulses was 9.3 over a period of 16.8 months. The mean cumulative dosage was 6.973 mg. Three patients developed ovarian failure. Those women were older than the others (P=0.0016). One patient became pregnant while on treatment. Two women delivered healthy children after cyc withdrawal. CONCLUSION: Ovarian failure developed in 15.8% of our patients. As described in the literature, the age at cyc initiation appears to be a determinant risk factor. Pregnancy may occur during cyc therapy, and thus, an effective contraception is mandatory. After cyc withdrawal, pregnancy is possible with a favourable outcome.
- Amiloidose secundária e lúpus eritematoso sistémicoPublication . Monteiro, P; Abreu, P; Salvador, MJ; Malcata, ABThe authors report a clinical case of a 57 years old woman with systemic lupus erythematosus diagnosed 25 years before and secondary amyloidosis. Secondary amyloidosis can be associated with inflammatory or infectious chronic diseases, however the association with systemic lupus erythematosus is rare. We discuss the association between the two entities.
- Anaphylaxis to mefenamic acid in a patient with new onset of systemic lupus erythematosusPublication . Couto, M; Duarte, C; Geraldes, L; Inês, L; Malcata, AB
- Aracnoidite Ossificante em Espondilartropatia SeronegativaPublication . Cunha, I; Noir, D; Pereira da Silva, JA; Silva, J; Malcata, AB; Fernandes, RA 52-year-old man, with the diagnosis of Ankylosing Spondylitis, since the age of 22, was admitted due to progressive neurological symptoms that had started two years before: paresthesias, impaired sensation and muscle weakness of the lower limbs; burning abdominal and lumbar pain; together with bladder, bowel and sexual dysfunction. Imaging investigations revealed severe lesions from D1 to L5: epidural calcification; spinal cord compression and syringomyelia. Based on this case, the authors review the neurological complications of Ankylosing Spondylitis.
- Arthritis and X-linked agammaglobulinemiaPublication . Machado, P; Santos, A; Faria, E; Silva, J; Malcata, AB; Chieira, CPrimary immunodeficiencies are defined as genetically determined functional and/or quantitative abnormalities in one or more of the components of the immune system. Immunodeficiency and arthritis can be related, although the mechanisms are not always clear. Different causes for immunodeficiency can secondarily be found in patients with arthritis; on the other hand, arthritis can be a manifestation of primary immunodeficiency. Arthritis occurs chiefly in humoral primary immunodeficiencies, namely in X-linked agammaglobulinemia and common variable immunodeficiency, and may be one of the warning signs for primary immunodeficiency. We report a case of arthritis as the presenting feature of X-linked agammaglobulinemia. In X-linked agammaglobulinemia, arthritis may be a consequence of infection, most notably by Mycoplasma, or of immune dysfunction itself. In children, and occasionally in young adults, a combination of arthritis and hypogammaglobulinemia should suggest primary immunodeficiency, although other causes of hypogammaglobulinemia must be excluded. Physicians evaluating patients with arthritis should be aware of this fact so that an early diagnosis can be pursued as it is of extreme importance in the optimal management and prognosis of these patients.
- Arthropathy of genetic hemochromatosis: a major and distinctive manifestation of the diseasePublication . Inês, L; Pereira da Silva, JA; Malcata, ABGenetic hemochromatosis is not a rare disease and represents a frequently underestimated cause of arthropathy. Joint involvement is one of the most frequent manifestations of the disease and presents typical clinical and radiological features that strongly suggest the diagnosis. Joint complaints are often the first clinical manifestation of GH. Their identification may be crucial to establish the diagnosis in the pre-cirrhotic phase and to institute appropriate therapy to prevent organ damage and associated mortality. Recent identification of the genetic defect responsible for the disease is leading to new insights into the pathogenesis of GH and the associated arthropathy.
- A articulação esternoclavicular na artrite psoriáticaPublication . Ambrósio, C; Alexandre, M; Malcata, AB
- Artralgias, dores ósseas, anticorpos anti-nucleares positivos e trombocitopenia...diagnóstico: Doença de Nieman-PickPublication . Ambrósio, C; Serra, S; Alexandre, M; Malcata, ABThe differential diagnosis of rheumatic diseases is sometimes very complex given the lack of specificity of some clinical manifestations. A careful physical examination with the aid of laboratory and radiographic findings can lead us to some rare conditions, reminding that they should never be forgotten in the differential diagnosis. The authors present a case report of a woman referred to the rheumatology department with joint and bone pain. Physical examination and laboratory findings lead us to the diagnosis of type B Niemann-Pick disease. Some considerations about the diagnostic challenge of this rare clinical condition are made.
- Artrite Reumatóide Quística: Um Subtipo com evolução Clínica Mais Favorável?Publication . Alexandre, M; Reis, P; Malcata, AB; Porto, AApresenta-se um caso de artrite reumatóide quística (ARQ), um subtipo de artrite reumatóide (AR), com características radiológicas particulares e com evoluções clínica e funcional habitualmente mais favoráveis
- Artropatia dos joelhos como manifestação inicial de neoplasia pulmonarPublication . Inês, L; Santos, MJ; Silva, C; Braña, A; Nour, D; Reis, P; Malcata, AB; Porto, AApresentamos o caso de uma doente de 46 anos que recorreu ao serviço de urgência por dor e tumefacção dos joelhos com 3 meses de evolução. Na subsequente observação em Reumatologia identificou--se a presença de baqueteamento digital nas mãos e pés (com cerca de 1 ano de evolução) e edema dos membros inferiores. As radiografias dos ossos longos demonstraram a presença de periostose. A investigação de causas de osteoartropatia hipertrófica secundária revelou a existência de uma neoplasia pulmonar volumosa, que não apresentou no exame clínico quaisquer manifestações respiratórias.