Caso clínico para discussão no New England de 31/03/2016

Caros,

Segue caso clínico para discussão no New England de 31/03/2016 :

• Homem de 80 anos com massa ileocecal, perda de peso, diarreia e dor abdominal

O caso clínico completo será disponibilizado após a discussão.

• Case 7-2016: An 80-Year-Old Man with Weight Loss, Abdominal Pain, Diarrhea, and an Ileocecal Mass. N Engl J Med 2016;374:970-9. (Diagnóstico diferencial de Tuberculose intestinal e Doença inflamatória intestinal).

Abraços,

Zika e Guillain-Barré: Como anda a associação? Lancet 2016

Zika virus and Guillain-Barré syndrome

Zika virus has been associated with Guillain-Barre syndrome (GBS), although a direct causal relationship has not been definitively established. A case-control study in French Polynesia evaluated the association between GBS and Zika virus infection during the 2013 to 2014 outbreak [1]. Cases included 42 patients diagnosed with GBS; one control group included 98 patients with nonfebrile illnesses and a second control group included 70 patients with Zika virus infection in the absence of neurological complications. Zika IgM was positive in 93 percent of GBS cases (versus 17 percent of patients in the first control group); serologic evidence of past dengue infection was similar among all three groups. Antiglycolipid IgG antibodies were detected in fewer than 50 percent of GBS cases, raising the possibility of direct viral neurotoxicity. Results of nerve conduction studies were consistent with the acute motor axonal neuropathy type of GBS; clinical improvement during follow-up suggested reversible conduction failure. Symptoms of Zika virus infection occurred in 88 percent of patients with GBS; the median interval between viral syndrome and onset of neurological symptoms was six days. All GBS cases received intravenous immune globulin, 38 percent required intensive care, and 29 percent needed respiratory care; all survived. The incidence of GBS during the outbreak was estimated to be 0.24 cases per 1000 Zika virus infections.

1. Cao-Lormeau VM, Blake A, Mons S, et al. Guillain-Barré Syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study. Lancet. 2016 Feb;

Caso clínico para discussão no New England de 17/03/2016

Caros,

Segue caso clínico para discussão no New England de 17/03/2016:

• Homem de 20 anos com odinofagia, febre, mialgia e derrame pericárdico

O caso clínico completo será disponibilizado após a discussão.

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Abraços,

Caso clínico para discussão no New England de 10/03/2015

Caros,

Segue caso clínico para discussão no New England de 10/03/2015:

• Homem de 43 anos com alteração do estado mental e uso abusivo de álcool

O caso clínico completo será disponibilizado após a discussão.

• Case 5-2016: A 43-Year-Old Man with Altered Mental Status and a History of Alcohol Use. N Engl J Med 2016;374:671-80.

Abraços,