ASCITE CRÔNICA COMO MANIFESTAÇÃO INICIAL DO LÚPUS ERITEMATOSO SISTÊMICO (LES)

O caso clínico de uma mulher de 23 anos, com lúpus eritematoso sistêmico, que desenvolveu peritonite crônica e ascite como sua primeira manifestação clínica é descrito. Os principais achados que levaram ao diagnóstico foram plenitude e dor abdominal, hérnia umbilical e ascite. Houve boa resposta ao tratamento com prednisona e hidroxicloroquina.  A 23 year old woman with systemic lupus erythematosus who developed chronic lupus peritonitis and ascites as her first clinical manifestation is described. The key findings for the diagnosis were abdominal fullness and pain, umbilical hernia, and ascites. The ascites responded well to treatment with prednisone and hydroxychloroquine.

Case Report Relapsing Polychondritis in a Patient with Ankylosing Spondylitis Using Etanercept

Relapsing polychondritis (RP) is an autoimmune disease characterized by recurrent episodes of inflammation and progressive destruction of cartilaginous tissues, especially of the ears, nose, joints, and tracheobronchial tree. Its etiology is not well understood, but some studies have linked its pathophysiology with autoimmune disease and autoantibody production. We described a case of a 46-year-old male patient with ankylosing spondylitis who developed RP after the use of etanercept. Few similar cases have been described in the literature. However, they show a possible association between the use of biological inhibitors of tumor necrosis factor (anti-TNF ), which potentially produces autoantibodies, and the development of RP. The treatment was based on data in the literature and included the cessation of biological therapy and the addition of corticosteroids with substantial improvement

Treatment of hemifacial spasm with botulinum toxin type a: effective, long lasting and well tolerated

ABSTRACT Hemifacial spasm (HFS) is a common movement disorder characterized by involuntary tonic or clonic contractions of the muscles innervated by the facial nerve. Objective To evaluate the long-term effect of botulinum toxin type A (BTX-A) in the treatment of HFS. Methods A retrospective analysis of patients treated at the Movement Disorders Outpatient Clinic in the Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, from 2009 to 2013 was carried out. A total of 550 BTX-A injections were administered to 100 HFS patients. Results Mean duration of improvement following each injection session was 3.1 months, mean latency to detection of improvement was 7.1 days and mean success rate was 94.7%. Patients were evaluated at an interval of 5.8 months after each application. Adverse effects, which were mostly minor, were observed in 37% of the patients at least once during follow-up. The most frequent was ptosis (35.1%). Conclusion Treatment of HFS with BTX-A was effective, sustainable and safe and had minimal, well-tolerated side effects