Bilateral posterior circulation stroke secondary to a crotalid envenomation: case report

Snake bite envenoming is a disease with potential serious neurological complications. We report a case of an adolescent who was bitten by a rattlesnake and developed bilateral posterior circulation stroke. The rattlesnake was later identified as being Crotalus durissus terrificus. Stroke was probably due to toxic vasculitis or toxin-induced vascular spasm and endothelial damage

Severe Jaccoud's arthropathy in systemic lupus erythematosus

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2016-08-02T16:58:27Z No. of bitstreams: 1 Santiago MB Severe Jaccoud's....pdf: 491490 bytes, checksum: b49d1ffc892e9f5f1ff7a307a8d590f4 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2016-08-02T17:11:47Z (GMT) No. of bitstreams: 1 Santiago MB Severe Jaccoud's....pdf: 491490 bytes, checksum: b49d1ffc892e9f5f1ff7a307a8d590f4 (MD5)Made available in DSpace on 2016-08-02T17:11:47Z (GMT). No. of bitstreams: 1 Santiago MB Severe Jaccoud's....pdf: 491490 bytes, checksum: b49d1ffc892e9f5f1ff7a307a8d590f4 (MD5) Previous issue date: 2015-10Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil / Serviços Especializados em Reumatologia da Bahia. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilUniversidade Federal da Bahia. Faculdade de Farmácia. Salvador, BA, Brasil. Departamento de Análises Clínicas e Toxicológicas. Salvador, BA, BrasilUniversidade Federal da Bahia. Faculdade de Farmácia. Salvador, BA, Brasil. Departamento de Análises Clínicas e Toxicológicas. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório de Biologia Molecular. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório de Biologia Molecular. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilJaccoud's arthropathy (JA) is a clinical situation nowadays present mostly in systemic lupus erythematosus (SLE). It is characterized by the presence of joint deformities such as "swan neck," ulnar deviation and "Z-thumb" resembling rheumatoid arthritis (RA) but that are passively correctable and without bone erosion on plain radiographs. From our cohort of SLE patients with JA, we selected a subgroup with a more severe form of this arthropathy and looked at their clinical and laboratory profile as well as studied the magnetic resonance imaging (MRI) findings or ultrasound (US) obtained from the hand with most evident deformities. Seven SLE patients with a severe form of JA were identified. All seven patients have "swan neck," ulnar deviation and "Z-thumb" deformities. Two out of seven had "mutilans-type JA" and four had fixed deformities in the metacarpophalangeal (MCP) joints. The MRI of the hand with more evident deformity clinically performed in six cases and US performed in one case showed mild synovitis in five and moderate synovitis in two patients, mild flexor tenosynovitis in six and severe tenosynovitis in one. Only two small bone erosions were observed in the second and third MCP joints of one patient with moderate synovitis. Severe JA compromises the functional capacity of the joints and imposes the risk of misdiagnosis of RA. With the improvement of the survival rate of SLE and the lack of specific prophylactic or therapeutical measures for JA, it is reasonable to assume that more and more cases of severe JA are going to be identified