Edema hemorrágico agudo da infância

O edema hemorrágico agudo da infância é uma vasculite leucocitoclástica rara que acomete crianças com menos de dois anos de idade. A doença tem curso benigno, geralmente sem complicações ou recidivas. Descreve-se um caso em criança de um ano e cinco meses de idade cujos achados clínicos e histopatológicos são típicos do edema agudo hemorrágico da infância

Hemophagocytic lymphohistiocytosis, a rare condition in renal transplant - a case report

Abstract Hemophagocytic lymphohistiocytosis (HLH) is an uncommon and life-threating condition characterized by major immune activation and massive cytokine production by mononuclear inflammatory cells, due to defects in cytotoxic lymphocyte function. It is even more unusual in renal transplant recipients, in which it is often associated with uncontrolled infection. The mortality is high in HLH and differential diagnosis with sepsis is a challenge. The approach and management depend on the underlying trigger and comorbidities. We report a case of a 50-year-old renal transplant female admitted with fever and malaise 3 months post-transplant and presenting anemia, fever, hypertriglyceridemia, high levels of serum ferritin, and positive CMV antigenemia. Urine was positive for decoy cells and BKV-DNA. Graft biopsy showed CMV nephritis. Both blood and urine cultures where positive for E. coli. Hemophagocytosis was confirmed by bone marrow aspiration. Immunosuppression was reduced, and the patient received high-dose intravenous immunoglobulin and dexamethasone, with complete response after 3 weeks. We highlight the importance of early diagnosis and proper management of a rare and serious condition in a renal transplant patient, which can allow a favorable clinical course and improve survival rate

Hamartoma angiomatoso écrino: um tumor doloroso Eccrine angiomatous hamartoma: a painful tumor

O hamartoma angiomatoso écrino (HAE) é lesão benigna, em geral, congênita. Apresenta-se na maioria dos casos como nódulo ou placa cor da pele ou eritematosa associada ou não à hiperidrose focal e dor. Localiza-se preferencialmente nos membros inferiores, próximo aos joelhos ou nos artelhos, mas lesões na face, região cervical, sacra e tronco foram descritas. O principal diagnóstico diferencial deve ser feito com o tumor glômico. Em geral, o HAE tem evolução benigna, havendo relatos de remissão espontânea da dor, sem necessidade de remoção. Contudo, foram descritos casos em que a dor levou à exérese da lesão e mesmo à amputação do membro afetado. Os autores relatam um caso de hamartoma angiomatoso écrino de aparecimento tardio, com sintomatologia exuberante e de difícil tratamento.<br>Eccrine angiomatous hamartoma (EAH) is a benign lesion usually present at birth. In most cases it presents as a flesh-colored or erythematous nodule or patch. It may or may not be associated with focal hyperhydrosis and pain. It is most commonly located in the lower extremities, near the knee or on the toes, but lesions on the face, sacral and cervical region and trunk have been described. The main differential diagnosis should be made with a glomus tumor. In general, EAH shows benign behavior, and spontaneous remission of pain has been described. Cases have been reported in which the pain led to excision and even to amputation of the affected member. The authors present a case of late onset EAH, with exuberant symptoms, which was difficult to treat