摘要:

We report the case of a middle-aged patient with repeated attacks of regional migratory osteoporosis of the lower limbs, manifesting as severe pain and swelling of both joint and periarticular areas, and marked physical disability during a period of 2 1/2 years. After the therapeutic failure of conservative therapy (physical therapy, rehabilitation therapy, analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs)) and after the correct diagnosis was reached, pamidronate treatment was instituted. The results were a rapid, complete, and long-lasting remission of the symptoms and the renewal of the patient's previous activities. Intravenous biphosphates are proposed as a safe and promising therapy for regional migratory osteoporosis. To our knowledge, this is the first report of pamidronate treatment for this condition.

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Juvenile dermatomyositis is an inflammatory disease of unknown etiology that primarily affects skin and muscles. The pathognomonic Gottron's sign consists of symmetric macules and papules on the dorsal aspect of the interphalangeal joints and exterior areas of the big joints. A periorbital violaceous (heliotrope) skin rash is also characteristic. There may be a discordance in time of presentation of the skin and muscle disease, and a small subset of patients apparently do not develop muscle disease at all. The absence of muscle involvement is termed 'amyopathic dermatomyositis.'We describe two children who presented with the characteristic rash of juvenile dermatomyositis but with no clinical evidence of muscle involvement. One developed muscle weakness 3 years later. Neither patient had a full muscle work-up at the onset of the disease, which left questions about diagnoses and whether or not there may have been subtle muscle involvement.On the basis of our literature review, the outcome of these patients is uncertain, although it appears that myositis develops in many, maybe most, affected children. We suggest that in the absence of muscle disease, application of sunscreen and administration of hydroxychloroquine sulfate may ameliorate the rash. More aggressive treatment will need to be given when muscle involvement can be demonstrated.

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Kawasaki syndrome in adults is very rare, with fewer than 50 cases reported in the English-language literature. We describe the case of a physician with Kawasaki syndrome and summarize the clinical features and treatment of 11 patients in the literature since the last review in 1994. Our patient presented with high fever, conjunctivitis, and arthralgias, then developed progressive toxicity with oral lesions, cervical adenopathy, and desquamation of the fingers and toes. No exanthematous rash or coronary artery aneurysms were found. Recovery was rapid after therapy with aspirin and intravenous immunoglobulin (IVIg).The diagnosis of Kawasaki syndrome depends on clinical criteria and the exclusion of other diseases. This diagnosis can be challenging to make in an adult, particularly when it presents without all typical features. Kawasaki syndrome must be considered nonetheless in an adult with unexplained fever of more than 5 days duration, because early diagnosis and combination therapy with aspirin and IVIg can prevent the life-threatening complication of coronary artery aneurysms.

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Periostitis pubis has been proposed as a new clinical entity, one characterized by abdominal pain and tenderness over the os pubis. Periostitis pubis, as defined by Rubenstein(1), is inflammation at the insertion point of the anterior abdominal musculature onto the periosteum of the os pubis.A case is described in which the patient underwent multiple invasive diagnostic procedures before seeking help at the author's medical facility with a clinical problem similar to periostitis pubis. Her pain was completely relieved by infiltration of the tender superior surface of the os pubis. It is suggested that a more appropriate term for this problem may be 'periostalgia pubis. As no evidence exists that inflammation is involved in the pathophysiology, the primary goal of this case description is to promote recognition of the disorder which is probably under reported. It is hoped that recognition will lead to further information regarding the natural history and prevalence of the disorder.

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID