Serum Angiotensin-Converting Enzyme Levels in Sarcoid Arthritis

Sequeira, Winston

doi:10.1001/archinte.1986.00360130151021

Cited by 10 publications

(3 citation statements)

References 17 publications

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“…O potencial pandêmico faz com que a influenza seja destaque entre outras doenças infecciosas 6 . Muitos são os estudos que apontam a ocorrência de possíveis e comprovados eventos de influenza na história, como os de 1889, 1918, 1957, 1968, 1977 A título de comparação, constata-se que a mais grave pandemia de influenza, a Gripe Espanhola, marcou na história um número de óbitos estimado entre 20 a 50 milhões de pessoas no mundo todo 10,12,32 -mais que o dobro de mortes em quatro anos da Primeira Guerra Mundial, e um terço das decorrentes da peste em seis séculos 33 . A estimativa global de óbitos para a pandemia de 2009 foi menor: entre 151.700 e 575.400 mortes 34 .…”

Section: Pandemias De Influenzaunclassified

“…A origem da gripe espanhola permanece incerta; é possível que tenha sido na China ou em campos militares no interior dos Estados Unidos da América 3,6 . Na Europa, os primeiros registros foram feitos em abril de 1918 em tropas francesas, possivelmente relacionados a chineses contratados como auxiliares 33 . O transporte de tropas e de trabalhadores entre os EUA, Europa e outras partes do mundo durante a Primeira Guerra Mundial certamente contribuiu para sua propagação, além de ter mascarado sua verdadeira origem 42 .…”

Section: Pandemia De 1918-1920: a Gripe Espanholaunclassified

“…Sugeriram o uso de desinfetantes para as vias respiratórias superiores e, mesmo sem saber o valor terapêutico para a gripe e seus efeitos adversos, passaram a distribuir quinino 41 , profilático da malária, sem efeito terapêutico para gripe. Conforme o conhecimento da época, o controle de epidemias, especialmente as bacterianas, era feito com quarentenas, isolamento, extermínio de animais portadores ou vetores, restrição à liberdade de movimento; medidas que se mostraram incapazes de conter a pandemia de gripe 33 .…”

Section: Pandemia De 1918-1920: a Gripe Espanholaunclassified

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Pandemias de influenza e a estrutura sanitária brasileira: breve histórico e caracterização dos cenários

Costa

Merchán-Hamann

2016

Rev Pan-Amaz Saude

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A influenza é reconhecida, mundialmente, pela sua capacidade de gerar ondas epidêmicas e pandêmicas com anotações das principais características virológicas, clínicas e epidemiológicas, incluindo sua mortalidade e letalidade e o contexto da sua ocorrência em caráter pandêmico. A estrutura sanitária brasileira frente à história das pandemias é caracterizada de forma breve. Aspectos da vigilância em diferentes animais também são abordados, face à possibilidade de propagação do vírus Influenza para a população humana. A abordagem histórica contribui para alertar sobre a importância da influenza enquanto virose respiratória de caráter zoonótico, alta capacidade de transmissão e distribuição global e a necessidade crescente de resposta articulada de governos.

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Section: Pandemias De Influenzaunclassified

Section: Pandemia De 1918-1920: a Gripe Espanholaunclassified

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Pandemias de influenza e a estrutura sanitária brasileira: breve histórico e caracterização dos cenários

Costa

Merchán-Hamann

2016

Rev Pan-Amaz Saude

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Sarcoidosis accompanied by pulmonary tuberculosis and complicated by sacroiliitis

Griep

Spiegel

Soesbergen

1993

Arthritis & Rheumatism

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We report the unique occurrence of a unilateral sacroiliitis in a patient with active sarcoidosis accompanied by pulmonary tuberculosis. Convincing (clinical) evidence of sarcoidosis as the extremely rare cause of this articular involvement is presented. Discussion is focused on comparison of sarcoidosis and tuberculosis, particularly with respect to their articular involvement, and the literature of previously reported cases of sarcoid sacroiliitis is briefly reviewed.The granulomatous diseases of sarcoidosis and tuberculosis can both lead to arthritis (1-7). Since both disorders may occur simultaneously (8), an apparent articular involvement can cause confusion. In tuberculosis, the vertebral column, including the sacroiliac (SI) joints, is involved relatively frequently (1,2); such involvement is very rare in sarcoidosis (3-7).To our knowledge, this report describes the first patient with sarcoidosis accompanied by pulmonary tuberculosis with concomitant evidence of a complicating sarcoid sacroiliitis. CASE REPORTIn January 1990, a 34-year-old Moroccan man presented in our emergency unit with severe asthma provoked by a recent upper respiratory tract infection. His family history suggested a familial tendency for this asthma. His medical history was otherwise unremarkable. Physical examination revealed no further abnormalities.The chest radiograph revealed a bilateral hilar and right-sided paratracheal polycyclic lymphadenopathy with a diffuse reticulonodular pattern in both upper lung fields ( Figure 1A). Laboratory investigations showed an erythrocyte sedimentation rate (ESR) of 16 mm/hour (Westergren), and normal values on hematologic, serum creatinine, and liver function tests. The angiotensin-converting enzyme (ACE) level was 58.7 unitsfliter (normal 16-51). The tuberculin skin reaction was 0 x 0 mm. Sputum showed no acid-fast bacilli (AFB) on Ziehl-Neelsen (ZN) stain, and cultures for (myco)bacteria were negative. Pulmonary function data were normal (Table 1). A fiberoptic bronchoscopy revealed no visible abnormalities, but peripheral transbronchial biopsies from the right upper lobe revealed tissue with noncaseating epithelioid cell granulomas without AFB ; cultures for (myco)bacteria were also negative.A diagnosis of sarcoidosis was made, and the condition was managed accordingly. His asthma responded well to a short course of oral prednisolone, followed by a regimen of inhaled bronchodilators and corticosteroids.He presented in March 1991 because of a 3-month history of slowly progressive, exerciseinduced fatigue and dyspnea. Results of the physical examination were unremarkable. The ESR and ACE values were unchanged. Radiographically, the upper lung fields showed alveolar shadowing. Pulmonary function data had worsened ( Table 1). Fiberoptic

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Synovitis of the knee in a 42‐year‐old man. clinicopathologic conference

Gravallese

Weissman

Corson

et al. 1993

Arthritis & Rheumatism

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The patient is a 42-year-old man from the Midwest, who was referred to a rheumatologist because of pain in his right knee. He had a history of mild low back pain, and spondylolisthesis had been noted on radiographs. At the time of referral he was free of back pain. He was a recreational runner. Three years prior to referral, he had a left medial collateral ligament tear, which required surgical repair. One year prior to referral, he developed pain and swelling in his left first metatarsophalangeal (MTP) joint while running. He was given an intramuscular injection of an unknown medication, and his symptoms improved.Four months prior to referral, he noted stiffness and snapping in the right knee. Full extension of the knee was difficult. Two months prior to referral, he suffered a mild twisting injury to the right knee and noted increasing stiffness thereafter. One month prior to referral, he consulted an orthopedic surgeon, who performed radiographs of the right knee. The arthroscopy demonstrated nodular changes within the synovium and irregular articular cartilage. No meniscal or ligamentous tear was present. The synovium was biopsied and samples were sent to pathology and to microbiology for culture. A portion of the sample was placed in formalin fixative and a portion was placed in absolute alcohol for pathologic evaluation. Hematoxylin and eosin (H & Ebstained sections of synovium revealed granulomatous synovitis, with giant cells. Findings on polarizing microscopy of the alcoholfixed, H & E-stained sections were negative. Special stains for mycobacteria and fungi, as well as routine cultures and cultures for acid-fast bacilli (AFB) and fungi, gave negative results. DrThree weeks after the arthroscopy, the patient was seen in consultation by a rheumatologist. His interim history was notable for the development of mild pain and stiffness of the right forefoot, without antecedent injury. He had no pain in the left knee, low back, ankle, or heel. He denied having a malar or other rash, photosensitivity, iritis, conjunctivitis, nephrolithiasis, colitis, dysuria, fever, chills, weight loss, cough, or shortness of breath. He was taking acetaminophen plus codeine (Tylenol #3; McNeil, Fort Washington, PA), 1-2 tabletdday.

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Serum Angiotensin-Converting Enzyme Levels in Sarcoid Arthritis

Cited by 10 publications

References 17 publications

Pandemias de influenza e a estrutura sanitária brasileira: breve histórico e caracterização dos cenários

Pandemias de influenza e a estrutura sanitária brasileira: breve histórico e caracterização dos cenários

Sarcoidosis accompanied by pulmonary tuberculosis and complicated by sacroiliitis

Synovitis of the knee in a 42‐year‐old man. clinicopathologic conference

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