Hypereosinophilic syndrome (HES) is a rare disorder with unknown global prevalence, barely reported in Hispanic population, and characterized by persistent eosinophilia in association with organ dysfunctions directly attributable to eosinophilic infiltration. Cardiac involvement may be present in 50 to 60% of the patients. This is known as Löffler endocarditis. We present a case of a 36-year-old Hispanic man with signs of heart failure. Laboratory studies showed eosinophilia (23,100/μL). Thoracic computer tomography showed bilateral pleural effusion and a large left ventricular mass. Transthoracic echocardiography showed left ventricle apical obliteration and a restrictive pattern. Pulmonary angiography demonstrated a thrombus in the lingular and middle lobe. Despite treatment, the patient deceased seven days after admission. Autopsy confirmed the diagnosis of Löffler endocarditis.
Cardiac angiosarcoma is a rare and clinically challenging pathology. It is a high-grade primary malignant tumor of the heart tissue that has many variants, of which the epithelioid variant is rarely present in the heart or the great vessels. As with many other cardiac tumors, it is mainly a diagnosis of exclusion and the initial diagnostic test is an echocardiogram followed by a biopsy with immunohistochemistry analysis to ascertain the type of tumor. The differential diagnosis of cardiac tumors is challenging due to the overlapping clinical manifestations with different cardiac tumors and systemic diseases. Cardiac angiosarcomas are often aggressive with a poor prognosis even with treatment. Herein, we present a case of the epithelioid variant of a cardiac angiosarcoma in addition to a thorough review of the recent literature on the clinical manifestation, diagnosis, and treatment of this type of tumors.
Quadricuspid aortic valve (QAV) is an anatomic valvular variant, with a prevalence of 0.008% to 0.033% in the general population, and 1.46% in patients that undergo aortic valve replacement. The QAV can be an isolated valvular abnormality or associated with other congenital heart defects. In this article, we present three of the few reported cases of QAV in the Hispanic population, all of which were asymptomatic and without evidence of hemodynamic alterations or other associated heart defects. Additionally a literature review is provided.
Reaction to a black henna tattoo treated with mometasone furoate and silicone gel: case report Black henna tattoos have paraphenylenediamine (PPD), which contains a product of herbal origin, which due to its molecular characteristics is capable of inducing, in susceptible individuals, a type IV hypersensitivity reaction. It clinically manifests as a contact dermatitis that usually when it disappears, scarring and hypopigmentation are left in the injured area. objective: To describe the case of a patient with hypersensitivity to henna tattoo and to present the most relevant phenomena associated with this condition. Case report: The case of a 6 year-old patient with a black henna tattoo on his right leg, who was diagnosed with contact dermatitis probably attributed to PPD, is presented. Mometasone furoate and topical silicone gel treatment was started with good response. Conclusion: Mometasone furoate and silicone gel are a good possible therapeutic option for treating contact dermatitis caused by PPD as the dermatosis was resolved without residual lesions. (Key words: Henna, paraphenylenediamine, type IV hypersensitivity reaction, mometasone furoate, silicone gel). Rev Chil Pediatr 2014; 85 (6): 720-723 resumen Los tatuajes de henna negra son aquellos que contienen parafenilendiamina (PPD), que contienen un producto de origen herbal, que por sus características moleculares es capaz de inducir, en individuos susceptibles, una reacción de hipersensibilidad tipo IV. Se manifiesta clínicamente como una dermatitis de contacto, que generalmente al desaparecer, persiste de manera residual una cicatriz hipertrófica e hipopigmentación en la zona lesionada. objetivo: Describir el caso de un paciente con hipersensibilidad al tatuaje de henna, y presentar los fenómenos más relevantes asociados a esta patología. Caso clínico: Paciente de 6 años de edad, que se realizó un tatuaje con henna negra en la pierna derecha, en quien se diagnosticó posteriormente una dermatitis de contacto atribuida probablemente a la PPD. Se comenzó tratamiento con furoato de mometasona y gel de silicona con buena respuesta por vía tópica. Conclusión: El furoato de mometasona y gel de silicona son una CASO CLíNICO Rev Chil Pediatr 2014; 85 (6): 720-723
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