Trombose de veia central da retina bilateral associada à síndrome de hiperviscosidade sanguínea: relato de caso

Helal, John; Malerbi, Fernando Korn; Filho, Roberto Melaragno

doi:10.1590/s0004-27492005000100023

Cited by 5 publications

(2 citation statements)

References 9 publications

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“…Symptoms related to hyperviscosity syndrome occur more frequently when the viscosity is above 6 cps, as was the case in our patient; however, the level of viscosity at which the symptoms become apparent varies among patients (6). Symptoms usually occur when an excess of immunoglobulin interacts with other blood elements leading to impairment in blood flow and increased viscosity (7,8). Other laboratory findings such as hypercalcemia, pseudohyponatremia, and pseudohypoglycemia may suggest hyperviscosity indirectly (2,7).…”

Section: Dr Alzaga Fernandezmentioning

confidence: 99%

Bilateral Simultaneous Central Retinal Vein Occlusions in an Otherwise Healthy Adult

Fernández

Shirka

Skarf

et al. 2011

Journal of Neuro-Ophthalmology

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A 53-year-old man presented with a 5-day history of progressive painless loss of vision in his right eye and a 1-day history of a similar deterioration in the left eye. He denied headaches, diplopia, transient visual obscurations, or other neurological symptoms. He stated that he was in good health and denied any systemic diseases. He was a vegetarian who exercised regularly.Ophthalmological examination revealed that the patient's best-corrected visual acuity was 20/200 in the right eye and 20/40 in the left eye. His pupils were equal and reactive to light; there was a questionable right relative afferent pupillary defect. Confrontation visual field testing showed that he could count fingers in all quadrants of both eyes. Kinetic perimetry of the right eye performed using the I-4e and I-2e test targets showed a moderately dense central scotoma, an enlarged blind spot, and slightly constricted peripheral isopters. The central scotoma in the right eye was confirmed using an Amsler grid. In the left eye, kinetic perimetry showed minimal constriction of the isopters superotemporally. With an Amsler grid, the patient noted distortion and waviness of lines superotemporally. The patient was able to identify 12 of 15 Ishihara plates with the right eye by fixating eccentrically with his nasal field. He identified all 15 color plates with his left eye. Extraocular movements were full, and the slit-lamp examination revealed no abnormalities. Intraocular pressures were within normal limits. Both optic discs were swollen and surrounded by multiple flame-shaped hemorrhages that radiated from the optic discs and obliterated the disc margins (Fig. 1). Small exudates and scattered dot and blot hemorrhages surrounded both optic discs; there was no substantial hemorrhage noted along the retinal vascular arcades outside the immediate peripapillary area. In both eyes, the retinal veins appeared distended and engorged, with boxcarring of the blood column. There were serous macular detachments in both eyes. There were no abnormalities in the retinal periphery of either eye.Patient evaluation showed mild pancytopenia (white blood cell count, 3.1 K/mL; hemoglobin B, 9.7 g/dL; platelets, 135 K/mL), high serum protein, low serum albumin, and high lactate dehydrogenase. Serum vitamin B12, folate, and iron levels were normal. CT and MRI of the brain, MRA, and venography were performed. Dr. Luetmer:CT of the head without contrast shows no abnormalities; however, magnetic resonance studies reveal a poorly defined heterogeneous infiltrate involving the clivus consistent with a marrow replacement process (Fig. 2). Dr. Skarf:Given the magnetic resonance findings, a whole-body bone scan and a metastatic bone survey were performed. Dr. Luetmer:The bone scan shows multiple areas of uptake involving the ribs on both sides, the right scapula, and the left femur (Fig. 3). The metastatic bone survey reveals vague lucencies throughout the skull. Dr. Skarf:Serum electrophoresis with immunofixation revealed a large IgA lambda monoclonal protein in the beta...

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Section: Dr Alzaga Fernandezmentioning

confidence: 99%

Bilateral Simultaneous Central Retinal Vein Occlusions in an Otherwise Healthy Adult

Fernández

Shirka

Skarf

et al. 2011

Journal of Neuro-Ophthalmology

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“…Identificar quais as especialidades médicas e os diagnósticos onde são mais utilizados os procedimentos de plasmaférese terapêutica. (HELAL et al, 2005).…”

Section: Específicosunclassified

Perfil dos procedimentos de plasmaférese terapêutica realizados pelo hemocentro da UNICAMP

Machado¹

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Therapeutic plasmapheresis is a therapy used for several diseases in various medical specialties, which consists of the patient's plasma withdrawal and replacement with fresh frozen plasma or human albumin in continuous or discontinuous flow apheresis devices. Our objective was to establish the profile of therapeutic plasmapheresis procedures performed by the Bloodcenter of UNICAMP in Hospital de Clínicas of UNICAMP, by comparing to International Protocols and to analyze the congruence of the indications of the procedures through a retrospective survey of the data of the therapeutic plasmapheresis procedures performed. The procedures profile was established according to the last Society for Apheresis (ASFA) protocol published at 2016 for the indications criteria and technical parameters. In the observed period (between 2016 and 2017), 295 therapeutic plasmapheresis procedures were performed in 48 patients in the specialties of cardiology, hematology, nephrology and neurology. The diagnoses were desensitization pre cardiac transplantation, antibodymediated rejection post cardiac transplantation, thrombotic thrombocytopenic purpura (PTT), multiple myeloma (MM), Waldenström macroglobulinemia (MW), uremic hemolytic syndrome (SHU), focal segmental glomerulosclerosis (GESF), desensitization pre renal transplantation, myasthenia gravis (MG), optic neuromyelitis (NMO), Guillain-Barré syndrome (SGB) and stiff man syndrome (SHR). Regarding the indication criteria, the great majority of the procedures are in agreement with the recommendations of ASFA's protocol and as for the technical parameters, we have that the quantity and frequency of sessions and liquid of replacement used are congruent with the protocol, however, the volume used did not always follow the recommendations due to the difficulty in obtaining some information from the patient at the time of the procedures. The medical specialty of hematology had the largest number of procedures and the neurology had the greatest number of patients. The most frequent diagnosis was PTT in number of procedures and, GESF in number of patients.

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Tumor orbitário como primeira manifestação clínica de mieloma múltiplo: relato de caso

Pinho¹,

Pinho²,

Alessandri³

et al. 2009

Arq. Bras. Oftalmol.

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Trombose de veia central da retina bilateral associada à síndrome de hiperviscosidade sanguínea: relato de caso

Cited by 5 publications

References 9 publications

Bilateral Simultaneous Central Retinal Vein Occlusions in an Otherwise Healthy Adult

Bilateral Simultaneous Central Retinal Vein Occlusions in an Otherwise Healthy Adult

Perfil dos procedimentos de plasmaférese terapêutica realizados pelo hemocentro da UNICAMP

Tumor orbitário como primeira manifestação clínica de mieloma múltiplo: relato de caso

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