Minerva medica
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Case Reports
[Anergic miliary tuberculosis, with principally splenic localization simulating hemolymphopathy. Report of 4 cases].
Four cases of disseminated tuberculosis with prevailing spleen involvement and lack of tuberculin reactivity are described. The atypical clinical picture justified, at the beginning of the disease, the suspect of a lymphoreticular disorder (malignant lymphoma in 3 cases) or of a pulmonary hemosiderosis (in 1 case). ⋯ The Authors discuss the pathogenesis of the observed features and the differential diagnosis of the cases of tuberculosis with only extrapulmonary involvement. These cases represent today about 1/6 of the patients with postprimary tuberculosis.
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So far no really successful therapy has been found for diabetes mellitus, though it is a common disease and its complications, involving microangiopathy, are extremely serious. The serious limitation of all forms of insulin therapy (various types of insulin and insulin pump) is the impossibility of achieving a fast, successful response to either the variations in blood sugar levels after eating or increased glucogenogenesis caused by glycosteroids and adrenalin. The prolonged hyperglycaemic peaks which result, may well be one of the possible causes of microangiopathy. ⋯ It is also important to bear in mind that long term immunosuppression may prove more dangerous than microangiopathy itself. For these reasons a new cell transplant system using molecular sieve membranes to create an immunological barrier is being investigated. Although it is too early to forecast long-term results, continuous progress is being made and recent discoveries about the physiology of beta pancreatic cells encourage the belief that this approach may be successful in the future.
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Case Reports
[Wegener's granulomatosis. Clinical and radiologic considerations and description of 3 cases].
The clinical, radiological and pathological findings, natural history and response to treatment are investigated in 3 patients. They represent the only examples of W. ⋯ The role of immune complexes in the pathogenesis of W. G. and diagnostic importance of pulmonary radiological pattern are described.