Introducction: Different characteristics from diseases can coexist in the mixed disease of the connective weave, unlike the syndrome of superposition or overlap, that is the presentation of several autoimmune diseases that fulfill their criteria diagnoses in a patient.Clinical case: We presented/displayed the case of a woman of 32 years tried by esclerodermia during four years, that in a new evaluation diagnosed lupus and polimiositis, well-known like superposition syndrome. We discuss to the particular characteristics of the sclerosis and their evolution to other immune diseases.

Introducction: Different characteristics from diseases can coexist in the mixed disease of the connective weave, unlike the syndrome of superposition or overlap, that is the presentation of several autoimmune diseases that fulfill their criteria diagnoses in a patient.Clinical case: We presented/displayed the case of a woman of 32 years tried by esclerodermia during four years, that in a new evaluation diagnosed lupus and polimiositis, well-known like superposition syndrome. We discuss to the particular characteristics of the sclerosis and their evolution to other immune diseases.

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 Brucellosis is a public health problem due to non-pasteurization of dairy products, with neurobrucellosis (NB) being the least common and most lethal presentation. We show the case of an 85-year-old woman who developed fever, headache and consciousness alteration. The physical examination showed motor disturbance. Serum agglutination and Bengal Rose tests were positive. Brain MRI showed ischemic lesions likely associated with vasculitis in pons, medulla oblongata and cerebellar hemispheres. The patient showed no improvement with antibiotic therapy and passed away. We emphasize the importance of suspecting NB in every febrile patient with neurological symptoms, in an endemic area like ours, for early detection and timely treatment that decreases morbidity and mortality.

 Brucellosis is a public health problem due to non-pasteurization of dairy products, with neurobrucellosis (NB) being the least common and most lethal presentation. We show the case of an 85-year-old woman who developed fever, headache and consciousness alteration. The physical examination showed motor disturbance. Serum agglutination and Bengal Rose tests were positive. Brain MRI showed ischemic lesions likely associated with vasculitis in pons, medulla oblongata and cerebellar hemispheres. The patient showed no improvement with antibiotic therapy and passed away. We emphasize the importance of suspecting NB in every febrile patient with neurological symptoms, in an endemic area like ours, for early detection and timely treatment that decreases morbidity and mortality.

A 30-year-old woman with a previous diagnosis of systemic lupus erythematosus presented with fever, night sweats, mild dyspnea, epigastric pain, and weight loss. The tomography showed a mediastinal mass. The pathology and immunohistochemistry of the tumor was compatible with a B1 thymoma. Even the low frequency among SLE patients, we must include thymoma in every patient with SLE and a mediastinal mass.

A 30-year-old woman with a previous diagnosis of systemic lupus erythematosus presented with fever, night sweats, mild dyspnea, epigastric pain, and weight loss. The tomography showed a mediastinal mass. The pathology and immunohistochemistry of the tumor was compatible with a B1 thymoma. Even the low frequency among SLE patients, we must include thymoma in every patient with SLE and a mediastinal mass.

Se presenta el caso de un varón de 43 años, con diagnóstico de diabetes mellitus, insuficiencia cardiaca, pigmentación de piel, cirrosis hepática, y de hemocromatosis hereditaria confirmada por biopsia hepática. El objetivo de esta publicación es tener presente como diagnóstico diferencial a la hemocromatosis ante un paciente en la edad media de la vida con varias patologías y órganos involucrados.

Se presenta dos casos de neumonía eosinofílica idiopática, uno crónico y otro agudo. En el caso clínico 1 se realizó una confirmación anatomopatológica de neumonía eosinofílica idiopática y en el caso clínico 2 se tuvo una neumonia eosinofílica aguda probable. Ambos presentaron tos, fiebre y disnea. El estudio radiográfico reveló lesiones alveolares bilaterales con tendencia a la consolidación. La marcada eosinofilia en sangre periférica fue un dato resaltante que facilitó el diagnóstico. Ambos casos tuvieron muy buena respuesta a la corticoterapia.

Mujer de 21 años, procedente de Camisea, Cusco, con dos semanas de debilidad muscular progresiva que llegó inclusive a la falla ventilatoria, elevación extrema de crantina fosfocinasa sérica total, patrón miopático en la electromiografía y con presencia de necrosis masiva sin infiltrado inflamatorio en la biopsia muscular. La paciente mejoró clínica y por losestudios de laboratorio con el tratamiento inmunosupresor.

Mujer de 21 años, procedente de Camisea, Cusco, con dos semanas de debilidad muscular progresiva que llegó inclusive a la falla ventilatoria, elevación extrema de crantina fosfocinasa sérica total, patrón miopático en la electromiografía y con presencia de necrosis masiva sin infiltrado inflamatorio en la biopsia muscular. La paciente mejoró clínica y por losestudios de laboratorio con el tratamiento inmunosupresor.