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      Tres casos consecutivos de gangrena seca en invierno Translated title: Three consecutive cases of dry gangrene in winter

      case-report

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          Abstract

          RESUMEN Se presentan tres casos de gangrena seca ocurridos en el invierno austral del 2018. El primero corresponde a un varón de 37 años, portador de vasculitis por crioglobulinemia y enfermedad celiaca silente, que desarrolla gangrena seca en manos y pies. El segundo es una mujer de 40 años que consulta por gangrena seca de manos y pies, sin etiología demostrable. El tercero es un varón de 38 años que ingresa por choque séptico de origen neumónico que requiere tratamiento con vasopresores desarrollando gangrena seca de manos y pies. A pesar que los tres casos tienen etiología diferente, coincidieron con temperaturas muy frías (media 6° C), inusuales para el clima tropical del Paraguay.

          Translated abstract

          ABSTRACT We present three cases of dry gangrene occurred in the southern winter of 2018. The first corresponds to a 37-year-old man, carrier of vasculitis due to cryoglobulinemia and silent celiac disease, which develops dry gangrene in hands and feet. The second is a 40-year-old woman who consults for dry gangrene of hands and feet, without demonstrable etiology. The third is a 38-year-old male admitted for septic shock of pulmonary origin that requires treatment with vasopressors developing dry gangrene of the hands and feet. Although the three cases have a different etiology, they coincided with very cold temperatures (average 6 °C), unusual for the tropical climate of Paraguay.

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          Most cited references14

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          Novel mechanisms and functions of complement

          Progress in the beginning of the 21 st century transformed our perception of complement from a blood-based antimicrobial system to a global regulator of immunity and tissue homeostasis. More recent years have witnessed remarkable advances regarding structure-function insights, mechanisms and locations of complement activation, thereby adding new layers of complexity in the biology of complement. This complexity is readily reflected by the multifaceted and contextual involvement of complement-driven networks in a wide range of inflammatory and neurodegenerative disorders and cancer. This Review provides an updated view of new and previously unanticipated functions of complement and how these impact immunity and disease pathogenesis.
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            Production of complement components by cells of the immune system.

            The complement system is an important part of the innate immune defence. It contributes not only to local inflammation, removal and killing of pathogens, but it also assists in shaping of the adaptive immune response. Besides a role in inflammation, complement is also involved in physiological processes such as waste disposal and developmental programmes. The complement system comprises several soluble and membrane-bound proteins. The bulk of the soluble proteins is produced mainly by the liver. While several complement proteins are produced by a wide variety of cell types, other complement proteins are produced by only a few related cell types. As these data suggest that local production by specific cell types may have specific functions, more detailed studies have been employed recently analysing the local and even intracellular role of these complement proteins. Here we review the current knowledge about extrahepatic production and/or secretion of complement components. More specifically, we address what is known about complement synthesis by cells of the human immune system.
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              Symmetrical peripheral gangrene.

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                anales
                Anales de la Facultad de Ciencias Médicas (Asunción)
                An. Fac. Cienc. Méd. (Asunción)
                EFACIM. Editorial de la Facultad de Ciencias Médicas - Universidad Nacional de Asunción (Asunción, Central, Paraguay )
                1816-8949
                December 2019
                : 52
                : 3
                : 111-116
                Affiliations
                [1] Itauguá orgnameMinisterio de Salud Pública y Bienestar Social orgdiv1Hospital Nacional orgdiv2Medicina Interna Paraguay
                [3] Asunción Asunción orgnameUniversidad del Pacífico orgdiv1Facultad de Ciencias Médicas Paraguay
                [2] Itauguá Itapúa orgnameUniversidad Nacional de Itapúa orgdiv1Hospital Nacional, Facultad de Medicina orgdiv2Postgrado en Medicina Interna Paraguay
                Article
                S1816-89492019000300111
                10.18004/anales/2019.052.03.111-116
                33428565-c0e2-40fe-96ed-b8c390526eb0

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 04 November 2019
                : 26 September 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 6
                Product

                SciELO Paraguay

                Categories
                Reporte de Casos

                vasculitis,enfermedad celiaca,vasopresores,gangrene,celiac disease,cold injury.,gangrena,lesión por frío.,vasopressors

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