Sunday, 7 December 2014
Exhibition Hall-Poster Area (Sul America)
Leonardo Mendonça, MD
,
Clinical Immunology and Allergy, Hcfmusp, Brazil
Pablo Torres, MD
,
Clinical Immunology and Allergy, Hcfmusp, Brazil
Fabiana Mascarenhas, MD
,
Clinical Immunology and Allergy, Hcfmusp, Brazil
Karla Boufleur, MD
,
Clinical Immunology and Allergy, Hcfmusp, Brazil
Carolina Tavares De Alcântara, MD
,
Clinical Immunology and Allergy Division, University of São Paulo, São Paulo, Brazil
Giane Garcia, MD
,
Clinical Immunology and Allergy, Hcfmusp, Brazil
Octavio Grecco, MD
,
Clinical Immunology and Allergy, Hcfmusp, Brazil
Luiz Augusto Marcondes, PhD
,
Clinical Immunology and Allergy, Hcfmusp, Brazil
Cristina Kokron, MD, PhD
,
University of São Paulo, Brazil
Jorge Kalil, PhD
,
Department of Allergy and Immunology, University of São Paulo, São Paulo, Brazil
Myrthes Toledo Barros, PhD, MD
,
Clinical Immunology and Allergy, Hospital Das Clínicas - Faculdade De Medicina - USP, Brazil
Background: In patients with common variable immunodeficiency (CVID) gastrointestinal disorders and malignancies occur higher than expected in the general population. These patients present risk of 50 times higher than the population (Kalha and Kellin, 2004) for development of gastric cancer, what reinforces the importance of screening for premature diagnosis and treatment.
Methods: Review of clinical data from eletronic records were performed. The objective of this paper is present a case of a patient with CVID with an atypical and very aggressive presentation of gastric cancer.
Results: M.S.S., 32 female patient, followed with CVID since 21 years old, was hospitalized with 30 days of cought, fever unresponsive to oral treatment. Despite intravenous broad-spectrum antibiotics, there was no clinical improvement. Thorax CT was made that incidentaly showed multiple liver abscesses and after that the patient developed porgressive ascitis. Investigation of origin of these abscesses evidentiated two gastric ulcers and one rectal ulcer. The pathologic analysis of gastric and rectum byopsis and cytologic analysis of ascitis liquid showed adenocarcinoma of stomach with peritoneal carcinomatosis. In a familial discussion about the prognosis of this patient were defined exclusive paliative care. On the 24th day of hospitalization the patient a natural evolution to death.
Conclusions: High incidence of gastric cancer in CVID reinforce necessity of screening. In our department we sugest to patients realize anual endoscopy with biopsy and this seems to be effective to early diagnosis and treatment. Despite our screening this patient had an unusual and aggressive presentation.
