Osteonecrose Multifocal e Síndrome de Guillain Barré

Pedro Mendes Moreira Aroso, Pedro Carvalho, Carla Amaral, João Pinheiro

Resumo


A osteonecrose multifocal, definida pelo envolvimento de 3 ou mais sítios anatómicos, é incomum, sendo observada em apenas 3% a 11% dos doentes com diagnóstico de osteonecrose. A síndrome de Guillain-Barré é uma doença de início agudo, habitualmente monofásica, imune mediada, que afeta o sistema nervoso periférico. O objetivo deste artigo é relatar um caso clínico de osteonecrose associado a síndrome de Guillain-Barré com revisão da literatura.

Apresentamos o caso de um doente do sexo masculino, de 40 anos, com sintomas e sinais neurológicos, que se apresenta no Serviço de Urgência uma semana após uma síndrome gripal. Por suspeita inicial de mielite, foi iniciada corticoterapia.

O diagnóstico de síndrome de Guillain-Barré foi mais tarde confirmado e iniciou tratamento com imunoglobulinas. Um ano depois, o doente desenvolveu artralgias da anca e ombro bilateralmente. O diagnóstico de osteonecrose multifocal foi estabelecido por ressonância magnética. Foi realizada artroplastia total da anca direita e programada a da esquerda. O doente foi submetido a um programa de reabilitação visando alívio da dor e melhoria funcional com bom resultado.

Nos últimos dez anos de revisão da literatura, não existem casos descritos da associação entre síndrome de Guillain- Barré e osteonecrose multifocal.


Palavras-chave


Osteonecrose; Síndrome Guillian-Barre

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Referências


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DOI: http://dx.doi.org/10.25759/spmfr.258

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Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação