RESUMO
BACKGROUND: The primary aim of this case-control study was to compare women whose pregnancy was complicated with gestational diabetes mellitus (GDM), diagnosed by the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, with a control group of healthy, pregnant women in terms of incidence of large- (LGA) and small-for-gestational-age (SGA) neonates. Our secondary aim was to compare intrauterine growth of fetuses between the same 2 populations. PATIENTS AND METHODS: The study included 289 women diagnosed as having GDM in the current pregnancy and 1 108 pregnant controls. Women were followed-up every 2 (GDM group) or 4 weeks (control group). The main metabolic parameters recorded were body mass index, fasting plasma glucose, home blood glucose and glycated hemoglobin A1c. The main ultrasonographic parameters were estimated fetal weight (EFW), head (HC) and abdominal circumferences (AC). Decisions on treatment modification in the GDM group were based on both metabolic and ultrasonographic parameters. RESULTS: There was no evidence for a difference in the incidence of LGA (9.9 vs. 9.2%, Chi-square, p=0.745) or SGA (10.5 vs. 9.0%, p=0.524) in GDM and in control group, respectively. No significant differences were found in EFW or AC between GDM and control groups during the second and third trimester. CONCLUSIONS: Incidence of LGA and SGA neonates is similar among healthy pregnant women and women with GDM, diagnosed by the new IADPSG criteria and treated according to both metabolic and ultrasonographic parameters.
Assuntos
Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiologia , Retardo do Crescimento Fetal/epidemiologia , Macrossomia Fetal/epidemiologia , Recém-Nascido Pequeno para a Idade Gestacional , Diagnóstico Pré-Natal/métodos , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Retardo do Crescimento Fetal/diagnóstico por imagem , Macrossomia Fetal/diagnóstico por imagem , Seguimentos , Humanos , Incidência , Recém-Nascido , Agências Internacionais/legislação & jurisprudência , Pessoa de Meia-Idade , Obstetrícia/legislação & jurisprudência , Obstetrícia/organização & administração , Guias de Prática Clínica como Assunto , Gravidez , Diagnóstico Pré-Natal/estatística & dados numéricos , Ultrassonografia , Adulto JovemRESUMO
We describe a 30-year-old male patient presenting with periodic fever. The patient underwent a series of laboratory tests, X-rays and CT scans. Quantitative immunoglobulin showed IgG 3210.00 mg/dl, IgA 20.00 mg/dl and IgM 27.70 mg/dl. Serum protein electrophoresis revealed a peak with a broad gamma band. Immunofixation revealed an immunoglobulin G -lambda monoclonal component. A bone marrow biopsy established the presence of multiple myeloma. To our knowledge, a periodic 24-hour-lasting fever as the only presenting symptom of multiple myeloma has never been reported.