Assuntos
Neoplasias das Glândulas Suprarrenais/complicações , Bloqueio Cardíaco/etiologia , Feocromocitoma/complicações , Neoplasias das Glândulas Suprarrenais/diagnóstico , Idoso , Eletrocardiografia , Feminino , Bloqueio Cardíaco/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Feocromocitoma/diagnósticoRESUMO
INTRODUCTION: Posttransplant diabetes mellitus (PTDM) is a common, serious complication of renal transplantation. The aim of this retrospective study was to estimate the incidence and to identify potential factors predisposing to PTDM. PATIENTS AND METHODS: We evaluated 296 adult nondiabetic patients who underwent kidney transplantation at our center. PTDM was defined according to 2003 international consensus guidelines. Potential factors predisposing to PTDM were analyzed individually and simultaneously using a logistic regression model. RESULTS: Over 2054.5 years of cumulative follow-up, 51 patients (17.2%) developed diabetes corresponding to an annual incidence of 2.5%. PTDM was diagnosed after a median of 2.9 months (range: 0.2-168). The mean age of affect individuals was 33.3±7.4 years. Patients with PTDM were significantly older (P<.0005) and showed an higher body mass index (BMI; P<.004). Univariate analysis revealed that age, BMI, family history of diabetes, vascular nephropathy, and hepatitis C infection were associated with PTDM. Multivariate analysis rescaled the roles of age (relative risk [RR]=1.046/y; P<.04), BMI (RR=1.107/kg/m2, P<.05), vascular nephropathy (RR=7.06, P<.03), and hepatitis C infection (RR=2.72, P<.03) as independent factors predisposing to PTDM. CONCLUSION: Among our relatively young kidney transplant recipients, in whom only 8% received tacrolimus, PTDM was a frequent complication. We suggest that the use of oral glucose tolerance tests to screen patients identifies those predisposed to develop this complication.
Assuntos
Complicações do Diabetes/diagnóstico , Transplante de Rim/métodos , Adulto , Complicações do Diabetes/epidemiologia , Feminino , Teste de Tolerância a Glucose , Humanos , Imunossupressores/farmacologia , Incidência , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/terapia , Transplante de Rim/efeitos adversos , Masculino , Análise Multivariada , Complicações Pós-Operatórias , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco , Tacrolimo/farmacologiaRESUMO
Ectopic thyroid is a rare condition (1/4000 to 1/8000 among patients with hypothyroidism). The underlying etiological pathogenic mechanisms remain unknown. Diagnosis is established on the basis of imaging findings. We report two cases of hypothyroidism in adult females who had ectopic sublingual thyroid glands. The first patient was a 20-Year-old woman who had been treated for hypothyroidism since the age of 13 Years before the diagnosis of ectopic thyroid 7 Years later. In both patients, the thyroid gland was palpable. In the first patient the physical examination revealed an ectopic sublingual gland. Scintigraphy confirmed the diagnosis in both patients. The CT-scan and MRI were positive in the second patient. Hormonal substitution therapy using L-thyroixine was given.
