RESUMEN
Fatty liver and male gonadal dysfunction are potential late effects of therapy in adult survivors treated with stem cell transplantation (SCT) in childhood. Obesity and metabolic syndrome also are associated with low serum testosterone levels in the general population. However, the relationship between the degree of fatty liver and changes in serum testosterone levels in adult survivors has not been fully studied. We reviewed the clinical records of 34 male patients who received allogeneic SCT in childhood or adolescence. The median age at SCT was 10.0 years, and the median follow-up after SCT was 15.9 years. All but one patient showed no tendency toward overweight/obesity during the follow-up period. Fatty liver was diagnosed by ultrasound in 15 patients at 4 to 20 years after SCT. Patients who received cranial radiation therapy before SCT were more likely to develop fatty liver and insulin resistance. Moreover, fatty liver was statistically associated with decreased serum testosterone levels, whereas nonfatty liver was not (median, 527 ng/dL [range, 168-944 ng/dL] versus 302 ng/dL [165-698 ng/dL]; P < .0001). Changes in testosterone levels after SCT are affected not only by primary gonadal dysfunction but also by subsequent development or exacerbation of fatty liver.
Asunto(s)
Hígado Graso/sangre , Trasplante de Células Madre Hematopoyéticas , Testosterona/sangre , Acondicionamiento Pretrasplante/métodos , Adolescente , Adulto , Glucemia/análisis , Encéfalo/efectos de la radiación , Niño , Preescolar , Hígado Graso/diagnóstico por imagen , Hígado Graso/etiología , Estudios de Seguimiento , Rayos gamma/efectos adversos , Gónadas/efectos de la radiación , Neoplasias Hematológicas/radioterapia , Humanos , Resistencia a la Insulina , Metabolismo de los Lípidos/efectos de la radiación , Hígado/diagnóstico por imagen , Hígado/efectos de la radiación , Masculino , Sobrevivientes , Trasplante Homólogo , UltrasonografíaRESUMEN
Adult intussusception is clinically rare. We report a case with colon intussusception caused by a pedunculated polyp of the sigmoid colon in a 54-year-old male. Abdominal ultrasonographic screening for hematochezia showed intussusception in the sigmoid colon, demonstrating a multiple concentric ring sign and a mobile leading colon polyp. Histological examination of a biopsy specimen of the polyp revealed adenoma. This report suggests that ultrasound imaging is a modality of choice for differential diagnosis of intestinal intussusception with hematochezia in adults.