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1.
Clin Physiol Funct Imaging ; 39(2): 135-142, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30325581

RESUMO

It has been suggested that technetium-99m (99mTc)-anti-tumour necrosis factor alpha (TNF-α) scintigraphy (SCI) may be a useful diagnostic tool in Graves' ophthalmopathy (GO). This study evaluated whether orbit total radioactivity uptake on SCI could be used to predict corticosteroid therapy (CorT) responses in active-GO patients. A longitudinal study of patients with active GO defined by Clinical Active Score (CAS) >3/7 was done. Clinical, laboratory and SCI evaluations were performed at baseline and 3 months after concluding intravenous CorT. SCI (planar and tomographic) was assessed after intravenous injection of 10 mCi of 99mTc-anti-TNF-α. Orbits and cerebral hemispheres were defined as regions of interest (ROIs) to enable orbit/hemisphere ROI-ratios of total radioactive uptake. ROI-ratios were considered positive at >2·5. Average total radiation uptake (TRU) was also determined for each orbit (AVGROI ). Clinical, laboratory and SCI data were compared between responders (CAS became inactive) and non-responders to CorT (18 patients). At baseline, AVGROI were higher in active OG orbits (67·3 cps) than in inactive ones (33·6 cps; P<0·05). AVGROI (absolute values) reduced (-29·9 cps) in CorT responders and tended (P = 0·067) to differ from variations occurred in non-responders (+6·9 cps in patients with maintained CAS positivity post-treatment). Higher baseline ROI-ratios (4·9 versus 3·3; P = 0·056) and its pronounced reductions following CorT (-37% versus +56% in non-responders; P = 0·036) tended to be associated with good CorT responses in the subgroup of GO history ≥1 year. SCI showed a good association with active eye disease and may be an additional tool to identify CorT responders.


Assuntos
Adalimumab/administração & dosagem , Corticosteroides/uso terapêutico , Oftalmopatia de Graves/diagnóstico por imagem , Oftalmopatia de Graves/tratamento farmacológico , Compostos Radiofarmacêuticos/administração & dosagem , Tecnécio/administração & dosagem , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Feminino , Oftalmopatia de Graves/imunologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Indução de Remissão , Reprodutibilidade dos Testes , Fatores de Tempo , Resultado do Tratamento , Fator de Necrose Tumoral alfa/imunologia
2.
Horm Res Paediatr ; 79: 179-84, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23445772

RESUMO

CASE REPORT: A 10-year-old male was referred to our institution due to short stature and bilateral cryptorchidism and reported pubic hair development and acne since the age of 4 years. Laboratory and molecular genetic tests indicated congenital adrenal hyperplasia due to 21-hydroxylase deficiency. After treatment with prednisone, adrenal hormones normalised but testosterone remained elevated. Magnetic resonance imaging of the abdomen due to cryptorchidism revealed uterus and adnexal attachments, a prostate and poorly defined nodules on the iliac chains. Upon exploratory laparotomy, a hysterectomy, bilateral oophorectomy and resection of a peri-adnexal nodular lesion on the patient's right side were performed. Histopathology of the nodule mass was compatible with a Leydig cell tumour with a low proliferation rate according to Ki67.


Assuntos
Hiperplasia Suprarrenal Congênita/diagnóstico , Tumor de Células de Leydig/diagnóstico , Hiperplasia Suprarrenal Congênita/cirurgia , Criança , Criptorquidismo/diagnóstico , Feminino , Humanos , Tumor de Células de Leydig/cirurgia , Masculino , Esteroide 21-Hidroxilase/genética , Testosterona/sangue
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