ABSTRACT
Background: Hyponatremic-hypertensive syndrome (HHS) is characterized bycombination of polyuria, polydipsia, hypertension, hyponatremia and hypokalemia inassociation with unilateral renal artery stenosis. Case characteristics: A 10-year- old girlpresented with polyuria, polydipsia, hypertension, hyponatremia, hypokalemia andproteinuria. Ultrasonography with doppler study revealed bilateral normal renal arteries.Completed tomography of abdomen detected a left adnexal mass, which was laterconfirmed as ovarian paraganglioma on histopathology. Outcome: After tumor excision,polyuria subsided and blood pressure normalized. Message: Hyponatremic-HypertensiveSyndrome does not always result from unilateral renal artery stenosis. High index of clinicalsuspicion with appropriate imaging technique may clinch rare endocrine causes ofhypertension, like paraganglioma.
ABSTRACT
We report a case of a 58-year-old female patient who presented with multiple, asymptomatic, slowly-growing, raised pigmented lesions all over her body for the past 10 years with ulceration in one of the lesions on the trunk for the past five months. Histopathology of the lesion revealed features consistent with melanoacanthoma. Here, we report the first case of cutaneous melanoacanthoma presenting with an ulcerated plaque and the third case of cutaneous melanoacanthoma with multiple lesions. To the best of our knowledge, ulceration has not yet been reported as a feature of cutaneous melanoacanthoma in the medical literature.
ABSTRACT
Gallic acid is a normal constituent of many edible foods, thus directly interacts with epithelial tissue in intestine. In the present study, the effect of gallic acid on intestinal alkaline phosphatase (IAP) and peptidase activities in rat intestine was evaluated. Gallic acid (0.27-0.5 mM) inhibited activities of leucine aminopeptidase (LAP) and -glutamyl transpeptidase (-GTP) by over 90%, compared to controls in rat intestine. In contrast, 0.1-0.6 mM gallic acid either had no effect or stimulated the activity of IAP in rat intestine. The observed inhibition of peptidases by gallic acid was reversible in nature. Kinetic analysis revealed no change in Vmax of LAP (0.42-0.44 units/mg protein) and -GTP (0.22-0.24 units/mg protein), while the values of apparent Km were increased 6-7 fold, exhibiting competitive-type of enzyme inhibition by gallic acid. The values of Ki for LAP and -GTP were 0.037 mM and 0.017 mM, respectively. These observations indicate that gallic acid is a potent inhibitor of brush border peptidases, and thus may interfere in the digestion and absorption of proteins in the intestine.