Subject(s)
Asthma/diagnosis , Churg-Strauss Syndrome/diagnosis , Adult , Asthma/complications , Churg-Strauss Syndrome/complications , Churg-Strauss Syndrome/drug therapy , Diagnosis, Differential , Female , Humans , Methylprednisolone/administration & dosage , Methylprednisolone/therapeutic use , Treatment OutcomeABSTRACT
We report the case of a 33-year-old HIV-infected man who presented with a recurrent, nonhealing perianal fistula. After multiple benign biopsies, the diagnosis of plasmablastic lymphoma (PBL) eventually was made. The patient underwent chemotherapy and radiation with a complete response. Perianal fistulas are frequent in HIV-positive patients, but PBL as a cause is extremely rare. This often delays the diagnosis and treatment of this highly aggressive disease. We review the literature and discuss the pitfalls in the diagnosis and management of the disease.
Subject(s)
Anus Neoplasms , Fistula , HIV Infections/complications , Lymphoma , Adult , Humans , MaleABSTRACT
This study aims at determining the association between markers of hepatic injury and serum, urinary, and intra-erythrocyte magnesium concentrations and dietary magnesium intake in obese children and adolescents. In a case-control study, 42 obese children and adolescents (8-18 years) and 42 sex- and puberty-matched controls were studied. Serum, urinary, and intra-erythrocyte magnesium levels, indices of insulin sensitivity, and liver enzymes were measured. Dietary magnesium intake was assessed using a food frequency questionnaire. Obese children and adolescents exhibited insulin resistance as determined by a higher fasting insulin and the HOMA-IR (p<0.001) and lower QUICKI indices (p=0.001); in addition these subjects had significantly higher intra-erythrocyte magnesium (IEM) concentrations, than non-obese ones (3.99±1.05 vs. 3.35±1.26 mg/dL of packed cell; p=0.015). Among liver enzymes, only gamma-glutamyl transferase (GGT) was significantly higher in obese than in non-obese subjects (22.7±9.4 vs. 17.1±7.9 U/l; p=0.002). A positive association was found between GGT and IEM in both groups; however in multivariate analysis, in obese subjects, only GGT (p=0.026) and, in non-obese subjects, only age (p=0.006) remained as significant predictors of IEM. In conclusion, increased IEM concentration was seen in insulin-resistant obese children and adolescents; furthermore, serum GGT was associated with IEM, independently of body mass index and HOMA-IR.
