Mucormycosis during Imatinib treatment: case report.

UNLABELLED: Philadelphia chromosome positive acute lymphoblastic leukemia is classified as a very high-risk group and it requires an intensive chemotherapy regimen associated with tyrosine-kinase inhibitors and allogeneic hematopoietic stem cell transplant from related or unrelated HLA matched donor. Most times, intensive chemotherapy regimens are associated with prolonged and profound pancytopenia when the risk of invasive fungal infection increases. After Candida and Aspergillus species, Mucormycosis is the third frequent fungal infection in hematology patients and it is associated with a reduced overall survival. When suspected, immediate treatment is needed. We present the case of 24-year-old patient diagnosed with Philadelphia chromosome positive acute lymphoblastic leukemia who developed right rhino-sino-orbital fungal infection with a favorable response to systemic antifungal treatment and noninvasive surgery. Later, patient refused consolidation and allogeneic hematopoietic stem cell transplant from an unrelated HLA matched donor but accepted the first generation tyrosine kinase inhibitor (Imatinib) and maintained a complete hematological and molecular response. ABBREVIATIONS: ENT = ear nose throat; BMB = bone marrow biopsy; ALL = acute lymphoblastic leukemia; TKI = tyrosine kinase inhibitor; IFI = invasive fungal infection; BMB = bone marrow biopsy; HE = hematoxylin and eosin; IHC = immunohistochemistry; CD = cluster of differentiation; ob = objective; Tdt = terminal deoxynucleotidyl transferase.

Hyperthyroidism--cause of depression and psychosis: a case report.

Psychiatric symptoms have been reported quite frequently in certain thyroid diseases, but more frequently in association with hypothyroidism. Thyrotoxicosis can be associated with various psychiatric symptoms, such as emotional lability, anxiety, restlessness and rarely frank psychosis. Psychotic symptoms in the context of hyperthyroidism typically present as an affective psychosis. The link between psychosis and hyperthyroidism is poorly understood. Because of this association of psychiatric symptoms is important to exclude a somatic cause, when assessing a patient first. We present the case of young woman who was followed over 2 years and who initially presented to psychiatric consultation for depressive symptoms, after being diagnosed with hyperthyroidism and specific therapy instituted, but who developed psychotic symptoms.

Circadian rhythm of beta-endorphin in the plasma of clinically healthy subjects and in patients with adrenocortical disorders.

Immunoreactive beta-endorphin was determined in the plasma of 37 elderly subjects (73 +/- 7 years of age), in 3 young or young adult subjects without adrenal disease, in 4 women with clinical adrenogenital syndrome, in 1 man with Cushing's disease. Immunoreactive beta-endorphin in plasma was measured by radioimmunoassay in six samples of each subject collected at 4-hour intervals over a 24-hour span. The observation of a circadian rhythm in circulating immunoreactive beta-endorphin with highest values during the late night and early morning hours is extended to elderly subjects in the 8th decade. The beta-endorphin plasma concentrations in the few clinically healthy young adult subjects studied fell within the same range. The circadian variation of the group of elderly subjects was used as reference in the clinical evaluation of plasma beta-endorphin concentrations in patients with pituitary-adrenocortical disorders. The need for circadian rhythm qualified reference values is shown by the observation of the circadian variations of circulating immunoreactive beta-endorphins in the patients with adrenogenital syndrome and Cushing's disease in whom abnormalities in the concentration of circulating beta-endorphin were found at certain circadian stages but not at others.

Dermatoglyphics in the virilizing polycystic ovary syndrome.

Quantitative and qualitative characteristics (form and orientation of the digital patterns, total digital ridges count, delta index, form and regional distribution of palmar patterns, palmar flexion creases, palmar delta index, atd angle, the direction of the A, B, C, and D palmar lines and the number of crests between the a, b, c, and d triradii) of digito-palmar dermatoglyphics in 33 women with virilizing polycystic ovary (VPO) were studied. The selection was made on the basis of the clinical examination and a complex bio-hormonal exploration of female patients with pilar virilism hospitalized in or treated at the outpatient clinic of the "C. I Parhon" Institute of Endocrinology between 1975 and 1984. The control lot was made up of 100 females and 100 males, clinically healthy, originally from various rural and urban areas in Romania. It was found that the VPO women come within the range of variability of the normal, with some dermatoglyphic peculiarities characteristic of the VPO syndrome; i.e., a lower total digital ridges count, and fewer ridges between the triradii at the basis of the fingers. Qualitatively, there is a preponderance of the loop-like digital patterns, especially those with radial orientation and palmar, compared to the normal, the VPO women present more frequently patterns in the interdigital space II. Palmar flexion lines indicate in VPO women a higher incidence of palmar transversal sulcus variants as compared to normal women. The existence of similar dermatoglyphic peculiarities both in VPO and in adrenogenital syndrome supports the hypothesis that the ovarian hormonogenesis disorders in the VPO syndrome may be genetically determined through an enzymatic defect.

Transsexualism; new observations.

Ten cases of transsexualism have been studied. All the patients present gonadal lesions, modifications of the morphotype and small hormonologic anomalies. It is supposed that the gonadal lesions are frequently associated with this psycho-behavioural disorder. Thus transsexualism may be considered a trouble of the whole process of post gonadal sexualization.

A histopathological, cytochemical and morphometrical study of the androgenic polycystic ovary.

The authors studied histopathologically, cytoenzymologically and morphometrically 64 cases of androgenic polycystic ovaries. The distinctive sign disclosed was a marked hyperplasia of theca interna. The mean values of this latter in the androgenic polycystic ovaries was of 87 mu +/- 19 as compared to that of 75 mu +/- 18 found for theca interna in the ovarian follicular cysts unaccompanied by endocrine symptoms. Large lipid-rich cells--the so-called androgenic cells--were often present in the polycystic ovary. Cytoenzymologically a high activity of glucose-6-phosphate dehydrogenase was assayed in theca interna and in the androgenic paralutein cells, while the lowest activity was shown by the 3beta-ol-hydroxysteroid dehydrogenase.

Three sisters with gonadoblastoma.

Three sisters with gonadoblastoma and an 46,XY karyotype are presented. This observation suggests that heredity may play an important role in the genesis of the tumour.