Insuficiencia renal aguda en una adolescente como presentación de hipotiroidismo primario autoinmune / Acute renal failure in a teenager as presentation of primary autoinmune hypothyroidism

No disponible

No disponible

[Rol of pituitary tumour-transforming gene (PTTG) in the pituitary adenomas]. / Papel de pituitary tumour-transforming gene (PTTG) en los adenomas hipofisarios.

The pathogenesis of pituitary tumours is far to be understood. Pituitary transforming tumour gene (PTTG), a gen that induces aneuploidy, genetic instability, cellular proliferation and to stimulate angiogenesis, has been involved in neoplasic transformation and shown overexpressed in many neoplasm as lung, breast, endometrium, thyroid and colon malignant tumours. On the other hand, PTTG has been inconsistently studied in pituitary tumours. The majority of studies have been performed in animals and there is a great variability in the methods used in its determination. The goal of this review is to resume the role of PTTG in tumourogenesis and critically to revise the studies published in humans in order to advance in the knowledge of the pathogenesis of pituitary adenomas and to find clinical useful predictors of the behavior of these tumours.

Papel de pituitary tumour-transforming gene (PTTG) en los adenomas hipofisarios / Rol of Pituitary Tumour-Transforming Gene (PTTG) in the pituitary adenomas

El pituitary transforming tumour gene (PTTG) está involucrado en una gran variedad de mecanismos fisiológicos. Se ha descrito sobreexpresión proteínica de PTTG en múltiples neoplasias, como los tumores hipofisarios, la cual favorece la aneuploidía, la inestabilidad genética, la proliferación celular y la angiogénesis, todos ellos procesos clave en la transformación neoplásica. Los estudios llevados a cabo en adenomas hipofisarios indican su asociación con un mayor grado de infiltración y de recidivas. Actualmente se plantea su función potencial como diana terapéutica (AU)

The pathogenesis of pituitary tumours is far to be understood. Pituitary transforming tumour gene (PTTG), a gen that induces aneuploidy, genetic instability, cellular proliferation and to stimulate angiogenesis, has been involved in neoplasic transformation and shown overexpressed in many neoplasm as lung, breast, endometrium, thyroid and colon malignant tumours. On the other hand, PTTG has been inconsistently studied in pituitary tumours. The majority of studies have been performed in animals and there is a great variability in the methods used in its determination. The goal of this review is to resume the role of PTTG in tumourogenesis and critically to revise the studies published in humans in order to advance in the knowledge of the pathogenesis of pituitary adenomas and to find clinical useful predictors of the behavior of these tumours (AU)

Treatment of Graves' ophthalmopathy with high-dose intravenous methylprednisolone: a comparison of two dosing regimens.

RATIONALE AND OBJECTIVE: The treatment of active moderate-severe Graves' ophthalmopathy (GO) is based on the administration of highdose intravenous glucocorticoids. The present study compares the efficacy and safety of 2 different intravenous methylprednisolone (MTPiv) dosing regimens. MATERIAL AND METHODS: We carry a retrospective descriptive study with sequential sampling of 24 patients (83% females) presenting moderatesevere GO (EUGOGO criteria) and receiving treatment in our center between January 2006 and June 2008. We use 2 dosing regimens: regimen A (12 weeks): 6 doses of 0.5g/week followed by 6 doses of 0.25 g/week, for a cumulative dose of 4.5 g of MTPiv (n=13); and regimen B (16 weeks): 4 cycles of 15 mg/kg, followed by 4 cycles of 7.5mg/kg, for a cumulative dose of 90 mg/kg (range, 4.9-7.4 g) (n=11). Comparisons were made for safety (fasting glucose, cytolysis-cholestasis enzymes, lipid profile) and efficacy data (clinical improvement and recurrence). RESULTS: Mild-moderate liver cytolysis was recorded in four patients, one with associated moderate cholestasis and another with hyperglycemia, leading to treatment suspension - with no differences between the 2 treatment regimens. Percentage clinical improvement with regimen A was 92% (CI, 65-94%) versus 100% with regimen B (CI, 74-100%). The recurrence rate was 43% with regimen A and 63% with regimen B (p>0.05). None of the variables examined in the univariate logistic regression study were associated to a lesser treatment response or increased risk of recurrence of GO. CONCLUSIONS: The treatment of GO with MTPiv is safe and effective, with a lower recurrence rate when using dosing regimen A.

Tratamiento de la oftalmopatía de graves con metilprednisolona intravenosa a altas dosis: comparación de dos esquemas / Treatment of Graves¿ ophthalmopathy with high-dose intravenous methylprednisolone: a comparison of two dosing regimens

Objetivo: El tratamiento de la oftalmopatía de Graves (OG) moderada-grave se basa en la administración de corticoides por vía intravenosa. El presente estudio compara la eficacia y la seguridad de dos regímenes de tratamiento intravenoso con metilprednisolona (MTPiv).Material y método: Se realizó un estudio descriptivo, retrospectivo, con muestreo secuencial de 24 pacientes (el 83% mujeres) que presentaban OG moderada-grave (criterios EUGOGO) y recibieron tratamiento en nuestro centro entre enero de 2006 y junio de 2008. Se utilizaron los dos regímenes siguientes: A (12 semanas), 6 dosis de 0,5 g/semana seguidas de 6 dosis de 0,25 g/semana, con una dosis acumulada de 4,5 g de MTPiv (n = 13);B (16 semanas), 4 ciclos de 15 mg/kg, seguidos de 4 ciclos de 7,5 mg/kg, para una dosis acumulada de 90 mg/kg (intervalo, 4,9-7,9 g) (n = 11). Se compararon las variables de seguridad (glucemia basal, enzimas de colestasis-citólisis, perfil lipídico) y de eficacia (mejoría clínica y recurrencia).Resultados: Se observó citólisis hepática de leve moderada en 4 pacientes, una de ellas asociada a colestasis moderada y otra a hiperglucemia, que determinaron la suspensión del tratamiento, sin diferencias entre regímenes. Hubo mejoría con el régimen A en el 92% (intervalo de confianza[IC] del 95%, 65-94) frente al 100% con el régimen B (IC del 95%, 74-100). La tasa de recurrencia fue del 43% con el régimen A y el 63% con el B (p > 0,05). Ninguna de las variables analizadas en el estudio univariable de regresión logística se asoció a menor respuesta al tratamiento o mayor recurrencia de OG.Conclusiones: El tratamiento de la OG mediante MTPiv es seguro y efectivo, con menor tasa de recurrencia con la dosificación del régimen A (AU)

Rationale and objective: The treatment of active moderate-severe Graves’ ophthalmopathy (GO) is based on the administration of high-dose intravenous glucocorticoids. The present study compares the efficacy and safety of 2 different intravenous methylprednisolone (MTPiv) dosing regimens.Material and methods: We carry a retrospective descriptive study with sequential sampling of 24 patients (83% females) presenting moderate-severe GO (EUGOGO criteria) and receiving treatment in our center between January 2006 and June 2008. We use 2 dosing regimens: regimen A (12 weeks): 6 doses of 0.5 g/week followed by 6 doses of 0.25 g/week, for a cumulative dose of 4.5 g of MTPiv (n = 13); and regimen B (16 weeks): 4 cycles of 15 mg/kg, followed by 4 cycles of 7.5 mg/kg, for a cumulative dose of 90 mg/kg (range, 4.9-7.4 g) (n = 11). Comparisons were made for safety (fasting glucose, cytolysis-cholestasis enzymes, lipid profile) and efficacy data (clinical improvement and recurrence).Results: Mild-moderate liver cytolysis was recorded in four patients, one with associated moderate cholestasis and another with hyperglycemia, leading to treatment suspension – with no differences between the 2 treatment regimens. Percentage clinical improvement with regimen A was 92% (CI, 65-94%) versus 100% with regimen B (CI, 74-100%). The recurrence rate was 43% with regimen A and 63% with regimen B (p > 0.05). None of the variables examined in the univariate logistic regression study were associated to a lesser treatment response or increased risk of recurrence of GO.Conclusions: The treatment of GO with MTPiv is safe and effective, with a lower recurrence rate when using dosing regimen A (AU)