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1.
World J Clin Cases ; 7(23): 4075-4083, 2019 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-31832411

RESUMO

BACKGROUND: Non-Hodgkin's lymphoma (NHL) can involve extralymphatic organs, resulting in diverse clinical manifestations, especially if the endocrine organs are affected. This type of involvement can often be difficult to detect accurately. Until now, no patients with NHL and concomitant bilateral adrenal and hypothalamic involvement have been reported. The purpose of this article is to discuss the diagnosis and treatment of lymphoma with bilateral adrenal gland and hypothalamic involvement so as to help physicians avoid misdiagnosis and missed diagnosis. CASE SUMMARY: We describe a case of a 52-years-old male patient with bilateral adrenal masses, who presented with a fever of unknown origin on admission. Subsequently, hypopituitarism of the anterior pituitary followed by posterior pituitary developed. 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) showed lesions with a high metabolism in both adrenal glands, hypothalamus, left supraclavicular lymph nodes, and other organs. The etiological diagnosis was determined based on a left supraclavicular lymph node biopsy. The patient, who eventually present with panhypopituitarism, was finally diagnosed with diffuse large B cell lymphoma with bilateral adrenal gland and hypothalamic involvement. After immunochemotherapy, glucocorticoids administration and desmopressin acetate replacement therapy, the symptoms of fever and panhypopituitarism improved, and all the lesions reduced in size. CONCLUSION: This report demonstrates that, although synchronous involvement of two endocrine organs is rare in NHL, extra caution should be taken when dysfunction occurs in multiple endocrine organs.

2.
Huan Jing Ke Xue ; 40(7): 3361-3368, 2019 Jul 08.
Artigo em Chinês | MEDLINE | ID: mdl-31854739

RESUMO

Soil aggregates are important indicators of soil quality and sustainable land utilization, and impact the retention abilities of water and fertilizers and the release of nutrients in soil. This study aimed to understand the effects of two land use types (an orchard and farmland) on the distribution, stability, and organic carbon content of soil aggregates, and provides a theoretical basis for the optimal management of the soil carbon pool in the Weibei Dryland of the Loess Plateau. We examined the soils from an orchard and from farmland by simultaneous sampling and wet sieving; the proportions of large macroaggregates (>2 mm), small macroaggregates (0.25-2 mm), microaggregates (0.053-0.25 mm), and silt and clay (<0.053 mm) were then determined; the content of organic carbon in each aggregate fraction at soil depths of 0-40 cm were also measured, and the total organic carbon content of all aggregates fractions was determined for each soil. The results showed that the type of agricultural land use had a significant effect on the distribution and stability of soil aggregates in the 0-20 cm soil layer, with the relative proportions of the different sized aggregates (>2, 0.25-2, 0.053-0.25, and<0.053 mm) being 12.9%, 51.3%, 28.8%, and 7.0% in the orchards, respectively, and 8.3%, 49.7%, 33.6%, and 8.4% on the farmland, respectively. The proportion of macro-aggregates (>0.25 mm) was significantly higher in the orchard soils than in the farmland soils. Mean weight diameter (MWD) and geometric mean diameter (GMD) are important indicators of the soil aggregate stability; the MWD and GWD of the farmland soils were significantly lower than the orchard soils in the 0-40 cm depth zone (P<0.05). The effects of different land use types on the organic carbon content of soil aggregates was most marked in the 0-10 cm layer. Compared with farmland, the organic carbon content in the large aggregates, intermediate aggregates, micro-aggregates, and the silt and clay fraction of orchard soils were relatively increased by 56.0% (P<0.05), 57.1% (P<0.05), 40.8% (P>0.05), and 13.0% (P>0.05), respectively. Organic carbon storage in each aggregate class (excluding the<0.053 mm fraction) in the orchard soils was higher than in the farmland soils. In the orchard soils, the proportion of soil macro-aggregates (>0.25 mm) and the associated organic carbon content was elevated, damage to aggregates was reduced, and the organic carbon stability was enhanced. In general, the soil aggregate stability and organic carbon content of orchard soils were higher than for the farmland soils. Orchards appear to enhance the physical stability of aggregates with respect to soil organic carbon, contribute to soil organic carbon accumulation, and thus promote soil carbon sequestration.

3.
Ying Yong Sheng Tai Xue Bao ; 29(5): 1626-1634, 2018 May.
Artigo em Chinês | MEDLINE | ID: mdl-29797896

RESUMO

Calculation of design drainage modulus is of great importance for the safety of farmland and reduction of waterlogging loss. We investigated the effects of main meteorological factors on design farmland drainage modulus by focusing on a closed farmland area in Ninghe District of Tianjin City. To resolve the problem of limited observation, the parameter sensitivity was analyzed according to mutual information and partial rank correlation coefficient aiming at the total runoff depth based on field observation experiment. The reasonable parameters were obtained by combining with soil water content and the relative variation of groundwater level. Then, a three-source runoff yield model coupling of excess infiltration and saturation was established to estimate runoff and design drainage modulus, and the effects of meteorological factors such as precipitation and evaporation on drainage modulus were analyzed. Results showed that summer precipitation significantly reduced and evaporation varied a little during 1960-2015. The corresponding drainage modulus decreased with the reduction of precipitation. When return period increased, the magnitude of the reduction in precipitation as well as the design drainage modulus increased. However, the effects of meteorological factors on design drainage modulus was generally inapparent. Thus, we concluded that the current drainage modulus is suitable for the study area.


Assuntos
Fazendas , Água Subterrânea , Movimentos da Água , Conceitos Meteorológicos , Solo
5.
Medicine (Baltimore) ; 97(2): e9084, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29480822

RESUMO

Pituitary stalk interruption syndrome (PSIS) is associated with simultaneous or subsequent pituitary hormone deficiencies (PHDs). Although the clinical features of multiple PHDs are well known, the status of the thyrotrophic axis in PSIS has not been thoroughly investigated.The clinical data of 89 PSIS patients and 34 Sheehan syndrome (SS) patients were retrospectively analyzed.The prevalence of central hypothyroidism in the PSIS patients and the SS patients was 79.8% and 70.6%, respectively. The thyroid-stimulating hormone (TSH) levels in the PSIS patients were significantly higher in comparison with the SS patients (5.13 ±â€Š3.40 vs 1.67 ±â€Š1.20 mU/L, P < .05). TSH elevation (8.79 ±â€Š3.17 mU/L) was noticed in 29 of 71 (40.85%) hypothyroid PSIS patients but not in the 24 hypothyroid SS patients. The TSH levels in the hypothyroid PSIS patients were significantly higher in comparison with the euthyroid PSIS patients (5.42 ±â€Š3.67 vs 3.66 ±â€Š1.50 mU/L). Thyroid hormone replacement significantly reduced the TSH levels in the PSIS patients with elevated TSH levels from 7.24 ±â€Š0.98 to 1.67 ±â€Š1.51 mU/L (P < .05). The logistic regression analysis suggested that TSH level was not significantly associated with pituitary stalk status and height of the anterior pituitary gland.PSIS is a newly recognized cause of central hypothyroidism. The proportion and amplitude of TSH elevations are higher in PSIS than in other causes of central hypothyroidism.


Assuntos
Doenças da Hipófise/metabolismo , Tireotropina/metabolismo , Adulto , Feminino , Terapia de Reposição Hormonal , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças da Hipófise/diagnóstico por imagem , Doenças da Hipófise/tratamento farmacológico , Doenças da Hipófise/epidemiologia , Hipófise/diagnóstico por imagem , Hipófise/efeitos dos fármacos , Hipófise/metabolismo , Prevalência , Estudos Retrospectivos , Tireotropina/administração & dosagem , Adulto Jovem
6.
Endocr J ; 65(3): 269-279, 2018 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-29279458

RESUMO

Primary macronodular adrenal hyperplasia (PMAH), also known in the past as bilateral macronodular adrenalhyperplasia or adrenocorticotropin (ACTH)-independent macronodular adrenal hyperplasia, is a rare type of Cushing's syndrome (CS) and is associated with bilateralenlargement of the adrenal glands. It accounts for <1% of all endogenous cases of CS. In order toidentify the pathogenic mutations in the causative gene of (AIMAH pedigrees, Whole-genome sequencing of three patients in family I was used to retrieve candidate causative genes. Meanwhile, the causative gene was identified by Sanger sequencing from the two pedigrees. Sequencing of ARMC5 exons of three patients was carried out to identify somatic mutations. Moreover, haploid clone of one tumor DNA sample was conducted. ARMC5 was the causative gene of two pedigrees confirmed by whole-genome sequencing (WGA) and Sanger sequencing. The variant sites of the two families were c.C943T (p.R315W) and c.C1960T (p.R654X), respectively. Autosomal dominant inheritance of AIMAH was confirmed by genotypes of one family member. Several somatic mutations were discovered in tumor DNA samples. In addition, haploid clone of tumor DNA was confirmed by germline mutation and somaticmutation, which suggested the pathogenic mechanism of "two-hit-model." ARMC5 was the causative gene of AIMAH pedigrees. This AIMAH in this study presented autosomal dominant inheritance, fitting to Mendelian inheritance law. However, the pathogenic mode of this disease showed as compound heterozygote.


Assuntos
Glândulas Suprarrenais/diagnóstico por imagem , Síndrome de Cushing/genética , Proteínas Supressoras de Tumor/genética , Adulto , Idoso , Proteínas do Domínio Armadillo , Síndrome de Cushing/diagnóstico por imagem , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Linhagem , Tomografia Computadorizada por Raios X , Sequenciamento Completo do Genoma
7.
Front Microbiol ; 7: 1451, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27679622

RESUMO

Early and accurate diagnosis of invasive candidiasis (IC) is very important. In this study, a lateral flow immunoassay (LFIA) was developed to detect antibody against Candida albicans enolase (Eno). Colloidal gold particle labeled mouse anti human IgG (1.0 mg/L) was used as the detector reagent. Recombinant enolase (rEno, 1.0 mg/L) and goat anti IgG (1.0 mg/L) were immobilized in test and control lines, respectively, of a nitrocellulose membrane, acting as the capture reagents. The LFIA was used to detect anti Eno in 38 sera from clinically proven IC patients, as well as in 50 healthy control subjects. Compared with an indirect ELISA designed as a reference test, the specificity and sensitivity of the LFIA were 98.2 and 84.8%, respectively. Excellent agreement between the results obtained by ELISA and the LFIA (κ = 0.851) was observed in this study. In addition, the agreement between the blood culture results and LFIA test is strong (κ = 0.658). The data presented in the study indicate that the LFIA test is a suitable tool for the serological surveillance of IC in the field or in poorly equipped laboratories.

8.
Neuro Endocrinol Lett ; 37(3): 189-192, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27618603

RESUMO

OBJECTIVE: Patients with malignant insulinoma always present with symptoms of severe hypoglycemia and have poor life expectancy. In addition, inoperable metastatic malignant insulinomas are very difficult to manage. The aim of this report is to present our successful experiences in diagnosis and treatment of this disease in 6 patients. PATIENTS/METHODS: Six patients (male 2, female 4) with malignant insulinomas were admitted into our hospital. Their clinical histories, including clinical presentations, endocrine evaluations, radiological images, pathological examination and treatments, were reviewed. RESULTS: The diagnosis of malignant insulinoma combined with liver metastases was confirmed in all patients by endocrine evaluation and radiological images. Patients 1-3 underwent surgical management. The primary and metastasized tumors were completely resected. After successful surgery, no hypoglycemia recurred. Patients 4-6 did not undergo surgery because of systemic disease and poor health. Instead, they were administrated with diazoxide 50 mg Three Times a Day (TID), with final doses up to 200-300 mg TID. These 3 patients had good responses to diazoxide administration. After treatment, the frequency and severity of hypoglycemia were improved significantly. All 6 patients had better life quality than previously expected. CONCLUSION: Combination of surgical and medical approaches can improve life quality and prolong survival of patients with malignant insulinomas.


Assuntos
Insulinoma/patologia , Neoplasias Pancreáticas/patologia , Adulto , Diazóxido/uso terapêutico , Diuréticos/uso terapêutico , Feminino , Humanos , Hipoglicemia/tratamento farmacológico , Hipoglicemia/etiologia , Insulinoma/cirurgia , Insulinoma/terapia , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/cirurgia , Neoplasias Pancreáticas/terapia , Estudos Retrospectivos , Adulto Jovem
9.
J Pediatr Endocrinol Metab ; 29(2): 209-16, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26495923

RESUMO

BACKGROUND: Reninoma is an extremely rare renal tumor characterized by excessive renin secretion causing secondary hypertension and hypokalemia. Reninoma is a benign and highly manageable lesion if it is discovered early and removed surgically. METHODS: We report six cases of reninoma and provide a literature review on this rare disease, highlighting the diagnostic evaluation and follow-up of each patient. RESULTS AND CONCLUSIONS: Reninoma should be considered in young adults with elevated renin activity and refractory hypertension. Imaging studies and selective venous catheterization are often helpful in identifying the lesion. In most cases of reninoma presenting with renin-mediated hypertension, conservative surgical treatment should be considered to remove the small, superficial lesion.


Assuntos
Hipertensão/fisiopatologia , Renina/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
11.
Exp Biol Med (Maywood) ; 240(11): 1480-9, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26031747

RESUMO

Kallmann syndrome, a form of idiopathic hypogonadotropic hypogonadism, is characterized by developmental abnormalities of the reproductive system and abnormal olfaction. Despite association of certain genes with idiopathic hypogonadotropic hypogonadism, the genetic inheritance and expression are complex and incompletely known. In the present study, seven Kallmann syndrome pedigrees in an ethnic Han Chinese population were screened for genetic mutations. The exons and intron-exon boundaries of 19 idiopathic hypogonadotropic hypogonadism (idiopathic hypogonadotropic hypogonadism)-related genes in seven Chinese Kallmann syndrome pedigrees were sequenced. Detected mutations were also tested in 70 sporadic Kallmann syndrome cases and 200 Chinese healthy controls. In pedigrees 1, 2, and 7, the secondary sex characteristics were poorly developed and the patients' sense of smell was severely or completely lost. We detected a genetic mutation in five of the seven pedigrees: homozygous KAL1 p.R191ter (pedigree 1); homozygous KAL1 p.C13ter (pedigree 2; a novel mutation); heterozygous FGFR1 p.R250W (pedigree 3); and homozygous PROKR2 p.Y113H (pedigrees 4 and 5). No genetic change of the assayed genes was detected in pedigrees 6 and 7. Among the 70 sporadic cases, we detected one homozygous and one heterozygous PROKR2 p.Y113H mutation. This mutation was also detected heterozygously in 2/200 normal controls and its pathogenicity is likely questionable. The genetics and genotype-phenotype relationships in Kallmann syndrome are complicated. Classical monogenic inheritance does not explain the full range of genetic inheritance of Kallmann syndrome patients. Because of stochastic nature of genetic mutations, exome analyses of Kallmann syndrome patients may provide novel insights.


Assuntos
Análise Mutacional de DNA , Síndrome de Kallmann/etnologia , Síndrome de Kallmann/genética , Adolescente , Adulto , Sequência de Aminoácidos , Criança , China , Códon sem Sentido , Éxons , Proteínas da Matriz Extracelular/genética , Saúde da Família , Feminino , Estudos de Associação Genética , Heterozigoto , Homozigoto , Humanos , Hipogonadismo/etnologia , Hipogonadismo/genética , Íntrons , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Proteínas do Tecido Nervoso/genética , Linhagem , Fenótipo , Receptor Tipo 1 de Fator de Crescimento de Fibroblastos/genética , Receptores Acoplados a Proteínas-G/genética , Receptores de Peptídeos/genética , Homologia de Sequência de Aminoácidos , Adulto Jovem
12.
Medicine (Baltimore) ; 94(21): e841, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-26020388

RESUMO

The diagnosis of malignant thyroid nodules is still a clinical challenge. This study aimed to determine the ultrasonographic characteristics of papillary thyroid carcinoma. The ultrasonographic and pathological data of 2453 thyroid nodules in a cohort of 1895 Chinese patients who underwent thyroidectomy from January 2010 to December 2012 were retrospectively reviewed. Anteroposterior and transversal (AP/TR) diameters ≥1, solid structure, infiltrative margins, hypoechoic appearance, and microcalcifications were more common in malignant nodules than in benign nodules (P < 0.01). These ultrasonographic features were independent risk factors of malignancy (P < 0.01) as determined by logistic regression analysis. Based on multivariate analysis, these characteristics were also present in large nodules (diameter >10 mm). However, in small nodules (diameter ≤10 mm), only AP/TR ≥1 and infiltrative margins were independent risk factors of malignancy (P < 0.01). Ultrasonography is of high diagnostic value for malignant thyroid nodules and may help to improve the differential diagnosis. Small and large nodules have distinct ultrasonographic features.


Assuntos
Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/diagnóstico , Carcinoma/diagnóstico por imagem , Carcinoma/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha Fina , Calcinose , Carcinoma/cirurgia , Carcinoma Papilar/cirurgia , Criança , China , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/cirurgia , Ultrassonografia , Adulto Jovem
13.
Neuro Endocrinol Lett ; 36(7): 650-2, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26859586

RESUMO

Lipodystrophies is a really rare group of diseases characterized by altered body fat amount and/or repartition and serious insulin resistance.We reported a lean Chinese girl with acquired generalized lipodystrophy, who had a long history of poorly controlled diabetes mellitus (DM) despite with extremely high dose insulin (6 u/kg/d) therapy, combined with severe hypertriglyceridemia and acanthosis nigricans. The differential diagnosis of Lipodystrophies should be considered in lean patients presenting with early onset DM, combined with serious insulin resistance.

14.
Endocr J ; 60(11): 1261-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24018882

RESUMO

This study was conducted to evaluate gender-related differences in clinical characteristics and vascular complications in patients with aldosterone-producing adenomas (APA). Clinical characteristics, biochemical markers and incidence of vascular complications were compared by gender in 187 consecutive patients with APA confirmed by pathological diagnosis. Patients were separated into two groups based on ages either older or younger than 49 years, the average age of menopause among Chinese women (<49 y and ≥49 y). Males had significantly higher BMI than females in the age group of <49 years (p = 0.017). In the <49 years group, males had significantly higher serum sodium levels (p = 0.003). However, no such gender differences in clinical characteristics were observed in patients ≥49 years. A higher proportion of vascular complications was observed in males as compared to females aged <49 years but the difference was not statistically significant (51.4% vs. 34.8%, p = 0.105). The only gender difference observed in vascular complications between patients aged ≥49 years was that a significantly greater proportion of males had cerebrovascular complication compared to females (p = 0.006). Our data suggest that female sex hormones are implicated in reducing serum sodium concentration and vascular complications in female APA patients.


Assuntos
Adenoma/epidemiologia , Adenoma/metabolismo , Neoplasias das Glândulas Suprarrenais/metabolismo , Aldosterona/metabolismo , Hipertensão/epidemiologia , Hipertensão/prevenção & controle , Sódio/sangue , Adenoma/cirurgia , Neoplasias das Glândulas Suprarrenais/epidemiologia , Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia , Aldosterona/biossíntese , Biomarcadores/sangue , Transtornos Cerebrovasculares/epidemiologia , China/epidemiologia , Comorbidade , Feminino , Hormônios Esteroides Gonadais/metabolismo , Humanos , Hiperaldosteronismo/epidemiologia , Hiperaldosteronismo/metabolismo , Masculino , Pessoa de Meia-Idade , Potássio/sangue , Estudos Retrospectivos , Caracteres Sexuais , Distribuição por Sexo , Fatores Sexuais , Doenças Vasculares/epidemiologia
16.
Zhonghua Nei Ke Za Zhi ; 52(12): 1041-4, 2013 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-24503403

RESUMO

OBJECTIVE: To explore the imaging features of congenital adrenal cortex hyperplasia (CAH). METHODS: A total of 45 patients clinically confirmed as CAH were retrospectively analyzed to investigate the imaging features and strengthening way of the multi-detector-row Computed tomography. RESULTS: The imaging features of all the cases presented as following: 25 with bilateral adrenal hyperplasia, 6 with unilateral adrenal hyperplasia, 6 with adrenal nodular hyperplasia, 2 with adrenal hyperplasia and unilateral solid cystic lesion, 2 with adrenal hyperplasia and double side real cystic lesion, 1 with adrenal hyperplasia and unilateral cystic changes and 3 with normal adrenal. The unilateral or bilateral hyperplasia adrenal could be homogeneously enhanced, while the enhanced performance of other cases was inequitable. CONCLUSIONS: The adrenal imaging features of CAH by multi-detector-row CT are variable, with the bilateral adrenal hyperplasia as the main form, which could be restored to normal morphology after hormone replacement therapy.No regression of the tumor size is observed in cases with adrenal mass. CT scanning combined with clinical manifestation and biochemical examination could facilitate the diagnosis of CAH.


Assuntos
Hiperplasia Suprarrenal Congênita/diagnóstico por imagem , Tomografia Computadorizada Espiral , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Estudos Retrospectivos , Adulto Jovem
18.
Neuro Endocrinol Lett ; 33(3): 265-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22635081

RESUMO

Tumors originating from ectopic adrenal tissue are relatively rare. In this article, we describe a case with Cushing's syndrome caused by an ectopic adrenal adenoma. A 38 year-old male patient presenting with cushingoid appearance for 2 years was diagnosed to have ACTH-independent Cushing's syndrome based on endocrinological evaluation. Mutiple radiological examinations detected bilateral adrenal atrophy. When the images were investigated in a more expanded scope, a 3.0×3.5×5.3 cm mass was detected in the anterior of left renal hilum and left renal vein. The mass was successfully resected with intraoperative endoscopy and pathological evaluation revealed an ectopic adrenal tumor. It is suggested that when the endocrinlogically confirmed adrenal neoplasm could not be well and definitely localized, the possibility of ectopic adrenal should be presumed and further radiography examinations should extend to the field where ectopic adrenal usually presents.


Assuntos
Corticosteroides/metabolismo , Neoplasias do Córtex Suprarrenal/cirurgia , Adenoma Adrenocortical/cirurgia , Neoplasias Renais/cirurgia , Laparoscopia/métodos , Hipersecreção Hipofisária de ACTH/cirurgia , Córtex Suprarrenal , Neoplasias do Córtex Suprarrenal/metabolismo , Neoplasias do Córtex Suprarrenal/patologia , Adenoma Adrenocortical/metabolismo , Adenoma Adrenocortical/patologia , Adulto , Coristoma/patologia , Humanos , Nefropatias/patologia , Neoplasias Renais/metabolismo , Neoplasias Renais/patologia , Masculino , Hipersecreção Hipofisária de ACTH/patologia
19.
Diabetes Res Clin Pract ; 96(2): e15-7, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22293929

RESUMO

The presentations of chronic inflammatory demyelinating polyneuropathy (CIDP) overlap with those of diabetic peripheral neuropathy (DPN). We described a young girl with CIDP underlying type 2 diabetes mellitus, presenting with progressive numbness and limb weakness, who was initially misdiagnosed to have DPN. Finally immunosuppressive therapy got good response.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Neuropatias Diabéticas/diagnóstico , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/diagnóstico , Adulto , Feminino , Humanos , Adulto Jovem
20.
Neuro Endocrinol Lett ; 32(4): 421-4, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21876495

RESUMO

A rare case with ectopic adrenocorticotrophic hormone syndrome (EAS) caused by medullar thyroid carcinoma (MTC) in mediastinum was reported. This 49 year-old male patient initially presented with serious and intractable hypokalemia. Endocrine evaluations showed increased levels of adrenocorticotrophic hormone (ACTH) and urinary free cortisol, which could not be suppressed more than 50% by high-dose dexamethasone suppression test. Computed tomography (CT) scan detected a 5×5×5 cm mass at the bottom of thyroid in anterior mediastinum. The patient underwent total thyroidectomy with central compartment and ipsilateral modified radical neck dissection. Pathological examination showed an infiltrating thyroid medullary carcinoma with abundant amyloid deposition, meanwhile immunohistochemical positive for ACTH. After surgery, serum levels of kalium, as well as cortisol and ACTH returned to normal range. During follow-up, the patient's clinical manifestation of Cushing syndrome relieved.


Assuntos
Síndrome de ACTH Ectópico/etiologia , Carcinoma Medular/complicações , Neoplasias do Mediastino/complicações , Neoplasias da Glândula Tireoide/complicações , Hormônio Adrenocorticotrópico/sangue , Biópsia , Carcinoma Medular/diagnóstico , Carcinoma Neuroendócrino , Humanos , Masculino , Neoplasias do Mediastino/diagnóstico , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/diagnóstico , Tomografia Computadorizada por Raios X
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