Current Issue : July - September Volume : 2020 Issue Number : 3 Articles : 8 Articles
We report the case of a woman with a sporadic medullary thyroid carcinoma. Genomic analysis found that her tumor did not\ncontain any common RET mutations but did harbor a BRAF V600E mutation. Only one other well-confirmed example of the\nBRAF V600E mutation has been reported in an MTC patient. We conclude that this common BRAF mutation may independently\ndrive neoplastic transformation of human parafollicular C cells....
Takotsubo syndrome is a rare but emerging form of acute reversible myocardial injury characterized by transient systolic LV\ndysfunction, often related to emotional or physical stress. Pheochromocytoma is increasingly recognised as another possible\ntrigger. Pheochromocytoma is a rare catecholamine-secreting tumour arising from chromaffin cells within the adrenal medulla or\nextra-adrenal paraganglia. The pathognomonic quartet of paroxysmal hypertension, palpitations, headache, and diaphoresis is\nrarely present, and diagnosis is often delayed. We describe a 43-year-old formerly healthy patient with an adrenal pheochromocytoma,\npresenting as an â??invertedâ? takotsubo syndrome complicated with acute heart failure and pulmonary oedema....
Cushingâ??s syndrome is the set of clinical manifestations secondary to a chronic\nexcess of glucocorticoids. Bilateral macronodular adrenal hyperplasia with subclinical\ncortisol secretion is the most common, but its prevalence remains unknown.\nWe describe a case of bilateral macronodular adrenal hyperplasia. This\nis a 36-year-old female patient who had been consulting for secondary amenorrhea\nand developing asthenia for 4 months. The clinical examination noted\nan overweight patient with high blood pressure, facio-trunk obesity, hirsutism\nand purple stretch marks in the abdomen and thighs. Biologically, hypokalemia\nat 2.9 meq/l (3.5 - 5.4), normal calcemia at 90 mg/l (85 - 104), fasting\nblood sugar was 0.84 g/l (0.7 - 1), the tests for minute, low and high dexamethasone\nsuppression test revealed insufficient suppression of cortisol. The cortisoluria\ncollected from the second day to the third day of the high dexamethasone\nsuppression test was at........................
Background: Pituitary adenomas as multifactorial intracranial neoplasms impose a massive burden of morbidity on\npatients and characterizing the molecular mechanism underlying their pathogenesis has received considerable\nattention. Despite the appealing role of cyclooxygenase enzymes and their bioactive lipid products in cancer\npathogenesis, their relevance to pituitary adenoma pathogenesis is debated and yet to be determined. Thus, the\ncurrent study perused this relevance.\nMethods: The expression level of the isoforms of cyclooxygenase (COX-1 and COX-2) was evaluated in hormonesecreting\nand in-active pituitary adenoma tumors and normal pituitary tissues through Real-Time PCR. The level of\nPGE2, as the main product of enzymes, was assessed using enzyme immunoassay kits in patients and healthy\nsubjects.\nResults: The results of the current study demonstrated that COX-1 and COX-2 expression levels were increased in\npituitary tumors including non-functional pituitary adenoma (NFPA), acromegaly, Cushingâ??s disease and\nprolactinoma compared with normal pituitary tissues. A significant expression level of COX-2 was observed in NFPA\ncompared with the other pituitary tumors. Furthermore, the COX-2 expression level was significantly increased in\nmacroadenoma and invasive tumors. The level of PGE2 was consistent with COX enzymes enhanced in pituitary\nadenoma tumors compared with healthy pituitary tissue. A significant elevation in the PGE2 level was detected in\nNFPA compared with hormone-secreting pituitary tumors. Additionally, the PGE2 level was increased in\nmacroadenoma compared with microadenoma and in invasive compared with non-invasive pituitary tumors. The\ndiagnostic values of cyclooxygenase isoforms and PGE2 were considerable between patients and healthy groups;\nhowever, COX-2 revealed more value in distinguishing endocrinologically active and non-active pituitary tumors.\nConclusions: Data from the current study provides expression patterns of COX-1, COX-2 and PGE2 in prevalent\npituitary tumors and their association with patientsâ?? clinical features which may open up new molecular targets for\nearly diagnosis/follow up of pituitary tumor growth....
Background: Differentiating Graves hyperthyroidism from the other causes\nof hyperthyroidism, using serum TRAb testing is essential step for diagnosis.\nObjectives: To study importance of TRAb in the diagnosis of Gravesâ?? disease,\ndistinguishing it from thyroiditis, and comparing it with clinical features and\nother tests such as TPOAb, US thyroid and thyroid scintiscan. Methods: A\ncross-sectional study was conducted on 120 patients attending endocrine clinicErbil\ncity. Patients were studied on clinical feature basis and investigated\nwith serum TRAb, TPOAb, TSH, Free T4, and Ultrasound examination of\nthyroid gland. Fisher exact test and Chi Square test of independence, Correlation\ncoefficient and t-test of independence were used. Results: Fifty-two patients\nwere found to have Gravesâ?? disease; There was significant correlation\nbetween TRAb positivity and diagnosis of Gravesâ?? disease p < 0.05. There was\nalso strong relation between presence of goiter, Orbitopathy and Ultrasound\nfindings and TRAb positivity, p < 0.05. There was statistically significant difference\nbetween mean levels of TRAb and fT4 between Graves patients and\nThyroiditis groups, while there was no statistically significant difference in\nTPOAb and TSH means between the two groups, p > 0.05. Conclusion: A\npositive correlation was found between TRAb titer and positivity and no significant\nrelation between TPOAb levels between Gravesâ?? disease patients compared\nwith thyroiditis patients, respectively....
Introduction: Gonadotroph adenomas are generally nonfunctioning. Hypersecretion\nof gonadotropins by gonadotroph adenomas rarely induced hypersecretion\nof testosterone. We report a case of functioning gonadotroph adenoma\nwith secondary hypersecretion of testosterone. Medical Observation:\nA 25-year-old patient who having had a progressive and bilateral loss of visual\nacuity for two years. The ophtalmologistâ??s examination concluded to bitemporal\nhemianopia. He had no other clinical manifestations of hyper or hypo\nhormonal secretion. The brain scan has revealed an intrasellar mass with suprasellar\ndevelopment that represses the optic chiasma and the carotids. The\nassessment carried out revealed an increase in FSH, LH and testosterone. The\ndiagnosis of a functioning gonadotroph macroadenoma with secondary hypersecretion\nof testosterone was retained. Surgical excision of the adenoma was\nperformed. Anatomo-pathological examination concluded to a pituitary adenoma.\nThe patient showed an improvement in the right visual acuity and developed\nan adrenal corticotropic insufficiency substituted by hydrocortisone 20\nmg per day. The postoperative hormonal profile revealed a normalization of\nFSH and testosterone. Conclusion: Functioning gonadotroph adenoma with\nsecondary hypersecretion of testosterone is rare. The first-line treatment is\nsurgical and allows an improvement of the cerebral tumor syndrome and the\nrestoration of the gonadotropic function....
Introduction: Hypertriglyceridemia is a frequent dyslipidemia in type 2 diabetes.\nWe aimed to determine its prevalence, its typology, and its associated\nfactors in newly type 2 diabetes patients in Ouagadougou. Material and Method:\nThis cross-sectional, descriptive and analytic study has been performed\nfrom May 2015 to June 2016 in the Internal medicine department in Yalgado\nOuédraogo teaching hospital, Ouagadougou. An accidental sample of newly\ntype 2 diabetes outpatients, naïve of antidiabetics therapy was studied. A\n12-hour fasting triglyceridemia was performed; hypertriglyceridemia was defined\nfor triglyceridemia > 1.5 g/L (1.7 mmol/L). Data were analyzed with Epi\ninfo 7.1.5.0. Proportions and means were compared respectively with Khi2 or\nFisherâ??s test and Studentâ??s test with a significance of p < 5%. Results: One\nhundred and three patients, i .e . 35 (34%) men and 68 (66%) women were included.\nThe sex ratio was 0.51 and the mean.........................
We describe a case of worsening Gravesâ?? orbitopathy due to immune reconstitution inflammatory syndrome (IRIS) in a 38-yearold\nHIV-infected male after beginning ART (antiretroviral therapy). Two years after initiation of ART, the patient developed\nsymptoms of hyperthyroidism and thyroid eye disease (TED) or Gravesâ?? orbitopathy (GO). Thyroid iodine uptake scan was\nconsistent with Gravesâ?? disease. The CT scan of the orbits revealed minimal right-sided proptosis, consistent with GO. He was\ntreated with methimazole and a short course of high-dose prednisone for GO. Thyroid function tests normalized, and eye\nsymptoms eventually stabilized. This case demonstrates the importance of awareness and early recognition of IRIS in its many\nforms, as it has significant therapeutic implications....
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