Adrenal hemangioma in a 19-year-old female

Adrenal masses are being detected with increasing frequency due to the widespread use of computed tomography, magnetic resonance imaging and even ultrasonography for the evaluation of diseases with abdominal involvement. It is estimated that adrenal masses are an accidental finding in 1% to 5% of all abdominal CT scans performed. Adrenal hemangiomas are rare and nonfunctioning benign tumors and their differential diagnosis preoperatively is rather challenging. Adrenal hemangiomas are most usually cavernous, unilateral lesions of the adrenal glands; bilateral involvement has been reported twice, which appears between the ages 50 and 70 years, with a 2:1 female-to-male ratio. Approximately 60 surgical cases have been reported in the literature. In general, this tumor is large, and all cases reported were treated with open surgery or retroperitoneoscopic procedure. We report a case of a 19-year-old female patient with adrenal hemangioma that was removed by laparoscopic adrenalectomy

Glycogen hepatopathy in a 13-year-old male with type 1 diabetes

Glycogenic hepatopathy [GH] is a rare cause of serum transaminase elevations in type 1 diabetes mellitus. We describe a 13-year-old male with a history of poorly controlled type 1 diabetes mellitus who presented with hepatomegaly and severe transaminase flares. Liver histology confirmed GH. Treatment consists of improving glycemic control. Hepatomegaly due to excess glycogen storage in poorly controlled type 1 diabetics has been associated with younger patients with poor glycemic control, occurring about 2-4 weeks after starting insulin treatment, and resolving upon glucose stabilization. We conclude that glycogenic hepatopathy can cause hepatomegaly and significant transaminase elevations in individuals with type I diabetes mellitus, The recovery of severe transaminase elevations in this patient illustrates the more benign course of GH, which is a condition with a far better prognosis. Clinician awareness of GH should prevent diagnostic delay and will provide better insight into the prevalence of GH

Prevalence of diabetes mellitus in a Saudi community

Quantifying the prevalence of diabetes mellitus is important to allow for rational planning and allocation of resources. Therefore, we designed this study to determine the prevalence of diabetes among Saudi nationals. A cross-sectional study among patients attending a primary care clinic in June 2009. Patients were interviewed with structured questionnaires to determine the presence of diabetes by questioning for history of the disease, and charts were reviewed to document any diabetic therapies that the patients may have undergone in the past or were undergoing at that time. Of 6024 subjects, diabetes mellitus was present in 1792 [30%] patients. The mean [SD] age of the patients was 55.3 [13.2] years. The prevalence of diabetes was 34.1% in males and 27.6% in females [P<.0001]. The mean [SD] age for onset of diabetes in males and females was 57.5 [13.1] and 53.4 [13.1] years, respectively [P<.0001]. Females <50 years old had a higher prevalence than males in the corresponding age range-34.1% and 25.1%, respectively [P<.0001]. The prevalence of diabetes decreased in patients older than 70 years. The prevalence of body mass index of >/= 25 was 72.5%. Among patients with diabetes, the prevalence of body mass index of >/= 25 was 85.7% [P<.0001]. There was a higher prevalence of obesity [body mass index >/= 25] in females [87.7%] as compared to males [83.1%] [P=.008]. The prevalence of diabetes is high among the Saudi population and represents a major clinical and public health problem. A national prevention program to prevent diabetes and address the modifiable risk factors at the community level, targeting high-risk groups, should be implemented soon

Glycemic changes after vitamin D supplementation in patients with type 1 diabetes mellitus and vitamin D deficiency

A prospective, nonblinded and nonrandomized controlled trial was conducted to test the hypothesis that vitamin D supplementation would improve glycemic control in patients with type 1 diabetes mellitus who have vitamin D deficiency. Eight patients with type 1 diabetes mellitus who had 25-hydroxyvitamin D levels less than 50 nmol/L were assigned to receive 4000 IU of vitamin D3. Calcium supplements were provided to ensure a total calcium intake of 1200 mg/d. Glycosylated hemoglobin and 25-hydroxyvitamin D levels were measured at baseline and at 12 weeks. There was a significant difference in mean [SD] glycosylated hemoglobin level [%] between the groups that achieved 25-hydroxyvitamin D levels of <35.4 nmol/L, 35.4-51 nmol/L and >51 nmol/L at 12 weeks [P=.02]. There was a significant difference in glycosylated hemoglobin change from baseline between the groups that achieved 25-hydroxvitamin D levels of<35.4 nmol/L, 35.4-51 nmol/L and >51 nmol/L at 12 weeks [P=0.4]. There was a significant difference in25-hydroxyvitamin D level between the groups that achieved glycosylated hemoglobin levels of <7.8, 7.8-9.9 and >9.9 at 12 weeks [P=.001]. Patients were more likely to achieve lower glycosylated hemoglobin levels at 12 weeks if they had higher 25-hydroxyvitamin D levels at 12 weeks [r=-0.4, p=0.01]. There was an observed effect of vitamin D supplementation on glycemic control in vitamin D-replete, type 1 diabetes mellitus patients. Further studies are needed to determine if these findings are applicable