ABSTRACT
PURPOSE: Diverse cytokines influence the pathogenesis of type 1 diabetes mellitus (T1DM) in different ways. We studied the profile of cytokines in sera from type 1 diabetic patients at diagnosis. METHODS: Serum levels of 11 cytokines (IL-1alpha, IL-1beta, IL-1Ra, IL-2, IL-4, IL-6, IL-10, IL-12 (p70), INF-gamma, and TNF-alpha) from 38 newly-diagnosed T1DM patents and 39 healthy controls were measured, using multiplex immunoanalytic xMAP. RESULTS: Patients showed significantly higher levels of IL-1beta (P < 0.01), IL-10 (P < 0.01), and TNF-alpha (P = 0.019), than the healthy controls. In 12 of 35 patients, the insulin autoantibody (IAA) was positive (34%) and the level of IAA was correlated with IL-10 (r = 0.454, P = 0.006), and TNF-alpha (r = 0.368, P = 0.030). CONCLUSION: These results suggest that IL-1beta, TNF-alpha, and IL-10 play a role in the pathogenesis of T1DM, and the level of the IAA is correlated with IL-10 and TNF-alpha.
Subject(s)
Humans , Autoantibodies , Cytokines , Diabetes Mellitus, Type 1 , Insulin , Interleukin 1 Receptor Antagonist Protein , Interleukin-10 , Interleukin-12 , Interleukin-1beta , Interleukin-2 , Interleukin-4 , Interleukin-6 , Tumor Necrosis Factor-alphaABSTRACT
PURPOSE: In medulloblastoma, craniospinal radiation therapy combined with chemotherapy improves the prognosis of tumors but results in significant endocrine morbidities. We studied the endocrine morbidity, especially growth pattern changes. METHODS: The medical records of 37 patients with medulloblastoma were reviewed retrospectively for evaluation of endocrine function and growth. We performed the growth hormone stimulation test in 16 patients whose growth velocity was lower than 4 cm/yr. RESULTS: The height loss was progressive in most patients. The height standard deviation score (SDS) decreased from -0.1+/-1.3 initially to -0.6+/-1.0 after 1 year(P<0.01). Growth hormone deficiency(GHD) developed in 14 patients. During the 2 years of growth hormone(GH) treatment, the improvements of height gain or progressions of height loss were not observed. Twelve patients(32.4 percent) revealed primary hypothyroidism. One of six patients diagnosed with compensated hypothyroidism progressed to primary hypothyroidism. Primary and hypergonadotropic hypogonadism were observed in two and one patients respectively. There was no proven case of central adrenal insufficiency. CONCLUSION: Growth impairment developed frequently, irrespective of the presence of GHD in childhood survivors of medulloblastoma. GH treatment may prevent further loss of height. The impairment of the hypothalamic-pituitary-gonadal and hypothalamic-pituitary-thyroidal axis is less common, while central adrenal insufficiency was not observed.
Subject(s)
Child , Humans , Adrenal Insufficiency , Axis, Cervical Vertebra , Drug Therapy , Growth Hormone , Hypogonadism , Hypothyroidism , Medical Records , Medulloblastoma , Prognosis , Retrospective Studies , SurvivorsABSTRACT
PURPOSE: GnRH analogues(GnRHa) are used to treat central precocious puberty(CPP). However, in some patients, the GV decrease is so remarkable that it impairs predicted adult height(PAH); and there fore, the addition of growth hormone(GH) is suggested. We analysed the growth changes during two years and final adult height(FAH) in girls with idiopathic CPP treated with combined therapy, compared with those of girls treated with GnRHa alone. METHODS: For the analysis, we classified the patients, who was treated for longer than two years, into three groups depending on the initial PAH and combination of GH; PAH_L, treated with GnRHa and PAH less than midparental height(MPH) -5 cm. PAH_H, treated with GnRHa and PAH greater than MPH -5 cm. GnRHa+GH, combined GH treatment, regardless of PAH before treatment. We analysed the GV and PAH change during the first two years and FAH. RESULTS: In PAH_L, the PAH(SDS) at first year of therapy was significantly increased to 153.5+/-6.5 cm(-1.4+/-1.3) from 149.7+/-6.4 cm(-2.1+/-1.3) before treatment(P=0.004). In PAH_H, there was no significant increase in PAH during the two years of treatment. During the first year of combination of GH and GnRHa, GV and PAH increased significantly. We observed significant increases in FAH, comparing to the initial PAH in the PAH_L and GnRHa+GH groups. The height gains(FAH-initial PAH) were significantly higher in the PAH_L and GnRHa+GH groups than that in the PAH_H group. CONCLUSION: This study suggests the FAH and height gains are improved in patients, whose predicted adult height before treatment was shorter than those with higher predicted adult height, with the treatment of GnRHa alone or in combination with GH. GH could not improve the final adult height, but compensated the growth in patients whose growth velocity was decelerated by GnRHa alone.
Subject(s)
Adult , Female , Humans , Gonadotropin-Releasing Hormone , Growth Hormone , Puberty, PrecociousABSTRACT
Thyroid hormone resistance (RTH) is a rare autosomal dominant disease characterized by reduced tissue sensitivity to thyroid hormone. Approximately 90% of subjects with RTH have mutation in the thyroid hormone receptor beta (TRbeta) gene. Approximately 10% of subjects diagnosed as having RTH do not carry mutation in the TRbeta gene. We report a 12-year-old male. The patient was euthyroid in spite of high total and free T4 and T3 concentrations, while TSH is slightly increased. TSH response to TRH stimulation was normal, and TSH values to TRH stimulation after T3 suppression revealed partial response. Sequence analysis of TRbeta gene showed no mutation. We report a case of RTH without mutations in the TRbeta gene.