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1.
Annals of Pediatric Endocrinology & Metabolism ; : 68-70, 2019.
Article in English | WPRIM | ID: wpr-762586

ABSTRACT

Congenital rubella infection is a transplacental infection that can cause intrauterine growth retardation, cataracts, patent ductus arteriosus, hearing loss, microcephaly, thrombocytopenia, and severe fetal injury. It has been shown that type 1 diabetes mellitus develops in 12%–20% of patients with congenital rubella infection, and disorders in the oral glucose tolerance test is observed in 40% of patients. No biochemical or serological markers exist which could indicate that type 1 diabetes was caused by a congenital rubella infection. We report a 13-year-old male patient who was admitted to our hospital with complaints of new-onset polyuria, polydipsia, urination, and weight loss. In addition, he was found to have neurosensory hearing loss, patent ductus arteriosus, and microcephaly. Immunemediated type 1 diabetes mellitus was considered due to the fact that the autoantibodies of diabetes mellitus were positive.


Subject(s)
Adolescent , Humans , Male , Autoantibodies , Cataract , Diabetes Mellitus , Diabetes Mellitus, Type 1 , Ductus Arteriosus, Patent , Fetal Growth Retardation , Glucose Tolerance Test , Hearing Loss , Microcephaly , Polydipsia , Polyuria , Rubella , Thrombocytopenia , Urination , Weight Loss
2.
Brain Tumor Research and Treatment ; : 73-77, 2018.
Article in English | WPRIM | ID: wpr-717502

ABSTRACT

Germinoma is the most common type of intracranial germ cell tumors (GCTs). Pineal gland and suprasellar region are the most frequent sites of central nervous system (CNS) involvement. Intracranial masses caused by Langerhans cell histiocytosis (LCH) mimics features of CNS GCTs. LCH frequently involve spine and is the most common cause of vertebra plana in children. A 15-year-old boy presented with progressing symptoms of polydipsia, polyuria, general headache, nausea and severe back pain. Brain MRI showed brain tumor with simultaneous involvement of suprasellar region and pineal gland. An excisional biopsy of suprasellar mass was done. The pathologic assessment confirmed the diagnosis of germinoma. Patient's treatment continued accordingly. A spine MRI, done due to persistent backache, showed a vertebra plana. We reevaluated the primary diagnosis suspecting LCH. Germinoma of CNS was confirmed and a biopsy of vertebral lesion resulted in hemangioma. Thus we report a case of CNS germinoma with co-occurrence of vertebra plana. We emphasized the importance of histopathologic diagnosis of pineal/suprasellar masses and primary investigation of other CNS regions including spine for possible metastasis or comorbidities.


Subject(s)
Adolescent , Child , Humans , Male , Back Pain , Biopsy , Brain , Brain Neoplasms , Central Nervous System , Comorbidity , Diagnosis , Germinoma , Headache , Hemangioma , Histiocytosis, Langerhans-Cell , Magnetic Resonance Imaging , Nausea , Neoplasm Metastasis , Neoplasms, Germ Cell and Embryonal , Pineal Gland , Polydipsia , Polyuria , Spine
3.
Journal of the Korean Neurological Association ; : 86-88, 2018.
Article in Korean | WPRIM | ID: wpr-766652

ABSTRACT

Severe hyponatremia (serum sodium concentration <120 mEq/L) is a well-known etiology of acute symptomatic seizure. Severe hyponatremia may occur as a rare but clinically important adverse reaction of psychotrophic drugs. Among them, patients with psychogenic polydipsia have especially higher risk of severe hyponatremia. We present a schizophrenic patient with polydipsia who developed severe hyponatremia and symptomatic seizures while receiving olanzapine treatment.


Subject(s)
Humans , Hyponatremia , Polydipsia , Polydipsia, Psychogenic , Seizures , Sodium
4.
Clinical Psychopharmacology and Neuroscience ; : 114-117, 2018.
Article in English | WPRIM | ID: wpr-739453

ABSTRACT

Bipolar affective disorder (BD) diagnosis and initiation of appropriate treatment are often delayed, and this is associated with poorer outcomes, such as rapid cycling or cognitive decline. Therefore, identifying certain warning signs of a probable successive episode during the inter-episode phase is important for early intervention. We present the retrospective data of three cases of BD. Our first case had a history of alcohol use disorder (AUD), where he drank in a dipsomaniac manner, and the other two cases had dipsomaniac alcohol use before their manic attacks, and none of them had any AUD after the mood episode was over. Two brothers also had hypertensive episodes during the manic attacks. None of the cases reported increased fluid intake when they were euthymic. We suggest that polydipsia in BD may be a warning sign of an upcoming manic episode, especially in those patients with AUD. Polydipsia in BD may be caused or facilitated by a combination of hyperdopaminergic activity, hypothalamic dysfunction, and dysregulated renin-angiotensin system. To be able to prevent new episodes, a patient’s drinking habits and change in fluid intake should be asked at every visit. Those patients with a history of alcohol abuse should especially be informed about polydipsia and manic episode association.


Subject(s)
Humans , Alcoholism , Binge Drinking , Bipolar Disorder , Comorbidity , Diagnosis , Drinking , Early Intervention, Educational , Mood Disorders , Polydipsia , Renin-Angiotensin System , Retrospective Studies , Siblings
5.
Childhood Kidney Diseases ; : 67-70, 2018.
Article in English | WPRIM | ID: wpr-739196

ABSTRACT

Primary polydipsia (PP) is marked by an increase in thirst, and most often presents in patients with psychiatric illnesses. Although uncommon in children, we experienced cases of PP in a 15-month-old boy and a 5-year-old girl. Both were admitted to the hospital with symptoms of polydipsia and polyuria that appeared 1–3 months before admission. Brain magnetic resonance imaging in both patients was normal. A water restriction test was performed after hospitalization and showed normal results. The symptoms improved after the parents were instructed to implement water-intake restriction for 2 weeks. Our report provides useful information for the treatment of PP in children.


Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Brain , Diabetes Insipidus , Hospitalization , Magnetic Resonance Imaging , Parents , Polydipsia , Polydipsia, Psychogenic , Polyuria , Thirst , Water
6.
Rev. chil. endocrinol. diabetes ; 10(3): 107-110, jul. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-998995

ABSTRACT

Infundibuloneurohypophysitis is a rare condition, which is part of the group of hypophysitis, of relatively recent description (1993). The main clinical manifestation is diabetes insipidus, whose natural evolution is towards chronicity. The differential diagnosis with other thickening of the hypophysial stem is very important, where the clinic, imaging, laboratory and eventually biopsy are a main support for a correct diagnosis. We present a clinical case that shows the usual picture of infundibuloneurohypophysitis, and illustrates the imaging evolution in a female patient, with diabetes insipidus as the main clinical manifestation


Subject(s)
Humans , Female , Adult , Pituitary Diseases/complications , Pituitary Diseases/diagnosis , Diabetes Insipidus/etiology , Pituitary Diseases/diagnostic imaging , Polyuria/etiology , Polyuria/drug therapy , Deamino Arginine Vasopressin/therapeutic use , Diabetes Insipidus/drug therapy , Diuresis/drug effects , Antidiuretic Agents/therapeutic use , Polydipsia/etiology , Polydipsia/drug therapy
7.
International Journal of Oral Biology ; : 99-106, 2017.
Article in Korean | WPRIM | ID: wpr-205039

ABSTRACT

Type1 diabetes mellitus (DM) is generally known to be caused by destruction of insulin-producing pancreatic β cells or an immune-related problem. Polydipsia is a representative symptom of DM, and it has been reported that this condition is closely related to xerostomia and is considered that hyposalivation from the salivary gland results in this phenomenon. Although various studies have reported that induction of diabetes reduces endogenous stem cells in other organs (heart, brain etc.), diabetes-related changes in endogenous stem cells in the salivary gland have not yet been well established. Therefore, in this study, to verify the change in salivary gland stem cells after diabetes, salivary gland tissues in the control and diabetes-induced groups were processed by histochemistry (Masson's trichrome staining) for morphological analysis, TUNEL assay for cell death, and immunohistochemistry (Ki-67 and c-Kit) for cell proliferation and maturation. Diabetes induced by STZ leads to vacuolization, apoptosis, and reduction in proliferating cells/salivary gland stem cells in salivary glands of rats. This result suggests that diabetes may be associated with reduction in salivary gland function such as degeneration and inhibition of regeneration in the salivary gland.


Subject(s)
Animals , Rats , Apoptosis , Brain , Cell Death , Cell Proliferation , Diabetes Mellitus , Immunohistochemistry , In Situ Nick-End Labeling , Polydipsia , Regeneration , Salivary Glands , Stem Cells , Xerostomia
8.
Journal of Korean Diabetes ; : 125-133, 2017.
Article in Korean | WPRIM | ID: wpr-727038

ABSTRACT

The primary causes of uncontrolled diabetes are poor life-style, infection, ischemic heart disease and inappropriate usage of oral anti-diabetic agents and insulin. Supplementary causes are stroke, acute pancreatitis and endocrine diseases. Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant syndrome characterized by primary hyperparathyroidism, pituitary neoplasia, and foregut lineage neuroendocrine tumors, and is associated with increased glucose levels. We present a case of a 69-year-old woman who had polyuria, polydipsia, weight loss and hyperglycemia over 6 months. She had hypertrophy of the face, hand, and foot, and active bleeding and large folds were observed in the stomach and duodenum upon esophagogastroduodenoscopy. She also had high levels of IGF-1 and gastrin and got the failure of growth hormone suppression after an oral glucose load (75 g). These findings suggested a diagnosis of acromegaly and gastrinoma, which was clinically diagnosed along with MEN 1. The patient improved glycemic control and symptoms after being treated with somatostatin analogues and insulin therapy over a 5-month follow-up period. Here, we report a case of MEN 1 in type 2 diabetes mellitus with a poorly controlled blood glucose level. Clinicians should consider endocrine disease in patients with poor glycemic control in diabetes.


Subject(s)
Aged , Female , Humans , Acromegaly , Blood Glucose , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Diagnosis , Duodenum , Endocrine System Diseases , Endoscopy, Digestive System , Follow-Up Studies , Foot , Gastrinoma , Gastrins , Glucose , Growth Hormone , Hand , Hemorrhage , Hyperglycemia , Hyperparathyroidism, Primary , Hypertrophy , Insulin , Insulin-Like Growth Factor I , Multiple Endocrine Neoplasia Type 1 , Multiple Endocrine Neoplasia , Myocardial Ischemia , Neuroendocrine Tumors , Pancreatitis , Polydipsia , Polyuria , Somatostatin , Stomach , Stroke , Weight Loss
9.
Electrolytes & Blood Pressure ; : 23-25, 2017.
Article in English | WPRIM | ID: wpr-29647

ABSTRACT

A 17-year-old girl presented with polyuria (7 L/day) and polydipsia for one year. Initial urine osmolality was 113mOsm/kg H₂O. Following 6 h of fluid restriction, serum plasma osmolality reached 300mOsm/kg H₂O, whereas urine osmolality was 108mOsm/kg H₂O. Urine osmolality was increased by 427% from 108 to 557mOsm/kg after vasopressin challenge. The patient was diagnosed with central diabetes insipidus, possibly derived from the atypical occupation of a Rathke's cleft cyst at the pituitary stalk following magnetic resonance imaging with enhancement. She was discharged with desmopressin nasal spray (10 µg); urine output was maintained at 2-3 L/day, and urine osmolality was >300 mOsm/kg. Additional pituitary image studies and evaluation of hypopituitarism should be included in the differential diagnosis of patients with central diabetes insipidus.


Subject(s)
Adolescent , Female , Humans , Deamino Arginine Vasopressin , Diabetes Insipidus, Neurogenic , Diagnosis, Differential , Hypopituitarism , Magnetic Resonance Imaging , Occupations , Osmolar Concentration , Pituitary Gland , Plasma , Polydipsia , Polyuria , Vasopressins
10.
Chonnam Medical Journal ; : 64-69, 2016.
Article in English | WPRIM | ID: wpr-169468

ABSTRACT

We examined the clinical and laboratory characteristics of children newly diagnosed with diabetes mellitus (DM) in a single-center study. We retrospectively reviewed the data of 155 children with DM between January 2000 and December 2013. Of 155 diabetic children, 87 (56.1%) were diagnosed with type 1 DM (T1DM) and 68 (43.9%) with type 2 DM (T2DM). Mean ages at diagnosis were 8.95+/-3.89 years (T1DM) and 13.76+/-2.23 years (T2DM), respectively (p3.59 ng/mL for 36 months. However, serum C-peptide levels in T1DM were slightly increased up to 6 months after onset and gradually decreased to 0.32 ng/mL for 36 months. The prevalence of children with DM has increased over the last 14 years, and the proportion of T2DM patients has rapidly increased since 2009. Because childhood DM is associated with several metabolic and cardiovascular complications, children should be screened for early detection of DM, especially asymptomatic T2DM in children and adolescents.


Subject(s)
Adolescent , Child , Humans , C-Peptide , Diabetes Mellitus , Diabetic Ketoacidosis , Diagnosis , Glutamate Decarboxylase , Mass Screening , Polydipsia , Polyuria , Prevalence , Retrospective Studies
11.
Brain Tumor Research and Treatment ; : 26-29, 2016.
Article in English | WPRIM | ID: wpr-132134

ABSTRACT

Langerhans cell histiocytosis (LCH) has diverse clinical manifestations, including intracranial mass lesions. We report a case of LCH that manifested as a suprasellar mass, and initially misdiagnosed as a germ cell tumor. A 29-year-old woman presented with polyuria, polydipsia and amenorrhea. Laboratory findings revealed hypopituitarism with central diabetes insipidus, and a suprasellar mass and a pineal mass were observed on magnetic resonance imaging. Under the clinical impression of a germ cell tumor, the patient was treated with germ cell tumor chemotherapy (cisplatin and etoposide) and radiation therapy without biopsy. After initial shrinkage of the lesions, further growth of the tumor was observed and a biopsy was performed. The histopathology revealed LCH. After chemotherapy according to the LCH III protocol, the tumor disappeared. She is on regular follow up for 5 years without relapse. The present findings indicate that LCH should be included in the differential diagnosis of a suprasellar mass, even in adults, especially when it manifests with diabetes insipidus. This case also underscores the importance of a histopathologic diagnosis in patients with suprasellar tumors before the initiation of a specific therapy, even if the clinical findings are highly suggestive of a specific diagnosis.


Subject(s)
Adult , Female , Humans , Amenorrhea , Biopsy , Central Nervous System Neoplasms , Diabetes Insipidus , Diabetes Insipidus, Neurogenic , Diagnosis , Diagnosis, Differential , Drug Therapy , Follow-Up Studies , Germinoma , Histiocytosis, Langerhans-Cell , Hypopituitarism , Magnetic Resonance Imaging , Neoplasms, Germ Cell and Embryonal , Polydipsia , Polyuria , Recurrence , Sella Turcica
12.
Brain Tumor Research and Treatment ; : 26-29, 2016.
Article in English | WPRIM | ID: wpr-132131

ABSTRACT

Langerhans cell histiocytosis (LCH) has diverse clinical manifestations, including intracranial mass lesions. We report a case of LCH that manifested as a suprasellar mass, and initially misdiagnosed as a germ cell tumor. A 29-year-old woman presented with polyuria, polydipsia and amenorrhea. Laboratory findings revealed hypopituitarism with central diabetes insipidus, and a suprasellar mass and a pineal mass were observed on magnetic resonance imaging. Under the clinical impression of a germ cell tumor, the patient was treated with germ cell tumor chemotherapy (cisplatin and etoposide) and radiation therapy without biopsy. After initial shrinkage of the lesions, further growth of the tumor was observed and a biopsy was performed. The histopathology revealed LCH. After chemotherapy according to the LCH III protocol, the tumor disappeared. She is on regular follow up for 5 years without relapse. The present findings indicate that LCH should be included in the differential diagnosis of a suprasellar mass, even in adults, especially when it manifests with diabetes insipidus. This case also underscores the importance of a histopathologic diagnosis in patients with suprasellar tumors before the initiation of a specific therapy, even if the clinical findings are highly suggestive of a specific diagnosis.


Subject(s)
Adult , Female , Humans , Amenorrhea , Biopsy , Central Nervous System Neoplasms , Diabetes Insipidus , Diabetes Insipidus, Neurogenic , Diagnosis , Diagnosis, Differential , Drug Therapy , Follow-Up Studies , Germinoma , Histiocytosis, Langerhans-Cell , Hypopituitarism , Magnetic Resonance Imaging , Neoplasms, Germ Cell and Embryonal , Polydipsia , Polyuria , Recurrence , Sella Turcica
13.
Annals of Pediatric Endocrinology & Metabolism ; : 51-55, 2016.
Article in English | WPRIM | ID: wpr-34964

ABSTRACT

In males, precocious puberty (PP) is defined as the development of secondary sexual characteristics before age 9 years. PP is usually idiopathic; though, organic abnormalities including tumors are more frequently found in male patients with PP. However, advanced puberty in male also can be an important clinical manifestation in tumors. We report 2 cases of rapidly progressive puberty in males, each associated with a germ-cell tumor. First, an 11-year-old boy presented with mild fever and weight loss for 1 month. Physical examination revealed a pubertal stage of G3P3 with 10-mL testes. Investigations revealed advanced bone age (16 years) with elevated basal luteinizing hormone and testosterone levels. An anterior mediastinal tumor was identified by chest radiography and computed tomography, and elevated α-fetoprotein (AFP) and β-human chorionic gonadotropin (β-hCG) levels were noted. Histopathologic analysis confirmed a yolk-sac tumor. Second, a 12-year-old boy presented with diplopia, polydipsia, and polyuria for 4 months. Physical examination revealed a pubertal stage of G3P3 with 8-mL testes. Bone age was advanced (16 years) and laboratory tests indicated panhypopituitarism with elevated testosterone level. A mixed germ-cell tumor was diagnosed with elevated AFP and β-hCG levels. Of course, these patients also have other symptoms of suspecting tumors, however, rapidly progressive puberty can be the more earlier screening sign of tumors. Therefore, in male patients with accelerated or advanced puberty, malignancy should be considered, with evaluation of tumor markers. In addition, advanced puberty in male should be recognized more widely as a unique sign of neoplasm.


Subject(s)
Adolescent , Child , Humans , Male , Chorionic Gonadotropin , Diplopia , Fever , Luteinizing Hormone , Mass Screening , Physical Examination , Polydipsia , Polyuria , Puberty , Puberty, Precocious , Radiography , Testis , Testosterone , Thorax , Biomarkers, Tumor , Weight Loss
14.
Chonnam Medical Journal ; : 64-69, 2016.
Article in English | WPRIM | ID: wpr-788324

ABSTRACT

We examined the clinical and laboratory characteristics of children newly diagnosed with diabetes mellitus (DM) in a single-center study. We retrospectively reviewed the data of 155 children with DM between January 2000 and December 2013. Of 155 diabetic children, 87 (56.1%) were diagnosed with type 1 DM (T1DM) and 68 (43.9%) with type 2 DM (T2DM). Mean ages at diagnosis were 8.95+/-3.89 years (T1DM) and 13.76+/-2.23 years (T2DM), respectively (p<0.001). There were significant differences in HbA1c, C-peptide, and glutamic acid decarboxylase antibody levels between the T1DM and T2DM groups. Annual numbers of children with DM have increased, and since 2011 the number of children with T2DM has surpassed the number with T1DM. The most common clinical symptom in T1DM was polyuria, and 26.4% of children with T1DM presented initially with diabetic ketoacidosis. In contrast, 60.3% of T2DM children showed glucosuria in a school urine screening, and only 19.1% presented with polydipsia. The rate of positivity for at least more than one islet autoantibody was 77.1% in T1DM and 26.3% in T2DM. Serum C-peptide levels in T2DM were increased up to 12 months after onset and remained >3.59 ng/mL for 36 months. However, serum C-peptide levels in T1DM were slightly increased up to 6 months after onset and gradually decreased to 0.32 ng/mL for 36 months. The prevalence of children with DM has increased over the last 14 years, and the proportion of T2DM patients has rapidly increased since 2009. Because childhood DM is associated with several metabolic and cardiovascular complications, children should be screened for early detection of DM, especially asymptomatic T2DM in children and adolescents.


Subject(s)
Adolescent , Child , Humans , C-Peptide , Diabetes Mellitus , Diabetic Ketoacidosis , Diagnosis , Glutamate Decarboxylase , Mass Screening , Polydipsia , Polyuria , Prevalence , Retrospective Studies
15.
Rev. chil. endocrinol. diabetes ; 9(2): 56-57, 2016. tab
Article in Spanish | LILACS | ID: biblio-831346

ABSTRACT

Partial forms of diabetes insipidus (DI) can be combined sometimes with alterations in the functionality of antidiuretic hormone (ADH) as a result of other co-morbidities. These entities are sometimes combined, it being necessary to assess this possibility further diagnostic protocols in particular cases. If clinical patient is within the spectrum of a DI of neurohypophyseal origin is described.


Subject(s)
Humans , Male , Child , Diabetes Insipidus/diagnosis , Polydipsia/etiology
16.
Article in English | IMSEAR | ID: sea-163462

ABSTRACT

SECTION A: Pathophysiology of Type 2 Diabetes mellitus in children Dr. Jyoti Kini While Type 2 diabetes mellitus (T2DM) continues to be a disease of the elderly and the middle aged, currently there has been an upsurge in the incidence of T2DM in the adolescents and the young. Family history, maternal gestational diabetes, low birth weight have contributory role to play in the pathophysiology of T2DM. The pathophysiology underlying the development of alterations in glucose metabolism ranging from abnormal fasting glucose (AFG) to impaired glucose intolerance (IGT) is multifactorial. The early onset of diabetes in childhood or adolescence heralds a long disease interval with resultant escalation of the probability of development of co-morbidities and the entire range of macro- and microvascular complications. SECTION B: Clinical scenario of Type 2 Diabetes mellitus in children Dr. Mallikarjungowda S Patil Type 2 diabetes mellitus (T2DM) is a heterogeneous disorder, characterized by peripheral insulin resistance and failure of beta cells to keep up with increasing insulin demand. T2DM children are usually obese, may present with mild symptoms of polyuria and polydypsia. A systemic approach for treatment of T2DM should be implemented according to the natural course of the disease, including adding insulin when oral hypoglycemic agents failure occurs. Life style modification is an essential part of management. When lifestyle interventions fail to normalize blood glucose, oral hypoglycemic agents are introduced for management of persistent hyperglycemia. SECTION C: Epidemiology and Prevention of Type 2 Diabetes mellitus in children Dr. Savindika Nawarathna , Dr. Animesh Jain Type 2 diabetes mellitus was considered rare amongst children, but recently the incidence has increased worldwide with almost half of the newly diagnosed cases being children and adolescents. Type 2 diabetes mellitus (T2DM) is primarily characterized by insulin resistance detected at the level of skeletal muscle, liver, and adipose tissues with a failure of β-cell compensation and a relative insulin deficiency. A variety of risk factors like race, obesity, insulin resistance, family history, psychococial factors, birth weight, exposure to maternal DM and breastfeeding can influence the development of T2DM. Type 2 DM screening in the paediatric population should be clinically focused and take into account not only those risk factors identified in the American Diabetes Association guidelines, but also the clinical context, pubertal status, and the results of simple screening measures such as fasting glucose and triglycerides. More outcome-based research is required before general screening, to identify children and adolescents with pre-diabetes or insulin resistance can be recommended. The pathophysiology underlying the development of alterations in glucose metabolism ranging from abnormal fasting glucose (AFG) to impaired glucose intolerance (IGT) is multifactorial. The early onset of diabetes in childhood or adolescence heralds a long disease interval with resultant escalation of the probability of development of co-morbidities and the entire range of macro- and microvascular complications.


Subject(s)
Administration, Oral , Adolescent , Child , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/physiopathology , Diabetes Mellitus, Type 2/prevention & control , Diabetes Mellitus, Type 2/therapy , Female , Humans , Hypoglycemic Agents/administration & dosage , Insulin , Male , Polydipsia
17.
Tuberculosis and Respiratory Diseases ; : 463-468, 2015.
Article in English | WPRIM | ID: wpr-149059

ABSTRACT

Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.


Subject(s)
Adult , Humans , Male , Biopsy , Cough , Diabetes Insipidus , Diabetes Insipidus, Neurogenic , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Dyspnea , Follow-Up Studies , Histiocytosis, Langerhans-Cell , Lung , Lung Diseases , Magnetic Resonance Imaging , Polydipsia , Smoke , Smoking , Smoking Cessation , Thoracic Surgery, Video-Assisted , Water Deprivation
18.
Endocrinology and Metabolism ; : 569-575, 2015.
Article in English | WPRIM | ID: wpr-36348

ABSTRACT

BACKGROUND: Inflammatory factors and beta-cell dysfunction due to high-fat diets aggravate chronic diseases and their complications. However, omega-3 dietary fats have anti-inflammatory effects, and the involvement of autophagy in the etiology of diabetes has been reported. Therefore, we examined the protective effects of autophagy on diabetes using fat-1 transgenic mice with omega-3 self-synthesis capability. METHODS: Streptozotocin (STZ) administration induced beta-cell dysfunction in mice; blood glucose levels and water consumption were subsequently measured. Using hematoxylin and eosin (H&E) and Masson's trichrome staining, we quantitatively assessed STZ-induced changes in the number, mass, and fibrosis of pancreatic islets in fat-1 and control mice. We identified the microtubule-associated protein 1A/1B light chain 3-immunoreactive puncta in beta-cells and quantified p62 levels in the pancreas of fat-1 and control mice. RESULTS: STZ-induced diabetic phenotypes, including hyperglycemia and polydipsia, were attenuated in fat-1 mice. Histological determination using H&E and Masson's trichrome staining revealed the protective effects of the fat-1 expression on cell death and the scarring of pancreatic islets after STZ injection. In the beta-cells of control mice, autophagy was abruptly activated after STZ treatment. Basal autophagy levels were elevated in fat-1 mice beta-cells, and this persisted after STZ treatment. Together with autophagosome detection, these results revealed that n-3 polyunsaturated fatty acid (PUFA) enrichment might partly prevent the STZ-related pancreatic islet damage by upregulating the basal activity of autophagy and improving autophagic flux disturbance. CONCLUSION: Fat-1 transgenic mice with a n-3 PUFA self-synthesis capability exert protective effects against STZ-induced beta-cell death by activating autophagy in beta-cells.


Subject(s)
Animals , Mice , Autophagy , Blood Glucose , Cell Death , Chronic Disease , Cicatrix , Diet, High-Fat , Dietary Fats , Drinking , Eosine Yellowish-(YS) , Fatty Acids, Omega-3 , Fatty Acids, Unsaturated , Fibrosis , Hematoxylin , Hyperglycemia , Islets of Langerhans , Mice, Transgenic , Pancreas , Phenotype , Polydipsia , Streptozocin
19.
Korean Journal of Schizophrenia Research ; : 86-90, 2015.
Article in Korean | WPRIM | ID: wpr-81043

ABSTRACT

Polydipsia in schizophrenic patients is not uncommon, but a frequently underdiagnosed condition. The etiology of polydipsia remains unclear, and its complications can be life-threatening, while often being difficult to manage it. We report a case of a successfully treated chronic schizophrenic patient with polydipsia. The patient was male, 47-year-old, suffering 27-years of residual schizophrenia who had been consuming more than 10 L of water per day, and is complicated by hyponatremia. He was treated with irbesarten 300 mg and naltrexone 50 mg in the setting of closed ward. He consumed less than 3.5 L of water per day and serum sodium levels seemed to be stable following discharge from the closed ward. We suggest that irbesartan and naltrexone may have beneficial effects for treating polydipsia, and future prospective and well-controlled studies are to be performed.


Subject(s)
Humans , Male , Middle Aged , Hyponatremia , Naltrexone , Polydipsia , Prospective Studies , Schizophrenia , Sodium , Water
20.
Journal of Korean Diabetes ; : 315-322, 2015.
Article in Korean | WPRIM | ID: wpr-726845

ABSTRACT

Hepatitis C virus (HCV) mainly affects the liver, but several tissues outside the liver have also been reported to be involved. It has been hypothesized that diabetes could be one of these extrahepatic conditions attributable to HCV infection. The specific mechanisms by which HCV leads to type 2 diabetes are not fully understood, but it seems that an increase in insulin resistance associated with both steatosis and overproduction of proinflammatory cytokines could play a crucial role. We report a patient whose type 2 diabetes that was resolved following interferon-alpha (IFN-alpha) therapy for HCV. A 57-year-old man presented with fatigue, polyuria, and polydipsia. He was newly diagnosed as type 2 diabetes and chronic hepatitis C. He was started on subcutaneous insulin and IFN-alpha. After 24 weeks of treatment with IFN-alpha, the results of HCV polymerase chain reaction were negative, and his diabetes had resolved. Our case shows a resolution of diabetes after IFN-alpha therapy for chronic hepatitis C. Although it is unclear whether the resolution of diabetes in this case occurred as an effect of IFN-alpha or as a result of becoming HCV RNA-negative, our finding suggest roles of IFN-alpha and HCV infection in the pathogenesis of diabetes.


Subject(s)
Humans , Middle Aged , Cytokines , Diabetes Mellitus, Type 2 , Fatigue , Hepacivirus , Hepatitis C, Chronic , Hepatitis, Chronic , Insulin , Insulin Resistance , Interferon-alpha , Liver , Polydipsia , Polymerase Chain Reaction , Polyuria
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