Résumé
Background: Many systemic changes take place in patients with chronic obstructive pulmonary disease (COPD) cause hormonalimbalance which, in turn, affects the severity of the disease. The systemic manifestations of COPD include a number of endocrinedisorders such as those involving the pituitary, the thyroid, the gonads, the adrenals, and the pancreas. The fluctuating severityof hypoxia in COPD patients results in alterations in thyroid function tests and insulin-like growth factor-1 (IGF-1) levels.Aim of the Study: This study aims to evaluate the thyroid function tests, insulin, and IGF-1 levels in patients with chronicCOPD disease and analyze the data.Materials and Methods: Sixty-four COPD patients and 32 normal subjects as control group were included in this study. TheCOPD group was diagnosed and classified according to Global Initiative for Chronic Obstructive Lung Disease criteria. All weresubjected to thorough clinical history, examination, and chest X-ray and spirometry. Hormonal levels of thyroxine hormone (totaltriiodothyronine [TT3], total thyroxin, free triiodothyronine, and free thyroxine) and IGF-1 and insulin were measured.Observations and Results: There was a statistically significant difference between patients with COPD and controls in regard withmean values of total T3, but there was no statistically significant difference in regard with mean values of total T4, thyroid-stimulatinghormone, free T3 and T4, or insulin levels in this study. Hormonal levels according to the stages of COPD showed no statisticaldifference between Stage I COPD patients and controls, but there was statistically significant difference in regard to other stagesof COPD and control groups, i.e., in the present study, the hormonal level of TT3was normal in all COPD patients; however, inStages III and IV, there was a reduction in the hormone level in these stages than control subject and in comparison to Stage I and II.Conclusion: There were significant differences between some hormonal levels in COPD and in controls. There weredemonstrable thyroid hormonal changes and insulin levels in patients of severe degree COPD patients which could be attributedto as systemic manifestation resulting in cachexia, muscle wasting.
Résumé
Background: Blood-related malignancies are the most common non-renal neoplasms affecting the kidneys. Renal involvementin patients with hematological malignancies varies according to the type of malignancy. The pathogenesis is either due to directinvolvement of the kidney or related to its treatment and/or effects of chemotherapy.Aim of the Study: This study aims to study and analyze the prevalence of kidney involvement in blood-related malignanciesand to observe the clinical and laboratory profile of patients in various hematological malignancies.Materials and Methods: A total of 93 consecutive patients of various hematological malignancies were included such asHodgkin’s disease, non-Hodgkin’s lymphoma, acute and chronic leukemias, and multiple myeloma. The renal involvement wasjudged on analysis of patient’s clinical parameters, urine analysis, biochemical, radiological, and when necessary, histologicalparameters. All the patients were investigated and treated on an established protocol described in literature. Patients wereadvised to give informed written consent followed by a detailed history taking and relevant physical examination. Patients wereasked about special emphasis on urinary symptoms and usage of nephrotoxic drugs.Observations and Results: A total of 93 consecutive patients of various hematological malignancies presenting to oncologyand medicine departments were included. There were 62 (66.66%) were male and 31 (33.33%) were female with a maleto-female ratio of 2:1. The youngest patient was aged 11 years and the eldest one was 81 years with a mean age of 43.13 ±16.2 years. Among 93 patients, 46/85 (49.46%) were diagnosed as leukemias, 27/93 (29.03%) patients had lymphomas, and20/93 (21.50%) patients were diagnosed as multiple myelomas. Acute leukemias were seen in 27/46 (58.69%) of the patientsand chronic leukemias in 19/46 (41.30%) of the patients. Forty-six patients with leukemias acute lymphatic leukemia were 7 inmales (25.92%) and 3 (11.11%) in females making it a total of 10/27 (37.03%), acute myeloid leukemia was 6 (22.22%) inmales and 3 (11.11%) in females with a total of 9/27 (33.33%). Acute basophilic leukemia was observed in 5 (18.51%) malepatients and 3 (11.11%) female patients; total 8/27 (29.62%). Chronic myeloid leukemia was seen in 5/19 (26.31%) male and2/19 (10.52%) female patients; 7/19 (36.84%).Conclusions: All patients with hematological malignancies should be periodically evaluated for renal dysfunction and necessarypreventive measures should be undertaken in such patients, especially when initiated on chemotherapy.