Résumé
Growth differentiation factor 15 (GDF15) is receiving great interest beyond its role as an aging and disease-related biomarker. Recent discovery of its receptor, glial cell line-derived neurotrophic factor (GDNF) family receptor α-like (GFRAL), suggests a central role in appetite regulation. However, there is also considerable evidence that GDF15 may have peripheral activity through an as-of-yet undiscovered mode of action. This raises the question as to whether increased GDF15 induction during pathophysiologic conditions also suppresses appetite. The present review will briefly introduce the discovery of GDF15 and describe the different contexts under which GDF15 is induced, focusing on its induction during mitochondrial dysfunction. We will further discuss the metabolic role of GDF15 under various pathophysiological conditions and conclude with possible therapeutic applications.
Résumé
Cytomegalovirus is a common virus that is mostly asymptomatic when infected, but rarely causes life-threatening hemolysis especially in immunocompromised children. We report a case of antiglobulin test negative severe hemolytic anemia caused by cytomegalovirus infection developed in an immune competent 9-year-old girl. The patient's hemoglobin level was 4.8 g/dL on the day of admission. The diagnosis was achieved by exclusion of other causes of hemolytic anemia and serological evidence of recent CMV infection. The patient was successfully treated with anti-viral agents and steroids resulting in recovery from anemia. Clinicians should consider cytomegalovirus infection in the differential diagnosis of hemolytic anemia in pediatric patients.
Sujets)
Enfant , Femelle , Humains , Anémie , Anémie hémolytique , Test de Coombs , Cytomegalovirus , Infections à cytomégalovirus , Diagnostic , Diagnostic différentiel , Hémolyse , StéroïdesRésumé
Myopathies associated with anti-signal-recognition particle (SRP) antibodies usually present with severe muscle weakness and exhibit necrotizing myopathy with little inflammation pathologically. Here we report a case of a 61-year-old man who presented with subacute progressive proximal muscle weakness, dysarthria, and dysphagia. Although polymyositis was expected clinically, muscle biopsy revealed myopathic changes with degenerating fibers without definite inflammation. Further laboratory study revealed that the patient was positive for anti-SRP antibodies.
Sujets)
Humains , Adulte d'âge moyen , Anticorps , Autoanticorps , Biopsie , Troubles de la déglutition , Dysarthrie , Inflammation , Faiblesse musculaire , Muscles , Maladies musculaires , Myosite , Polymyosite , Particule de reconnaissance du signalRésumé
BACKGROUND AND OBJECTIVE: It is well known that compensation begins after acute unilateral peripheral vestibular function loss. The change of vestibulo-ocular reflex (VOR) is variable and affected by many factors. But there is no studies reported on the changes of individuals with the lapse of time. Using the rotation chair test and caloric test, we wanted to know the individual compensatory process of VOR as time progresses following an acute unilateral peripheral vestibular loss. MATERIALS AND METHODS: Subjects were patients of acute peripheral vestibular neuritis (n=19) whose nystagmus showed more than 24 hours. The follow up period was 10 weeks until the head shake nystagmus (HSN) disappeared. We measured the duration of each spontaneous nystagmus (SN) and HSN. Sinusoidal harmonic acceleration (SHA) was tested at 0.04 and at 0.08 Hz level, with the step velocity of 100 degrees per second. We also performed caloric test after HSN disappeared. RESULTS: SN and HSN each lasted 25 days and 50 days. VOR changes had an irregular pattern among individuals with gain increasing after decrement and phase lead decreasing after increment. Furthermore, the gain asymmetry was more irregular and lasted longer as well at the step velocity. Even though compensation has been reached, the caloric test revealed continuous abnormal values, which is quite different from the recovery of VOR in the rotatory test. CONCLUSION: During the early compensation period, we could recognize that the individual VOR changes recovered with a irregular pattern. On the other hand, the caloric test was not altered even after compensation.