RESUMO
Hypophysitis (HP) is a rare disease which develops secondary to chronic or acute inflammation of the pituitary gland and may cause symptoms related to pituitary dysfunction and mass compression. Lymphocytic HP is the most common subtype of primary HP, while xanthomatous HP (XHP) is considered the rarest form, with 35 reported cases, to date. A 35-year-old woman was initially admitted to a Gynecology clinic with a 2-year history of amenorrhea and headache. She was started on cabergoline 0.5 mg twice a week for macroprolactinoma. Due to persistent amenorrhea with low gonadotropins, she was referred to our Endocrinology clinic. Her pituitary function profile revealed panhypopituitarism and a 13×11×12 mm sized sellar mass with diffuse enhancement which sustained toward the infundibulum and dura was observed on the gadolinium-enhanced pituitary MRI. The patient underwent an endoscopic endonasal transsphenoidal approach for tumor resection and thick yellowish fluid draining from the lesion was observed. The histopathological diagnosis was reported as a rupture of an Rathke’s cleft cyst and an XHP. The surgery did not improve the symptoms/pituitary functions, however, headache recovered immediately after the first dose of high dose methylprednisolone treatment. The inflammatory process in a xanthomatous lesion may actually be a secondary response to mucous fluid content release from a ruptured cyst, thus recommended to classify XHP as secondary hypophysitis. Since the differentiation of XHP from other pituitary tumors may be challenging preoperatively, surgery is the major diagnostic tool and also, the most recommended therapeutic option.
RESUMO
Objective: To investigate whether there is an association between the 45bp insertion/deletion polymorphism in the uncoupling protein 2 [UCP2] gene, and obesity and/or obesity-related phenotypes
Design: A prospective analytical case control survey
Setting: Afyon Kocatepe University Medical Faculty and Afyonkarahisar State Hospital, Turkey
Subjects: A total of 138 obese cases and 75 non-obese controls from Western population of Turkey were included in this study
Interventions: Anthropometric data were obtained by measurements of weight, height and circumferences of waist; and hip and body mass index and waisthip ratio [WHR] were calculated. DNA was isolated from peripheral blood and statistical analysis was conducted using the SPSS programme [version 17.0]. The genotypes for the UCP 45 bp ins/del polymorphism were identified by polymerase chain reaction
Main outcome measures: The relationship between the 45bp insertion/deletion polymorphism in the UCP2 gene and obesity and/or obesity related phenotypes
Results: No significant difference was detected between obese cases and non-obese controls regarding genotype distribution and allele frequencies. However, the WHRs from phenotypes among obese cases having Del/Del and Ins/Del genotypes were found to be respectively higher [0.87 +/- 0.09 and 0.90 +/- 0.10] than in the ones having Ins/Ins genotypes [0.81 +/- 0.13] [p <0.05]
Conclusions: This is the first study supporting the role of the 45 bp insertion/deletion polymorphism in obesity in Turkey. Further studies with larger sample sizes may confirm these findings