Patterns of pituitary adenoma among adult Sudanese patients

The objective of this study is to determine the clinical presentation and hormonal secretions of patients with pituitary adenomas. This is a descriptive, prospective study on 53 adult Sudanese patients with pituitary adenoma. Only adults [16 years or more] were included. The study was conducted in Al-Shaab Teaching Hospital in the period from January 2001 to February 2007. Twenty eight [52.8%] patients were females and 25 [47.2%] were males. Their ages ranged between 16 -80 years [mean 40.8 +/- 15.6 years]. Twenty seven [50.9%] patients had functioning pituitary adenomas [FPA] and 26 [49.1%] patients had nonfunctioning pituitary adenomas [NFPA]. Hormonal secretion of the adenomas was found to be prolactin in 16 patients [14 females and 2 males], growth hormone in 8 patients [3 females and 5 males], ACTH in 2 patients [one female and one male] and TSH in one female. Macroadenoma was found in 44 patients [83%], while microadenoma was found in 9 patients. All non functioning adenomas were found to be macroadenomas, while functioning adenomas were found in 18 patients with macroadenoma and in 9 patients with microadenoma. In our series all NFPAS were macroadenomas. They were usually discovered late after assuming mass effect or incidentally on imaging for other reasons. Patients with functioning adenomas tend to present earlier with hormonal dysfunction and hence are diagnosed earlier before the tumors assume big sizes. Prolactin secreting tumors are the commonest among functioning pituitary adenomas and tend to predominate in females

Ataxia telangiectasia: findings from two families in the Sudan

We report herein two families with ataxia telangiectasia. Patients in both families fulfilled the diagnostic criteria and showed unusual presentations that are rarely reported in literature. No patient developed malignancy yet. To the best of our knowledge this is the first report on Ataxia telangiectasia from Sudan

Pott's disease of the spine: findings from Sudan

Spinal tuberculosis is the commonest type of skeletal tuberculosis. It has variable presentations, but commonly presents with backache and weakness of lower limbs. Its prevalence is increasing world wide after the epidemic of HIV. To the best of our knowledge there are no studies addressing the clinical presentation of this disease in Sudan. In this study we included 84 patients with spinal tuberculosis. The study was conducted in two major hospitals in Khartoum in the period from January 2002 to December 2006. Results show males constituted 46 patients [54.8%] and females 38 [45.2%]. Their ages ranged between 16 years and 80 years, the mean age was 44.46 +/- SD 16.99. All patients had pain and or tenderness at the site of the lesion. Paraplegia or paraparesis was reported in 36 patients [42.8%], quadriplegia or quadriparesis in 25 [30%], Sciatica and root weakness in 22 [26.1%] and right brachial monoplegia in one patient. Evidence of active pulmonary tuberculosis was found in 15 patients [17.8%], abdominal tuberculosis in 7 patients [8.3%], lymphatic Tuberculosis in 1 patient [1.2%]. Cervical vertebrae were affected in a total of 26 patients [30.9%], the dorsal in 39 patients [46.4%] and the lumbar in 30 patients [35.7%]. One vertebra was affected in 3 patients [2.57%], 2 adjacent vertebrae in 48 patients [57.14%], 3 vertebrae in 24 patients [28.57%], 4 vertebrae in 4 patients [4.76%], 5 vertebrae in 1 patient [1.19%] and 6 vertebrae in 4 patients [4.76%]. HIV test was negative in all patients. Tuberculin test was positive in 80 patients [95%] and negative in 4 patients [5%]

Osteopetrosis: a rare disease with rare presentations

At least eight types of osteopetrosis have been described in humans. The primary underlying mechanism involved in all forms is the failure of normal osteoclastic bone resorption. Osteopetrosis tarda, the benign adult form, is inherited as an autosomal dominant trait. Patients typically are asymptomatic and have good long-term survival rates because bone marrow failure rarely occurs. A more common and malignant form, osteopetrosis congenita, presents in infancy and results in bone marrow failure caused by complete replacement of the marrow spaces with osteoclasts. Other forms are rare and have variable manifestations. In this communication we report 2 cases on possibly a rare form of osteopetrosis, the intermediate form