ABSTRACT
Vegetative dysfunction with episodes of tachycardia, hypertension, paleness, general hyperhidrosis, subfebrile condition, hyperglycemia manifest first among clinical symptoms of chromaffinoma. In respect to these symptoms severity the crises observed in chromaffinoma are classified as minor or major. Major crises may be cerebral, epileptiform, cardial and abdominal. The crises are attributed to hypercatecholaminergic arterial hypertension. A reliable laboratory diagnosis of the disease involves urinary measurements of catecholamines and their metabolites. Manifold increase of the latter concentrations may serve the diagnostic indication. The only effective treatment is the removal of the tumor from the adrenals.
Subject(s)
Adrenal Gland Neoplasms/diagnosis , Nervous System Diseases/diagnosis , Pheochromocytoma/diagnosis , Adolescent , Adrenal Gland Neoplasms/complications , Adrenal Gland Neoplasms/surgery , Adrenal Gland Neoplasms/urine , Adrenalectomy , Adult , Aged , Catecholamines/urine , Child , Chronic Disease , Female , Humans , Hypertension/diagnosis , Male , Middle Aged , Nervous System Diseases/etiology , Neurologic Examination , Pheochromocytoma/complications , Pheochromocytoma/surgery , Pheochromocytoma/urine , Syndrome , Vanilmandelic Acid/urineSubject(s)
Adrenal Gland Neoplasms/diagnosis , Myasthenia Gravis/diagnosis , Neoplasms, Second Primary/diagnosis , Pheochromocytoma/diagnosis , Thymoma/diagnosis , Thymus Neoplasms/diagnosis , Adrenal Gland Neoplasms/complications , Humans , Male , Middle Aged , Myasthenia Gravis/complications , Pheochromocytoma/complications , Thymoma/complications , Thymus Neoplasms/complicationsABSTRACT
Three cases of insulinoma-related neuropsychic disturbances and literature data are considered. Special emphasis is given to polymorphism of epileptiform syndrome, concomitant disphoric paroxyms and lethargy. A case of a rare syndrome coma vigil is described in the advanced stage of the disease. The discussion covers pathogenetic mechanisms and differential diagnosis.
Subject(s)
Hypoglycemia/complications , Insulin/metabolism , Insulinoma/metabolism , Pancreatic Neoplasms/metabolism , Seizures/etiology , Syncope/etiology , Adult , Female , Humans , Insulin Secretion , Insulinoma/complications , Pancreatic Neoplasms/complicationsABSTRACT
Hypoglycemic disease is characterized by neurasthenic and encephalopathic syndromes. Three stages, an initial one, a stage marked by pronounced alterations and rehabilitation one (after insulinoma removal) were distinguished. Hypoglycemic paroxysms manifest themselves by syncopal, epileptic, pseudostroke and psychomotor excitation. Of paramount importance for diagnosis are EEG studies during fasting or rastinon test. Surgical removal of insulinoma results in normalization of neurological disturbances.
Subject(s)
Consciousness Disorders/etiology , Hypoglycemia/complications , Insulinoma/metabolism , Pancreatic Neoplasms/metabolism , Seizures/etiology , Adolescent , Adult , Aged , Female , Humans , Insulinoma/complications , Insulinoma/psychology , Male , Middle Aged , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/psychologyABSTRACT
A clinical picture of the disease was analyzed in 55 patients with primary aldosteronism due to adrenal aldosteronoma. A crisis variant of the course in arterial hypertension was detected in 50% of the patients. Its comparison with morphological signs of the adrenals enabled the authors to reveal that the crisis of arterial hypertension was accompanied by adrenal medullary hyperplasia and hyperfunction.
Subject(s)
Hyperaldosteronism/complications , Hypertension/complications , Adrenal Cortex Neoplasms/complications , Adrenal Cortex Neoplasms/metabolism , Adrenal Gland Neoplasms/complications , Adrenocortical Hyperfunction/complications , Adult , Aldosterone/metabolism , Female , Humans , Hyperaldosteronism/etiology , Hypertension/etiology , Male , Middle Aged , Pheochromocytoma/complicationsABSTRACT
The immune status and the time course of ophthalmological indices were studied in 54 patients with endocrine ophthalmopathy during bromocriptine therapy. Twelve weeks after the onset of therapy indices of the immune status returned to normal in parallel with the regression of ophthalmological symptoms. In the control group (20 patients with endocrine ophthalmopathy who did not receive bromocriptine) significant improvement of the clinicoimmunological status was unnoticed. An increase in the number of T-lymphocytes, a decrease in the number of B-lymphocytes, an increase in the level of IgG, and a decrease in the levels of IgA and IgM were observed during bromocriptine therapy. The time of the immunity indices could serve as a criterion of bromocriptine therapeutic efficacy in patients with endocrine ophthalmopathy.
Subject(s)
Bromocriptine/therapeutic use , Eye Diseases/immunology , Thyroid Diseases/immunology , Adult , Aged , Antibody Formation/drug effects , B-Lymphocytes/immunology , Chronic Disease , Combined Modality Therapy , Drug Evaluation , Eye Diseases/drug therapy , Eye Diseases/etiology , Female , Humans , Immunity, Cellular/drug effects , Immunoglobulins/immunology , Male , Middle Aged , T-Lymphocytes/immunology , Thyroid Diseases/complications , Thyroid Diseases/drug therapySubject(s)
Adrenal Gland Neoplasms/diagnosis , Carcinoma/diagnosis , Multiple Endocrine Neoplasia/diagnosis , Pheochromocytoma/diagnosis , Thyroid Neoplasms/diagnosis , Adrenal Gland Neoplasms/genetics , Adrenal Gland Neoplasms/pathology , Adult , Carcinoma/genetics , Carcinoma/pathology , Chromosome Deletion , Chromosomes, Human, Pair 20 , Humans , Male , Multiple Endocrine Neoplasia/genetics , Multiple Endocrine Neoplasia/pathology , Pheochromocytoma/genetics , Pheochromocytoma/pathology , Thyroid Neoplasms/genetics , Thyroid Neoplasms/pathologyABSTRACT
Altogether 34 patients with corticosteroma were examined. In 29 (85%) of them accurate topical diagnosis was established as a result of ultrasonic investigation. All erroneous results were obtained only for corticosteromas of small sizes (4 cm and less in diameter). Tumors not exceeding 4 cm in diameter were benign in 88% of cases. If tumor sizes were over 4 cm, they were malignant in 89%. The earliest possible investigation for the presence or absence of a tumor was indicated to patients with hypercorticism.
Subject(s)
Adrenal Cortex Neoplasms/diagnosis , Adrenal Cortex/pathology , Corticosterone/metabolism , Ultrasonography , Adolescent , Adrenal Cortex/metabolism , Adrenal Cortex Neoplasms/metabolism , Adult , Diagnosis, Differential , Humans , Middle AgedSubject(s)
Adrenal Glands/physiopathology , Hypertension/diagnosis , Adrenal Cortex Function Tests , Adrenal Glands/diagnostic imaging , Adult , Diagnosis, Differential , False Negative Reactions , Humans , Hyperaldosteronism/diagnosis , Middle Aged , Radionuclide Imaging , Tomography, X-Ray ComputedABSTRACT
Renal parenchyma, and the juxtaglomerular apparatus in particular, was studied in 23 patients with verified diagnosis of pheochromocytoma. Intraoperative renal biopsy was performed in 21 cases, and kidneys obtained at nephrectomy or autopsy were examined in 2 cases. Twenty-one patients were examined following the removal of pheochromocytoma (2 patients died). Arterial BP returned to normal in 86.4%, and residual hypertension due to continuous hyperfunction of the juxtaglomerular apparatus in the presence of hypertensive angiosclerosis was recorded in 13.6%. Tubular epithelial atrophy of varying markedness, associated with renal ischemia, was detected in all cases. The pathogenetic contribution of the renin-angiotensin system to pre- and postoperative hypertension in pheochromocytoma patients is discussed.
Subject(s)
Adrenal Gland Neoplasms/complications , Hypertension/pathology , Kidney/pathology , Pheochromocytoma/complications , Adolescent , Adrenal Gland Neoplasms/surgery , Adult , Atrophy , Female , Humans , Hypertension/etiology , Male , Middle Aged , Pheochromocytoma/surgeryABSTRACT
A comparative assessment of the results of differential-diagnosis load tests and morphologic changes in adrenal tissue removed at surgery has been carried out in patients with arterial hypertension and low-renin hyperaldosteronism. Assessment of plasma aldosterone variations in response to load tests has shown this parameter to be unrelated to the structure of aldosteroma, either before or after the test. Different patterns of aldosterone production control were demonstrated in cases of diffuse-nodular and adenomatous adrenal changes. The study has provided additional information on the pathogenesis of this condition.
Subject(s)
Adrenal Cortex/pathology , Hyperaldosteronism/pathology , Renin/blood , Adult , Aldosterone/blood , Enzyme Repression , Humans , Hyperaldosteronism/blood , Hyperplasia , Middle Aged , Renin/biosynthesisABSTRACT
The authors reported the results of parlodel therapy of 18 patients with diffuse toxic goiter complicated by endocrine ophthalmopathy. The patients ranged in age from 24 to 59 with a period of disease from 3 months to 10 years and more. The drug was given for 6 weeks at a dose of 2.5 mg twice a day after meals, a course dose varied from 150 to 225 mg. A radioimmunoassay was used to determine T3, T4 and TTH, the patients underwent a thorough ophthalmological examination. Six weeks after parlodel therapy was initiated, a decrease in the TTH level up to normal values was observed in parallel with the regression of clinical signs of endocrine ophthalmopathy. The use of parlodel did not change considerably the level of the thyroid hormones T3 and T4.
Subject(s)
Bromocriptine/therapeutic use , Graves Disease/drug therapy , Adult , Female , Graves Disease/physiopathology , Humans , Male , Middle Aged , Thyrotropin/blood , Thyroxine/blood , Time Factors , Triiodothyronine/bloodABSTRACT
Sixty-one patients with chromaffinoma were examined by echography. Of these, 6 patients (9.8%) had extraadrenal tumors. Application of echography permitted a correct topical diagnosis to be made in 5 patients. In 2 persons, the tumor was located in Zuckerkandl's fascia, in 2 in the paraaortal ganglia at the level of the splenic vein and the left hilus renalis, and in 1 patient, it was located in the urinary bladder. In one of the cases, no chromaffinoma was found. Since the majority of extraadrenal chromaffinomas (96%) are located in the retroperitoneal space echography can successfully be used for diagnosing such tumors with the exception of intrathoracic tumors which cannot be visualized in connection with the presence of air in the lungs. In such cases use should be made of computer-aided tomography.
Subject(s)
Nervous System Neoplasms/diagnosis , Pheochromocytoma/diagnosis , Ultrasonography , Urinary Bladder Neoplasms/diagnosis , Adolescent , Adult , Child , Humans , Middle AgedSubject(s)
Adenocarcinoma/metabolism , Adenoma/metabolism , Adrenal Cortex Hormones/metabolism , Adrenal Cortex Neoplasms/metabolism , Cushing Syndrome/etiology , Neoplasms, Multiple Primary , Adenocarcinoma/pathology , Adenoma/pathology , Adrenal Cortex Neoplasms/pathology , Female , Humans , Middle AgedSubject(s)
Adenoma, Islet Cell/diagnosis , Cerebrovascular Disorders/diagnosis , Epilepsy/diagnosis , Hypoglycemia/diagnosis , Insulinoma/diagnosis , Pancreatic Neoplasms/diagnosis , Adolescent , Adult , Diagnostic Errors , Female , Humans , Hyperinsulinism/complications , Hypoglycemia/etiology , Insulinoma/metabolism , Male , Middle Aged , Pancreatic Neoplasms/metabolismABSTRACT
The authors provide a clinical example illustrating difficulties in the diagnosis of pheochromocytoma in a patient with infarction-like lesions in the heart, marked proteinuria, and diverse symptomatics due to excess catecholamine secretion by the tumor.
