Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 14 de 14
Filter
2.
Tunis Med ; 91(12): 724-8, 2013 Dec.
Article in French | MEDLINE | ID: mdl-24458676

ABSTRACT

OBJECTIVE: evaluate the assay of urinary metanephrines in diagnosis of pheochromocytoma (PH) and determine diagnostic cut-off values. METHODS: this is a retrospective study about 87 patients suspected of pheochromocytoma,whose of 24-h urinary fractionated metanephrine was measured. These cases were collected from Internal Medecine Departments (A and B) at Charles Nicolle's Hospital. Two groups of patients were studied: a pheochromocytoma group (n=33) with a histologically-proven pheochromocytoma and a control group of 54 patients. Receiver Operating Characteristic (ROC) curves were used to determine the best sensitivities and specificities. RESULTS: The analysis of biological parameters showed that means and standard deviation of urinary fractionated metanephrines in pheochromocytoma group were significantly higher than those of control group. Sensitivity and specificity of urinary normetanephrine test (95% and 98.1% respectively) were higher than those of urinary metanephrine and 3-methoxytyramine. A correlation between urinary normetanephrine and tumor size of pheochromocytoma was found. CONCLUSION: Urinary fractionated metanephrines is an efficient biochemical test for the diagnosis of pheochromocytoma.


Subject(s)
Adrenal Gland Neoplasms/diagnosis , Metanephrine/urine , Pheochromocytoma/diagnosis , Urinalysis/methods , Adolescent , Adrenal Gland Neoplasms/urine , Adult , Aged , Female , Humans , Male , Middle Aged , Pheochromocytoma/urine , Reference Values , Sensitivity and Specificity , Urinalysis/standards , Young Adult
3.
Transplant Proc ; 43(2): 568-71, 2011 Mar.
Article in English | MEDLINE | ID: mdl-21440763

ABSTRACT

INTRODUCTION: Posttransplant diabetes mellitus (PTDM) is a common, serious complication of renal transplantation. The aim of this retrospective study was to estimate the incidence and to identify potential factors predisposing to PTDM. PATIENTS AND METHODS: We evaluated 296 adult nondiabetic patients who underwent kidney transplantation at our center. PTDM was defined according to 2003 international consensus guidelines. Potential factors predisposing to PTDM were analyzed individually and simultaneously using a logistic regression model. RESULTS: Over 2054.5 years of cumulative follow-up, 51 patients (17.2%) developed diabetes corresponding to an annual incidence of 2.5%. PTDM was diagnosed after a median of 2.9 months (range: 0.2-168). The mean age of affect individuals was 33.3±7.4 years. Patients with PTDM were significantly older (P<.0005) and showed an higher body mass index (BMI; P<.004). Univariate analysis revealed that age, BMI, family history of diabetes, vascular nephropathy, and hepatitis C infection were associated with PTDM. Multivariate analysis rescaled the roles of age (relative risk [RR]=1.046/y; P<.04), BMI (RR=1.107/kg/m2, P<.05), vascular nephropathy (RR=7.06, P<.03), and hepatitis C infection (RR=2.72, P<.03) as independent factors predisposing to PTDM. CONCLUSION: Among our relatively young kidney transplant recipients, in whom only 8% received tacrolimus, PTDM was a frequent complication. We suggest that the use of oral glucose tolerance tests to screen patients identifies those predisposed to develop this complication.


Subject(s)
Diabetes Complications/diagnosis , Kidney Transplantation/methods , Adult , Diabetes Complications/epidemiology , Female , Glucose Tolerance Test , Humans , Immunosuppressive Agents/pharmacology , Incidence , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/therapy , Kidney Transplantation/adverse effects , Male , Multivariate Analysis , Postoperative Complications , Regression Analysis , Retrospective Studies , Risk Factors , Tacrolimus/pharmacology
4.
Ann Endocrinol (Paris) ; 67(3): 238-44, 2006 Jun.
Article in French | MEDLINE | ID: mdl-16840915

ABSTRACT

The authors report three cases of malignant pheochromocytomas. Metastases occurred in the liver in two cases whereas malignancy was suspected in the third case because of recurrence and local invasion. One case was pregnant at diagnosis of pheochromocytoma. Pheochromocytoma was associated to papillary thyroïd carcinoma in another case. The treatment considered was surgery in all cases.


Subject(s)
Adrenal Gland Neoplasms/pathology , Pheochromocytoma/pathology , 3-Iodobenzylguanidine , Adrenal Gland Neoplasms/diagnostic imaging , Adult , Carcinoma, Papillary/pathology , Carcinoma, Papillary/secondary , Female , Humans , Liver Neoplasms/secondary , Magnetic Resonance Imaging , Middle Aged , Neoplasm Recurrence, Local , Pheochromocytoma/diagnostic imaging , Radionuclide Imaging , Radiopharmaceuticals , Thyroid Neoplasms/pathology , Thyroid Neoplasms/secondary
5.
Ann Endocrinol (Paris) ; 65(3): 213-20, 2004 May.
Article in French | MEDLINE | ID: mdl-15277979

ABSTRACT

Acquired central diabetes insipidus (CDI) is a rare disease due to anatomic lesions of the hypothalamo-pituitary system. We discuss the etiologic and therapeutic aspects of CDI. Through 5 cases and a review of the literature. We report: Two cases of Langerhans histiocytosis, a 21 year old man and a 37 year old women. The CDI was the only endocrine manifestation in the man, but it was associated with panhypopituitarism and infiltration of the thyroid gland by histiocytosis cells in the women. One case of suprasellar germinoma, a 18 year old adolescent had hypocorticism, hypothyroidism, and hypogonadism associated with CDI and hyperprolactinemia. One case of pituitary cystic lesion with extension to the suprasellar area, a 36 year old women presenting with hypocorticism, growth hormone deficiency, and hyperprolactinemia. One case of neuro-Behçet's disease in a 47 year old man. He presented with strokes and CDI. When the CDI is isolated Langerhans Histiocytosis should be considered first. The exploration of the hypothalamo-pituitary region using MRI showed different anatomic lesions in patients with CDI. It is very difficult to determine definitive diagnosis before surgery in the cases of cystic lesions.


Subject(s)
Diabetes Insipidus, Neurogenic/etiology , Diabetes Insipidus, Neurogenic/therapy , Adolescent , Adult , Behcet Syndrome/complications , Behcet Syndrome/diagnosis , Central Nervous System Cysts/complications , Central Nervous System Cysts/diagnosis , Central Nervous System Neoplasms/complications , Central Nervous System Neoplasms/diagnosis , Female , Germinoma/complications , Germinoma/diagnosis , Histiocytosis, Langerhans-Cell/complications , Histiocytosis, Langerhans-Cell/diagnosis , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Pituitary Neoplasms/complications , Pituitary Neoplasms/diagnosis , Tomography, X-Ray Computed
6.
Ann Endocrinol (Paris) ; 65(3): 233-7, 2004 May.
Article in French | MEDLINE | ID: mdl-15277982

ABSTRACT

Ectopic thyroid is a rare condition (1/4000 to 1/8000 among patients with hypothyroidism). The underlying etiological pathogenic mechanisms remain unknown. Diagnosis is established on the basis of imaging findings. We report two cases of hypothyroidism in adult females who had ectopic sublingual thyroid glands. The first patient was a 20-Year-old woman who had been treated for hypothyroidism since the age of 13 Years before the diagnosis of ectopic thyroid 7 Years later. In both patients, the thyroid gland was palpable. In the first patient the physical examination revealed an ectopic sublingual gland. Scintigraphy confirmed the diagnosis in both patients. The CT-scan and MRI were positive in the second patient. Hormonal substitution therapy using L-thyroixine was given.


Subject(s)
Choristoma/diagnosis , Mouth Diseases/diagnosis , Thyroid Gland , Adult , Choristoma/complications , Female , Humans , Hypothyroidism/drug therapy , Hypothyroidism/etiology , Magnetic Resonance Imaging , Mouth Floor , Thyroxine/therapeutic use , Tomography, X-Ray Computed
8.
J Gynecol Obstet Biol Reprod (Paris) ; 32(3 Pt 1): 261-5, 2003.
Article in French | MEDLINE | ID: mdl-12773930

ABSTRACT

We discuss the causes of virilism in pregnancy and the impact of hyperandrogeny on the female foetus. We report a case of virilism in a 28-year-old, gravida 1, para 1 patient with normal pregnancy and review the literature. After conception, the patient had been well until the 18th week of gestation, when she developed signs of virilization; her serum testosterone was markedly elevated. She delivered of a normal male infant at term. After delivery, signs of virilization regressed with normalization of testosterone level but a wide mass of the left ovary that persisted for 8 months. The histological study of the tumor showed luteinized thecoma. Luteomas and hyper-reactio luteinalis were the principal causes of virilism in pregnancy, thecomas are rare.


Subject(s)
Ovarian Neoplasms/pathology , Pregnancy Complications, Neoplastic , Thecoma/pathology , Virilism/diagnosis , Adult , Female , Humans , Ovarian Neoplasms/blood , Pregnancy , Pregnancy Complications, Neoplastic/blood , Testosterone/blood , Thecoma/blood
9.
Nephrologie ; 24(2): 95-9, 2003.
Article in French | MEDLINE | ID: mdl-12723515

ABSTRACT

We report a case of a 22 years old type 1 diabetic man with a history of weight loss, weakness, anorexia, fever and recurrent urinary tract infection since February 2001. In April 2001, he presented anuria due to obstructive acute renal failure. Hepatosplenomegaly and lymphadenopathy were absent at physical examination. Laboratory tests revealed a high level of gamma globulin (53.4 g/l) and anaemia (haemoglobin 7.7 g/100 ml) without leukopenia and thrombocytopenia. CT scan showed multiple retroperitoneal lymphadenopathies causing compression of the two ureters, hydro-ureter associated with hydronephrosis, hepatosplenomegaly and multiple pulmonary nodes. Lymphadenopathies, anaemia, high level of gamma globulin, high titres of anti-leishmanial antibodies and the excellent outcome after treatment with meglumine antimoniate (Glucantime) confirmed visceral leishmaniasis. This report documented an unusual clinical presentation of Visceral leishmaniasis in a diabetic patient.


Subject(s)
Acute Kidney Injury/complications , Diabetes Mellitus, Type 1/complications , Leishmaniasis, Visceral/diagnosis , Adult , Antibodies, Protozoan/blood , Antiprotozoal Agents/therapeutic use , Humans , Leishmaniasis, Visceral/complications , Leishmaniasis, Visceral/drug therapy , Male , Meglumine/therapeutic use , Meglumine Antimoniate , Organometallic Compounds/therapeutic use , Tomography, X-Ray Computed
10.
Ann Endocrinol (Paris) ; 64(6): 426-7, 2003 Dec.
Article in French | MEDLINE | ID: mdl-15067246

ABSTRACT

Vasculitis with central diabetes insipidus is a rare condition which must be recognized for an appropriate management. We report a case of Behçet disease with central diabetes insipidus. A forty seven year old men presented recurring oral and genital ulcers, skin lesions, polyarthralgia. Two years later, he showed right uveitis and central diabetes insipidus without dysfunction of the pituitary gland. Computed tomographic scan showed normal neurohypophysis and pituitary gland. Later on, he presented hemiplegia. The cerebral computed tomographic scan showed hypodense lesions. Central diabetes insipidus should not be systematically searched because it is a rare feature of the Behçet disease.


Subject(s)
Behcet Syndrome/complications , Diabetes Insipidus, Neurogenic/etiology , Behcet Syndrome/diagnosis , Brain Ischemia/etiology , Deamino Arginine Vasopressin/therapeutic use , Diabetes Insipidus, Neurogenic/drug therapy , Hemiplegia/etiology , Humans , Magnetic Resonance Imaging , Male , Middle Aged
11.
Rev Med Interne ; 23(10): 857-61, 2002 Oct.
Article in French | MEDLINE | ID: mdl-12428490

ABSTRACT

INTRODUCTION: Vasculitis is a rare complication of antithyroid drugs reported with propylthiouracil, carbimazole, methimazole and we describe the first case with benzylthyouracil. Renal involvement during thyroid auto-immune diseases and during vasculitis as complication of antithyroid drugs will be discussed. EXEGESIS: We present a case study of 28-year-old female patient with Graves' disease diagnosed in 1996 and treated by benzylthiouracil for 2 years. The thyroid function was poorly controlled, so surgical treatment was indicated in May 1998. One month later, she developed vasculitis with pulmonary and renal involvement. Her renal function deteriorated rapidly. On admission, the additional laboratory findings showed hematuria, proteinuria of 1.44 g/day and serum creatinine level at 1000 mumol/l. She had myeloperoxidase-anti neutrophil cytoplasmic antibody, antithyroglobulin and antimicrosome antibodies. A renal biopsy revealed pauci-immune crescentic glomerulonephritis with 75% sclerous crescents. Chest-X-ray showed unilateral alveolar shadowing and a bronchio-alveolar lavage revealed lymphocytic alveolitis. She was treated with high dose of prednisolone and cyclophosphamide. After a follow-up of 18 months, the serum creatinine level decreased at 186 mumol/l and chest-X-ray returned to normal. CONCLUSION: Some cases of vasculitis associated with anti-thyroid drug treatment are reported.


Subject(s)
Glomerulonephritis/chemically induced , Graves Disease/drug therapy , Lung Diseases, Interstitial/chemically induced , Thiouracil/analogs & derivatives , Thiouracil/adverse effects , Vasculitis/chemically induced , Adult , Antibodies, Antineutrophil Cytoplasmic/analysis , Autoantibodies/analysis , Female , Humans , Thiouracil/therapeutic use
12.
Ann Endocrinol (Paris) ; 63(3): 235-9, 2002 Jun.
Article in French | MEDLINE | ID: mdl-12193881

ABSTRACT

Diabetic fibrous mastoplasty or diabetic fibrous breast disease is a benign condition rarely observed. First described in 1984, it can lead to misdiagnosis because it simulates breast cancer. Diabetic fibrous mastoplasty usually occurs in patients with autoimmune disorders, particularly in patients with longstanding and complicated insulin-dependent diabetes mellitus. We present a case of fibrous mastoplasty in a patient with insulin-dependent diabetes mellitus known for 17 years. The clinical and radiological features and the clinical course are illustrative. We discuss the different pathogenic theories put forward.


Subject(s)
Diabetes Mellitus, Type 1/complications , Fibrocystic Breast Disease/diagnosis , Adult , Biopsy , Breast Neoplasms , Diagnosis, Differential , Female , Fibrocystic Breast Disease/etiology , Fibrocystic Breast Disease/immunology , Humans , Mammography , Ultrasonography
13.
Diabetes Metab ; 27(5 Pt 1): 584-90, 2001 Nov.
Article in English | MEDLINE | ID: mdl-11694858

ABSTRACT

OBJECTIVE: To determine the epidemiological and clinical characteristics of 299 uremic diabetics at the initiation of renal replacement therapy (RRT) and to evaluate their morbidity and the factors influencing their mortality during the dialysis period. PATIENTS AND METHODS: All patients starting RRT for diabetic end-stage renal disease (ESRD) at Charles Nicolle Hospital of Tunis during a period of seven years (1990-1996) constituted the study population. During the follow-up period ended on December 31, 2000, all morbid events, hospitalizations and deaths were recorded. Multivariate analysis according to the Cox proportional hazards model was performed to identify the predictors of mortality. RESULTS: There were 238 type 2 (79.6%) and 61 type 1 diabetics (20.4%) representing 20.3% of all patients accepted for RRT. The mean age at the onset of RRT was 53.16 +/- 12.43 years (range: 23 to 80 years). A poor glycemic control was observed in 46.7% of type 2 diabetics and in 67.3% of type 1 diabetics (p=0.0055). A third of patients started RRT in emergency conditions and 91% required a temporary vascular access. At the time of onset of RRT, 86.7% of patients were hypertensive and 52.1% had a nephrotic syndrome. Blindness was observed in 22.9% of type 1 diabetics and in 7.5% of type 2 diabetics (p=0.0014). During the follow-up period, 217 patients died representing a rate of 22% patient-years, 26.7% of these deaths occurred during the first 3 months of RRT and 53% were attributed to infectious or cardiovascular complications. Actuarial survival rates were 68.4%, 59.6% and 45.3% at 1, 2 and 4 years, respectively. Age, co-morbidities and conditions of onset of RRT were independently correlated with survival time. CONCLUSION: Diabetes is a frequent cause of ESRD in Tunisia, the delayed referral to a nephrologist and coexistence of serious co-morbidities at the initiation of RRT resulted in a high rate of early death. Greater efforts should be made in our country in view of improving the quality of medical care of uremic diabetics before and during RRT.


Subject(s)
Diabetes Mellitus, Type 1/physiopathology , Diabetes Mellitus, Type 2/physiopathology , Diabetic Nephropathies/therapy , Kidney Failure, Chronic/therapy , Renal Replacement Therapy , Adolescent , Adult , Age of Onset , Blindness/epidemiology , Comorbidity , Confidence Intervals , Diabetic Nephropathies/complications , Diuresis , Heart Diseases/epidemiology , Hemiplegia/epidemiology , Humans , Kidney Failure, Chronic/complications , Middle Aged , Retrospective Studies , Risk , Stroke/epidemiology , Tunisia
SELECTION OF CITATIONS
SEARCH DETAIL
...