ABSTRACT
PURPOSE: High GH and IGF I levels increase tubular phosphate reabsorption in patients with acromegaly. We aimed to investigate the utility of serum phosphorus levels as an indicator for predicting chance of remission in acromegaly patients. DESIGN: Fifty-one patients (n: 51; F: 24, M: 27) with diagnosis of acromegaly were included in the study. Plasma IGF-1, Phosphorus (P) and nadir GH levels on oral glucose tolerance test (OGTT) at the time of diagnosis were analysed retrospectively. Patients were classified into two groups according to their plasma P levels; P ≤ 4.5 mg/dl (Group-1, n: 23, 45.1%), P > 4.5 mg/dl (Group-2, n: 28, 54.9%). Two groups were compared according to remission status; remission (n: 27) and non-remission (n: 24). Remission was defined with absence of clinical symptoms, normal plasma IGF-1 (adjusted for age and gender) and GH levels (<1 mcg/dl) at least 3 months after initial treatment. RESULTS: Serum P levels decreased significantly after treatment in both groups (p < 0.001). There was a significant correlation between baseline phosphorus levels and remission rates, nadir GH in OGTT, pituitary adenoma size and Ki-67 scores (p = 0.001, r: -0.51; p = 0.01, r: 0.44; p = 0.001, r: 0.52; p = 0.02, r: 0.71, respectively). Mean baseline P levels were significantly higher in patients with non-remission (4.8 vs 4.2, P < 0.001). Logistic regression analysis did not reveal an independent effect on remission with any of these risk factors. CONCLUSION: High serum P levels may be an indicator for a low likelihood of onset of remission in acromegaly patients. Further studies with wider spectrum are needed to make specific suggestions.
Subject(s)
Acromegaly/blood , Biomarkers/blood , Human Growth Hormone/blood , Insulin-Like Growth Factor I/analysis , Phosphorus/blood , Acromegaly/therapy , Adult , Female , Glucose Tolerance Test , Humans , Male , Middle Aged , Remission Induction , Retrospective StudiesABSTRACT
WHAT IS KNOWN AND OBJECTIVE: Somatostatin analogs control GH/IGF-1 excess in acromegaly. Somatostatin receptors also mediate the complex effects of somatostatin on the gastrointestinal tract and may be defensive in inflammatory bowel diseases, such as ulcerative colitis. We present a patient who showed good response to long-acting octreotide (OCT-LAR) treatment in terms of both acromegaly and ulcerative colitis (UC). CASE SUMMARY: A 58-year-old female patient with diagnosis of acromegaly and ulcerative colitis was started on long-acting somatostatin treatment as a first-line treatment for acromegaly as she refused to undergo transsphenoidal surgery. During the follow-up period, a significant amelioration was also observed in the course of ulcerative colitis, and clinical remission of both diseases was achieved uneventfully. WHAT IS NEW AND CONCLUSION: Somatostatin appears to be a promising candidate in the treatment of inflammatory bowel diseases.
Subject(s)
Acromegaly/drug therapy , Colitis, Ulcerative/drug therapy , Delayed-Action Preparations/administration & dosage , Somatostatin/administration & dosage , Colitis, Ulcerative/metabolism , Female , Humans , Insulin-Like Growth Factor I/metabolism , Middle Aged , Octreotide/administration & dosageABSTRACT
A mass at fat density in the parotid gland: dermoid cyst or lipoma. Dermoid cysts (DC) of the head and neck are uncommon and account for only 7% of all dermoid cysts in the body. DCs of the parotid gland are even rarer. In this article, a 42-year-old female patient with DC of the parotid gland is presented and discussed with a brief review of the literature. Radiologic findings suggested that the mass was a lipoma, but observation of a hair in the cyst during surgery changed the clinical diagnosis to DC; this suspicion was confirmed by pathological analysis. Although DCs are rare among the parotid masses, they should be kept in mind during the differential diagnosis.
Subject(s)
Dermoid Cyst/pathology , Lipoma/pathology , Parotid Neoplasms/pathology , Adult , Dermoid Cyst/surgery , Diagnosis, Differential , Female , Humans , Parotid Neoplasms/surgeryABSTRACT
Orbital hydatid cyst is rare. Hydatid cysts in other organ systems are not mentioned in the previous papers emphasizing an orbital hydatid. Four cases of inferiorly located retrobulbar hydatid cysts have been reported previously. We present a rare inferiorly located retrobulbar hydatid cyst case in a Turkish child that also had multiple hydatid lesions in the lungs and the liver. We present the orbital CT and MRI findings. Preoperative diagnosis is important to avoid cyst rupture. Although hydatid disease is prevalent in South America, Australasia, the Middle East and Mediterranean countries, increased travel-isolated cases can be seen anywhere in the world.
Subject(s)
Echinococcosis/diagnostic imaging , Echinococcosis/pathology , Magnetic Resonance Imaging , Orbital Diseases/diagnostic imaging , Orbital Diseases/pathology , Tomography, X-Ray Computed , Child, Preschool , Echinococcosis/surgery , Humans , Male , Orbital Diseases/surgeryABSTRACT
Orbital hydatid cyst is rare. We present a case with CT and MRI, emphasizing the superiority of the latter.
