RESUMEN
We report a 14-year-old girl with primary amenorrhea and virilization. The chromosomal analysis showed a normal 46,XX female karyotype and the hormonal assays disclosed high serum levels of testosterone (T): 450 ng/dL (normal 5-90), dehidroepiandrosterone-sulfate (DHEA-S): 690 microg/dL (normal 30-450) and 17-hydroxiprogesterone (17-OHP) >20 ng/mL (normal <2). A pelvic ultrasound disclosed a small uterus and bilateral enlargement of the ovaries, a computed axial tomographic scan of the abdomen identified a large right mass in the adrenal gland and a norcholesterol-I 131 adrenal gammagraphy revealed a functional adrenal tumor. The histological analysis of the surgical removed tumor revealed and adrenal adenoma. After surgery, a steep decline to normal serum levels of T and DHEA-S was observed, remaining an elevated level of 17-OHP: 5.4 ng/mL. During the first three months of follow up, the hirsutism declined sharply and spontaneous mammary development occurred, remaining elevated the 17-OHP serum level: 4.8 ng/mL. Prednisone 5 mg/day, was initiated decreasing the 17-OHP to normal level: 1.4 ng/mL, appearing the menarche followed by cyclical menses. One year after surgery, prednisone was withdrawn during one week, and an ACTH test and HLA typing were done, disclosing a 17-OHP response of an heterozygote for adrenal hyperplasia, and identifying B65 a subtype of B14, and DR1, that are frequently associated to adrenal hyperplasia. Previous reports have informed silent adrenal tumors associated to adrenal hyperplasia, but this is the first report of a functional adrenal tumor associated to adrenal hyperplasia.
Asunto(s)
Adenoma/diagnóstico , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Hiperplasia Suprarrenal Congénita/diagnóstico , Amenorrea/diagnóstico , Virilismo/diagnóstico , Adenoma/genética , Adolescente , Neoplasias de las Glándulas Suprarrenales/genética , Hiperplasia Suprarrenal Congénita/genética , Amenorrea/genética , Femenino , Tamización de Portadores Genéticos , Humanos , Cariotipificación , Tomografía Computarizada por Rayos X , Virilismo/genéticaRESUMEN
The prevalence of antibodies against human T-cell lymphotrophic virus (HTLV-I/II) in blood donors from the city of Monterrey, Mexico was investigated. We found that 4 out of 1017 sera (0.39%) reacted against HTLV-I/II, as determined by a passive agglutination test (PA). However, none of PA-positive sera reacted to HTLV-I/II specific polypeptides as demonstrated by Western blot. These findings indicate that the population of Monterrey has very low or no seroprevalence for HTLV-I/II.