Morphofunctional Assessment beyond Malnutrition: Fat Mass Assessment in Adult Patients with Phenylketonuria-Systematic Review.

Morphofunctional assessment was developed to evaluate disease-related malnutrition. However, it can also be used to assess cardiometabolic risk, as excess adiposity increases this risk. Phenylketonuria (PKU) is the most prevalent inherited metabolic disease among adults, and obesity in PKU has recently gained interest, although fat mass correlates better with cardiometabolic risk than body mass index. In this systematic review, the objective was to assess whether adult patients with PKU have higher fat mass than healthy controls. Studies of adult PKU patients undergoing dietary treatment in a metabolic clinic reporting fat mass were included. The PubMed and EMBASE databases were searched. Relevance of articles, data collection, and risk of bias were evaluated by two independent reviewers. Ten articles were evaluated, six with a control group, including 310 subjects with PKU, 62 with mild hyperphenylalaninemia, and 157 controls. One study reported a significant and four a tendency towards an increased fat mass in all patients or only females with PKU. Limitations included not having a healthy control group, not reporting sex-specific results and using different techniques to assess fat mass. Evaluation of fat mass should be included in the morphofunctional assessment of cardiometabolic risk in adult patients with PKU.

[Late onset hypopituitarism due to hypoplasia of the adenohypophysis with invisible stalk and ectopic neurohypophysis in a 67-year-old patient]. / Inicio tardío de hipopituitarismo debido a hipoplasia adenohipofisaria y ausencia de tallo con neurohipófisis ectópica en un paciente de 67 años de edad.

Congenital hypopituitarism due to pituitary stalk and anterior pituitary hypoplasia accompanied by an ectopic posterior pituitary lobe is a rare disorder causing multiple hormone deficiencies. Clinical signs can be present at birth (hypoglycemia, prolonged jaundice and micropenis) and there can be severe growth restriction. Therefore, diagnosis is usually performed in childhood. We present the uncommon case of a 67-year-old man with hypopituitarism due to hypoplasia of the anterior pituitary and pituitary stalk together with an ectopic posterior pituitary who presented symptoms of hyponatremia due to adrenocorticotropic hormone deficiency.

Inicio tardío de hipopituitarismo debido a hipoplasia adenohipofisaria y ausencia de tallo con neurohipófisis ectópica en un paciente de 67 años de edad / Late onset hypopituitarism due to hypoplasia of the adenohipophysis with invisible stalk and ectopic neuro hipophysis in 67 years old patient

El hipopituitarismo congénito por hipoplasia conjunta de tallo hipofisario e hipófisis anterior acompañada de neurohipófisis ectópica es un trastorno raro que causa múltiples deficiencias en la producción de hormonas. Todo ello puede conducir a signos clínicos en el momento del nacimiento (hipoglucemia, ictericia prolongada y micropene) y retraso severo del crecimiento. Por lo tanto, su diagnóstico se realiza habitualmente en edad infantil. Aquí presentamos un raro caso de un paciente de 67 años de edad con hipopituitarismo por una hipoplasia de la hipófisis anterior y el tallo hipofisario, junto con neurohipófisis ectópica diagnosticado por clínica de hiponatremia, debido a una deficiencia de corticotropina (ACTH)(AU)

Congenital hypopituitarism due to pituitary stalk and anterior pituitary hypoplasia accompanied by an ectopic posterior pituitary lobe is a rare disorder causing multiple hormone deficiencies. Clinical signs can be present at birth (hypoglycemia, prolonged jaundice and micropenis) and there can be severe growth restriction. Therefore, diagnosis is usually performed in childhood. We present the uncommon case of a 67- year-old man with hypopituitarism due to hypoplasia of the anterior pituitary and pituitary stalk together with an ectopic posterior pituitary who presented symptoms of hyponatremia due to adrenocorticotropic hormone deficiency(AU)