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O Bisfenol A (BPA) é um produto químico desregulador endócrino com potencial papel em cânceres endócrinos. Entretanto, os efeitos do BPA sobre as glândulas salivares têm sido pouco explorados. Investigamos o impacto da exposição in vivo subcrônica ao BPA e seus efeitos in vitro nas linhagens celulares do carcinoma mucoepidermóide de glândula salivar. Camundongos machos e fêmeas foram expostos ao BPA (30.000 µg/kg/dia). Analisamos glândulas salivares sublinguais e submandibulares desses camundongos C56BL6 e camundongos fêmeas submetidos a ovariectomia. A concentração de BPA nas glândulas salivares foi avaliada por cromatografia gasosa acoplada à espectrometria de massa com armadilha de íons. A expressão dos receptores ERα e ERß foi avaliada em amostras de glândulas salivares de camundongos e linhagens celulares UM-HMC-1 e UM-HMC-3A pelo qRT-PCR, RNA mensageiro. Foram avaliadas in vitro, a viabilidade celular p63 e Ki-67, a imunoglobulina e a expressão de proteínas-alvo relacionadas às vias de sobrevivência/proliferação. O BPA prejudicou a morfologia das glândulas submandibulares e sublingual, particularmente nas fêmeas, e aumentou a expressão dos receptores de estrogênio, também acompanhado por um acúmulo significativo de BPA nestes tecidos. Ao contrário, a redução dos níveis de estrogênio pelo modelo de ovariectomia teve um leve impacto nas alterações morfológicas induzidas pela BPA. In vitro, a BPA não afetou a proliferação de células neoplásicas, mas aumentou a expressão dos receptores de p63 e estrogênio. A fosforilação ERK1/2 foi aumentada enquanto a fosforilação AKT e NF-κB foi reduzida. Os dados destacam um efeito nocivo do BPA sobre os tecidos das glândulas salivares e células tumorais. Os dependentes de estrogênio podem combinar o mecanismo de acúmulo de BPA, juntamente com a via de sinalização pró-sobrevivência e aumento da expressão da p63.
Bisphenol A (BPA) is an endocrine-disrupting chemical with potential role in endocrine cancers. However, BPA effects on the salivary glands have been barely explored. We investigated the impact of in vivo sub-chronic exposure to BPA and its in vitro effects on salivary gland mucoepidermoid carcinoma cell lines. Male and female mice were exposed to BPA (30,000 µg/kg/day). We analyzed sublingual and submandibular salivary glands from sham C56BL6 mice and that female ones underwent ovariectomy. Concentration of BPA in salivary glands was evaluated by gas chromatography coupled to ion trap mass spectrometry. Expression of ERα and ERß receptors was assessed in mouse salivary gland samples and cell lines UM-HMC-1 and UM-HMC3A by qRT-PCR, mARN. In vitro, cell viability p63 and Ki-67 immunostaining and expression of target proteins related to survival/proliferation pathways were evaluated. BPA impaired the architectural of the submandibular and sublingual glands, particularly in female mice, and increased the expression of estrogen receptors. This was accompanied by a significant accumulation of BPA in these tissues. Conversely, the reduction of estrogen levels by the ovariectomy model slightly impacted BPA-induced morphological changes. In vitro, BPA did not affect the proliferation of neoplastic cells, but increased the expression of p63 and estrogen receptors. ERK1/2 phosphorylation was increased while AKT and NF-κB phosphorylation was reduced. Data highlight a harmful effect of BPA on salivary gland tissues and tumorigenic cells. Estrogendependent may orchestrate the BPA-accumulation mechanism, along with pro-survival signaling pathway and increased p63 expression.
Assuntos
Glândulas Salivares , Receptores de Estrogênio , Compostos Químicos , Poluentes Ambientais , Disruptores EndócrinosRESUMO
Introducción: Las enfermedades del tiroides son relativamente frecuentes, constituyen un importante grupo dentro de las enfermedades crónicas no transmisibles. Objetivo: Determinar la calidad de vida en pacientes con enfermedades tiroideas. Métodos: Se realizó un estudio observacional, descriptivo y transversal. El universo estuvo constituido por 210 pacientes con diagnóstico de enfermedades tiroideas, que cumplieron con los criterios de inclusión y exclusión previstos en el estudio, previo consentimiento informado y la muestra no probabilística de 198 pacientes. Se utilizaron las variables: edad, sexo, enfermedad tiroidea diagnosticada (hipertiroidismo, hipotiroidismo, bocio difuso eutiroideo) y calidad de vida (facetas según dimensiones, según la clasificación de expertos y enfermedades tiroideas y la calidad de vida integral según enfermedades tiroideas). Se utilizó el cuestionario World Health Organization Quality of Life. Resultados: Predominó el hipotiroidismo como afección tiroidea más frecuente en las féminas entre 50 a 59 años. Las manifestaciones clínicas que puntuaron las medias más bajas fueron el dolor y malestar, seguido de indicaciones médicas y sentimientos negativos; las dimensiones físicas y psicológicas puntuaron con medias bajas, al igual que el ambiente, valores considerados como deficientes. Conclusiones: Predominó una calidad de vida integral media en el mayor por ciento de los pacientes, estas enfermedades deben ser identificadas a tiempo, para evitar otras complicaciones en diferentes sistemas del organismo que pudieran comprometer la vida del paciente.
Introduction: Thyroid diseases are relatively frequent; they constitute an important group within chronic non-communicable diseases. Objective: To determine the quality of life in patients with thyroid diseases. Methods: An observational, descriptive and cross-sectional study was carried out. The universe (210 patients) with a diagnosis of thyroid diseases, who met the inclusion and exclusion criteria provided for in the study, prior informed consent, and the non-probabilistic sample (198 patients). The variables used were: age, sex, diagnosed thyroid disease (hyperthyroidism, hypothyroidism, diffuse euthyroid goiter) and quality of life (facets according to dimensions, according to expert classification and thyroid diseases and comprehensive quality of life according to diseases thyroid). The World Health Organization Quality of Life questionnaire was used. Results: Hypothyroidism predominated as the most frequent thyroid condition in women between 50 and 59 years of age. The clinical manifestations that scored the lowest average were pain and discomfort, followed by medical indications and negative feelings; the physical and psychological dimensions scored with low averages, as well as the environment, values considered deficient. Conclusions: An average comprehensive quality of life prevailed in the highest percentage of patients; these diseases must be identified in time, to avoid other complications in different body systems that could compromise the patient's life.
RESUMO
El síndrome de Down constituye la cromosopatía más frecuente a nivel mundial y afecta 6,03 a 7,86 de cada 10.000 nacidos vivos en Colombia. Los pacientes pediátricos de este grupo poblacional presentan una mayor incidencia de complicaciones endocrinológicas comparados con la población general. El objetivo de este artículo es revisar las complicaciones endocrinológicas prevalentes en el paciente pediátrico con síndrome de Down, relacionadas con el hipocrecimiento, desarrollo puberal, patología tiroidea, diabetes mellitus, dislipidemias y obesidad; así como describir su seguimiento y tratamiento. Se realizó una búsqueda en la literatura desde agosto de 2020 hasta diciembre de 2021, en las bases de datos PubMed y Google Scholar; incluyendo un total de 44 publicaciones para la presente revisión. Se concluye que el paciente pediátrico con síndrome de Down evidencia un patrón de hipocrecimiento junto a un mayor riesgo de obesidad y sobrepeso. Adicionalmente, presenta con mayor frecuencia patología tiroidea y diabetes mellitus.
Down syndrome is the most common chromosomal disorder worldwide, affecting 6,03 to 7,86 per 10.000 live births in Colombia. Pediatric patients with Down syndrome have a higher incidence of endocrine disorders compared to the general population. The aim of this paper was to review the endocrinological manifestations prevalent in pediatric patients with Down syndrome related to small stature, pubertal development, thyroid dysfunction, diabetes mellitus, dyslipidemia, and obesity. Additionally, their follow-up and adequate treatment are described. A literature search was carried out from August 2020 to December 2021 in the PubMed and Google Scholar databases. A total of 44 publications were included for this review. It is concluded that pediatric patients with Down syndrome are more likely to have short stature and have a higher risk of obesity and overweight. In addition, thyroid dysfunction and diabetes mellitus are frequent complications.
Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Síndrome de Down , Doenças do Sistema Endócrino , Pediatria , Hormônios Tireóideos , Puberdade , Diabetes Mellitus , Transtornos do Metabolismo dos Lipídeos , Fertilidade , Crescimento , ObesidadeRESUMO
Introdução: Síndrome POEMS trata de um raro evento paraneoplásico, sem relato atual na literatura sobre sua real prevalência. A maior parte dos casos ocorre em homens de meia idade. Relato do Caso:Paciente masculino, 65 anos, com queixa edema e parestesia em pernas que evoluiu para plegia, associada a hiporexia e fadiga. Investigação ambulatorial inicial evidenciou Polirradiculoneuropatia Inflamatória Desmielinizante Crônica (PIDC) de etiologia indefinida. Excluídos secundarismos, o paciente foi diagnosticado com hipotireoidismo primário, hipogonadismo severo, lesões hipercrômicas em pele, ascite, derrame pleural e trombocitose, além de gamopatia monoclonal IgA Lambda por imunofixação sérica. Sorologias virais negativas. Excluída a possibilidade de Mieloma Múltiplo e outras gamopatias, foi aventada a hipótese de Síndrome POEMS, sendo realizada dosagem de VEGF plasmática (425 pg/mL; VR = <96.2). Trata-se de um caso atípico na medida em que, lesões ósseas, presentes em até 97% dos casos, não foram evidenciadas no paciente em questão, tornando desafiador o diagnóstico. Conclusões: O diagnóstico de síndromes raras, embora desafiante, traz ao clínico um olhar mais amplo do paciente na medida em que incrementa o raciocínio clínico. [au]
Introduction: POEMS syndrome is a rare paraneoplastic event, with no current report in the literature about its real prevalence. Most cases occur in middle-aged men. Case Report: Male patient, 65 years old, complaining of edema and paresthesia in the legs that evolved to plegia, associated with hyporexia and fatigue. Initial outpatient investigation revealed Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) of undefined etiology. Excluding secondaries, the patient was diagnosed with primary hypothyroidism, severe hypogonadism, hyperchromic skin lesions, ascites, pleural effusion and thrombocytosis, in addition to monoclonal IgA Lambda gammopathy by serum immunofixation. Viral serologies was negative. Excluding the possibility of Multiple Myeloma and other gammopathies, the hypothesis of POEMS Syndrome was raised, and plasma VEGF measurement was performed (425 pg/mL; RV = <96.2). This is an atypical case in that bone lesions, present in up to 97% of cases, were not evidenced in the patient in question, making the diagnosis challenging. Conclusions: The diagnosis of rare syndromes, although challenging, brings the clinician a broader view of the patient as it increases clinical reasoning. [au]
RESUMO
BACKGROUND: Prurigo nodularis (PN) as an extremely pruritic and hyperplastic chronic dermatosis induces psychologically and physiologically stressful responses. PN-induced responses in the hypothalamic-pituitary-adrenal, hypothalamic-pituitary-gonadal axes and endocannabinoid system are abnormal. Extant studies on the PN's pathogenesis mostly focused on the PN's psychological responses. To date, the PN's physiological responses remain not been fully uncovered yet. OBJECTIVES: To investigate the PN-induced physiological responses via the levels of 5steroids and 2endocannabinoids combined with their ratios in plasma and examine the association between the psychological and physiological responses. MATERIALS AND METHODS: Thirty-six patients with PN, 36 age- and gender-matched healthy controls were recruited. The PN's psychological symptoms including pruritus severity, pain and life quality were measured with the visual analogue scale, the prurigo score index, numerical rating scale, verbal rating scale and dermatology life quality index. Their concentrations of steroids and endocannabinoids were determined with liquid chromatography-tandem mass spectrometry. RESULTS: Compared to controls, the PN patients showed lower plasma levels in cortisol, cortisone, N-arachidonoyl-ethanolamine, and the ratio of DHEA to 1-arachydonoyl glycerol (1-AG), which negatively moderately and over correlated with PN's symptoms, especially with the pruritus severity. Additionally, the PN patients exhibited higher levels in the ratios of testosterone and 1-AG to cortisol, which positively moderately and over correlated with pruritus severity. Thus, the 7biomarkers would be sensitive and reliable biomarkers for assessing the pruritus severity of PN because they met the screening criteria that the biomarkers show intergroup differences and showed moderate or over correlation with the pruritus severity of PN. CONCLUSIONS: To the best of our knowledge, this is the first study exploring PN-induced physiological responses. The findigs suggest that alterations in these 3endocrine systems may lead to new insights to psychological mechanisms and responses to PN.
Assuntos
Neurodermatite , Prurigo , Biomarcadores , Endocanabinoides , Humanos , Hidrocortisona , Prurigo/diagnóstico , Prurigo/etiologia , Prurigo/psicologia , Prurido/diagnóstico , Prurido/etiologia , Prurido/psicologia , EsteroidesRESUMO
BACKGROUND: Prurigo nodularis (PN) as an extremely pruritic and hyperplastic chronic dermatosis induces psychologically and physiologically stressful responses. PN-induced responses in the hypothalamic-pituitary-adrenal (HPA), hypothalamic-pituitary-gonadal (HPG) axes and endocannabinoid system (ECS) are abnormal. Extant studies on the PN's pathogenesis mostly focused on the PN's psychological responses. To date, the PN's physiological responses remain not been fully uncovered yet. OBJECTIVES: To investigate the PN-induced physiological responses via the levels of five steroids and two endocannabinoids combined with their ratios in plasma and examine the association between the psychological and physiological responses. MATERIALS AND METHODS: Thirty-six patients with PN, 36 age- and gender-matched healthy controls were recruited. The PN's psychological symptoms including pruritus severity, pain and life quality were measured with the visual analog scale, the prurigo score index, numerical rating scale, verbal rating scale and dermatology life quality index. Their concentrations of steroids and endocannabinoids were determined with liquid chromatography-tandem mass spectrometry. RESULTS: Compared to controls, the PN patients showed lower plasma levels in cortisol, cortisone, N-arachidonoyl-ethanolamine (AEA), and the ratio of DHEA to 1-arachydonoyl glycerol (1-AG), which negatively moderately and over correlated with PN's symptoms, especially with the pruritus severity. Additionally, the PN patients exhibited higher levels in the ratios of testosterone and 1-AG to cortisol, which positively moderately and over correlated with pruritus severity. Thus, the seven biomarkers would be sensitive and reliable biomarkers for assessing the pruritus severity of PN because they met the screening criteria that the biomarkers show intergroup differences and showed moderate or over correlation with the pruritus severity of PN. CONCLUSIONS: To the best of our knowledge, this is the first study exploring PN-induced physiological responses. The findings suggest that alterations in these three endocrine systems may lead to new insights to psychological mechanisms and responses to prurigo nodularis.
Assuntos
Neurodermatite , Prurigo , Biomarcadores , Endocanabinoides , Humanos , Hidrocortisona , Prurigo/complicações , Prurigo/diagnóstico , Prurigo/psicologia , Prurido/diagnóstico , Prurido/etiologia , Prurido/psicologiaRESUMO
Background: Prurigo nodularis (PN) as an extremely pruritic and hyperplastic chronic dermatosis induces psychologically and physiologically stressful responses. PN-induced responses in the hypothalamicpituitaryadrenal (HPA), hypothalamicpituitarygonadal (HPG) axes and endocannabinoid system (ECS) are abnormal. Extant studies on the PN's pathogenesis mostly focused on the PN's psychological responses. To date, the PN's physiological responses remain not been fully uncovered yet. Objectives: To investigate the PN-induced physiological responses via the levels of five steroids and two endocannabinoids combined with their ratios in plasma and examine the association between the psychological and physiological responses. Materials and methods: Thirty-six patients with PN, 36 age- and gender-matched healthy controls were recruited. The PN's psychological symptoms including pruritus severity, pain and life quality were measured with the visual analog scale, the prurigo score index, numerical rating scale, verbal rating scale and dermatology life quality index. Their concentrations of steroids and endocannabinoids were determined with liquid chromatography-tandem mass spectrometry. Results: Compared to controls, the PN patients showed lower plasma levels in cortisol, cortisone, N-arachidonoyl-ethanolamine (AEA), and the ratio of DHEA to 1-arachydonoyl glycerol (1-AG), which negatively moderately and over correlated with PN's symptoms, especially with the pruritus severity. Additionally, the PN patients exhibited higher levels in the ratios of testosterone and 1-AG to cortisol, which positively moderately and over correlated with pruritus severity. Thus, the seven biomarkers would be sensitive and reliable biomarkers for assessing the pruritus severity of PN because they met the screening criteria that the biomarkers show intergroup differences and showed moderate or over correlation with the pruritus severity of PN AU)
Antecedentes: El prúrigo nodular (PN), una dermatosis crónica prurítica e hiperplásica, induce respuestas psicológica y fisiológicamente estresantes. Las respuestas inducidas por PN en los ejes hipotalámico-pituitario-adrenal (HPA) e hipotalámico-pituitario-gonadal (HPG) y en el sistema endocannabinoide (SEC) son anómalas. En cierta medida los estudios sobre la patogenia de PN se centran principalmente en las respuestas psicológicas del mismo. Hasta la fecha no se han revelado plenamente las respuestas fisiológicas. Objetivos: Investigar las respuestas fisiológicas inducidas por PN a través de los niveles de cinco esteroides y dos endocannabinoides junto con sus ratios a nivel plasmático, y examinar la asociación entre las respuestas psicológicas y fisiológicas. Materiales y métodos: Se seleccionaron treinta y seis pacientes con PN, y 36 controles sanos equiparados por sexo y edad. Se midieron los síntomas psicológicos de PN incluyendo la gravedad y dolor del prurito y la calidad de vida con la escala visual analógica, el índice de puntuación del prúrigo, la escala de calificación numérica, la escala de calificación verbal, y el índice de calidad de vida dermatológica. Se determinaron las concentraciones de esteroides y endocannabinoides mediante cromatografía de líquidos-espectometría de masas en tándem. Resultados: En comparación con los controles, los pacientes de PN reflejaron menores niveles plasmáticos de cortisol, cortisona, N-araquidonoiletanolamina (AEA), y el ratio DHEA con respecto a 1-araquidonol glicerol (1-AG), que se correlacionaron de manera negativamente moderada y estrecha con los síntomas de PN, especialmente con la gravedad del prurito. Además, los pacientes de PN mostraron niveles mayores de los ratios de testosterona y 1-AG con respecto a cortisol, que se correlacionaron de manera positivamente moderada y estrecha con la gravedad del prurito (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Esteroides/sangue , Endocanabinoides/sangue , Biomarcadores/sangue , Prurigo/sangue , Prurigo/classificação , Índice de Gravidade de Doença , Estudos de Casos e ControlesRESUMO
Antecedentes: El prúrigo nodular (PN), una dermatosis crónica prurítica e hiperplásica, induce respuestas psicológica y fisiológicamente estresantes. Las respuestas inducidas por PN en los ejes hipotalámico-pituitario-adrenal (HPA) e hipotalámico-pituitario-gonadal (HPG) y en el sistema endocannabinoide (SEC) son anómalas. En cierta medida los estudios sobre la patogenia de PN se centran principalmente en las respuestas psicológicas del mismo. Hasta la fecha no se han revelado plenamente las respuestas fisiológicas. Objetivos: Investigar las respuestas fisiológicas inducidas por PN a través de los niveles de cinco esteroides y dos endocannabinoides junto con sus ratios a nivel plasmático, y examinar la asociación entre las respuestas psicológicas y fisiológicas. Materiales y métodos: Se seleccionaron treinta y seis pacientes con PN, y 36 controles sanos equiparados por sexo y edad. Se midieron los síntomas psicológicos de PN incluyendo la gravedad y dolor del prurito y la calidad de vida con la escala visual analógica, el índice de puntuación del prúrigo, la escala de calificación numérica, la escala de calificación verbal, y el índice de calidad de vida dermatológica. Se determinaron las concentraciones de esteroides y endocannabinoides mediante cromatografía de líquidos-espectometría de masas en tándem. Resultados: En comparación con los controles, los pacientes de PN reflejaron menores niveles plasmáticos de cortisol, cortisona, N-araquidonoiletanolamina (AEA), y el ratio DHEA con respecto a 1-araquidonol glicerol (1-AG), que se correlacionaron de manera negativamente moderada y estrecha con los síntomas de PN, especialmente con la gravedad del prurito. Además, los pacientes de PN mostraron niveles mayores de los ratios de testosterona y 1-AG con respecto a cortisol, que se correlacionaron de manera positivamente moderada y estrecha con la gravedad del prurito (AU)
Background: Prurigo nodularis (PN) as an extremely pruritic and hyperplastic chronic dermatosis induces psychologically and physiologically stressful responses. PN-induced responses in the hypothalamicpituitaryadrenal (HPA), hypothalamicpituitarygonadal (HPG) axes and endocannabinoid system (ECS) are abnormal. Extant studies on the PN's pathogenesis mostly focused on the PN's psychological responses. To date, the PN's physiological responses remain not been fully uncovered yet. Objectives: To investigate the PN-induced physiological responses via the levels of five steroids and two endocannabinoids combined with their ratios in plasma and examine the association between the psychological and physiological responses. Materials and methods: Thirty-six patients with PN, 36 age- and gender-matched healthy controls were recruited. The PN's psychological symptoms including pruritus severity, pain and life quality were measured with the visual analog scale, the prurigo score index, numerical rating scale, verbal rating scale and dermatology life quality index. Their concentrations of steroids and endocannabinoids were determined with liquid chromatography-tandem mass spectrometry. Results: Compared to controls, the PN patients showed lower plasma levels in cortisol, cortisone, N-arachidonoyl-ethanolamine (AEA), and the ratio of DHEA to 1-arachydonoyl glycerol (1-AG), which negatively moderately and over correlated with PN's symptoms, especially with the pruritus severity. Additionally, the PN patients exhibited higher levels in the ratios of testosterone and 1-AG to cortisol, which positively moderately and over correlated with pruritus severity. Thus, the seven biomarkers would be sensitive and reliable biomarkers for assessing the pruritus severity of PN because they met the screening criteria that the biomarkers show intergroup differences and showed moderate or over correlation with the pruritus severity of PN AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Esteroides/sangue , Endocanabinoides/sangue , Biomarcadores/sangue , Prurigo/sangue , Prurigo/classificação , Índice de Gravidade de Doença , Estudos de Casos e ControlesRESUMO
Introdução: Síndrome POEMS trata de um raro evento paraneoplásico, sem relato atual na literatura sobre sua real prevalência. A maior parte dos casos ocorre em homens de meia idade; Relato do Caso: Relatamos o caso de um paciente masculino, 65 anos, admitido com queixa edema e parestesia em pernas que evoluiu para plegia, associada a hiporexia e fadiga. Investigação ambulatorial inicial evidenciou polirradiculoneuropatia inflamatória desmielinizante crônica (PIDC) de etiologia indefinida. Excluídos secundarismos para polirradiculoneuropatia inflamatória desmielinizante crônica, o paciente foi a seguir diagnosticado com hipotireoidismo primário, hipogonadismo severo, lesões hipercrômicas em pele, ascite, derrame pleural e trombocitose, além de gamopatia monoclonal IgA Lambda por imunofixação sérica. Sorologias para HIV, Sífilis e Hepatites todas negativas. Excluída a possibilidade de Mieloma Múltiplo e outras gamopatias, foi aventada a hipótese de Síndrome POEMS, sendo realizada dosagem de Fator de Crescimento Endotelial Vascular (VEGF) plasmática (425 pg/mL; VR = <96.2). O paciente passou então a preencher os critérios obrigatórios para diagnóstico, além de um maior (VEGF elevada) e vários outros menores. Trata-se de um caso atípico na medida em que, lesões ósseas, presentes em até 97% dos casos, não foram evidenciadas no paciente em questão, tornando desafiador o diagnóstico e sendo então necessário recorrer à dosagem de VEGF. O diagnóstico de síndromes raras, embora desafiante, traz ao clínico um olhar mais amplo do paciente na medida em que incrementa o raciocínio clínico. Difundir e explorar esse universo é cada vez mais necessário
Introduction: POEMS syndrome is a rare paraneoplastic event, with no current report in the literature about its real prevalence. Most cases occur in middle-aged men; Case Report: We report the case of a male patient, 65 years old, admitted with complaints of edema and paresthesia in the legs that progressed to plegia, associated with hyporexia and fatigue. Initial outpatient investigation revealed Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) of undefined etiology. Excluding secondaries for chronic inflammatory demyelinating polyradiculoneuropathy, the patient was subsequently diagnosed with primary hypothyroidism, severe hypogonadism, hyperchromic skin lesions, ascites, pleural effusion and thrombocytosis, in addition to monoclonal IgA Lambda gammopathy by serum immunofixation. All serologies for HIV, Hepatitis and syphilis were negative. Excluding the possibility of Multiple Myeloma and other gammopathies, the hypothesis of POEMS Syndrome was raised, and plasma Vascular Endotelial Growth Factor (VEGF) measurement was performed (425 pg/mL; RV = <96.2). The patient then started to fulfill the mandatory criteria for diagnosis, in addition to a major (elevated VEGF) and several other minors. This is an atypical case in that bone lesions, present in up to 97% of the cases, were not evidenced in the patient in question, making the diagnosis challenging and therefore requiring the use of VEGF dosage. The diagnosis of rare syndromes, although challenging, brings the clinician a broader view of the patient as it increases clinical reasoning. Spreading and exploring this universe is increasingly necessary
Assuntos
Humanos , Paraproteinemias , Síndrome POEMS/diagnóstico , Polineuropatia Paraneoplásica , Diagnóstico Diferencial , Doenças do Sistema EndócrinoRESUMO
El "microbioma" no solo está constituido por los microbios, sino por todos los componen-tes que viven en el mismo hábitat conforman-do un nicho ecológico. Es decir, está conformado por los microorganismos (bacterias, hongos, protozoos, etc.), todo el espectro de moléculas producidas por ellos tales como sus componentes estructurales (ácidos nucleicos, proteínas, lípidos y glúcidos), meta-bolitos, toxinas, etc., y las moléculas producidas por el huésped. El microbioma intestinal (MI) ha emergido como un factor que tiene un gran efecto sobre la cantidad, calidad y fuerza del hueso. Las investigaciones revelan que la homeostasis ósea está ligada al micro-bioma saludable, mientras que la disbiosis (alteración en la biodiversidad microbiana) puede exacerbar la actividad osteoclástica y promover la osteoporosis. Los mecanismos potenciales involucrados en la interacción del microbioma intestinal y el hueso son la influencia del metabolismo del huésped, el mantenimiento de la integridad intestinal y regulación de la absorción de nutrientes, la regulación del eje intestino-sistema inmune y la modulación del sistema endocrino. Es decir que hay múltiples vías por las cuales el MI influye sobre el hueso, pero estos y otros mecanismos deben profundizarse más aún. También es necesario que se identifiquen y caractericen mejor los microorganismos que están asociados a las enfermedades óseas. El conocimiento de estos aspectos podría ser útil para el desarrollo de herramientas terapéuticas basadas en el MI que puedan mejorar la eficacia de los distintos tratamientos existentes. (AU)
The microbiome is not only constituted by microbes, but by all the components that live in the same habitat forming an ecological niche. It is conformed by the microorganisms ( bacteria, fungi, protozoa, etc), the entire spectrum of molecules produced by them (nucleic acids, proteins, lipid and carbohydrates, metabolites, toxins, etc) and the molecules produced by the host. The intestinal microbiome (IM) has emerged as a factor with great effects on the quantity, quality and strength of bone. The investigations reveal that bone homeostasis is linked to the healthy microbiome, while the dysbiosis (alteration in the microbial biodiversity) can exacerbate the osteoclastic activity and promote osteoporosis. The potential mechanisms involved in the interaction between IM and bone are the influence of the host metabolism, the maintenance of the intestinal integrity and regulation of the nutrient absorption, the regulation of the intestine/ immune system axis and the modulation of the endocrine system. That is, there are multiple ways through which IM influences on bone, but these and other mechanisms need to be further studied. It is also necessary to identify and characterize the microorganisms associated with the bone diseases. Knowledge of these aspects could be useful to develop therapeutical tools based on the IM that could improve the efficacy of the current treatments. (AU)
Assuntos
Humanos , Osteoblastos/imunologia , Osteoclastos/imunologia , Osso e Ossos/imunologia , Disbiose/complicações , Microbioma Gastrointestinal/imunologia , Osteoblastos/metabolismo , Osteoclastos/metabolismo , Osso e Ossos/metabolismo , Intestinos/imunologia , Intestinos/microbiologiaRESUMO
INTRODUCCIÓN. Los feocromocitomas son tumores que provienen de las células neuroendócrinas de la médula adrenal y producen alta secreción de catecolaminas. Generan complicaciones cardiovasculares graves que suelen asociarse con crisis hipertensivas. Es importante valorar el impacto cardiovascular de esta entidad. OBJETIVO. Realizar una revisión exhaustiva de las diversas manifestaciones de los feocromocitomas como causa de hipertensión arterial, su impacto cardiovascular, conducta diagnóstica y terapéutica. MATERIALES Y MÉTODOS. Revisión bibliográfica y análisis de 141 artículos científicos que incluyeron temas sobre el impacto cardiovascular, conducta diagnóstica y terapéutica del feocromocitoma como causa de hipertensión arterial. Se usó bases de datos: Medline, Embase, Scopus, Pubmed, Google Académico. Criterios de búsqueda en DECS, MeSH: "pheochromocytoma OR hypertension arterial AND cardiomyopathy", en inglés- español. Fueron seleccionados: 13 publicaciones de texto completo, 10 artículos retrospectivos, 2 guías de práctica clínica y 1 revisión. Se excluyeron 128 artículos científicos. RESULTADOS. Se realizó una revisión de las manifestaciones clínicas de los feocromocitomas como causa de hipertensión arterial y el impacto cardiovascular se relacionó con la producción de catecolaminas. Para el diagnóstico, la sensibilidad de la resonancia magnética es del 93-100%; la especificidad de resonancia magnética o tomografía computarizada en combinación con gammagrafía con metayodobencilguanidina con 123I es cercana al 100%. La resección del feocromocitoma tiene potencial curativo. CONCLUSIÓN. Los feocromocitomas presentan variabilidad clínica, se asocian a complicaciones cardiovasculares y cerebrovasculares graves por producción de catecolaminas. El diagnóstico oportuno y eficaz debe realizarse mediante resonancia magnética y gammagrafía en caso de alta sospecha clínica. El tratamiento quirúrgico es de elección.
INTRODUCTION. Pheochromocytomas are tumors arising from the neuroendocrine cells of the adrenal medulla and produce high secretion of catecholamines. They generate severe cardiovascular complications that are often associated with hypertensive crises. It is important to assess the cardiovascular impact of this entity. OBJECTIVE. To perform an exhaustive review of the various manifestations of pheochromocytomas as a cause of arterial hypertension, their cardiovascular impact, diagnostic and therapeutic conduct. MATERIALS AND METHODS. Bibliographic review and analysis of 141 scientific articles that included topics on the cardiovascular impact, diagnostic and therapeutic behavior of pheochromocytoma as a cause of arterial hypertension. The following databases were used: Medline, Embase, Scopus, Pubmed, Google Scholar. Search criteria in DECS, MeSH: "pheochromocytoma OR hypertension arterial AND cardiomyopathy", in English-Spanish. The following were selected: 13 full-text publications, 10 retrospective articles, 2 clinical practice guidelines, and 1 review. A total of 128 scientific articles were excluded. RESULTS. A review of the clinical manifestations of pheochromocytoma as a cause of arterial hypertension was performed and the cardiovascular impact was related to catecholamine production. For diagnosis, the sensitivity of MRI is 93-100%; the specificity of MRI or computed tomography in combination with 123I-methiodobenzylguanidine scintigraphy is close to 100%. Resection of pheochromocytoma has curative potential. CONCLUSION. Pheochromocytomas present clinical variability, are associated with severe cardiovascular and cerebrovascular complications due to catecholamine production. Timely and effective diagnosis should be made by MRI and scintigraphy in case of high clinical suspicion. Surgical treatment is the treatment of choice.
Assuntos
Humanos , Feocromocitoma/complicações , Neoplasias das Glândulas Suprarrenais/complicações , Hipertensão/etiologia , Feocromocitoma/cirurgia , Feocromocitoma/diagnóstico , Catecolaminas/metabolismo , Neoplasias das Glândulas Suprarrenais/cirurgia , Neoplasias das Glândulas Suprarrenais/diagnóstico , Coração/fisiopatologia , Cardiopatias/etiologiaRESUMO
Resumo Fundamento: A síndrome dos ovários policísticos (SOP) é a doença endócrino-metabólica mais comum em mulheres em idade reprodutiva, e ocorre em uma a cada 10 mulheres. A doença inclui irregularidade menstrual e excesso de hormônios masculinos e é a causa mais comum de infertilidade em mulheres. A dispneia é um sintoma frequente e muitas vezes acredita-se que seja decorrente da obesidade, mas não se sabe se é decorrente de disfunção cardíaca. Objetivo: Avaliar o acoplamento ventrículo-arterial (VDAP) e a rigidez arterial pulmonar em pacientes com SOP. Métodos: Foram incluídos 44 pacientes com SOP e 60 controles; amostras de sangue venoso foram coletadas para exames laboratoriais e ecocardiograma transtorácico 2-D, Modo-M e com Doppler tecidual foram realizados em todos os participantes. Um valor de p<0,05 foi considerado estatisticamente significativo. Resultados: Quando comparadas ao grupo controle, as pacientes com SOP apresentaram valores maiores de rigidez da artéria pulmonar (p = 0,001), que se correlacionaram positivamente com o índice HOMA-IR (r = 0,545 e p <0,001). O acoplamento VDAP também estava comprometido em 34% dos pacientes do estudo. Conclusão: A rigidez da artéria pulmonar está aumentada e o acoplamento VDAP está comprometido em pacientes com SOP. (Arq Bras Cardiol. 2021; 116(4):806-811)
Abstract Background: Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disease in women in reproductive age, and occurs in one of 10 women. The disease includes menstrual irregularity and excess of male hormones and is the most common cause of female infertility. Dyspnea is a frequent symptom and is often thought to be due to obesity, and whether it is due to cardiac dysfunction is unknown. Objective: To evaluate right ventricle-pulmonary artery (RV-PA) coupling and pulmonary arterial stiffness in patients with PCOS. Methods: 44 PCOS patients and 60 controls were included; venous blood samples were taken for laboratory tests and 2-D, m-mode and tissue doppler transthoracic echocardiography were performed for all the participants. P<0,05 was considered as statistically significant. Results: When compared to the control group, PCOS patients had higher pulmonary artery stiffness values (p=0,001), which were positively correlated with HOMA-IR (r=0,545 and p<0,001). RV-PA coupling was also impaired in 34% of the study patients. Conclusion: Pulmonary artery stiffness is increased and RV-PA coupling is impaired in patients with PCOS. (Arq Bras Cardiol. 2021; 116(4):806-811)
Assuntos
Humanos , Masculino , Feminino , Síndrome do Ovário Policístico/complicações , Rigidez Vascular , Artéria Pulmonar/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , ObesidadeRESUMO
RESUMEN El coma mixedematoso es la complicación más grave de un hipotiroidismo. Ocurre, por lo general, en mujeres ancianas con hipotiroidismo conocido sin un adecuado manejo y en presencia de un evento desencadenante. El diagnóstico es difícil y debe realizarse en forma oportuna para disminuir el riesgo de muerte. El coma es una de las presentaciones neurológicas de esta urgencia endocrinológica y no es necesario su presencia para el diagnóstico. En este reporte de caso se presentan varías manifestaciones inusuales en un paciente masculino con hipotiroidismo profundo que, al diagnóstico, debutó con coma mixedematoso con predictores de mal pronóstico durante la hospitalización, pero debido al abordaje temprano y el manejo integral, se dio una resolución satisfactoria a esta urgencia endocrinológica infrecuente.
SUMMARY Myxedema coma is the most serious complication of hypothyroidism. It usually occurs in the context of elderly women, with known hypothyroidism without proper management and in the presence of a triggering event. The diagnosis is challenging and must be made in a timely manner to prevent the development of adverse outcomes. Coma is one of the neurological manifestations of the entity, not being necessary for its diagnosis. This case report presents a constellation of unusual manifestations of a male patient with myxedema coma at the debut of severe hypothyroidism with predictors of poor prognosis during hospitalization, but due to the early approach and comprehensive management, this uncommon endocrinological emergency was satisfactorily resolved.
Assuntos
Humanos , Idoso , Derrame Pericárdico , Mixedema , Convulsões , ComaRESUMO
Calcinose enzoótica, causada por Nierembergia rivularis, no Uruguai, e Nierembergia veitchii, no Brasil, é uma doença caracterizada por mineralização de tecidos moles, hiperplasia das células parafoliculares da tireoide e elevação nos níveis de cálcio e fósforo. Descreve-se um caso de hiperplasia e carcinoma de células parafoliculares bilateral em um ovino de quatro anos, com calcinose enzoótica associada à intoxicação por Nierembergia rivularis. O diagnóstico histológico de hiperplasia e carcinoma de células parafoliculares é suportado pelas marcações imuno-histoquímicas positivas para calcitonina, peptídeo relacionado ao gene da calcitonina e enolase neurônio específica. Como a hiperplasia de células parafoliculares é uma lesão pré-neoplásica induzida por hipercalcemia, sugere-se que a hipercalcemia crônica causada pela intoxicação por N. rivularis pode ter induzido hiperplasia de células parafoliculares seguida de transformação em carcinoma, neste caso. Os efeitos carcinogênicos das plantas calcinogênicas no sistema endócrino devem ser melhor explorados.(AU)
Assuntos
Animais , Intoxicação por Plantas/veterinária , Calcinose/veterinária , Ovinos , Neoplasias da Glândula Tireoide/veterinária , Células Epiteliais da Tireoide/patologia , Plantas TóxicasRESUMO
Resumen Antecedentes las enfermedades del sistema endocrino pueden afectar la sexualidad por sus efectos hormonales, las comorbilidades asociadas y su impacto psicosocial, tema poco estudiado desde las perspectivas de personas con estas enfermedades. Objetivos: se realizó un estudio cualitativo dirigido a comprender las experiencias sexuales de mujeres y varones con enfermedades endocrinas que producen cambios en la apariencia física. Método: se estructuró un diseño de estudio analítico-interpretativo. Participaron 68 personas entre 20 y 45 años de edad, atendidos en el Instituto Nacional de Endocrinología, La Habana, Cuba. Los instrumentos de recolección de la información utilizados fueron una planilla de datos generales, una guía de entrevista en profundidad y dos pruebas psicológicas proyectivas. Los aspectos éticos fueron considerados. Resultados: de las entrevistas en profundidad, emergieron 4 temas: 1) la expresión multidimensional de la enfermedad, 2) enfermedad y áreas de vida, 3) ejercicio de la sexualidad con la enfermedad, y 4) estrategias de afrontamiento en el área sexual; vinculados con los significados expresados sobre la salud, el cuerpo, el género y la sexualidad. Conclusiones: las/los participantes contextualizaron sus experiencias sexuales en el impacto biopsicosocial de la enfermedad. La reproducción o cuestionamiento de los significados expresados influyó en la calidad de sus experiencias sexuales. El estudio mostró que esta constituye un área de vulnerabilidad para la salud integral de las/los participantes.
Abstract Background endocrine disorders may affect sexuality due to hormonal changes, associated comorbidities and psychosocial impact. This topic remains poorly researched from the perspective of people with these conditions. Objectives: a qualitative research was conducted to understand the sexual experiences of women and men living with endocrine disorders that change their physical appearance. Methods: an analytical-interpretive study was carried out with a sample of 68 participants aged between 20 and 45, and treated at the National Institute of Endocrinology, Havana, Cuba. Data collection instruments were a personal information sheet, an in-depth interview guide and two projective psychological tests. Ethical aspects were considered. Results: in-depth interviews gave rise to four topics: 1) multidimensional expression of the disease, 2) the disease and life areas, 3) sexuality with the disease, and 4) coping strategies in the sexual area. These topics were linked to the meanings of health, body, gender and sexuality. Conclusions: the participants contextualized their sexual experiences within the biopsychosocial impact of the endocrine disorder, as well as the reproduction or questioning of the meanings that influenced the quality of their sexual experiences. The study showed that sexuality is a vulnerable area for the participants' comprehensive health.
RESUMO
Los problemas médicos gastrointestinales, nutricionales, metabólicos, endocrinológicos y de microbiota en los pacientes pediátricos con diagnóstico de trastorno del espectro autista (TEA) son parte de los problemas médicos concomitantes al diagnóstico. La prevalencia alcanza a más del 91 % en el caso de los problemas gastrointestinales, hasta el 89 % para los nutricionales y metabólicos, más del 50 % de disfunción tiroidea y hasta el 100 % para los relacionados con la microbiota.Es urgente actualizar la práctica médica para incluir la evaluación, testeo, diagnóstico y tratamiento de estos problemas médicos concomitantes al diagnóstico de TEA en la población pediátrica, adolescente y adulta. El tratamiento riguroso de dichos problemas genera cambios positivos en la calidad de vida y en la sintomatología bajo la cual el TEA se diagnostica en muchos casos. Debe basarse en evidencia científica de alta calidad, con control y cuidado médico adecuado
Gastrointestinal, nutritional, metabolic, endocrine, and microbiota medical problems in pediatric patients diagnosed with autism spectrum disorder (ASD) are some of the coexisting medical conditions in ASD diagnosis. Their prevalence reaches more than 91 % for gastrointestinal problems, up to 89 % for nutritional and metabolic disorders, more than 50 % for thyroid dysfunction, and up to 100 % for microbiota-related conditions.There is an urgency for medical practice to be updated and to include the assessment, testing, diagnosis, and treatment of these coexisting medical conditions in ASD diagnosis in the pediatric, adolescent, and adult population. A strict management of such conditions results in positive changes in the quality of life and symptoms based on which ASD is diagnosed many times. It should be based on high-quality scientific evidence with an adequate medical care and control
Assuntos
Humanos , Pré-Escolar , Criança , Adolescente , Doenças do Sistema Endócrino/metabolismo , Microbiota , Transtorno do Espectro Autista/microbiologia , Gastroenteropatias/metabolismo , Sintomas Concomitantes , Estado Nutricional , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/dietoterapia , Transtorno do Espectro Autista/metabolismo , Gastroenteropatias/complicações , Gastroenteropatias/dietoterapiaRESUMO
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Abstract In Colombia there are no guidelines for diagnosis and management of patients with short stature and for the use of recombinant human growth hormone, mainly caused by the diversity of training centers in pediatric endocrinology. In response to this situation, the Asociación Colegio Colombiana de Endocrinología Pediátrica leds the first colombian short stature expert committee in order to standardize the use of human recombinant growth hormone. This work had the participation and endorsement of a consortium of clinical experts representing the Sociedad Colombiana de Pediatría, Secretaría Distrital de Salud de Bogotá- Subred Integrada de Servicios de Salud Suroccidente, Fundación Universitaria Sanitas, Universidad de los Andes and some public and private health institutions in the country, in addition to the participation of methodological experts from the Instituto Global de Excelencia Clínica Keralty. By reviewing the literature and with the best available evidence, we proposed to unify definitions, a diagnostic algorithm, biochemical and dynamic tests with their reference parameters, a description of the considerations about growth hormone use among the indications approved by regulatory agency for medications and food in Colombia and finally a proposal for an informed consent and a medication fact sheet available for parents and patients.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Hormônio do Crescimento , Redução de Peso , Colômbia , EndocrinologiaRESUMO
Los autoanticuerpos son proteínas producidas en el organismo por la inducción de un antígeno propio del individuo el cual no reconocen y rechazan. Su aparición en sangre puede iniciarse tiempo antes de la presentación de síntomas o signos. El deterioro funcional de dos o más glándulas es una afectación endocrinológica múltiple que puede asociarse con otras patologías autoinmunes no endocrinas, tales como vitiligo, alopecia areata, gastritis autoinmune y anemia perniciosa. Se clasifica en tres síndromes poliendocrinos autoinmunes (SPA). En Europa la incidencia del tipo I es menor a 1:100000 por año y los 2 y 3 varían entre 12:100000 por año. Colombia no cuenta con registros que permitan calcularla. Se reporta el caso de un hombre de 18 años diagnosticado con hipotiroidismo autoinmune, a los 15 años de edad debutó con cetoacidosis diabética y a los 17 con posterior aparición de vitiligo. El manejo inicial se realizó con levotiroxina sódica y análogos de insulina. Este caso corresponde a un SPA tipo IIIA, ya que cursa con hipotiroidismo autoinmune, diabetes mellitus y como último hallazgo cronológico la asociación con vitiligo. La detección de una endocrinopatía autoinmune en pacientes jóvenes debe alertar sobre la posible existencia de un SPA
Autoantibodies are blood proteins produced in response to and counteracting a specific antigen. Autoantibodies may be present before signs and symptoms occur. A polyendocrinopathy is characterized by the coexistence of at least two endocrine glands insufficiency and may be associated with another non-endocrine autoimmune illness including vitiligo, alopecia areata, autoimmune gastritis and pernicious anemia. It is classified into three types of autoimmune polyglandular syndromes (APS). In Europe the incidence of APS-1 is less than one new case per 100000 persons per year and the incidence of the other two APS types vary between1 to 2 new cases per 100000 persons per year. APS incidence in Colombia cannot be estimated due to lack of records on this subject. We report the case of an 18-year-old male with autoimmune hypothyroidism diagnosed at 15 years of age, with onset of diabetic ketoacidosis at 17 followed by vitiligo. Therapy with levothyroxine 100 mcg daily and insulin glargine 10 units daily did not yield successful correction of APS in the patient. This patient was affected by APS- IIIA, characterized by the association of autoimmune hypothyroidism, diabetes mellitus and vitiligo, as the last manifestation. Detecting an autoimmune polyendocrinopathy in young patients should raise the suspicion of APS.
Assuntos
Humanos , Masculino , Adolescente , Doenças do Sistema Endócrino , Hipotireoidismo , Vitiligo , Poliendocrinopatias Autoimunes , Diabetes Mellitus Tipo 1RESUMO
INTRODUCCIÓN: La radioterapia, quimioterapia y la cirugía empleada en el tratamiento de los tumores cerebrales tienen efectos en el eje hipotálamo-hipofisario y pueden resultar en disfunción endocrina hasta en el 96% de los casos. PACIENTES Y MÉTODO: Estudio retrospectivo y descriptivo en pacientes diagnos ticados de meduloblastoma sometidos a tratamiento con quimio y radioterapia en los últimos 20 años en un hospital terciario. Se analizan variables edad, sexo, peso, talla, índice de masa corporal (IMC) al final del seguimiento, estadio de maduración sexual, niveles séricos de TSH y T4 libre, ACTH/cortisol e IGF-1, FSH, LH, estradiol, testosterona, perfil lipídico (colesterol total) y prueba de función dinámica de hormona de crecimiento. RESULTADOS: Muestra total de 23 pacientes. El déficit de hormona de crecimiento es la secuela más frecuente (82 %) seguido de disfunción ti roidea (44,8%) y disfunción puberal (24,1%). Solo se diagnosticó un caso de diabetes insípida y 2 casos de déficit de corticotrofina. CONCLUSIONES: El seguimiento a largo plazo de los supervivientes de meduloblastoma tratados con quimio y radioterapia revela una prevalencia muy alta de disfun ción endocrina, particularmente de deficiencia de hormona del crecimiento y de hipotiroidismo. Creemos oportuna la monitorización y el seguimiento a largo plazo de estos pacientes con el fin de garantizar un manejo terapéutico adecuado de aquellas disfunciones tratables.
INTRODUCTION: Radiation therapy, chemotherapy, and surgery used to treat brain tumors have effects on the hy pothalamic-pituitary-adrenal axis and can result in endocrine dysfunction in up to 96% of cases. PATIENTS Y METHOD: Retrospective and descriptive study in patients diagnosed with medulloblasto ma who underwent treatment with chemo and radiotherapy in the last 20 years in a tertiary hospital. The variables analyzed were age, sex, weight, height, body mass index (BMI) at the end of follow-up, sexual maturity stage, serum levels of TSH and free T4, ACTH/cortisol and IGF-1, FSH, LH, estradiol, testosterone, lipid profile (total cholesterol), and growth hormone dynamic function test. RESULTS: Total sample of 23 patients. Growth hormone deficiency is the most frequent sequelae (82%) fo llowed by thyroid dysfunction (44.8%), and disorders of puberty (24.1%). Only one case of diabetes insipidus and two cases of corticotropin deficiency were diagnosed. CONCLUSIONS: Long-term follow- up of medulloblastoma survivors treated with chemo and radiotherapy reveals a very high prevalence of endocrine dysfunction, especially growth hormone deficiency and hypothyroidism. We believe that monitoring and long-term follow-up of these patients is necessary in order to ensure adequate therapeutic management of those treatable dysfunctions.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Neoplasias Cerebelares/terapia , Quimiorradioterapia/efeitos adversos , Meduloblastoma/terapia , Puberdade Precoce/etiologia , Doenças da Glândula Tireoide/etiologia , Neoplasias Cerebelares/sangue , Estudos Retrospectivos , Hormônio Adrenocorticotrópico/deficiência , Hormônio do Crescimento Humano/deficiência , Diabetes Insípido/etiologia , Doenças do Sistema Endócrino/etiologia , Sobrepeso/etiologia , Sobreviventes de Câncer , Hipogonadismo/etiologia , Meduloblastoma/sangueRESUMO
RESUMEN Introducción: la erupción de los dientes es un fenómeno biológico de interés médico y social. Este puede ser alterado por causas congénitas y adquiridas. Objetivo: caracterizar el brote dentario en individuos infanto-juveniles con enfermedades endocrinas frecuentes. Métodos: se realizó un estudio epidemiológico, descriptivo y transversal, en el Hospital Universitario Pediátrico José Luis Miranda, de Villa Clara, en el período comprendido de marzo de 2016 a abril de 2017. Se tomó una muestra intencional de 114 individuos de ambos sexos, desde tres meses a 14 años de edad, con diabetes mellitus, hipotiroidismo congénito, hipertiroidismo o hiperplasia adrenal congénita. Se aplicó un cuestionario contentivo de variables relacionadas con el tipo de enfermedad endocrina y el brote dentario, la información fue procesada mediante el paquete estadístico SPSS versión 15.0. Resultados: la muestra se caracterizó por una prevalencia del sexo masculino, del grupo de edad de 7 a 11 años. Las enfermedades endocrinas más frecuentes fueron en orden ascendente: el hipertiroidismo, el hipotiroidismo congénito y la diabetes mellitus. El brote dentario se relacionó significativamente con el tipo de enfermedad; predominó el brote dentario tardío (presente en la mayoría de los pacientes con diabetes mellitus). Conclusiones: existió una relación altamente significativa entre el tipo de enfermedad endocrina y el brote dentario.
ABSTRACT Introduction: tooth eruption is a biological phenomenon of social and medical interest. This can be altered by congenital and acquired causes. Objective: to characterize tooth eruption in infantile and juvenile individuals with common endocrine diseases. Methods: an epidemiological, descriptive and cross-sectional study was conducted at José Luis Miranda Pediatric University Hospital in Villa Clara, from March 2016 to April 2017. An intentional sample of 114 individuals of both genders, from three months to 14 years of age who suffered from diabetes mellitus, congenital hypothyroidism, hyperthyroidism or congenital adrenal hyperplasia was taken. A questionnaire containing variables related to the type of endocrine disease and tooth eruption was applied; the information was processed using the statistical package SPSS version 15.0. Results: the sample was characterized by a prevalence of male gender, from the age group of 7 to 11 years. The most frequent endocrine diseases were in ascending order: hyperthyroidism, congenital hypothyroidism and diabetes mellitus. Tooth eruption was significantly related to the type of disease; the late tooth eruption was predominant in most of patients with diabetes mellitus). Conclusions: there was a highly significant relationship between the type of endocrine disease and tooth eruption.