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Medicine Lodge, United States

Rajewska J.,Poznan University of Medical Sciences | Lacka K.,Metabolism and Internal Medicine | Stawny B.,Gastroenterological and Endocrinological Surgery
Polski Merkuriusz Lekarski

Patient with primary hyperparathyroidism and papillary thyroid cancer was presented. The female patient, 45 years old, because of papillary thyroid cancer was treated in the typical way by total stru-mectomy with lymphadenectomy following by 1131 therapy and L-thyroxine suppressive therapy. After 9 years, during one of control routine examinations, the serum levels of calcium and parathormone were increased (Ca2+: 1.449 mmol/l; Ca: 2.91 mmol/l; PTH: 256 pg/ml). Primary hyperparathyroidism was diagnosed and the patient underwent the surgery in the anterior cervical region with removal of parathyroid adenoma, histopathologically confirmed. Serum PTH level together with calcium levels decreased into the normal range. The coexistence of primary hyperparathyroidism and thyroid non-medullary cancer was already reported, but in this case the time of the onset was delayed. Due to the fact that patients after the treatment of thyroid non-medullary cancer, especially after of the neck radiation or radioactive iodine therapy, are more exposed to develop hyperparathyroidism, complete and wide examinations, even many years after treatment of thyroid cancer, are needed. Source

Herman W.A.,Outpatients Unit of Endocrine Diseases | Krzoska A.,Poznan University of Medical Sciences | Lacka K.,Metabolism and Internal Medicine | Bugaj R.,Laboratory of Neurobiology | Dorszewska J.,Laboratory of Neurobiology
Polski Merkuriusz Lekarski

Metabolic syndrome (MS) is associated with low-grade systemic inflammation. Hyperhomocysteinemia is considered recently as a consequence of immune activation. Acute phase proteins, proinflammatory cytokines and probably homocysteine (hHcy) are involved in the pathogenesis of MS, atherosclerosis and ageing. The aim of our study was to investigate the reciprocal links between hHcy and selected negative and positive acute phase reactants as well as interleukin-18 in men over 40 years of age suffering from MS compared to healthy subjects. Material and methods. In 160 randomly selected men aged 40 to 70 years hHcy, C-reactive protein, transferrin, α1- antichymotrypsin and IL-18 were evaluated and features of MS using IDF (International Diabetes Federation-2005) criteria were estimated. Results. Hcy plasma levels are not correlated with age. Men suffering from MS revealed significantly higher serum hHcy levels than healthy subjects (11.52 ±6.87 μM/L vs 10.08 ±5.44 μM/L, p=0.0074). A weak but positive (r=0.099; p=0.014) correlation between hHcy and the numbers of MS traits is shown. However, the plasma hHcy level is correlated only with HDL-cholesterol serum levels (r= -0.132; p=0.035) and fasting blood glucose (r=0.164; p=0.009). hHcy concentration is strongly positively correlated with IL-18 (r=0.276; p=0.005), although not with CRP, α1-ACT and transferrin. Conclusions. In men over 40 years of age suffering from MS significant higher serum Hcy levels than healthy subjects are presented, but hHcy (as opposed to acute phase reactants) correlates only with IL-18 plasma concentrations. Source

Hashimoto K.-I.,Metabolism and Internal Medicine | Hashimoto K.-I.,Gifu University | Ito Y.,Metabolism and Internal Medicine | Tanahashi H.,Metabolism and Internal Medicine | And 3 more authors.
Journal of Clinical Endocrinology and Metabolism

Content: Hyperglycemic chorea-ballism is predominantly observed in older type 2 diabetic patients, and it is rare in type 1 diabetes and diabetic ketoacidosis (DKA). Huntington's disease (HD) is one of several genetic syndromes associated with diabetes, although the reported prevalence of the association varies. There are few opportunities for most physicians to diagnose early-stage HD. Objective: We describe bilateral hyperglycemic chorea-ballism in a 40-yr-old female type 1 diabetes patient with DKA and HD. Setting: The study was conducted in a tertiary care referral hospital. Results: On admission, the patient exhibited severe involuntary movement of bilateral extremities with DKA, and hyperglycemic chorea-ballism was diagnosed. She recovered from chorea-ballism with admission of fluids and insulin, but mild choreatic movement persisted in the upper extremities. Brain magnetic resonance imaging and DNA analysis revealed HD. Although it has been considered that depletion of striatal γ-aminobutyric acid (GABA) content is rare in DKA, it is largely decreased in HD. Therefore, it is probable that hyperglycemic chorea-ballism or exacerbation of Huntington's chorea resulted from transient depletion of GABA. Conclusion: The present case provides important insights on the role of GABA in hyperglycemic chorea-ballism and on the clinical issues associated with HD diagnosis. Copyright © 2012 by The Endocrine Society. Source

Kolanska K.,Metabolism and Internal Medicine | Owecki M.,Metabolism and Internal Medicine | Nikisch E.,Poznan University of Medical Sciences | Sowinski J.,Metabolism and Internal Medicine
Neuroendocrinology Letters

OBJECTIVE: The influence of obesity on cancer development has been proven for numerous tumours. In contrast, the association between obesity and non-secreting adrenal incidentaloma has never been proven. Therefore, the aim of this study was to investigate this relationship in a large sample of patients. METHODS: 143 patients with benign non-secreting adrenal incidentalomas treated in the Department of Endocrinology at the Poznan University of Medical Sciences between the years 2000-2007 were examined. To rule out subclinical hyperfunctioning lesions, serum dehydroepiandrosterone sulphate, Cortisol (8 am, 6 pm, and after 1 mg dexamethasone suppression), sodium and potassium, along with concentrations of sodium, potassium, vanillylmandelic acid, metanephrine and normetanephrine in 24-hour urine collection were determined. Radiological evaluation included computed tomography and/or magnetic resonance imaging. Only non-secreting lesions and those of benign radiologic appearance were considered. The patients body mass index was compared to that of the general population of Poland and the Western Poland Region of Wielkopolska. RESULTS: The average body mass index of our patients was 28.77 kg/m2 (SD=4.71), with a 40% prevalence of obesity in the study group. One-proportion z-test showed a statistically significantly higher prevalence of obesity as compared to the general population of Poland and Wielkopolska (40% vs 12.5%, p<0.005); the results were similar for the whole cohort, and for each gender separately. CONCLUSIONS: This clinical research study demonstrates a strong association between obesity and incidentally discovered non-functioning adrenal tumours. © 2010 Neuroendocrinology Letters. Source

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