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Mahim, India

Ramachandran A.,India Diabetes Research Foundation | Das A.K.,Jawaharlal Institute of Postgraduate Medical Education & Research | Joshi S.R.,Leelavati and Bhatia Hospitals | Yajnik C.S.,Diabetes Unit | And 2 more authors.
Journal of Association of Physicians of India | Year: 2010

The prevalence of diabetes is rising all over the world due to population growth, aging, urbanisation and an increase of obesity and physical inactivity. Unlike in the West, where older persons are most affected, diabetes in Asian countries is disproportionately high in young to middle-aged adults. This could have long-lasting adverse effects on a nation's health and economy, especially for developing countries. The International Diabetes Federation (IDF) estimates the total number of people in India with diabetes to be around 50.8 million in 2010, rising to 87.0 million by 2030. The primary goal in the management of diabetes mellitus is the attainment of near-normal glycaemia. In India, more than half of patients have poor glycaemic control and have vascular complications. Therefore, there is an urgent need to develop novel therapeutic agents of diabetes without the development and progression of complications or compromising on safety. Glucagon-like peptide-1 (GLP-1) analogues and dipeptidyl peptidase-4 (DPP-4) are novel agents that show promising results. Exenatide is the first in the incretin mimetic class and liraglutide is a once-daily human GLP-1 analogue. Oncedaily liraglutide was effective and well tolerated when used as monotherapy or in combination with oral antidiabetic drugs (OADs) in patients with type 2 diabetes, and is therefore a promising new treatment option for the management of type 2 diabetes. © SUPPLEMENT TO JAPI.


We report a case documenting fluorodeoxyglucose (FDG) accumulation in cervical, supraclavicular and axillary lymph nodes resulting from acute toxoplasmosis. A 50-year-old Indian female with history of non-Hodgkin's lymphoma (NHL) of left breast, postchemotherapy status, was found to have hypermetabolic right cervical, supraclavicular and axillary lymph nodes on a surveillance FDG positron emission tomography/computed tomography (PET/CT) scan. Her previous two PET/CT scans were unremarkable with no evidence of metabolically active disease. Therefore, a differential diagnosis of relapse of NHL versus infectious/inflammatory pathology was raised in the report. Biopsy of axillary lymph node demonstrated features characteristic of toxoplasmosis. The serological test results were also compatible with acute toxoplasmosis infection. Infective and inflammatory diseases are known to accumulate FDG, resulting in false positives for malignancy. This case demonstrates lymph nodal toxoplasmosis as a potential cause of false positive FDG PET/CT findings in patients with known malignancy and highlights the importance of histopathological and laboratory correlation for the accurate interpretation of FDG PET/CT scans.

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