Ann Endocrinol Paris
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Ann Endocrinol Paris · Nov 2008
Unilateral testicular tumour associated to congenital adrenal hyperplasia: Failure of specific tumoral molecular markers to discriminate between adrenal rest and leydigioma.
Testicular adrenal rest tumours are frequently associated with congenital adrenal hyperplasia (CAH). These ACTH-dependent tumours cannot be easily distinguished histologically from Leydig-cell tumours. We report the case of a 30-year-old man who was explored for infertility, azoospermia and unilateral testicular tumour. ⋯ No 11-beta-hydroxylase nor ACTH receptor mRNAs could be found in the tumour, which did not behave like usual adrenal rest cells. For this unilateral testicular tumour, the lack of adrenal-specific markers associated with a high rate of mitosis and pleiomorphism supported a leydigian origin with malignant potential. However, lack of tumoral LH-R mRNA expression and a tumour-free 3-year follow-up led us to retain the diagnosis of adrenal rest tumour with loss of adrenal gene expression and progressive autonomous behaviour.
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X-linked adrenoleukodystrophy (ALD) is a severe neurodegenerative disorder. ALD is characterized by progressive demyelination within the central and peripheral nervous system, adrenal insufficiency (Addison's disease) and accumulation of very-long-chain fatty acids (VLCFA) in plasma, fibroblasts and tissues. The overall incidence of ALD is 1:17,000 including hemizygotes and heterozygotes who are frequently symptomatic. ⋯ Treatment of Addison's disease is mandatory but does not modify the course of neurological symptoms. Dietary therapy failed to halt the neurologic progression in cerebral ALD and AMN. It might have a partial preventive effect in boys treated before 6 years of age.
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Ann Endocrinol Paris · Oct 2007
Case Reports[Cerebral salt wasting syndrome in bacterial meningitis].
Subarachnoid hemorrhage is the most common cause of cerebral salt wasting syndrome. There are few reports of this condition in infectious meningitis. ⋯ The purpose of this report is to alert clinicians to the fact that hyponatremic patients with central nervous system disease do not necessarily have a syndrome of inappropriate secretion of antidiuretic hormone (SIADH), but may have cerebral salt wasting syndrome. By contrast with SIADH, the treatment requires saline administration.
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Ann Endocrinol Paris · Dec 2004
[Thyroid hormone levels and thyroid dysfunction of French adults participating in the SU.VI.MAX study].
Abnormal thyroid function has important public health consequences. However, the various degrees of thyroid dysfunction remain unsettled. The SU. ⋯ In summary, abnormal TSH values and thyroid dysfunction were more prevalent in women than men, increased with age and were significantly associated with environmental factors. A high prevalence of identified thyroid diseases in the French population was confirmed by the high number of subjects in this study with laboratory evidence of abnormal biochemical thyroid function. Further studies are needed to determine the geographical determinants of thyroid dysfunctions, especially regional differences in iodine intakes, and to assess the long-term adverse effects of biochemical thyroid dysfunction on all-cause morbidity.
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Obesity and osteoarthritis are frequently associated, particularly in older patients. Obesity increases the relative risk to develop knee or hip osteoarthritis, mainly in case of early obesity. ⋯ Therapeutic management of obese patients is not different from those of non-obese patients; however, it is essential to integrate weight loss within the therapeutic project. Obesity should not be a contraindication to total knee or hip replacement, but weight loss has to be part of the pre- and post surgical management program of the obese patient.