Biochemically silent pheochromocytoma — rare, but not uncommon. Case study

Approximately 5–6.5% of adrenal incidentalomas are pheochromocytomas, and 8% of the patients with a pheochromocytoma are completely asymptomatic. Marker-negative pheochromocytomas represent a small group of rare tumours, yet rarely reported in the current medical literature. In the current study presents a case of 49-year old patient with hypertension, caused by biochemically silent pheochromocytoma and the potential medical complications, which can be particularly dangerous in cases of misdiagnosed, non-functional tumours

The role of serological testing for <i>Chlamydia trachomatis</i> in differential diagnosis of pelvic pain

Introduction Pelvic pain is typically associated with pelvic inflammatory disease (PID). The most common cause of PID is Chlamydia trachomatis . The aim of this study was to verify the role of serological testing for Chlamydia trachomatis in patients with suspected PID. Material and Methods The retrospective study included 185 patients with pelvic pain hospitalized at the Department of Obstetrics and Gynecology in 2003 and 2004. Titers of anti- Chlamydia trachomatis IgG and IgA were measured by means ELISA immunoassays. Erythrocyte sedimentation rate (ESR), serum concentration of C-reactive protein (CRP) and leukocyte count (WBC) were also determined. Final diagnosis was established on the basis of laparoscopic examination. Results The presence of anti- Chlamydia trachomatis antibodies correlated significantly with abnormal values of ESR, WBC and CRP. The most common laparoscopic pathology were pelvic adhesions, typically found in women with elevated titers of anti- Chlamydia trachomatis IgG. Conclusions Serological examination for Chlamydia trachomatis is helpful in evaluation of patients with suspected PID. Elevated titers of anti- Chlamydia trachomatis antibodies are frequently associated with laparoscopic evidence of pelvic adhesions and inflammation

The role of serological testing for Chlamydia trachomatis in differential diagnosis of pelvic pain

Introduction Pelvic pain is typically associated with pelvic inflammatory disease (PID). The most common cause of PID is Chlamydia trachomatis . The aim of this study was to verify the role of serological testing for Chlamydia trachomatis in patients with suspected PID. Material and Methods The retrospective study included 185 patients with pelvic pain hospitalized at the Department of Obstetrics and Gynecology in 2003 and 2004. Titers of anti- Chlamydia trachomatis IgG and IgA were measured by means ELISA immunoassays. Erythrocyte sedimentation rate (ESR), serum concentration of C-reactive protein (CRP) and leukocyte count (WBC) were also determined. Final diagnosis was established on the basis of laparoscopic examination. Results The presence of anti- Chlamydia trachomatis antibodies correlated significantly with abnormal values of ESR, WBC and CRP. The most common laparoscopic pathology were pelvic adhesions, typically found in women with elevated titers of anti- Chlamydia trachomatis IgG. Conclusions Serological examination for Chlamydia trachomatis is helpful in evaluation of patients with suspected PID. Elevated titers of anti- Chlamydia trachomatis antibodies are frequently associated with laparoscopic evidence of pelvic adhesions and inflammation

Simultaneous unilateral laparoscopic adrenalectomy for pheochromocytoma and thyroidectomy in MEN 2A and MEN 2B syndrome

Not required for Clinical Vignette

Massive upper gastrointestinal bleeding from a splenic artery pseudoaneurysm caused by a penetrating gastric ulcer : case report and review of literature

BACKGROUND: Splenic artery aneurysm and pseudoaneurysm are rare pathologies. True aneurysms are usually asymptomatic. Aneurysm rupture occurring in 2-3% of cases results in bleeding into the lesser sack, peritoneal space or adjacent organs typically presenting as abdominal pain and hemodynamic instability. In contrast, pseudoaneurysms are nearly always symptomatic carrying a high risk of rupture of 37-47% and mortality rate of 90% if untreated. Therefore, prompt diagnosis and treatment are essential in the management of patients with splenic artery pseudoaneurysm. Typical causes include pancreatitis and trauma. Rarely, the rupture of a pseudoaneurysm presents as upper gastrointestinal (UGI) bleeding. Among causes, peptic ulcer is the casuistic one. CASE REPORT: This report describes a very rare case of recurrent UGI bleeding from a splenic artery pseudoaneurysm caused by a penetrating gastric ulcer. After negative results of endoscopy and ultrasound, the diagnosis was established in CT angiography. The successful treatment consisted of surgical ligation of the bleeding vessel and suture of the ulcer with preservation of the spleen and pancreas, which is rarely tried in such situations. CONCLUSIONS: The most important factor in identifying a ruptured splenic artery pseudoaneurysm as a source of GI bleeding is considering the diagnosis. UGI hemorrhage from splenic artery pseudoaneurysm can have a relapsing course providing false negative results of endoscopy and ultrasound if performed between episodes of active bleeding. In such cases, immediate CT angiography is useful in establishing diagnosis and in application of proper therapy before possible recurrence

Clinical analysis of selected complement-derived molecules in human adipose tissue

Abstract Background It has been suggested that action of complement cascade [CC]-derived anaphylatoxins/molecules may represent a missing link between obesity and metabolic disorders. However, to date, the direct biochemical/immunomodulatory composition of the human AT environment remains poorly understood. In this study, we examined plasma and AT (subcutaneous and visceral/omental) levels of selected CC-derived anaphylatoxins/molecules, and adipsin as well as verified their associations with immune and stem cells chemoattractant - stromal-derived factor-1 (SDF-1). Methods A total of 70 (35 subcutaneous and 35 omental) AT samples were obtained from patients undergoing elective surgery. Plasma and AT-derived interstitial fluid levels of C3a, C5a, C5b-9/membrane attack complex (MAC), complement factor D (adipsin) were measured using ELISA. Results AT levels of all examined substances were significantly lower than the corresponding levels in the plasma (in all cases P  Conclusions Our study demonstrated for the first time that significantly reduced levels of complement-derived molecules were present in human AT than in the peripheral blood, and that these factors are associated with the metabolic status of examined individuals. Moreover, in human AT, various associations between complement-derived molecules and SDF-1 levels exist.</p