Bone Mineral Density in Children and Adolescents with Congenital Adrenal Hyperplasia

Chronic glucocorticoid therapy is associated with reduced bone mineral density. In paediatric patients with congenital adrenal hyperplasia, increased levels of androgens could not only counteract this effect, but could also advance bone age, with interference in the evaluation of densitometry. We evaluate bone mineral density in paediatric patients with classic congenital adrenal hyperplasia taking into account chronological and bone ages at the time of the measurement. Patients aged between 5 and 19 years underwent radiography of the hand and wrist followed by total body and lumbar spine densitometry. Chronological and bone ages were used in the scans interpretation. In fourteen patients, mean bone mineral density Z-score of total body to bone age was −0.76 and of lumbar spine to bone age was −0.26, lower than those related to chronological age (+0.03 and +0.62, resp.). Mean Z-score differences were statistically significant (P=0.004 for total body and P=0.003 for lumbar spine). One patient was classified as having low bone mineral density only when assessed by bone age. We conclude that there was a reduction in the bone mineral density Z-score in classic congenital adrenal hyperplasia paediatric patients when bone age was taken into account instead of chronological age

Insulin autoimmune syndrome: case report

CONTEXT: Insulin autoimmune syndrome (IAS, Hirata disease) is a rare cause of hypoglycemia in Western countries. It is characterized by hypoglycemic episodes, elevated insulin levels, and positive insulin antibodies. Our objective is to report a case of IAS identified in South America. CASE REPORT: A 56-year-old Caucasian male patient started presenting neuroglycopenic symptoms during hospitalization due to severe trauma. Biochemical evaluation confirmed hypoglycemia and abnormally high levels of insulin. Conventional imaging examinations were negative for pancreatic tumor. Insulin antibodies were above the normal range. Clinical remission of the episodes was not achieved with verapamil and steroids. Thus, a subtotal pancreatectomy was performed due to the lack of response to conservative treatment and because immunosuppressants were contraindicated due to bacteremia. Histopathological examination revealed diffuse hypertrophy of beta cells. The patient continues to have high insulin levels but is almost free of hypoglycemic episodes

Biochemical, hormonal and genetic evaluation of the families of two Brazilian patients with type 2 familial partial lipodystrophy (Partially pictured article)

ARTIGO PARCIALMENTE RETRATADO - O Conselho Editorial dos Arquivos Brasileiros de Endocrinologia e Metabologia, ISSN 0004 2730, decidiu, após análise, retratar as figuras 1 e 2 do seguinte artigo original: Caldas D, Silva Júnior WS, Simonetti JP, Costa EV, de Farias MLF. Avaliação bioquímica, hormonal e genética das famílias de duas pacientes brasileiras portadoras de lipodistrofia parcial familiar tipo 2. ABEM. 2013;57/8:583-93. Trata-se de solicitação das pacientes retratadas. Lamentamos qualquer mal-entendido causado ao nosso leitor.Submitted by Sandra Infurna ([email protected]) on 2019-12-03T15:03:01Z No. of bitstreams: 1 JosePascoaSimonetti_etal_IOC_2013.pdf: 550641 bytes, checksum: bc89614583d69ebc4f261c9139d11e83 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-12-03T15:59:21Z (GMT) No. of bitstreams: 1 JosePascoaSimonetti_etal_IOC_2013.pdf: 550641 bytes, checksum: bc89614583d69ebc4f261c9139d11e83 (MD5)Made available in DSpace on 2019-12-03T15:59:22Z (GMT). No. of bitstreams: 1 JosePascoaSimonetti_etal_IOC_2013.pdf: 550641 bytes, checksum: bc89614583d69ebc4f261c9139d11e83 (MD5) Previous issue date: 2013Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione. Rio de Janeiro, RJ, Brasil.Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro. Programa de PósGraduação em Fisiopatologia Clínica e Experimental. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro. Programa de PósGraduação em Fisiopatologia Clínica e Experimental. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Avaliar características clínicas, bioquímicas, hormonais e genéticas de familiares de duas pacientes portadoras de lipodistrofia parcial familiar (FPLD) tipo 2.To evaluate clinical, biochemical, hormonal and genetic characteristics of relatives of two patients with familial partial lipodystrophy (FPLD) type 2

Análise densitométrica da região femoral de homens acima de 50 anos oriundos de um ambulatório de urologia

INTRODUÇÃO: A osteoporose em homens ainda é pouco diagnosticada. O objetivo deste estudo é mensurar a densidade mineral óssea (DMO) e a prevalência de osteoporose em uma amostra de homens. PACIENTES E MÉTODOS: Cento e cinquenta e um homens de 50 a 93 anos, em boas condições clínicas, oriundos de um ambulatório de rotina de Urologia, realizaram a medida da densidade óssea da coluna lombar e da região femoral. RESULTADOS: A idade teve influência negativa na DMO e no T-Score femoral (rs = 0,49 e 0,73, respectivamente, P < 0,0001), utilizando o coeficiente de correlação de Spearman. Detectamos osteoporose na região femoral em 25,16% (n = 38). A maioria (81,56%) dos pacientes osteoporóticos tinha mais de 70 anos, sendo uma parcela expressiva (47,37%) muito idosa, ou seja, homens com 80 anos ou mais. Além da idade, hipogonadismo induzido por análogo de GNRH ou acetato de ciproterona para tratamento de câncer de próstata, uso crônico de anticoagulante, histórico de revascularização miocárdica e uso de álcool foram fatores de risco encontrados em cerca de 18% da população osteoporótica. CONCLUSÃO: Todos os homens acima de 70 anos e também os mais jovens com fatores de risco devem realizar densitometria óssea