Bilateral giant adrenal myelolipoma associated with congenital adrenal hyperplasia

Adrenal myelolipomas are rare benign tumors, often non-functioning, located in the adrenal cortex, consisting mainly of mature adipose tissue and hematopoietic tissue. Although uncommon, the number of reported cases has increased due to the greater use of diagnostic imaging techniques. This tumor is usually unilateral and found as an adrenal incidentaloma, although there is a predominance of bilaterality in patients with congenital adrenal hyperplasia (CAH). In this study, we report the case of a 33-year-old male patient with CAH due to 21-hydroxylase deficiency, in non-regular use of the control medication, with bilateral giant adrenal myelolipoma and subsequent evolution of bilateral testicular adrenal rest tumors. He underwent bilateral adrenalectomy by video laparoscopy. The anatomopathological analysis, which confirmed myelolipomas’ diagnosis, revealed the right adrenal with 430 g and 12.5 x 9.3 cm and the left with 257 g and 11.5 x 10.4 cm. This tumor may be accompanied by adrenocortical adenoma and carcinoma, ganglioneuroma, pheochromocytoma, Addison’s disease, Cushing’s syndrome, or CAH.Among the hypotheses of its pathogenesis, we highlight an association between the development of adrenal myelolipoma and chronic hormonal stimulation by the adrenocorticotrophic hormone (ACTH), especially in CAH. The non-regular treatment of CAH with glucocorticoids may have contributed to the chronic and elevated secretion of ACTH and, consequently, to the development of bilateral giant adrenal myelolipoma.Mielolipomas adrenais são tumores benignos raros, com frequência não-funcionantes, localizados no córtex da adrenal, constituídos, principalmente, por tecido adiposo maduro e tecido hematopoético. Apesar de incomum, onúmero de casos relatados tem aumentado devido ao maior uso de técnicas diagnósticas de imagens. Esse tumor é geralmente unilateral e encontrado como um incidentaloma adrenal, embora haja predominância de bilateralidadeem casos de portadores de hiperplasia adrenal congênita (HAC). Neste estudo, relatamos o caso de um paciente do sexo masculino, de 33 anos, portador de HAC por deficiência de 21-hidroxilase, em uso não-regular da medicaçãode controle, com mielolipoma adrenal gigante bilateral e posterior evolução de tumor bilateral testicular de restos de adrenais. Ele foi submetido à adrenalectomia bilateral por videolaparoscopia. A análise anátomo-patológica, que confirmou o diagnóstico de mielolipomas, revelou adrenal direita com 430 g e 12,5 x 9,3 cm, e esquerda com 257 g e 11,5 x 10,4 cm. Esse tumor pode vir acompanhado de adenoma e carcinoma adrenocortical, glanglioneuroma, feocromocitoma, doença de Addison, Síndrome de Cushing ou HAC. Dentre as hipóteses de sua patogênese, destacamosuma associação entre o desenvolvimento do mielolipoma adrenal e a estimulação hormonal crônica pelo hormônio adrenocorticotrófico (ACTH), especialmente na HAC. O tratamento não-regular da HAC com glicocorticoides pode ter contribuído para a secreção crônica e elevada de ACTH e, consequentemente, para o desenvolvimento do mielolipoma adrenal gigante bilateral

Enzima-imunoensaio para deteccao de anticorpos anti-tiroglobulina no soro: desenvolvimento metodologico e implicacoes diagnosticas

BV UNIFESP: Teses e dissertaçõe

The effect of different training programs on antioxidant status, oxidative stress, and metabolic control in type 2 diabetes

We compared the effects of 12 weeks of 3 different exercise types on type 2 diabetic (T2DM) male and female human subjects, randomly divided into 4 groups: aerobic training (AT; n = 11), strength training (ST; n = 10), combined training (CBT; n = 10), and no training (NT; n = 12). Metabolic control, anthropometric parameters, lipid and hematological profiles, kidney and liver function markers, hormones, antioxidant enzymes, and oxidative stress markers were assessed prior to and after the training programs. At baseline, fasting blood glucose and hemoglobin A(1c) in the ST group were higher than in the NT group; after the training, we no longer observed differences in these groups, suggesting an improvement on these parameters. in the AT group, catalase and superoxide dismutase activity, nitrite concentration, levels of sulfhydryl groups, and peak rate of oxygen consumption were elevated after the training (p < 0.05). No changes were observed in antioxidant enzymes or oxidative stress markers in the ST group. the levels of sulfhydryl groups diminished in the NT group (p < 0.01) and increased in the CBT group (p < 0.05). These data demonstrate that the AT program for the T2DM subjects provided important upregulation in antioxidant enzymes and increased nitric oxide bioavailability, which may help minimize oxidative stress and the development of the chronic complications of diabetes. We propose that the beneficial effects observed in the metabolic parameters of the ST group occurred in response to the poor baseline metabolic health n this group, and not necessarily in response to the training itself.Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG)Univ Fed Uberlandia, Inst Genet & Biochem, BR-38400902 Uberlandia, MG, BrazilUniv Fed Uberlandia, Dept Clin Med, Fac Med, BR-38400902 Uberlandia, MG, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, BR-04020060 São Paulo, BrazilUniv Fed Uberlandia, Fac Phys Educ, BR-38400678 Uberlandia, MG, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, BR-04020060 São Paulo, BrazilFAPEMIG: EDT 3273/06Web of Scienc