RESUMEN
We report the case of a B-cell type pituitary lymphoma in a 65 year-old male immunocompetent patient who presented with hypogonadotropic hypogonadism and central hypothyroidism and subsequently developed pulmonary lymphoma. Only three cases of pituitary lymphoma have been previously reported, one in a patient with acquired immunodeficiency syndrome, one case of T-cell lymphoma reported in the Japanese literature, and one case of B-cell lymphoma. The previously reported immunocompetent patients presented with signs and symptoms of optic chiasm compression as contrasted to our patient's endocrinologic presentation. B-cell lymphoma of the pituitary gland is a exceedingly rare though distinct clinical entity.
Asunto(s)
Linfoma de Células B/complicaciones , Linfoma de Células B/patología , Neoplasias Hipofisarias/complicaciones , Neoplasias Hipofisarias/patología , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Anciano , Diagnóstico Diferencial , Humanos , Hipogonadismo/complicaciones , Hipogonadismo/patología , Hipogonadismo/terapia , Hipotiroidismo/complicaciones , Hipotiroidismo/patología , Hipotiroidismo/terapia , Linfoma de Células B/terapia , Linfoma de Células B/ultraestructura , Linfoma de Células T/complicaciones , Linfoma de Células T/patología , Linfoma de Células T/terapia , Masculino , Quiasma Óptico/fisiopatología , Neoplasias Hipofisarias/terapia , Neoplasias Hipofisarias/ultraestructuraRESUMEN
Some features of hyperthyroidism mimic sympathetic nervous system overactivity. We have compared the clinical (scored on the Wayne Therapeutic Index), hemodynamic (blood pressure and heart rate) and biochemical (plasma epinephrine, norepinephrine, glucose, free fatty acids, insulin, growth hormone and free thyroxine index) effects of clonidine (alpha 2-agonist, which reduces plasma catecholamine levels) with those of nadolol (non-selective beta adrenergic receptor antagonist) in ten female hyperthyroid patients. Each patient received nadolol for 1 week followed by clonidine for 1 week in a single-blind manner. All measurements were made before treatment and then repeated at the end of the nadolol and clonidine treatment periods. Thyroid function remained unaltered during the study. Both agents caused significant clinical improvement--the mean Wayne Index score was 18 pretreatment, 2 on nadolol and 6 on clonidine (P less than .003 for each). Heart rate was reduced by both drugs, but blood pressure was unchanged. Side effects occurred in eight out of ten patients while on clonidine. Nadolol increased plasma concentrations of epinephrine from 47 +/- 18 pg/mL to 87 +/- 24 pg/mL, and norepinephrine from 241 +/- 154 pg/mL to 338 +/- 224 pg/mL (P less than .001 for each). In contrast, clonidine depressed norepinephrine levels from 241 +/- 154 pg/mL to 110 +/- 49 pg/mL (P less than .001) without lowering plasma epinephrine significantly. Plasma free fatty acids tended to fall on both agents compared to pretreatment levels. The blood glucose, insulin and growth hormone concentrations were unaffected by either drug.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Clonidina/uso terapéutico , Hipertiroidismo/tratamiento farmacológico , Nadolol/uso terapéutico , Adulto , Biomarcadores/sangre , Presión Sanguínea/efectos de los fármacos , Catecolaminas/sangre , Ensayos Clínicos como Asunto , Ácidos Grasos no Esterificados/sangre , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Hipertiroidismo/sangre , Hipertiroidismo/fisiopatología , Persona de Mediana EdadRESUMEN
Intrathoracic hydatid disease is rarely seen in black patients hospitalized in the Johannesburg area. Eleven patients with pulmonary hydatid disease were treated during 4 years at a major referral center for black patients. The clinical features and management of these patients are described.
Asunto(s)
Equinococosis Pulmonar/diagnóstico , Adolescente , Adulto , Negro o Afroamericano , Anciano , Población Negra , Equinococosis Pulmonar/epidemiología , Equinococosis Pulmonar/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sudáfrica , Salud UrbanaRESUMEN
A case of a middle-aged Black woman with maturity-on-set diabetes is described. The patient had had a cerebrovascular accident and subsequently developed thrombosis of the descending thoracic aorta, with extension into the left subclavian artery and emboli in the right femoral and left brachial arteries. Occlusive large-vessel disease rarely occurs in Black diabetics. Vascular disorders and haemostatic factors in Black and White diabetics are discussed.