RESUMEN
While NHL commonly affects lymph nodes, peritoneal lymphomatosis causing ascites is rare in pediatric patients. We present a unique case of DLBC lymphoma in a Peruvian child presenting as ascites associated with peritoneal lymphomatosis. The 11-year-old boy was admitted with ascites and dyspnea. Physical examination revealed collateral circulation, abdominal distension, and diminished breath sounds. Investigations led to a suspected diagnosis of peritoneal tuberculosis; however, a laparoscopic biopsy showed granulomatous infiltration consistent with high-grade diffuse B-cell lymphoma. The peritoneal lymphomatosis causing ascites is uncommon, and its initial presentation as peritoneal symptoms is even rarer. Differential diagnosis between peritoneal tuberculosis and DLBCL involvement can be challenging due to both shared signs and symptoms. Staging systems, such as the International Pediatric NHL Staging System, aid in determining the extent of the disease. DLBCL has a good prognosis, with treatment regimens such as the LMB-89 protocol showing high overall survival rates. Awareness of DLBCL's atypical presentations is crucial for timely diagnosis and management in the pediatric population. To conclude, children with ascites represent a diagnostic challenge posed by overlapping symptoms with other conditions, such as tuberculosis, and the need for a comprehensive approach to rule out different etiologies. Additionally, it is important the prompt treatment to avoid complications.
RESUMEN
AIM: To evaluate the association between elevated body fat percent (BF%) and the prevalence of insulin resistance (IR) in the adult population with body mass index (BMI) in the normal values. METHODS: We carry out an analytical cross-sectional study. The participants attended outpatient from 2012 to 2016 in a private clinic in Lima-Peru between 18 and 60 years with a BMI between 19 and 24.9/Kg/m2. We defined elevated BF% if the values were greater than 25% in men and 30% in women and IR with a cut-off point of HOMA-IR based in the 75th percentile. We performed a generalized linear model from family Poisson (crude and adjusted) with robust standard errors to evaluate the association between BF% and the IR. We reported as association measure the prevalence ratio (PR) with their respective 95% confidence intervals (CI). RESULTS: We included 284 participants, the average age was 33.77⯱â¯10.86 (SD) years and the percentage of women was 88.1%. The prevalence of elevated BF% was 71.13% and the prevalence of IR was 25%. We found an association between the elevated BF% and IR, PRâ¯=â¯3.17; 95% CI: 1.46-6.91. CONCLUSIONS: Body fat percentage seems to be a good indicator of IR in patients with normal BMI and without endocrine comorbidities. Longitudinal prospective studies are recommended to corroborate our findings.