[Schooling of children with diabetes mellitus followed in the department of paediatrics of Bordeaux].
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Child↗
Biomedical subjects
H Dubourg
Publications and source records attributed to H Dubourg.
[Macronodule associated with bilateral adrenal hyperplasia. A rare misleading cause of primary aldosteronism (two cases)].
Aldosterone-producing adrenal adenoma and bilateral hyperplasia are the two predominant subtypes of primary aldosteronism. Their recognition is based essentially on adrenal CT scan and on measurements of plasma aldosterone and 18-hydroxycorticosterone (18-OHB) concentrations in response to postural testing. We report 2 cases of primary aldosteronism associated with a unilateral hyperplastic macronodule resembling an aldosterone-producing adenoma on CT scan. Plasma aldosterone and 18-OHB concentrations were consistent with this diagnosis in one patient. In the light of these two cases and of those previously published, the investigations needed for the etiological diagnosis of primary aldosteronism are discussed.
18-Hydroxycorticosterone↗
Low levels of serum thyroglobulin after withdrawal of thyroid suppression therapy in the follow up of differentiated thyroid carcinoma.
We evaluated the reliability of very low serum thyroglobulin (Tg) levels (less than 3 ng/ml) obtained after withdrawal of thyroid suppression therapy in 224 patients without anti-Tg antibodies, who had undergone total thyroidectomy (125 patients) or thyroidectomy followed by 1 or more courses of 131I therapy (99 patients), by performing whole body scans after a therapeutic course of 131I given at the same time of Tg measurement. In 79 patients (35%) a positive scan, associated with a very low level of Tg, was noted. The 131I uptake was limited to the thyroid bed in 60 patients, but metastases were demonstrated in 19 patients (8.5%). These results are mainly explained by the much improved performance of scintigraphy after administration of therapeutic doses of 131I. In the majority of patients, especially those whose 131I uptake was limited to the thyroid bed, further scans were negative. Therefore, in these cases, negative Tg values can generally be considered an early indication of satisfactory evolution. However, in 8.5% of all cases, very low Tg levels were associated with metastases. Thus the follow up of thyroid cancer should not rely only upon Tg determination, even after suppression therapy withdrawal.
Adenocarcinoma↗
[Thyroglobulin and thyroid pathology in children].
Thyroglobulin, a marker for thyroid vesicles, is a normal constituent of serum. For the last ten years, thyroglobulin has been routinely assayed using a radioimmunologic double antibody technique. In children, normal values are usually under or equal to 30 ng/ml. Neonates have higher levels. The main indications of thyroglobulin assays in pediatrics include diagnosis of metastases of differentiated thyroid epitheliomas and etiologic diagnosis of congenital hypothyroidism. Thyroglobulin assays are less helpful in the other childhood thyroid diseases (goiter, hyperthyroidism).
Carcinoma↗