Biomedical subjects

M Chaieb Chadli

Publications and source records attributed to M Chaieb Chadli.

3 recordsLinked to original sources

PubMed2005

[Factitious Cushing syndrome: two case reports].

INTRODUCTION: Search of corticosteroid use is an important precaution before any exploration of hypercorticism. Nevertheless, this use may be factitious leading to serious misdiagnosis and pitfalls. EXEGESIS: We report two cases of 29 and 60 years old male patients, referred for hypercorticism with patent features including metabolic and trophical signs. Laboratories findings revealed unelevated urinary cortisol values (40 and 27 microg/ day) in both cases with normal ACTH and normal plasmatic cortisol response to synacthène (32,5 and 35 microg/dl). Corticosteroid use, initially denied, was finally approved by the patients (hydrocortisone and dexamethasone for the first patient and betametasone for the second). So, they were assigned to psychiatric therapy. CONCLUSION: Our cases emphasize that corticosteroid misuse must be evoked in patients with unexpected hormonal assessment of pituitary adrenal axis despite patent clinical features of hypercorticism. Several specific tests are actually available for detect factitious Cushing syndrome. However, differential diagnostic remains difficult mainly with pseudo Cushing and cyclical Cushing syndromes.

Adolescent↗

PubMed2004

[Hepatic abscess in diabetics, 2 case reports].

INTRODUCTION: Over the past few years, the hepatic abscess appears as a privileged septic localisation in the case of diabetes mellitus, particularly in the elderly. OBSERVATIONS: Two, 75 year-old and 82 year-old, diabetic patients were hospitalised for non-ketonic decompensation of type 2 diabetes mellitus. Examination revealed a sub-febrile state, the absence of clinical hepatic signs and a biological infectious syndrome The abscesses were discovered during the systematic hepatic sonography. Liver puncture was only possible in one patient and revealed Klebsiella oxytoca. The progression with antibiotics alone in one patient, and associated with surgical draining in the other, was positive. The origin appeared to be bilary in one patient and arterial on the other. COMMENTS: These case reports underline the interest of the systematic evocation of an abscessed hepatic localisation in cases of imbalance in diabetes, particularly when associated with an unexplained infectious syndrome.

Aged↗

PubMed2003

[Craniopharyngioma of the adults. Three cases].

Craniopharyngioma, an intra- and suprasellar tumor generally observed in pediatric patients, can also occur in adults. We report three cases of histologically confirmed craniopharyngioma in three men aged 34 to 53 Years. Clinical manifestations were headache with visual and gonadic disorders associating impotence, infertiligy, and gynecomastia. Computed tomographic and magnetic resonance imaging revealed an intra- and suprasellar tumor with solid, hydric, and calcified components. Third ventricle compression was observed in two patients. Hormone test revealed gonadotrope insufficiency in two patients, associated with hyperprolactinemia in one of them, and pituitary insufficiency in the third patient. None of the patients had diabetes insipidus. The frontopterional approach was used for surgery. One patient died and the two others experienced persistent visual impairment with worsening pituitary insufficiency. Our observations suggest that these craniopharyngiomas were probably clinically latent congienital forms since endocrine features were lacking during childhood. Early diagnosis is required to achieve good outcome.

Adult↗