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M Elmay

Publications and source records attributed to M Elmay.

18 recordsLinked to original sources

[Desmoid cervical tumour following the placing of an internal jugular catheter].

INTRODUCTION: A desmoid tumour is a rare fibroblastic tumour and generally located in the abdomen. However, it can also develop on surgical scars. OBSERVATION: A 36 year-old woman on chronic dialysis consulted for a cervical mass on the left side that was progressively increasing in volume, on the site of a scar of an internal jugular catheter placed 7 months earlier. Histological analysis of a sample of this mass concluded in a benign fibroblastic proliferation and led to the diagnosis of a desmoid tumour. Study of the patient's history revealed that a left jugular catheter had been placed on two occasions to be used for the hemodialysis approach, the lesion provoked by the latter would explain the development of the desmoid tumour. COMMENTS: The potential severity of this tumour is related to its proximity with the carotid, trachea and base of the skull. In general, desmoid tumours, rare benign tumours of the connective tissue, exhibit a complex multifactor etiopathogenesis. A surgical trauma can often trigger-off such tumours.

Adult↗

[Feminine pseudo-hermaphroditism and ovarian polycystic syndrome: the role of hydrocortisone].

We report the case of a patient who was initially assigned as a male, and in whom the diagnosis of CAH was delayed (17 years of age). He was shown to have female pseudohermaphrodites. Before treatment, plasma testosterone level was: 15 ng/mL (N: 0.1-0.7), 17 OH progesterone (17 OHP): 45 ng/mL (N: 0.1-1.1) and FSH, LH values were below the normal range. While taking hydrocortisone, a rapid onset of new clinical, biological and radiological findings were observed after three months: rapid menarche and thelarche occurred, plasma testosterone and 17 OHP levels decreased, respectively 1 and 3.7 ng/mL, plasma FSH and LH were respectively 4.1 mUI/mL (N: 1.5-7) and 14.3 m UI/mL (N: 1.1-11.7). Polycystic ovaries were shown at sonography. Authors try to discuss the mechanism of the new events observed and specially those related to the polycystic ovarian disease. In a female with untreated CAH at adult age, menarche can rapidly occur once appropriate treatment was started.

17-alpha-Hydroxyprogesterone↗

Large bilateral adrenal incidentalomas complicating untreated 11B hydroxylase deficiency in the third decade of life. A case report.

The occurrence of bilateral giant adrenal incidentalomas is reported in a 22-year-old man who was evaluated for urinary tract infection. The right gland measured 16 cm, the left one 6 cm at computed tomography. Height was 145 cm, blood pressure 190/100 mm Hg. Testes were not palpable. Laboratory investigations revealed elevated levels of 17 hydroxyprogesterone:>50 ng/ml (n<1,1); 11 desoxycortisol: 919 nmol/l (n<30); testosterone: 19 ng/ml (n<0.7) and ACTH: 1 402 ng/l (n<48). Karyotype was 46 XX. The patient was a female pseudohermaphrodite with congenital adrenal 11 B hydroxylase deficiency. Adrenal masses responded to glucocorticoid therapy with marked reduction of their size after six months. We confirm previous recommendations that patients with adrenal incidentaloma should be checked for congenital adrenal hyperplasia.

Adrenal Gland Neoplasms↗

[Primary hypothyroidism and glomerular involvement].

Association between auto-immune dysthyroidism and glomerulonephritis is quite rare. The authors report 3 cases with proteinuria varying from 2.72 to 6.06 g/day and hypothyroidism. Nephrotic syndrome was found in 2 cases and thyroid auto-antibodies (microsomal and thyroglobulin) and circulating immun complexes (C.I.C.) in 1 case, complement fractions C3 and C4 were normal in all cases. Renal biopsy showed membranous glomerulonephritis in 2 cases and minimal lesions in the third case. Proteinuria disappeared with glucocorticoids and thyroxine in 1 case, with thyroxine alone in an other case and persisted in the third case with normal thyroid function.

Adult↗

[Familial distal tubular acidosis].

This study concerned a Tunisian family of 52 members. We have looked for distal tubular acidosis (D.T.A.) after we had discovered that 2 members of this family suffered from nephrocalcinosis with D.T.A. Twenty six of our patients (group I) suffered from D.T.A., 17 from confirmed metabolic acidosis with low urinary pH (5.22 +/- 0.25). Patients of latest groups may present a D.T.A. with intact capacity to lower urinary pH. Our literature review revealed 27 families composed of 228 patients.

Acidosis, Renal Tubular↗

[Diagnosis of extruded herniated disks].

In a patient with disk herniation it is often difficult to establish that the disk is free in the spinal canal. A retrospective medical record study comparing 65 cases of free herniated disk (FHD) confirmed upon surgery and 65 cases of disk protrusion (DP) demonstrated that FHD was more common in young male blue collar workers, especially those who worked in the sitting position. No clinical findings were diagnostic of FHD although the straight-leg raising test was positive at smaller angles than in disk protrusion. In this study, sensitivity and specificity of CT scan for the diagnosis of FHD were 75% and 80%, respectively. CT scan findings suggestive of FHD included a free disk fragment, found in 22.5% of cases, and an acute connecting angle. Saccoradiculography was more sensitive but less specific than CT scan in this study. In FDH, migration was common and ragged hernia contours were seen on the saccoradiculography images.

Adult↗

[The nephrotic syndrome in kala-azar].

Glomerular nephropathy is unusually known in kala-azar. We present 3 cases and we report a review on the clinical, biological and immunohistological aspects of this glomerulonephritis. The immunologic mechanisms of this parasitic nephropathy and its reversibility after specific treatment are characteristic.

Child↗