PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Tuberculosis, Endocrine”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 451 records · Page 25Linked to original sources

[Takayasu-Onishi arteritis. Current etiopathogenetic aspects].

By Takayasu-Onishi's arteritis is meant an arteritic process with unknown aetiology which electively affects young women, seemingly of prevalently Asiatic stock. The disease concerns almost exclusively large elastic arteries and presents clinically with early preocclusive symptomatology followed, after a varying period, by a picture of obstructive angiopathy. Here, the most recent aetiopathogenetic findings are considered. The disease's predilection for the young female, together with certain clinical and experimental observations, suggest that a dysendocrine condition may have some pathogenetic responsibility, at least in a favourable sense; this responsibility is documented by the finding of high levels of oestrogenuria during the entire cycle in patients suffering from the disease. On the other hand, the angiopathy localization in the large elastic arteries and in certain segments of the aortic arch and epiaortic trunks means that the role of topographic moments whould not be underestimated. As regards infectious factors, the tubercular and streptococcic continue to be of great importance even today. Neither acts directly, however, but by way of an abnormal immunitary reaction which they seem able to trigger off. The infectious moment would thus appear to be related to the immunitary moment, and the latter would seem to play the part of perpetuating the pathological vascular involvement promoted by contact of the organism with the aetiological agent.

Adolescent↗

Pituitary granuloma and pyoderma gangrenosum.

Pyoderma gangrenosum is a rare chronic and recurrent skin disease characterized by progressing lesions from papulopustules to large necrotic sterile ulcers. Its definite etiology remains unknown. In a 40-year-old woman with typical pyoderma gangrenosum an intrasellar mass with suprasellar extension was diagnosed and removed by transsphenoidal surgery. Histopathological features of the lesion were those of a nonspecific granulomatous hypophysitis. Five months postoperatively the patient experienced visual defects and hypopituitarism demonstrated by endocrine evaluation. Computerized tomography showed the recurrence of the intrasellar expanding mass. Extensive and repeated evaluation failed to find any evidence of sarcoidosis, tuberculosis or histiocytosis. Corticosteroid therapy was preferred to surgery and 80 mg daily prednisone produced a dramatic shrinkage of the pituitary pseudotumor. Long-term follow-up studies did not disclose any recurrence of the pituitary granulomatous process nor objective evidence of underlying disease even after steroid dosage has been tapered. The hypothesis of a pituitary localization of pyoderma gangrenosum is suggested by the similarity between the histopathologic findings of the two conditions and the excellent response to steroid therapy.

Adult↗

[10 cases of xanthogranulomatous pyelonephritis].

Xanthogranulomatous pyelonephritis (XGP) is a chronic inflammation of the kidney usually associated with renal stones, recurrent urinary tract infections or endocrine disorders. A correct preoperative diagnosis is rarely made, since no specific clinical or radiological pattern is known. Differential diagnosis must include renal tuberculosis and renal carcinoma. Ten cases of XGP are reported. Clinical findings, radiological and pathological features, biolaboratory abnormalities are discussed.

Adult↗

Biphasic changes in behavioral, endocrine, and sympathetic systems in adjuvant arthritis in Lewis rats.

Adjuvant arthritis (AA) is an experimental model for rheumatoid arthritis, and is induced most easily in inbred Lewis rats by an intradermal injection of heat-killed Mycobacterium tuberculosis (MT) in incomplete Freund's adjuvant. Susceptivity to the arthritis in Lewis rats is thought to be related to a defect in their responses of the hypothalamo-pituitary-adrenal (HPA) axis to the disease. Because the use of an inbred strain is necessary for our immunological studies, we examined in Lewis rats changes in behavior, the HPA axis, and sympathetic nerve activities during development of the adjuvant arthritis. Following intradermal injections of heat-killed MT in adjuvant, the arthritis began to develop on day 12, reaching its maximum severity on day 21, and remained at the level for over a month. The body temperature rose from day 0 to 5 (the primary phase--before the onset of the arthritis). It then fell to normal temperature, and again rose from day 10 to 21 (the secondary phase--with fully developed arthritis). The behavioral (physical activity, food, and water intake) and hormonal parameters [plasma adrenocorticotropic hormone (ACTH) and corticosterone levels] also changed in two phases, similar to those observed in the temperature responses. No change in plasma vasopressin level was observed. Sympathetic nerve activities, assessed by changes in plasma noradrenalin levels, increased more in the primary than in the secondary phase. The possible causes for the biphasic changes associated with development of arthritis are discussed.

Animals↗

Somatostatin analogue scintigraphy in granulomatous diseases.

Normal as well as activated lymphocytes and macrophages have previously been shown by radioreceptor analysis to express somatostatin receptors (SS-R). The somatostatin (SS) analogue [111In-DTPA-D-Phe1]octreotide (111In-octreotide) is already used successfully in the visualization of a variety of neuro-endocrine tumours and malignant lymphomas. In the present study 20 consecutive patients were investigated, 12 with sarcoidosis, one with both sarcoidosis and aspergillosis, four with tuberculosis and three with Wegener's granulomatosis. For in vivo SS-R imaging, total-body scintigraphy was performed 24 and 48 h after the administration of 111In-octreotide. Granuloma localizations could be visualized in all patients studied; additional sites were found in nine patients with sarcoidosis and in two patients with tuberculosis. In vitro autoradiography of fresh tissue biopsies, using the SS analogue [125I-Tyr3]octreotide, showed binding at sites that were microscopically identified as granulomatous inflammation. These observations demonstrate the expression of SS-R by human granulomas. This scintigraphy procedure may contribute to a more precise staging and evaluation of granulomatous diseases, but more importantly it may be a sensitive indicator of the efficacy of glucocorticoid and/or immunosuppressive therapy.

Adult↗

[Pituitary tuberculosis: a case report].

Through a case of sellar and suprasellar tuberculoma which presented with central diabetes insipidus, the authors report the frequency of pituitary tuberculoma, its physiopathology, clinical presentation hormonal and radiological findings thus management and evolution. A 42 years old woman, with a history of erythema nodosum, presented with polyuria polydipsia (PUPD), amenorrhea and galactorrhea. Endocrine investigations showed central diabetes insipidus, elevated serum prolactin levels and cortisol failure. Magnetic resonance imagining scans (MRI) revealed a nodular thickening of the pituitary enlargement and loss of posterior pituitary hypointensity signal. Etiologic inquiry has removed the diagnosis of sarcoidosis, Langerhan's histosis, autoimmune hypophysitis and sellar metastasis. The history of erythema nodosum, the positivity of tuberculin skin test and the presence of koch bacillus in the bronchial fluid after culture led to a diagnosis of tuberculosis. Treatment was started with four drug antitubercular chemotherapy regimen for 2 months, and tow drug antitubercular chemotherapy regimen for 16 months. This treatment is associated with hydrocortisone, desmopressin nasal spray and bromocriptine. Under treatment, there was an improvement in clinical condition, disapearence of headache, PUPD and galactorrhea thus normalization of prolactin. A follow-up MRI, 8 months later, showed that pituitary lesion has been completely removed, suggesting our clinical and biology presumption. Pituitary tuberculosis is rare, however, when encountered, they may present a diagnostic difficulty. Accurate diagnosis and management is important because pituitary tuberculoma is curable.

Adult↗

Autosensitization to connective tissue elements and endogenous adaptation hormones in mycobacterioses.

The contribution of some adaptation hormones to the process regulating production of autoantibodies to collagen (Abc) and elastin (Abe) was studied in leprosy (37 patients) and tuberculosis (31 patients). In both mycobacterioses the Abc and Abe titers were increased and inversely correlated with endogenous cortisol levels. In leprosy the antibody titers directly correlated with the triiodothyronine (T3) levels which were significantly higher than the values in healthy controls. A new approach to research for remedies and methods of preventing and curing autosensitization to connective tissue is suggested by combining medications according to individual endocrine and immune indices.

Adult↗

Unmasking a current medical pretender: anorexia nervosa in gastrointestinal practice.

Anorexia nervosa (AN) resembles the 'great pretenders' of medicine in the nineteenth century, syphilis and tuberculosis, by presenting occultly as a disorder of specific organs. Many physicians fail to identify the true primary cause, AN, which can mimic in its medical consequences gastrointestinal disorders, endocrine failure, pituitary tumors, or cancer. This is especially likely when the patients are older, have an established complex medical history, and challenge a specialist to find a medical cause and treatment, resulting in ordering more laboratory tests and medical instrumentation. Everyone suffers as a result, including the patient, the family, the frustrated physician, and the National Health Service, for whom the costs of medical care of these patients are enormous and out of proportion. Remembering that AN is as much a medical as a psychological disorder, assessing the patient with more time and expertise in history taking, and referring to a psychiatric consultant when National Institute for Clinical Excellence guidelines for identifying AN in non-mental health settings trigger suspicions, results in good outcome of the AN, cessation of ineffective gastrointestinal treatments, and substantial savings to the National Health Service.

Anorexia Nervosa↗