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Elleuch M, Ben Bnina M, Loukil F, Hadj Kacem F, Boujelben K, Mnif M, Mnif F, Charfi N, Rekik N, Ben Salah D, Abid M. Metabolic Disorders During Prolactinomas. Metab Syndr Relat Disord 2024; 22:85-89. [PMID: 38232370 DOI: 10.1089/met.2023.0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Abstract
The metabolic profile during prolactinoma may be subject to significant changes. We aimed to describe the different metabolic aspects in patients monitored for prolactinoma and to study the correlations between the size of the prolactinoma and the metabolic parameters. We conducted a retrospective, descriptive, and analytical study of 77 cases of prolactinomas collected and monitored at the endocrinology and diabetology department of the Hedi Chaker Hospital in Sfax between 2000 and 2017. Our patients were divided into three groups according to the size of their prolactinomas. Statistical correlations were sought between tumor size and clinical and biological parameters. The mean age of our patients was 38.3 ± 14.2 years. They were divided into 51 women (66.2%) and 26 men (33.7%). Pituitary tumor syndrome was the most common circumstance of discovery in our population (62.3%). The clinical examination revealed an average waist circumference of 95.71 cm. Android fat distribution was observed in 25 women (49%) and 12 men (46.1%). A statistically significant positive correlation was objectified between waist circumference and tumor size (r = 0.29 and P = 0.019). The average body mass index was 28.08 kg/m2. Obesity was noted in 56 cases (72.7%). Glucose tolerance disorders and hypertriglyceridemia were also more evident each time prolactinoma size increased in contrast to the level of high-density lipoprotein cholesterol which decreased with adenoma size. Our study highlighted the metabolic and hormonal repercussions of prolactinomas. Metabolic syndrome was more common in patients with larger prolactinoma. These results should guide the initial assessment and therapeutic management of prolactin adenomas.
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Affiliation(s)
- Mouna Elleuch
- Department of Endocrinolgy Diabetology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Molka Ben Bnina
- Department of Endocrinolgy Diabetology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Fatma Loukil
- Department of Endocrinolgy Diabetology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Faten Hadj Kacem
- Department of Endocrinolgy Diabetology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Khouloud Boujelben
- Department of Endocrinolgy Diabetology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Mouna Mnif
- Department of Endocrinolgy Diabetology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Fatma Mnif
- Department of Endocrinolgy Diabetology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Nadia Charfi
- Department of Endocrinolgy Diabetology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Nabila Rekik
- Department of Endocrinolgy Diabetology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Dhouha Ben Salah
- Department of Endocrinolgy Diabetology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Mohamed Abid
- Department of Endocrinolgy Diabetology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
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Hadj Kacem F, Trimeche O, Gargouri I, Ben Salah D, Charfi N, Rekik N, Mnif F, Mnif M, Elleuch M, Abid M. Diagnosis and management of pituitary apoplexy: a Tunisian data. Chin Neurosurg J 2023; 9:17. [PMID: 37391784 DOI: 10.1186/s41016-023-00331-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 06/12/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Pituitary apoplexy (PA) is defined as the hemorrhage or the infraction of a pituitary adenoma. Aiming to determine the epidemiological, clinical, paraclinical characteristics as well as management and outcomes of PA in our population, we conducted this cross-sectional study. METHODS This cross-sectional study was conducted at the Department of Endocrinology of Hedi chaker university hospital, Sfax. Data was collected from medical charts of patients with pituitary apoplexy admitted in our department between 2000 and 2017. RESULTS We included 44 patients with PA. Their mean age was 50 ± 12.6 years. Among them, 31.8% had a known pituitary adenoma, and it was in all cases a macroadenoma, predominantly a prolactin secreting tumor (42.8%). A triggering factor of PA was encountered in 31.8% of cases and it was mainly: head trauma, dopamine antagonists, and hypertension. The clinical presentation of PA encompassed headaches (84.1%), visual disturbances (75%), and neurological signs (40.9%). Gonadotropin deficiency was the most frequent form of hypopituitarism noted (59.1%), followed by corticotropin deficiency (52.3%), thyrotropin deficiency (47.7%), and somatotropin deficiency (2.3%). Hormonal assessment at PA onset, concluded that 23 had a secreting adenoma: 18 prolactinomas, 3 ACTH-secreting adenomas, and 2 GH-secreting adenomas. In the 21 remaining cases, the tumor was non-functioning (47.7%). Pituitary MRI was performed in 42 cases (95.5%), revealing infraction and or hemorrhage in the pituitary gland in 33 cases; a heterogenous signal or a fluid level within the adenoma, in nine cases. Urgent administration of intra venous hydrocortisone was required in 19 cases. Mannitol administration was mandatory in a patient who had severe intracranial hypertension. Surgical management of the PA was imperative in 24 patients (54.5%): 15 suffered from severe visual impairment, 4 had an intracranial hypertension, 2 cases demonstrated an impaired consciousness, 2 patients experienced a tumor enlargement and one case had a severe Cushing's disease. Operative complications found were rhinorrhea attributable to cerebral spinal fluid leakage, insipidus diabetes associated with rhinorrhea, isolated insipidus diabetes, and hydrocephalus in one case each. Long-term follow-up concluded that headaches persisted in five cases, owing to the tenacity of a macroprolactinoma regardless of cabergoline treatment in one case, the recurrence of an adenoma in two cases and its persistence despite the medical and the surgical treatment in two patients. Concerning the visual acuity defects, only two patients had persistent diminished visual acuity at long-term follow-up. Among 25 patients, 13 were diagnosed with definitive thyrotropin deficiency. Similarly, 14 patients had persistent corticotropin deficiency (CD). Additionally, CD was de novo diagnosed in two patients. Otherwise, gonadotropin deficiency prevailed in all cases. Persistent prolactin deficiency was seen in two patients. Disappearance of the pituitary tumor was encountered in 11 out of 24 cases at long-term follow-up. Overall, surgery was associated with better outcome than conservative management. Pituitary apoplexy is a challenging condition due to its variable course, its diagnosis difficulty and management, as gaps remain to determine the best approach to treat this condition. CONCLUSIONS To conclude, pituitary apoplexy is a challenging condition due to its variable course, its diagnosis difficulty and management, as gaps remain to determine the best approach to treat this condition. Further studies are thus needed.
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Affiliation(s)
| | | | | | | | | | | | - Fatma Mnif
- Hedi Chaker Hospital, 3029, Sfax, Tunisia
| | - Mouna Mnif
- Hedi Chaker Hospital, 3029, Sfax, Tunisia
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Belabed W, Mnif F, Missaoui AM, Elleuch M, Ben Salah D, Charfi N, Mnif M, Rekik N, Hadj Kacem F, Abid M. Insulinoma with equivocal imaging. Endocrinol Diabetes Metab Case Rep 2023; 2023:23-0015. [PMID: 37227189 DOI: 10.1530/edm-23-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/09/2023] [Indexed: 05/26/2023] Open
Abstract
Summary A 55-year-old patient was admitted to our department for the management of a repetitive alteration of consciousness. Biological investigation results were consistent with endogenous hyperinsulinemic hypoglycemia. Insulinoma was therefore suspected. Abdominal computed tomography and endoscopic ultrasound showed no obvious pancreatic mass.Somatostatin receptor scintigraphy showed abnormal radioactive uptake in both the pancreatic tail and the uncinate process. Contrariwise, abdominal magnetic resonance imaging showed a unique lesion in the pancreas tail. The patient was then proposed for pancreatic surgery. Both intraoperative manual palpation and intraoperative ultrasonography of the pancreas showed a single corporal lesion of 1.5 cm. No lesion was found in the uncinate process. After a left pancreatectomy, the lesion was histopathologically confirmed to be a well-differentiated neuroendocrine tumor. The symptoms of the patient resolved almost immediately following the surgery. The follow-up is one and a half years to date. Learning points The exact preoperative localization of the pancreatic mass remains the most challenging part of insulinoma diagnostic workup. The radiologist's experience is the best warrantor to a precise localization of the tumor. 111In-DTPA-octreotide uptake in the pancreatic uncinate process may be physiological and its interpretation must, therefore, be vigilant. Manual palpation along with intraoperative ultrasonography is considered as the most effective method for the localization of insulinomas during open surgery.
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Affiliation(s)
- Wafa Belabed
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Fatma Mnif
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia
| | | | - Mouna Elleuch
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Dhoha Ben Salah
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Nadia Charfi
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Mouna Mnif
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Nabila Rekik
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Faten Hadj Kacem
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Mohamed Abid
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia
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Elleuch M, Ben Teber S, Ben Salah D, Frikha H, Hamza F, Mnif M, Mnif F, Guermazi F, Hadjkacem F, Abid M. Les modalités du traitement isotopique de la cardiothyréose. Médecine Nucléaire 2023. [DOI: 10.1016/j.mednuc.2023.01.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Elleuch M, Ben Teber S, Ben Salah D, Frikha H, Hamza F, Mnif M, Mnif F, Guermazi F, Hadjkacem F, Abid M. Données de la scintigraphie au cours des complications thromboemboliques de l’hyperthyroïdie. Médecine Nucléaire 2023. [DOI: 10.1016/j.mednuc.2023.01.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Elleuch M, Ben Teber S, Ben Salah D, Frikha H, Hamza F, Mnif M, Mnif F, Guermazi F, Hadjkacem F, Abid M. Place de la scintigraphie dans l’exploration d’une hyperthyroïdie compliquée de cardiothyréose. Médecine Nucléaire 2023. [DOI: 10.1016/j.mednuc.2023.01.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Ben Salah D, Trimeche O, Elleuch M, El abed W, Salah A, Abdelhadi F, Kammoun H, Feki W, Mnif Z, Chaabouni K, Ayedi F, Mnif F, Rekik N, Mnif M, Charfi N, Hadj kacem F, Abid M. Case report: Management challenges of late diagnosed 17-alpha hydroxylase deficiency. Clin Case Rep 2023; 11:e6962. [PMID: 36846181 PMCID: PMC9944042 DOI: 10.1002/ccr3.6962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/24/2023] Open
Abstract
Herein we report the intriguing case of a 42-year-old woman presenting with grade three hypertension, severe hypokalemia and primary amenorrhea, which revealed to be the complete form of 17 alphahydroxylase deficiency. We also discuss the challenging therapeutic approach as well as the outcomes and the follow-up of this patient.
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Affiliation(s)
| | | | - Mouna Elleuch
- Department of EndocrinologyHedi Chaker HospitalSfaxTunisia
| | - Wafa El abed
- Department of EndocrinologyHedi Chaker HospitalSfaxTunisia
| | - Ameni Salah
- Department of EndocrinologyHedi Chaker HospitalSfaxTunisia
| | - Fatma Abdelhadi
- Department of Human Molecular Genetics, Faculty of MedicineSfaxTunisia
| | - Hassen Kammoun
- Department of Human Molecular Genetics, Faculty of MedicineSfaxTunisia
| | - Wiem Feki
- Department of RadiologyHedi Chaker HospitalSfaxTunisia
| | - Zeineb Mnif
- Department of RadiologyHedi Chaker HospitalSfaxTunisia
| | | | - Fatma Ayedi
- Department of BiochemistryHabib Bourguiba HospitalSfaxTunisia
| | - Fatma Mnif
- Department of EndocrinologyHedi Chaker HospitalSfaxTunisia
| | - Nabila Rekik
- Department of EndocrinologyHedi Chaker HospitalSfaxTunisia
| | - Mouna Mnif
- Department of EndocrinologyHedi Chaker HospitalSfaxTunisia
| | - Nadia Charfi
- Department of EndocrinologyHedi Chaker HospitalSfaxTunisia
| | | | - Mohamed Abid
- Department of EndocrinologyHedi Chaker HospitalSfaxTunisia
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Missaoui A, Hadjkacem F, Soomauroo S, Trimeche O, Ben Salah D, Elleuch M, Mnif F, Charfi N, Mnif M, Rekik N, Abid M. Les marqueurs du syndrome métabolique chez les patients atteints d’adénomes hypophysaires non fonctionnels. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Missaoui A, Hadjkacem F, Belabed W, Ben Salah D, Mnif F, Charfi N, Mnif M, Rekik N, Elleuch M, Abid M. L’influence du profil métabolique du patient diabétique sur les manifestations de la neuro-vessie diabétique. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Hadjkacem F, Belabed W, Missaoui A, Ben Salah D, Mnif F, Charfi N, Mnif M, Rekik N, Elleuch M, Abid M. Les complications ophtalmologiques au cours de l’acromégalie. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Jmal E, Ben Salah D, Missaoui A, Elleuch M, Mnif F, Charfi N, Mnif M, Rekik N, Hadjkacem F, Abid M. Profil étiologique et évolutif des pancréatites aiguës chez le diabétique de type 1. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Ourida S, Ben Salah D, Jmal E, Elleuch M, Charfi N, Mnif F, Mnif M, Rekik N, Hadj Kacem F, Abid M. Risque cardiovasculaire chez le sujet âgé obèse hospitalisé au service d’endocrinologie. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Mnif F, Boujelben K, Ben Salah D, Elleuch M, Mnif M, Charfi N, Rekik N, Hadj Kacem F, Abid M. Étude de la satisfaction des patients traités par les psychotropes ayant développé une surcharge pondérale dans un service d’endocrinologie. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Ben Salah D, Boujelben K, Elleuch M, Missaoui A, Charfi N, Mnif F, Mnif M, Rekik N, Hadj Kacem F, Abid M. Impact de la substitution glucocorticoïde sur les paramètres anthropométriques des Addisoniens. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Hadjkacem F, Missaoui A, Belabed W, Mohamed Ahmed M, Ben Salah D, Elleuch M, Mnif F, Charfi N, Rekik N, Mnif M, Abid M. Les particularités phénotypiques et génétiques de la dyshormonosynthèse thyroïdienne familiale dans la population Tunisienne. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Hadjkacem F, Belabed W, Missaoui A, Ben Salah D, Mnif F, Charfi N, Mnif M, Rekik N, Elleuch M, Abid M. Prévalence de l’obésité chez les patients atteints d’acromégalie. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Hadjkacem F, Missaoui A, Belabed W, Ben Salah D, Mnif F, Charfi N, Mnif M, Rekik N, Elleuch M, Abid M. La qualité de vie chez les patients atteints de neuro-vessie diabétique. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Missaoui A, Hadjkacem F, Soomauroo S, Frikha H, Ben Salah D, Elleuch M, Mnif F, Charfi N, Mnif M, Rekik N, Abid M. Les caractéristiques radiologiques des adénomes hypophysaires non fonctionnels. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Ammar M, Safi W, Tlili A, Alila-Fersi O, Frikha F, Chouchen J, Mnif F, Kharrat M, Maalej M, Felhi R, Abid M, Mnif-Feki M, Kacem FH, Fakhfakh F, Mkaouar-Rebai E. A novel TYMP mutation in a family with MNGIE syndrome: Molecular docking, dynamic simulation and computational investigations. Int J Dev Neurosci 2022; 82:626-638. [PMID: 35841120 DOI: 10.1002/jdn.10215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/27/2022] [Accepted: 07/02/2022] [Indexed: 11/11/2022] Open
Abstract
Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE; OMIM 603041) is a rare inherited metabolic disorder mostly caused by mutations in TYMP gene encoding thymidine phosphorylase (TP) protein that affects the mitochondrial nucleotide metabolism. TP, functionally active as a homodimer, is involved in the salvage pathway of pyrimidine nucleosides. MNGIE-like syndrome having an overlapping phenotype of MNGIE was also described and has been associated with mutations in POLG and RRM2B genes. In the present study, we report the molecular investigation of a consanguineous family including two patients with clinical features suggestive of MNGIE syndrome. Bioinformatics analyses were carried out in addition to mtDNA deletion screening and copy number quantification in the blood of the two patients. Whole exome sequencing and Sanger sequencing analyses revealed the segregation in the affected family a novel mutation c.1205T>A (p.L402Q) within the exon 9 of the TYMP gene. In addition, mtDNA analysis revealed the absence of mtDNA deletions and a decrease of the copy number in the blood of the two patients of the studied family. The p.Leu402Gln mutation was located in a conserved amino acid within the α/β domain of the TP protein and several software supported its pathogenicity. In addition, and based on docking and molecular dynamic simulation analyses, results revealed that L402Q caused a conformational change in TP mutated structure and could therefore alter its flexibility and stability. These changes prevent also the formation of stable homodimer leading to non-functional protein with partial or complete loss of its catalytic activity.
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Affiliation(s)
- Marwa Ammar
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences. University of Sfax, Tunisia
| | - Wajdi Safi
- Department of Endocrinology Diabetology, CHU Hedi Chaker, Sfax, Tunisia
| | - Abdelaziz Tlili
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Olfa Alila-Fersi
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences. University of Sfax, Tunisia
| | - Fakher Frikha
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Jihen Chouchen
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Fatma Mnif
- Department of Endocrinology Diabetology, CHU Hedi Chaker, Sfax, Tunisia
| | - Marwa Kharrat
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences. University of Sfax, Tunisia
| | - Marwa Maalej
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences. University of Sfax, Tunisia
| | - Rahma Felhi
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences. University of Sfax, Tunisia
| | - Mohamed Abid
- Department of Endocrinology Diabetology, CHU Hedi Chaker, Sfax, Tunisia
| | - Mouna Mnif-Feki
- Department of Endocrinology Diabetology, CHU Hedi Chaker, Sfax, Tunisia
| | - Faten Hadj Kacem
- Department of Endocrinology Diabetology, CHU Hedi Chaker, Sfax, Tunisia
| | - Faiza Fakhfakh
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences. University of Sfax, Tunisia
| | - Emna Mkaouar-Rebai
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences. University of Sfax, Tunisia
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Mnif F, Elleuch M, Malouf J, Benlassoued M, Kamel M, Abid M. Inventory of insulin access in Tunisia, IDF-MENA Region. J Diabetol 2022. [DOI: 10.4103/jod.jod_113_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
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Hadj Kacem F, Boujelben K, Ellouze F, Ben Salah D, Mnif M, Mnif F, Charfi N, Rekik N, Elleuch M, Abid M. Impact du déficit en magnésium sur l’apparition des complications microvasculaires. Annales d'Endocrinologie 2021. [DOI: 10.1016/j.ando.2021.08.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mnif-Feki M, Safi W, Bougacha-Elleuch N, Abid G, Moalla M, Elleuch M, Ben Salah DH, Rekik N, Belguith N, Abdelhedi F, Kammoun T, Hachicha M, Charfi N, Mnif F, Kammoun H, Hadj Kacem H, Hadj-Kacem F, Abid M. Occurrence of Hypopituitarism in Tunisian Turner Syndrome patients: familial versus sporadic cases. Gynecol Endocrinol 2021; 37:848-852. [PMID: 34124982 DOI: 10.1080/09513590.2021.1939298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To explore unusual association between Turner Syndrome (TS) and Hypopituitarism in a Tunisian cohort. METHODS We reported 6 patients with TS associated to Hypopituitarism, including three familial cases except the fourth sister who showed only a TS phenotype. Biochemical analysis, resonance magnetic imaging and cytogenetic analyses were performed. RESULTS The average age of our patients was 17.2 years (11-31 years). They were all referred for short stature and pubertal delay, except for the fourth sister who presented spontaneous puberty with the integrity of the pituitary axis and the presence of an X ring chromosome. Karyotype analysis showed monosomy in 3 cases and a mosaic TS in the 3 remaining cases, including one patient with abnormal X chromosome structure. Somatotropic and corticotropic deficiencies were confirmed in 2 sporadic cases while the gonadotropic and thyrotropic axes were spared. In contrast; familial cases were consistently affected by the integrity of the corticotropic axis. MRI showed pituitary hypoplasia in all familial cases and pituitary stalk interruption syndrome in only one sporadic case. No correlation was found between the chromosome formula and the anterior pituitary involvement. CONCLUSION Co-segregation of congenital Hypopituitarism with pituitary hypoplasia and X chromosome aberrations could imply a molecular anomaly of transcription factors responsible for the differentiation and development of pituitary cells such as PROP1, POUF1, Hesx1, Lhx3, Lhx4. The etiopathogenic link between X chromosome abnormalities and the occurrence of Hypopituitarism remains unclear; however, the progress of molecular biology may clarify the interrelation between transcription factors and sex chromosome segregation abnormalities.
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Affiliation(s)
- M Mnif-Feki
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - W Safi
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Bougacha-Elleuch
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences of Sfax, Sfax University, TUNISIA
| | - G Abid
- Department of Medical Imaging, Auxerre Hospital Center, Auxerre, France
| | - M Moalla
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, Sfax, Tunisia
| | - M Elleuch
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - D H Ben Salah
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Rekik
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Belguith
- Genetic Department, Medicine CHU Hédi Chaker, Sfax, Tunisia
| | - F Abdelhedi
- Genetic Department, Medicine CHU Hédi Chaker, Sfax, Tunisia
| | - T Kammoun
- Pediatric Department, CHU Hédi Chaker, Sfax, Tunisia
| | - M Hachicha
- Pediatric Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Charfi
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - F Mnif
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - H Kammoun
- Genetic Department, Medicine CHU Hédi Chaker, Sfax, Tunisia
| | - H Hadj Kacem
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - F Hadj-Kacem
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - M Abid
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
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Elleuch M, Charfi H, Ben Salah D, Hadj Kacem F, Mnif F, Mnif M, Charfi N, Rekik N, Abid M. Sclérœdème de Buschke : à propos de 2 cas. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Elleuch M, Hana C, Boujelben K, Ben Salah D, Hadj Kacem F, Mnif M, Mnif F, Charfi N, Rekik N, Abid M. L’alimentation du diabétique pendant le mois de Ramadan en Tunisie. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gargouri B, Mseddi M, Mnif F, Abid M, Attia H, Lassoued S. Oxidative stress enhances the immune response to oxidatively modified catalase enzyme in patients with Graves' disease. J Clin Lab Anal 2020; 34:e23051. [PMID: 31617239 PMCID: PMC7031633 DOI: 10.1002/jcla.23051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 09/14/2019] [Accepted: 09/17/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Oxidative stress is associated with several autoimmune disorders and oxidative modification of proteins that may result in autoimmune response. This study aims to evaluate the catalase (CAT) activity and the autoimmune response against the native CAT and the oxidatively modified enzyme in patients with Graves' disease (GD) and healthy controls in a comparative way. METHODS The CAT activity was evaluated via spectrophotometric method. Using enzyme-linked immunosorbent assay, the reactivities of autoantibody toward native, malondialdehyde (MDA) and hydrogen peroxide (H2 O2 ) modified CAT were evaluated in plasmas of patients and controls. RESULTS Reduced CAT activity was found in patients compared with controls (P < .05). It was proved that levels of IgG antibodies against MDA-modified CAT were higher than against unmodified ones (P < .001). No changes were found for the reactivities to H2 O2 -modified CAT. Positive correlation was found between the reactivity to MDA-modified CAT and the triiodothyronine level (P < .001, r = .6). CONCLUSION Our findings incriminate the MDA in the autoantibodies reactivity to oxidatively modified CAT leading to a disturbed oxidative profile and/or the progression of GD pathology.
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Affiliation(s)
| | - Malek Mseddi
- Laboratory LR11ES45Research Group “Biotechnology and Pathology”National School of Engineers of SfaxSfaxTunisia
| | - Fatma Mnif
- Department of endocrinologyHedi Chaker HospitalSfaxTunisia
| | - Mohamed Abid
- Department of endocrinologyHedi Chaker HospitalSfaxTunisia
| | - Hamadi Attia
- Laboratory LR11ES45Research Group “Biotechnology and Pathology”National School of Engineers of SfaxSfaxTunisia
| | - Saloua Lassoued
- Laboratory LR11ES45Research Group “Biotechnology and Pathology”National School of Engineers of SfaxSfaxTunisia
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Elfekih H, Hadjkacem F, Elleuch M, Ghorbel D, Charfi N, Mnif F, Rekik N, Mnif M, Abid M. Successful Treatment of Insulin Allergy with Desensitization Therapy: A Case Report and Literature Review. Iran J Allergy Asthma Immunol 2019; 18:572-583. [PMID: 32245301 DOI: 10.18502/ijaai.v18i5.1927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 09/11/2018] [Indexed: 12/21/2022]
Abstract
Insulin therapy is an essential treatment for type 1 and uncontrolled type 2 diabetes mellitus (DM). Hypersensitivity reactions have been described since the first administration of insulin, the same as any other therapy. Despite being a rare situation nowadays, it requires careful intra-hospital monitoring and multidisciplinary management. Here, we present a case of a 57-year-old patient with type 2 DM, an average glycemic control, and both penicillin and insulin allergy. Heunderwent a desensitization protocol which allowed successfully dismiss him with intermediate-acting insulin.
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Affiliation(s)
- Hamza Elfekih
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia.
| | - Faten Hadjkacem
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia.
| | - Mouna Elleuch
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia.
| | - Dorra Ghorbel
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia.
| | - Nadia Charfi
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia.
| | - Fatma Mnif
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia.
| | - Nabila Rekik
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia.
| | - Mouna Mnif
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia.
| | - Mohamed Abid
- Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia.
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Salah DB, Charfi N, Elleuch M, Kacem FH, Rekik N, Mnif M, Mnif F, Abid M. [Cardiovascular and metabolic impact of glucocorticoid substitution therapy in patients with Addison's disease]. Pan Afr Med J 2019; 30:251. [PMID: 30627312 PMCID: PMC6307925 DOI: 10.11604/pamj.2018.30.251.12546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/11/2018] [Indexed: 12/01/2022] Open
Abstract
Les études récentes menées chez des patients atteints de maladie d'Addison (MA) ont permis de révéler que cette pathologie, même traitée, reste grevée d'une morbi-mortalité non négligeable. L'objectif de notre étude était de déterminer les effets délétères de la substitution glucocorticoïde au long cours principalement sur le plan métabolique et cardiovasculaire. Il s'agit d'une étude rétrospective qui a inclu 28 patients ayant une MA traitée, évoluant depuis plus que 15 ans. L'âge moyen était de 58,53 ans avec une prédominance féminine à 65%. La durée moyenne de suivi était de 17,87 ans. La dose d'hydrocortisone était initialement à 32,5mg/j (20,52 mg/m2) et à 27,9mg/j (16,41mg/m2) au moment de l'étude. La prévalence du syndrome métabolique (SM) au cours de la MA était de 35,71% après une durée de traitement supérieur à 15 ans. On note au terme du suivi que 28,57% des patients étaient obèses. Vingt-cinq (25)% des patients avaient développé une HTA et un diabète de type 2. La prévalence de la dyslipidémie était passé de 3,57% à 42,85%. Un seul patient avait présenté un infarctus de myocarde à 25 ans de suivi. Les facteurs favorisant la survenue du SM dans notre étude étaient l'ancienneté de la maladie et la perte du poids à la découverte de la maladie. L'ajustement du traitement substitutif au cours de la maladie d'Addison reste un enjeu au vu de la morbi-mortalité liée au surdosage. Un suivi régulier, et une approche thérapeutique personnalisée sont nécessaires pour améliorer le pronostic de ses patients.
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Affiliation(s)
- Dhoha Ben Salah
- Service d'Endocrinologie et Diabétologie du CHU Hédi Chaker Sfax, Tunisie
| | - Nadia Charfi
- Service d'Endocrinologie et Diabétologie du CHU Hédi Chaker Sfax, Tunisie
| | - Mouna Elleuch
- Service d'Endocrinologie et Diabétologie du CHU Hédi Chaker Sfax, Tunisie
| | - Faten Hadj Kacem
- Service d'Endocrinologie et Diabétologie du CHU Hédi Chaker Sfax, Tunisie
| | - Nabila Rekik
- Service d'Endocrinologie et Diabétologie du CHU Hédi Chaker Sfax, Tunisie
| | - Mouna Mnif
- Service d'Endocrinologie et Diabétologie du CHU Hédi Chaker Sfax, Tunisie
| | - Fatma Mnif
- Service d'Endocrinologie et Diabétologie du CHU Hédi Chaker Sfax, Tunisie
| | - Mohamed Abid
- Service d'Endocrinologie et Diabétologie du CHU Hédi Chaker Sfax, Tunisie
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Dhoha BS, Rekik N, Mnif F, Elleuch M, Mnif M, Abid M. A case of insulin antibody-mediated insulin resistance in type 2 diabetes treated by glucocorticoid. PAMJ-CM 2019. [DOI: 10.11604/pamj-cm.2019.1.40.20684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Salah DB, Rekik N, Affes L, Elleuch M, Mnif F, Mnif M, Abid M. [Unusual mode of revelation of primary hyperparathyroidism in young subjects: about two cases]. Pan Afr Med J 2018; 30:232. [PMID: 30574250 PMCID: PMC6295291 DOI: 10.11604/pamj.2018.30.232.12779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 06/22/2018] [Indexed: 11/11/2022] Open
Abstract
L'hyperparathyroïdie primaire est classique chez le sujet âgé. Les formes juvéniles sont rares et posent des problèmes diagnostiques et thérapeutiques particuliers. Nous rapportons l'observation de deux jeunes patientes, âgées respectivement de 14 et 19 ans, présentant une hyperparathyroïdie primaire révélée par une atteinte osseuse de la tête fémorale dont l'une avait une épiphysiolyse fémorale supérieure. Le retentissement était uniquement osseux dans les deux cas, sans éléments en faveur d'une forme familiale. L'hyperparathyroïdie primaire était en rapport avec un adénome parathyroïdien unique et bénin chez les deux patientes. Elles avaient bénéficié d'une adénomectomie compliquée d'une hypocalcémie persistante. Cette dernière était en rapport avec une hypoparathyroïdie aggravée par un hungry bone syndrome, nécessitant un traitement vitaminocalcique substitutif. La rareté de l'hyperparathyroïdie primaire du sujet jeune est bien classique. Le tableau clinique est dominé par les formes rénales, le mode de révélation osseux n'est pas habituel et en particulier la présence d'épiphysiolyse. Primary hyperparathyroidism usually affects the elderly. Juvenile hyperparathyroidism is rare and poses specific diagnostic and therapeutic problems. We report the case of two young female patients, aged 14 and 19 years, with primary hyperparathyroidism detected due to femoral head involvement. One of those patients had slipped upper femoral epiphysis. Hyperparathyroidism only affected bone in both cases. No patient had a family history of this disease. Primary hyperparathyroidism was associated with solitary and benign parathyroid adenoma in both patients. They underwent complicated adenomectomy by persistent hypocalcaemia. This last was associated with hypoparathyroidism exacerbated by hungry bone syndrome, requiring substitutive vitaminocalcic therapy. It is well known that primary hyperparathyroidism rarely occurs in young subjects. Renal involvement is the most common clinical manifestation of hyperparathyroidism. Bone involvement and, in particular, slipped femoral epiphyses are an uncommon mode of revelation.
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Affiliation(s)
- Dhoha Ben Salah
- Service d'Endocrinologie, Diabétologie CHU Hédi Chaker Sfax, Tunisie
| | - Nabila Rekik
- Service d'Endocrinologie, Diabétologie CHU Hédi Chaker Sfax, Tunisie
| | - Lilia Affes
- Service d'Endocrinologie, Diabétologie CHU Hédi Chaker Sfax, Tunisie
| | - Mouna Elleuch
- Service d'Endocrinologie, Diabétologie CHU Hédi Chaker Sfax, Tunisie
| | - Fatma Mnif
- Service d'Endocrinologie, Diabétologie CHU Hédi Chaker Sfax, Tunisie
| | - Mouna Mnif
- Service d'Endocrinologie, Diabétologie CHU Hédi Chaker Sfax, Tunisie
| | - Mohamed Abid
- Service d'Endocrinologie, Diabétologie CHU Hédi Chaker Sfax, Tunisie
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Ben Salah D, Loukil F, Mnif F, Elleuch M, Abid M. Sex-mismatched after stem cell transplant: A case report. Annales d'Endocrinologie 2018. [DOI: 10.1016/j.ando.2018.06.866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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El Aoud S, Elleuch M, Charfi N, Hadj Kacem F, Mnif M, Rekike N, Mnif F, Abid M. Fahr's syndrome in Southern Tunisia: A broad spectrum of clinical and etiological features. Tunis Med 2018; 96:490-494. [PMID: 30430526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM We describe the clinical and etiological profile of patients with Fahr's syndrome (FS). METHODS Charts of sixteen patients diagnosed with FS between 1999 and 2014 were retrospectively assessed. RESULTS The mean age at diagnosis was 44.68 years (11-67 years). The most main presenting neurological features were seizures in 6 cases, headaches in 5 cases and parkinson's syndrome in 3 cases. Psychiatric disorders were observed in 2 patients including memory loss and iritability. Hypocalcemia clinical features were observed in 7 cases. The mean value of hypocalcemia was 1.69 mmol/l. Etiologies included idiopathic hypoparathyroidism in 4 patients, pseudohypoparathyroidism in 5 cases, secondary hypoparathyroidism, isolated hypovitaminosis D and cerebral radiotherapy in one case for each and Fahr's disease in 4 patients. Oral calcium and vitamin D substitution were started in patients with parathyroid disturbances with favorable outcome. CONCLUSION In this report, we propose to discuss the clinical manifestations of FS, its etiologies especially parathyroid disturbances and its therapeutic modalities.
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Affes L, Elleuch M, Mnif F, Kacem FH, Salah DB, Mnif M, Charfi N, Rekik N, Abid M. [Guillain Barré syndrome and diabetic acido-ketotic decompensation during pregnancy: a case report and review of the literature]. Pan Afr Med J 2017; 26:86. [PMID: 28491217 PMCID: PMC5409988 DOI: 10.11604/pamj.2017.26.86.11091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 12/19/2016] [Indexed: 11/25/2022] Open
Abstract
Une femme enceinte âgée de 27 ans a été admise dans le service de réanimation pour une décompensation acidocétosique sévère spontanée inaugurale d'un diabète type 1. La patiente a été réanimée et insulinée avec une bonne évolution clinique et biologique. Au 4ème jour, la patiente a présentée un tableau de polyradiculonévrite aigue d'installation brutale. Les examens complémentaires faites en urgences étaient négatives. Une cytoponction lombaire a montré une dissociation albuminocytologique. L'électromyogramme a confirmé le diagnostic de syndrome de Guillain Barré (SGB). La patiente a été mise sous veinoglobuline avec rééducation physique. Une amélioration spectaculaire des signes neurologiques a été notée. Concernant sa grossesse, la patiente a avorté au bout d'une semaine de diagnostic de SGB. L'association de SGB avec une décompensation cétosique est rare. En effet, quelques cas ont été rapportés dans la littérature. Cette association au cours d'une grossesse n'est jamais décrite d'où l'originalité de notre cas.
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Affiliation(s)
- Lilia Affes
- Service d'Endocrinologie Diabétologie, Hôpital Hedi Chaker de Sfax
| | - Mouna Elleuch
- Service d'Endocrinologie Diabétologie, Hôpital Hedi Chaker de Sfax
| | - Fatma Mnif
- Service d'Endocrinologie Diabétologie, Hôpital Hedi Chaker de Sfax
| | - Faten Hadj Kacem
- Service d'Endocrinologie Diabétologie, Hôpital Hedi Chaker de Sfax
| | - Dhouha Ben Salah
- Service d'Endocrinologie Diabétologie, Hôpital Hedi Chaker de Sfax
| | - Mouna Mnif
- Service d'Endocrinologie Diabétologie, Hôpital Hedi Chaker de Sfax
| | - Nadia Charfi
- Service d'Endocrinologie Diabétologie, Hôpital Hedi Chaker de Sfax
| | - Nabila Rekik
- Service d'Endocrinologie Diabétologie, Hôpital Hedi Chaker de Sfax
| | - Mohamed Abid
- Service d'Endocrinologie Diabétologie, Hôpital Hedi Chaker de Sfax
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Sellami R, Moalla M, Affes L, Feki I, Mnif F, Abid M, Masmoudi J. Body shape perception among obese Tunisian women. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IntroductionIn today's societies, pressures from the idea of thinness are omnipresent and lead to a corporal dissatisfaction with an excessive preoccupation of the body's image. Obese persons are often targets of stigmatization and are vulnerable to negative feeling about their physical appearance.AimsTo evaluate the worries towards the weight and the shape of the body among obese women.MethodsOur study was a transversal study, descriptive and analytic. A total of 42 obese women were included. Obesity was defined by body mass index (BMI) ≥ 30 and divided into 3 classes: class I: moderate obesity (30 ≤ BMI ≤ 34.9); class II: severe obesity (35 ≤ BMI ≤ 39.9); class III: morbid obesity (BMI≥40). Patients were studied by mean of body shape questionnaire (BSQ-34) (Considering score BSQ < 80 lack of altered body image perception and score > 140 excessive preoccupation).ResultsThe mean age of participants was 33.6 years. The average BMI was 37.42 kg/m2 (30.45–56.26 kg/m2). Third (35%) of women had a high educational level, 41.4% were inactive, and 70.8% had an average socioeconomic level.The average BSQ score was 108.31 (47–188). The majority of women (78.1%) had excessive preoccupation about their body image. The BSQ score was correlated to morbid obesity (P = 0.014). Women aged between 20 and 3 years were significantly more preoccupied about their body image (P = 0.046).ConclusionMajority of obese women were preoccupied about their body image. Young women and those having morbid obesity seemed more preoccupied about their body image.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Sellami R, Moalla M, Affes L, Feki I, Mnif F, Abid M, Masmoudi J. Sexual dysfunction in obese women. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionThe increasing prevalence of obesity represents a major public health problem, with can effect on physical and emotional well-being and psychosocial function. Somatic and psychological dysfunctions, such as infertility, osteoarthritis, social disabilities caused by stigmatization, sleeping problems or apnea, are also known to follow obesity. Sexual dysfunction (SD) may also be related to obesity, but is rarely mentioned, and may cause concern for the affected individual and partner, constituting a great problem.ObjectivesThe aim of this study was to identify the frequency of SD among obese women.MethodsOur study concerned 42 obese married women consulting in endocrinology department. Obesity was defined by body mass index (BMI) ≥30. All participants assessed a sociodemographic data and the “Female Sexual Function Index” (FSFI). FSFI is a 19-item multidimensional self-reporting measure that quantifies six domains of female sexual dysfunction (FSD), including desire, arousal, lubrication, orgasm, satisfaction, and pain. Score ≤26 indicate the presence of FSD.ResultsThe mean age was 33.6 years (20 → 47 years). The mean total score of FSFI was 22.5 (3.2 → 32.6). The percentage of SD among obese women was 68.2%. FSFI score was correlated to ancient obesity (P = 0.026; r = 0.347) and waist circumference (P = 0.007; r = 0.412). High socio-economic level was correlated to desire and satisfaction (P = 0.021 and P = 0.048 respectively). Women with high educational level have better blurbification (P = 0.005). FSFI score was not correlated to BMI or obesity class.ConclusionAlmost two-thirds of obese women have sexual dysfunctions. Women with ancient obesity and higher waist circumference seemed to have better sexual functions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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El Aoud S, Charfi N, Hajkacem F, Cheikhrouhou N, Mnif F, Abid M. Un syndrome parkinsonien. Rev Med Interne 2017; 38:284-285. [DOI: 10.1016/j.revmed.2016.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 01/11/2016] [Indexed: 10/22/2022]
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Mseddi M, Ben Mansour R, Gouiia N, Mnif F, Bousselaa R, Abid M, Boudaouara T, Attia H, Lassoued S. A comparative study of nuclear 8-hydroxyguanosine expression in Autoimmune Thyroid Diseases and Papillary Thyroid Carcinoma and its relationship with p53, Bcl-2 and Ki-67 cancer related proteins. Adv Med Sci 2017; 62:45-51. [PMID: 28187375 DOI: 10.1016/j.advms.2016.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 04/12/2016] [Accepted: 06/01/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate whether the oxidative stress is involved in the evolution of Graves' disease (GD) and Hashimoto thyroiditis (HT) into Papillary Thyroid Carcinoma (PTC), 8-hydroxy-2'-deoxyguanosine (8-OHdG) and cancer related proteins (Bcl-2, p53 and Ki-67) expressions were evaluated in these pathologies. PATIENTS AND METHODS Immunohistochemical method was applied on 25 thyroid tissues. Allred score (AS) serving to evaluate the immunostaining is based on a scale from 0 to 8. "Negligible expression" was assigned to a score of 0 to 2, "expression" and "overexpression" were attributed to a score of 3-5 and ≥6 respectively. RESULTS PTC cancer cells exhibited 100% 8-OHdG "overexpression" compared to 87.5% in PTC non-malignant epithelial (NME) ones (p<0.05). Higher 8-OHdG AS was found in PTC NME cells compared to GD and HT (p<0.001, p<0.05 respectively). "Overexpression" of Bcl-2 was noted in all PTC cell types. Remarkably, just like the PTC cancer and NME cells 33.3% of HT and 50% of GD patients' revealed simultaneous "overexpression" of Bcl-2 and 8-OHdG in epithelial cells. No staining was detected for p53 in all pathologies. PTC lymphoid cells exhibited 100% "overexpression" for 8-OHdG and Bcl-2 with concomitant "negligible expression" for Ki-67 in 87.5% of patients. In contrast, HT lymphoid cells showed 22.2% "expression" and GD 62.5% "expression" and 12.5% "overexpression" of Ki-67. CONCLUSIONS Simultaneous "overexpression" of 8-OHdG and Bcl-2 in GD and HT could be considered as prognostic markers while "negligible expression" of Ki-67 in PTC lymphoid cells suggests an anergic state favoring the tumor escapes from the immune system.
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Ghommam J, Mnif F. Predictor-based control for an inverted pendulum subject to networked time delay. ISA Trans 2017; 67:306-316. [PMID: 28126273 DOI: 10.1016/j.isatra.2017.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 06/05/2016] [Accepted: 01/05/2017] [Indexed: 06/06/2023]
Abstract
The inverted pendulum is considered as a special class of underactuated mechanical systems with two degrees of freedom and a single control input. This mechanical configuration allows to transform the underactuated system into a nonlinear system that is referred to as the normal form, whose control design techniques for stabilization are well known. In the presence of time delays, these control techniques may result in inadequate behavior and may even cause finite escape time in the controlled system. In this paper, a constructive method is presented to design a controller for an inverted pendulum characterized by a time-delayed balance control. First, the partial feedback linearization control for the inverted pendulum is modified and coupled with a state predictor to compensate for the delay. Several coordinate transformations are processed to transform the estimated partial linearized system into an upper-triangular form. Second, nested saturation and backstepping techniques are combined to derive the control law of the transformed system that would complete the design of the whole control input. The effectiveness of the proposed technique is illustrated by numerical simulations.
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Affiliation(s)
- J Ghommam
- Control and Energy Management Lab (CEM, Lab), Tunisia.
| | - F Mnif
- Sultan Quabous University, Oman.
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El Aoud S, Mnif F, Lassoued N, Mnif Feki M, Rekik N, Charfi N, Abid M. Une cause inhabituelle d’hémoptysie. Rev Med Interne 2017; 38:150-151. [DOI: 10.1016/j.revmed.2015.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 12/08/2015] [Indexed: 11/26/2022]
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Boudabous M, Mnif F, Grati A, Chtourou L, Mnif L, Amouri A, Tahri N. Hyperthyroïdie : cause inhabituelle d’un ictère. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bougacha-Elleuch N, Elleuch M, Charfi N, Mnif F, Belghith N, Abdelhedi F, Kammoun H, Hachicha M, Mnif M, Abid M. Unusual association of turner syndrome and hypopituitarism in a Tunisian family. Curr Res Transl Med 2016; 64:9-13. [DOI: 10.1016/j.retram.2016.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 01/08/2016] [Indexed: 11/30/2022]
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Regaieg S, Charfi N, Elleuch M, Mnif F, Marrakchi R, Yaich S, Jammousi K, Damak J, Abid M. [Obesity, physical activity and sedentary time among school adolescents aged 15 to 18 years in the city of Sfax (Tunisia)]. Pan Afr Med J 2015; 22:370. [PMID: 27022430 PMCID: PMC4789185 DOI: 10.11604/pamj.2015.22.370.6121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 09/02/2015] [Indexed: 01/06/2023] Open
Affiliation(s)
- Sofien Regaieg
- Unité de Recherche Obésité-Syndrome Métabolique, Service d''Endocrinologie, CHU Hédi Chaker, Sfax, Tunisie
| | - Nadia Charfi
- Unité de Recherche Obésité-Syndrome Métabolique, Service d''Endocrinologie, CHU Hédi Chaker, Sfax, Tunisie
| | - Mouna Elleuch
- Unité de Recherche Obésité-Syndrome Métabolique, Service d''Endocrinologie, CHU Hédi Chaker, Sfax, Tunisie
| | - Fatma Mnif
- Unité de Recherche Obésité-Syndrome Métabolique, Service d''Endocrinologie, CHU Hédi Chaker, Sfax, Tunisie
| | - Rim Marrakchi
- Laboratoire de Biochimie, CHU Hédi Chaker, SFAX, Tunisie
| | - Sourour Yaich
- Service Médecine Communautaire et d'Epidémiologie, CHU Hédi Chaker, Sfax, Tunisie
| | - Kamel Jammousi
- Laboratoire de Biochimie, CHU Hédi Chaker, SFAX, Tunisie
| | - Jamel Damak
- Service Médecine Communautaire et d'Epidémiologie, CHU Hédi Chaker, Sfax, Tunisie
| | - Mohamed Abid
- Unité de Recherche Obésité-Syndrome Métabolique, Service d''Endocrinologie, CHU Hédi Chaker, Sfax, Tunisie
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Mseddi M, Ben Mansour R, Mnif F, Gargouri B, Abid M, Guermazi F, Attia H, Lassoued S. Lipid peroxidation, proteins modifications, anti-oxidant enzymes activities and selenium deficiency in the plasma of hashitoxicosis patients. Ther Adv Endocrinol Metab 2015; 6:181-8. [PMID: 26445640 PMCID: PMC4579411 DOI: 10.1177/2042018815589057] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The aim of this study was to explore the oxidative stress profile in hashitoxicosis (HTX) and to compare it with that of healthy subjects. PATIENTS AND METHODS Spectrophotometric methods were used to evaluate the oxidative stress markers. The selenium level was investigated by atomic absorption. RESULTS High levels of thiobarbituric acid reactive species (TBARS) and conjugated dienes were found in HTX patients (p = 0.034 and p = 0.043, respectively) compared with healthy controls. For antioxidant enzymes, superoxide dismutase (SOD) and catalase activities increased, whereas that of glutathione peroxidase (GPx) decreased (p = 0.000, p = 0.014, p = 0.000, respectively) compared with controls. A reduction in the level of selenium (p = 0.029) and thiol groups (p = 0.008) were shown in patients; however, levels of carbonyl group and malondialdehyde (MDA) protein adducts decreased (p = 0.000) compared with controls. Positive correlation was shown between levels of free thyroxine (FT4) and TBARS (r = 0.711, p = 0.048) and between FT4 level and SOD activity (r = 0.713, p = 0.047). Conversely, GPx activity presented a negative correlation with FT4 and free triiodothyronine (FT3) levels (r = -0.934, p = 0.001; r = -0.993, p = 0.000, respectively). In addition, GPx activity showed positive correlation with selenium level (r = 0.981, p = 0.019) and the FT3 level correlated negatively with the level of thiol groups (r = -0.892, p = 0.017). CONCLUSIONS This study shows the presence of an oxidative stress and selenium deficiency in HTX patients and suggests that the hyperthyroid state is strongly implicated in the establishment of this disturbed oxidative profile.
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Affiliation(s)
| | | | - Fatma Mnif
- Department of Endocrinology and Diabetes Hedi Chaker, Sfax, Tunisia
| | | | - Mohamed Abid
- Department of Endocrinology and Diabetes Hedi Chaker, Sfax, Tunisia
| | - Fadhel Guermazi
- Department of Nuclear Medicine, Habib Bourguiba, Sfax, Tunisia
| | - Hamadi Attia
- National School of Engineers of Sfax, Sfax, Tunisia
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Mnif L, Damak R, Mnif F, Ouanes S, Abid M, Jaoua A, Masmoudi J. Alexithymia impact on type 1 and type 2 diabetes: A case-control study. Annales d'Endocrinologie 2014; 75:213-9. [DOI: 10.1016/j.ando.2014.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 05/27/2014] [Accepted: 06/13/2014] [Indexed: 10/24/2022]
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Kamoun M, Mnif MF, Charfi N, Ben Naceur B, Mnif F, Rekik N, Mnif Z, Sfar MH, Sfar MT, Hachicha M, Ben Salem A, Keskes LA, Abid M. Fertility outcome in male and female patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Middle East Fertility Society Journal 2014. [DOI: 10.1016/j.mefs.2013.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Several disorders of coagulation and fibrinolysis have been widely reported in patients with hyperthyroidism. Most reports have focused on only the venous thromboembolism risk, and few of them have studied specifically the association between hyperthyroidism and pulmonary embolism (PE). We report two cases of Graves' disease complicated by PE. The first patient is a 32 year-old man, and the second patient is a 23-year-old female. PE was suspected on the basis of pulmonary hypertension in patient one, and clinical presentation in the other patient. The first patient had also right heart failure. PE was confirmed in both patients by a lung perfusion-ventilation scan test. Thrombophilia screen revealed normal findings in the first patient and an elevation in coagulation factor VIII in the second one. Both patients received heparin, followed by oral anticoagulant therapy. In addition, they were treated with radioactive iodine resulting in partial recovery from hyperthyroidismforpatient oneand clinical euthyroidism for patient two. The former died of acute heart failure secondary to a chest infection, while the later was lost to follow-up. In conclusion, hyperthyroidism is associated with increased risk of venous thromboembolism, including PE. Potential mechanisms involved in this association include endothelial dysfunction, decreased fibrinolytic activity, and increased coagulation factors levels. Thyroid evaluation is recommended in patients with unprovoked venous thromboembolic events. Conversely, the diagnosis of venous thromboembolism should be considered in patients with hyperthyroidism, particularly if additional prothrombotic risk factors are present.
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Affiliation(s)
- Sonia Grine
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Nadia Charfi
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Mahdi Kamoun
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Fatma Mnif
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Basma Ben Naceur
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Nabila Rekik
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Mouna Mnif
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Mohamed Abid
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
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Kacem FH, Charfi N, Mnif MF, Kamoun M, Akid F, Mnif F, Naceur BB, Rekik N, Mnif Z, Abid M. Isolated adrenocorticotropic hormone deficiency due to probable lymphocytic hypophysitis in a woman. Indian J Endocrinol Metab 2013; 17:S107-S110. [PMID: 24251125 PMCID: PMC3830271 DOI: 10.4103/2230-8210.119521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We report a 22-year-old woman who presented with asthenia, weight loss and hypotension in which extensive pituitary and adrenal investigations were diagnostic of isolated adrenocorticotropic hormone deficiency (IAD) of pituitary origin. Magnetic resonance imaging of the hypothalamus and pituitary showed a normal-sized pituitary, with no mass lesion. The diagnosis of IAD probably secondary to lymphocytic hypophysitis (LYH) was made. IAD is able to be the way of presentation of LYH, although the disease could or could not turn into a panhypopituitarism. Prompt recognition of this potentially fatal condition is important because of the availability of effective treatment. Indeed, regular endocrine and imaging follow up is important for patients with IAD and normal initial pituitary imaging results to detect early new-onset pituitary hormones deficiencies or imaging abnormalities.
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Affiliation(s)
- Faten Hadj Kacem
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Nadia Charfi
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Mouna Feki Mnif
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Mahdi Kamoun
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Faouzi Akid
- Department of Radiology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Fatma Mnif
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Basma Ben Naceur
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Nabila Rekik
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Zainab Mnif
- Department of Radiology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Mohamed Abid
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
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Mnif MF, Kamoun M, Kacem FH, Mnif F, Charfi N, Naceur BB, Rekik N, Abid M. Reproductive outcomes of female patients with congenital adrenal hyperplasia due to 21-hydroxylase defi ciency. Indian J Endocrinol Metab 2013; 17:790-793. [PMID: 24083158 PMCID: PMC3784860 DOI: 10.4103/2230-8210.117196] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Fertility in women with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) appears to be reduced, especially in women with the classic salt-wasting type. Several factors have been suggested to contribute to this subfertility such as androgen excess, adrenal progesterone hypersecretion, consequences of genital reconstructive surgery, secondary polycystic ovaries syndrome, and psychosexual factors. In contrast to this subfertility, pregnancies are commonly normal and uneventful. Adequate glucocorticoid therapy and improvement of surgical and psychological management could contribute to optimize fertility in CAH female patients, even among women with the classic variant. This review provides current information regarding the reproductive outcomes of women with CAH due to 21-OHD and the fertility and pregnancy issues in this population.
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Affiliation(s)
- Mouna Feki Mnif
- Department of Endocrinology, Hedi Chaker Hospital, Magida Boulila Avenue, 3029 Sfax, Tunisia
| | - Mahdi Kamoun
- Department of Endocrinology, Hedi Chaker Hospital, Magida Boulila Avenue, 3029 Sfax, Tunisia
| | - Faten Hadj Kacem
- Department of Endocrinology, Hedi Chaker Hospital, Magida Boulila Avenue, 3029 Sfax, Tunisia
| | - Fatma Mnif
- Department of Endocrinology, Hedi Chaker Hospital, Magida Boulila Avenue, 3029 Sfax, Tunisia
| | - Nadia Charfi
- Department of Endocrinology, Hedi Chaker Hospital, Magida Boulila Avenue, 3029 Sfax, Tunisia
| | - Basma Ben Naceur
- Department of Endocrinology, Hedi Chaker Hospital, Magida Boulila Avenue, 3029 Sfax, Tunisia
| | - Nabila Rekik
- Department of Endocrinology, Hedi Chaker Hospital, Magida Boulila Avenue, 3029 Sfax, Tunisia
| | - Mohamed Abid
- Department of Endocrinology, Hedi Chaker Hospital, Magida Boulila Avenue, 3029 Sfax, Tunisia
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Mnif MF, Kamoun M, Kacem FH, Bouaziz Z, Charfi N, Mnif F, Naceur BB, Rekik N, Abid M. Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management. Indian J Endocrinol Metab 2013; 17:442-445. [PMID: 23869299 PMCID: PMC3712373 DOI: 10.4103/2230-8210.111637] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Diabetes mellitus has a number of long-term effects on the genitourinary system. These effects predispose to bacterial urinary tract infections (UTIs) in the patient with diabetes mellitus. Complicated UTIs are also common and potentially life-threatening conditions. They include emphysematous pyelonephritis, emphysematous pyelitis/cystitis, xanthogranulomatous pyelonephritis, renal/perirenal abscess, and renal papillary necrosis. Improved outcomes of these entities may be achieved by early diagnosis, knowledge of common predisposing factors, appropriate clinical and radiological assessment, and prompt management. Herein we review complicated UTIs associated with diabetes mellitus in terms of pathogenesis, clinical manifestations, radiological features, and current management options.
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Affiliation(s)
- Mouna Feki Mnif
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Mahdi Kamoun
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Faten Hadj Kacem
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Zainab Bouaziz
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Nadia Charfi
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Fatma Mnif
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Basma Ben Naceur
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Nabila Rekik
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Mohamed Abid
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
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Mnif MF, Kamoun M, Mnif F, Charfi N, Kallel N, Rekik N, Naceur BB, Fourati H, Daoud E, Mnif Z, Sfar MH, Younes-Mhenni S, Sfar MT, Hachicha M, Abid M. Brain magnetic resonance imaging findings in adult patients with congenital adrenal hyperplasia: Increased frequency of white matter impairment and temporal lobe structures dysgenesis. Indian J Endocrinol Metab 2013; 17:121-127. [PMID: 23776864 PMCID: PMC3659878 DOI: 10.4103/2230-8210.107833] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Congenital adrenal hyperplasia (CAH) is an inherited recessive disorder of adrenal steroidogenesis. The enzymes most commonly affected are 21-hydroxylase. Past reports suggested brain magnetic resonance imaging (MRI) abnormalities in CAH patients, affecting white matter signal, temporal lobe and amygdala structure and function. AIMS In the present study, we aimed to investigate the frequency of white matter changes and temporal lobes structures dysgenesis in a population of patients having CAH due to 21-hydroxylase deficiency. MATERIALS AND METHODS Neurological examination and brain MRI were performed in 26 patients. RESULTS Neurological examination revealed mental retardation in three patients, tremor in two patients, tendon reflexes asymmetry in one patient, and cerebellar syndrome in one patient. Eleven patients (42.3%) showed MRI abnormalities: Eight of them had white matter hyperintensities, one patient had moderate atrophy in the right temporal, and hippocampal dysgenesis was found in the remaining two patients. CONCLUSIONS Brain MRI abnormalities in CAH patients include white matter hyperintensities and temporal lobe structures dysgenesis. The mechanisms involved seem related to hormonal imbalances during brain development and exposure to excess exogenous glucocorticoids. Clinical implications of such lesions remain unclear. More extensive studies are required to define better the relationships between brain involvement and different CAH phenotypes and treatment regimens.
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Affiliation(s)
- Mouna Feki Mnif
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Mahdi Kamoun
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Fatma Mnif
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Nadia Charfi
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Nozha Kallel
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Nabila Rekik
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Basma Ben Naceur
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Hela Fourati
- Department of Radiology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Emna Daoud
- Department of Radiology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Zainab Mnif
- Department of Radiology, HediChaker Hospital, 3029 Sfax, Tunisia
| | - Mohamed Habib Sfar
- Department of Endocrinology and Internal Medicine, Tahar Sfar Hospital, 5111 Mahdia, Tunisia
| | - Samia Younes-Mhenni
- Department of Endocrinology and Internal Medicine, Tahar Sfar Hospital, 5111 Mahdia, Tunisia
| | | | - Mongia Hachicha
- Department of Pediatric, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Mohamed Abid
- Department of Endocrinology, HediChaker Hospital, 3029 Sfax, Tunisia
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Mnif MF, Kamoun M, Mnif F, Charfi N, Naceur BB, Kallel N, Rekik N, Mnif Z, Sfar MH, Sfar MT, Hachicha M, Abid M. Metabolic profile and cardiovascular risk factors in adult patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Indian J Endocrinol Metab 2012; 16:939-946. [PMID: 23226639 PMCID: PMC3510964 DOI: 10.4103/2230-8210.102995] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND In congenital adrenal hyperplasia (CAH), long-term glucocorticoid treatment coupled with increased androgens may lead to undesirable metabolic effects. The aim of our report was to determine the prevalence of metabolic abnormalities and cardiovascular risk factors in a population of adult patients with CAH due to 21 hydroxylase deficiency. MATERIALS AND METHODS Twenty-six patients (11 males and 15 females, mean age ± SD=27.4±8.2 years) were recruited. Anthropometry, body composition, metabolic parameters and cardiovascular risk factors were studied. RESULTS Obesity (overweight included) was noted in 16 patients (61.5%), with android distribution in all cases. Bioelectrical impedance showed increased body fat mass in 12 patients (46.1%). Lipid profile alterations and carbohydrate metabolism disorders were detected in seven (26.9%) and five (19.2%) patients respectively. Moderate hepatic cytolysis, associated with hepatic steatosis, was found in one patient. Seven patients (27%) had insulin resistance. Ambulatory blood pressure monitoring showed abnormalities in six patients (23%). Increased carotid intima media thickness was found in 14 patients (53.8%). CONCLUSION Adult CAH patients tend to have altered metabolic parameters and a higher prevalence of cardiovascular risk factors. Lifelong follow-up, lifestyle modifications, and attempts to adjust and reduce the glucocorticoid doses seem important.
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Affiliation(s)
- Mouna Feki Mnif
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Mahdi Kamoun
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Fatma Mnif
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Nadia Charfi
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Basma Ben Naceur
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Nozha Kallel
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Nabila Rekik
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Zainab Mnif
- Department of Radiology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Mohamed Habib Sfar
- Department of Endocrinology and Internal Medicine, Tahar Sfar Hospital, 5111 Mahdia, Tunisia
| | | | - Mongia Hachicha
- Department of Pediatric, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Mohamed Abid
- Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
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