A pituitary mass is not always an adenoma: A rare case of pituitary tuberculoma in an adolescent

INTRODUCTION AND IMPORTANCE

Tuberculosis of the central nervous system is unusual and accounts for 1 % of all cases of tuberculosis in the world. The pituitary location is even scarcer.

CASE PRESENTATION

A 14-year-old girl presented with polyuria-polydipsia syndrome and menstrual irregularity. MRI showed an intrasellar lesion of the pituitary gland. She underwent transsphenoidal surgery for histopathological diagnosis and removal of the lesion. Histological findings were consistent with a tuberculoma. She was put on anti-tuberculosis drugs and is being followed up.

CLINICAL DISCUSSION

In endemic areas, pituitary tuberculosis should be considered in the differential diagnosis of pituitary tumors. The histological examination will guide the diagnosis. Sometimes, other complementary examinations such as the tuberculin skin test can be of great help when the histology is not conclusive. Medical treatment can be curative, however, surgery can be necessary for decompression.

CONCLUSION

In addition to being the first case of histologically proven primary pituitary tuberculosis in a child reported in Morocco, the present case is unique in the way that the extensive radiological examinations did not reveal any evidence of other systemic or pulmonary tuberculosis.

Life cycle of the coleopter Bruchidius raddianae and the seed predation of the Acacia tortilis Subsp. raddiana in Tunisia

Seeds of Acacia tortilis (Forsskal) Hayne ssp. raddiana (Save) Brenan, a savannah tree of great potential for forestry and an excellent browse for game and livestock, is heavily infested by the bruchid beetle Bruchidius raddianae Anton & Delobel. The development from egg to beetle, and the various development stages were investigated using Scanning Electron Microscopy (SEM). The adult B. raddianae lays eggs on the green pod in the autumn. The first instar larva hatches from five to seven weeks and develops outside the host seed. From the second instar onwards development took place inside the host seed. Pupation takes about three weeks, late in the summer. The beetle of B. raddianae is univoltine and the newly emerged adult makes an exit hole to leave the seed. During the development from first instar lava to imago, all embryonic tissue is destroyed. This results in a weakness of its soil seed stock, which reduces the possibilities of natural regeneration of the species.

Calpain 10 and development of diabetes mellitus in cystic fibrosis

Diabetes mellitus (DM) and abnormal glucose tolerance (IGT) are common in cystic fibrosis (CF). The loss of pancreatic beta-cells due to pancreatic fibrosis is thought to be one of the principal causes of diabetes in CF, but the aetiology of DM remains somewhat puzzling. Genetic factors may contribute to the development of CF related diabetes (CFRD). The purpose of this study was to investigate the role of polymorphisms in six genes on IGT or DM incidence. PCR and dHPLC were used to screen DNA samples for polymorphisms. Using 2-h oral glucose tolerance tests, 163 adult pancreatic insufficient CF patients have been subdivided in 3 groups: 54 NGT (normal glucose tolerance), 33 IGT and 76 CFRD. We found the first evidence for the association between CFRD and UCSNP-19 polymorphism in the CAPN10 gene. The UCSNP-19 genotype distribution differed significantly between NGT, IGT and CFRD groups. The difference reflected an increase in the 22 genotype (3 copies of 32-bp sequence) in IGT and CFRD patients (p=0.05). Odds ratio for the homozygote 22 versus homozygote 11 was 3.4 (p=0.02). All allele and genotype distributions for the other polymorphisms were similar in the three groups. In conclusion, our observations suggest that UCSNP-19 of CAPN10 may be involved in the pathogenesis of diabetes in CF.

[Contraception with levonorgestrel subdermal implants. A Tunisian study]

OBJECTIVES

We report our experience in Tunisia with contraception by subdermal levonogestrel implants.

METHODS

From January 1, 1990 through June 30, 1994 we inserted 1021 implants at our family planning center in Ariana.

RESULTS

Our experience with this pure progesterone implant showed that this method provides effective long-duration contraception. There was only one case of ectopic pregnancy among our 1021 patients. The most frequent undesirable effect and the first cause of discontinuing treatment was disturbed menstrual cycle with irregular discharge.

CONCLUSION

Our results underline the importance of counselling before implant insertion. A 10-day estrogen regimen may provide a solution for menstrual disorders.