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Ulhøi M, Stelmach M, McCulloch T, Hansen K, Andersen J, Sorensen B, Meldgaard P. EP08.02-099 Liquid Biopsies as a Tool for Monitoring Patients with Metastatic ALK-positive NSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.782] [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: 10/14/2022]
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Małachowska B, Borowiec M, Antosik K, Michalak A, Baranowska-Jaźwiecka A, Deja G, Jarosz-Chobot P, Brandt A, Myśliwiec M, Stelmach M, Nazim J, Peczyńska J, Głowińska-Olszewska B, Horodnicka-Józwa A, Walczak M, Małecki MT, Zmysłowska A, Szadkowska A, Fendler W, Młynarski W. Monogenic diabetes prevalence among Polish children-Summary of 11 years-long nationwide genetic screening program. Pediatr Diabetes 2018; 19:53-58. [PMID: 28436179 DOI: 10.1111/pedi.12532] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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] [Received: 12/16/2016] [Revised: 03/10/2017] [Accepted: 03/28/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Estimated monogenic diabetes (MD) prevalence increases as screening programs proceeds. OBJECTIVE To estimate prevalence of MD among Polish children. SUBJECTS Patients and their family members suspected of suffering from MD (defined as causative mutation in one of the Maturity Onset Diabetes of the Young or permanent neonatal diabetes mellitus genes) were recruited between January 2005 and December 2015. METHODS Nationwide prevalence was estimated based on data from 6 administrative provinces (out of 16 in Poland) with high referral rates of patients (>10 per 100 000 children). RESULTS During the analysis, probands from 322 of 788 screened families tested positive yielding a total of 409 children and 299 family members with MD. An average of 70 probands/year were referred. Screening success rate reached 40% over the study period. We estimated the prevalence of MD in 2015 to 7.52/100 000 children (1 in 13 000). The most frequent MODY in this group was GCK- MODY (6.88/100 000). The prevalence estimates increased nearly 2-fold since our report in 2011 (4.4/100 000). However, the figure reached a plateau because of screening saturation in 2014 what was also proven by lowering of the median age of diagnosis lowered in time (R = -0.73, P = .0172) along with shortening of the delay between clinical and genetic diagnosis (R = -0.65, P = .0417). CONCLUSIONS The screening for childhood MD in Poland reached a plateau phase after 10 years showing a stable prevalence estimate. The true frequency of MD in the overall population may be higher given later onset of reportedly more frequent types of MD than GCK -MODY.
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Affiliation(s)
- Beata Małachowska
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Lodz, Poland.,Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland.,Postgraduate School of Molecular Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Borowiec
- Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - Karolina Antosik
- Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - Arkadiusz Michalak
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Anna Baranowska-Jaźwiecka
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Grażyna Deja
- Department of Children's Diabetology, Medical School of Silesia, Katowice, Poland
| | | | - Agnieszka Brandt
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Gdansk, Poland
| | - Małgorzata Myśliwiec
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Gdansk, Poland
| | - Małgorzata Stelmach
- Pediatric Endocrinology Department, University Children's Hospital Jagiellonian University, Medical College, Cracow, Poland
| | - Joanna Nazim
- Pediatric Endocrinology Department, University Children's Hospital Jagiellonian University, Medical College, Cracow, Poland
| | - Jadwiga Peczyńska
- Outpatient Clinic for Pediatric Patients with Diabetes, Bialystok, Poland
| | - Barbara Głowińska-Olszewska
- Department of Pediatrics, Endocrinology, Diabetology with Cardiology Divisions, Medical University of Bialystok, Bialystok, Poland
| | - Anita Horodnicka-Józwa
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Mieczysław Walczak
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Maciej T Małecki
- Department of Metabolic Disease, Collegium Medicum Jagiellonian University of Cracow, Cracow, Poland
| | - Agnieszka Zmysłowska
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Agnieszka Szadkowska
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Wojciech Fendler
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Lodz, Poland.,Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
| | - Wojciech Młynarski
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Lodz, Poland
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O’keeffe M, Kelly M, O’herlihy E, O’toole P, Kearney P, Timmons S, Stanton C, Rolland Y, Sulmont Rosse C, Maitre I, Boeing H, Stelmach M, Nagel G, Wolters M, Hebestreit A, De Groot L, Teh R, Agnes Peyron M, Dardevet D, Papet I, Streicher M, Torbahn G, Kiesswetter E, Visser M, Volkert D, O’connor E. SUN-LB306: Potentially Modifiable Determinants of Malnutrition in Older Adults: A Systematic Review. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30657-x] [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: 10/18/2022]
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Wędrychowicz A, Tobór E, Wilk M, Ziółkowska-Ledwith E, Rams A, Wzorek K, Sabal B, Stelmach M, Starzyk JB. Phenotype Heterogeneity in Glucokinase-Maturity-Onset Diabetes of the Young (GCK-MODY) Patients. J Clin Res Pediatr Endocrinol 2017; 9:246-252. [PMID: 28663157 PMCID: PMC5596806 DOI: 10.4274/jcrpe.4461] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 12/31/2022] Open
Abstract
OBJECTIVE The aim of the study was to evaluate the clinical phenotypes of glucokinase-maturity-onset diabetes of the young (GCK-MODY) pediatric patients from Southwest Poland and to search for phenotype-genotype correlations. METHODS We conducted a retrospective analysis of data on 37 CGK-MODY patients consisting of 21 girls and 16 boys of ages 1.9-20.1 (mean 12.5±5.2) years, treated in our centre in the time period between 2002 and 2013. RESULTS GCK-MODY carriers were found in a frequency of 3% among 1043 diabetes mellitus (DM) patients and constituted the second most numerous group of DM patients, following type 1 DM, in our centre. The mean age of GCK-MODY diagnosis was 10.4±4.5 years. The findings leading to the diagnosis were impaired fasting glucose (IFG) (15/37), symptoms of hyperglycemia (4/37), and a GCK-MODY family history (18/37). Mean fasting blood glucose level was 6.67±1.64 mmol/L. In the sample, there were patients with normal values (4/37), those with DM (10/37), and IFG (23/37). In OGTT, 120 min glucose level was normal in 8, diabetic in 2, and characteristic for glucose intolerance in 27 of the 37 cases. Twelve of the 37 cases (32%) were identified as GCK-MODY carriers. In the total group, mean C-peptide level was 2.13±0.65 ng/mL and HbA1c was 6.26±0.45% (44.9±-18 mmol/mol). Thirty-two patients had a family history of DM. DM autoantibodies were detected in two patients. The most common mutations were p.Gly318Arg (11/37) and p.Val302Leu (8/37). There was no correlation between type of mutations and plasma glucose levels. CONCLUSION The phenotype of GCK-MODY patients may vary from those characteristic for other DM types to an asymptomatic state with normal FG with no correlation with genotype.
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Affiliation(s)
- Anna Wędrychowicz
- Polish-American Pediatric Institute, Jagiellonian University Collegium Medicum, Department of Pediatric and Adolescent Endocrinology, Cracow, Poland
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Equal main/first authors
,* Address for Correspondence: Polish-American Pediatric Institute, Jagiellonian University Collegium Medicum, Department of Pediatric and Adolescent Endocrinology, Cracow, Poland Phone: +48 12 658 12 77 E-mail:
| | - Ewa Tobór
- Polish-American Pediatric Institute, Jagiellonian University Collegium Medicum, Students’ Scientific Group at the Department of Pediatric and Adolescent Endocrinology, Cracow, Poland
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Equal main/first authors
| | - Magdalena Wilk
- Polish-American Pediatric Institute, Jagiellonian University Collegium Medicum, Students’ Scientific Group at the Department of Pediatric and Adolescent Endocrinology, Cracow, Poland
,
Equal main/first authors
| | - Ewa Ziółkowska-Ledwith
- Polish-American Pediatric Institute, Jagiellonian University Collegium Medicum, Students’ Scientific Group at the Department of Pediatric and Adolescent Endocrinology, Cracow, Poland
| | - Anna Rams
- Polish-American Pediatric Institute, Jagiellonian University Collegium Medicum, Students’ Scientific Group at the Department of Pediatric and Adolescent Endocrinology, Cracow, Poland
| | - Katarzyna Wzorek
- Polish-American Pediatric Institute, Jagiellonian University Collegium Medicum, Students’ Scientific Group at the Department of Pediatric and Adolescent Endocrinology, Cracow, Poland
| | - Barbara Sabal
- Polish-American Pediatric Institute, Jagiellonian University Collegium Medicum, Students’ Scientific Group at the Department of Pediatric and Adolescent Endocrinology, Cracow, Poland
| | - Małgorzata Stelmach
- Polish-American Pediatric Institute, Jagiellonian University Collegium Medicum, Department of Pediatric and Adolescent Endocrinology, Cracow, Poland
| | - Jerzy B. Starzyk
- Polish-American Pediatric Institute, Jagiellonian University Collegium Medicum, Department of Pediatric and Adolescent Endocrinology, Cracow, Poland
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Zmyslowska A, Borowiec M, Antosik K, Ploski R, Ciechanowska M, Iwaniszewska B, Jakubiuk-Tomaszuk A, Janczyk W, Krawczynski M, Salmonowicz B, Stelmach M, Mlynarski W. Genetic evaluation of patients with Alström syndrome in the Polish population. Clin Genet 2015; 89:448-453. [PMID: 26283575 DOI: 10.1111/cge.12656] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 02/15/2015] [Revised: 07/15/2015] [Accepted: 07/15/2015] [Indexed: 12/21/2022]
Abstract
Alström syndrome (AS) is a rare syndromic form of obesity and type 2 diabetes (T2D) in children coexisting with retinal dystrophy and disorders of many organs caused by the mutations in ALMS1 gene. Aim of this study was to identify the causative mutations in ALMS1 in a group of 12 patients of Polish origin with clinical symptoms of AS, and their 21 first-degree relatives. Using DNA sequencing, nine different mutations including three novel were identified. These mutations were not present in 212 Polish individuals with no symptoms of AS, subjected to whole-exome sequencing and collected in a national registry. Looking for genotype-phenotype relationships, we confirmed a severe phenotype in a boy with homozygous mutation in exon 16, and a relationship between a presence of T2D and mutations in exon 19. Evaluation of the type of mutation and its clinical effects gives hope for earlier diagnosis of AS in future patients and more advanced therapeutic approaches for patients with already diagnosed AS.
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Affiliation(s)
- A Zmyslowska
- Department of Pediatrics, Oncology, Hematology and Diabetology, Lodz, Poland
| | - M Borowiec
- Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - K Antosik
- Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - R Ploski
- Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland
| | - M Ciechanowska
- Department of Endocrinology for Children and Adolescents, Jagiellonian University, Cracow, Poland
| | - B Iwaniszewska
- Department of Pediatrics, Endocrinology and Neurology, Children's hospital, Torun, Poland
| | | | - W Janczyk
- Department of Gastroenterology, Hepatology, Nutrition Disorders and Pediatrics, Warsaw, Poland
| | - M Krawczynski
- Department of Clinical Genetics, Medical University of Poznan, Poznan, Poland
| | - B Salmonowicz
- Department of Pediatric Endocrinology, Wroclaw Medical University, Wroclaw, Poland
| | - M Stelmach
- Department of Endocrinology for Children and Adolescents, Jagiellonian University, Cracow, Poland
| | - W Mlynarski
- Department of Pediatrics, Oncology, Hematology and Diabetology, Lodz, Poland
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Wędrychowicz A, Ciechanowska M, Stelmach M, Starzyk J. Diabetes mellitus after allogeneic hematopoietic stem cell transplantation. Horm Res Paediatr 2013; 79:44-50. [PMID: 23296512 DOI: 10.1159/000345547] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 11/01/2012] [Indexed: 11/19/2022] Open
Abstract
Survivors of pediatric hematopoietic stem cell transplantation (HSCT) are known to be at risk of developing endocrine abnormalities, but occurrence of diabetes mellitus (DM) is a relatively recent observation. We present a 17.5-year-old girl with DM after high-dose radio- and chemotherapy followed by allogeneic HSCT for the treatment of acute lymphoblastic leukemia, diagnosed when she was 10 years old. In the posttransplantation period, multiple acute and chronic complications occurred. Among them, we observed graft versus host disease requiring corticosteroid therapy, pancreatitis and some endocrine complications like primary hypothyroidism, growth hormone deficiency and hypergonadotropic hypogonadism. DM with some components of metabolic syndrome-like insulin resistance, high arterial blood pressure and dyslipidemia developed during the first year after HSCT. Five years later, a trend towards increased requirement of insulin with deterioration in metabolic control of DM was observed, despite a normal level of C-peptide and negative diabetes autoantibodies. After the addition of metformin to continuous subcutaneous insulin infusion in the therapy of DM, an improvement in metabolic control was observed. Due to the possible mechanism of insulin resistance which is associated with impaired insulin receptors after HSCT procedure, metformin with insulin appears to be effective in the treatment of this type of diabetes.
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Affiliation(s)
- Anna Wędrychowicz
- Department of Pediatric and Adolescent Endocrinology, Polish-American Pediatric Institute, Medical College, Jagiellonian University, Cracow, Poland.
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Wójcik M, Januś D, Maślanka A, Olchawa-Czech A, Radwańska M, Dylag K, Dolezal-Ołtarzewska K, Roztoczyńska D, Tyrawa K, Zygmunt-Górska A, Kumorowicz-Czoch M, Kalicka-Kasperczyk A, Ciechanowska M, Stelmach M, Nazim J, Starzyk J. [Disorders of lipid metabolism in adolescents with simple obesity]. Przegl Lek 2010; 67:1168-1171. [PMID: 21442970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Obesity affects approximately 45 millions of children worldwide. Some of them present with secondary dyslipidemia that leads to premature atherosclerosis. AIM OF THE STUDY 1) Assessment of the frequency and type of dyslipidemia in obese adolescents. 2) An attempt at defining risk factors of atherogenic lipid profile in obese adolescents. MATERIAL AND METHODS In 146 (84 girls/62 boys) obese (mean BMI SDS 4.95, 95% CI 4.62-5.29) adolescents (age 10-18, mean 14.7 years), the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc) and triglicerydes (TG) were measured. Atherogenic dyslipidemia was defined as a high TG level with a concomitant low HDLc level. Standard oral glucose tolerance test was performed with the assessment of fasting and after 120' post-load of 75 g of glucose and insulin levels; the insulin resistance index HOMA-IR was calculated. RESULTS The mean values of the lipid fractions were in normal ranges: TC 4.64 mmol/L (95% CI 4.48-4.8), LDLc 2.86 mmol/L (95% CI 2.73-2.99), TG 1.4 mmol/L (95% CI 1.3-1.5), and HDLc 1.16 (95% CI 1.1-1.2). However, in 50.69% of the patients (45.24% girls and 58.06% boys), elevated levels of TC, LDLc, and TG were observed respectively in 23.29%, 17.81% and 37.67%, and low HDLc in 15.07% of patients. A total of 10.96% of the patients presented with coexistence of a low HDLc and a high TG. In 26.7%, dyslipidemia was followed by arterial hypertension. There was a reverse correlation between a low HDLc value and BMI SDS [R (-) 0.22, p < 0.05] and not with TC, LDLc, and TG. The relative risk of abnormal lipid profile occurrence was higher in obese patients with insulin resistance (OR 1.72; 95% CI 0.8-3.4; p = 0.12), being significant only for boys (OR 3.67; 95% CI 1.1-12.1; p = 0.03). There was a reverse correlation between fasting insulin level, HOMA-IR and HDLc [R (-) 0.2; p < 0.05; R (-) 0.2; p < 0.05) respectively], as well as TG (R 0.26 ; p < 0.05; R 0.26; p < 0.05, respectively), and between post-load insulin level and TG (R 0.24; p < 0.05). CONCLUSIONS 1) Lipid disorders occur in about one-half of obese adolescents, of which 10% presents with atherogenic lipid profile. 2) One of the most important risk factors of atherogenic lipid profile occurrence is insulin resistance, especially in boys. The severity of the obesity (BMI-SDS) is of lesser importance.
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Affiliation(s)
- Małgorzata Wójcik
- Klinika Endokrynologii Dzieci i Młodziezy Katedry Pediatrii, Polsko-Amerykański Instytut Pediatrii, Uniwersytet Jagielloński Collegium Medicum, Kraków.
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Ataullah S, Whitehouse RW, Stelmach M, Shah S, Leatherbarrow B. Missed orbital wall blow-out fracture as a cause of post-enucleation socket syndrome. Eye (Lond) 1999; 13 ( Pt 4):541-4. [PMID: 10692927 DOI: 10.1038/eye.1999.134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Post-enucleation socket syndrome (PESS: deep upper lid sulcus, ptosis or upper lid retraction, enophthalmos and lower lid laxity) is a well-recognised complication of a volume-deficient anophthalmic socket. A patient requiring enucleation following severe ocular trauma may have an underlying orbital wall blow-out fracture which if overlooked can cause severe volume deficit with poor cosmesis and limited prosthesis motility. PURPOSE To establish the prevalence of an undiagnosed blow-out fracture in patients with PESS and a history of relevant trauma. METHODS Medical records and orbital computed tomography (CT) scans were reviewed for all patients presenting with PESS and a history of relevant trauma. RESULTS Undiagnosed blow-out fractures were found in 15 (33%) of 45 patients presenting between August 1993 and December 1996. These were significant enough to warrant surgical repair in 13 (29%) patients. CONCLUSIONS We suggest that any patient presenting with PESS and a history of relevant trauma should be considered to have an orbital wall blow-out fracture until proven otherwise by CT scanning of the orbit. Similarly any patient requiring enucleation following severe ocular trauma should undergo CT scanning to rule out a coexisting blow-out fracture which could be repaired at the time of enucleation.
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Abstract
OBJECTIVE To define accurate wound infection rates for the cardiac surgery service based on site of infection and characterization as "deep" or "incisional" and to determine whether a correctable cause for an apparent increase in deep wound infection rates existed. DESIGN Observational. SETTING Tertiary-care teaching hospital. PARTICIPANTS All adults undergoing open heart surgery in 1988 and 1989. INTERVENTIONS Changed from razor to clipper preoperative hair removal in January 1989. RESULTS Deep sternotomy wound infections decreased significantly from 1.2% in 1988 to 0.2% in 1989 (p = .010) and deep venectomy (vein donor site) wound infections declined from 1.6% to 0.4% (p = .014) during the same time period. Incisional wound infection rates did not change. Patients with deep infections more likely required readmission or operation to treat their infection than those with incisional wound infections. The percentage of gram-negative organisms causing wound infections decreased from 56.3% in 1988 to 34.7% in 1989 (p = .017). CONCLUSIONS Preoperative hair removal using a clipper appears to have decreased the risk of deep wound infection compared with razor preparation. The dichotomous wound classification of "deep" and "incisional" distinguished between patients who required additional interventions for treatment of wound infections.
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Affiliation(s)
- J A Sellick
- Division of Infectious Diseases, State University of New York, Buffalo
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Abstract
A young woman presented in the third trimester of pregnancy with a rapid onset of bitemporal hemianopia and reduced visual acuity caused by an unusual steroid responsive suprasellar tumor. A computerized tomography scan revealed a 2-cm suprasellar mass which was thought to be a tuberculum sellae meningioma. Surgery was delayed because of pregnancy. A short course of high-dose steroids was given to promote fetal lung maturity. This produced an unexpected and dramatic resolution of the field loss. As the steroid dose was reduced, the visual fields deteriorated, necessitating a craniotomy. The histology revealed lymphocytic hypophysitis, a rare but distinct clinicopathological entity affecting the anterior pituitary lobe. The significance of the suprasellar site and a possible role for the use of steroids in the preoperative management of this condition is discussed.
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Affiliation(s)
- M Stelmach
- Department of Anatomy, University of Melbourne, Parkville, Australia
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Stelmach M, Postma J, Goldstein S, Shepard KF. Selected factors influencing job satisfaction of attendants of physically disabled adults. Rehabil Lit 1981; 42:130-7. [PMID: 6455724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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