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Biomedical subjects

D Betea

Publications and source records attributed to D Betea.

10 recordsLinked to original sources
PubMed2004

Hormonal and biochemical normalization and tumor shrinkage induced by anti-parathyroid hormone immunotherapy in a patient with metastatic parathyroid carcinoma.

Parathyroid carcinoma is a rare cause of primary hyperparathyroidism, and the efficacy of medical therapy and chemo- and radiotherapy is poor in recurrent or metastatic disease. We report the first case of PTH immunization in which tumor shrinkage accompanied hormonal, biochemical, and clinical improvements in a patient with metastatic parathyroid carcinoma.A 50-yr-old woman with refractory parathyroid carcinoma and pulmonary metastases was immunized eight times between February 2001 and December 2003 with bovine and modified human PTH fragments and intact human PTH, mixed with Freund's adjuvant. Total and ionized calcium and PTH levels were assayed weekly for 6 months and regularly thereafter. Thoracic computed tomography scans were performed regularly. Antibodies to all PTH fragments were detected after two immunizations. Baseline PTH and total calcium were 213.0 ng/liter and 13.96 mg/dl, respectively, and remained elevated during the first three immunizations. From the fourth immunization onward, PTH and calcium decreased, and the patient's clinical condition improved markedly. PTH and calcium levels have remained controlled for more than 24 months, and the sizes (surface area) of pulmonary metastases decreased from baseline by 39-71%. This is the first evidence that PTH immunization not only can improve clinical, hormonal, and biochemical measures in parathyroid carcinoma but also has an antitumor effect.

Animals↗
PubMed2003

The treatment of sporadic versus MEN1-related pituitary adenomas.

The treatment of pituitary tumours strongly depends on their clinical presentation. In general, the treatment aims are reducing tumour volume and/or decreasing hormone hypersecretion. It relies on single or a combination of three different methods: surgery, medication and radiotherapy. The rationale for deciding the treatment are many but include the aggressiveness of the tumour. The aetiologies of sporadic pituitary adenomas are not fully understood. However, several causes have been identified resulting in specific familial phenotypes like multiple endocrine neoplasia type I (MEN1). MEN1 is related to mutations in the MEN1 gene, a tumour suppressor gene localized on chromosome 11q13 and which encodes menin, a 610 amino acid protein. During the last years, an evidence progressively emerged that MEN1-related adenomas were more aggressive and less responsive to therapy than their sporadic counterparts. In this article, we review the differences between sporadic and MEN1-related adenomas and suggest specific ways of treatment and follow-up for MEN1-related tumours.

Acromegaly↗
PubMed2003

[Clinical case of the month. Anterior mediastinal mass in a patient with acromegaly].

The discovery of an anterior asymptomatic mediastinal mass with acromegaly creates a dilemma for the clinician. As acromegaly can be due to a pituitary tumor but also to an ectopic production of GHRH, the first diagnostic step consists of finding the etiology of the disease in order to use adequate treatment. This can be complicated by the fact that acromegaly can be associated with other tumors (for instance in MEN-1 disease and Carney Complex) and because chronic GH hypersecretion can stimulate tumor overgrowth and perhaps tumor formation. We describe the case of a 44-year-old acromegalic woman with an anterior mediastinal mass. We present the different diagnoses and a review of the literature.

Acromegaly↗
PubMed2002

[Differential diagnosis and medical treatment in Cushing's disease].

Cushing's disease remains a difficult diagnosis in spite of new technical procedures such as pituitary MRI, selective bilateral petrosal or cavernous sampling, (111)In pentreotide scan and 18 Flurodeoxyglucose pituitary PET scan. In this article, we review biological diagnostic procedures of Cushing's disease and corticotroph adenomas. According to our experience and the literature, we summarize the approach in medical treatment of Cushing's disease.

ACTH Syndrome, Ectopic↗
PubMed2002

[Pituitary diseases in elderly patients with chronic renal insufficiency].

Chronic renal failure (CRF) in the elderly is a cause of multiple endocrine dysfunctions. The three most common pituitary axes involved are the thyrotrope, lactotrope and gonadotrope axes. Thyroid dysfunction may be the consequence of thyroid or pituitary failure. Hyperprolactinemia results in gonadal failure and is present in 30% of patients. Early presentation of menopause and andropause are common in patients with CRF. Sexual hormonal replacement is controversial and must be individually tailored. We propose a systematic screening in the elderly with CRF: determination of TSH, TPO antibodies and cervical palpation, measures of PRL, LH, FSH and testosterone to explore lactotrope and gonadotrope axis.

Aged↗
PubMed2000

[Clinical case of the month. A new case of nephropathia epidemica due to Puumala virus].

Nephropathia epidemica due to Puumala virus has already been described in Belgium. Its evolution is usually favourable. The main symptoms are fever, a decrease platelet count, proteinuria and acute renal insufficiency, which, in an epidemiological context, quickly point the correct diagnosis. Acute and transitory myopia is typical. Nevertheless, the clinical presentation, including multisystemic symptoms may lead to the false diagnosis of an acute bacterial or immune disease.

Acute Kidney Injury↗
PubMed2000

[Pituitary pathology and MEN 1].

Multiple Endocrine Neoplasia type 1 (MEN 1) is an autosomal dominant syndrome characterized by neoplasia of the parathyroid glands, the endocrine pancreas and the anterior pituitary gland. Recently the identification on chromosome 11 (locus q13) of the gene responsible for MEN 1 has allowed direct genetic diagnosis of MEN 1-affected family members. To date almost 300 families have been described and genetically characterized. The genetic etiology of most pituitary tumours remains unknown. Pituitary adenomas can develop sporadically or as a part of multiple endocrine neoplasia type 1. In this review, the recently published data on the pathology of the MEN 1 syndrome will be summarized. The clinical, morphological and genetic aspects of sporadic and MEN 1-associated pituitary adenomas will be outlined.

Adenoma↗
PubMedDate not supplied

[Secondary forms of diabetes mellitus associated with endocrine diseases].

Diabetes mellitus may occur in association with endocrine disorders and is termed "other causes of diabetes" by the American Diabetes Association. Hyperglycaemia results from sustained excessive hormonal secretion, which alters insulin secretion or action. It is characterized by the absence of ketosis because of the persistence of endogenous insulin secretion. Diabetes is usually reversible with successful treatment of the underlying endocrine disorder and the correction of hormonal overproduction. Most important endocrine diseases associated with diabetes mellitus are briefly described and the underlying mechanisms of glucose abnormalities are discussed.

Blood Glucose↗
PubMedDate not supplied

[Thyroid nodules].

Thyroid nodules are commonly encountered in clinical practice. They are present in 4 to 7% of the population by neck palpation and 30 to 50% by ultrasonography. Most are benign and could be neglected by the clinician and his patient. However, 5% of nodules are malignant, requiring surgical treatment; therefore, an exhaustive evaluation is needed. The diagnostic approach includes physical examination, laboratory analysis, ultrasonography, radioisotope imaging, and fine needle aspiration. This article, based on the literature and the authors'experience, provides recommandations for thyroid nodule management.

Humans↗