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L Perlemuter

Publications and source records attributed to L Perlemuter.

80 records · Page 5Linked to original sources
PubMedDate not supplied

[Late diagnosis hyperandrogenism due to adrenal enzyme deficiency (author's transl)].

Six women aged from 17 to 30 years (mean: 21 years) were referred on account disorders which had begun at puberty and had been present for 3 to 15 years. The reasons for consulting were hirsutism in 5 cases and sterility in one. The patients' height (1.61 to 1.70 m; mean: 1.64 m) and weight (54 to 70 kg; mean: 59 kg) were normal. Three women menstruated regularly and 3 had anovular spaniomenorrhaea. Hirsutism with enlargement of the clitoris (Prader's stage I) was apparent in all six cases. Three patients had permanent, though moderate hypertension. The biochemical changes essential to the diagnosis were as follows: 1) in 2 women with 21-hydroxalyse deficiency there was a rise in cortisol precursors (plasma 17-OH progesterone and its urinary metabolite, pregnanetriol). In 4 women with 11-hydroxylase deficiency urinary 17-OH corticosteroids were increased; two had high desoxycorticol levels. A rise in plasma desoxycortisol/cortisol ration under tetracosactrin stimulation is of considerable diagnostic value; 2) plasma androgens (testosterone, delta 4 androstenedione) and their urinary metabolites (17-ketosteroids) were increased; 3) all abnormalities disappeared when the adrenal function was suppressed. Under dexamethasone treatment hirsutism became stabilized or even regressed, blood pressure values rapidly returned to normal, menstrual disorders disappeared and ovular cycles were established. Three women became pregnant and delivered on term.

Adolescent↗
PubMedDate not supplied

[Primary hyperparathyroidism. Relationships of symptoms to age, sex, calcemia, anatomical lesions and weight of the glands].

OBJECTIVES: Primary hyperparathyroidism is a polymorphic disease. We evaluated the effect of different factors on clinical expression. METHODS: Clinical expression in 259 patients who underwent surgery for primary hyperparathyroidism were analyzed as a function of patient age, sex, calcium level, anatomic lesions and weight of the diseased glands. RESULTS: Behaviour disorders and bone images were more frequent in women and urinary lithasis and gastric ulcers were more frequent in men. Behaviour disorders, bone images, chondrocalcinosis, renal failure and acute episodes were more frequent in elderly patients. Inversely, urinary lithiasis was more frequent in young subjects. The prevalence of asymptomatic forms was not related to the level of calcaemia, even for very high levels. Calcium levels above 3.5 mmol/l led to a significantly higher rate of behaviour disorders and acute episodes. Moderately elevated calcium levels were associated most frequently with urinary lithiasis. There was no evidence that anatomic lesions were related to symptomatology, particularly cancer which was not related with more frequent or more severe forms. Finally, nephrocalcinosis, renal failure and acute episodes were particularly frequent when the weight of the parathyroid tissue was greatest. CONCLUSION: The main therapeutic conclusion concerned primary hyperparathyroidism with moderately elevated calcium levels: since there is no difference between the clinical expression of primary hyperparathyroidism with moderately elevated calcaemia, the same surgical approach is recommended.

Adenoma↗