1/11. Malignant glucagonoma of the pancreas diagnoses through anemia and diabetes mellitus.glucagonoma of the pancreas is a rare tumor with distinct clinical manifestations, such as necrolytic migratory erythema,weight loss, anemia, diabetes mellitus, and hypoamino-acidemia. We report the case of a 68-year-old Japanese man who underwent curative resection for malignant glucagonoma of the pancreas diagnosed through anemia and diabetes mellitus. The patient had had diabetes mellitus for 20 years. anemia was diagnosed in 1998. On admission, the hemoglobin level was 8.3g/dl, but the levels of serum iron, vitamin B12, and erythropoietin and, the number of reticulocytes were within normal limits. The levels of carcinoembryonic antigen (CEA), carbohydrate antigen (CA)19-9, and DUPAN-2 were also within normal limits, and exocrine function of the pancreas (PFD, 75%) was normal. ultrasonography (US) revealed a hypoechoic tumor in the distal pancreas. Computed tomography (CT) demonstrated a high-density area 4 cm in diameter with calcification. The serum glucagon level was very high (2360 pg/ml), but the levels of other hormones such as somatostatin or gastrin were within normal limits, while insulin was low. glucagonoma of the pancreas was diagnosed, and distal pancreatectomy with splenectomy was performed. Histological examination revealed a malignant endocrine tumor,which was immunohistochemically positive for chromogranin a and glucagon. Two months after the operation, the serum glucagon level had decreased to within normal limits and the hemoglobin level had increased to 10.4 g/dl. The case of glucagonoma reported here was found through diagnostic examinations of anemia and treated by surgical resection, by which the patient's anemia was largely alleviated. Therefore, we recommend checking patients who have diabetes mellitus and anemia in order to diagnose and treat glucagonoma in its early stage.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/11. Cutaneous cryptococcosis in a diabetic renal transplant recipient.A diabetic renal transplant recipient with cellulitis caused by cryptococcus neoformans, serotype A, is described. The diagnosis was based on the demonstration of capsulated, budding yeast cells in the aspirated material and tissue from the cellulitic lesion and isolation of the aetiological agent in culture. The isolate formed well-developed capsules in the brain tissue of experimentally infected mice and produced cherry-brown colonies on niger seed medium. The patient's serum was positive for cryptococcal antigen (titre 1 : 4) with no other evidence of systemic infection. He was successfully treated with AmBisome, followed by fluconazole, resulting in the complete resolution of cellulitis and disappearance of the cryptococcal antigen. This report underscores the fact that patients with cutaneous cryptococcosis should be thoroughly evaluated, as it may be the first manifestation of a systemic disease. Prompt diagnosis and treatment are important to improve survival.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/11. Fatal yersinia enterocolitica septicemia complicated by unique hemosiderosis. A case report.A fatal case of yersinia enterocolitica septicemia which was complicated by unique hemosiderosis is reported. On admission, the patient had diabetes and showed unusual hyperferritinemia. Postmortem examination revealed that the liver was studied with abscesses, and Yersinia antigen was expressed in foamy macrophages within these abscesses. Moreover, the cadaver showed generalized hemosiderin deposition, which was mainly observed in the liver and, to lesser degrees, in the pancreas, spleen, lymph nodes, brain, thyroid and kidneys. Since there was no apparent cause of the hyperferritinemia and generalized hemosiderosis, consideration was given to possible primary hemochromatosis. However, no liver or pancreatic fibrosis was demonstrated. kupffer cells were also loaded with hemosiderin, and therefore it was considered that these cells had lost their ability to phagocytize the microorganism adequately, leading to major liver involvement. Interestingly, hemosiderin deposits in the kidneys were mostly present in glomerular epithelial cells. To our knowledge, this unique presentation has not been previously described in humans.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
4/11. The syndrome of caudal dysplasia: a review, including etiologic considerations and evidence of heterogeneity.The syndrome of caudal dysplasia (CDS) and the wide spectrum of associated skeletal and other anomalies are reviewed, and a further case of this disorder is presented. The syndrome of CDS should be distinguished from the familial forms of sacral dysgenesis, three forms of which are tentatively identified. Two of these usually involve some degree of "hemi-sacrum." The third is usually manifested as partial sacral agenesis with absent distal segments. All these familial types are probably genetic dominants, and none is associated with maternal diabetes. Usually CDS is not familial, but it often is associated with a tendency toward diabetes in the mother. The suggestion is advanced here that CDS is the result of a combination of two principal factors represented by (a) a maternal diabetic tendency and (b) separate nondiabetogenic genes. Determination of the human leucocyte antigen (HLA) haplotypes involved in CDS is suggested to investigate the possibility of genetically distinctive factors in this condition.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
5/11. Hereditary ring sideroblastic anaemia and Christmas disease in a Swedish family.The association of hereditary ring sideroblastic anaemia with Christmas disease in a Swedish family is described. We have studied the transmission of the sideroblastic trait, in relation to HLA groups and Christmas disease, and also evaluated the erythrocyte morphology, uroporphyrinogen-I-synthetase activity and S-ferritin for the detection of latent cases of ring sideroblastic anaemia. The proband had ring sideroblastic anaemia, Christmas disease and haemochromatosis. 3 cases of ring sideroblastic anaemia were found among the 12 family members studied. Using the factor ix deficiency as a marker of the x chromosome, it appeared that autosomal transmission of the sideroblastic trait was most likely. The sideroblastic trait did not seem to be linked to HLA-A3-alloantigen. Erythrocyte morphology was normal in all non-anaemic subjects. S-ferritin was found to be increased in all 3 cases of sideroblastic anaemia as well as in 1 non-anaemic relative. Erythrocyte uroporphyrinogen-I-synthetase was elevated in 10 of the 12 family members; those with sideroblastic anaemia had the highest values indicating that uroporphyrinogen-I-synthetase is of importance in the disturbed haem-synthesis of ring sideroblastic anaemia. This interpretation is supported by the positive correlation between S-ferritin values and the uroporphyrinogen-I-synthetase activity.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
6/11. diagnosis of self-induced hyperinsulinism in an insulin-dependent diabetic patient by radioimmunoassay of free c-peptide.On the basis of results of simultaneous determinations of plasma free insulin and free c-peptide, episodes of hypoglycemia in an insulin-dependent diabetic were attributed to surreptitious self-administration of insulin. Immunoreactive c-peptide values were falsely increased and diagnostically misleading when measured in unextracted plasma. After preliminary removal of antigen/antibody complexes from the plasma by extraction with polyethylene glycol, the c-peptide values, referred to as "free c-peptide," were suppressed. We suggest that insulin antibodies formed complexes with proinsulin-like material in the plasma of this patient, which accounted for most of the c-peptide immunoreactivity in her unextracted plasma. These complexes must be removed if c-peptide measurements are to be accurate.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
7/11. Immune competence and diabetes mellitus: pyogenic human hand infections.An unexpectedly high incidence of diabetes mellitus was found in 12 patients with pyogenic hand infections. Three patients had overt diabetes, four had latent diabetes, and only five were normal when tested after resolution of the acute inflamatory state. Cellular immunity, assessed in five patients by intradermal injections of common antigens and the topical application of the neoantigen, dinitrochlorobenzene, appeared to be grossly normal in all patients. If changes in immunity were present, it is likely that the skin tests were not sensitive enough to detect these alterations.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/11. Familial islet-cell adenomatosis.Familial multiple adenoma of pancreatic beta-cells is described for the first time. The occurrence of diabetes mellitus in different members of the family raises the possibility of a common genetic origin for the multiple islet-cell adenomas and the diabetic trait. The evidence suggests that this gene is autosomal and dominant, that it is not linked with the hla antigens, and that is causes an abnormal sensitivity of the beta-cells, which become hyperplastic or hypofunctional.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
9/11. Histologic observations of pleomorphic corynebacterium-like microorganisms in diabetic scleredema adultorum.Diabetic scleredema adultorum is a rare connective tissue disorder characterized by scleroderma-like changes, usually affecting the skin of the neck, shoulders, and upper back in diabetics. Presented herein are two cases in which pleomorphic, but predominantly coccoid forms, were observed in acid-fast, Giemsa, and Gram-stained tissue, sections of the affected skin. culture of the skin was positive for a microaerophilic, corynebacterium-like organism in one case and an anaerobic propionibacterium (corynebacterium) sp in the other case. The morphologic appearance of the bacterial isolates greatly resembled the morphologic forms observed in the tissue sections, suggesting that bacteria, possibly in a cell-wall-deficient phase, may play a role in the pathogenesis of this disorder. Findings of similar bacteria in previously reported cases of other connective tissue disorders such as sclerodermiformis, and rheumatoid arthritis, might support our idea that bacteria could supply the antigenic stimulus for the production of scleredema.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
10/11. Hepatitis B surface antigen and e antigen in pleural effusion: a case report.Hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) were demonstrated in pleural fluid obtained from a 40-year-old dialysis patient who had HBSAg and HBeAg in her serum. The titers of HBsAg and HBeAg were similar in serum and pleural fluid. Examination of the pleural fluid by electron microscopy revealed the presence of intact hepatitis b virus particles. These findings underline the potential hepatitis b virus infectivity of other body fluids besides blood, especially for medical and laboratory personnel.- - - - - - - - - - ranking = 5keywords = antigen (Clic here for more details about this article) |
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