ACTA ENDOCRINOLOGICA (BUC)

Abstract Objective. The aim of the present study is to evaluate the effects of methimazole (MTZ) and propylthiouracil (PTU) treatments on osteopontin (OPN) and oxidative stress in Graves’ disease (GD). Material and Methods. The study included 60 cases with GD in hyperthyroid state and taking no antithyroid treatment, and 30 healthy volunteers. GD patients were randomly separated into two groups; 30 of them took PTU, and the other 30 took MTZ treatments. Blood samples were taken from the patients with GD before the treatment, and three months after the treatment was begun, when they were in the euthyroid state; blood samples of the healthy control subjects were also taken at these times. Results. TAS and OSI levels before treatment were significantly higher in the GD group, when compared to the control group (p<0.001, for each). GD subjects taking PTU treatment had significantly higher TAS levels (p=0.001), and significantly lower TOS and OSI levels (p=0.008 and p=0.001, respectively). TAS levels significantly decreased in the patients taking MTZ treatment (p=0.029), but TOS and OSI levels did not change significantly (p>0.05). Pretreatment OPN levels were significantly higher in GD patients, when compared to the control group (p=0.014). OPN level significantly decreased in the GD group taking PTU treatment; however OPN levels in the group taking MTZ treatment did not change significantly when compared to the pretreatment value. Conclusion. PTU treatment is more effective in decreasing OPN and oxidative stress in GD patients, when compared to the MTZ treatment.

Introduction. Antioxidants and unsaturated fatty acids have protective effects in obesity. Aim. We investigated the benefits of Omega-3 fatty acids associated with antioxidant vitamins in obese children. Magnesemia and calcemia were observed in relation with other metabolic parameters, before and after the treatment. Materials and methods. 60 obese children were compared with 35 normal weight children. Each obese child received daily, one pill, containing: 130mg docosahexaenoic acid, 25mg of eicosapentaenoic acid, vitamin A 200μg, vitamin D 1,25μg, vitamin E 2,5mg and vitamin C 30mg for three months. All the participants were instructed not to change their lifestyle. Results. The serum values for these minerals and for 25(OH) vitamin D were lower in obese children. The obese children had insulin resistance (HOMA-IR) and an imbalance of serum adipocytokines. In obese children, the body mass index was negatively correlated with calcemia (r=-0.34) and serum 25(OH) vitamin D (r=-0.33). The HOMA-IR was negatively correlated with magnesemia (r=-0.34) and serum adiponectin (r=-0.29). The treatment improved the mineral serum level, the insulin sensitivity and the adipocytokines levels. Conclusion. In obese children, the intake of Omega-3 fatty acids associated with antioxidant vitamins, for three months improved calcemia and magnesemia and increased insulin sensitivity.

Background. Mixed gonadal dysgenesis is a disorder of sex development associated with a numerical or sex chromosome abnormality. There is no association between the degree of mosaicism and the phenotype. Case report. An 11 years old girl was admitted for excessive weight [BMI: 31.55 kg/m2 (+ 3 SD)]. The family medical history was positive for overweight and obesity, type 2 diabetes mellitus, but no evidence of gonadal disorders or infertility was found. Physical examination revealed Turner Syndrome stigmata, acanthosis nigricans, excessive adipose tissue, normal female type external genitalia, Tanner pubertal stage 0. Even though the patient’s main complaint was the excessive weight, the most striking feature was the short stature. Further evaluation showed decreased IGF-1 level, delayed bone age, GH deficiency and Impaired Glucose Tolerance. The genetic analysis performed showed 45, X0 (20%)/ 46, XY (80%) karyotype with positive SRY gene. The histopathological examination of bilateral gonad biopsy confirmed the presence of ovarian hypoplastic tissue in the left gonad and ovarian tissue suggesting gonadoblastoma of the right gonad. Conclusion. Correct diagnosis and management of these patients needs a multidisciplinary team effort. The benefit of GH treatment therapy was demonstrated in the majority of 45, X0 / 46, XY short stature patients.

Background: The solitary benign thyroid nodules represent one of the most common\r\nabnormalities affecting the thyroid gland. The appearance of solitary thyroid nodules is\r\nvariable and all the patients should be assessed as soon as possible in order to establish the\r\nbenign nature of the lesion and to rule-out malignancy.\r\nThe aim of the present study is to show the histological changes that appear during\r\nevolution of benign solitary thyroid nodules and rapid growing rate along 6 years, in 71\r\npatients (65 women and 6 men).\r\nMethods: All cases were evaluated by clinical, ultrasound, biochemical (at every 6\r\nmonths) and FNA (initially and repeated between 10 months and 4 years afterwards); 26 out\r\nof 71 presented, along evolution, an increase of thyroid nodule (24 women and 2 men) from\r\n1.77 cm diameter (1.4-2 cm) to more than 2.5 cm (2.5-4.3 cm), therefore a radical surgical\r\nattitude was performed.\r\nResults: Histological postsurgery data showed degenerative changes in all cases, with\r\nrepetitive nodular hemorrhage (26 cases), sclerohyalinisation of the interfollicular stroma (4\r\ncases), cholesteatoma (5 cases) and inflammatory infiltrate (8 cases).\r\nIn conclusion, the significant growth of a benign solitary nodule is determined by\r\nrepetitive hemorrhages in the thyroid tissue. The associated sclerosis induces changes in the\r\nnodular firmness and might trigger the thyroid surgery.

Background. Sweet's syndrome (SS) or acute febrile neutrophilic dermatosis is a dermatological illness that can be described by tender erythematous plaques or nodules and acute onset fever. The etiology is multifactorial and is not fully understood. SS is separated in three subclasses: classical, malignancy-associated, and drug-induced. It was shown that this syndrome can reveal an underlying hematological or solid malignancy. Case presentation. We report the case of a 55-yearold female patient referred to the Urology department for management of pheochromocytoma in the right adrenal gland, revealed by abdominal imaging in another medical unit during the evaluation and diagnosis of multiple mucocutaneous lesions, characterized by erythematousviolaceous plaques and nodules, and painful aphthous ulcers of the tongue. The eruption of each lesion was preceded by low-grade fever and chills. The hormonal profile highlighted the presence of elevated normetanephrines. We performed 3D laparoscopic transperitoneal right adrenalectomy after preoperative treatment with alpha blocker therapy. The clinical outcome was favourable, given that the cutaneous lesions started to heal after the surgery. Conclusions. Sweet’s syndrome in association with pheochromocytoma is a very rare condition, only few cases were described in literature to our knowledge. The multidisciplinary collaboration is extremely important in the management of such cases.

We report on a 4-years old girl with mosaic Turner karyotype: 45X/46XX (10% the 45,X line, 90% 46,XX line) / karyotype performed by the classical method and direct FISH (centromeres X and Y on buccal smears). As turnerian manifestations she presented short stature (more than &#8211;2 SD), mental retardation and slightly webbed neck. The most clinical manifestations were suggestive for the Kabuki syndrome, i.e.: -peculiar facies: very long palpebral fissures, arching of the eyebrows, short nasal septum, cleft palate, open mouth; -ventricular septal defect, left renal agenesis, dislocated hip on the left side. We present shortly the Kabuki and Turner syndromes and discuss the relationship between them.

Aim. There is no data for platelet distribution width (PDW) levels as a marker of platelet activation in patients with\r\nmetabolic syndrome (MetS). The present study tested the hypothesis that PDW levels may be elevated in MetS patients. Based on this hypothesis, PDW levels in patients with MetS were compared with those of patients without MetS. The relation between PDW levels and cardiometabolic risk factors was also evaluated.\r\nMaterials and Methods. Two hundred and nineteen non-diabetic MetS patients (MetS group; 155 females, 64 males) and 155 non-diabetic patients without MetS (Control group; 123 females, 32 males) were included consecutively. The primary endpoint of the study was to compare the PDW levels between the groups, while the secondary endpoint was to evaluate the relationship between PDW and cardiometabolic risk factors.\r\nResults. PDW levels were 16.75?1.73%, and 16.89?1.92% in MetS patients and control subjects, respectively (p>0.05). In correlation analysis, insulin and homeostasis model assessment of insulin resistance (HOMA-IR) (r:0.193, p:0.004, and r:0.215, p:0.001, respectively) were associated with the PDW.\r\nConclusion. Although there is a weak positive correlation between PDW and insulin and HOMA-IR, these findings do\r\nnot support our hypothesis that PDW levels may be elevated in MetS patients.

Background. The aim of the present study was to systematically review the effects of Realsil (silybin– phospholipid–vitamin E complex) on liver enzymes in patients with NAFLD or NASH. Methods. We searched Web of Science, MEDLINE, Google Scholar, Cochrane Library, Science Direct, ProQuest, Scopus, and 1868 articles were found up to December 2018. Four studies that examined the effect of Realsil intake on liver enzymes among NAFLD or NASH patients were included. Exclusion criteria include: animal studies, studies with the design other than clinical trials, studies on non-adult individuals, studies that assess the effect of vitamin E, silybin, or phospholipid solely, studies that examined the effect of Realsil on other outcomes, or studies with insufficient data. Results. The analysis demonstrated that Realsil intake led to a significant decrease in Gamma-Glutamyl Transpeptidase (GGT) levels (standardized mean difference (SMD) =-0.37; 95% confidence interval (CI]): -0.68 to -0.06). Realsil intake non-significantly decrease alanine transaminase (ALT) levels (SMD=-1.02 U/L; 95% CI: -2.23 to 0.20) and non-significantly increase aspartate aminotransferase (AST) levels (SMD = 0.17 U/L; 95% CI: -0.26–0.61). Conclusion. Realsil intake was associated with a significantly decreased circulating GGT level without any significant effect on AST and ALT levels.