Cutaneous tuberculosis (CTB), a rare manifestation of tuberculosis is one of the most challenging diagnoses to establish. Metastasic tuberculous abscess is a form of CTB which is characterized by cold abscesses on the patient's extremities or trunk without any involvement of underlying tissue. Here we report a case of 56-year-old Bangladeshi male with no previous history of TB, who presented with multiple abscesses over the body for 3 months. His diagnosis was confirmed on the basis of demonstration of
Mycobacterium tuberculosis
in the lesions by staining, PCR and culture. But no primary focus was found. After 1 month of anti-tubercular therapy, significant improvement was noted.
Background
Hypogonadism is one of the most frequent complications in transfusion-dependent thalassemia patients, and early recognition and treatment is the core element to restore impaired gonadal function. Despite the high burden of disease, relevant studies are scarcely addressing the gonadal function of such patients. The pattern of gonadal function in transfusion-dependent thalassemia patients must be picturized before planning a generalized management plan; therefore, this study was conducted.
Methods
This cross-sectional study was conducted at the Department of Transfusion Medicine of Bangabandhu Sheikh Mujib Medical University. According to inclusion and exclusion criteria, a total of 94 patients were enrolled in this study. A detailed history and thorough clinical examination were carried out in each patient and recorded using a pretested structured questionnaire. In addition, laboratory assessment of LH, FSH, testosterone and estradiol in serum were also done. Data were analyzed using STATA (v.16).
Results
The mean age of the patients with transfusion-dependent thalassemia was 18.81±4.65 (SD), with 53.3% of the patients being male. The most common symptoms of gonadal dysfunction among males were loss of body hair (6%) followed by fatigue (4%), and among females were slow or absent breast growth, hot flashes and amenorrhea (6.82% each).
Conclusion
The overall prevalence of hypogonadism was 35.11%, 18.1% being normogonadotropic, 11.7% being hypogonadotropic, and 5.3% being hypergonadotropic. Therefore, gonadal hormone analysis of transfusion-dependent thalassemia patients can be considered a screening tool for assessing gonadal function and early detection and prevention of hypogonadism.
A 32‐year‐old male case with short stature presented to us with audio‐visual impairment, obesity, impaired glucose tolerance, dyslipidemia, and hypogonadism. The single‐gene genetic analysis revealed an ALMS1 gene mutation. A diagnosis of ALMS was reached for meeting one major and four minor criteria.
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