Six cases of chronic calcific pancreatitis in Thailand occurring in patients aged 13 to 22 years are reported. Protein malnutrition was a possible aetiologic factor. Abdominal pain was mild to moderate and intermittent and not a presenting feature. Severe diabetes mellitus was present at all. Extensive pancreatic calcification was seeen on abdominal X-ray.
SYNOPSIS A case is reported of a neoplasm of mixed mesenchymal and neuroepithelial origin consisting of plasmacytoma, lymphoma, ganglioneuroma, and astrocytoma in the same mass. The tumour arose in the hypothalamus of a 43 year old diabetic woman who also had alpha cell hyperplasia and beta cell hypoplasia of the islets of Langerhans. It is suggested that both hypothalamic and pancreatic lesions produced diabetes mellitus in this patient.The manifestations of destruction of the hypothalamus have been frequently investigated in animals but the opportunity to study human lesions is rare. In this communication we describe a case of a hypothalamic neoplasm of mixed mesenchymal and neuroepithelial origin with cellular abnormalities of the islets of Langerhans. The lesions are considered to be the cause of disturbances of the carbohydrate metabolism in this instance. To our knowledge, no previous example has been recorded of combined hypothalamic and pancreatic lesions associated with diabetes mellitus.
CASE REPORTTwo years before admission to hospital, this married woman, aged 43 years, first experienced hyperphagia and polyuria. The progressive symptoms were severe during the period of two months before admission. One month before admission she had intermittent diffuse headache, pitting oedema of the lower limbs, anorexia, nausea, vomiting, mental confusion, and transient loss of consciousness. These symptoms were relieved occasionally by medical treatment. On the day of admission, she suffered respiratory difficulty and hyperpyrexia. There was no history of diabetes mellitus in her family. The patient had had 11 pregnancies, which included one
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