Ganglioneuroblastoma is a primary malignant tumor of the sympathetic nervous system. It usually occurs in children and is extremely rare in adults. Here, we report a case of an adrenal ganglioneuroblastoma in a 38-year-old man. The adrenal incidentaloma was surgically removed and pathologically diagnosed as a ganglioneuroblastoma. The characteristics were described, because it is an unusual tumor based on the published reports in adults. To the best of our knowledge, fewer than 50 cases of ganglioneuroblastoma and 19 cases of adrenal ganglioneuroblastoma, including this case, are reported in the literature.
Background: Prevalence and clinical significance of hyperprolactinemia in subclinical hypothyroidism have been reported in few studies. The upper limit of the normal range for TSH used to diagnose subclinical hypothyroidism is a matter of controversy. Some experts believe that the upper limit of the normal TSH range should be reduced from 4.2 to 2.5 mIU/L. Some evidence suggests a positive relationship between TSH > 2.5 mIU/L and cortisol as an indicator of metabolic stress. With this view prolactin as a stress hormone can be elevated in TSH >2.5 in comparison to TSH< 2.5. Hence the aim of this study was to evaluate the relationship between TSH and prolactin levels in the TSH range <10. Methods: This cross-sectional study was performed on apparently healthy subjects with TSH<10 mIU/L. Subjects with the age of 18 to 35 years were enrolled. The sera were analyzed for prolactin, FT3, FT4, TSH, TPO-Ab and Tg-Ab. Results: From the total number of 519 participants, in 65 subjects (12.5%) TSH was < 2.5. Seventy-nine subjects (15.2%) had TSH: 2.5-4.2 and 375 (72.3%) of the participants had TSH> 4.2 mIU/L. The mean age, weight and BMI of subjects in the three TSH groups were not significantly different. In the three TSH groups, the prevalence of hyperprolactinemia was zero, 3.8 and 30.7%, respectively. There was a positive and significant correlation between prolactin and TSH levels (r=0.613). Conclusion: Hyperprolactinemia is common in patients with subclinical hypothyroidism (30.7%) and there is a positive correlation between TSH and PRL in subjects with TSH<10 mIU/l.
Background: Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are recognized as two common health problems. Metabolic diseases, such as dyslipidemia, obesity, and hypertension are known risk factors for NAFLD. In addition to these risk factors, other risk factors have been recently suggested, such as thyroid dysfunction. Materials and Methods: In this study, adult patients with T2DM were recruited. Various clinical and biochemical parameters including thyroid function tests, liver function tests, and liver sonography in all participants were assessed and compared between with and without NAFLD groups. Results: Data from 926 diabetic patients were analyzed; of which, 744 (80.3%) had fatty liver. The prevalence of subclinical hypothyroidism (SCH) in patients with NAFLD was 11.6% and in patients without NAFLD was 6.0% ( P = 0.029). Furthermore, the prevalence of overt hypothyroidism was higher in diabetic patients with NAFLD (3.9% vs. 1.6%); this difference was not statistically significant. In univariate logistic regression analysis, hemoglobin A1c (odds ratio [OR]: 8.13); history of insulin consumption (OR: 5.35); duration of diabetes (OR: 2.20); family history of diabetes (OR: 2.85); history of antihypertensive drug use (OR: 2.14) as well as SCH (OR: 2.03) were significant variables for NAFLD. According to the multivariate logistic model, after eliminating the confounding effect of age, sex, and body mass index; the chance of developing NAFLD in patients with SCH was 2.32 times higher than patients without SCH ( P = 0.014). Conclusion: NAFLD is extremely common in patients with T2DM. The relationship between hypothyroidism and NAFLD is independent of other risk factors.
Objective: Short stature is a common problem encountered by endocrinologists. The objective of this study was to evaluate the frequency of common causes of short stature in children referred to the endocrinology clinic. Material and Methods: This prospective and descriptive study was carried out between August 2018 and September 2020. Included criteria were: age below 18 years, height more than 2 SD below the mean (< 3rd percentile), growth failure (< 4 cm/year), small for mid-parental height, and adequate follow-up. They were evaluated by anthropometric measurements; biochemical panel; hormonal tests; radiological studies; and hormonal provocative tests. Results: A total of 509 cases, 238 males (46.8%), and 271 females (53.2%) had short stature. The age of participants varied between 2-18 years. The mean chronological age was 11.83±3.44 years. Most study participants were over 10 years old (68%). Normal variants of growth with 271 (53.34%) children, were the most prevalent causes. These causes included in three subgroups: Familial short stature: 133 (26.14%); Constitutional delay of growth and puberty: 112 (22%); and Idiopathic short stature: 26 (5.12%). Totally 238 cases (46.66%) were due to pathologic types of Short Stature. The leading cause of short stature in this group was Growth Hormone deficiency that is seen in 70 (13.76%) patients. Conclusion: The normal variants of short stature as a group were the most common cause of short stature, followed by endocrinological causes of short stature and non-endocrinological causes.
Background: Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are major public health concerns. Besides the known risk factors, other risk factors, such as vitamin D deficiency, have been suggested for NAFLD. Objectives: This cross-sectional research aimed to investigate the relationship between serum vitamin D levels and NAFLD in a group of patients with T2DM. Methods: We investigated various clinical and biochemical parameters, including serum vitamin D level, liver function tests, and liver sonography in 1,110 adult patients with T2DM. The mean difference of numerical variables in NAFLD and non-NAFLD groups was analyzed with an independent sample t-test. Chi-square test was used to evaluate the association between two categorical variables. Results: Out of 1,110 patients with T2DM, 837 (75.4%) had NAFLD. The mean vitamin D level in diabetic patients with NAFLD was significantly lower than non-NAFLD group (19.71 ng/mL vs. 27.68 ng/mL, respectively; P < 0.001). Furthermore, 410 (49%) patients with NAFLD were found with vitamin D deficiency, while this value was 85 (31.1%) in non-NAFLD group. According to the results of univariate logistic regression analysis, vitamin D deficiency (OR = 3.87) and insufficient vitamin D (OR = 2.83) were the significant variables for NAFLD. Conclusions: There was a significant association between vitamin D deficiency and NAFLD in patients with T2DM.
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