Background: The suppression of the hypothalamic-pituitary-adrenal axis by cortisol-secreting adrenocortical tumors is well recognized and requires peri- and postoperative hydrocortisone substitution. Case Presentation...Background: The suppression of the hypothalamic-pituitary-adrenal axis by cortisol-secreting adrenocortical tumors is well recognized and requires peri- and postoperative hydrocortisone substitution. Case Presentation: A 48-year-old female patient with hypertension and progressive weight gain, the clinical signs of hypercorticism motivated a hormonal workup revealing an independent ACTH Cushing’s syndrome: with urinary free cortisol (UFC) at 649 nmol/24h (4× normal), adrenocorticotropin hormone (ACTH) at 1.5 ng/l. The rest of the hormonal workup was not performed due to a lack of financial means. An Adrenal CT scan showed a 4 cm right adrenal adenoma. The patient underwent a right adrenalectomy with an adrenal adenoma on pathological examination. The contralateral side was normal. The patient was treated with hydrocortisone 30 mg/d for 6 weeks then 15 mg/d, during the monitoring we noted a persistence of the adrenal insufficiency for now 4 years. Basal cortisol levels during follow-up were very low (<3 μg/dl) ruling out the need for synacthen stimulation tests. Conclusion: Adrenal cortisol tumors are recognized by suppression, the duration of hypothalamic-pituitary-adrenal axis suppression is variable from 11 to 60 months depending on the series, which depends on the duration, severity of hypercortisolism, tumor size and other unknown factors. A longer follow-up of these patients is necessary to look for recovery of the contralateral adrenal gland.展开更多
Introduction: Studies showed a high prevalence of metabolic abnormalities including dyslipidemia, type 2 diabetes in cases of low testosterone in men and which are associated with increased cardiovascular risk. Hypogo...Introduction: Studies showed a high prevalence of metabolic abnormalities including dyslipidemia, type 2 diabetes in cases of low testosterone in men and which are associated with increased cardiovascular risk. Hypogonadism represents the second cause of endocrine osteoporosis. Objectives: The objectives of our work were: to determine the main causes of hypogonadism in women and men;to assess the frequency of metabolic and osteosdensitometric abnormalities in the hypogonadal population. Patients and methods: A retrospective descriptive study was carried out over 7 years on 120 patients, hospitalized in the Endocrinology department of the Hassan II University Hospital of Fez-Morocco for hypogonadism. The patients selected were those who had symptoms of hypogonadism confirmed in men by: low total testosterone for Tanner stage in adolescents, ng/ml or lower limit of normal for adults;in women, hypoestrogenia 30 pg/l. Gonadotropin dosage, karyotype, pelvic or testicular ultrasound and pituitary MRI, for etiological diagnosis, were performed. Bone densitometry was performed for bone impact and lipid profile for metabolic profile. Results: Out of 120 patients, there were 77 women and 43 men. The average age was 31.51 years. In men, the main causes were central hypogonadism in 67.4% and primary testicular failure in 32.6%. In women, central hypogonadism was also the most common cause noted in 63.7% and premature ovarian failure was observed in 36.4%. HypoHDL was significantly more frequent p (0.005) in women, osteopenia and osteoporosis were significantly more frequent in women than in men p (0.046). Conclusion: Central causes represent the most common etiology of hypogonadism in both sexes;abnormalities of bone mineralization and metabolic disorders were predominant in women.展开更多
Background: Iron deficiency anemia in pregnant women is a serious public health problem, especially in developing countries. Aim: The objective of this study is to determine the prevalence of iron deficiency anemia an...Background: Iron deficiency anemia in pregnant women is a serious public health problem, especially in developing countries. Aim: The objective of this study is to determine the prevalence of iron deficiency anemia and its associated factors during pregnancy in the south of Morocco. Methods: A cross-sectional study was carried in the regional Hospital Center Hassan II (RHC) from April to august 2021 in all the pregnant women coming for consultation in the maternity service. 500 pregnant women were randomly recruited for the study. A complete blood count and serum ferritin was performed in every case. They have been the subjects of a questionnaire containing their background and health data. The analysis of our data was done by the IBM SPSS Statistics 25 software. Results: The prevalence of iron deficiency anemia was 20% with a CI of (44.7% - 53.5%). The most affected age group was 25 to 35 years with a rate of 42.86%. The majority of women had mild anemia (84.61%) followed by moderate anemia (11.54%) and severe anemia (3.85%). 57.14% of the anemic pregnant women were primigravida. The results of serum ferritin made it possible to identify 70% of women deficient, with a dominance of normocytic normochromic anemia. The influence of geographic origin and place of birth was not significant. Conclusion: The prevalence of iron deficiency anemia is more or less low in our study. However, there is a high prevalence of iron deficiency and anemia during pregnancy. Statistically, there was no significant association between iron deficiency anemia and the various parameters studied, such as age, parity, origin and place of birth.展开更多
文摘Background: The suppression of the hypothalamic-pituitary-adrenal axis by cortisol-secreting adrenocortical tumors is well recognized and requires peri- and postoperative hydrocortisone substitution. Case Presentation: A 48-year-old female patient with hypertension and progressive weight gain, the clinical signs of hypercorticism motivated a hormonal workup revealing an independent ACTH Cushing’s syndrome: with urinary free cortisol (UFC) at 649 nmol/24h (4× normal), adrenocorticotropin hormone (ACTH) at 1.5 ng/l. The rest of the hormonal workup was not performed due to a lack of financial means. An Adrenal CT scan showed a 4 cm right adrenal adenoma. The patient underwent a right adrenalectomy with an adrenal adenoma on pathological examination. The contralateral side was normal. The patient was treated with hydrocortisone 30 mg/d for 6 weeks then 15 mg/d, during the monitoring we noted a persistence of the adrenal insufficiency for now 4 years. Basal cortisol levels during follow-up were very low (<3 μg/dl) ruling out the need for synacthen stimulation tests. Conclusion: Adrenal cortisol tumors are recognized by suppression, the duration of hypothalamic-pituitary-adrenal axis suppression is variable from 11 to 60 months depending on the series, which depends on the duration, severity of hypercortisolism, tumor size and other unknown factors. A longer follow-up of these patients is necessary to look for recovery of the contralateral adrenal gland.
文摘Introduction: Studies showed a high prevalence of metabolic abnormalities including dyslipidemia, type 2 diabetes in cases of low testosterone in men and which are associated with increased cardiovascular risk. Hypogonadism represents the second cause of endocrine osteoporosis. Objectives: The objectives of our work were: to determine the main causes of hypogonadism in women and men;to assess the frequency of metabolic and osteosdensitometric abnormalities in the hypogonadal population. Patients and methods: A retrospective descriptive study was carried out over 7 years on 120 patients, hospitalized in the Endocrinology department of the Hassan II University Hospital of Fez-Morocco for hypogonadism. The patients selected were those who had symptoms of hypogonadism confirmed in men by: low total testosterone for Tanner stage in adolescents, ng/ml or lower limit of normal for adults;in women, hypoestrogenia 30 pg/l. Gonadotropin dosage, karyotype, pelvic or testicular ultrasound and pituitary MRI, for etiological diagnosis, were performed. Bone densitometry was performed for bone impact and lipid profile for metabolic profile. Results: Out of 120 patients, there were 77 women and 43 men. The average age was 31.51 years. In men, the main causes were central hypogonadism in 67.4% and primary testicular failure in 32.6%. In women, central hypogonadism was also the most common cause noted in 63.7% and premature ovarian failure was observed in 36.4%. HypoHDL was significantly more frequent p (0.005) in women, osteopenia and osteoporosis were significantly more frequent in women than in men p (0.046). Conclusion: Central causes represent the most common etiology of hypogonadism in both sexes;abnormalities of bone mineralization and metabolic disorders were predominant in women.
文摘Background: Iron deficiency anemia in pregnant women is a serious public health problem, especially in developing countries. Aim: The objective of this study is to determine the prevalence of iron deficiency anemia and its associated factors during pregnancy in the south of Morocco. Methods: A cross-sectional study was carried in the regional Hospital Center Hassan II (RHC) from April to august 2021 in all the pregnant women coming for consultation in the maternity service. 500 pregnant women were randomly recruited for the study. A complete blood count and serum ferritin was performed in every case. They have been the subjects of a questionnaire containing their background and health data. The analysis of our data was done by the IBM SPSS Statistics 25 software. Results: The prevalence of iron deficiency anemia was 20% with a CI of (44.7% - 53.5%). The most affected age group was 25 to 35 years with a rate of 42.86%. The majority of women had mild anemia (84.61%) followed by moderate anemia (11.54%) and severe anemia (3.85%). 57.14% of the anemic pregnant women were primigravida. The results of serum ferritin made it possible to identify 70% of women deficient, with a dominance of normocytic normochromic anemia. The influence of geographic origin and place of birth was not significant. Conclusion: The prevalence of iron deficiency anemia is more or less low in our study. However, there is a high prevalence of iron deficiency and anemia during pregnancy. Statistically, there was no significant association between iron deficiency anemia and the various parameters studied, such as age, parity, origin and place of birth.
