Navegando por Palavras-chave "hypogonadism"
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- ItemSomente MetadadadosOsteopenia occurs in a minority of patients with acromegaly and is predominant in the spine(Springer, 1997-01-01) Kayath, M. J.; Vieira, JGH; Universidade Federal de São Paulo (UNIFESP)Acromegaly may induce abnormalities in bone metabolism; however, there are limited data related to bone mineral density (BMT)) in this condition. To evaluate the effects of an excess of growth hormone/insulin-like growth fractor I(GH/IGF-I) in the skeleton, we measured the BMD in spine and femoral region, total body calcium and body composition in 45 patients (24 females and 21 males) aged 21-77 years (median 43 years) with acromegaly for 11.4 +/- 7.5 years (range 0.5-26 years) using a dual-energy X-ray absorptiometer (Lunar DPX). Thirty-four patients had had hypogonadism fur 8.6 +/- 6.5 years (1-24 years). Mean serum GH and IGF-I levels were respectively 159 +/- 183 mu g/l and 843 +/- 497 mu g/l. Total body calcium was increased in the acromegalics (males: 1272 +/- 217 g, range 916-1816 g; females: 1041 +/- 223 g,range 739-1609 g)when compared with normal individuals (males: 1115 +/- 144 g, range 856-1398 g; females: 909 +/- 144 g, range 511-1311 g; p = 0.01). the lean body mass was significantly higher in acromegalic patients (p<0.001) compared with normal individuals. There was a tendency for a lower fat percentage in the acromegalics; however, this difference was not significant. Osteopenia (I Z-score below the mean) was found in the spine in 20% (n = 9) of the patients, while BMD was decreased in the femoral region in only 8.8% (n = 4). the group with osteopenia had a greater duration of hypogonadism than the normal BMD group (14 +/- 11 years vs 4.4 +/- 4.0 years;p = 0.01). A negative correlation was also found between the duration of hypogonadism and BMT) in spine (r = -0.4; p = 0.003) and femoral region (r = -0.37; p = 0.013), the hypogonadal patients had a lower BMD in spine (p<0.005), but not in other regions analyzed. No correlation was found between duration of hypersomatotropism, GH/IGF-I levels and BMD. We conclude that the majority of patients with acromegaly have preserved BMD despite the presence of hypogonadism.
- ItemAcesso aberto (Open Access)Pituitary glycoprotein hormone a-subunit secretion by cirrhotic patients(Associação Brasileira de Divulgação Científica, 1999-01-01) Oliveira, M.c.; Pizarro, C.b.; Cassal, A.; Cremonese, R.; Vieira, J.g.h. [UNIFESP]; A01; Fundação Faculdade Federal de Ciências Médicas de Porto Alegre; Universidade Federal de São Paulo (UNIFESP)Secretion of the a-subunit of pituitary glycoprotein hormones usually follows the secretion of intact gonadotropins and is increased in gonadal failure and decreased in isolated gonadotropin deficiency. The aim of the present study was to determine the levels of the a-subunit in the serum of patients with cirrhosis of the liver and to compare the results obtained for eugonadal cirrhotic patients with those obtained for cirrhotic patients with hypogonadotropic hypogonadism. Forty-seven of 63 patients with cirrhosis (74.6%) presented hypogonadism (which was central in 45 cases and primary in 2), 7 were eugonadal, and 9 women were in normal menopause. The serum a-subunit was measured by the fluorimetric method using monoclonal antibodies. Cross-reactivity with LH, TSH, FSH and hCG was 6.5, 1.2, 4.3 and 1.1%, respectively, with an intra-assay coefficient of variation (CV) of less than 5% and an interassay CV of 5%, and sensitivity limit of 4 ng/l. The serum a-subunit concentration ranged from 36 to 6253 ng/l, with a median of 273 ng/l. The median was 251 ng/l for patients with central hypogonadism and 198 ng/l for eugonadal patients. The correlation between the a-subunit and basal LH levels was significant both in the total sample (r = 0.48, P<0.01) and in the cirrhotic patients with central hypogonadism (r = 0.33, P = 0.02). Among men with central hypogonadism there was a negative correlation between a-subunit levels and total testosterone levels (r = 0.54, P<0.01) as well as free testosterone levels (r = -0.53, P<0.01). In conclusion, although the a-subunit levels are correlated with LH levels, at present they cannot be used as markers for hypogonadism in patients with cirrhosis of the liver.
- ItemSomente MetadadadosA prolactin-secreting tumor in a patient with Klinefelter's syndrome: A case report(Editrice Kurtis S R L, 1996-04-01) Pinto, Ana Claudia AR [UNIFESP]; Czepielewski, M. A.; Gross, J. L.; Mussio, W. [UNIFESP]; Lengyel, AMJ [UNIFESP]; UNIV FED RIO GRANDE SUL; Universidade Federal de São Paulo (UNIFESP)We report the case of a patient with Klinefelter's syndrome who developed a prolactin (PRL)-secreting tumor. The patient developed headaches, visual alterations and also symptoms of hypogonadism despite appropriate testosterone (T) replacement therapy, The diagnosis of hyperprolactinemia was then suspected. The laboratory findings confirmed the hypothesis, showing high levels of serum PRL. The patient was initially treated with oral bromocriptine, and afterwards with the injectable form. There was a marked decrease in PRL levels and in tumor size. Although some neoplasms, like breast carcinoma and germ cell tumors, are known to occur more frequently in patients with Klinefelter's syndrome, an association with PRL-secreting tumor has not been reported yet. In conclusion, symptoms of hypogonadism in patients with Klinefelter's syndrome receiving appropriate T replacement therapy can suggest the presence of hyperprolactinemia.