Cláudia Veiga Chang

Fetal toxicity of Solanum lycocarpum (Solanaceae) in rats.

Lobeira (Solanum lycocarpum) is a Brazilian plant used as a hypoglycemic agent. In this study, the toxic effects of lobeira were evaluated during the fetogenesis period. Twenty pregnant Wistar rats were randomly allocated into two groups: control and treated, which received, via oral gavage, 0.5 ml of distilled water or 100 mg of the lobeira powder/kg of body weight, respectively, during days 17-20 of pregnancy. Maternal toxicity was evaluated by body weight, food intake, piloerection, locomotor activity, diarrhoea and vaginal bleeding. Euthanasia was done on 21st day, when ovaries, fetuses and their respective placentas were removed. Resorptions, live and dead fetuses were recorded. External malformations and fetal body, brain, liver, lung and kidneys were also weighed. No clinical signs of maternal toxicity were observed. The placenta weights of the treated rats were lower than those of the control (P<0.01). Lungs (P<0.01) and kidneys (P<0.02) of the fetuses treated with lobeira were also significantly reduced, suggesting a fetotoxic effect of this plant.

Hemichorea-hemiballism as the first presentation of type 2 diabetes mellitus

Universidade Federal de Sao Paulo (UNIFESP) Movement Disorders Unit Department of Neurology and Neurosurgery

PROP1 overexpression in corticotrophinomas: evidence for the role of PROP1 in the maintenance of cells committed to corticotrophic differentiation

OBJECTIVE: The expression of transcription factors involved in early pituitary development, such as PROP1 and POU1F1, has been detected in pituitary adenoma tissues. In this study, we sought to characterize the transcriptional profiles of PROP1, POU1F1, and TBX19 in functioning and nonfunctioning pituitary adenomas in an attempt to identify their roles in tumorigenesis and hormone hypersecretion. METHODS: RT-qPCR analyses were performed to assess the transcriptional pattern of PROP1, POU1F1, TBX19, and hormone-producing genes in tissue samples of corticotrophinomas (n = 10), somatotrophinomas (n = 8), and nonfunctioning adenomas (n = 6). RESULTS: Compared with normal pituitary tissue, POU1F1 was overexpressed in somatotrophinomas by 3-fold. PROP1 expression was 18-fold higher in corticotrophinomas, 10-fold higher in somatotrophinomas, and 3-fold higher in nonfunctioning adenomas. TBX19 expression was 27-fold higher in corticotrophinomas. Additionally, the level of TBX19 mRNA positively correlated with that of pro-opiomelanocortin (r = 0.49, p = 0.014). CONCLUSIONS: Our data demonstrate that PROP1 is overexpressed in pituitary adenomas, mainly in corticotrophinomas. Together with previously published data showing that patients who harbor PROP1 loss-of-function mutations present a progressive decline in corticotrope function, our results support a role for PROP1 in pituitary tumor development and in the maintenance of cell lineages committed to corticotrophic differentiation.

Myxedema ascites with elevated serum CA 125 concentration.

We report a case of myxedema ascites and markedly elevated serum CA 125 concentration. The cause of ascites and elevated tumor markers in hypothyroidism remains unknown. Diagnosis was characterized by no evidence of malignancy seen by transvaginal ultrasonography or abdominal computed tomography and ascites resolution with serum CA 125 normalization after adequate hormonal treatment. Our data suggest that hypothyroidism should be considered in patients with ascites and elevated serum CA 125.

Oncogenic osteomalacia: loss of hypophosphatemia might be the key to avoid misdiagnosis

Diagnosing oncogenic osteomalacia is still a challenge. The disorder is characterized by osteomalacia caused by renal phosphate wasting and low serum concentration of 1,25-dihydroxyvitamin D3 occurring in the presence of a tumor that produces high levels of fibroblast growth factor 23. However, it is possible that the disease is much more misdiagnosed than rare. We present the case of a 42-year-old man with a long-term history of undiagnosed progressive muscle weakness. His laboratory results mainly showed low serum phosphate. Surgical removal of a nasal hemangiopericytoma that had been diagnosed five years earlier, brought him to a symptom-free condition. Even though knowing the underlying etiology would explain his osteomalacia, the patient sought medical help from countless physicians for five consecutive years, and only after adequate treatment a rewarding outcome was achieved.

Predisposing Factors for Pituitary Apoplexy

Pituitary apoplexy is a rare threatening condition, still often misdiagnosed. In line with this the treating physician should be aware of pituitary apoplexy as a potential diagnoses whenever a patient seeks care with acute-onset headache associated with visual loss, ophthalmoparesis and altered mental status. In line with this there are several known predisposing factors that may lead to pituitary apoplexy as well, and eventually their early identification will be a clue to diagnosis or will help tailor patient management. Herein, our aim is to focus on these factors associated with pituitary apoplexy grouped into six major categories: associated medical conditions, surgery, head trauma and endocrinological testings.

Possible association between Carney complex and multiple endocrine neoplasia type 1 phenotypes

Carney Complex (CNC) and Multiple Endocrine Neoplasia type 1 (MEN1) are forms of multiple endocrine neoplasia of dominant autosomal inheritance. Diagnosis of CNC occurs when two major criteria (lentiginoses, primary pigmented nodular adrenocortical disease, cardiac and cutaneous myxomas, acromegaly, testicular neoplasias, thyroid cancer) are observed and/or a major criterion associated with a supplementary criterion (affected relative, PRKAR1A gene mutation) occurs. On the other hand, diagnosis for MEN1 occurs through detection of two or more tumors located at the pituitary gland, parathyroid and/or pancreatic cells. The present case describes a 55 year-old male patient, diagnosed with acromegaly, primary hyperparathyroidism and papillary thyroid cancer, exhibiting components that meet the diagnostic criteria of both conditions described. Despite the occurrence of only one sporadic association or the acromegaly per se being responsible for the papillary cancer, new molecular mechanisms may not be ruled out.