Androgen excess (hyperandrogenism) is a common endocrine disorder affecting women of reproductive age. The potential causes of androgen excess in women include polycystic ovary syndrome, congenital adrenal hyperplasia (CAH), adrenal tumors, and racial disparity among many others. During pregnancy, luteoma, placental aromatase deficiency, and fetal CAH are additional causes of gestational hyperandrogenism. The present report reviews the various phenotypes of hyperandrogenism during pregnancy and its origin, pathophysiology, and the effect of hyperandrogenism on the fetal developmental trajectory and offspring consequences.
Background: Skin manifestations are common in patients infected with the human immunodeficiency virus (HIV) but the prognostic significance of many of them is not clear. Methods: Skin disorders were studied in a cohort of 267 HIV-infected patients followed prospectively and were correlated to the CD4+ cell count. Results: Among the most specific to HIV infection, Kaposi’s sarcoma, oral hairy leukoplakia, molluscum contagiosum, xerosis and oral candidiasis were statistically associated to a low CD4+ cell count (200–300 CD4+/ mm3; p < 0.001). Kaposi’s sarcoma, oral candidiasis and molluscum contagiosum were more frequent in homosexual males (p < 0.05). Genital warts were more frequent in intravenous-drug users (p < 0.001). Conclusions: These results suggest that dermatological findings are useful clinical predictors of the presence or progression of HIV infection.
Approximately 85% of kidney tumors are renal cell carcinoma (RCC). RCC commonly metastasizes to the lung, bone, and lymph nodes; however, gastric metastasis is exceedingly rare. We present an 86-year-old woman with left-sided RCC with known metastatic disease to the lungs, lymph nodes, and bone, who presented with acute blood loss anemia. After hemodynamic stabilization, esophagogastroduodenoscopy revealed a large infiltrative, polypoid, and ulcerated polyp in the gastric body. After complete polypectomy, histological examination demonstrated gastric mucosa ulcerated by clear-cell carcinoma, compatible with metastatic RCC. Our patient was successfully treated with palliative radiation to the gastric body.
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