Introduction: Aging is associated with a large increase in the prevalence of hypovitaminosis D. 25- Hydroxyvitamin D, 25(OH)D, is the best indicator for vitamin D status. Its possible role in the pathogenesis of Alzheimer’s disease (AD), the leading cause of dementia in the elderly, is particularly important. The aim of the present study was to examine the association between 25-hydroxyvitamin D (25(OH)D) and cognitive functions in a group of Italian elderly patients affected with AD. Methods: We studied the relationship between 25(OH)D and cognitive functions assessed by MMSE (Mini Mental State Examination) in 150 consecutive elderly patients (F 76 %, age 78,66+ 6,05 years old) attending our Geriatric ambulatory for cognitive disorders with diagnosis of AD. Results: In our sample hypovitaminosis D was present in 100% of the screened patients; 111 patients (74%) had 25(OH)D serum levels inferior to 20 ng/ml; 39 (26%) patients had serum levels included between 20 and 30 ng/ml. After adjustment for age, gender, systolic blood pressure, education, cardiovascular diseases and antihypertensive treatment, a significant relationship was observed between 25(OH)D and cognitive status. MMSE appeared significantly higher in subjects with 25(OH)D serum levels ≥ 20 ng/ml than in those with 25(OH)D < 20 ng/ml (18,42+4,33 vs 12,22+4,44; p=0,000). Conclusion: Our results showed a relationship between 25(OH)D and cognitive impairment in patients with AD, suggesting that 25(OH)D could be involved in the onset of dementia.

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How to cite this article: Ruotolo G, Bonacci E, Cerra RP, et al. Histological confirmation of a rare case of hyperfunctioning thyroid cancer with bone metastasis in elderly patient.

Toxic epidermal necrolysis (TEN) or Lyell’s syndrome is a rare but serious potentially fatal autoimmune dermatologic disease. It is characterized by cutaneous damage due to apoptosis of the keratinocytes with consequent dermo-epidermal separation for a >30% extension of the body surface, associated with mucosal lesions. It is due to the activation of the immune system, often following the intake of potentially toxic drugs [antibiotics, antiepileptics, non-steroidal antinflammatory drugs (NSAIDs), allopurinol] or after infection with herpetic viruses or mycoplasma. We describe the case of an 82- year-old man starting therapy of Allopurinol for hyperuricemia. After four days the patient shows an extensive erythematous rash localized to the trunk and upper limbs. The following day the rash also involves the face, tending to the confluence and after another two days, the macules turn into de-epithelized areas because of dermo-epidermal separation and the lesions involve the oral and ocular mucosa, causing dysphagia and difficulty in speaking. He was treated with steroid and antihistamine therapy, suspending the previously undertaken therapy with antibiotic and Allopurinol.