Objective
Langerhans cell histiocytosis (LCH) is a rare inflammatory myeloid neoplasm which can infiltrate any organ or tissue. Endocrine involvement has mostly been described in case reports and small retrospective studies. We aimed to describe endocrine manifestations in a large cohort of adulthood onset (AO) and childhood onset (CO) patients with LCH.
Design
Single-center observational study conducted between January 2002 and December 2017 at Pitié-Salpêtrière University Hospital (Paris, France), a tertiary care hospital.
Method
Clinical, biological and morphological evaluations of pituitary, gonadal, adrenal and thyroid function evaluations performed in 63 consecutive patients with LCH (AO patients: 40, CO patients: 23). Fifty-eight patients underwent follow-up assessments.
Results
Complete pituitary evaluation was performed in 38/63 patients (60.3%); at least one anterior pituitary dysfunction (APD) was found in 63.2% of them. In this subgroup of patients, the most prevalent deficiencies were diabetes insipidus (DI) and GHD (55.3% each), followed by gonadotropin deficiency (34.2%) and thyrotropin deficiency (23.7%). In the subgroup of the 25 incompletely evaluated patients, we found DI in 44%, GHD in 50%, gonadotropin deficiency in 30.4% and thyrotropin deficiency in 16%. APD was more common in CO patients (P = 0.003) but was not systematically associated with DI regardless of the age of onset. Endocrine dysfunction was most often permanent; moreover, occurrence of new deficiencies has been described during follow-up.
Conclusion
The spectrum of endocrine disorders appears to be large in LCH (both in AO and CO patients) and should be evaluated carefully at diagnosis and during follow-up. APD was not always associated with DI.
We performed a retrospective study on diabetic ketosis decompensations in 101 diabetic patients in Endocrinology and Metabolic Diseases Service of the National Hospital and Universitary Koutoukou Hubert Maga (CNHU-HKM) for a period of 3 years. Objective: The main objective of the study was to identify the underlying factors of ketosis decompensations for a more focused education program. Results: The mean age was 43.84 years. In half of cases (49.5%), the ketosis decompensations were inaugural for the diabetes. Type 2 diabetes was predominant with a frequency of 85.1% versus 14.9% for type 1 diabetes. The overall prevalence rate of ketosis decompensations was 21.82%. The precipitating factors were infections (51.49%) and treatment withdrawal (25.74%). The average blood glucose was 4.46 g/L with ranges of 1.86 g/L and 13 g/L. The outcome was favorable in 89.1% of cases. The mortality rate was 7.9%. The average hospital stay was 13.23 days. Conclusion: This study showed that ketosis decompensations are still frequent. The main precipitating factors are infection and therapeutic noncompliance. Preventive actions are needed through screening programs, regular monitoring and targeted education.
Background: Achieving and maintaining glycemic targets are a challenge for health practitioners around the world. We aimed to study the factors associated with prolonged poor diabetes control in the cohort of T2DM patients monitored and treated in the Department of Internal Medicine at the Yalgado OUEDRAOGO Teaching Hospital in Ouagadougou in order to optimize therapeutic education in these patients. Methodology: This was a descriptive and analytical cross-sectional study combining retrospective data collection from the last year of patient follow-up and prospective collection of some information. The study included all diabetic patients, aged at least 18 years old, followed and treated in the Department of Internal Medicine at the Yalgado OUEDRAOGO Teaching Hospital between January 1, 2010 and December 31, 2018 following a systematic random sampling with a sampling step of 10. The variables collected were sociodemographic, anthropometric, lifestyle, cardiovascular risk factors and diabetes-related characteristics.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.