Endocrine
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Vitamin D status assessed by serum 25-hydroxyvitamin D levels (25(OH)D) has been shown to be inversely associated with insulin resistance. The underlying basis for such association is less clear. In the present study, we assessed the prevalence of inadequate vitamin D levels and its relationship to glucose tolerance status and circulating adiponectin in healthy Thai population. ⋯ An independent association between 25(OH)D and adiponectin levels was demonstrated after controlling for BMI (r = 0.17, P < 0.05). High prevalence of vitamin D inadequacy and seasonal variation of vitamin D status are found in Thai population. We demonstrated an association between insufficient vitamin D status and lower circulating adiponectin in subjects with abnormal glucose tolerance independently of adiposity which may indicate the role of adiponectin as a link between vitamin D status and insulin resistance.
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Case Reports
Successful chemotherapy of hepatic metastases in a case of succinate dehydrogenase subunit B-related paraganglioma.
Compared to other familial pheochromocytoma/paragangliomas (PHEO/PGLs), the succinate dehydrogenase subunit B (SDHB)-related PHEO/PGLs often present with aggressive and rapidly growing metastatic lesions. Currently, there is no proven effective treatment for malignant PHEO/PGLs. Here, we present a 35-year-old white man with primary malignant abdominal extra-adrenal 11 cm paraganglioma underwent surgical successful resection. ⋯ Here, we present an SDHB-related PHEO/PGL patient with extensive tumor burden, numerous organ lesions, and rapidly growing tumors, which responded extremely well to CVD therapy. We conclude patients with SDHB-related PHEO/PGLs can be particularly sensitive to CVD chemotherapy and may have an excellent outcome if this therapy is used and continued on periodic basis. The data in this patient also illustrate the importance of measuring plasma levels of DA and MTY to provide a more complete and accurate assessment of the biochemical response to therapy than provided by measurements restricted to other catecholamines and O-methylated metabolites.
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A 38-year-old male was admitted to our hospital with epigastric pain, and he was confirmed to have acute exudative pancreatitis. After the episode of acute pancreatitis subsided, laboratory investigation revealed increased serum calcium (12.0 mg/dl), decreased serum phosphorus (2.7 mg/dl), and increased serum parathyroid hormone (intact) levels (131 pg/ml). A computed tomography (CT) scan of the neck did not reveal any mass lesions in the parathyroid gland. ⋯ We report the case of a patient diagnosed with primary hyperparathyroidism due to an ectopic mediastinal parathyroid adenoma. An ectopic mediastinal parathyroid adenoma may manifest as an episode of acute pancreatitis. Preoperative investigation to determine the exact location of an adenoma should include two types of imaging studies, preferably (99m)Tc sestamibi scintigraphy and CT of the neck and chest.