It was realized an analytic, case control study in 111 children affected with Autism Spectrum Disorder (ASD) and 333 children without this pathology who consulted in Neuropediatrics in Belen Hospital of Trujillo between January 2010 and march 2015. The objective was to determine the association between preeclampsy/eclampsy and the development of ASD. It was found in 40,54% of the children with ASD the antecedent of preeclampsy/eclampsy in their mothers, while it was present in 4,20% of the children without ASD. It was found association between preeclampsy/eclampsy and the development of Autism Spectrum Disorders (OR = 15,54; ℎ = 9,75; CI 95% = 8,07 – 29,94; p<0,05). It was concluded that preeclampsy/eclampsy is a risk factor for the development of autism spectrum disorders

Background and aims: Treatment-induced neuropathy of diabetes is an acute small-fibre neuropathy associated with rapid glycaemia improvement. Methods: This study is a narrative review carried out based on a bibliographic review, using articles indexed in PubMed/Medline and Scielo. Results: This entity is more frequent in adult patients with poor previous glycaemic control. Its precise pathophysiology is unknown, but it is likely related to unrestored microcirculation changes that occurred during the hyperglycaemic period. It presents with intense, sudden neuropathic pain and autonomic dysfunction after a rapid glycaemic correction and a poorer analgesic response than in diabetic neuropathy. Conclusions: Since rapid glycaemia correction is the cause of this problem, clinical practice guidelines that can help physicians to prevent, diagnose and manage this entity should be developed. Copyr...

Introduction: Refractory hypothyroidism (RH) represents a challenge in the diagnosis and treatment within the field of thyroidology. It is defined as the inability to achieve disease control despite using levothyroxine (LT4) doses of 1.9 mg/kg/d or higher. Methods: A comprehensive review, encompassing 103 articles, was conducted using the Scielo, Scopus, and EMBASE databases, providing an approach to evaluation and diagnosis of this condition. Results: LT4 disintegrates and dissolves within an acidic gastric environment before being absorbed in the jejunum and ileum. It then extensively binds to serum transporter proteins and undergoes deiodination to yield tri-iodothyronine, the biologically active hormone. There are various nonpathological causes of RH, such as noncompliance with treatment, changes in the brand of LT4, food and drug interferences, as well as pregnancy. Pathological cau...

Introducción: El carcinoma adrenocortical (CAC), el segundo tumor endocrino maligno más frecuente, se origina en la corteza suprarrenal y se diagnostica principalmente en personas de mediana edad. El CAC funcionante suele presentarse con hiperandrogenismo, con o sin hipercortisolismo. Aproximadamente el 50 % de los casos son funcionantes. Reporte de caso: Presentamos los casos de dos mujeres adultas que manifestaron hiperandrogenismo y una masa abdominal gigante al examen físico. El diagnóstico de CAC fue confirmado mediante análisis histopatológico. Discusión: El CAC funcionante se presenta típicamente con una gran masa abdominal y niveles elevados de hormonas suprarrenales. El diagnóstico incluye pruebas hormonales y estudios de imagen. La tomografía computarizada es fundamental en la evaluación inicial del CAC, ya que permite identificar características como la heterogen...

“Autoimmune dysglycemia syndrome (ADS) is a rare condition that presents as episodes of hypoglycemia as well as hyperglycemia and is classified as insulin autoimmune syndrome (IAS) and type B insulin resistance (TBIR). Autoimmunity plays a key role in the pathogenesis ofthis disorder, as evidenced by the presence of autoantibodies against endogenous insulin or the insulin receptor, and by its association with rheumatologic disorders. Treatment usually includes glycemic control and immunomodulatory agents. We report a case of a 31-year-old woman who was admitted for severe hypoglycemia. Further workup revealed underlying systemic lupus erythematosus (SLE) with renal involvement. During hospitalization, she continued to experience episodes of fasting hypoglycemia, as well as episodes of postprandial hyperglycemia. Hypoglycemia associated with a high serum insulin concentration and positi...

El síndrome de disglucemia autoinmune (SDA) es una enfermedad poco frecuente que se presenta en forma de episodios de hipoglucemia e hiperglucemia y se clasifica como síndrome autoinmune a la insulina (SAI) y resistencia a la insulina tipo B (RTBI). La autoinmunidad desempeña un papel clave en la patogenia de este trastorno, como lo demuestra la presencia de autoanticuerpos contra la insulina endógena o el receptor de insulina, y por su asociación con trastornos reumatológicos. El tratamiento suele incluir control glucémico y agentes inmunomoduladores. Informamos de un caso de una mujer de 31 años que ingresó por hipoglucemia grave. Estudios posteriores revelaron lupus eritematoso sistémico (LES) subyacente con afectación renal. Durante la hospitalización, continuó experimentando episodios de hipoglucemia en ayunas, así como episodios de hiperglucemia posprandial. La hipogl...

Background: Euglycemic diabetic ketoacidosis (EDKA) accounts for up to 7% of cases of diabetic ketoacidosis (DKA) and is characterized by blood glucose levels below 200 mg/dL. It has been associated with the use of sodium-glucose cotransporter-2 inhibitors (SGLT-2i).  Case report: We present the case of a 34-year-old male with obesity and type 2 diabetes who, four days prior to admission, began treatment with empagliflozin/metformin 12.5/1000 mg twice daily due to hyperglycemia exceeding 350 mg/dL. He presented to the emergency department with symptoms consistent with DKA and a blood glucose level of 180 mg/dL. The patient was managed with fluid resuscitation and insulin therapy, resulting in significant clinical improvement.  Discussion: The typical blood glucose level in EDKA is 184.5 mg/dL, often with false-negative urine ketone results, which can delay diagnosis. Management include...

Up to 80% of patients with hypothyroidism present with neuromuscular symptoms. We report the case of a 56-year-old male with a two-year history of symptoms suggestive of hypothyroidism, which worsened over the last five months, with difficulty walking, muscle rigidity, and cramps. Laboratory tests confirmed primary hypothyroidism with elevated creatine kinase (CK) and lactate dehydrogenase (LDH) levels. Following treatment with levothyroxine, the clinical and biochemical response was favorable. Hoffmann syndrome, an atypical form of hypothyroid myopathy, is rare and primarily affects males with long-standing hypothyroidism. It is characterized by pseudohypertrophy and progressive muscle weakness, affecting less than 10% of hypothyroid patients. The pathogenesis is thought to involve alterations in the IGF1–PI3K–Akt/mTOR and myostatin-Smad3 pathways. Treatment with levothyroxine norma...

Background Obesity is a multifactorial chronic disease with a high, increasing worldwide prevalence. Genetic causes account for 7% of the cases in children with extreme obesity. Data sources This narrative review was conducted by searching for papers published in the PubMed/MEDLINE, Embase and SciELO databases and included 161 articles. The search used the following search terms: “obesity”, “obesity and genetics”, “leptin”, “Prader-Willi syndrome”, and “melanocortins”. The types of studies included were systematic reviews, clinical trials, prospective cohort studies, cross-sectional and prospective studies, narrative reviews, and case reports. Results The leptin-melanocortin pathway is primarily responsible for the regulation of appetite and body weight. However, several important aspects of the pathophysiology of obesity remain unknown. Genetic causes of obesity can ...