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Volume 73 - 2010 - Fasc.2 - Letters

Ornidazole-induced hepatitis

Ornidazole, a synthetic nitroimidazole derivative, is a commonly prescribed antiparasitic drug for parasitic infestations, including amoebiasis, giardiasis and Tricho- monas vaginalis. The drug is generally well tolerated. Hepatobiliary dysfunction associated with ornidazole has been reported infrequently (1-4). Here, we describe a Turkish female patient who developed hepatitis after ornidazole use.


The prevalence of gallbladder polyps is higher in HBsAg positive population

In a hospital-based, cross-sectional study, we retro- spectively analyzed the medical records of all the subjects undergoing self-referred health examination at one medical center located at Taichung city in Taiwan between 2000 and 2004. Excluding subjects with cholecystectomy, 3070 men (56.0%) and 2411 women (44.0%) were included in the study. Mean age was 49.2 ± 12.3 years (range from 20 to 87). Ultrasonographic findings showed a normal gallbladder in 4920 subjects (89.8%), polyps in 265 subjects (4.8%), stones in 278 subjects (5.1%), and mixed stones/polyps in 18 sub- jects (0.3%). Thus, the overall prevalence of gallbladder polyps was 5.1% [(265 + 18)/5481]. Data from these 283 subjects were used for further evaluation. Among 283 subjects with polyps (265+18), due to missing data, we found that 139 subjects (50.2%) had a single gallbladder polyp and 138 subjects (49.8%) had multiple gallbladder polyps (?? 2) (Table 1). The age group of 40- 64 years had a higher prevalence of gallbladder polyps (5.7%) than the other two groups (3.9% in age group 20- 39 years and 4.3% in age group ?? 65 years). Overall, the prevalence of gallbladder polyps was significantly higher in men than in women (7.0% vs 2.9%, P < 0.001). In particular, in age groups 20-39 years and 40-64 years, this prevalence was significantly higher in men than in women (P = 0.028 and P < 0.001, respectively). In the age group of 65 years, men also had higher prevalence than women, but without reaching a statistically signifi- cant difference (P > 0.05) (Fig. 1).


Insulinoma and extreme obesity in a patient with MEN1 syndrome

We report a patient aged 16 experiencing headache, galactorrhea and ammenorrhea. Laboratory examina- tion showed an increased prolactin (PRL) level (> 400 ng/mL ; normal range 5-30 ng/mL ) and computed tomography (CT) of pituitary gland revealed a tumor mass, 1.5 ?? 0.9 cm in size. Transnasal selective partial adenomectomy was performed, and postoperative exci- sional biopsy showed a prolactinoma. Postoperatively, she developed hypopituitarism, for which levothyroxin (100 µg/day) and hydrocortison (30 mg/day) replacement therapy were prescribed. Further laboratory tests showed decreased glucose levels (3.0 mmol/L ; normal range 3.5- 6.5 mmol/L), never completely explained, because the patient left the hospital on her demand. She returned to our department at the age of 21, with long-standing symptoms of weakness, sweating, tremor and mental confusion. She was 150 cm high and had 158 kg (90 kg more than at previous hospitalization), BMI 70.2 kg/m2. Laboratory examination revealed persistent hypoglyce- mia (2.5-3.1mmol/L), hyperinsulinemia (105pmol/L; normal range < 5 pmol/L) and increased C-peptide level (95 µg/L ; normal range 1.1-5.0 µg/L). The serum levels of IGF-1, cortisol, vanillylmandelic acid, metanephrines, parathormone, PRL, thyroid stimulating hormone, growth hormone, follicle-stimulating hormone and luteinizing hormone were within normal limits. Abdominal ultra- sonography revealed a tumor mass in the distal part of the pancreatic tail, 2.6 cm in size (Fig. 1).