Secondary Resistance to dopamine agonist after thirteen months of successful treatment in a 42 years old man.

Prolactinomas are the most common hormone-secreting pituitary tumors and represents approximately 40% of all pituitary adenomas. Pharmacology therapy with dopamine agonists is the mainstay treatment for prolactinomas. Usually, patients respond to these drugs with decreased level of the serum prolactin and with time, by tumor shrinkage.

Secondary Resistance to dopamine agonist after thirteen months of successful treatment in a 42 years old man.

Prolactinomas are the most common hormone-secreting pituitary tumors and represents approximately 40% of all pituitary adenomas. Pharmacology therapy with dopamine agonists is the mainstay treatment for prolactinomas Usually, patients respond to these drugs with decreased level of the serum prolactin and with time, by tumor shrinkage. Less than 10% of patients with prolactinomas exhibit resistance to the action of dopamine agonists, as defined by the lack of normalization of the serum prolactin levels despite long- term treatment at high doses of these drugs.

A middle aged woman with isolated ACTH deficiency associated with transient growth hormone deficiency.

Isolated ACTH deficiency (IAD) is a rare entity characterized by secondary adrenal insufficiency with low levels of serum cortisol, decreased production of ACTH, adequate secretion of other pituitary hormones and normal pituitary structure on radioimaging. The prevalence of IAD as a cause of secondary adrenal insufficiency has not been determined. Impairment of growth hormone (GH) secretion has been noted in 20 to 30% of patients with IAD which is normalized after glucocorticoid replacement.

An unusual cause of muscle weakness: a diagnostic challenge.

We report a case of 24 year-old-female presenting with bilateral leg heaviness sensation and difficult walking of one-day duration. Over the past three months she developed progressive and frequent tingling sensation on her hands accompanied by headache and increased thirst. Hypokalemia was identified and treated with resolution of symptoms.

Right lower quadrant abdominal pain in an immunocompromised patient: importance for an urgent diagnosis and treatment.

This is a case of a 34 years old male Hispanic patient with history of AIDS who presented to the ER with severe right lower quadrant abdominal pain of three days of evolution, associated with fever, chills, nausea, vomiting, watery diarrhea, weakness and general malaise. Acute appendicitis, Clostridium Difficile Colitis and Ischemic Colitis were the most important clinical conditions to consider in the differential diagnosis. Abdominal CT with IV contrast demonstrated thickening of the ascending colonic wall a finding highly suggestive of a transmural inflammatory necrotizing colitis of infectious etiology.

Uncommon cause of acute abdominal pain at the emergency room: epiploic appendagitis.

This is a case of 49 year-old-female with left lower quadrant pain. Initial diagnosis of acute diverticulitis entertained and treated accordingly. Diagnosis of epiploic appendagitis was done by abdominal CT-Scan.

Clinical and thyroid ultrasound evaluation in an asymptomatic adult Puerto Rican population: The San Juan city hospital experience Coromoto A. Pale.

Objectives: to determine the prevalence of thyroid disease in an asymptomatic Puerto Rican adult population within an iodine sufficient area. Correlate the clinical thyroic features during palpation with thyroid sonographic findings. Relate gender, laboratory data, and family history with the presence or absence of thyroid pathology.