Publications by authors named "Lubna Mirza"

4 Publications

  • Page 1 of 1

An unusual case of Adrenocortical Adenocarcinoma with Biochemical Masquerade of Pheochromocytoma.

Pak J Med Sci 2021 Jul-Aug;37(4):1241-1243

Lubna Mirza Norman Regional Hospital, Norman, United State.

Adrenocortical carcinoma (ACC) is a rare malignancy that arises from the adrenal cortex and often presents as adrenal incidentaloma on abdominal scans with rise in the use of imaging modalities. ACC often presents as Cushing's syndrome or virilization. On the other hand, pheochromocytoma is an adrenal medullary tumor. It is rare for ACC to present as pheochromocytoma even though both may coexist. Moreover, ACC tumors have radiological and histological features suggestive of aggressive nature of the disease. We present a case of a 65-year-old lady who initially presented with a 3cm left adrenal incidentaloma. All of her adrenal hormones were in normal range. She was lost to follow up for several years and returned with a much enlarged lesion. Biochemical work up showed mildly increased catecholamines and metanephrines suggestive of pheochromocytoma. She didn't have any signs or symptoms of pheochromocytoma. She was treated with alpha blockers before surgery as a prophylactic measure. Surgical pathology was consistent with the diagnosis of primary adrenal adenocarcinoma. We recommend that adrenal incidentalomas should be followed annually for up to five years as per American association of Endocrinology and the Endocrine Society guidelines to prevent morbidity and mortality in patients.
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http://dx.doi.org/10.12669/pjms.37.4.3916DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8281192PMC
November 2020

Morbid Obesity Due to Prolactinoma and Significant Weight Loss After Dopamine Agonist Treatment.

AACE Clin Case Rep 2021 May-Jun;7(3):204-206. Epub 2021 Mar 11.

Department of Endocrinology, Norman Regional Hospital, Oklahoma.

Objective: Morbid obesity may be related to a prolactinoma, although uncommon, and can lead to adverse effects like insulin resistance and metabolic syndrome. Recent research suggests that hyperprolactinemia causes an abnormal lipid profile, weight gain, and cardiovascular diseases. Moreover, high prolactin levels lead to decreased testosterone production by disrupting 17-b-estradiol synthesis. Our objective was to present a case of prolactinoma with morbid obesity, hypogonadism, and then significant weight loss after dopamine agonist treatment.

Methods: The clinical course, in addition to serial laboratory and imaging results, are presented. These include prolactin levels, testosterone levels, thyroid function tests, blood sugar levels, and serial lipid profiles.

Results: In this report, we discuss a case of 30-year-old male with prolactin-secreting macroadenoma with clinical features of hypogonadism, hypothyroidism, and morbid obesity. He showed marked improvement in obesity and hypogonadism with dopamine agonist therapy supplemented with clomiphene citrate.

Conclusion: Prolactinomas with morbid obesity can be successfully treated contingent upon proper medication and compliance with medications. Insulin resistance, hypogonadism, prolactin levels, body mass index, and tumor size all improved by regular follow-up and treatment adherence.
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http://dx.doi.org/10.1016/j.aace.2021.01.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165126PMC
March 2021

Euglycemic Diabetic Ketoacidosis in a 27 year-old female patient with type-1-Diabetes treated with sodium-glucose cotransporter-2 (SGLT2) inhibitor Canagliflozin.

Pak J Med Sci 2016 May-Jun;32(3):786-8

Lubna Mirza, MD. Norman Regional Hospital, Norman, Oklahoma, USA.

We are reporting a timely case of atypical euglycemic diabetic ketoacidosis in a type 1 diabetic patient treated with sodium-glucose cotransporter-2 (SGLT-2) inhibitor canagliflozin. The clinical history, physical examination findings and laboratory values are described. Other causes of acidosis such as salicylate toxicity or alcohol intoxication were excluded. Ketoacidosis resolved after increasing dextrose and insulin doses supporting the hypothesis that SGLT-2 inhibitors may lead to hypoinsulinemia. Euglycemic ketoacidosis did not recur in our patient after discontinuing canagliflozin. We recommend reserving SGLT2 inhibitor therapy to type 2 diabetics, discontinuing medication and treating patients presenting with ketoacidosis due to SGLT-2 inhibitors with higher concentrations of dextrose with appropriate doses of insulin to help resolve acidosis.
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http://dx.doi.org/10.12669/pjms.323.9201DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928443PMC
July 2016

A Case of 36-Year-Old Woman With Recurrent Hypoglycemia Due to Insulinoma With Cytokeratin-19 Expression: A Marker of Poor Prognosis.

Pancreas 2016 Feb;45(2):e3-4

Tabriz University of Medical Sciences Tabriz, Iran Department of Endocrinology Norman Regional Hospital Norman, OK Department of Endocrinology University of Oklahoma Health Sciences Center Oklahoma City, OK.

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http://dx.doi.org/10.1097/MPA.0000000000000492DOI Listing
February 2016
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