Oral and maxillofacial manifestations of Gardner's syndrome associated with growth hormone deficiency: case report and literature review.

Gardner's syndrome (GS) is a hereditary disorder inherited as autosomal dominant with complete penetrance and variable expression. GS is a variant of familial adenomatous polyposis characterized by extracolonic manifestations including osteomas, dental anomalies, and epidermoid cysts. The association between GS and endocrine abnormalities has been well documented but a direct pituitary involvement has never been reported. We present a case of oral and maxillofacial manifestations in an adult patient affected by GS associated with growth hormone deficiency, a hitherto unreported association. The possible pathogenic mechanisms are discussed.     

Enzymuria in carboplatin nephrotoxicity

Urinary excretion of N-acetyl-beta-glucosaminidase (NAG) is an early marker of nephrotoxicity. NAG activity was assayed by the fluorimetric method of Leaback and Walker in 17 patients treated (22 courses) with carboplatin (CBDCA, 220-550 mg/m2) before infusion and 24, 48, 72 and 96 h after. Increased excretion of NAG, a sensitive index of renal tubular damage, was observed following 10 of the 22 courses. A transient increase in plasma creatinine and/or abnormal proteinuria was observed in 6 cases. Impaired renal function prior to therapy seems to be a predisposing factor to the nephrotoxicity.     

Evaluation of a screening test for detection of IgA antigliadin antibodies in coeliac disease

The reliability of antigliadin antibodies of IgA and IgG classes for the diagnosis and follow-up of coeliac disease was evaluated by ELISA tests. Forty coeliac patients, 41 patients with other gastrointestinal diseases and 50 healthy subjects were studied. IgA antigliadin antibodies were detected in all patients on unrestricted diet and in those on a challenge with a gluten-containing diet. A low incidence of positivities was found in patients on a gluten free-diet, while no positivity was found in controls or gastrointestinal patients. IgG determination, in contrast, showed poor specificity. Our data suggest that a positive IgA antigliadin test may be a reliable marker for the presence of active coeliac disease, which should be confirmed by intestinal biopsy; it is, moreover, a good marker for monitoring patients, since elevated values might suggest non-compliance with the diet.