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      Re-emergence of a rare syndrome: A case of mauriac syndrome

      case-report

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          Abstract

          Mauriac syndrome is a rare syndrome associated with type 1 diabetes (T1DM) in children presenting with growth retardation, hepatomegaly, and cushingoid features. Recently, there has been re-emergence of this syndrome, especially with the use of premix insulin. A 15-year old type 1 diabetic boy, who was on premix insulin with erratic blood glucose, was referred to us for evaluation of short stature. He had significant short stature, hepatomegaly, and cushingoid features. His growth hormone (GH) stimulation was normal, and so was the overnight dexamethasone suppression test, based on which the diagnosis of Mauriac syndrome was reported. He was made to switch over to basal bolus regime, and was advised to follow-up for 6 months. He had reduction in hepatomegaly and a height gain of 3 cms.

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          Most cited references10

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          ISPAD Clinical Practice Consensus Guidelines 2014. Type 2 diabetes in the child and adolescent.

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            Gros ventre, hepatomegalie, troubles de croissance chez les enfants diabetiques traites depuis plusiers annee par l’insuline

            P Mauriac (1930)
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              Progressive retinopathy with improved control in diabetic dwarfism (Mauriac's syndrome).

              We report four children aged 11-18 1/2 yr first seen 7-14 yr after the diagnosis of insulin-dependent diabetes. At presentation, all had marked short stature, two had hepatomegaly, and the older three had delayed adolescence. They had been severely underinsulinized. Initial funduscopy demonstrated only occasion microaneurysms in two children and a single intraretinal hemorrhage in another. The youngest was normal. Improved control required large increases in insulin dosage. Growth rate improved significantly and hepatomegaly regressed. Puberty progressed rapidly in two older patients with poor final height. Paradoxically, with improved control, retinopathy progressed rapidly with appearance of multiple microaneurysms, nerve fiber layer infarctions, intraretinal microangiopathic changes, hemorrhages, exudates, and macular edema in all the patients and severe proliferation changes in three. One child with proliferative retinopathy in both eyes developed vitreous hemorrhage and blindness in one eye. Two required panretinal photocoagulation with no further progression of their retinopathy. These rapidly progressive retinal changes remain unexplained. We advise caution when correcting metabolic derangements of diabetic patients who have been poorly controlled for a prolonged period.
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                Author and article information

                Journal
                Indian J Endocrinol Metab
                Indian J Endocrinol Metab
                IJEM
                Indian Journal of Endocrinology and Metabolism
                Medknow Publications & Media Pvt Ltd (India )
                2230-8210
                2230-9500
                October 2013
                : 17
                : Suppl1
                : S283-S285
                Affiliations
                [1] Department of Endocrinology, Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India
                Author notes
                Corresponding Author: Dr. Manish Gutch, G 10, PG Hostel, Lala Lajpat Rai Memorial Medical College, Meerut - 250 004, Uttar Pradesh, India. E-mail: endollrm@ 123456yahoo.com
                Article
                IJEM-17-283
                10.4103/2230-8210.119611
                3830333
                24251187
                8da3b588-a277-4a01-ad26-f4f441147d9b
                Copyright: © Indian Journal of Endocrinology and Metabolism

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Brief Communication

                Endocrinology & Diabetes
                growth retardation,hepatomegaly,mauriac syndrome,type 1 diabetes
                Endocrinology & Diabetes
                growth retardation, hepatomegaly, mauriac syndrome, type 1 diabetes

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