Browsing by Author "Haddad, Nadine G."

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    Characteristics, clinical laboratory, histopathology, and outcomes of glycogenic hepatopathy in children
    (Wolters Kluwer, 2024) Jarasvaraparn, Chaowapong; González, Iván A.; Tolliver, Kyla M.; Haddad, Nadine G.; Molleston, Jean P.; Pediatrics, School of Medicine
    Introduction: Glycogenic hepatopathy (GH) is a rare complication of type I diabetes mellitus (DM1), resulting in abnormal deposition of glycogen in the liver due to poor glycemic control. Clinical characteristics and natural history of GH are not completely understood in children. In this study, we investigated clinical, biochemical, histologic parameters and outcomes in children with GH. Method: This was a retrospective review of patients less than 18 years old diagnosed with GH and DM. GH was confirmed on liver biopsy. Medical records were reviewed for clinical presentation, laboratory tests, and clinical outcomes. Liver biopsy findings were reviewed by a pediatric pathologist (I. A. G.). Results: Nine children were diagnosed with GH and type 1 DM. The median age at diagnosis of GH was 16 (IQR 14.5-17) years. Duration of diagnosis of DM until GH diagnosis was 7 (IQR 5-11) years. The median frequency of diabetic ketoacidosis before GH diagnosis was three times (IQR 2-5.25). Peak Aspartate transaminase (AST) and Alanine transaminase (ALT) ranged from 115 to 797, and 83-389 units/L, respectively. Only two children had mild fibrosis. Seven of nine had steatosis without steatohepatitis. There was no correlation between glycosylated hemoglobin (HbA1c), or other laboratory tests and liver fibrosis on biopsy. HbA1c was 11.2 (IQR 10.2-12.8) at GH diagnosis and 9.8 (IQR 9.5-10.8) with normalization of liver enzymes. Conclusion: GH appears to be related to poor glycemic control in teenagers with long-term diabetes. GH presents with high to very high aminotransferase especially AST > ALT and resolves with modestly improved glycemic control. Diffuse hepatocyte swelling, steatosis, minimal fibrosis without hepatocyte ballooning or lobular inflammation are most common histological features.
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    An ovulating follicle presenting as a testicular mass in a teenage patient with ovotesticular DSD
    (Elsevier, 2018-01-31) Roth, Joshua D.; Haddad, Nadine G.; Albright, Eric A.; Cheng, Liang; Rink, Richard C.; Kaefer, Martin; Urology, School of Medicine
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    Peripheral precocious puberty including congenital adrenal hyperplasia: causes, consequences, management and outcomes
    (Elsevier, 2019) Haddad, Nadine G.; Eugster, Erica A.; Pediatrics, School of Medicine
    Peripheral precocious puberty results from peripheral production of sex steroids independent of activation of the hypothalamic-pituitary gonadal axis. It is much less common than central precocious puberty. Causes are variable and can be congenital or acquired. In this review, we will discuss the diagnosis and management of the most common etiologies including congenital adrenal hyperplasia, McCune Albright syndrome, familial male-limited precocious puberty, and adrenal and gonadal tumors.