Differences in clinicopathological characteristics between lipohypertrophy and localized insulin‐derived amyloidosis: A scoping review
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SUBMITTER: Mukai K
PROVIDER: S-EPMC10914015 | biostudies-literature | 2023 Nov
REPOSITORIES: biostudies-literature
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Project description:BackgroundInsulin-derived amyloidosis is a skin-related complication of insulin therapy that interferes with insulin therapy. Although toxicities of in vitro-formed insulin amyloid fibrils have been well studied, the toxicity of insulin-derived amyloidosis remains to be clarified.Case presentationA 58-year-old man with type 2 diabetes mellitus underwent a lower limb amputation due to diabetic gangrene. Several antibiotics including minocycline were administered for infection and sepsis. A hard mass at the insulin injection sites in the lower abdomen was discovered by chance four months later. Although no abnormal findings in the surface skin of the mass were observed, necrotic tissue was seen around the mass when a biopsy was performed. Histological and toxicity studies were performed for this patient and four other patients with abdominal masses at insulin injection sites. Histological and immunohistochemical studies showed that the masses had typical characteristics of amyloid deposits in all cases, whereas necrotic findings were seen adjacent to the amyloid deposit only in the case presented. Toxicity studies indicated that the amyloid tissue from the present case had significant cell toxicity compared to the control skin tissue or the amyloid tissues from the other four cases.ConclusionsThis report showed that toxic insulin-derived amyloidosis can occur. In addition, this report suggested that toxic insulin-derived amyloidosis may cause necrosis in the surrounding tissue. Although the toxic amyloid deposit of insulin-derived amyloidosis was found in only one patient, no structural differences between toxic and non-toxic deposits were seen on histological and immunohistochemical studies.
| S-EPMC6567432 | biostudies-literature
Project description:Primary outcome(s): Clinicopathological features included patient age, sex, initial treatment, tumor size, morphology, invasion depth, histological grade, lymphatic invasion, vascular invasion, tumor budding, and lymph node metastasis.
| 2660159 | ecrin-mdr-crc
Project description:Primary outcome(s): Clinicopathological features included patient age, sex, initial treatment, tumor size, morphology, invasion depth, histological grade, lymphatic invasion, vascular invasion, tumor budding, and lymph node metastasis.
| 2647855 | ecrin-mdr-crc
Project description:Introduction: Lipohypertrophy is the most reported cutaneous complication of insulin injection. In cases refractory to conservative management, liposuction has been proposed as a treatment. This review aims to evaluate the use of liposuction for the treatment of insulin-induced lipohypertrophy. Methods: A literature search was conducted to identify case reports and case series that met inclusion criteria. Demographic, procedural, and outcome data were collected and summarized. Results: Ten case reports and 1 case series met eligibility criteria; 18 patients (16 female) with a mean age of 31 years were included for analysis. The primary indication for lipectomy was cosmetic (100%), followed by pain (16.7%), injection difficulty (16.7%), and poor glycemic control (11.1%). Ten patients (55.6%) underwent general anesthesia for their procedure, while 8 (44.4%) received local anesthesia. Thighs (53.8%) were the most common anatomical site of liposuction, followed by the upper arm (19.2%), abdomen (15.4%), buttocks (7.7%), and the flank (3.8%). The median volume of adipose tissue removed per site was 300 mL (range: 25-600 mL), while the total volume per patient was 910.8 mL (range: 200-2900 mL). The average postoperative follow-up time was 5.3 months (range: 2-10 months). Three patients reported postoperative improvement of glycemic control; 100% of patients were satisfied with their procedure. Small surface irregularities were reported in 2 patients. Conclusion: Although future investigations are warranted, these results may indicate that the use of liposuction to treat insulin-induced lipohypertrophy is a safe and effective procedure that achieves improved cosmetics with high patient satisfaction and enhanced glycemic control.
| S-EPMC11770779 | biostudies-literature
Project description:BackgroundLipohypertrophy (LH) of subcutaneous tissue is an insulin-induced complication occurring in patients with diabetes. We aimed to define the prevalence of LH and identify its risk factors in type 1 diabetes (T1DM) patients treated with continuous subcutaneous insulin infusion (CSII).Materials and methodsThe study included 79 consecutive CSII-treated T1DM patients. The diagnose of LH was based on ultrasonography (US) as a reference method, physical examination was also performed. Clinical characteristics were available from the medical records.ResultsThe median age of patients was 28 years (interquartile range [IQR], 24-30.5) with a body mass index (BMI) of 24.5 ± 3.5 kg/m2, HbA1c 7.1% (IQR, 6.7-8.1), T1DM duration 15 (9-20) years, and CSII use duration of 8 year (IQR, 5-11). LH was detected by US in 75 (94.9%) patients. This value was much higher than this obtained by visual assessment (n = 39, 49.4%) or palpation (n = 59, 74.7%). In univariate analyses, the following risk factors for occurrence of 5 and more LH lesions were identified: the ratio of insulin dose to body mass exceeding 0.7 IU/kg (OR, 3.69; 95% CI, 1.43-10.01) and the total daily insulin dose (OR, 1.05; 95% CI, 1.02-1.09). A higher dose of insulin per kg remained a significant risk factor of LH amount in multivariate analysis.ConclusionThis selected T1DM cohort treated with CSII had a very high prevalence of LH. US assessment should be considered as a reference method for LH screening in T1DM patients. The identified risk factors for the number of LH lesions were related to insulin dosing.
| S-EPMC8803446 | biostudies-literature
Project description:To date, almost all case reports of insulin-derived amyloidosis described the presence of a subcutaneous mass that was observable on physical examination. This report presents two cases of insulin-derived amyloidosis without palpable masses at insulin injection sites. In both cases, blood glucose concentrations improved, and the insulin dose could be reduced by an average of 45% after changing the insulin injection sites. The insulin absorption at the site was reduced to at most 40% of that at a normal site in one case. Magnetic resonance imaging and ultrasonography were useful to screen and differentiate insulin-derived amyloidosis without a palpable mass. This report showed that insulin-derived amyloidosis without a palpable mass can be present at the insulin injection site, and has similar clinical effects to insulin-derived amyloidosis with palpable masses.
| S-EPMC7378411 | biostudies-literature
Project description: Not available
| S-EPMC8257140 | biostudies-literature
Project description:Primary outcome(s): Lymph node metastasis
| 2626355 | ecrin-mdr-crc
Project description:ObjectiveOral leukoplakia is keratinized lesions in the buccal mucosa, tongue, and gingiva. It is the most common oral precancerous lesion; oxidative stresses and irrelevant autophagy have been reported to be the cause of oncogenesis. p62, a cytoplasmic protein induced by oxidative stress, is an adaptor protein involved in the formation of protein aggregates and induction and inhibition of autophagy. The inhibition of autophagy induces p62 overexpression and promotes oncogenesis via the oncogenic signaling pathway. The aim of the present study was to elucidate the involvement of intracellular expression of p62 in oral leukoplakia and to address its potential clinical implementation as a biomarker to predict malignant transformation.Material and methodsFifty samples from subjects with confirmed oral leukoplakia were evaluated by immunohistochemical staining for the expression of p62, 8-hydroxy-2'-deoxyguanosine (8-OHdG), Ki67, and p53. Univariate and multivariate logistic regression analyses were performed to evaluate the association between p62, 8-OHdG, Ki67, and p53 and clinical characteristics, including epithelial dysplasia.ResultsSignificant associations were observed between p62 expression in the nucleus, p62 aggregation, and epithelial dysplasia (adjusted odds ratio [OR] = 5.75; 95% confidence interval [CI]: [1.28, 26.2]; .024 and OR = 6.16; 95% CI: [1.01, 37.4]; .048, respectively). The expression of p62 in the cytoplasm and the levels of 8-OHdG, Ki67, and p53 were not significantly associated with epithelial dysplasia. A significant relationship was found between p62 expression in the nucleus and p53 expression (OR = 3.94; 95% CI: [1.14, 13.6]; .031).ConclusionsThe results suggested that p62 expression in the nucleus and p62 aggregation can be potential markers to predict the malignant transformation of oral leukoplakia.
| S-EPMC6704027 | biostudies-literature
Project description: Not available
| S-EPMC8812698 | biostudies-literature