Cases reported "Hyperthyroidism"

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1/13. Malignant ophthalmopathy presenting one week after radioiodine treatment of hyperthyroidism.

    A 46-year-old woman presented with malignant ophthalmopathy 1 week after a therapeutic dose of radioiodine for treatment of hyperthyroidism. The patient was a smoker and had clinical evidence of mild thyroid-associated ophthalmopathy (TAO) prior to treatment with radioiodine. Anti-thyrotropin (TSH) receptor antibodies and antiflavoprotein antibodies were not detected at the time of presentation with malignant ophthalmopathy. The patient responded rapidly to anti-inflammatory treatment with intravenous methylprednisolone and orbital radiation.
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keywords = ophthalmopathy
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2/13. triiodothyronine-induced thyrotoxicosis in ophthalmic graves disease.

    A euthyroid woman with ophthalmic graves disease developed endogenous hyperthyroidism coincident with T3 suppression test. There is a putative role of liothyronine administration in precipitating or activating hyperthyroidism. Aberrancies in T3 suppression testing in graves disease occur.
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ranking = 0.0039319037259454
keywords = grave
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3/13. An autonomously functioning thyroid carcinoma associated with euthyroid Graves' disease.

    A 39-yr-old man with an autonomously functioning thyroid carcinoma is presented. Only 17 similar cases have been reported in the literature. The patient had unilateral Graves' ophthalmopathy. He was euthyroid as reflected by normal TSH concentration, whereas the results of a T3 suppression test established the presence of autonomous thyroid function. A thyroid scan with (123)I revealed a hot nodule corresponding to the location of a papillary carcinoma and remained substantially unchanged after T3 administration. The hyperfunction of the carcinoma itself was clearly confirmed by the intense concentration of (131)I within the tumor on microautoradiograms. While a hot nodule on radioiodine scan is unlikely to be malignant, the possibility of carcinoma should not be overlooked.
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ranking = 0.14285714285714
keywords = ophthalmopathy
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4/13. A case of thymic enlargement in hyperthyroidism in a young woman.

    We present the case of a 24-year-old woman with thymic enlargement accompanied by hyperthyroidism. An x-ray incidentally detected her thymic enlargement and the size was estimated to be 226 cm(3) by computed tomography (CT) using three-dimensional analysis. physical examination revealed a soft diffuse goiter, increased sweating and restlessness; thyroid function tests showed hyperthyroidism. Because the possibility of a thymoma could not be completely excluded, a mediastinal biopsy via a supracervical approach was done that determined the specimen was composed of normal thymic tissue. Together with these findings, the patient's thymic enlargement was likely to be consistent with true thymic hyperplasia. Moreover, we have demonstrated the presence of the thyrotropin (TSH) receptor in her thymus using reverse transcription-polymerase chain reaction (RT-PCR). She was treated with methimazole, resulting in the resolution of not only the thyroid dysfunction but also thymic enlargement. Thymic enlargement has often been recognized as a complication of hyperthyroidism. However, the pathophysiologic mechanisms underlying these conditions remain obscure. Our result raises the speculation that the thymus is also a target organ of autoimmune attack as are the orbital and fibroblasts, which lead to Graves' ophthalmopathy and pretibial dermopathy, respectively.
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ranking = 0.14285714285714
keywords = ophthalmopathy
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5/13. TSH-induced hyperthyroidism caused by a pituitary tumor.

    BACKGROUND: A 45-year-old man presented with frontal headache and visual disturbances to our clinic. For the previous 5 years, he had been receiving treatment for long-lasting mild hyperthyroidism with antithyroid therapy, but therapy had not been carefully followed. During the last 2 years he had also complained of erectile dysfunction and loss of libido. On physical examination, he had a small goiter, normal skin, no Graves' ophthalmopathy, normal BMI, and reduced testis volume and pubic hair. INVESTIGATIONS: serum levels of free T3 and T4, serum prolactin, testosterone, serum gonadotropins, insulin-like growth factor 1, adrenocorticotropic hormone, and cortisol were measured. MRI scan, TSH-releasing hormone test, and T3 suppression test were carried out. Levels of pituitary glycoprotein hormone alpha-subunit and sex-hormone-binding protein were also measured. diagnosis: hyperthyroidism caused by a mixed pituitary adenoma that secretes prolactin and TSH. MANAGEMENT: Trans-sphenoidal resection of the pituitary tumor. After surgery, T3 suppression test failed to completely suppress TSH secretion, which suggested a persistence of residual adenomatous cells. hyperthyroidism and hypogonadism recurred after 5 years, therefore, treatment with lanreotide was initiated, and resulted in complete resolution of signs and symptoms of the disease.
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ranking = 0.14285714285714
keywords = ophthalmopathy
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6/13. Hodgkin's disease and hyperthyroidism.

    In recent years we have had the occasion to observe hyperthyroidism in 6 patients with Hodgkin's disease. All patients had received Mantlefield irradiation and were disease-free when hyperthyroidism appeared. hyperthyroidism allows three different pictures to be distinguished: 1 case report of Graves' disease without ophthalmopathy, 1 case report of Hashimoto's thyroiditis corresponding to a particular form called hashitoxicosis, and 4 case reports of atypical silent thyroiditis. Reports concerning case studies of postirradiation Graves' disease or Hashimoto's thyroiditis during Hodgkin's disease are only to be found exceptionally. Atypical silent thyroiditis was recently individualized, but no postirradiation case studies have been reported. It is suggested that these 6 cases represent a radiation-induced immune thyroid disease: physiopathology and predisposing factors are discussed.
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ranking = 0.14285714285714
keywords = ophthalmopathy
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7/13. Prenatal treatment of thyrotoxicosis to prevent intrauterine growth retardation.

    A woman with hypothyroidism and graves ophthalmopathy was treated with propylthiouracil during her second pregnancy. This was employed because her first pregnancy resulted in an infant with severe intrauterine growth retardation and neonatal thyrotoxicosis. The antithyroid drug used during the second pregnancy crossed the placenta and treated the infant in utero. The infant was delivered by elective cesarean section at 36 weeks and was a live-born male with appropriate height and weight without evidence of thyrotoxicosis. The therapeutic benefit of propylthiouracil during this second pregnancy seems likely, based on the development of neonatal thyrotoxicosis after 4 days of life and on the presence of high thyroid-stimulating immunoglobulin levels in the mother and the infant.
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ranking = 0.14285714285714
keywords = ophthalmopathy
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8/13. Managing strabismus in endocrine eye disease.

    In Graves' ophthalmopathy, now considered a separate autoimmune disorder, 15% of patients have a motility disorder. This is usually a restrictive strabismus, most often involving the inferior rectus muscle, and is diagnosed with the aid of forced duction testing, saccadic velocity measurement, binocular visual field testing and prism cover testing. Adjustable sutures may be used, depending on the intraoperative findings. The case presentations in this paper demonstrate the principles of diagnosis and treatment.
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ranking = 0.14285714285714
keywords = ophthalmopathy
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9/13. Dysthyroid optic neuropathy. Clinical profile and rationale for management.

    Dysthyroid optic neuropathy (DON) was diagnosed in 36 eyes of 21 patients with progressive visual loss and congestive ophthalmopathy. Systemic features in the patients with DON did not differ from those reported for Graves' disease patients except that patients with DON were older (mean age, 61 years) and did not show female preponderance. Congestive symptoms always preceded visual loss, which was gradual in onset and bilateral in most patients but acute and asymmetrical in several. Presenting acuities were poorer than 20/60 in 50% of cases; central scotomas, sometimes combined with inferior depression, were the predominant field defects. Congestive signs were of moderate intensity without severe proptosis or exposure keratopathy. Bilateral and symmetrical ductional restriction was the most common motility disturbance. Oral corticosteroids were effective in restoring visual function in ten of 21 eyes treated. Many steroid-unresponsive eyes were improved promptly by supervoltage orbital irradiation or surgical decompression. In general, therapeutic intervention appeared to hasten recovery and improve visual outcome.
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ranking = 0.14285714285714
keywords = ophthalmopathy
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10/13. Graves' ophthalmopathy and subclinical hypothyroidism: diagnostic value of the thyrotropin releasing hormone test.

    Five patients with Graves' ophthalmopathy and no previously documented clinical or laboratory evidence of hyperthyroidism were studied. Their serum levels of thyroxine and triiodothyronine (T3) and their T3 uptake were normal. Although the baseline serum level of thyrotropin (TSH) was normal in two patients, it was increased on the other three, and when TSH releasing hormone (TRH) was administered the T3 response was impaired in three patients and the TSH response was exaggerated in all five. These findings facilitated the diagnosis of subclinical hypothyroidism and distinguished the patients from those with Graves' ophthalmopathy and normal thyroid function or subclinical hyperthyroidism. Thyroid antibodies were detected in the serum of four of the five patients, suggesting the coexistence of chronic autoimmune thyroiditis; this disorder could account in part for the subclinical hypothyroidism, which was even present in the two patients in whom thyroid-stimulating immunoglobulin was found in the serum. These observations indicate the value of a TRH stimulation test in detecting subclinical hypothyroidism in patients with Graves' ophthalmopathy who appear from clinical and routine laboratory studies to have normal thyroid function but could have normal function or subclinical hyperthyroidism.
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ranking = 1
keywords = ophthalmopathy
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