1/924. TSH-secreting pituitary macroadenoma: rapid tumor shrinkage and recovery from hyperthyroidism with octreotide. A 44-year-old man with atrial fibrillation caused by hyperthyroidism is described. The underlying disease was a TSH-secreting macroadenoma of the pituitary. Treatment with the somatostatin analog octreotide eliminated hyperthyroidism and atrial fibrillation within 4 days and the tumor size diminished substantially within 3 weeks. ( info) |
2/924. 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. ( info) |
3/924. Thyroid autonomy (Plummer's disease) with contralateral malignancy--mere coincidence? A patient with an autonomously functioning nodule in the left lobe and a papillary carcinoma in the right lobe of the thyroid gland is described. Some evidence suggests the association to be more than coincidental. ( info) |
4/924. Subclinical hyperthyroidism and hyperkinetic behavior in children. The authors report three children who exhibited developmental learning disabilities (DLDs) associated with behavioral disturbances, such as attention deficit, hyperactivity, and autistic features. The thyroid function tests performed as a part of routine endocrinologic evaluation of children with DLDs revealed a hormonal profile consistent with hyperthyroidism. These children had no systemic signs of hyperthyroidism. Treatment with neomercazole resulted in good control of their hyperkinetic behavior and subsequent improvement in language function attributable to an increased attention span, thereby facilitating speech therapy. Although routine screening of all children with DLDs for thyroid dysfunction may not be cost-effective, selective screening of children with familial attention-deficit hyperactivity disorder and those with attention-deficit and hyperactivity in association with DLDs and pervasive developmental disorders appears to be justified. ( info) |
5/924. Ob-Gyn interactive case challenge--a case of sadness and anxiety 9 months postpartum. If you were the primary care provider, how would you diagnose and treat postpartum anxiety and depression in this young, first-time mother? After a normal, uncomplicated pregnancy, this 27-year-old woman developed anxiety and depressed mood, which she was still struggling to control 9 months after the birth of her child. Among the diagnostic possibilities to consider are occult malignancy, diabetes mellitus, and thyroid disorder, as well as major depression/anxiety disorder and postpartum depression. ( info) |
6/924. Primary biliary cirrhosis associated with painless thyroiditis. A case of anti-mitochondrial antibody (AMA)-negative primary biliary cirrhosis (PBC) associated with painless thyroiditis is reported in a 47-year-old woman who diagnosed as PBC based on her elevated serum gamma-glutamyl transpeptidase and immunoglobulin m levels, as well as histological findings of destroyed bile ducts surrounded by mononuclear infiltrates in the biopsied liver. She was negative for AMA and had a depressed level of thyroid-stimulating hormone accompanied by increased free thyrosine, thyroxine and triiodothyronine levels and low titers of anti-microsomal and anti-thyroid peroxidase antibodies. Her thyroid disorder corresponded with painless thyroiditis. An association between PBC and hyperthyroidism is rare. Furthermore, an association between AMA-negative PBC and hyperthyroidism due to painless thyroiditis has not previously been reported. ( info) |
7/924. hyperpigmentation caused by hyperthyroidism: differences from the pigmentation of Addison's disease. Two cases of hyperthyroidism with hyperpigmentation are presented. In both cases, hyperpigmentation was seen on the lower extremities, most strikingly on the shins, backs of the feet and the nail bed. histology of the pigmented skin showed basal melanosis and heavy deposition of haemosiderin around dermal capillaries and sweat glands. Treatment with mercazol in both cases resulted in no significant waning of pigmentation. Distribution of hyperpigmentation, haemosiderin deposition and poor response to the treatment may be characteristic features of the pigmentation caused by hyperthyroidism, and may represent differences from the pigmentation seen in Addison's disease. ( info) |
struma ovarii is a teratoma of the ovaries that contains a large amount of thyroid tissue. Like the cervical thyroid gland, this ectopic thyroid tissue can become autonomous. We present a case of hyperthyroidism caused by thyroid tissue in a large ovarian cystic teratoma and provide detailed endocrinological, radiological, and pathological preoperative and postoperative data. This is also the first documented case of struma ovarii in association with a secreting pituitary tumor. In addition, we provide a retrospective pathological analysis of 1390 surgically removed ovarian tumors at 2 major academic centers. ( info) |
9/924. Adoptive autoimmune hyperthyroidism following allogeneic stem cell transplantation from an HLA-identical sibling with Graves' disease. autoimmune diseases which follow allogeneic BMT from a donor who is a patient or a carrier of an autoimmune condition are considered to be a paradigm of adoptive autoimmunity. Seven cases of autoimmune thyroiditis associated with clinical hyperthyroidism have been published to date. In the case reported here a 35-year-old female patient with AML of the M2 subtype received unmanipulated PBSC from her HLA-identical sister who had therapeutically controlled Graves' disease. Antithyroid antibodies, including thyrotropin receptor (TSHR) antibodies, appeared 1 year after transplant. Clinical hyperthyroidism requiring thyrostatic medication appeared after 2 years. The biological and clinical implications of adoptive, post-transplant autoimmunity are briefly discussed. ( info) |
10/924. Spontaneous resolution of upper eyelid retraction in thyroid orbitopathy. This study was conducted to document in the literature case reports of spontaneous resolution of eyelid retraction in patients with thyroid orbitopathy. Two cases of thyroid orbitopathy associated with eyelid retraction were observed without surgical treatment. Spontaneous resolution of upper eyelid retraction occurred during an 8- to 12-month period. ( info) |