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Case Reports in Endocrinology

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https://www.readbyqxmd.com/read/28540093/myxedema-crisis-presenting-with-seizures-a-rare-life-threatening-presentation-a-case-report-and-review-of-the-literature
#1
Sonali Sihindi Chapa Gunatilake, Uditha Bulugahapitiya
Myxedema crisis is a life-threatening extreme form of hypothyroidism with a high mortality rate if left untreated. Myxedema crisis is commonly seen in older patients, especially in women, and is associated with signs of hypothyroidism, hypothermia, hyponatraemia, hypercarbia, and hypoxemia. Patients might present with different organ specific symptoms. Seizures are a recognized but rare manifestation of myxedema with a very high mortality rate. Prompt diagnosis and appropriate management may improve the prognosis...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28487781/hypocalciuric-hypercalcemia-due-to-impaired-renal-tubular-calcium-excretion-in-a-type-2-diabetic-patient
#2
Sihao Yang, Yan Ren, Xi Li, Haoming Tian, Zhenmei An, Tao Chen
The case we presented here was a 73-year-old gentleman, who was admitted to endocrinology department due to recurrent fatigue for 1 year. He had medical histories of type 2 diabetes for 18 years and developed CKD 4 years ago. He also suffered from dilated cardiomyopathy, and coronary heart disease, moderate sleep apnea syndrome, primary hypothyroidism, and gout. His treatment regimen was complicated which included Caltrate D and compound α-keto acid (1200 mg calcium/d). Laboratory examination revealed that his serum calcium level elevated, 24-hour urine calcium output decreased, PTH level was suppressed, and 25-hydroxyvitamin D was in normal low range...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28484653/anaplastic-spindle-cell-squamous-carcinoma-arising-from-tall-cell-variant-papillary-carcinoma-of-the-thyroid-gland-a-case-report-and-review-of-the-literature
#3
Darren K Patten, Alia Ahmed, Owain Greaves, Roberto Dina, Rashpal Flora, Neil Tolley
Tall cell variant (TCV) of papillary thyroid carcinoma (PTC), an aggressive form of thyroid cancer, is characterised by 50% of cells with height that is three times greater than the width. Very rarely, some of these cancers can progress to spindle cell squamous carcinoma (SCSC) resulting in cancers with elements of both SCSC and TCV PTC. Here we report a case of SCSC arising from TCV PTC. In addition to this case, we have performed a literature review and compiled all published reports of SCSC arising from TCV PTC, including the nature of treatment and the prognosis for each of the 20 patients recorded...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28469946/a-normotensive-patient-with-primary-aldosteronism
#4
Xiao Lin, Xiaoyu Miao, Pengli Zhu, Fan Lin
This study was to report a case of normotensive patient with primary aldosteronism who was admitted to our department recently. The patient was a 33-year-old male with right adrenal incidentaloma, but without any symptom. He has no history of hypertension, and blood pressure was normal when measured at multiple time points during hospitalization stay. The 24-hour ambulatory blood pressure prompted a normal blood pressure with the existence of circadian rhythm. The patient was diagnosed with primary aldosteronism by screening and confirmatory test...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28465846/a-rare-complication-following-thyroid-percutaneous-ethanol-injection-plummer-adenoma
#5
Roberto Cesareo, Anda Mihaela Naciu, Valerio Pasqualini, Giuseppe Pelle, Silvia Manfrini, Gaia Tabacco, Angelo Lauria Pantano, Alessandro Casini, Roberto Cianni, Andrea Palermo
Percutaneous ethanol injection (PEI) is a technique used only for benign thyroid nodules, cystic or mixed cystic-solid with a large fluid component. It is a quite low-cost, safe, and outpatient method of treatment. Rare and severe complications have been described after PEI: jugular vein thrombosis and severe ethanol toxic necrosis of the larynx combined with necrotic dermatitis. Moreover, only four thyrotoxicosis cases due to Graves' disease have been reported. We report a case of 58-year-old female with a voluminous thyroid cystic nodule, occupying almost the entire left thyroid lobe...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28458934/normalization-of-bilateral-adrenal-gland-enlargement-after-treatment-for-cryptococcosis
#6
Yuka Muraoka, Shintaro Iwama, Hiroshi Arima
Cryptococcosis usually occurs in immunocompromised patients and can cause enlargement of the adrenal glands, although the morphologic changes after treatment have not been reported in detail. We report the case of 24-year-old man with fevers, headaches, and impaired consciousness who had been treated with glucocorticoids for a protein-losing gastroenteropathy. The cerebrospinal fluid analysis revealed cryptococcal meningitis. Computed tomography showed bilateral adrenal enlargement. A retrospective analysis revealed that the enlargement had been detected 5 months before admission and gradually increased...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28396808/usefulness-of-stereotactic-radiotherapy-using-cyberknife-for-recurrent-lymph-node-metastasis-of-differentiated-thyroid-cancer
#7
Joji Kawabe, Shigeaki Higashiyama, Mitsuharu Sougawa, Atsushi Yoshida, Kohei Kotani, Susumu Shiomi
A woman in her 60s presented with a recurrent lymph node metastasis from a papillary thyroid carcinoma in the right parapharyngeal space. She had already undergone total thyroidectomy, five resections for cervical lymph node metastases, and right carotid rebuilding. Surgical resection of the current metastasis was impossible. (131)I-radioiodine therapy (RIT) with 3.7 GBq (131)I was not effective; therefore, stereotactic radiation therapy (SRT) using a CyberKnife radiotherapy system was scheduled. The prescription dose was 21 Gy, and a dose covering 95% of the planning target volume (PTV) in three fractions was administered...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28386489/psychological-aspects-of-androgen-insensitivity-syndrome-two-cases-illustrating-therapeutical-challenges
#8
Filippa Pritsini, Georgios A Kanakis, Ioannis Kyrgios, Eleni P Kotanidou, Eleni Litou, Konstantina Mouzaki, Aggeliki Kleisarchaki, Dimitrios G Goulis, Assimina Galli-Tsinopoulou
Androgen Insensitivity Syndrome (AIS) and its heterogeneous phenotypes comprise the pieces of a challenging clinical problem. The lack of standardized guidelines results in controversies regarding the proper diagnostic and therapeutic approach, including the time and type of intervention. Due to its variable phenotype, AIS is not diagnosed at the proper age that would allow optimal psychological and medical support to the patient. Therapeutic approaches are not established, mainly due to the rarity of the disease...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28357143/a-rapid-biochemical-and-radiological-response-to-the-concomitant-therapy-with-temozolomide-and-radiotherapy-in-an-aggressive-acth-pituitary-adenoma
#9
Ana Misir Krpan, Tina Dusek, Zoran Rakusic, Mirsala Solak, Ivana Kraljevic, Vesna Bisof, David Ozretic, Darko Kastelan
Background and Importance. In the last eight years temozolomide (TMZ) has been used as the last-line treatment modality for aggressive pituitary tumors to be applied after the failure of surgery, medical therapy, and radiotherapy. The objective was to achieve a rapid control of tumor growth and hormone normalization with concurrent chemoradiotherapy in a patient with very aggressive ACTH pituitary adenoma. Clinical Presentation. We describe a patient with an aggressive ACTH-producing adenoma treated with concurrent temozolomide and radiotherapy...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28348902/atypical-complications-of-graves-disease-a-case-report-and-literature-review
#10
Khaled Ahmed Baagar, Mashhood Ahmed Siddique, Shaimaa Ahmed Arroub, Ahmed Hamdi Ebrahim, Amin Ahmed Jayyousi
Graves' disease (GD) may display uncommon manifestations. We report a patient with rare complications of GD and present a comprehensive literature review. A 35-year-old woman presented with a two-week history of dyspnea, palpitations, and edema. She had a raised jugular venous pressure, goiter, and exophthalmos. Laboratory tests showed pancytopenia, a raised alkaline phosphatase level, hyperbilirubinemia (mainly direct bilirubin), and hyperthyroidism [TSH: <0.01 mIU/L (reference values: 0.45-4.5), fT4: 54...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28348901/addison-s-disease-and-possible-cannabis-withdrawal-syndrome-presenting-as-an-eating-disorder-in-a-thirty-year-old-female
#11
Kimberly Lazare
A 30-year-old female with a history of anxiety, cannabis use, and Avoidant/Restrictive Food Intake Disorder presented for residential treatment of a Cannabis Use Disorder. Upon arrival, she had not eaten for two days and was found to be hypotensive with electrolyte disturbances. She was admitted to a nearby hospital, where the Internist diagnosed her with Addison's disease. She was treated with corticosteroid therapy, with rapid normalization of her electrolytes, eating, and anxiety. This is the first published case of undiagnosed Addison's disease presenting as an eating disorder, with cannabis use likely contributing to symptoms...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28321344/pituitary-adenoma-and-hyperprolactinemia-accompanied-by-idiopathic-granulomatous-mastitis
#12
Sebahattin Destek, Vahit Onur Gul, Serkan Ahioglu, Kursat Rahmi Serin
Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of the breast, and its etiology remains not fully elucidated. IGM is observed more often in patients with autoimmune disease. Hyperprolactinemia is observed during pregnancy, lactation, and a history of oral contraceptive use. A 39-year-old patient with no history of oral contraceptive use presented with complaints such as redness, pain, and swelling in her left breast. Ultrasound and magnetic resonance imaging (MRI) revealed a suspicious inflamed mass lesion...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28270939/simultaneous-papillary-carcinoma-in-thyroglossal-duct-cyst-and-thyroid
#13
Gustavo Cancela E Penna, Henrique Gomes Mendes, Adele O Kraft, Cynthia Koeppel Berenstein, Bernardo Fonseca, Wagner José Martorina, Andreise Laurian N R de Souza, Gustavo Meyer de Moraes, Kamilla Maria Araújo Brandão Rajão, Bárbara Érika Caldeira Araújo Sousa
Thyroglossal duct cyst (TDC) is a cystic expansion of a remnant of the thyroglossal duct tract. Carcinomas in the TDC are extremely rare and are usually an incidental finding after the Sistrunk procedure. In this report, an unusual case of a 36-year-old woman with concurrent papillary thyroid carcinoma arising in the TDC and on the thyroid gland is presented, followed by a discussion of the controversies surrounding the possible origins of a papillary carcinoma in the TDC, as well as the current management options...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28246564/false-positive-findings-on-i-131-wbs-and-spect-ct-in-patients-with-history-of-thyroid-cancer-case-series
#14
Zeina C Hannoush, Juan D Palacios, Russ A Kuker, Sabina Casula
Introduction. Although whole body scan (WBS) with I-131 is a highly sensitive tool for detecting normal thyroid tissue and metastasis of differentiated thyroid cancer (DTC), it is not specific. Additional information, provided by single photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) and by the serum thyroglobulin level, is extremely useful for the interpretation of findings. Case Presentation. We report four cases of false positive WBS in patients with DTC: ovarian uptake corresponding to an endometrioma, scrotal uptake due to a spermatocele, rib-cage uptake due to an old fracture, and hepatic and renal uptake secondary to a granuloma and simple cyst, respectively...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28168064/hypercalcemia-of-malignancy-in-thymic-carcinoma-evolving-mechanisms-of-hypercalcemia-and-targeted-therapies
#15
Cheng Cheng, Jose Kuzhively, Sanford Baim
Here we describe, to our knowledge, the first case where an evolution of mechanisms responsible for hypercalcemia occurred in undifferentiated thymic carcinoma and discuss specific management strategies for hypercalcemia of malignancy (HCM). Case Description. We report a 26-year-old male with newly diagnosed undifferentiated thymic carcinoma associated with HCM. Osteolytic metastasis-related hypercalcemia was presumed to be the etiology of hypercalcemia that responded to intravenous hydration and bisphosphonate therapy...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28163940/asymptomatic-congenital-hyperinsulinism-due-to-a-glucokinase-activating-mutation-treated-as-adrenal-insufficiency-for-twelve-years
#16
Kae Morishita, Chika Kyo, Takako Yonemoto, Rieko Kosugi, Tatsuo Ogawa, Tatsuhide Inoue
Congenital hyperinsulinism (CHI) caused by a glucokinase- (GCK-) activating mutation shows autosomal dominant inheritance, and its severity ranges from mild to severe. A 43-year-old female with asymptomatic hypoglycemia (47 mg/dL) was diagnosed as partial adrenal insufficiency and the administration of hydrocortisone (10 mg/day) was initiated. Twelve years later, her 8-month-old grandchild was diagnosed with CHI. Heterozygosity of exon 6 c.590T>C (p.M197T) was identified in a gene analysis of GCK, which was also detected in her son and herself...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28163939/isolated-liver-metastasis-in-h%C3%A3-rthle-cell-thyroid-cancer-treated-with-microwave-ablation
#17
Konstantinos Segkos, Carl Schmidt, Fadi Nabhan
Hürthle cell thyroid cancer (HCTC) is a less common form of differentiated thyroid cancer. It rarely metastasizes to the liver, and when it does, the metastasis is almost never isolated. Here we report a 62-year-old male with widely invasive Hürthle cell thyroid cancer, who underwent total thyroidectomy and received adjuvant treatment with I-131 with posttreatment scan showing no evidence of metastatic disease. His thyroglobulin however continued to rise after that and eventually an isolated liver metastasis was identified...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28133554/horner-syndrome-secondary-to-thyroid-surgery
#18
Meliha Demiral, Ciğdem Binay, Enver Simsek, Hüseyin Ilhan
Horner syndrome (HS), caused by an interruption in the oculosympathetic pathway, is characterised by myosis, ipsilateral blepharoptosis, enophthalmos, facial anhydrosis, and vascular dilation of the lateral part of the face. HS is a rare complication of thyroidectomy. A 15-year-old female patient presented with solitary solid and large nodule in the right thyroid lobe. Ultrasound-guided fine-needle aspiration was performed and the cytological examination results were undefined. The patient underwent a total thyroidectomy...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28127476/vasopressin-bolus-protocol-compared-to-desmopressin-ddavp-for-managing-acute-postoperative-central-diabetes-insipidus-and-hypovolemic-shock
#19
Anukrati Shukla, Syeda Alqadri, Ashley Ausmus, Robert Bell, Premkumar Nattanmai, Christopher R Newey
Introduction. Management of postoperative central diabetes insipidus (DI) can be challenging from changes in volume status and serum sodium levels. We report a case successfully using a dilute vasopressin bolus protocol in managing hypovolemic shock in acute, postoperative, central DI. Case Report. Patient presented after bifrontal decompressive craniotomy for severe traumatic brain injury. He developed increased urine output resulting in hypovolemia and hypernatremia. He was resuscitated with intravenous fluids including a dilute vasopressin bolus protocol...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28116181/artifactual-hypoglycaemia-in-systemic-sclerosis-and-raynaud-s-phenomenon-a-clinical-case-report-and-short-review
#20
R H Bishay, A Suryawanshi
Background. Artifactual hypoglycaemia, defined as a discrepancy between glucometer (capillary) and plasma glucose levels, may lead to overtreatment and costly investigations. It is not infrequently observed in patients with Raynaud's phenomenon due to vascular capillary distortion, yet this is clinically underappreciated. Case Report. We report a 76-year-old woman with systemic sclerosis and Raynaud's phenomenon, who presented with upper gastrointestinal bleeding and found to have concomitant persistent hypoglycaemia (1...
2016: Case Reports in Endocrinology
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