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Michiko Wada, Makoto Kita, Kaoru Kawasaki, Toru Kusakabe, Tetsuya Tagami, Noriko Satoh-Asahara, Akira Shimatsu, Koshi Hashimoto
Maternal Graves' disease (GD) during pregnancy may influence thyroid function in fetuses. Neonates born to mothers with high serum TSH receptor antibody (TRAb) levels have been reported to develop 'neonatal GD'. Therefore, evaluations of serum thyroid hormone and TRAb levels in neonates upon birth are crucial for a prompt diagnosis. At delivery, we measured TRAb with third-generation TRAb test using an M22 human monoclonal antibody in neonates by collecting umbilical cord blood in a blood collection tube with lithium-heparin, which provides a whole blood/plasma sample...
March 10, 2018: Endocrine Journal
Qiang Nai, Mohammad Ansari, Stella Pak, Yufei Tian, Mohammed Amzad-Hossain, Yanhong Zhang, Yali Lou, Shuvendu Sen, Mohammed Islam
Thyroid storm is a potentially fatal manifestation of thyrotoxicosis. Cardiopulmonary failure is the most common cause of death in thyroid storm. Clinicians should keep in mind that thyroid storm complicated with cardiopulmonary failure can be the first presentation of thyrotoxicosis. As early intervention is associated with improved patient outcome, prompt diagnosis based on clinical grounds is of paramount importance in the management of thyrotoxicosis. A high index of suspicion and the ability of early recognition of impending thyroid storm depends on a thorough knowledge of both the typical and atypical clinical features of this illness...
April 2018: Journal of Clinical Medicine Research
Ilias Attaye, Merel van Andel, Albertus Jozef Kooter
A 67-year-old Caucasian woman with no prior medical history was admitted to our hospital with complaints of generalised weakness, nausea, diarrhoea and weight loss. The patient suffered from tachycardia and hypotension. Blood tests revealed Graves' thyrotoxicosis and the patient was treated accordingly. However, patient's health continued to decline rapidly and further tests revealed a concomitant Addisonian crisis. Additional treatment with corticosteroids led to a full recovery. It is well known that autoimmune endocrine disorders tend to cluster...
March 5, 2018: BMJ Case Reports
Jade A U Tamatea, Marianne S Elston, John V Conaglen
BACKGROUND: As thyrotoxicosis is a risk factor for atrial fibrillation, current guidelines recommend measuring a thyroid-stimulating hormone level in patients with this disorder. Hyperthyroidism may also be associated with other heart diseases including cardiac ischaemia and cardiac failure. Currently, the prevalence of thyrotoxicosis in cardiac admissions in the absence of a rhythm disorder is unknown. AIMS: The aims of this study were: 1) to calculate the prevalence of admissions for thyrotoxicosis-associated cardiac disease, 2) determine the type of cardiac disease i...
November 21, 2017: Heart, Lung & Circulation
Kriti Joshi, Margaret Zacharin
BACKGROUND: Neonatal hyperthyroidism is rare, seen in infants of mothers with Graves' disease (GD), with transplacental transfer of thyroid-stimulating hormone receptor (TSHR) antibodies (TRAbs). We describe a neonate with severe hyperthyroidism due to TRAbs, born to a mother with autoimmune hypothyroidism. CASE PRESENTATION: A baby boy born preterm at 35 weeks had irritability, tachycardia and proptosis after birth. The mother had autoimmune hypothyroidism, from age 10, with thyroxine replacement and normal thyroid function throughout her pregnancy...
March 1, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
Yuanli Lei, Ming-Hua Zheng, Weijian Huang, Jie Zhang, Yingru Lu
RATIONALE: Circulatory failure, especially with low systemic vascular resistance (SVR), as observed in septic shock, thyrotoxicosis, and anemia, is a particular pattern that should suggest thiamine (vitamin B1) deficiency. The clinical picture of wet beriberi secondary to thiamine deficiency only demonstrates non-specific clinical manifestations. For a diagnosis of wet beriberi, medical history is very important. Interestingly, imprisonment was also found to be related to thiamine deficiency...
March 2018: Medicine (Baltimore)
Jorge I Conte, Marilyn A Arosemena, Kunal Kapoor, Naomi G Dempsey, Megan L Zaleski, Atil Y Kargi
Thyroid storm is the life-threatening end-organ manifestation of severe thyrotoxicosis. If left untreated, thyroid storm may cause acute heart failure, multiorgan dysfunction, and death. A high degree of suspicion is necessary to make the diagnosis and start antithyroid medications to decrease mortality. Thyroid storm is generally seen in patients with Graves' disease but should also be suspected in patients with fever, tachycardia, altered mental status, and risk factors including local trauma to the neck, such as strangulation...
2018: Case Reports in Endocrinology
Hiroyuki Ariyasu, Hidefumi Inaba, Takayuki Ota, Hiroyuki Yamaoka, Yasushi Furukawa, Hiroshi Iwakura, Naotaka Doi, Yuki Yamamoto, Takashi Akamizu
BACKGROUND: Immune-checkpoint inhibitors (ICIs) are novel promising agents for the treatment of malignant tumors. However, critical endocrine immune-related adverse events (irAEs) by ICIs often occur. CASE REPORT: A 63-year-old woman with advanced malignant melanoma had received anti-PD-1 antibody (nivolumab, 2 mg/kg every 3 weeks) for 8 cycles (from day 0 to day 147). On day 168, nivolumab was switched to anti-CTLA-4 antibody (ipilimumab, 3mg/kg every 3 weeks)...
March 2018: In Vivo
Abigail White, Sabin J Bozso, Michael C Moon
PURPOSE: Thyrotoxicosis-induced cardiomyopathy (TCM) is a rare, potentially life-threatening complication requiring extracorporeal membrane oxygenation (ECMO) for temporary mechanical support while a euthyroid state is being achieved. MATERIALS AND METHODS: The current review searched Ovid Medline and PubMed for all relevant studies reported in English from January 1, 1970 to December 31, 2017. We included studies where patients were diagnosed with thyrotoxicosis, eventually deteriorating into TCM, requiring veno-arterial ECMO...
February 3, 2018: Journal of Critical Care
Chamara Dalugama
BACKGROUND: Pyrexia of unknown origin is a difficult and challenging problem for the physician. Endocrine disorders, such as subacute thyroiditis, rarely present with pyrexia of unknown origin. Subacute thyroiditis can have a broad spectrum of clinical presentations including fever and biochemical thyrotoxicosis without overt signs or symptoms. CASE PRESENTATION: A previously healthy 42-year-old Sri Lankan Sinhalese man was extensively investigated for a prolonged fever of 3 weeks with high inflammatory markers...
February 23, 2018: Journal of Medical Case Reports
Jie-Eun Lee, Dong Hwa Lee, Tae Jung Oh, Kyoung Min Kim, Sung Hee Choi, Soo Lim, Young Joo Park, Do Joon Park, Hak Chul Jang, Jae Hoon Moon
BACKGROUND: Thyrotoxicosis is a common disease caused by an excess of thyroid hormones. The prevalence of thyrotoxicosis about 2% and 70-90% of thyrotoxicosis cases are caused by Graves' disease, an autoimmune disease, which has a high recurrence rate when treated with antithyroid drugs such as methimazole or propylthiouracil. The clinical symptoms and signs of thyrotoxicosis include palpitation, weight loss, restlessness, and difficulty sleeping. Although these clinical changes in thyrotoxicosis can be detected by currently available wearable activity trackers, there have been few trials of the clinical application of wearable devices in patients with thyrotoxicosis...
February 21, 2018: JMIR Research Protocols
Rohan K Henry, Monika Chaudhari
BACKGROUND: Amiodarone-induced thyrotoxicosis (AIT) type 2, characterized as a destructive thyroiditis, is well described in the medical literature; however, iodine-induced thyrotoxicosis (IIT) is not, though the latter has similar features and can be managed similarly. CASE PRESENTATION: We present a 17-year-old female who presented with a history of an intermittent goiter with thyroid function tests (TFTs): thyroid-stimulating hormone (TSH)<0.015 (0.4-4 μU/mL), free thyroxine (T4)≥6 (0...
February 21, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
Chiaki Kishida, Ryo Naito, Hiroki Kasuya, Tomohiro Kaneko, Kosuke Yabe, Midori Kakihara, Ryosuke Shimai, Hiroyuki Isogai, Dai Ozaki, Yuki Yasuda, Fuminori Odagiri, Tetsuro Miyazaki, Ken Yokoyama, Takashi Tokano, Hajime Koyano, Yuji Nakazato
A 35-year-old Japanese man was emergently admitted to our hospital with chief complaints of palpitation and dyspnea. He has been treated for Basedow's disease. He was diagnosed with acute decompensated heart failure, atrial fibrillation and thyrotoxicosis. We started anti-thyroid agents and a treatment for heart failure with beta blockers and diuretics under anti-coagulation therapy. His B-type natriuretic peptide levels remained high, although the heart failure had been compensated and the heart rate was well controlled while hyperthyroidism still existed...
February 9, 2018: Internal Medicine
Stephanie L Samuels, Sisi M Namoc, Andrew J Bauer
Neonatal thyrotoxicosis (hyperthyroidism) is less prevalent than congenital hypothyroidism; however, it can lead to significant morbidity and mortality if not promptly recognized and adequately treated. Most cases are transient, secondary to maternal autoimmune hyperthyroidism (Graves disease [GD]). This article summarizes recommendations for screening and management of hyperthyroidism in both the fetal and neonatal periods, with a focus on neonatal thyrotoxicosis secondary to maternal GD. Early monitoring and treatment are crucial for optimizing short-term and long-term patient outcomes...
March 2018: Clinics in Perinatology
Sucharita Ray, Deepti Vibha, Gauri Gupta, Kameshwar Prasad, Achal K Srivastava, Garima Shukla
No abstract text is available yet for this article.
November 27, 2017: Neuromuscular Disorders: NMD
Jing Yang, Shu Liu, Zhe Yang, Yin Bing Shi
RATIONALE: Ectopic thyrotropin (TSH)-secreting pituitary adenomas are exceedingly rare. To date, there are only 6 cases reported. Here, we describe an even rarer ectopic TSH-secreting pituitary adenoma (TSH-oma) concomitant with papillary thyroid carcinoma. PATIENT CONCERNS: A 27-year-old female was admitted to the hospital in 2002 for neck enlargement and palpitation. Thyroid function test showed increased thyroid hormones and unrepressed TSH. Thyroid ultrasound examination displayed diffuse goiter...
December 2017: Medicine (Baltimore)
Shigehiro Karashima, Toyonobu Tsuda, Yusuke Wakabayashi, Mitsuhiro Kometani, Masashi Demura, Taro Ichise, Masa-Aki Kawashiri, Yoshiyu Takeda, Kenshi Hayashi, Takashi Yoneda
A J wave is a common electrocardiographic finding in the general population. Individuals with prominent J waves in multiple electrocardiogram (ECG) leads have a higher risk of lethal arrhythmias than those with low-amplitude J waves. There are few reports about the relationship between thyroid function and J-wave amplitude. We report the case of a 45-year-old man who had unexpected ventricular fibrillation (VF). He had dynamic J-point elevation in multiple ECG leads. Possible early repolarization syndrome was diagnosed...
February 1, 2018: Journal of the Endocrine Society
Aiman K Al-Wahaibi, Santosh Kumar, Ali Al-Risi, Farook Wali
Acute polyneuropathy is a rare manifestation of severe hyperthyroidism. We report a 22-year-old Omani male who presented to the Sohar Hospital, Sohar, Oman, in 2016 with acute-onset rapidly progressive flaccid areflexic paraplegia as the presenting manifestation of thyrotoxicosis. Nerve conduction studies revealed mixed axonal and demyelinating polyneuropathy in both the motor and sensory nerves. Treatment of the hyperthyroidism with β-blockers and carbimazole along with physiotherapy resulted in the patient's full recovery and the alleviation of his symptoms...
November 2017: Sultan Qaboos University Medical Journal
Valeria Pastorino Casas, M Florencia Borghi Torzillo, Daniel Schere, Rubén J Lutfi, Eduardo N Faure
Hyperthyroidism is defined as an excessive production of thyroid hormones by eutopic or ectopic mature thyroid tissue. The overall prevalence of hyperthyroidism is 1.2% and the most common cause is Graves' disease. Struma ovarii represents 1% of all ovarian tumors and is an uncommon cause of ectopic hyperthyroidism. It is benign in >90% of the cases; usually asymptomatic, and only 8% are presented with thyrotoxicosis, being rare its association with Graves' disease. We report the case of a patient with this association...
2018: Medicina
Myrthe Marguerite van Dijk, Iris Smits, Eric Fliers, Peter H Bisschop
BACKGROUND: In pregnant women with Graves' disease, maternal thyrotropin receptor antibodies (TRAb) can cross the placenta and induce fetal or neonatal thyrotoxicosis. Symptoms of fetal thyrotoxicosis are tachycardia, intrauterine growth restriction and intra-uterine death. Recommendations on an upper limit of TRAb concentrations below which intensive fetal monitoring can be safely omitted vary between different guidelines. The objective of this study was to define an evidence-based cut-off level for maternal TRAb necessitating additional fetal monitoring during pregnancy...
January 12, 2018: Thyroid: Official Journal of the American Thyroid Association
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