Current Issue : January - March Volume : 2020 Issue Number : 1 Articles : 5 Articles
Background: Thyroid alterations have adverse effects on other health systems\nin the body, and reproductive system is one of the most affected organs. Here,\nwe perform a comprehensive analysis on the effects of different thyroid abnormalities\non sexual and reproductive-related hormones in both men and\nwomen in different age groups. Method: A comprehensive analysis was performed\non 15,043 subjects within the reproductive age (15 - 49 years). They\nwere tested for thyroid markers (TSH, FT4, anti-TPO, anti-Tg) and 13 reproductive\nhormones in Vibrant America Clinical Laboratory between March\n2016 to July 2018. The alterations of each reproductive hormone in hypothyroidism,\nhyperthyroidism, anti-TPO+ anti-Tg+ groups were evaluated. Results:\nA total of 10,626 women was tested. Women with hypothyroidism had\nelevated cortisol and low SHBG and DHEA-S. Women with hyperthyroidism\nshowed elevated total testosterone and SHBG. Women seropositive for anti-\nTPO had elevated total testosterone and low cortisol. Women seropositive\nfor anti-Tg had low parathyroid hormones. Similarly, a total of 4417 men was\ntested. Men with hypothyroidism had low IGF-I. Similarly, men with hyperthyroidism\nhad low DHEA-S, but elevated estradiol, FSH, LH and prolactin.\nMen seropositive for anti-TPO had elevated SHBG and low progesterone.\nMen seropositive for anti-Tg had elevated progesterone. The reproductive\nand related hormone levels of age group 36 - 49 showed the most variations.\nConclusion: Our results clearly show that individuals with different thyroid\nalterations have different effects on reproductive health, especially in the age\ngroup 36 - 49. Hence, routine testing and follow-up checkups on reproductive\nsystem would be beneficial for individuals in the age group 36 - 49 with thyroid\ndisorders....
Methimazole is a thionamide drug that inhibits the synthesis of thyroid hormones by blocking the oxidation of iodine in the\nthyroid gland.We report a case of methimazole-induced recurrent pleural effusion. A 67-year-old female with recently diagnosed\nGravesâ?? disease on methimazole 20mg daily was admitted with dyspnea and new onset atrial fibrillation with rapid ventricular\nrate. Chest X-ray revealed a unilateral right pleural effusion, which was consistent with a transudate on thoracocentesis. She was\nmanaged as a case of congestive heart failure and methimazole dose was increased to 30 mg daily. She was readmitted twice with\nrecurrent right pleural effusion.Thefluid revealed an exudative process on repeat thoracocentesis.CT scan of the chestwith contrast\nshowed mediastinal lymphadenopathy and a diffuse ground glass process involving the right lower lobe suggestive of pneumonitis.\nBronchoalveolar lavage showed neutrophil predominant fluid, and cytology and adenosine deaminase were negative. Patient also\nhad an endobronchial ultrasound guided biopsy of the lymph nodes (EBUS). She was treated empirically with steroids 40 mg for\n10 days and themethimazole was also discontinued.The antinuclear antibodies (ANA) came back positive with a speckled pattern;\nantineutrophil cytoplasmic antibody (c-ANCA) and antimyeloperoxidase were also positive. The effusion resolved but recurred\non rechallenge with methimazole. She was referred for urgent thyroidectomy. The patientâ??s repeat chest X-ray showed complete\nresolution of the pleural effusion after stopping themethimazole. Fewweeks later, repeat ANCA and antimyeloperoxidase antibody\nwere both negative. Our case report highlights the importance of the recognition of a rare side effect of methimazole. Timely\ndiagnosis would ensure that appropriate treatment is given....
Introduction: The diabetes constitutes the factor risk of mycotic infections.\nThe pathogenic agents depend on the climate, geography and the migration.\nThe objective of this study is to evaluate the prevalence of the mycotic infections\nwithin the hospitalized diabetic patients, to describe their localization\nand identify the responsible germs. Patients and methods: It is about a descriptive\nand retrospective study conducted from November 2015 to March\n2016 in endocrinology office at CHU Ibn Roch of Casablanca. It was included\nall diabetic patients hospitalized with whom mycotic infection has been suspected.\nResults: In total 350 diabetic patients have been hospitalized during\nthe period of research. A mycotic infection has been suspected in 138 patients\ncorresponding to the prevalence of 39.4 percent. The means localizations of\nmycotic infections were feet (intertrigos: 38.4%), onychomycosis (29%), vulvovaginal\n(21.7%) and mouth (oral candidiasis: 13.3%). The most frequent\npathogenic agents were dermatophytes (Trichophyton rubrum: 61%, Trichophyton\nmentagrophytes : 6.3%) and Candida albicans (23.1%). The direct\ntest and the culture were negative in 7.3%. Conclusion: One-third of the\ndiabetic patients showed a mycotic infection. The feet, constitute the predilection\nlocalization of mycotic infections in the diabetic. The dermatophytes\nand Candida albicans constitute the most frequent pathogenic agents found\nin our study....
Background: In patients with diabetes mellitus, the urinary microalbumin-to-urine creatinine ratio (UACR) can not\nonly predict the occurrence of diabetic nephropathy but also can be a risk factor for cardiovascular disease and renal\nfunction damage. Current studies on subclinical hypothyroidism (SCH) and UACR are mainly cross-sectional studies, and\nthe results suggest that SCH is an independent risk factor for UACR. To further explore the longitudinal effect of SCH on\nUACR, we carried out this study.\nMethods: This was a retrospective cohort study including 46 patients with type 2 diabetes mellitus and SCH in the\nDepartment of Endocrinology, The Affiliated Huaiâ??an Hospital of Xuzhou Medical University from January 2013 to April\n2018. At the same time, 96 patients with type 2 diabetes mellitus and euthyroid were chosen according to 1:2\napproximately matched with age, sex and duration of diabetes mellitus. Univariate analysis, stratified analysis, and\nmultiple linear regression analysis were used to investigate the effect of SCH on DELTA UACR(DELTAUACR = UACR after 1 year -\nbaseline UACR) in patients with type 2 diabetes mellitus.\nResults: There was no significant difference between the baseline UACR, (p > 0.05). However, the DELTAUACR was significantly\nhigher in SCH group than euthyroid group, as shown by univariate analysis, stratified analysis and multiple linear regression\nanalysis (Beta:-1.071, 95% CI: - 1.713-0.428), and the difference was statistically significant (all p<0.05).\nConclusion: SCH is associated with an increased UACR in type 2 diabetes mellitus patients. It is necessary to screen for\nthyroid function in type 2 diabetes mellitus and increase the follow-up frequency of UACR in patients with SCH....
Background: The diagnosis of subacute thyroiditis (SAT) is based mainly on the presence of painful thyroid goitre\nand a significant increase in erythrocyte sedimentation rate (ESR). Proceeding according to these diagnostic criteria\nmay lead to an incorrect diagnosis and treatment. Extremely dangerous is the situation when the diagnosis of SAT\nis erroneously made based on criteria other than ultrasound (US) image and fine needle aspiration biopsy (FNAB),\nwhich leads to delayed diagnosis of malignant tumour with poor prognosis.\nCase presentation: Five patients with typical SAT symptoms are presented. In all of them, anaplastic thyroid cancer\nor metastatic thyroid tumours were finally diagnosed as the cause of the initial symptoms resembling SAT. Most of\nthe patients were initially misdiagnosed and the proper diagnosis of malignancy was delayed.\nConclusions: The authors have proposed the new diagnostic criteria for SAT, and strongly suggest that thyroid\ngland US should be included in the main criteria of SAT diagnosis, together with FNAB result excluding the presence\nof malignant tumour....
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