Endocrine Abstracts

Introduction: The testicular disorder of sexual differentiation (DSD) is a rare clinical condition with a reported incidence of 1:20 000 newborn males. It is characterised by a male phenotype with 46,XX karyotype. There are three clinical phenotypes: normal male phenotype, males with genital ambiguities and males who are true hermaphrodites. SRY positive 46,XX testicular DSD results from the translocation of a Y chromosome segment containing the SRY gene during spermatogenesis...

Introduction: Diabetic gastroparesis (DGP) is defined by delayed gastric emptying in the absence of mechanical obstruction caused by autonomic neuropathy. Only 5% of type 1 and 1% of type 2 diabetic patients combine the delay of gastric emptying with typical gastroparesis symptoms. This entity is usually identified in patients with least 10 years of diabetes evolution and is presented typically in the 4th to 5th decades of life in type 1 diabetes mellitus (T1DM). It is associa...

Introduction: Generalized lipodystrophies are rare disorders characterized by almost total loss of adipose tissue, and they are often accompanied by metabolic complications such as severe insulin resistance, diabetes mellitus, hypertriglyceridemia, and fatty liver.Case report: We diagnosed a 17-year-old woman whose subcutaneous adipose tissue began to decrease in her late elementary school days with the acquired and generalized types of idiopathic lipoat...

Introduction: The most common cause for persistent elevation of TSH levels in hypothyroid patients treated with levothyroxine is poor compliance. The levothyroxine absorption test (LAT) is usually confirmed this phenomenon called “pseudo-malabsorption”.Case report: Sixty-year-old female, weight 60 kg, BMI 24.3 kg/m2, presented with sleepiness, tiredness, fatigue and forgetfulness. Her skin was very dry and flaky. She had low toleranc...

Introduction: Bone densitometry is currently one of the mainstays in the evaluation of systemic bone diseases. The most frequently assessed densitometric parameter is areal bone mineral density (BMD), measured by dual energy X-ray absorptiometry (DEXA) and expressed as g/cm2. However BMD is a bone size-dependent measure and may be found inappropriately low in children and adults with short stature. Osteopenia/osteoporosis have been described in patients with short s...

Context: Lipodystrophy is characterized by subcutaneous fat loss, fat maldistribution, and metabolic syndrome. We present a novel phenotype of partial acquired lipodystrophy, possibly associated with childhood chemotherapy.Case reports: Two adult female patients that had been exposed to intensive cytostatic treatment in childhood for leukemia and aplastic anemia, respectively, were referred for therapy resistant diabetes. Both patients had distinct parti...

Pseudohypoaldosteronism is one of the least explored questions in clinical endocrinology. That leads to complexity in diagnosis and differential diagnostics of disease. A boy, aged 13 days was admitted to the hospital with complains: vomiting, low weight gain, constipation. Biochemical blood assay (BBA) and acid-base balance of blood: level of sodium −127 mmol/l (N 132 – 145 mmol/l), potassium −6.6 mmol/l (N 3.1 – 5.1 mmol/l), chlorine &...

Introdution: Erdheim-Chester disease is a rare multisystemic form of Non-langerhans cell histiocytosis CD67 positive, with approximately 550 published cases. Papillary carcinoma is the most common thyroid cancer with BRAF V600E the most common mutation. Both diseases may be associated to BRAF V600E mutation. If Erdheim- Chester disease is positive to this mutation on histiocytes, a specific pharmacolgical treatment is available, (vemurafenib), with better results.<p class=...

Introduction: Immunoglobulin-G4-related disease (IgG4RD) is a multidisciplinary problem due to plasmatic cells infiltration and areas of fibrosis in the affected tissues. In IgG4RD, elevation of serum IgG4 immunoglobulins is present. Clinically, the disease is mainly manifested as: autoimmune pancreatitis, salivary gland involvement, sclerosing cholangitis, lymphadenopathy, lachrymal gland enlargement, retroperitoneal fibrosis or orbital pseudotumor. The simultaneous involveme...

Introduction: The Disorders of Sex Development (DSDs) may arise from various genetic disorders therefore cytogenetic studies are necessary to determine the chromosomal sex. The 45,X/46,XY karyotype is considered a mixed gonadal dysgenesis (MGD) and the mosaicism in this condition has a low incidence: 1.5 per 10 000 newborns, characterized by a broad phenotypic spectrum.Objective: The aim of this report is to present a mexican newborn female patient with ...

A rare ovarian teratoma consisting mainly of thyroid tissue, Struma ovarii accounts for up to 3% of all ovarian tumors. The thyroid tissue may demonstrate the same spectrum of pathological features as in the normal thyroid including benign and malignant changes.A 46-year-old woman was referred to our clinic in July 2015 by the oncologist, with the diagnosis of struma ovarii with carcinomatous transformation (follicular variant of papillary carcinoma).</p...

Introduction: Glutamic acid decarboxylase (GAD65) is expressed by pancreatic beta cells and also by GABA (gamma-aminobutyric acid)-secreting neurons. Cerebellar ataxia associated with anti-GAD65 antibodies (antiGAD Ab) is a rare neurological disorder that frequently coexists with other autoimmune conditions, namely Diabetes Mellitus (DM).Case reports: We describe two cases of ataxia associated with antiGAD Ab. The first case is a 69-year-old obe...

A 34-year-old refugee from Somalia was referred because of a suspected DSD. Due to ambiguous, but predominantly female external genitalia at birth he was raised as a girl, whereas his subjective gender identity has always been male. Puberty led to a significant virilization of the body but only to a very limited virilization of the external genitalia. The patient presented himself with an undoubtedly male-type body composition. External genitalia were now predominantly male wi...

Introduction: Calcium metabolism during pregnancy changes significantly but ionized calcium level remains normal. During pregnancy, there is two-fold increase in intestinal calcium absorption mediated by increase in 1,25-dihydroxyvitamin D. Hypercalcemia in pregnancy is uncommon and most reported cases are primary hyperparathyroidism.Case report: A 18-year-old 10 weeks’ pregnant African American female presented to hospital with epigastric pain, nau...

Background: Werner syndrome is a rare autosomal recessive disease caused by a mutation of the DNA helicase gene (WRN), characterized by the premature onset of multiple age-related disorders.Objective: To describe unusual multiple endocrine and metabolic disorders in three unrelated clinical cases of Werner syndrome.Methods: Three patients with obvious clinical features of premature ageing were referred to an endocrinologist due to ...

Introduction: Parathyroid adenomas are rarely large in size. Here, we present a giant cystic parathyroid adenoma presented with pancytopenia.Case report: Twenty two years old female presented with fatigue, bone pain, polyuria, a lump in the neck and pancytopenia. She had a pulsatile mass on the right side of the neck which compressed her trachea. She was evaluated by Hematology since her Hb was 4.7 g/dl, WBC was 2200 u/l platelet count was: 69 000 u/l. B...

Parathyromatosis, a rare cause of recurrent hyperparathyroidism, consists of ectopic hyper-functioning parathyroid tissues scattered throughout neck. Two forms of parathyromatosis have been reported, type-1 due to hyperplasia of parathyroid rests from embryologic development and type-2 occurs due to spillage, seeding of parathyroid tissue during parathyroid surgery. Repeated surgery often is necessary. Preoperative diagnosis is rarely made, may be due to lack of awareness of e...

Introduction: Type 1a Diabetes (DM1) is a challenging disease with a rising incidence (up to 40 per 100 000 in Finland and Sardinia) being less common in the African population. It is believed to have an autoimmune basis and has been associated with other autoimmune diseases namely autoimmune thyroiditis and celiac disease. Acquired hemophilia is a rare clinical entity characterized by bleeding diathesis induced by circulating inhibitors to coagulation factors (VIII ou IX) tha...

Introduction: Acute pancreatitis induced by hypertriglyceridemia is a severe condition and its management is complicated.Case report: We present a case of severe acute pancreatitis induced by hypertriglyceridemia secondary to lipoprotein lipase -LPL- deficiency (188 Gly-Glu mutation, LPL undetectable activity) in a pregnant patient with gestational diabetes.The patient was sent to our Lipid Unit in the 13th gestation’ week. Th...

Stiff person syndrome (SPS) is a rare disease characterized by progressive muscle rigidity and spasms, which can lead to functional disability. This condition can be challenging to diagnose if there is no high index of suspicion. Its etiology is unknown, but one of the most likely causes is autoimmune aggression, which is corroborated by that fact that it is associated with other autoimmune diseases in half of the cases described in literature.We will pr...

Introduction: The prevalence of autoimmune thyroid diseases in patients with type 1 diabetes mellitus (T1DM) is high. Thyroid hormones have a pronounced effect on the regulation of glucose homeostasis. We report patient with well controlled T1DM and good compliance, presented with severe diabetic ketoacidosis (DKA) due to thyrotoxicosis.Case report: A 15-year-old girl with well-controlled T1DM for 5 years (HbA1c<8%) had no tissue complications of dia...

Introduction: Dermoid cysts are usually presented as solitary hamartomatous tumor, containing all skin adnexa. They can be found in the skin and subcutis of the face and neck; or can be intracranial, intraspinal, or intra-abdominal, localized in the ovary or omentum. Cutaneous cysts most commonly appear on the forehead, around eyes, as well as on the floor of the mouth, rarely on the neck.Case report: We present a 24-year-old female patient with a dermoi...

Introduction: Polycystic ovarian syndrome (PCOS) is a common cause of hyperandrogenism in women of reproductive age but rarely causes very high testosterone levels and frank virilisation which is associated with ovarian or adrenal tumours. We present a rare case of progressively increasing testosterone levels causing virilisation from a histologically confirmed right polycystic ovary. Complete cure was achieved by right salpingo-oophrectomy.Case: A 32 ye...

Acute intermittent porphyria (AIP) is an uncommon monogenic autosomal dominant disorder with a defect in the haem biosynthesis pathway at the level of the enzyme porphobilinogen deaminase. The disease has low penetrance; most patients could stay asymptomatic throughout life. Clinical manifestation depends on various precipitants, which increase hepatic haem production and cytochrome activity. We report a case of a female patient who had regular moderate-to-severe cyclic AIP at...

Introduction: In addition to the medication prescribed by their doctors, patients may recourse to natural medicine and take herbal medications without thinking about their potential side effects and interactions with other drugs.Case Report: A 39-year-old female, with personal history of iron deficiency anemia, regular menses but long-standing dysmenorrhea and polymenorrhea and reactive anxiety-depressive disorder, complained of frequent intermenstrual s...

Introduction: An 80-year old female with known osteoporosis was reassessed for BMD measurement. Her baseline BMD and T-score of lumbar spine (L1–L4) measured in 2004 were 0.699 g/cm2, −3.5 S.D., T-score of total left hip was 0.618 g/cm2, −2.7 S.D.. She was treated with alendronate 70 mg, cholecalciferol 7000 IE per week and calcium supplements.Case report: At follow-up...

Introduction: Struma ovarii (SO) is a specialized monodermal teratoma predominantly composed of mature thyroid tissue (>50%). It accounts for ~5% of all ovarian teratomas. Thyrotoxicosis is seen in about 8% of patients with SO. Most struma ovarii are benign with only 5–10% being malignant. Malignant SO causing thyrotoxicosis is very uncommon.Case presentation: A 64-year-old woman had been diagnosed with thyrotoxicosis 2 years ago. The thyroid gl...

Introduction: Langerhans cell histiocytosis (LCH) is a rare sporadic disease characterized by histiocytic neoplastic infiltration of various organ systems and a wide spectrum of clinical manifestations, ranging from benign and self-limiting to lethal.Case report: We report a rare case of adult onset multi-systemic LCH in a 36-year-old male patient with an initial perianal presentation and incidental finding of subsequent thyroid gland involvement in the ...

Introduction: Type 2 amiodarone-induced thyrotoxicosis (AIT2), resulting from the release of thyroid hormones, is a rarer form of side effect of this drug. Treatment of thyrotoxicosis in patients with end stage renal disease (ESRD) is difficult because hemodialysis alters renal clearance of drugs and iodine, may impact the results of assessment and treatment and can increase the medical instability of patients.Aim: The aim was to present the difficulties...

Radioactive iodine (RAI) treatment has been used in the treatment of differentiated thyroid cancer (DTC) since 1946. RAI treatment is recently used as adjuvant treatment for ablation of residual tissue following thyroidectomy and in the treatment of metastases of thyroid cancer. Some acute (nausea, vomiting, ageusia, salivary gland swelling and pain) and long-term side effects (sialadenitis, pulmonary fibrosis, second primary malignancies) may be observed following RAI treatme...

A lactating 31-year-old woman who developed L5 vertebral compression fracture 2 months after the delivery of her first child is presented. Serum concentrations of Ca was 10.24 mg/dl (8.6–10.2 mg/dl), phosphorus was 4.1 mg/dl (2.7–4.5 mg/dl), albumin was 4.6 mg/dl, ALP was 210 U/l (35–105 U/l), PTH was 13.8 pg/ml (15–65). There was axial osteoporosis, as assessed by dual-energy X-ray absorptiometry. Z score; L1 (−3), L2 (−3.8), L3 (&#872...

Gout is an arthritis characterized by the deposition of monosodium urate cyristales in the joints because of chronic hyperuricemia. Infections, intravenous contrast materials, acidosis, trauma, surgical interventions can be counted as common causes of acute gout attack. The aim of this study was to present postoperative gout attack at a patient with parathyroidectomy.Case: Sixty five year old man presented with back pain and fatique was admitted to our e...

Introduction: Androgen excess in women usually is presented as hirsutism and alopecia. Androgens could be expressed from adrenal or ovarian origin.Case reports: Female, 57 years (yrs) old, presented with hirsutism (Ferriman Galwey score, FGS 18), weight gain, type 2 diabetes mellitus (DM2), hypertension, hyperlipidemia and obesity (BMI 38.5 kg/m2). Diagnostic evaluation revealed normal prolactin, SHBG, DHEAS, IGF-1, ACTH, TSH, serum cortisol i...

Introduction: Pretibial myxedema (PM) is a rare extrathyroidal manifestation of Graves’ disease, with most patients being in hyperthyroid state. PM has also rarely been described in Hashimoto thyroiditis.Case report: A 61-year old Caucasian woman attended our outpatient dermatology clinic for evaluation and management of bilateral erythema, involving the lower two-thirds of the pretibial regions. She reported appearance of the same lesion 11 years a...

Introduction: Radioiodine whole-body scintigraphy (WBS) has been widely used for detection of differentiated thyroid cancer (DTC), based on the marked storage of iodine in functioning thyroid tissue. However, radioiodine uptake is not specific for thyroid gland. Iodine accumulation in lactating breast has been demonstrated, but it is rare in nonlactating breast.Case report: A 74-year-old-woman who underwent near-total thyroidectomy in 1988 due to a multi...

Lenalidomide a thalidomide derivative has immunomodulatory, antiangiogenic and anticancer properties.Lenalidomide has significantly improved survival in myeloma although toxicity,side effects do occur.We report a case of thyroiditis with hyperthyroidism in a patient receiving lenalidomide in treatment for Anaplastic multiple myeloma.Case Presentation: Sixty four year old female with anaplastic multiple myeloma but...

A 60-year-old lady was referred with male pattern hair loss and facial hirsutism of 5–7 years duration. She was otherwise well and had two children in their 30s. She was not taking any medication and reported a normal menstrual cycle prior to menopause at the age of 50.Her androgen profile showed a high testosterone level of 6.1 nmol/l (range <2.5), androstenedione 3.8 nmol/l (0.7–3.8), DHEAS 5.7 μm/l (0.80–4.9), SHBG 33 nmol/l, F...

Introduction: Ectopic thyroid tissue can be found anywhere along the normal path of thyroid descent, but is most commonly found at the base of the tongue, in which case it may be referred to as a lingual thyroid. Although the patients are usually asymptomatic, it can lead to symptoms such as dysphonia and dysphagia. We present a child patient with a lingual thyroid resulting in severe dysphagia that was cured surgically.Case reports: An 4-year-old male c...

Introduction: Endocrinopathies are a common late effect of haematopietic stem cell transplantation, resulting in thyroid dysfunction, impaired growth and pubertal development during childhood and metabolic syndrome. Because of the possible endocrine complications, transplanted patients need life-long endocrine follow-up.Case report: A 14-year-old male patient with a history of Fanconi anemia (7 years), bone marrow transplant (10 years) and Graves Disease...

Introduction: Ectopic and atypically localized parathyroid adenomas such as in the anterior mediastinum, paraesophageal or retrotracheal position, although rare, can be seen in clinical practice. Ultrasound (US) which is a frequently used and one of the best conventional imaging modality sometimes fails to identify the lesion especially in atypically localized adenomas. Endoscopic US (EUS) is a new technique that can be used for localization of parathyroid lesions. We reported...

Introduction: Parathyroid lipoadenoma (PLA) is a rarely seen, benign variant of parathyroid adenoma (PA). However, PA usually consists of uniform, polygonal chief cells with a few nests of oxyphil cells, PLA consists of similar histologic features, but with an abundance of fat cells. Additionally, PLA may be functional with the secretion of parathyroid hormone (PTH) or non-functional. Here, we present a case of atypical PLA presented with severe hypercalcemia and skeletal defo...

Anaplastic thyroid carcinoma (ATC) is the most aggressive and lethal thyroid malignancy. The median survival time following diagnosis is typically 6 months or less. β2 microglobulin (β2-MG) is a component of MHC class I molecules, which exists in all nucleated cells except red blood cells and placental trophoblast cells. Levels of beta-2 microglobulin can be elevated in multiple myeloma, lymphoma and amyloidosis. In few studies on anaplastic thyroid cancer, β2-M...

Introduction: Co-morbidity of DM t 2 and insulinoma is extremely rare. There are only some case reports of diagnosing insulinoma but they concern patients already diagnosed with DM t. 2. We present patient diagnosed at the same time with DM t. 2 and insulinoma.Case report: A 69-year-old female patient was admitted to hospital because of high blood pressure. Since 2 years she reported attacks of weakness, tachycardia and sweating within the day, usually s...

Introduction: Family hypobetalipoproteinemia (HBF) is a rare genetic disorder, in 50% of cases are due to mutations APOB gene, which leads to decreased values of total cholesterol, low density lipoprotein (LDL-cholesterol) and apo-B. It is inherited as an autosomal dominant and heterozygous carriers are usually asymptomatic.Clinical case: Thirty-two-year-old male with abdominal pain and diarrhea associated with food, no relevant history and physical exam...

Introduction: Cornelia de Lange Syndrome (CDLS) a relatively uncommon genetic disorder diagnosed mainly by clinical features: distinctive facial features, developmental delay, hirsutism, mental retardation and structural abnormalities. Most cases are due to spontaneous mutations (NIPBL on chromosome 5, SMC1A on X chromosome, and SMC3 on chromosome 10). Short stature in CDLS is due to GH deficiency and resistance.Case report: We present a 9-year-old girl,...

Introduction: Pancreatitis due to hypercalcemia from primary hyperparathyroidism is rare with an incidence of 1–1.5%. We report on a case of recurrent pancreatitis secondary to an ectopic parathyroid adenoma with co-existing severe vitamin D deficiency with its management difficulties.Case report: A 45-year-old male admitted to the hospital with abdominal pain and attendant nausea had investigations ruling out structural lesions for his symptoms but...

Insulinoma is generally a rare benign tumor of the pancreas islet cell. The typical clinical symptom of insulinoma are repetitive hypoglycemia attacks. Insulinoma with coexisting diabetes is extremely rare condition, We aim to present a case with insulinoma conmomittant with type 2 diabetes mellitus.Case report: A 65-year-old woman diagnosed with type 2 diabetes mellitus was admitted by our internal medicine clinic. She complained from perspiration and t...

Introduction: Horner’s syndrome represents a clinical symptom that may result from a variety of lesions both in the central and peripheral nervous system. It is a combination of ipsilateral ptosis, pupillary miosis and anisocoria, enophthalmos and facial anhydrosis induced by disruption of the sympathetic innervation of the eye anywhere along its three-neuron trail. Tumors are the most frequent causes of Horner’s syndrome.Aim: Aim of the study ...

Background: Parathyroid adenomas represent the most common anatomoclinical variety of hyperparathyroidism.Material and method: From our experience of 84 cases of hyperparathyroidism – 20 primary and 64 ‘renal’ (CKD-MBD) – 18 patients underwent surgery for solitary adenomas of these glands. Clinical data, laboratory and imaging test results, surgical procedures and outcome were comprehensively analysed.Results: W...

Introduction: Pats with Klinefelter Syndrome (KS) have elevated morbidity and mortality due to several reasons. Yet, there is no connection between KS and male-to-female sex change.Case: A 74-year-old man was sent for endocrine work-up prior to surgery due to gynecomastia. The patient had lived as a man-to-woman transgender for many years. He was told not to qualify for a transgender surgical approach when he was 55 years old. He took estradiol substitut...

Introduction: Autoimmune polyglandular syndrome type 2 (APS2) is the most common form of the polyglandular failure syndromes. Seventy-five percent of cases occur in women. Adrenal insufficiency is the principal manifestation occurs with autoimmune thyroid disease or type I diabetes mellitus. The incidence of autoimmune thyroid diseases in APS2 is 70%; 30% Hashimoto’s thyroiditis, 20% non toxic goiter, 20% hypertyroidism is seen. We will discuss about a patient with APS2, ...

Introduction: Primary hyperparathyroidism (pHPT) during pregnancy is rare and associated with increased morbidity for both mother and fetus. Maternal complications of pHPT include nepfhrolithiasis, pancreatitis, cardiac arrhytmias, hypertension, nausea and vomiting. pHPT is caused by a solitary adenoma in 85–90% of patients, and the curative treatment is parathyroidectomy. Here, we presented two women who have diagnosed pHPT and operated without complications in pregnancy...

Introduction: The calcific uremic arteriolopathy (CUA) is one of the several types of extra-osseous calcification that may occur in patients with end-stage renal disease (ESRD). CUA is a serious disorder characterized by calcification of the arterioles that leads to ischemia and subcutaneous necrosis. The pathogenesis is poorly understood, and the optimal treatment is not known.Case report: We present the case of a 64-year-old female with ESRD on hemodia...

Introduction: Brown tumor is a rare benign bone lesion with incidence ranging from 1.5% in primary hyperparathyroidism to 13% in secondary hyperparathyroidism. Common sites of involvement are pelvis, femur and ribs, but may appear in any bone. Since the incidence of thyroid disease is higher among patients with hyperparathyroidism than the general population, these lesions must be distinguished from metastases from thyroid carcinoma.We present a patient ...

Objective: To report a case of thalassemia major diagnosed per chance when investigated for undetectable HbA1C.Clinical Presentation: A 2-year-old male patient presented with fever since 3 days and moderate pallor. His blood was sent to Biochemistry laboratory for the estimation of HbA1C. Later on it was found that there was no indication for this test in this case. When assayed, his haemoglobin (Hb)A1C was not detectable on a BioRad D10 HPLC ...

Background: Tuberculous (TB) lymphadenitis can mimic cervical node metastasis from papillary thyroid carcinoma (PTC) since the distribution and appearance of affected lymph nodes is similar.Case: A 50-year-old Filipino presented with a gradually-enlarging anterior neck mass, with a solitary lymph node palpated at the left cervical area. The rest of the history, physical examination and blood workup were unremarkable. A thyroid ultrasound showed a 6.5&#21...

Introduction: Hypertriglyceridemia is rare but associated cause of pancreatitis and accounts for 10% of cases. Hypertriglyceridemia induced pancreatitis may occur secondary to causes such as diabetes, pregnancy, hypothyroidism and obesity. Management of hypertriglyceridemia includes a change in dietary intake as well as lipid lowering agents, fenofibrates, statins and omega 3 fatty acids. To reduce the triglycerides acutely, intravenous heparin and insulin have been used. In t...

Case 1: 78-years-old female with progressive increase volume in cervical area with dysphagia, drowsiness, slowness, dispnea, and change in of voice. Hypothyroidism and a TPO >1000 UI/ml. Thyroid ultrasound: heterogeneous mass in the left lobe, vascularized with ipsilateral multiple lymph nodes of 0.8×0.6 cm. PAAF: Bethesda 1. Four weeks later course with major obstruction of the upper airway. In ER a near-total thyroidectomy is performed. Postoperatory without complic...

Introduction: The hyperthyroidism is a risk factor for tachyarrhythmia and dilated cardiomyopathy. Amiodarone is an effective antiarrhythmic medication, however if coexisting thyroid pathology complicates the treatment of thyroid dysfunction. It presents a case of Graves’ disease (GD) of long evolution, which illustrates the complexity of these associations. Clinical case: man, 44 years old, smoker, history of acute myocardial infarction and GD diagnosed at age 28. Has ma...

Introduction: Despite the fact that Graves’ disease (GD) almost always presents as a diffuse hyperfunctioning goiter involving both lobes of the thyroid gland, it may rarely reveal at only unilateral lobe with bilobar thyroid gland. We herein present a case of unilateral GD involving the right thyroid lobe of a bilobar gland.Case report: A 42-year-old woman presented with symptoms and signs of hyperthyroidism; thyrotropin (TSH) was undetectable, whi...

Introduction: Type 1 diabetes mellitus (T1DM) is the most common form of diabetes in children and young adults. Though T1DM often presents in an acute manner, it may be preceded by a prodromal period, often extending over years.Case report: A 19-year-old male, diagnosed with T1DM at the age of 15, with no insulin treatment, was admitted to our department for high glycemic value (G) of 365 mg/dl on a routine exam at his GP. At diagnosis the patient was as...

Background: While psychiatric disturbances are well-documented manifestations of hypothyroidism, initiation of levothyroxine (LT4) therapy can also present in a similar manner.Case: A 34-year-old Filipino with Hashimoto’s thyroiditis consulted for signs and symptoms of hypothyroidism. Thyroid function tests were severely deranged, and an electrocardiogram revealed high grade atrioventricular block. Twenty-four hours after a full replaceme...

Introduction: Thyroid disorders are common within the elderly population and are particularly challenging to diagnose and treat due to the presence of a wide variety of comorbidities. Graves’ ophtalmopathy remains a therapeutic predicament despite all progress made in understanding its pathogenesis, especially in the elderly population with severe presentation.Case presentation: We present the case of a 71-years-old female patient who was admitted i...

Aplastic anemia is an idiopathic/idiosyncratic or hereditary bone marrow failure characterized by hypocellular bone marrow and pancytopenia without abnormal infiltration and increase in reticulin fibers. Papillary thyroid cancer (PTC) constitutes 85% of all differentiated thyroid cancers. There is no data on the application of radioactive iodine treatment for the treatment of high-risk differentiated thyroid carcinoma detected in the subjects with aplastic anemia.<p class=...

We present two case reports of patients who were diagnosed with hyperparathyroidism based on a parathyroid gland adenoma (PTA). The pathological parathyroid tissue was precisely localised by ultrasonography and scintigraphy before the surgery. In both cases all four parathyroid glands were revised by the surgeon resulting in an operation extension. Another parathyroid gland was removed and histologically confirmed as PTA. This surgeon’s approach was beneficial for the pat...

Introduction: Hypothyroidism is a rare cause of early puberty in childhood. It reduces the growth rate by decreasing the amplitude of GH pulses. We report the case of a child who developed precocious puberty and reduced speed consequent to hypothyroidism growth. The treatment of thyroid disease with levothyroxine led to regression of pubertal development and resumption of growth.Methods: A.J.S., female, 1 year and 5 months of age at first consultation. S...

Introduction: Hypoglucemia is one of the most common endocrine symptoms and supposes a challenging in endocrine clinical practise. In most cases, are produced in relation with diabetes (drugs and diet). In other cases, there was an endogenous insulin production which cause the symptoms.Clinical report: A 58-year-old was attended in the Emergency Department with episodes of lightheadedness, diaphoresis, palpitation, tremulousness for month duration. In th...

Introduction: Hyperthyroidism during pregnancy is a rare condition and occurs in 0.1–0.4% of all pregnancies. Graves’ Disease and transient gestational thyrotoxicosis constitute the majority of emerging thyrotoxicosis during pregnancy. Subacute thyroiditis (SAT) may also cause temporary hyperthyroidism.Case report: A thirty-three-year-old, 13-week pregnant patients was admitted with fatigue, pain and swelling in thyroid lodge. Thyroid function ...

Anaplastic thyroid carcinoma (ATC) is one of the most aggressive and lethal human malignancies. The median survival time following diagnosis is typically 6 months or less. Spontaneous thyroid haemorrhage may occur following an increase in venous pressure after Valsalva manoeuvre, hemodialysis session along with the use of heparin, trauma and in the patients with hypertension, especially in those with coagulopathy. Intrathyroidal hemorrhage may develop from a previous silent le...

Aim: To present a patient with all manifestations of long-term unsubstituted hypothyroidism-from alopecia to myxedema megacolon.Case: Sixty-one-old year women was admitted in ICU due to disturbance of consciousness, respiratory failure and electrolyte imbalance. Sopor, expressed alopecia, dry, flaky, pail skin, generalized edema, lung stasis and pericardial friction. A laboratory parameters pointed to the presence of normocytic normochromic anemia, hypon...

Case: A 34-year-old, Saudi male, known case of hypothyroidism with coarse (potato) voice, referred for isotopic thyroid scan. After withdrawing the Eltroxin for one month, thyroid scan was done and showed abnormal uptake rounded in shape and appears bi-lobar, seen highly in the neck, at the midline, between both submandibular glands. No evidence of any uptake at the normal anatomical position of the thyroid gland. Ultrasound of the neck was done and showed large submental mass...