Endocrine Abstracts

Silent thyroiditis is characterized by the destructive thyroid inflammation and is considered to be a chronic autoimmune thyroid disease, although the etiology could not have been fully explained. On the other hand, Graves’ disease is autoimmune phenomena as well as silent thyroiditis and silent thyroiditis has been classified as part of the spectrum of Graves’ disease. Although, the thyroid stimulating antibody (TSAb) are found positive in most of Graves’ disea...

Introduction: Amyloidosis refers to a variety of conditions in which amyloid proteins are abnormally deposited in organs and/or tissues. Clinically significant enlargement of the thyroid owing to amyloid deposition is a rare occurrence.Case report: 58-year-old female referred to endocrinology clinic presenting with increasing dyspnea, dysphagia and visible swelling at the base of the neck for the last 6 months. She had been diagnosed with rheumatoid arth...

Graves’ disease (GD) is a common cause of hyperthyroidism. Associated hematological complications rarely occur. Most review articles describe it as a rare manifestation and often reported as isolated cases or series. These disorders in hyperthyroidism may stem from the primary thyroid pathology or its treatment. In untreated primary hyperthyroidism, effects on hematological parameters range from mild single lineage involvement to pancytopenia. The most feared treatment re...

Macro TSH is a large molecular-sized thyroid-stimulating hormone (TSH) that is including TSH and anti-TSH antibody. Patients with macro TSH have elevated serum TSH and normal free thyroxine levels similar to subclinical hypothyroidism. A 18-year old female patient was referred from gynecology and obstetrics to endocrinology clinic for evaluating of elevated TSH with normal free thyroxine levels. Laboratory and clinical investigations revealed that only discordant TSH levels (n...

Thyrotoxic crisis is a manifestation of an extreme and rare state of thyrotoxicosis. It is an acute, life-threatening state. The mortality of thyrotoxic crisis is currently reported at 8–25% [1]. The clinical presentation includes fever, tachycardia, hypertension followed by congestive heart failure, neurological and mental disorders. We present a case of 34-year-old woman without any history of thyroid hyperactivity. She was admitted to hospital after premature amniotic ...

Introduction: It is known that hypothyroidism has multiple etiologies including tyrosinkinase inhibitors (TKI) agents which can cause thyroid disfunction through different mecanisms, not fully defined yet- Vascular endothelial growth factor receptor (VEGFR) blockade, thyroiditis, iodine uptake blockade, increased activity of deiodinase 3, increased hormone clearance. Some recent trials suggest that there is a correlation between the incidence of hypothyroidism and the outcome ...

Tuberculosis (TB) infection incidence is still high among solid organ transplant recipients. TB in recipients can manifest several years after transplantation, especially in developing countries. Atypical clinical presentations and extrapulmonary involvement are not uncommon in recipients. Herein, we reported a kidney transplant recipient with TB abscess who admitted with fever and swelling on thyroid gland region.Case: A 57-year old female recipient und...

Introduction: Graves’ disease (GD) is associated with cardiac complications like tachydysrythmias, coronary ischaemia and cardiomyopathy. They are uncommon in the young. We present three individuals without previous cardiac disease, who developed significant cardiac complications of GD.Case presentations Subject 1: A 34-year-old female smoker, presented with breathlessness, palpitations, tremors and agitation for several weeks. Her fT4 was ...

Introduction: Rituximab is indicated in patients with active rheumatoid arthritis (RA), which through the Fab domain, binds to the CD20 antigen on the surface of B lymphocytes, generating lysis of B cells, present in the thyroid, by cytotoxicity dependent on complement, as a result of the binding of C1q, mediated by the Fc domain, destroying the thyroid follicles, by infiltration of inflammatory cells (1) (2).Objective: Describe the characteristics of pa...

Introduction: Anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis drugs induced are a rare side effect of antithyroid drugs. It is more commonly associated with propylthiouracil (PTU). The clinical manifestations are polymorphic like in primary vasculitides, but less severe; ranging from less specifics syndromes to multiple organs injured and lifethreatening in rare case. Cardiac involvement is uncommon. Herby we present the first case report of a 25-yr-old wom...

Introduction: De Quervain’s Thyroiditis (DQT) is a self-restriction inflammatory disease of the thyroid gland that presents severe pain localized in the neck. But few cases of a painful variant of Hashimoto’s thyroiditis (HT) have been described as well. Thyroid ultrasound (US) may reveal in homogeneous hypoechoic pattern in both conditions.Case: A 51-year old woman was admitted to the Hospital of Lithuanian University of Health Sciences, Kauno...

Introduction: Biological casuses of levothyroxine (LT4) malabsorption are well known. Congestive heart failure, gastrointestinal diseases, pregnancy, medication or dietary interference are the most commonly known causes of poor oral absorption of LT4. However, when substitution therapy with LT4 fails we need to be more exploratory.Case description: Female, born in 1987, BH 164 cm, BW 73kg, in 2010 she was presented as M. Basedowi and in october 2011 near...

Introduction: Struma ovarii (SO) is a rare ovarian tumor that occurs as part of a teratoma or is found in serous or mucinous cystadenomas and consist of more than 50% thyroid tissue. More uncommon is to diagnose thyroid cancer in struma ovarii and thyroid gland of two different origins. We present a case of follicular thyroid carcinoma arising in struma ovarii of the right ovary and papillary thyroid gland carcinoma.Case: A 70-year-old woman admitted to ...

Introduction: Differentiated thyroid carcinoma is usually associated with a good prognosis. However, some of these tumors (5%) are radioiodine refractory and have different progression, associated with poor prognosis. In these situations, some tyrosine kinase inhibitors (TKI) can be used. We present a clinical case showing the difficulties in the follow-up and treatment of these patients.Clinical case: A 60 years old woman, with a “multicentric papi...

Background: Although hyperthyroidism has many treatment options, hyperthyroidism is difficult to control in some patients. Hyperthyroidism has three main treatment options: antithyroid drugs, radioactive iodine therapy and surgical treatment. However, in some cases none of these treatments can be used. However, there are some patients who failed to respond to radioactive iodine therapy, patients who choose not to receive any one of the options, and others who are poor surgical...

Introduction: Inappropriate secretion of TSH, despite elevated levels of T4, is due to either a TSH-secreting adenoma (TSHoma) or thyroid hormone resistance (RTH). RTH is a rare disorder, usually caused by mutations in the thyroid hormone receptor beta, characterized by a variable tissue hyporesponsiveness to thyroid hormone. The increased level of TSH may predispose to thyrotroph hyperplasia and possible adenoma formation.Case report: A 21 years old fem...

Introduction: Liver abnormalities are rarely observed in thyrotoxicosis. Diagnosis should be considered only after outruling other possibilities of hepathic pathology, especially autoimmune disaese. We report the case of a 6-year-old girl with Graves’ disease who presented a liver dysfuntion.Case report: A 6-year-old girl with a history of Graves’ disease diagnosed and treated 15 days before, was admitted for jaundice and pruritus. The interrog...

Objective: Considering that the patients with Turner syndrome (TS) have a high prevalence of autoimmune disease, an early investigation for digestive system diseases should be carried out in those with TS.Case 1: A 13-year-old girl, followed for Turner’s syndrome with characteristic facial dysmorphia, developed glaring diarrhea. Colon and endoscopic endoscopic examinations have led to ulcerative colitis. It was put pentasa with a favorable evolution...

Introduction: Viral infections have been implicated as a possible predisposing factor in the pathogenesis of subacute thyroiditis (ST). The seasonal distribution and the common clinical presentation of ST following upper respiratory track infections suggest a possible causative association. Direct serological or thyroid tissue evidence of viral infection during ST is however limited to a few case reports.Case presentation: We present the case of a 59-yea...

Introduction: Resistant thyrotoxicosis is condition in which patients fail to respond to maximal doses of antithyroid drugs. Definitive treatment is radioactive ablation and operative treatment. However, achievement of euthyroid status before definitive treatment is important in patients with underlying cardiovascular disorder in whom thyroid crises can be detrimental.Case report: We describe a case of resistant thyrotoxicosis and right heart failure. A ...

Introduction: TRH, thyroid hormones, dopamine, somatostatin and glucocorticoids have a recognized influence on TSH secretion. On the other hand, serotoninergic, histaminergic, catecholaminergic, opioidergic and GABAergic systems establish connections with hypophysiotropic neurons involved in TSH regulation; their relative contribution to TSH secretion is unknown. Still, there are a few reports of H1 receptor antagonists impact on TSH levels.Case report: ...