D. Usuda, S. Takagi, Kohei Takanaga, Toshihide Izumida, R. Sangen, Toshihiro Higashikawa, Y. Kasamaki
A 64-year-old woman was transported suffering from persistent lower abdominal pain, vomiting, and low-grade fever. Magnetic resonance imaging revealed an empty sella (ES) and hormone tests revealed a disappearance of diurnal variation of cortisol, low cortisol and adrenocorticotropic hormone (ACTH) secretion especially in the morning, and poor ACTH-cortisol axis reaction, as well as normal hypothalamus-pituitary gland-thyroid or adrenal gland axis hormone reaction. The cause of ES remained unclear; however, based on a diagnosis as adrenal insufficiency due to inappropriate ACTH secretion caused by total primary ES syndrome, we started hydrocortisone (15 mg/day). Afterwards, she immediately became symptom-free and was discharged. J Endocrinol Metab. 2020;10(5):144-153 doi: https://doi.org/10.14740/jem686
{"title":"Adrenal Insufficiency due to Total Primary Empty Sella Syndrome","authors":"D. Usuda, S. Takagi, Kohei Takanaga, Toshihide Izumida, R. Sangen, Toshihiro Higashikawa, Y. Kasamaki","doi":"10.14740/jem686","DOIUrl":"https://doi.org/10.14740/jem686","url":null,"abstract":"A 64-year-old woman was transported suffering from persistent lower abdominal pain, vomiting, and low-grade fever. Magnetic resonance imaging revealed an empty sella (ES) and hormone tests revealed a disappearance of diurnal variation of cortisol, low cortisol and adrenocorticotropic hormone (ACTH) secretion especially in the morning, and poor ACTH-cortisol axis reaction, as well as normal hypothalamus-pituitary gland-thyroid or adrenal gland axis hormone reaction. The cause of ES remained unclear; however, based on a diagnosis as adrenal insufficiency due to inappropriate ACTH secretion caused by total primary ES syndrome, we started hydrocortisone (15 mg/day). Afterwards, she immediately became symptom-free and was discharged. J Endocrinol Metab. 2020;10(5):144-153 doi: https://doi.org/10.14740/jem686","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48660898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Subacute thyroiditis (SAT) is a non-suppurative thyroid gland inflammation, which usually develops after viral upper respiratory tract infections, accompanied by pain and fever. Here, we present a 49-year-old Turkish man who developed SAT 10 days after the diagnosis of coronavirus disease 2019 (COVID-19). After the COVID-19 outbreak, affecting millions of people worldwide, millions of people are also likely to develop SAT. Therefore, clinicians should pay attention to the development of SAT after COVID-19. J Endocrinol Metab. 2020;10(3-4):110-112 doi: https://doi.org/10.14740/jem678
{"title":"Subacute Thyroiditis in the Course of Coronavirus Disease 2019: A Case Report","authors":"M. Guven","doi":"10.14740/jem678","DOIUrl":"https://doi.org/10.14740/jem678","url":null,"abstract":"Subacute thyroiditis (SAT) is a non-suppurative thyroid gland inflammation, which usually develops after viral upper respiratory tract infections, accompanied by pain and fever. Here, we present a 49-year-old Turkish man who developed SAT 10 days after the diagnosis of coronavirus disease 2019 (COVID-19). After the COVID-19 outbreak, affecting millions of people worldwide, millions of people are also likely to develop SAT. Therefore, clinicians should pay attention to the development of SAT after COVID-19. J Endocrinol Metab. 2020;10(3-4):110-112 doi: https://doi.org/10.14740/jem678","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":"36 17","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41330474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Individuals with comorbidities such as diabetes mellitus (DM) are more likely to develop the complications and fatalities from COVID-19. Although researchers have performed studies across the world to evaluate the interaction between DM and COVID-19 with a specific focus on DM as a predictor or determinant for COVID-19, these studies are not synthesized collectively to provide stronger evidence. Hence we aimed to review the studies that have assessed whether diabetes is a predictor or determinants for morbidity and death among patients with COVID-19. Different articles were searched from databases such as Google Scholar and PubMed. We undertook a narrative review of full-text research articles that were published in the English language both in developed and developing countries, with a specific focus on diabetes and COVID-19. All primary research articles were examined for information pertinent to the objective. We also reviewed all references of the eligible article to avoid missing any article relevant to the topic of interest. The existing evidence suggests that diabetic patients are at increased risk for adverse outcomes including death from COVID-19. The synthesis of the review revealed that evidence regarding diabetes as a predictor or determinants for morbidity and death among patients with COVID-19 is mixed. Individuals with diabetes are at risk of infections such as COVID-19. Thus, most of the studies have identified DM as a predictor for mortality in patients with COVID-19. In contrast, there are very few studies that reported contrary findings. Individuals with DM are at higher risk of catching infections such as COVID-19. This risk can be decreased, though not eradicated, by maintaining optimum levels of glucose in the blood. Indeed, diabetes was an important predictor for morbidity and death among patients with COVID-19. Therefore, these patients should take extra precautionary measures with good glycemic control and frequent monitoring of blood glucose. J Endocrinol Metab. 2020;10(3-4):74-78 doi: https://doi.org/10.14740/jem665
{"title":"Diabetes Mellitus Is an Important Predictor for Hospitalization and Mortality From the COVID-19 Infection: A Substantial Interface Between Two Outbreaks","authors":"K. Aldossari","doi":"10.14740/jem665","DOIUrl":"https://doi.org/10.14740/jem665","url":null,"abstract":"Individuals with comorbidities such as diabetes mellitus (DM) are more likely to develop the complications and fatalities from COVID-19. Although researchers have performed studies across the world to evaluate the interaction between DM and COVID-19 with a specific focus on DM as a predictor or determinant for COVID-19, these studies are not synthesized collectively to provide stronger evidence. Hence we aimed to review the studies that have assessed whether diabetes is a predictor or determinants for morbidity and death among patients with COVID-19. Different articles were searched from databases such as Google Scholar and PubMed. We undertook a narrative review of full-text research articles that were published in the English language both in developed and developing countries, with a specific focus on diabetes and COVID-19. All primary research articles were examined for information pertinent to the objective. We also reviewed all references of the eligible article to avoid missing any article relevant to the topic of interest. The existing evidence suggests that diabetic patients are at increased risk for adverse outcomes including death from COVID-19. The synthesis of the review revealed that evidence regarding diabetes as a predictor or determinants for morbidity and death among patients with COVID-19 is mixed. Individuals with diabetes are at risk of infections such as COVID-19. Thus, most of the studies have identified DM as a predictor for mortality in patients with COVID-19. In contrast, there are very few studies that reported contrary findings. Individuals with DM are at higher risk of catching infections such as COVID-19. This risk can be decreased, though not eradicated, by maintaining optimum levels of glucose in the blood. Indeed, diabetes was an important predictor for morbidity and death among patients with COVID-19. Therefore, these patients should take extra precautionary measures with good glycemic control and frequent monitoring of blood glucose. J Endocrinol Metab. 2020;10(3-4):74-78 doi: https://doi.org/10.14740/jem665","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":"53 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67230490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nephrotic syndrome (NS) is one of the most important causes of secondary hyperlipidemia. Here, I describe characteristics and mechanisms for hyperlipidemia due to NS, and systematically reviewed the association of such hyperlipidemia with atherosclerotic progression and the development of cardiovascular diseases (CVD) by Pubmed. Further, I searched literatures on the effects of interventions including diet, statin, fibrates, low-density lipoprotein (LDL)-apheresis and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors on hyperlipidemia and cardiovascular and renal outcomes in NS patients. Although dyslipidemia may be associated with atherosclerosis in NS, other factors such as age, duration of disease, number of relapses and blood pressure are also crucial determinants of atherosclerosis. The disease-specific risk of thromboembolism was different across the histological groups. One cohort study suggested that persons with NS are at increased risk of coronary heart disease (CHD). Among various interventions for NS, statin is relatively safe and effective for hyperlipidemia due to NS, but, it does not show sufficient evidence for cardiovascular and renal outcomes. Although PCSK9 inhibitors are promising therapeutic options for NS, large-scale trials are needed to elucidate such effect. J Endocrinol Metab. 2020;10(3-4):63-73 doi: https://doi.org/10.14740/jem663
{"title":"Hyperlipidemia due to Nephrotic Syndrome: Its Effects and Effects of Interventions on Atherogenesis, Cardiovascular and Renal Outcomes","authors":"H. Yanai","doi":"10.14740/jem663","DOIUrl":"https://doi.org/10.14740/jem663","url":null,"abstract":"Nephrotic syndrome (NS) is one of the most important causes of secondary hyperlipidemia. Here, I describe characteristics and mechanisms for hyperlipidemia due to NS, and systematically reviewed the association of such hyperlipidemia with atherosclerotic progression and the development of cardiovascular diseases (CVD) by Pubmed. Further, I searched literatures on the effects of interventions including diet, statin, fibrates, low-density lipoprotein (LDL)-apheresis and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors on hyperlipidemia and cardiovascular and renal outcomes in NS patients. Although dyslipidemia may be associated with atherosclerosis in NS, other factors such as age, duration of disease, number of relapses and blood pressure are also crucial determinants of atherosclerosis. The disease-specific risk of thromboembolism was different across the histological groups. One cohort study suggested that persons with NS are at increased risk of coronary heart disease (CHD). Among various interventions for NS, statin is relatively safe and effective for hyperlipidemia due to NS, but, it does not show sufficient evidence for cardiovascular and renal outcomes. Although PCSK9 inhibitors are promising therapeutic options for NS, large-scale trials are needed to elucidate such effect. J Endocrinol Metab. 2020;10(3-4):63-73 doi: https://doi.org/10.14740/jem663","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46338578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zeina Hadad, Louise Tjelum, P. Eiken, W. Trolle, I. Haupter, P. Afzelius
Brown tumors are benign osteolytic lesions, which usually respect the bone cortex. Since these lesions may resemble bone metastases, it is important to consider them as a potential differential diagnosis. They occur as a result of increased parathyroid hormone (PTH) secretion mainly due to primary or secondary hyperparathyroidism. We present a case of multiple osteolytic lesions incidentally found on X-ray examinations in a patient, who had a radius fracture after a low-energy trauma. Due to the suspicion of multiple bone metastases, one of them mimicking sequels after a pathological fracture in the ulna, the patient had a positron emission tomography/computed tomography (PET/CT) and a magnetic resonance imaging (MRI) scan performed supporting the existence of pervasive bone lesions without suggesting a primary malignancy. The blood samples showed highly elevated ionized calcium and PTH levels. Therefore, an ultrasound examination and parathyroid scintigraphy were performed, revealing a hyperfunctioning parathyroid adenoma. After removal of the adenoma, the PTH level normalised and the bone changes regressed without surgical intervention. J Endocrinol Metab. 2020;10(3-4):94-100 doi: https://doi.org/10.14740/jem637
{"title":"Multiple Brown Tumors Caused by Primary Hyperparathyroidism as a Differential Diagnosis to Multiple Osteolytic Bone Metastases: A Case Report","authors":"Zeina Hadad, Louise Tjelum, P. Eiken, W. Trolle, I. Haupter, P. Afzelius","doi":"10.14740/jem637","DOIUrl":"https://doi.org/10.14740/jem637","url":null,"abstract":"Brown tumors are benign osteolytic lesions, which usually respect the bone cortex. Since these lesions may resemble bone metastases, it is important to consider them as a potential differential diagnosis. They occur as a result of increased parathyroid hormone (PTH) secretion mainly due to primary or secondary hyperparathyroidism. We present a case of multiple osteolytic lesions incidentally found on X-ray examinations in a patient, who had a radius fracture after a low-energy trauma. Due to the suspicion of multiple bone metastases, one of them mimicking sequels after a pathological fracture in the ulna, the patient had a positron emission tomography/computed tomography (PET/CT) and a magnetic resonance imaging (MRI) scan performed supporting the existence of pervasive bone lesions without suggesting a primary malignancy. The blood samples showed highly elevated ionized calcium and PTH levels. Therefore, an ultrasound examination and parathyroid scintigraphy were performed, revealing a hyperfunctioning parathyroid adenoma. After removal of the adenoma, the PTH level normalised and the bone changes regressed without surgical intervention. J Endocrinol Metab. 2020;10(3-4):94-100 doi: https://doi.org/10.14740/jem637","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48244313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kusunoki, N. Wakazono, D. Sato, T. Miyata, K. Tsutsumi, Y. Oshida
Background: Diabetes mellitus is known to be associated with an increased risk of bone fracture. We investigated the effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on bone strength and density in type 2 diabetic patients. Methods: Nineteen Japanese patients with type 2 diabetes mellitus were administered 2.5 mg/day of luseogliflozin or 5 mg/day of dapagliflozin for 6 months. Serum levels of tartrate-resistant acid phosphatase 5b (TRACP-5b), an osteoclastic marker, and total procollagen type 1 amino-terminal propeptide (P1NP), a bone formation marker, were measured and compared with those before the treatment. Bone strength was measured by quantitative ultrasound (QUS), and bone density was evaluated by dual-energy X-ray absorptiometry (DEXA). Results: SGLT2 inhibitors significantly increased the calcaneal bone strength as measured by QUS compared to that in young adult mean. However, there was no effect in the lumbar spine density as measured by DEXA after administration. The drug treatment had no effect on serum TRACP-5b, but significantly increased serum P1NP. Conclusions: The results imply that the SGLT2 inhibitors improve bone strength while the inhibitors had no effect on bone density. These results suggest that the increase in bone strength was due to improved bone quality through an increase in serum P1NP level. J Endocrinol Metab. 2020;10(3-4):89-93 doi: https://doi.org/10.14740/jem683
{"title":"Sodium-Glucose Co-Transporter 2 Inhibitors Increase Serum Level of Total Procollagen Type 1 Amino-Terminal Propeptide and Bone Strength in Japanese Patients With Type 2 Diabetes Mellitus","authors":"M. Kusunoki, N. Wakazono, D. Sato, T. Miyata, K. Tsutsumi, Y. Oshida","doi":"10.14740/jem683","DOIUrl":"https://doi.org/10.14740/jem683","url":null,"abstract":"Background: Diabetes mellitus is known to be associated with an increased risk of bone fracture. We investigated the effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on bone strength and density in type 2 diabetic patients. Methods: Nineteen Japanese patients with type 2 diabetes mellitus were administered 2.5 mg/day of luseogliflozin or 5 mg/day of dapagliflozin for 6 months. Serum levels of tartrate-resistant acid phosphatase 5b (TRACP-5b), an osteoclastic marker, and total procollagen type 1 amino-terminal propeptide (P1NP), a bone formation marker, were measured and compared with those before the treatment. Bone strength was measured by quantitative ultrasound (QUS), and bone density was evaluated by dual-energy X-ray absorptiometry (DEXA). Results: SGLT2 inhibitors significantly increased the calcaneal bone strength as measured by QUS compared to that in young adult mean. However, there was no effect in the lumbar spine density as measured by DEXA after administration. The drug treatment had no effect on serum TRACP-5b, but significantly increased serum P1NP. Conclusions: The results imply that the SGLT2 inhibitors improve bone strength while the inhibitors had no effect on bone density. These results suggest that the increase in bone strength was due to improved bone quality through an increase in serum P1NP level. J Endocrinol Metab. 2020;10(3-4):89-93 doi: https://doi.org/10.14740/jem683","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42786864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Tomonaga, Masaki Kobayashi, Ryoma Tagawa, Y. Higami
Background: In the treatment of diabetes mellitus, it is important to prevent dyslipidemia, which is one of the complications. However, no study has examined the long-term effects of teneligliptin on the blood parameters of apolipoprotein B (apoB) after a meal in patients with type 2 diabetes. Methods: The effects of teneligliptin on blood glucose and lipids were examined by measurement of biomarkers before and after a meal. We gathered data before and after 6-month treatment in diabetic patients. Results: After treating 31 patients with teneligliptin for 6 months, the blood level of apoB-48, expressed as total area under the curve (tAUC), was significantly decreased. A multiple regression analysis of factors affecting the decreases in apoB-48 tAUC indicated that apoB-48 is more likely to decrease if it is higher at the start of testing, and that the apoB-48 tAUC value is more likely to fall in women than in men. Conclusions: Teneligliptin may be beneficial for the treatment of postprandial hyperlipidemia in diabetic patients. J Endocrinol Metab. 2020;10(3-4):79-88 doi: https://doi.org/10.14740/jem679
{"title":"The Effects of Teneligliptin on Lipid Profile: A Prospective Study for Comparison of Biomarkers Before and After a Meal","authors":"O. Tomonaga, Masaki Kobayashi, Ryoma Tagawa, Y. Higami","doi":"10.14740/jem679","DOIUrl":"https://doi.org/10.14740/jem679","url":null,"abstract":"Background: In the treatment of diabetes mellitus, it is important to prevent dyslipidemia, which is one of the complications. However, no study has examined the long-term effects of teneligliptin on the blood parameters of apolipoprotein B (apoB) after a meal in patients with type 2 diabetes. Methods: The effects of teneligliptin on blood glucose and lipids were examined by measurement of biomarkers before and after a meal. We gathered data before and after 6-month treatment in diabetic patients. Results: After treating 31 patients with teneligliptin for 6 months, the blood level of apoB-48, expressed as total area under the curve (tAUC), was significantly decreased. A multiple regression analysis of factors affecting the decreases in apoB-48 tAUC indicated that apoB-48 is more likely to decrease if it is higher at the start of testing, and that the apoB-48 tAUC value is more likely to fall in women than in men. Conclusions: Teneligliptin may be beneficial for the treatment of postprandial hyperlipidemia in diabetic patients. J Endocrinol Metab. 2020;10(3-4):79-88 doi: https://doi.org/10.14740/jem679","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45189460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Radioactive iodine (RAI) treatment is an effective method for the treatment of thyroid remnant ablation and metastasis in patients with differentiated thyroid cancer. The current guidelines recommend patients to drink lots of water to reduce the amount of iodine in the body during RAI treatment; however, water intoxication is a life-threatening condition resulting from hyponatremia. This case report describes water intoxication during RAI treatment in a 55-year-old patient who was evaluated for the management of angio-invasive follicular thyroid cancer following a total thyroidectomy. Hyponatremia is an electrolyte imbalance commonly encountered in oncology practice and is usually defined as a serum sodium level of less than 135 mEq/L. Water intoxication is a rare phenomenon that occurs due to an excessive intake of water, especially when the volume of water intake exceeds the excretory capacity of the kidney. This case report has revealed that all relevant information and instructions including the consumption of water should be clearly and accurately communicated to patients. J Endocrinol Metab. 2020;10(3-4):101-105 doi: https://doi.org/10.14740/jem646
{"title":"A Case Report of Water Intoxication During Radioactive Iodine Treatment: Why Physicians Should Communicate Clearly With Patients","authors":"S. Teye, N. Malan, M. Vangu","doi":"10.14740/jem646","DOIUrl":"https://doi.org/10.14740/jem646","url":null,"abstract":"Radioactive iodine (RAI) treatment is an effective method for the treatment of thyroid remnant ablation and metastasis in patients with differentiated thyroid cancer. The current guidelines recommend patients to drink lots of water to reduce the amount of iodine in the body during RAI treatment; however, water intoxication is a life-threatening condition resulting from hyponatremia. This case report describes water intoxication during RAI treatment in a 55-year-old patient who was evaluated for the management of angio-invasive follicular thyroid cancer following a total thyroidectomy. Hyponatremia is an electrolyte imbalance commonly encountered in oncology practice and is usually defined as a serum sodium level of less than 135 mEq/L. Water intoxication is a rare phenomenon that occurs due to an excessive intake of water, especially when the volume of water intake exceeds the excretory capacity of the kidney. This case report has revealed that all relevant information and instructions including the consumption of water should be clearly and accurately communicated to patients. J Endocrinol Metab. 2020;10(3-4):101-105 doi: https://doi.org/10.14740/jem646","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49296141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adrenal leiomyoma is a rare tumor. Bilateral adrenal leiomyoma is even rarer. Most of the patients with adrenal leiomyoma are asymptomatic. Hence, it was found incidentally most of the time. Some of the patients with huge tumor might complain of abdominal pain, fatigue or weigh loss. In this study, we report a middle-aged gentleman with bilateral huge adrenal leiomyoma, who presented with recurrent episodes of syncopal attack due to hypoglycemia. J Endocrinol Metab. 2020;10(3-4):106-109 doi: https://doi.org/10.14740/jem655
{"title":"Bilateral Adrenal Leiomyoma: A Rare Tumor With Unusual Presentation","authors":"Amy Cheng-Mei Khor, Naveen Rajaratnam","doi":"10.14740/jem655","DOIUrl":"https://doi.org/10.14740/jem655","url":null,"abstract":"Adrenal leiomyoma is a rare tumor. Bilateral adrenal leiomyoma is even rarer. Most of the patients with adrenal leiomyoma are asymptomatic. Hence, it was found incidentally most of the time. Some of the patients with huge tumor might complain of abdominal pain, fatigue or weigh loss. In this study, we report a middle-aged gentleman with bilateral huge adrenal leiomyoma, who presented with recurrent episodes of syncopal attack due to hypoglycemia. J Endocrinol Metab. 2020;10(3-4):106-109 doi: https://doi.org/10.14740/jem655","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44754581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thyrotoxic periodic paralysis (TPP) is an endocrine emergency. In initial hours, it requires multidisciplinary care as it involves heart and nervous system. Early diagnosis demands highest clinical acumen as symptoms and signs of thyrotoxicosis are often subtle. TPP is not nowadays confined to particular ethnic groups. Different cellular ion channels have been identified in its etiopathogenesis. Definitive treatment of thyrotoxicosis is also important to prevent relapse. In all cases of hypokalemia in emergency room, TPP should be excluded. of hypokalemia should be rationalized to prevent rebound hyperkalemia as total body potassium loss is minimum or nil. Patients should be made euthyroid as soon as possible to prevent relapse of TPP. Future research on ethnic variation of Na + -K + ATPase activity may enlighten us the cause of higher prevalence in Asians. J Endocrinol Metab. 2020;10(3-4):60-62 doi: https://doi.org/10.14740/jem662
{"title":"Thyrotoxic Periodic Paralysis: An Update","authors":"J. Chakraborty, Semanti Chakraborty, R. Moitra","doi":"10.14740/jem662","DOIUrl":"https://doi.org/10.14740/jem662","url":null,"abstract":"Thyrotoxic periodic paralysis (TPP) is an endocrine emergency. In initial hours, it requires multidisciplinary care as it involves heart and nervous system. Early diagnosis demands highest clinical acumen as symptoms and signs of thyrotoxicosis are often subtle. TPP is not nowadays confined to particular ethnic groups. Different cellular ion channels have been identified in its etiopathogenesis. Definitive treatment of thyrotoxicosis is also important to prevent relapse. In all cases of hypokalemia in emergency room, TPP should be excluded. of hypokalemia should be rationalized to prevent rebound hyperkalemia as total body potassium loss is minimum or nil. Patients should be made euthyroid as soon as possible to prevent relapse of TPP. Future research on ethnic variation of Na + -K + ATPase activity may enlighten us the cause of higher prevalence in Asians. J Endocrinol Metab. 2020;10(3-4):60-62 doi: https://doi.org/10.14740/jem662","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45944619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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