Pub Date : 2010-05-01DOI: 10.1097/TEN.0B013E3181DFE618
R. Gen, E. Akbay, K. Sezer
Introduction: The aim of this study was to investigate insulin resistance in patients with mild and severe subclinical hypothyroidism (SH), and to explore the relationship between insulin resistance and cardiovascular risk factors. Material and Methods: The study group consisted of 27 women with severe SH (body mass index BMI, 28.35/3.92 kg/m 2 ), 25 women with mild SH (BMI, 27.13/3.16 kg/m 2 ), and 22 healthy women (BMI, 27.365/2.92 kg/m 2 ). The mean systolic blood pressure, diastolic blood pressure, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, LDL-cholesterol (LDL-C), triglyceride, thyroid-stimulating hormone (TSH), and high-sensitive CRP (hs-CRP) levels were higher in patients with severe SH than patients with mild SH and control subjects. The mean fasting insulin level, TSH level, LDL-C, and hs-CRP was higher in patients with mild SH than the control group. However, systolic blood pressure, diastolic blood pressure, and HOMA-IR were similar between patients with mild SH and those in the control group. In patients with severe SH, HOMA-IR was positively associated with TSH, total cholesterol, LDL-C, triglyceride, hs-CRP, and diastolic blood pressure but negatively associated with HDL-C. There was no correlation between HOMA-IR and waist circumference, W/H ratio, fT3, fT4, and systolic blood pressure in patients with severe SH. In patients with mild SH, HOMA-IR was positively correlated with TSH and hs-CRP, but there was no correlation between HOMA-IR and other parameters. Conclusion: We conclude that severe SH was associated with increased insulin resistance and increased cardiovascular risk factors such as lipid abnormalities, hypertension, and hs-CRP. Our data also suggest that insulin resistance may play a role in mediating the effects of severe SH on diastolic blood pressure, lipid abnormalities, and low-grade inflammation. Mild SH is associated only with early insulin resistance, LDL-C, and low-grade inflammation.
{"title":"Insulin Resistance and Cardiovascular Risk Factors in Patients With Mild and Severe Subclinical Hypothyroidism","authors":"R. Gen, E. Akbay, K. Sezer","doi":"10.1097/TEN.0B013E3181DFE618","DOIUrl":"https://doi.org/10.1097/TEN.0B013E3181DFE618","url":null,"abstract":"Introduction: The aim of this study was to investigate insulin resistance in patients with mild and severe subclinical hypothyroidism (SH), and to explore the relationship between insulin resistance and cardiovascular risk factors. Material and Methods: The study group consisted of 27 women with severe SH (body mass index BMI, 28.35/3.92 kg/m 2 ), 25 women with mild SH (BMI, 27.13/3.16 kg/m 2 ), and 22 healthy women (BMI, 27.365/2.92 kg/m 2 ). The mean systolic blood pressure, diastolic blood pressure, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, LDL-cholesterol (LDL-C), triglyceride, thyroid-stimulating hormone (TSH), and high-sensitive CRP (hs-CRP) levels were higher in patients with severe SH than patients with mild SH and control subjects. The mean fasting insulin level, TSH level, LDL-C, and hs-CRP was higher in patients with mild SH than the control group. However, systolic blood pressure, diastolic blood pressure, and HOMA-IR were similar between patients with mild SH and those in the control group. In patients with severe SH, HOMA-IR was positively associated with TSH, total cholesterol, LDL-C, triglyceride, hs-CRP, and diastolic blood pressure but negatively associated with HDL-C. There was no correlation between HOMA-IR and waist circumference, W/H ratio, fT3, fT4, and systolic blood pressure in patients with severe SH. In patients with mild SH, HOMA-IR was positively correlated with TSH and hs-CRP, but there was no correlation between HOMA-IR and other parameters. Conclusion: We conclude that severe SH was associated with increased insulin resistance and increased cardiovascular risk factors such as lipid abnormalities, hypertension, and hs-CRP. Our data also suggest that insulin resistance may play a role in mediating the effects of severe SH on diastolic blood pressure, lipid abnormalities, and low-grade inflammation. Mild SH is associated only with early insulin resistance, LDL-C, and low-grade inflammation.","PeriodicalId":50531,"journal":{"name":"Endocrinologist","volume":"7 1","pages":"128-130"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82364369","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}
Pub Date : 2010-05-01DOI: 10.1097/TEN.0B013E3181DFDC98
K. GaneshH., R. Gopal, J. George, T. Bandgar, P. Menon, N. Shah
{"title":"von Hippel-Lindau Disease: A Case Series of Unusual Familial Cancer Syndrome","authors":"K. GaneshH., R. Gopal, J. George, T. Bandgar, P. Menon, N. Shah","doi":"10.1097/TEN.0B013E3181DFDC98","DOIUrl":"https://doi.org/10.1097/TEN.0B013E3181DFDC98","url":null,"abstract":"","PeriodicalId":50531,"journal":{"name":"Endocrinologist","volume":"24 1","pages":"134-136"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88999826","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}
Pub Date : 2010-05-01DOI: 10.1097/TEN.0B013E3181DEE6B6
C. Zou, Zheng Shen, Xian Chen, L. Liang, Zhengyan Zhao
{"title":"Sex Reversal Syndrome With 47, XYY Karyotype: Case Report and Literature Review","authors":"C. Zou, Zheng Shen, Xian Chen, L. Liang, Zhengyan Zhao","doi":"10.1097/TEN.0B013E3181DEE6B6","DOIUrl":"https://doi.org/10.1097/TEN.0B013E3181DEE6B6","url":null,"abstract":"","PeriodicalId":50531,"journal":{"name":"Endocrinologist","volume":"33 1","pages":"98-99"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86332856","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}
Pub Date : 2010-05-01DOI: 10.1097/TEN.0B013E3181DFDB14
A. Fridman, Q. Nguyen, E. Plummer
Chronic lithium therapy can adversely affect thyroid, parathyroid, and kidney function. We present a 67-year-old man on chronic lithium therapy for bipolar disorder who developed thyroid storm, hypercalcemia, and nephrogenic diabetes insipidus following lithium intoxication. Diagnostic studies revealed no infectious precipitant of thyroid storm, with negative thyroid stimulating immunoglobulin and antithyroid peroxidase antibody levels. Thyroid ultrasound demonstrated small thyroid glands with decreased blood flow, not suggestive of Graves' disease. The patient's symptoms improved on only a few weeks of antithyroid drug and was discharged home without thyroid medications. His thyroid function followed a thyroiditis pattern when it dipped into the hypothyroid range before returning to normal without further interventions. To our knowledge, this is the first reported case of lithium-induced thyroiditis precipitating a thyroid storm and the third reported occurrence of thyroid storm in the context of thyroiditis. The patient's hospital course was further complicated by the development of hypercalcemia and nephrogenic diabetes insipidus requiring specialized treatments. We review the literature on mechanisms and treatment of lithium-induced thyroid dysfunction, hypercalcemia, and diabetes insipidus. Lithium-treated patients should have periodic thyroid function tests, and electrolyte measurements, especially following lithium dose adjustment.
{"title":"A Case of Lithium-Induced Polyendocrinopathy Including Thyroid Storm:","authors":"A. Fridman, Q. Nguyen, E. Plummer","doi":"10.1097/TEN.0B013E3181DFDB14","DOIUrl":"https://doi.org/10.1097/TEN.0B013E3181DFDB14","url":null,"abstract":"Chronic lithium therapy can adversely affect thyroid, parathyroid, and kidney function. We present a 67-year-old man on chronic lithium therapy for bipolar disorder who developed thyroid storm, hypercalcemia, and nephrogenic diabetes insipidus following lithium intoxication. Diagnostic studies revealed no infectious precipitant of thyroid storm, with negative thyroid stimulating immunoglobulin and antithyroid peroxidase antibody levels. Thyroid ultrasound demonstrated small thyroid glands with decreased blood flow, not suggestive of Graves' disease. The patient's symptoms improved on only a few weeks of antithyroid drug and was discharged home without thyroid medications. His thyroid function followed a thyroiditis pattern when it dipped into the hypothyroid range before returning to normal without further interventions. To our knowledge, this is the first reported case of lithium-induced thyroiditis precipitating a thyroid storm and the third reported occurrence of thyroid storm in the context of thyroiditis. The patient's hospital course was further complicated by the development of hypercalcemia and nephrogenic diabetes insipidus requiring specialized treatments. We review the literature on mechanisms and treatment of lithium-induced thyroid dysfunction, hypercalcemia, and diabetes insipidus. Lithium-treated patients should have periodic thyroid function tests, and electrolyte measurements, especially following lithium dose adjustment.","PeriodicalId":50531,"journal":{"name":"Endocrinologist","volume":"34 1","pages":"131-133"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83720345","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}
Pub Date : 2010-05-01DOI: 10.1097/TEN.0B013E3181DFFEBB
A. Marić, D. Katalinic, V. Čerina, H. Pećina, M. Vrkljan
{"title":"Sphenopharyngeal Encephalocele Presenting With Partial Hypopituitarism and Diabetes Insipidus: Case Report and Literature Review","authors":"A. Marić, D. Katalinic, V. Čerina, H. Pećina, M. Vrkljan","doi":"10.1097/TEN.0B013E3181DFFEBB","DOIUrl":"https://doi.org/10.1097/TEN.0B013E3181DFFEBB","url":null,"abstract":"","PeriodicalId":50531,"journal":{"name":"Endocrinologist","volume":"51 1","pages":"109-111"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78293977","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}
Pub Date : 2010-05-01DOI: 10.1097/TEN.0B013E3181DE5C22
D. Karásek, H. Vaverkova, M. Halenka, D. Jackuliaková, Z. Fryšák, Dalibor Novotný Ing
{"title":"Adiponectin in Members of Families With Familial Combined Hyperlipidemia","authors":"D. Karásek, H. Vaverkova, M. Halenka, D. Jackuliaková, Z. Fryšák, Dalibor Novotný Ing","doi":"10.1097/TEN.0B013E3181DE5C22","DOIUrl":"https://doi.org/10.1097/TEN.0B013E3181DE5C22","url":null,"abstract":"","PeriodicalId":50531,"journal":{"name":"Endocrinologist","volume":"23 1","pages":"117-121"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75698632","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}
Pub Date : 2010-05-01DOI: 10.1097/TEN.0B013E3181DE5B20
O. Akgul, S. Ocak, E. Göçmen, M. Koç, M. Tez
{"title":"Clinical Significance of Cellular Microfollicular Lesions in Goiter","authors":"O. Akgul, S. Ocak, E. Göçmen, M. Koç, M. Tez","doi":"10.1097/TEN.0B013E3181DE5B20","DOIUrl":"https://doi.org/10.1097/TEN.0B013E3181DE5B20","url":null,"abstract":"","PeriodicalId":50531,"journal":{"name":"Endocrinologist","volume":"13 1","pages":"115-116"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82369766","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}
Pub Date : 2010-05-01DOI: 10.1097/TEN.0B013E3181DFDCC2
M. Gama, T. Jonasson, J. Gama, Patrícia Zeni Lima Teixeira de Freitas, Ana Carolina Ossowski, Rafaela Cristina Perraro, B. V. Souza, Gislaine Custódio
{"title":"Extreme Insulin-Resistance Syndrome Associated With Alpha-1 Antitrypsin Deficiency: A Case Report and Literature Review","authors":"M. Gama, T. Jonasson, J. Gama, Patrícia Zeni Lima Teixeira de Freitas, Ana Carolina Ossowski, Rafaela Cristina Perraro, B. V. Souza, Gislaine Custódio","doi":"10.1097/TEN.0B013E3181DFDCC2","DOIUrl":"https://doi.org/10.1097/TEN.0B013E3181DFDCC2","url":null,"abstract":"","PeriodicalId":50531,"journal":{"name":"Endocrinologist","volume":"56 1","pages":"137-140"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75348223","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}
Pub Date : 2010-05-01DOI: 10.1097/TEN.0B013E3181DEE646
E. Baessa
Abstract: Carcinoid tumors most frequently develop in the gastrointestinal tract but have been described in many organs of the body. Primary neuroendocrine carcinoma of the breast is rare-only 31 cases have been reported in literature. Immunohistochemical examination showing expression of chromogranin and/or synaptophysin confirms evidence of neuroendocrine differentiation. In primary neuroendocrine carcinoma of the breast, more than 50% of the cell population shows neuroendocrine differentiation. Foci of neuroendocrine differentiation usually can be seen in breast carcinoma and are reported to be present in about 2% to 5% of breast cancer cases. Carcinoid tumor metastatic to the liver from the breast is very unusual. We report a case in which the patient underwent breast lumpectomy with axillary dissection. The tumor initially was diagnosed as an infiltrative lobular carcinoma with axillary lymph node metastasis. Re-examination of the breast tumor histopathology, however, proved it to be a primary carcinoid tumor.
{"title":"Primary Breast Carcinoid With Metastasis and Ectopic Acth Secretion: A Diagnostic Dilemma","authors":"E. Baessa","doi":"10.1097/TEN.0B013E3181DEE646","DOIUrl":"https://doi.org/10.1097/TEN.0B013E3181DEE646","url":null,"abstract":"Abstract: Carcinoid tumors most frequently develop in the gastrointestinal tract but have been described in many organs of the body. Primary neuroendocrine carcinoma of the breast is rare-only 31 cases have been reported in literature. Immunohistochemical examination showing expression of chromogranin and/or synaptophysin confirms evidence of neuroendocrine differentiation. In primary neuroendocrine carcinoma of the breast, more than 50% of the cell population shows neuroendocrine differentiation. Foci of neuroendocrine differentiation usually can be seen in breast carcinoma and are reported to be present in about 2% to 5% of breast cancer cases. Carcinoid tumor metastatic to the liver from the breast is very unusual. We report a case in which the patient underwent breast lumpectomy with axillary dissection. The tumor initially was diagnosed as an infiltrative lobular carcinoma with axillary lymph node metastasis. Re-examination of the breast tumor histopathology, however, proved it to be a primary carcinoid tumor.","PeriodicalId":50531,"journal":{"name":"Endocrinologist","volume":"16 1","pages":"96-97"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73200051","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}
Pub Date : 2010-05-01DOI: 10.1097/TEN.0B013E3181DFCB01
S. R. Santos, M. Ferreira, A. S. Borges, R. M. Pinto, M. L. M. P. Fernandes, P. T. Jorge
{"title":"Thyroid Disorders in Hepatitis C Patients Treated or Not With α-Interferon and Ribavirin","authors":"S. R. Santos, M. Ferreira, A. S. Borges, R. M. Pinto, M. L. M. P. Fernandes, P. T. Jorge","doi":"10.1097/TEN.0B013E3181DFCB01","DOIUrl":"https://doi.org/10.1097/TEN.0B013E3181DFCB01","url":null,"abstract":"","PeriodicalId":50531,"journal":{"name":"Endocrinologist","volume":"10 1","pages":"122-124"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82873576","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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