JCEM case reports最新文献_第5页

Cardiac Tamponade as a Harbinger of Hypothyroidism. 心脏填塞是甲状腺功能减退症的先兆

JCEM case reports Pub Date : 2024-08-23 eCollection Date: 2024-09-01 DOI: 10.1210/jcemcr/luae150

Fateen Ata, Fatima Al-Hattab, Ammara Bint I Bilal, Ezeddin Alataresh, Haval Surchi

{"title":"Cardiac Tamponade as a Harbinger of Hypothyroidism.","authors":"Fateen Ata, Fatima Al-Hattab, Ammara Bint I Bilal, Ezeddin Alataresh, Haval Surchi","doi":"10.1210/jcemcr/luae150","DOIUrl":"10.1210/jcemcr/luae150","url":null,"abstract":"Cardiac tamponade is a rare complication of hypothyroidism. In rarer cases, hypothyroidism may initially present with tamponade. Cardiac tamponade is an emergency condition that usually requires urgent intervention. However, guidelines for tamponade secondary to hypothyroidism are not optimal, and cases have been managed variably (ranging from levothyroxine alone to pericardiocentesis followed by thyroid hormone replacement) with diverse outcomes. Here, we report a case of a 42-year-old male with no medical history who presented with exertional dyspnea, lower leg swelling, facial puffiness, constipation, and weight gain. He had low blood pressure (80/60 mm Hg), normal heart rate with sinus rhythm, normal oxygen saturation, and was afebrile. Apart from a mildly raised creatinine, his test results were normal. An echocardiogram revealed features of tamponade. Further laboratory tests showed severe hypothyroidism. Following the initiation of levothyroxine, he demonstrated significant improvement. Coronary angiography revealed 95% stenosis in the mid-left anterior descending artery, treated with stenting. Serial echocardiograms showed regression of the pericardial effusion, stabilizing his condition without the need for invasive pericardiocentesis. This case highlights the importance of prompt diagnosis and management of hypothyroidism-related tamponade to prevent severe cardiac compromise. Hence, it may be necessary to consider hypothyroidism in the differential for patients with unexplained cardiac tamponade.","PeriodicalId":73540,"journal":{"name":"JCEM case reports","volume":"2 9","pages":"luae150"},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lymphoid Structure Presenting as a Hypermetabolic Adrenal Incidentaloma. 淋巴结构表现为高代谢性肾上腺偶发瘤

JCEM case reports Pub Date : 2024-08-21 eCollection Date: 2024-09-01 DOI: 10.1210/jcemcr/luae149

Xavier Gilis, Thomas Servais, Guillaume Pierman, Marie-Cécile Nollevaux, Etienne Delgrange

引用次数: 0

Starvation Ketoacidosis in Pregnancy: An Unusual Presentation and Brief Literature Review. 妊娠期饥饿性酮症酸中毒：妊娠期饥饿性酮症酸中毒：不寻常的表现和简要的文献综述。

JCEM case reports Pub Date : 2024-08-16 eCollection Date: 2024-09-01 DOI: 10.1210/jcemcr/luae145

Lisa Abraham, Xinyuan Ning, Hilary B Whitlatch

引用次数: 0

Thyroid Paraganglioma: A Rare Manifestation of Paraganglioma Syndrome Associated With Pathogenic Variant in SDHD. 甲状旁腺瘤：副神经节瘤综合征的一种罕见表现与 SDHD 的致病变异有关。

JCEM case reports Pub Date : 2024-08-16 eCollection Date: 2024-09-01 DOI: 10.1210/jcemcr/luae135

Valentina D Tarasova, Kelara Samuel, Caitlin McMullen, Sergiy Kushchayev, Juan C Hernandez Prera, Colleen Veloski

{"title":"Thyroid Paraganglioma: A Rare Manifestation of Paraganglioma Syndrome Associated With Pathogenic Variant in SDHD.","authors":"Valentina D Tarasova, Kelara Samuel, Caitlin McMullen, Sergiy Kushchayev, Juan C Hernandez Prera, Colleen Veloski","doi":"10.1210/jcemcr/luae135","DOIUrl":"10.1210/jcemcr/luae135","url":null,"abstract":"Evaluation of an incidentally discovered indeterminate thyroid nodule (TN) in a previously healthy 59-year female led to diagnosis of thyroid paraganglioma (TPGL) and subsequently hereditary succinate dehydrogenase complex subunit D (SDHD)-related multifocal head and neck paragangliomas (PGLs). An ultrasound-guided fine needle aspiration (FNA) biopsy of the 1.7-cm TN was nondiagnostic and core biopsy was suspicious for papillary thyroid carcinoma. Pathology slides reviewed at tertiary center showed neuroendocrine neoplasm consistent with PGL. Her 24-hour urinary catecholamines and metanephrines were normal. Given the diagnosis of TPGL, genetic testing was recommended, which identified a pathogenic variant in SDHD (c.242C > T(p.P81L). Gallium-68-DOTATATE PET/CT revealed multifocal areas of increased somatostatin receptor expression from the skull base to thoracic inlet. Magnetic resonance imaging of the brain/neck showed multiple PGLs (right jugular, carotid, thyroid, left vagal, left level II, and superior mediastinal), all measured up to 1.7 cm. The right jugular PGL was treated with external beam radiation therapy of 3000 cGy. All PGLs remained stable and asymptomatic at 22-month follow-up imaging. TPGL should be considered in the differential diagnosis of a hypervascular TN in patients with SDHx-related pheochromocytoma-PGL syndromes and when such lesions with indeterminate cytology are encountered in patients with no known history of SDHx-mutation or syndrome.","PeriodicalId":73540,"journal":{"name":"JCEM case reports","volume":"2 9","pages":"luae135"},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11327117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypercalcemia in Pregnancy Caused by a Uterine Myoma. 子宫肌瘤导致的妊娠高钙血症

JCEM case reports Pub Date : 2024-08-14 eCollection Date: 2024-09-01 DOI: 10.1210/jcemcr/luae126

Stephanie van der Leij, Doenja Hertog

引用次数: 0

Reversible Gynecomastia and Hypogonadism Due to Usage of Commercial Performance-Enhancing Supplement Use. 使用商业性能增强补充剂导致的可逆性妇科肿瘤和性腺功能减退症。

JCEM case reports Pub Date : 2024-08-14 eCollection Date: 2024-08-01 DOI: 10.1210/jcemcr/luae148

Serena Chong, Catherine A Woolnough, Sundar R Koyyalamudi, Nimalie J Perera

{"title":"Reversible Gynecomastia and Hypogonadism Due to Usage of Commercial Performance-Enhancing Supplement Use.","authors":"Serena Chong, Catherine A Woolnough, Sundar R Koyyalamudi, Nimalie J Perera","doi":"10.1210/jcemcr/luae148","DOIUrl":"10.1210/jcemcr/luae148","url":null,"abstract":"Commercially available performance-enhancing supplements can contain banned performance-enhancing drugs (PEDs) and undisclosed steroid hormones that can induce hormonal abnormalities with associated clinical signs. We present a case of a 40-year-old male who developed bilateral gynecomastia and biochemical hypogonadotropic hypogonadism with a corresponding 6-month history of consuming commercially available performance-enhancing supplements for gym workouts. These performance-enhancing supplements were found to contain amounts of RAD-140, a selective androgen receptor modulator, MK-677, a GH secretagogue and cardarine, all of which are banned PEDs. In vitro analysis also detected undisclosed hormones testosterone, estradiol, and GH in all 3 supplements, with further steroid analysis using liquid chromatography mass spectrometry identifying an unidentified compound coeluting close to the testosterone peak. Cessation of these supplements led to full resolution of symptoms including normalization of hypogonadotropic hypogonadism. This case highlights the need for clinicians to consider commercially available performance-enhancing supplements as potential sources of PEDs and exogenous steroid hormones that can have adverse clinical consequences.","PeriodicalId":73540,"journal":{"name":"JCEM case reports","volume":"2 8","pages":"luae148"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thyroid Arteriovenous Malformation in Hereditary Hemorrhagic Telangiectasia: Insights on Successful Noninvasive Imaging. 遗传性出血性远端血管扩张症中的甲状腺动静脉畸形：无创成像的成功启示。

JCEM case reports Pub Date : 2024-08-12 eCollection Date: 2024-08-01 DOI: 10.1210/jcemcr/luae138

Hisanori Goto, Iyo Tanimura, Yujiro Nakano, Yumie Takeshita, Toshinari Takamura

引用次数: 0

Ultrasound-Guided Microwave Ablation of Thyroid Schwannoma. 超声引导下的甲状腺许旺瘤微波消融术

JCEM case reports Pub Date : 2024-08-12 eCollection Date: 2024-08-01 DOI: 10.1210/jcemcr/luae146

Xue Han, Yuzhi Zhang, Yu Li, Ruiping Li, Chao Liu, Shuhang Xu

引用次数: 0

Rapid Resolution of Recalcitrant Headache With Pasireotide in an Adult Patient With Acromegaly. 帕西瑞奥肽能迅速缓解肢端肥大症成人患者的顽固性头痛

JCEM case reports Pub Date : 2024-08-09 eCollection Date: 2024-08-01 DOI: 10.1210/jcemcr/luae142

Zeinab Dabbous, Zaina Rohani, Abeer Kaled Abdalrubb, Yaman Alkailani, Rosario Pivonello, Tarik Elhadd

引用次数: 0

Neonatal Severe Hyperparathyroidism Causing Life-Threatening Hypercalcemia Treated With Medical and Surgical Management. 新生儿严重甲状旁腺功能亢进症导致危及生命的高钙血症，采用内科和外科手术治疗。

JCEM case reports Pub Date : 2024-08-09 eCollection Date: 2024-08-01 DOI: 10.1210/jcemcr/luae133

Kerri Rosettenstein, Andrew Parasyn, Kristen Neville, Shihab Hameed

{"title":"Neonatal Severe Hyperparathyroidism Causing Life-Threatening Hypercalcemia Treated With Medical and Surgical Management.","authors":"Kerri Rosettenstein, Andrew Parasyn, Kristen Neville, Shihab Hameed","doi":"10.1210/jcemcr/luae133","DOIUrl":"10.1210/jcemcr/luae133","url":null,"abstract":"A 3-day-old male presented to a peripheral remote hospital in New South Wales, Australia, with tachypnea. He was found to have hypercalcemia, with ionized calcium >2.5 mmol/L (>10 mg/dL) (0.97-1.5 mmol/L or 1.14-1.3 mg/dL) and serum calcium of 3.85 mmol/L (15.43 mg/dL) (2.2-2.8 mmol/L or 8.5-10.5 mg/dL). Peak serum calcium was 5.4 mmol/L (21.64 mg/dL). He was transferred to a tertiary pediatric intensive care unit. Medical management (including hyperhydration, diuretics, corticosteroids, bisphosphonates, cinacalcet, and calcitonin) failed to maintain normocalcemia; therefore, total parathyroidectomy was performed on day 16 of life. Hungry bones syndrome developed postoperatively, requiring high doses of calcium, calcitriol, and phosphate supplementation. Genetic testing identified compound heterozygosity for 2 likely pathogenic variants in the calcium-sensing receptor gene. He is now 3 years old and is growing and developing without any concerns. This case highlights the importance of aggressive initial management in addressing severe hypercalcemia through perioperative management principles as well as the prolonged nature of hungry bones syndrome.","PeriodicalId":73540,"journal":{"name":"JCEM case reports","volume":"2 8","pages":"luae133"},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11311693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0