Case Reports in Endocrinology最新文献_第9页

The Unusual Late-Onset Graves' Disease following Hashimoto's Related Hypothyroidism: A Case Report and Literature Review. 与桥本氏甲状腺功能减退症相关的罕见晚发型巴塞杜氏病：病例报告与文献综述

IF 1.1

Case Reports in Endocrinology Pub Date : 2020-12-08 eCollection Date: 2020-01-01 DOI: 10.1155/2020/5647273

Aseel Sukik, Sara Mohamed, Mhd-Baraa Habib, Sundus Sardar, Bashar Tanous, Raad Tahtouh, Mouhand F H Mohamed

{"title":"The Unusual Late-Onset Graves' Disease following Hashimoto's Related Hypothyroidism: A Case Report and Literature Review.","authors":"Aseel Sukik, Sara Mohamed, Mhd-Baraa Habib, Sundus Sardar, Bashar Tanous, Raad Tahtouh, Mouhand F H Mohamed","doi":"10.1155/2020/5647273","DOIUrl":"10.1155/2020/5647273","url":null,"abstract":"Background. The shift of Graves' disease (GD) to Hashimoto's disease- (HD-) related hypothyroidism is well established. However, the opposite is rare. This is likely to the loss of critical thyroid mass available for stimulation by thyroid hormone receptor stimulating antibody, making this shift unusual. Herein, we report a young lady with a late shift from HD into GD and present a scoping literature review. Case presentation. We report a twenty-five-year-old lady with a sixteen-year-history of Hashimoto's-related hypothyroidism stable on levothyroxine. While following in the clinic, she started developing thyrotoxic symptoms in the form of anxiety, weight loss, and palpitation. Physical examination was remarkable for mild exophthalmos. The thyroid function test confirmed hyperthyroidism. Levothyroxine-induced hyperthyroidism was initially suspected; however, the symptoms did not improve despite reducing and stopping levothyroxine. Subsequent workup confirmed the diagnosis of GD. Discussion and Conclusion. This case highlights a unique association that has significant diagnostic and management implications. This shift should be considered when hyperthyroidism persists despite reducing or stopping levothyroxine. The diagnosis is made utilizing antibody titers and radioiodine update scan. While the management depends on the disease's stage and the treating physician preference, antithyroid agents can be used initially. Following up these patients is essential as the shift can be transient.","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2020 ","pages":"5647273"},"PeriodicalIF":1.1,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38859489","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

Sheehan Syndrome Presenting with Psychotic Manifestations Mimicking Schizophrenia in a Young Female: A Case Report and Review of the Literature. 希恩综合征在一名年轻女性中表现为精神分裂症的精神病表现:一例报告和文献回顾。

IF 1.1

Case Reports in Endocrinology Pub Date : 2020-12-04 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8840938

Nipun Lakshitha de Silva, Janith Galhenage, Madhubhashinee Dayabandara, Noel Somasundaram

{"title":"Sheehan Syndrome Presenting with Psychotic Manifestations Mimicking Schizophrenia in a Young Female: A Case Report and Review of the Literature.","authors":"Nipun Lakshitha de Silva, Janith Galhenage, Madhubhashinee Dayabandara, Noel Somasundaram","doi":"10.1155/2020/8840938","DOIUrl":"https://doi.org/10.1155/2020/8840938","url":null,"abstract":"Introduction: Sheehan syndrome presents with features of multiple hormone deficiencies including lactation failure and amenorrhoea as well as with features of central hypothyroidism and adrenocorticotropic hormone deficiency. Psychiatric manifestations are mostly limited to cognitive impairment. Psychotic presentations are rare and limited to case reports. Case Presentation. A 32-year-old female was evaluated for fearfulness and delusions for one year. She had persecutory and bizarre delusions, delusion of thought possession, and elementary auditory hallucinations. These began four months after the birth of her third child. The delivery had been complicated with postpartum haemorrhage. Her symptoms caused the functional decline and progressively worsened, resulting in suicidal ideation. Cognitive assessment revealed mild impairment in attention. Further inquiry revealed lethargy, constipation, cold intolerance, and lactation failure. She was slow, having dry skin, puffy face, and bradycardia with a blood pressure of 80/60 mmHg (supine) and 70/50 mmHg (standing). She had hyponatraemia, elevated creatine phosphokinase, low thyroxine, prolactin, FSH, LH, and IGF-1. She had poor cortisol and growth hormone response to the insulin tolerance test. MRI-pituitary showed empty sella. A diagnosis of Sheehan syndrome was made. Her symptoms improved completely after the initiation of levothyroxine and hydrocortisone.Conclusions: Sheehan syndrome can present with psychotic symptoms mimicking schizophrenia with variable involvement of cognition. Detailed reporting of these patients would enhance better characterization of the clinical presentation and risk profile of these patients.","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2020 ","pages":"8840938"},"PeriodicalIF":1.1,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38731616","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: 4

Parathyroid Carcinoma in the Setting of Tertiary Hyperparathyroidism: Case Report and Review of the Literature. 三级甲状旁腺功能亢进症中的甲状旁腺癌：病例报告与文献综述

IF 0.9

Case Reports in Endocrinology Pub Date : 2020-12-02 eCollection Date: 2020-01-01 DOI: 10.1155/2020/5710468

Federico Cappellacci, Fabio Medas, Gian Luigi Canu, Maria Letizia Lai, Giovanni Conzo, Enrico Erdas, Pietro Giorgio Calò

{"title":"Parathyroid Carcinoma in the Setting of Tertiary Hyperparathyroidism: Case Report and Review of the Literature.","authors":"Federico Cappellacci, Fabio Medas, Gian Luigi Canu, Maria Letizia Lai, Giovanni Conzo, Enrico Erdas, Pietro Giorgio Calò","doi":"10.1155/2020/5710468","DOIUrl":"10.1155/2020/5710468","url":null,"abstract":"Introduction: Parathyroid carcinoma is one of the rarest cancers in normal population, and it is extremely uncommon in the setting of tertiary hyperparathyroidism. Indeed, only 24 cases have been reported in the literature. Presentation of the Case. We report the case of parathyroid carcinoma in a 51-year-old man, with a history of end-stage renal disease due to a horseshoe kidney treated with haemodialysis since 2013. He came to our attention due to an increase in calcium and parathyroid hormone serum levels. Neck ultrasound (US) showed a solid hypodense mass, probably the right inferior parathyroid gland, with an estimated size of 25 × 15 × 13 mm; the 99mTc-sestamibi SPECT/CT scan revealed a large radiotracer activity area in the right cervical region, compatible with a hyperfunctioning right inferior parathyroid gland. So, a tertiary hyperparathyroidism diagnosis was made. In April 2018, resection of three parathyroid glands was performed. Histopathological examination demonstrated the right inferior parathyroid gland specimen to be a parathyroid carcinoma, due to the presence of multiple, full-thickness, capsular infiltration foci, and a venous vascular invasion focus. Discussion. Diagnosis of parathyroid carcinoma in tertiary hyperparathyroidism is remarkably complex because of the lack of clinical diagnostic criteria and, in many cases, is made postoperatively at histopathological examination.Conclusion: To date, radical surgery represents the mainstay of treatment, with a five- and ten-year survival rates overall acceptable.","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2020 ","pages":"5710468"},"PeriodicalIF":0.9,"publicationDate":"2020-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38731615","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

A Case of Successful Treatment with Unilateral Oophorectomy in a Patient with Resistant Polycystic Ovary Syndrome. 单侧卵巢切除术成功治疗顽固性多囊卵巢综合征1例。

IF 1.1

Case Reports in Endocrinology Pub Date : 2020-11-25 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8893000

S Pathmanathan, I Ranathunga, N P Somasundaram

{"title":"A Case of Successful Treatment with Unilateral Oophorectomy in a Patient with Resistant Polycystic Ovary Syndrome.","authors":"S Pathmanathan, I Ranathunga, N P Somasundaram","doi":"10.1155/2020/8893000","DOIUrl":"https://doi.org/10.1155/2020/8893000","url":null,"abstract":"Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder with heterogeneous etiology. Typical features consist of oligo/anovulation, polycystic ovaries, and features of hyperandrogenism. Pathogenesis is multifactorial, and positive family history may have a predisposition for disease development. The syndrome is associated with multiple metabolic and nonmetabolic entities. As the disease is involved with multiple adverse outcomes, the successful treatment is pivotal. Among the more advanced options, the unilateral oophorectomy is considered as a last resort to alleviate the symptoms. Case Presentation. A 29-year-old female presented to us with oligomenorrhea, severe hirsutism, androgenic pattern hair loss, acne, increased skin pigmentation, and secondary subfertility. On examination, she was obese with a body mass index (BMI) of 29.6 kg/m2. She had evidence of acanthosis nigricans, androgenic pattern balding, acne, dorsal, supraclavicular fat deposition, and moderate-severe hirsutism. Investigations confirmed excess right ovarian testosterone secretion which led to the ultimate management with right oophorectomy with successful alleviation of clinical features.Conclusions: The multifaceted medical treatment comprises the first-line therapy in PCOS. Surgery is considered as a second-line option in resistant PCOS following failure of initial therapeutic options. We report a case of resistant polycystic ovary syndrome with secondary subfertility and moderate-to-severe hirsutism who was successfully treated with unilateral oophorectomy with favorable results.","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2020 ","pages":"8893000"},"PeriodicalIF":1.1,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7710407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38697124","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

Severe Dental Disease as a Presenting Sign of Relapsed 6q24-Related Transient Neonatal Diabetes Mellitus. 重度牙病是复发性6q24相关的暂时性新生儿糖尿病的表现

IF 1.1

Case Reports in Endocrinology Pub Date : 2020-11-16 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8828516

Anna Delamerced, Lauren J Massingham, Jose Bernardo Quintos

引用次数: 0

Pulmonary Hypertension and Hypocholesterolemia Secondary to Thyrotoxicosis. 继发于甲状腺毒症的肺动脉高压和低胆固醇血症。

IF 1.1

Case Reports in Endocrinology Pub Date : 2020-11-12 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8884061

Narangoda Liyanage Ajantha Shyamali, Chandrike Ponnamperuma

{"title":"Pulmonary Hypertension and Hypocholesterolemia Secondary to Thyrotoxicosis.","authors":"Narangoda Liyanage Ajantha Shyamali, Chandrike Ponnamperuma","doi":"10.1155/2020/8884061","DOIUrl":"https://doi.org/10.1155/2020/8884061","url":null,"abstract":"Background: Thyroid disorders commonly affect the cardiovascular system. Thyrotoxicosis leading to pulmonary hypertension has been increasingly reported during recent years. Thyroid dysfunction affects the lipid metabolism, and thyrotoxicosis can be associated with low lipid levels. Thyrotoxicosis presenting with right ventricular dysfunction is rare, and only few cases had been reported. Case Presentation. A 53-year-old woman presented with progressive shortness of breath and swelling of body for four months. Examination showed generalized oedema and a systolic murmur over the left sternal border. Transthoracic echocardiography confirmed pulmonary hypertension with tricuspid regurgitation. Investigations revealed thyrotoxicosis and very low cholesterol levels. Diagnosis of Graves' disease was confirmed with detection of thyrotropin receptor antibodies. Pulmonary pressure was normalized six months after antithyroid therapy.Conclusion: Thyrotoxicosis is a recognized cause of reversible pulmonary hypertension and acquired hypocholesterolemia. However, most clinicians are not aware of these associations. This case illustrates the importance of assessing thyroid function in patients presenting with pulmonary hypertension.","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2020 ","pages":"8884061"},"PeriodicalIF":1.1,"publicationDate":"2020-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8884061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38333793","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

Headache in a Child with Pseudohypoparathyroidism: An Alarming Symptom Not to Miss. 儿童假性甲状旁腺功能减退症的头痛:一个不容错过的警示症状。

IF 1.1

Case Reports in Endocrinology Pub Date : 2020-11-10 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8840082

Sarah Wing-Yiu Poon, Brian Hon-Yin Chung, Anita Man-Ching Tsang, Grace Wing-Kit Poon

{"title":"Headache in a Child with Pseudohypoparathyroidism: An Alarming Symptom Not to Miss.","authors":"Sarah Wing-Yiu Poon, Brian Hon-Yin Chung, Anita Man-Ching Tsang, Grace Wing-Kit Poon","doi":"10.1155/2020/8840082","DOIUrl":"https://doi.org/10.1155/2020/8840082","url":null,"abstract":"Background: While the endocrine manifestations of pseudohypoparathyroidism are well known, less is known about the associated brain and spine abnormalities. These abnormalities may present with nonspecific symptoms in the paediatric population, and lack of awareness to these uncommon manifestations of the disease may result in a delay in necessary intervention. Case Presentation. We herein present a case of known pseudohypoparathyroidism type 1a who presented initially with minor head injury. She later developed progressive worsening headache, increased irritability, and vomiting. Repeated imaging showed hydrocephalus and Chiari malformation type 1 necessitating emergency craniectomy.Conclusion: Growth hormone deficiency, a common manifestation of pseudohypoparathyroidism type 1a, results in underdevelopment of the posterior cranial fossa and may account for the higher incidence of Chiari malformation in this group of patients. Other associated neurological features reported in pseudohypoparathyroidism type 1a include spinal stenosis, syringomyelia, and craniosynostosis. While less commonly seen, awareness to these associations is important in order to optimize the multidisciplinary care to this group of patients.","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2020 ","pages":"8840082"},"PeriodicalIF":1.1,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8840082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38634638","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: 3

Three Cases of Anaplastic Thyroid Carcinoma Transformation and Leukocytosis during Lenvatinib Treatment. Lenvatinib治疗期间甲状腺间变性癌转化及白细胞增多3例。

IF 1.1

Case Reports in Endocrinology Pub Date : 2020-11-09 eCollection Date: 2020-01-01 DOI: 10.1155/2020/6667237

Hiroyuki Iwasaki, Soji Toda, Daisuke Murayama, Hiroyuki Takahashi

引用次数: 2

Myxedema Coma: A Life-Threatening Condition in Patients Using Pembrolizumab. 黏液水肿昏迷:使用派姆单抗患者的一种危及生命的疾病。

IF 1.1

Case Reports in Endocrinology Pub Date : 2020-10-22 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8855943

Sangeetha Gummalla, Madhura Manjunath, Brian Phillips

{"title":"Myxedema Coma: A Life-Threatening Condition in Patients Using Pembrolizumab.","authors":"Sangeetha Gummalla, Madhura Manjunath, Brian Phillips","doi":"10.1155/2020/8855943","DOIUrl":"https://doi.org/10.1155/2020/8855943","url":null,"abstract":"The advent of immune checkpoint inhibitors has significantly improved the prognosis of patients with advanced malignancies. As we begin to understand these medications, multiple immune-related adverse effects (irAEs) have been found with these drugs, including endocrinopathies. Understanding the treatment-related adverse events of these medications is critical for clinical practice. Thyroid-related adverse effects usually occur within the first three months of treatment and rarely after eight months. It can manifest as an early onset of thyrotoxicosis, which is largely asymptomatic, followed by a rapid transition to hypothyroidism, requiring long-term levothyroxine substitution. We present a case in which our patient was found unresponsive, hypothermic, and with respiratory failure almost after completing a year of treatment with pembrolizumab. He had an initial mild elevation in thyroid-stimulating hormone (TSH) of 6.52, although with normal free thyroxine (T4) of 1.06, in his first three months of starting treatment which then rapidly progressed to a true myxedema coma. The infrequency with which this occurs makes it a diagnostic challenge.","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2020 ","pages":"8855943"},"PeriodicalIF":1.1,"publicationDate":"2020-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8855943","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38564344","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: 3

Type IV RTA in Chronic Adrenal Insufficiency and Concomitant Lisinopril Treatment. 慢性肾上腺功能不全的IV型RTA及赖诺普利治疗。

IF 1.1

Case Reports in Endocrinology Pub Date : 2020-10-19 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8897112

Francesca Galbiati

{"title":"Type IV RTA in Chronic Adrenal Insufficiency and Concomitant Lisinopril Treatment.","authors":"Francesca Galbiati","doi":"10.1155/2020/8897112","DOIUrl":"https://doi.org/10.1155/2020/8897112","url":null,"abstract":"Type IV renal tubular acidosis (RTA) is the only RTA characterized by hyperkalemia, and it is caused by a true aldosterone deficiency or renal tubular aldosterone hyporesponsiveness. It is frequent among hospitalized patients as it is related to type 2 diabetes mellitus (T2DM) and common medications such as ACE-inhibitors (ACE-is) and trimethoprim-sulfamethoxazole (TMP-SMX). Drug-induced RTA commonly manifests in patients with predisposing conditions such as mild renal insufficiency and certain pharmacological therapies. ACE-i use and chronic adrenal insufficiency (cAI) are other significant risk factors. Chronic ACTH suppression is thought to induce global adrenal atrophy, including the zona glomerulosa, thus affecting aldosterone secretion as well. Furthermore, in the setting of cAI, treatment with ACE-is further suppresses aldosterone production. This case report describes a patient with cAI secondary to corticosteroid use for years who developed type IV RTA in the setting of lisinopril use. Potassium (K) elevation persisted despite removing underlying conditions and metabolic acidosis correction. The patient required long-term treatment with mineralocorticoids in addition to sodium bicarbonate to maintain normal K levels and acid-base status. Mineralocorticoid administration is a second-line treatment for type IV RTA, but it might be necessary for a subgroup of high-risk patients. In fact, it is important to consider patients with chronic adrenal insufficiency and on ACE-is treatment at increased risk for refractory hyperkalemia in the setting of type IV RTA. Indeed, this subgroup of patients can have severe hypoaldosteronism.","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2020 ","pages":"8897112"},"PeriodicalIF":1.1,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8897112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38554090","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: 2