1/12. thyrotoxicosis in Down's and Turner's syndromes: the likelihood of Hashimoto's thyroiditis as the underlying aetiology.Biochemical thyrotoxicosis in young women is almost invariably due to Graves' disease. Its occurrence in females with Turner's and Down's syndromes, both of which are seldom associated with Graves' hyperthyroidism but are frequently allied to Hashimoto's thyroiditis, should alert physicians to the possibility of the latter. The discharge thyroiditis of Hashimoto's disease can be recurrent and protracted. A brisk response to antithyroid therapy would favour a thyroiditis and, in this circumstance, radio-iodine uptake should be reduced. The absence of TSH receptor antibodies in such cases, while not wholly refuting the notion of active Graves' disease, lends support to the existence of Hashimoto's thyroiditis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/12. Thyrotoxic hypokalaemic paralysis in a pregnant Afro-Caribbean woman. A case report and review of the literature.This paper reports the case of a 21-year-old Afro-Caribbean pregnant woman with hyperthyroidism and hypokalaemic quadriparesis and reviews the literature on the topic. Thyrotoxic periodic paralysis is a very rare condition in the Caribbean. This case reminds West Indian physicians to consider this rare condition in any patient that presents with paralysis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/12. Unusual presentation of thyrotoxicosis--a case report and review of literature.BACKGROUND: The majority of patients with thyrotoxicosis are readily diagnosed clinically. It must be accepted however that not every patient presents with the characteristic picture. thyrotoxicosis occasionally presents in an unknown or atypical fashion in which the diagnosis may not be obvious. CASE REPORT: A 45-year-old woman presented with choreoathetoid movements of the right upper limb, persistent vomiting and generalized body weakness. Over the next few weeks, the clinical picture slowly evolved to give the characteristic symptoms and signs of thyrotoxicosis, which were not evident at presentation. thyroid function tests revealed elevated serum thyroxine and triiodothyronine as well as low thyroid stimulating hormone concentrations, confirming the diagnosis of thyrotoxicosis. CONCLUSION: This case illustrates unusual initial presenting features of thyrotoxicosis, which long preceded the development of the characteristic and more common manifestations. This led to a delay in the diagnosis. awareness of these atypical presentations will further assist the physician to make a timely and cost effective diagnosis of this condition.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/12. Hypocalcaemia following therapy of thyrotoxicosis in an infant.A 2-mo-old infant born to a mother with Graves' disease and having symptoms of thyrotoxicosis was started on antithyroid drugs. life-threatening hypocalcaemia requiring high-dose calcium infusions developed 1 mo after starting therapy. serum alkaline phosphatase and paratharmone levels were elevated. This communication may serve to alert treating physicians about this rare complication in infants with thyrotoxicosis after initiation of antithyroid therapy. Conclusion: Severe hypocalcaemia may follow initiation of antithyroid therapy in infants with thyrotoxicosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/12. hemorrhage into a thyroid nodule as a cause of thyrotoxicosis.OBJECTIVE: To describe a case of thyrotoxicosis after nontraumatic hemorrhage into the thyroid gland during anticoagulant therapy. methods: We report the details of the initial presentation, subsequent course, and outcome in a patient with a nontraumatic thyroid hematoma and thyrotoxicosis. RESULTS: In a 63-year-old woman, an acute painful neck mass developed during follow-up while she was receiving low-molecular-weight heparin therapy for deep vein thrombosis. Ultrasound study and magnetic resonance imaging revealed a massive intrathyroidal hematoma. This finding was followed by an increase in serum free thyroxine and free triiodothyronine levels and a decrease in the level of serum thyroid-stimulating hormone (thyrotropin). Anticoagulant therapy was discontinued. The clinical course of the thyrotoxicosis was self-limited, and no antithyroid therapy was necessary. The serum thyroid hormone levels decreased into normal ranges as the hematoma underwent subtotal shrinkage. CONCLUSION: endocrine glands are highly vascularized tissues, but nontraumatic hematomas into these organs are extremely rare conditions. Nevertheless, physicians should be aware of the potential occurrence of such a situation, as emphasized in the current case report.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/12. iodine-induced thyrotoxicosis after ingestion of kelp-containing tea.Complementary medication is en vogue and an increasing number of patients consume herbal medicine without reporting their use to physicians. We report a case of iodine-induced hyperthyroidism due to the ingestion of a kelp-containing tea. A 39-year-old woman with multinodular goiter presented with typical signs of hyperthyroidism, which was confirmed by endocrine tests. She was not exposed to iodinated radiocontrast media and did not take medications containing iodine, such as amiodarone. However, a detailed medical history revealed that she had been treated for a period of 4 weeks by a Chinese alternative practitioner with a herbal tea containing kelp because of her enlarged thyroid. The consumption of the tea was discontinued and an antithyroid drug therapy was initiated. physicians should advise patients with underlying thyroid disease to avoid all complementary or alternative medications containing iodine.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/12. An unusual cause of muscle weakness: a case report.Thyrotoxic hypokalemic periodic paralysis (THPP) has been reported earlier in the Asian population. However, it is now becoming increasingly common in the Western countries as well. Thus, its in-depth knowledge is a must for every physician so that this diagnosis is not overlooked in any case presenting with extremity weakness and paralysis, especially considering its reversible nature. We present an interesting case of THPP in a Vietnamese patient presenting with bilateral lower extremity weakness and extremely low serum potassium levels. We also present a comprehensive discussion and review of literature related to THPP, which would be helpful for the internists to diagnose and appropriately manage this disease.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/12. Thyrotoxic periodic paralysis in a Caucasian man: recognition and diagnosis.Periodic paralyses are uncommon disorders characterized by episodic muscle weakness, often with hypokalemia. Thyrotoxic periodic paralysis (TPP) is the most common and is rarely seen in the Caucasian population; the relative unfamiliarity of TPP among physicians in the united states may lead to initial errors in diagnosis. This article presents the case of a 25-year-old white man with frequent episodes of skeletal muscle weakness and cramping, associated with profound hypokalemia. Laboratory evaluation demonstrated primary hyperthyroidism, and a diagnosis of TPP was made. The disorder is found more commonly in men between the ages of 20 and 40. hypokalemia is the most consistent laboratory abnormality, representing a transcellular shift rather than a total body deficit; the exact mechanism is unknown. The exercise test demonstrates distinct electromyographical abnormalities in those with periodic paralysis. The definitive treatment of TPP is establishing a euthyroid state.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/12. thyrotoxicosis in the critically ill.The thyrotoxic patient offers a considerable challenge to the critical care physician because the "obvious" diagnosis often will be a cardiac (or other nonthyroidal) problem, but the "correct" diagnosis will be an endocrinologic one. The importance of considering the diagnosis of thyrotoxicosis in any patient with tachyarrhythmias, new-onset congestive heart failure, weight loss, or change in mental status cannot be overstated. Treatment for presumed thyroid disease sometimes will have to be initiated prior to the availability of the results of diagnostic tests. Timely and appropriate treatment of the thyroid problem is vital for a successful outcome in treating patients with thyrotoxicosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/12. Surgical management of thyrotoxicosis in young children.thyrotoxicosis is a rare disease in childhood. However, due to it's adverse effect on the growth and development of the developing child, physician should pay attention to manage the patients properly. In this paper, the incidence, pathophysiology, pathogenesis, medical and surgical intervention of this disease in children have been reviewed. In addition, 2 cases of thyrotoxicosis in children have been presented. There should be a close cooperation between pediatrician and surgeon to handle these patients before and after surgery.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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