No abstract available.
Hypothyroidism*

No abstract available.
Dehydroepiandrosterone*

Osteoporosis is a common disease of the elderly and occurs especially in the postmenopausal women. Rarely, it occurs during a pregnancy or shortly thereafter and is accompanied by a substantial bone loss, resulting in fractures. The clinical significance of pregnancy-associated osteoporosis has been noted since the 1950s. Although its etiology is still unknown, it has recently been proposed that PTHrP may be an important causative factor in pregnancy-associated osteoporosis. There are three types of the pregnancy-associated osteoporosis, (1) a transient osteoporosis of the hip pregnancy, (2) a postpregnancy spinal osteoporosis and (3) a lactation-associated osteoporosis. Postpregnancy spinal osteoporosis typically occurs within three months after a first delivery and usually involving the axial skeleton accompanied by back pain, bone loss and a fracture. We present a case of postpregnancy spinal osteoporosis that developed three months after a first delivery. Our patient also showed multiple compression fractures in her lumbar spine and biochemical evidence of increased bone resorption.
Aged ; Back Pain ; Bone Resorption ; Female ; Fractures, Compression ; Hip ; Humans ; Osteoporosis* ; Parathyroid Hormone-Related Protein ; Pregnancy ; Skeleton ; Spine

Thyrotoxicosis factitia, a syndrome that results from a surreptitious ingestion of excess thyroid hormone, has generally been diagnosed in young or middle-aged women who have psychopathological disturbances. An 18-year-old female was admitted to the hospital 24 hours after taking an overdose of more than 50 tablets of synthyroid (levothyroxine, 5mg). She had taken 6 to 9 tablets of synthyroid daily for 6 months for the purpose of weight reduction even though she was not overweight. Because of her stuporous mental state and an acute respiratory failure, she was intubated and treated in the intensive care unit. After careful history taking and after her plasma thyroid hormone levels were determined, we diagnosed a thyroid storm that was caused by a thyrotoxicosis factitia. The laboratory results were, T3 430.0 ng/dL, free T4 70.0 ng/dL, TSH 0.05 IU/mL. Her symptoms improved after treatment by steroids and propranolol. She was discharged 8days after admission. Cases of thyrotoxicosis factitia have been reported very infrequently and, there has been no reports of a thyroid storm due to thyrotoxicosis factitia in Korea. We now report a case of a thyroid storm that resulted from thyrotoxicosis factitia that was caused by the ingestion of a massive dose of thyroid hormone that was takan daily for 6 months. We also present a brief review of the relevant literature.
Adolescent ; Eating ; Female ; Humans ; Intensive Care Units ; Korea ; Overweight ; Plasma ; Propranolol ; Respiratory Insufficiency ; Steroids ; Stupor ; Tablets ; Thyroid Crisis* ; Thyroid Gland* ; Thyrotoxicosis* ; Weight Loss

BACKGROUND: Postpartum thyroiditis is an autoimmune thyroid dysfunction that occurs in the first year after a delivery. Although a postpartum thyroid dysfunction after a full-term pregnancy is well described, little is known about its association with an abortion. The purpose of this study was to investigate the clinical and laboratory findings in thyroid dysfunction that develops after abortion and to investigate the differences in the clinical course according to the types of abortion. METHODS: Thirty patients who were proven to have thyroid dysfunction after either spontaneous or an elective abortion were studied. We analyzed their past history, the type of abortion, their clinical features, the laboratory findings and the courses of the disease. RESULTS: Seventeen patients were hypothyroid and 13 were thyrotoxic at the time of the initial thyroid function evaluation. In the thyrotoxic group, the T3 and free T4 were significantly higher but the TSH was lower than in the hypothyroid group. The titers of antimicrosomal and antithyroglobulin antibody were not different between the two groups. In the thyrotoxic group, 3 cases showed normal values, 2 cases were hypothyroid and the remaining 8 cases were persistently thyrotoxic during the 2 months of observation. TSH receptor antibodies were absent in all of the transient thyrotoxic patients, but they were present in 83.3% of the persistent thyrotoxic patients. The clinical manifestations of the thyroid dysfunction were not different according to the type of abortion. CONCLUSION: Reproductive-age women who have an abnormal thyroid function require careful history taking with respect to their history of regarding parturition or abortion in order to evaluate the possibility of a transient thyroid dysfunction after the abortion.
Antibodies ; Female ; Humans ; Parturition ; Postpartum Period ; Postpartum Thyroiditis ; Pregnancy ; Receptors, Thyrotropin ; Reference Values ; Thyroid Gland*

Oncocytomas are neoplasms, histologically are composed of epithelial cells, with abundant, acidophilic and granular cytoplasm. Electron microscopic studies of oncocytomas have shown that the cytoplasm of oncocytes is packed with mitochondria. The adrenal gland is a very rare anatomical site for oncocytomas, and to the best of our knowledge, only thirty-six cases of adrenal oncocytomas have been described. Herein, a case of a large adrenal mass in a forty-year-old man, which was incidentally detected by abdominal ultrasonography, is presented. This patient demonstrated no clinical manifestation associated with adrenal hyperfunction. Hormonal studies showed no abnormal findings, except for a mild elevation of the 24-hour urinary VMA level. Abdominal computed tomography with enhancement revealed a large, well-defined left adrenal mass, measuring 5.0x.2 x.0cm. The patient underwent a left adrenalectomy, and a light microscopic examination confirmed an adrenocortical oncocytoma, with characteristic oncocytes and polygonal, abundant, eosinophilic and granular cytoplasm. The tumor cells were positive for cytokeratin and vimentin as well as S-100, but negative for chromogranin on immunohistochemical staining. An electron microscopic examination demonstrated closely packed mitochondria, containing intramitochondrial inclusions. After surgery, there was no evidence of a recurrent or distant metastatic disease at the 5 month follow-up. In summary, an extremely rare case of a man with an adrenocortical oncocytoma is reported, which was confirmed by histological examinations, including electron microscopy.
Adenoma, Oxyphilic* ; Adrenal Gland Neoplasms ; Adrenal Glands ; Adrenalectomy ; Cytoplasm ; Eosinophils ; Epithelial Cells ; Follow-Up Studies ; Humans ; Keratins ; Microscopy, Electron ; Mitochondria ; Oxyphil Cells ; Ultrasonography ; Vimentin

Fifteen percent of patients with Cushing's syndrome could be accompanied with nonpituitary tumors that secrets ACTH-the ectopic ACTH syndrome. Among them, bronchial carcinoid is one of the rare causes of the ectopic ACTH syndrome. We experienced a 60-year-old woman who showed conditions of weight gain, generalized edema, hypokalemia, diabetes mellitus, and right middle lung mass. Histologically, the tumor was diagnosed with bronchial carcinoid and was confirmed as an ectopic ACTH syndrome through immunohistochemical staining of ACTH. After resection of the lung mass, blood sugar, electrolytes, generalized weakness, and blood pressure improved.
ACTH Syndrome, Ectopic* ; Adrenocorticotropic Hormone ; Blood Glucose ; Blood Pressure ; Carcinoid Tumor* ; Cushing Syndrome ; Diabetes Mellitus ; Edema ; Electrolytes ; Female ; Humans ; Hypokalemia ; Lung ; Middle Aged ; Weight Gain

This is the first case report about acute suppurative thyroiditis with thyrotoxicosis and pyriform sinus in Korea. A female patient, who was previously healthy, visited our hospital for the treatment of common cold symptoms and neck pain which developed 2 weeks before the visit. The condition of the patient did not improve through the use of antipyretics and even worsened. The patient was admitted to the hospital and was diagnosed with acute suppurative thyroiditis. The culture result of the drained fluid revealed group D Streptococcus. The patients condition was improved after using antibiotics and drainage. After recovery from acute thyroiditis, esophagography was performed and the pyriform sinus was found to be obliterated by chemical cauterization. It is very important yet difficult to differentiate acute thyroiditis with thyrotoxicosis from subacute thyroiditis. In this study, we discussed the differential diagnosis between acute thyroiditis and subacute thyroiditis with a review of literature.
Anti-Bacterial Agents ; Antipyretics ; Cautery ; Common Cold ; Diagnosis, Differential ; Drainage ; Female ; Fistula* ; Humans ; Korea ; Neck Pain ; Pyriform Sinus* ; Streptococcus ; Thyroid Gland ; Thyroiditis ; Thyroiditis, Subacute ; Thyroiditis, Suppurative* ; Thyrotoxicosis*

Alcohol ingestion during pregnancy can be damaging to embryonic and fetal development. A specific pattern of malformation, identified as Fetal alcohol syndrome, has been documented in 1~2 of every 1,000 live infant births Fetal alcohol syndrome is characterized by growth deficiency, facial abnormalities, cardiac defects, minor joint and limb abnormalities, as well as central nervous system dysfunction, including microcephaly, mental retardation and abnormal neurobehavioral development. However, there are few reports of fetal alcohol syndrome associated with hormonal abnormality or amenorrhea. Recently, a case of secondary amenorrhea, which developed in a 19-year-old woman with fetal alcohol syndrome, was experienced at our institute, but the exact cause of the amenorrhea was difficulty to find. Herein, this case is reported, with a review of the literature.
Amenorrhea* ; Central Nervous System ; Eating ; Embryonic and Fetal Development ; Extremities ; Female ; Fetal Alcohol Spectrum Disorders* ; Humans ; Infant ; Intellectual Disability ; Joints ; Microcephaly ; Parturition ; Pregnancy ; Young Adult

Methimazole is a widely used and generally well-tolerated antithyroid agent. Adverse reactions occur in 1~5% of patients taking methimazole medication, but these are most commonly transient, benign leukopenia and a skin rash. Severe cholestatic jaundice, combined with agranulocytosis, has been known as a rare complication. Herein, a case of methimazole induced cholestatic jaundice, with agranulocytosis, is reported.
Agranulocytosis* ; Exanthema ; Humans ; Jaundice, Obstructive* ; Leukopenia ; Methimazole