Tuberculosis (TB) of the thyroid gland is rare, with acute abscess formation being the least common form of presentation. As such, TB of the thyroid may be overlooked as an initial clinical impression. A careful approach by history, physical examination, laboratory testing and radiologic imaging may aid in defining the etiology of the thyroid abscess, but these remain nonspecific. An accurate diagnosis may only be made by histologic examination. We present a case of a tuberculous abscess of the thyroid gland in a 37-year-old female. TB of the thyroid should also be considered when evaluating patients presenting with a painful thyroid nodule.

Human ; Female ; Adult ; Abscess ; Physical Examination ; Thyroid Nodule ; Tuberculosis ; Viscera ; Thyroid Nodule

Turner syndrome (TS) with an isochromosome mosaic karyotype 45,X/46,X,i(X) (q10) is an unusual variant, with only an 8-9% prevalence among women with TS based on international studies and 15% of all TS in the Philippines. Clinical features are atypical and any case should be investigated to detect potential complications.A 20-year-old female came in due to amenorrhea and alopecia. Physical examination revealed short stature, cubitus valgus and Tanner Stage 1 pubic hair and breast development. Transrectal ultrasound revealed absent ovaries and infantile uterus. Hormonal evaluation revealed hypergonadotropic hypogonadism. Bone aging was that of a 13-year-old for females with non-fusion of epiphyseal plates. Cytogenetic study revealed 45,X [37]/46, X, i (X) (q10)[13]. This is consistent with a variant Isochromosome Mosaic Turner Syndrome (IMTS). She was screened for medical complications. Audiogram and two-dimensional echocardiography were unremarkable. She has dyslipidemia and was given a statin. She has subclinical hypothyroidism with positive test for anti-thyroglobulin antibody. Her intelligence quotient (IQ) was below average. She received conjugated estrogen and progesterone that patterned the hormonal changes in a normal menstrual cycle. On the third week of hormonal therapy, she developed breast mound and on the fourth week, she had her first menstrual period. Her alopecia spontaneously resolved. The case is a variant of Turner Syndrome requiring supportive, medical and psychological care
Turner Syndrome ; Isochromosomes ; Alopecia

We report the case of a 61-year-old Filipino woman with postmenopausal virilization presenting with androgenic alopecia, progressive hirsutism and deepening voice over 5 years due to elevated testosterone levels. Ultrasound and computed tomography imaging suggested a left adnexal mass. Histology obtained following total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) demonstrated stromal luteoma of the left ovary. On immunohistochemistry, the tumor was positive for inhibin. Postoperatively, there was note of rapid normalization of testosterone level.
Hyperandrogenism

Doege-Potter syndrome (DPS) is a rare paraneoplastic condition characterized by hypoinsulinemic hypoglycemia from a solitary fibrous tumor. The underlying mechanism is the secretion of a prohormone form of insulin-like growth factor II (IGF-II) by the tumor, which causes decreased release of glucose into the circulation. We report the case of a 27-year-old Filipino male with presumptive DPS from a recurrent right temporo-zygomatic hemangiopericytoma (HPC). The complexity of DPS requires a multidisciplinary approach. Early screening for metastases from HPC may prevent the undesirable sequelae of the disease process.
Hemangiopericytoma ; Hypoglycemia

Objective: To determine the effect of metformin on maternal and neonatal outcome among pregnant Filipino women with polycystic ovary syndrome (PCOS). Methodology: This is a retrospective cohort study of PCOS women who were on metformin treatment prior to achieving pregnancy. The women were divided into two groups: women who continued metformin during pregnancy and women who discontinued metformin at the time the pregnancy was confirmed. Determination of the effect of metformin on pregnancy outcomes were analyzed using chi-square test. Multivariate regression analysis was used to determine the factors related to spontaneous abortion. Result: A total of 101 women continued metformin during pregnancy while 60 women discontinued metformin. Women who continued metformin had lower rates of first trimester spontaneous abortion compared to those who discontinued metformin (5% versus 36.2%, p<0.001). There was no significant difference in gestational diabetes between those who continued and discontinued metformin during pregnancy (19.0% versus 32.6%, p=0.07). Logistic regression analysis showed that only metformin during pregnancy has a protective effect on abortion (OR=0.168; 95% CI 0.048,0.592; p=0.005). The differences in neonatal outcomes between the two groups did not achieve statistical significance. Conclusion In Filipino women with PCOS, continuous use of metformin during pregnancy reduces the rate of first trimester spontaneous abortion
Polycystic Ovary Syndrome ; Pregnancy Complications ; Metformin