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Biomedical subjects

A Brinkane

Publications and source records attributed to A Brinkane.

10 recordsLinked to original sources
PubMed2004

[Nephrolithiasis and primary hyperarathyroidism in pregnancy].

Diagnosis of hyperparathyroidism is unusual during pregnancy. The presence of a renal stone is a very exceptional finding. Hypercalcemia is often revealed by standard blood tests. We present here a clinical case of renal nephretic colic occurring during the third trimester of a fourth pregnancy. Our investigations led to the diagnosis of primary hyperparathyroidism which was successfully treated. Hyperparathyroidism during pregnancy is associated with a high incidence of fetal and maternal complications, essentially neonatal hypocalcemia. In utero death is rare but has been reported. Calcium metabolism during pregnancy is dependent on PTHrp. The surgical option is usually taken during the second trimester but can only be proposed during the third trimester in the event of medically resistant hypercalcemia.

Adult↗
PubMed2004

[Hyperplasia of the thymus in Graves' disease. A case report].

Graves' disease is rarely associated with hypertrophy of the thymus which takes on a pseudotumor aspect. We observed a case in a 40-year-old woman who presented clinical and biological hyperthyroidism with anti-TSH receptor antibodies, favoring the diagnosis of Graves' disease which was confirmed by scintigraphy. The chest x-ray performed because of chest pain revealed enlargement of the mediastinum. The thoracic CT-scan without contrast injected showed a pseudotumor aspect of the thymus. Medical treatment with anti-thyroid drugs and beta blockers led to regression of the thymus mass. Knowledge of this type of association can avoid unnecessary thymus surgery. The clinical course is favorable irrespective of the type of anti-thyroid drug given.

Adult↗
PubMed2003

[Hyperthyroid rheumatism. Review of the literature and a case report].

INTRODUCTION: It is extremely rare that an inflammatory rheumatism reveals a hyperthyroidism. Only six observations have been described. We report a case of rheumatismal hyperthyroidism successfully treated with carbimazole and propranolol. OBSERVATION: A 52 year-old woman presented with inflammatory rheumatismal pain predominating at the waist for the past six months and resistant to synthetic anti-inflammatories. Thyroid hormone analysis permitted diagnosis of hyperthyroidism. Initiation of treatment with carbimazole led to the rapid regression of the rheumatismal manifestations. COMMENTS: Hyperthyroidism is classically manifested by signs of hypercatabolism. Osteoarticular manifestations are dominated by humeroscapular periarthrosis. Rheumatismal hyperthyroidism is characterised by inflammatory rheumatismal pain evoking, as in our patient, a rhizomelic pseudo-polyarthritis. The outcome, whatever the anti-thyroid treatment, is always good. The physiopathological mechanisms are unknown. They may be due to an attack of the antibodies against the synovial and/or cartilage structures, or to the effect of propranolol. CONCLUSION: It is important to underline the interest of thyroid hormone assay in cases of dubious etiological inflammatory rheumatism and/or resistant to classical treatments.

Adrenergic beta-Antagonists↗
PubMed2003

[Empty sella turcica revealed by panhypopituitarism disclosed by severe hyponatremia].

A 56-year old multiparious woman taking medication for depression was hospitalized for vomiting and abdominal pain. Laboratory tests showed severe hyponatremia and led to the diagnosis of panhypotuitarism due to an empty sella turcica. We recall the mechanism of hyponatremia in this context and point at the importance of endocrine tests in patients with an empty sella turcica.

Blood Gas Analysis↗
PubMed2003

[Thymoma and autoimmune thyroiditis. A case report].

We report an association between a thymus tumor and autoimmune thyroiditis. This association is probably related to loss of immune control secondary to loss of thymus integrity. A 48-year-old woman was hospitalized for thoracic pain. Her past history included thyroiditis treated by L-thyroxin for two years. The chest x-ray demonstrated a mediastinal opacity which was confirmed by computed tomography. Surgical resection was performed and histological analysis of the surgical specimen confirmed the diagnosis of lympho-epithelial thymoma. Thyroid immunity tests demonstrated the presence of anti-peroxidase antibodies confirming the diagnosis of Hashimoto's thyroiditis. Chest x-ray and CT-scan are indicated in patients with autoimmune thyroiditis to search for a thymic mass. Conversely, search for autoimmune thyroiditis is warranted in patients with an identified thymic mass.

Female↗
PubMed2001

[Whipple disease associated with pulmonary arterial hypertension. Jarisch-Herxheimer reaction after antibiotic therapy].

BACKGROUND: Pulmonary hypertension is an uncommon feature of Whipple's disease and the underlying pathophysiological mechanism remains a subject of debate. CASE REPORT: A 57-year-old woman was hospitalized for exploration of migrating joint pain that had developed for 5 years. Histologically proven Whipple's disease was diagnosed on duodenal biopsies. The lung angiogram performed to explore signs of right heart failure demonstrated pulmonary hypertension and ruled out pulmonary embolism. Abundant pericardial effusion developed progressively. Antibiotic therapy using sulfamethoxazole-trimethoprime led to a systemic Jarisch Herxheilmer reaction. The pulmonary hypertension resolved rapidly, the pericardial effusion more slowly. DISCUSSION: The pulmonary hypertension in this patient appeared to be directly related to Whipple's disease, probably via vascular infiltration by Tropheryma whippeli.

Anti-Infective Agents↗
PubMed2001

[Rare association of hypoparathyroidism and mediastinal-pulmonary sarcoidosis].

We report the case of a 52-year-old woman who presented hypoparathyroidism and sarcoidosis. The hypoparathyroidism developed 8 years after the diagnosis of sarcoidosis. No element in favor of an autoimmune disease of the parathyroid could be evidenced. Pathology and immunology blood tests were equally noncontributive. Another pathophysiological mechanism, possibly sarcoidic granulomatous infiltration of the parathyroid glands, was suspected. The patient also presented apparently coincidental vitiligo.

Biopsy↗