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Biomedical subjects

E Pratesi

Publications and source records attributed to E Pratesi.

3 recordsLinked to original sources

Serum 25-hydroxyvitamin D levels in normal subjects: seasonal variations and relationships with parathyroid hormone and osteocalcin.

The measurement of human 25-hydroxyvitamin D (25-OH-D) serum levels has a potential role in evaluating calcium and bone metabolism disorders. To determine normal ranges were studied, cross-sectionally, a healthy population of men and women, aged 18-69 years, over a 12-month period. Changes in 25-OH-D levels for the examined population fitted a mathematical model that demonstrated a highly significant periodic relationship to time. Gender had a significant (p < 0.03) effect on mean 25-OH-D concentration, but age was not significantly correlated with 25-OH-D in either sex. A 95% tolerance band was computed in order to have a time-qualified "range of normality" with circannual periodicity. Interesting periodic variations were seen for the parathyroid hormone (PTH) as well as for osteocalcin (OST). A moderate negative correlation was found between 25-OH-D and PTH in both sexes, with more significant evidence in males. No relationship was observed between 25-OH-D and OST.

Adolescent

[Euthyroid exophthalmos: evaluation of 6 patients].

To determine if "euthyroid Graves' exophthalmopathy" is a separate autoimmune disorder, we have examined 6 clinically euthyroid male patients (aged 30-50 yrs) who have never had thyrotoxicosis, with recently developed bilateral exophthalmos (classes 2-4 in the A.T.A. classification). We have evaluated T4 and T3 levels, FTI, TSH response to TRH (200 micrograms i.v.), antithyroglobulin and antimicrosomal antibodies (Tgab and Mab) titres and thyroid stimulating antibody (TSab) activity of patients' IgG. In 5 patients we performed also orbital computerized axial tomography (CAT). The T4 and T3 levels ranged 5.6-7.9 micrograms/d1 and 1.2-2.1 ng/ml respectively; FTI ranged 7-9.7 U. 5 patients showed an impaired TSH response to TRH; only one had a normal TSH increase. The Tgab and Mab titre was undetectable in 5 patients; only one showed high autoantibody titre and developed a clear hypothyroidism 8 months later. TSab activity was detectable in the overall group. The CAT revealed a consistent infiltrative involvement of extraocular muscles in 4 patients; the 5th showed evidence of increased density of retroorbital fat, without any muscle involvement. In conclusion, the presence of TSab activity (6/6), the impaired TRH test (5/6) and the infiltrative retroorbital muscle involvement (4/5) seem to suggest an autoimmune thyroid disease even if apparently normal iodothyronine levels were found.

Antibodies

[Thyroid function in patients chronically treated with amiodarone].

The effects of Amiodarone (1000-1400 mg/week, for a period ranging from 3 to 24 months) on thyroid gland function were studied in 45 patients with heart disease, using a new method of free thyroid hormone assay. Forty-four untreated patients and 11 normal subjects were used as controls. In treated patients the prevalence of dysthyroidism was 22,2% (15,6% hypothyroidism and 6,6% hyperthyroidism); the onset of dysthyroidism ranged from 20 days to 2 years after the beginning of treatment. In control patients the prevalence of dysthyroidism was 4,4% (2,2% hypothyroidism and 2,2% hyperthyroidism). In patients with hypothyroidism (TSH greater than 7 microunits/ml) T4 levels were generally low, while T3, fT4 and fT3 levels were normal. In treated patients with hyperthyroidism (fT3 greater than 5,3 pg/ml and fT4 greater than 16 pg/ml) T4 values were high, while T3 concentrations were in the normal range. In Amiodarone-treated euthyroid patients, mean T4, fT4 and rT3 values were significantly (p less than 0,01) higher than those of control subjects; TSH levels were normal in all the groups studied. These data suggest that Amiodarone can exert both a direct effect on the thyroid gland and the peripheral metabolism of thyroid hormones. The action on the thyroid gland is suggested by the high prevalence of dysthyroidism in Amiodarone-treated patients and by the high levels of T4 and fT4 observed in patients who did not show dysthyroidism. The action on the peripheral hormonal metabolism seems to be proved by the high levels of rT3 and by the prolongation of QTc interval.

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