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Biomedical subjects

J C Paffoy

Publications and source records attributed to J C Paffoy.

11 recordsLinked to original sources

[Variation in high density lipoprotein cholesterol during treatment of thyroid gland diseases].

Serum cholesterol concentration is usually increased in primary hypothyroidism and decreased in hyperthyroidism. The role of hypercholesterolemia in hypothyroidism as a causal factor for coronary atherosclerosis has been extensively discussed. Epidemiologic studies have stablished that there is a very strong negative correlation between plasma HDL cholesterol levels and coronary atherosclerosis. Plasma concentration of HDL cholesterol was determined in 36 controls after separation of HDL from other lipoproteins by ultracentrifugation (uc), by precipitation by heparin-manganese chloride (hmc) and by phosphotungstate magnesium chloride (pmc). The recovery of HDL after both precipitations was almost 100% as shown by HDL immunoassay (kit Behring). There was a very strong correlation between cholesterol HDL values obtained by uc and hmc (r = 0.91) and by uc and pmc (r = 0.90). Normal values were 1.22 +/- 0.27 mmol/1 (mean +/- SD) in males and 1.57 +/- 0.31 mmol/L in females. We have measured HDL cholesterol by both precipitation technics in 17 hypothyroid patients before and under treatment for at least 2 months. Plasma total cholesterol levels were 7.01 +/- 2.61 mmol/1 before and 4.94 +/- 0.85 mmol/1 after treatment (p < 0.001); in contrast plasma HDL cholesterol did not change (1.29 +/- 0.33 vs 1.28 +/- 0.38 mmol/1). In 11 hyperthyroid patients plasma total cholesterol was 4.14 +/- 1.03 before and 5.74 +/- 0.88 mmol/l after recovery (p < 0.001). The mean plasma HDL cholesterol did not change (1.43 +/- 0.23 vs 1.59 +/- 0.42 mmol/1). However, 5 out of 11 patients had an increase of more than 10% of the plasma HDL cholesterol levels.

Adolescent↗

[Low thyrotrope hormone: a new entity].

The combination of the TRH stimulation of TSH release with the plasma iodide (PII) increase test, which gives a physiological measure of TSH basal activity, allows characterization of a syndrome we have called a low pituitary TSH reserve. These patients were euthyroid, had a normal PII increase test but a mild or no response to TRH. It was chiefly found in acromegaly and diabetes mellitus, after prolonged high levels of thyroid hormones or hypophysectomy. It appears to be a transient state between normal and abnormal thyrotropin function. So the absence of TSH increase after TRH injection can be of diagnostic value only when other tests of thyrotropin function are performed.

Acromegaly↗

[Hyperthyroidism by autonomous metastasis of thyroid carcinoma (author's transl)].

Nine years after surgical ablation of a trabeculo-vesicular carcinoma of the tyroid, a patient developped bone and liver metastasis. She had clinical signs of thyrotoxicosis, clear increase of blood T3 and sligh increase of T4. The TSH secretion was blocked. Exogenous TSH increased iodine uptake in the thyroid and not in the metastasis. After 2 doses of 120 mCi of 131I, she became hypothyroid, the liver was normal and the scan revealed the disappearance of uptake in thyroid and in metastasis. Such a clinical course was previously found in only 10 cases despite the frequent funcitonal differenciation of the metastasis of thyroid carcinomas.

Adenocarcinoma↗

[Metastatic thyroid carcinoma with hyperthyroidism (author's transl)].

Eight years after subtotal thyroidectomy for thyroid carcinoma, a patient developped multiple metastasis in bones and liver with high radioiodine uptake. This patient had clinical and biological thyrotoxicosis with low iodine uptake in the cervical remaining thyroid tissue and TSH secretion was not stimulated by TRH. Administration of 240 millicuries of 131 I led to hypothyroidism, to clinical regression of liver metastasis and to disappearance of extra-cervical iodine uptake. Eleven similar case have been reported in the literature.

Bone Neoplasms↗