[Echocardiographic study of hypothyroidism].
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Biomedical subjects
Publications and source records attributed to J Sebaoun.
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A clinical, scintigraphic and hormonal study of the thyroid was performed in 50 patients with intrathoracic sarcoidosis. The patients were divided into two groups: T - : n = 32, no thyroid abnormality; T +, 18 cases, with thyroid disorders (9 moderate diffuse goitres, 2 thyroid nodules, 7 nodular goitres). All had normal T4, T3 and TSH levels, except one patient with Graves's disease. Scarce sarcoid granulomas were found in 3 out of 4 patients who underwent thyroidectomy. Dissemination, activity, type of sarcoid thoracic involvement were not different in the two groups. In contrast, T + group had higher seric IgG levels than T - group (p less than 0,05). The association of sarcoidosis and goitre is not fortuitous but thyroid enlargement and sarcoid diffusion do not seem interrelated. Auto-immune thyroiditis seems unlikely in our cases, according to the low frequency of thyroid auto-antibodies. We discuss the possible role of seric immunoglobulins in the constitution of thyroid hypertrophy with or without hyperthyroidism in sarcoidosis.
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An echocardiographic study of nine patients with graves' disease before and after treatment demonstrates changes in myocardial contractility predominantly in the posterior wall and, to a lesser extent, in the intraventricular septum. The parameters most significantly changed were: velocity of posterior wall thickening and posterior left ventricular wall relaxation rate. There was not in any of the cases neither evidence of cardiac insufficiency nor a diminution of VCF. All of the modifications regressed rapidly with the euthyroid state. These results affirm the functional character of this disease dismissing the existence of an autonome cardiomyopathy of thyroid etiology.
The case reported here consisted of an association of a Wolff-Parkinson-White syndrome (WPW) with thyrotoxicosis, with simultaneous recovery by thyroidectomy; this lead the authors to review 13 previous cases in the literature. The physiopathologic discussion emphasized several points: 1) the specific action of thyroid hormones, 2) the hypothesis of the possible existence of inapparent pathways of pre-exitation in most subjects and 3) a simple practical attitude to adopt in all Wolff-Parkinson-White cases especially when rapid.
202 cases of Grave's disease were reviewed; among the 81 patients submitted to medical treatment, 53,1 p. 100 of patients failed to respond; 10 p. 100 relapsed and 35,9 p. 100 are euthyroid. The factors favouring a treatment failure were: age below thirty, severity of thyrotoxicosis, big enlargement of thyroid gland, duration of treatment shorter than 12 months. Relapses are more frequent after two years of medical treatment. Subtotal thyroidectomy was performed in 82 patients: 9,5 p. 100 relapsed, permanent hypothyroidism developed in 30,5 p. 100 and 50 p. 100 were euthyroid. The factors favouring post-operative hypothyroidism are estimated weight of the thyroid remnant, the moderate size of goiter and perhaps a six to twelve months preoperative medical treatment. 39 patients had I 131 therapy: among them, 24 p. 100 relapsed, 25,7 p. 100 had permanent hypothyroidism and 50,3 p. 100 are euthyroid.
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The serum of a patient with myasthenia gravis contained a particularly high titer of antistriated muscle antibodies, as well as a monoclonal IgM Kappa immunoglobulin. The antibody activity was only associated with IgG fractions and not with the monoclonal IgM, when these immunoglobulins were separated by chromatography. The association of these two immunological disorders is discussed.
A polysecretory cortico-adrenal tumor from a 46 year old woman was incubated in presence of tritiated pregnenolone and progesterone. Nine estrogens were isolated and identified by radio-gas-chromatography. This outstanding synthesis ability was in line with the high rates of urinary estrogens found in this patient.
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