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Biomedical subjects

M Mnif

Publications and source records attributed to M Mnif.

13 recordsLinked to original sources
PubMed2006

[Myasthenia gravis and hyperthyroidism: two cases].

It is well known that hyperthyroidism occurs in approximately 2 to 17.5% of patients with myasthenia gravis. Hyperthyroidism may influence the clinical course of myasthenia gravis. We report the cases of two patients, a 53-year-old man and an 18-year-old woman, who had both severe myasthenia gravis and hyperthyroidism due to Graves' disease. Myasthenia gravis affected in particular facio-ocular areas with diffuse myopathy and signs of neuromuscular block on the electromyogram. In one patient, the diagnosis of thyroid disease was made three months before the diagnosis of myasthenia gravis while in the other, thyroid disease was recognized four months after myasthenia gravis. Myasthenia gravis worsened after the development of hyperthyroidism in the second patient. Both patients were given anti-cholinesterase drugs. One underwent thymectomy. Radioiodine used for the treatment of hyperthyroidism improved the symptoms of myasthenia gravis in the first patient. The association of myasthenia gravis and hyperthyroidism is more than a coincidence; our cases illustrate the difficult diagnosis and management of these diseases. Clinicians should look for myasthenia gravis in hyperthyroid patients and vice versa, especially when symptoms of myasthenia gravis or hyperthyroidism worsen.

Adolescent↗
PubMed2006

[Epidemiologic study of autoimmune thyroid disease in south Tunisia].

In order to study incidence and prevalence of autoimmune thyroid diseases (AITDs), we studied a retrospective cohort of 1,079 patients explored in the department of Endocrinology of Sfax (south of Tunisia). The overall incidence of AITDs was 9.9%. Mean age was 39.6+15 years; sex ratio 5 F/1M. Graves' disease was the most frequent (45%). Atrophic thyroiditis was present in 32.2% of patients and Hashimoto's thyroiditis in 22.8%. The incidence of AITDs increased from 1990 to 2000 and by 2003 it had fallen to 67 cases per year. TPO antibody was present in two-thirds of patients with Hashimoto thyroiditis, and half of those with atrophic thyroiditis. TG antibodies were less frequent (one-third of patients). Association with other autoimmune diseases was noted in 6.3% of patients: type I diabetes mellitus, adrenal insufficiency and vitiligo. Statistic analysis did not disclose any association between autoantibody levels and thyroid dysfunction. There was an association between TG antibody and TSH levels among patients with Graves' disease and between TG antibody level and age in atrophic thyroiditis patients (p<0.05); a correlation was also noted between these antibodies and other autoimmune diseases (p=0.05). It is difficult to assess the frequency of ATD in the clinical setting. Characteristic features of AITDs in patients seen in south Tunisia were found to be similar to those described in the literature. Other more large-scale representative studies would be useful to establish the epidemiology of AITDs in Tunisia.

Autoantibodies↗
PubMed2006

[MRI pituitary stalk abnormalities: etiology aspects in 11 patients].

Newer techniques of magnetic resonance imaging (MRI) describe more accurately pituitary stalk abnormalities such as infections, infiltrative lesions and tumors. In absence of all the above mentioned etiological factors, genetics defects are suspected, mainly when other malformations are equally present. We attempt to show through 11 observations the variability of pathologies involving the pituitary stalk with their respective clinical and radiological features and associated endocrine abnormalities. This is a retrospective study of 7 men (67%) and 4 women (33%), mean age of 28 year (range: 15 to 53) in whom pituitary MRI was performed for hypopituitarism, diabetes insipidus or hyperprolactinemia. Three patients had brain MRI for an extra-pituitary condition. The pituitary MRI showed a stalk section in 3 cases (27%), atrophy in 1 case and thickening in 7 cases (67%). The pituitary stalk anomaly was associated with hyperprolactinemia in 3 cases (27%), central diabetes insipidus in 4 cases (36%), growth hormone deficiency in 4 cases (36%), adrenal insufficiency in 5 cases (45%), hypogonadism in 5 cases (45%) and hypothyroidism in one case (9%). Established diagnoses were: sellar metastasis in 2 cases (18%), Langerhans' histocytosis, tuberculosis and autoimmune hypophysitis respectively in 3 cases (9%). In 6 cases (54%), no clear etiology was found. Given the multitude of pituitary stalk pathologies, a detailed etiologic inquiry must be performed in order to detect elements able to reclassify an initially idiopathic disorder.

Adolescent↗
PubMed2005

[Feminizing testicular syndrome with multiple hamartomas and bilateral paratesticular leiomyomas].

INTRODUCTION: Complete androgen insensitivity syndrome or testicular feminization syndrome (TF) is the most common form of male pseudohermaphrodism, caused by a failure of androgen receptor binding. Patient with male genotype 46 XY, has a female morphotype with well developed external sexual organs. EXEGESIS: - We report the case of a 29 year-old girl with a TF syndrome discovered during the exploration of a primary amenorrhoea. Bilateral orchidectomy was performed. The testis were immature; they showed bilateral leiomyoma of the tunica albuginea and multiple hamartomas on the right side. CONCLUSION: Benign tumors are developped in 80% of cases of TF and they are generally hamartomatous nodules of testis. Association of paratesticular leiomyoma to synchronous hamartoma has never been described, its histogenesis is discussed.

Adult↗
PubMed2003

[Association of distal tubular acidosis, Hashimoto's thyroiditis and Gougerot-Sjögren's syndrome].

INTRODUCTION: Distal tubular acidosis is associated with auto-immune diseases not specific to organ. The coexistence of distal tubular acidosis and auto-immune thyroid affection is very rare. OBSERVATION: A 36-year-old woman exhibiting primary hypothyroidism, Gougerot-Sjögren's syndrome and hypergammaglobulinemia, presented distal tubular acidosis revealed by severe hypokaliemia and complicated by quadriplegia and circulatory arrest. Correcting the thyroid defect did not appear to influence the progression of acidosis. COMMENTS: Based on this observation, one can discuss the pathogenesis of distal tubular acidosis during auto-immune diseases (hypothyroidism, Gougerot-Sjögren's syndrome and monoclonal hypergammaglobulinemia) and its impact on therapy.

Acidosis, Renal Tubular↗
PubMed2001

[Post-traumatic hypopituitarism].

BACKGROUND: Post-trauma hypopituitarism is a rare disease, accounting for only 3% of all cases of hypopituitarism reported in the literature. CASE REPORT: A 56-year old woman developed central diabetes insipidus immediately after severe cranio-facial trauma. Four years later, she suffered severe asthenia and hypoglycemia faintness. The diagnosis of isolated corticotrope insufficiency was retained. Magnetic resonance imaging evidenced an intrasellar arachnoidoceae with extinction of the posterior pituitary gland's spontaneous hypersignal. DISCUSSION: Most cases of post-trauma hypopituitarism occur after high-energy head trauma. Hypopituitarism exceptionally involves only one hormone, particularly growth hormone. The pathogenesis involves hypothalamic failure more often than pituitary gland failure.

Asthenia↗
PubMed2001

[Hypothyroidism after external radiotherapy. Fifteen cases].

Hypothyroidism frequency is estimated to be between 10 and 45% after radiotherapy alone, and 40 to 67% after radiotherapy associated with thyroidectomy. This hypothyroidism is infraclinical in 60% of the cases. Our study concerned 15 cases of hypothyroidism after external radiotherapy delivered between and 1991 and 1999. An irradiation of the cervical, cerebral and thorax regions was indicated for different types of cancers. Larynx carcinoma epidermoid was the most frequent cancer (seven cases); the radiation treatment used cobalt 60 with conventional fractionation, i.e., 2 Gy per treatment, five treatments a week. In nine cases, the hypothyroidism was discovered during a systematic examination; it was clinically evident in the six remaining cases. Hypothyroidism appeared after an irradiation dose average of 50 Gy (extremes 30-65 Gy). The average duration of the irradiation was about 7 weeks and the hypothyroidism appeared in a mean 22 months. In all cases, the substituting treatment was initiated with a favorable progression. Faced with the risk of hypothyroidism, it is necessary to check patients who have undergone external irradiation of the neck.

Adult↗
PubMed2001

[Thyrotoxicosis hepatitis: a case report].

Abnormal liver function in thyroid disorders may be secondary to thyrotoxicosis or to autoimmune injury to the liver. We report the case of a 36-year-old female who developed jaundice and pruritus with mild cholestasis and moderately elevated transaminase levels. The diagnosis of Graves' disease was made shortly thereafter. Laboratory findings were: alanine and aspartate aminotransferase 219 (IU/I (N: 9-50) and 102 IU/I (N: 10-15) respectively, alkaline phosphatase 336 IU/I (N: 40-135), bilirubin 24 micromol/I (N: 2-23), and gamma-glutamyl transpeptidase 232 IU/I (N: 9-43). Abdominal ultrasonography showed normal bile ducts; echocardiography ruled out heart failure; viral and autoimmune markers for hepatitis and cirrhosis were negative. Percutaneous liver biopsy showed moderate intrahepatic steatosis, anisokaryosis, lymphocyte infiltration in the portal areas, and Kupffer cell hyperplasia. Outcome was favorable after seven months of iodine therapy, confirming the diagnosis of thyrotoxicosis hepatitis.

Adult↗
PubMed2001

[Perrault's syndrome: two cases].

Perrault's syndrome is an autosomal recessive ovarian dysgenesis associated with sensorineural deafness. We report two cases in sisters issuing from consanguinous parents. Aged 16 and 21 years, both patients present the two cardinal symptoms of the syndrome. Magnetic resonance imaging in the second sister showed high intensity signals in the periventricular and subcortical white substance and in the central ovale, suggestive of cerebral leucodystrophy. This element may be one of a wide spectrum of neurological symptoms found in Perrault's syndrome. The discovery of the causal genes may allow better understanding of the biomolecular mechanisms involved in gonad and sensorineural differentiation.

Adolescent↗
PubMedDate not supplied

[Pure primitive dysautonomia or Bradbury-Eggleston syndrome. Report of 3 cases].

The primary autonomic failure (Bradbury-Eggleston syndrome) is rare. We report three cases (two females and one male) who are 55 year old with orthostatic hypotension, tachycardia, and other signs of dysautonomia. They hadn't a pyramidal, extrapyramidal or cerebellar syndromes. The other causes of postural hypotension are excluded. The autonomic dysfunction was confirmed by autonomic reflex tests and by evaluating of cardiac reflex function; these included heart rate responses to deep breathing and to the valsalva maneuver. Hypotension occurs in a variety of clinical setting; ascertainment of the cause is by non means easy. Primary autonomic failure remains a diagnostic category based on exclusion; its pathophysiology isn't well know and its treatment is only symptomatic.

Autonomic Nervous System Diseases↗