Ved V Gossain | PubMed Health

PubMed2005

Hyperthyroidism.

The clinical spectrum of hyperthyroidism varies from asymptomatic,subclinical hyperthyroidism to the life-threatening "thyroid storm". Hyperthyroidism is a common form of thyroid disease that mimics many of the common complaints in the emergency department. The diagnosis of hyperthyroidism is often challenging due to the multitude of physical and even psychiatric complaints. Recognition and treatment by emergency physicians of severe hyperthyroidism is critical and can be life saving.

Adult↗

PubMed2005

Hypothyroidism: mimicker of common complaints.

Hypothyroidism is a common condition presenting a challenge to emergency physicians in diagnosing the underlying etiology of vague complaints. Making the diagnosis of a critically ill patient in myxedema coma allows early treatment with appropriate thyroid hormone replacement and avoids higher patient mortality. To do this, the emergency physician must maintain a high degree of clinical suspicion for thyroid disease.

Diagnosis, Differential↗

PubMedDate not supplied

Spontaneous long-term remission in a patient with premature ovarian failure.

OBJECTIVE: To describe a patient with premature ovarian failure who after a pregnancy achieved a prolonged remission, which has lasted for more than 10 years. METHODS: Clinical and laboratory data of a patient who had premature ovarian failure with a spontaneous pregnancy and a prolonged remission are described. The pertinent literature is reviewed and summarized. RESULTS: A 26-year-old woman presented with secondary amenorrhea of 6 months' duration in 1984. Her serum total estrogen level was low, and gonadotropins were in the postmenopausal range. She also had a history of primary hypothyroidism, diagnosed in 1979. The physical examination showed normal findings, except for an enlarged thyroid gland and a few areas of vitiligo on her back, arms, and legs. Antithyroid antibodies were present. Adrenal insufficiency was excluded on the basis of results of the cosyntropin stimulation test. She had a normal 46,XX karyotype. A diagnosis of premature ovarian failure was made, and therapy with cyclic estrogen and progesterone was initiated. In 1991, she spontaneously conceived and gave birth to a healthy baby. After delivery, the patient began to have normal menstrual cycles and continues to do so without hormone replacement therapy. Subsequently, serum estrogen and gonadotropins were in the normal range. Her thyroid antibodies also became negative. When last contacted by her primary-care physician in November 2002, she was still having normal menstrual periods, and the patches of vitiligo were no longer present. CONCLUSION: It is well known that many autoimmune diseases subside during pregnancy; however, most of them relapse in the postpartum period. The mechanism of the prolonged remission in our patient is unknown, but hormonal as well as autoimmune changes related to pregnancy and the post partum period might have had a role.

Adult↗