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Biomedical subjects

Y Rakover

Publications and source records attributed to Y Rakover.

31 records · Page 2Linked to original sources
PubMed1993

[Congenital hypothyroidism in the Jezreel Valley].

39 patients in the Jezreel Valley area with congenital hypothyroidism were studied during the years 1978-1991. The incidence of the disease was 1:3.085 births. The most common subgroup was peroxidase deficiency which was found in 12 (30.7%) of them, as compared to the 6% reported in the literature. The average age at diagnosis was 30 days, and the average age at the start of 1-thyroxin replacement therapy 48 days. 80% had clinical signs of hypothyroidism at the time of diagnosis. Average height was at the 25th centile, as compared to midparental height at the 40th centile. 15 (38%) of the children had psychomotor delay. This study reveals that despite the national thyroid function screening program which shortens the time to diagnosis and improves the clinical course of congenital hypothyroidism, 38% of these children have irreversible damage.

Congenital Hypothyroidism↗
PubMed1990

A case of transient hypothyroidism: sequential serum measurements of autoantibodies inhibiting thyrotropin-stimulated thyroid cAMP production in a neonate.

Transient neonatal hypothyroidism has been observed in three successive offspring of a mother with autoimmune thyroiditis. Thyroxine replacement therapy was initiated in a 23-year-old woman with overt clinical and laboratory findings of non-goitrous primary hypothyroidism. While on such treatment, she gave birth to three infants manifesting hypothyroidism immediately after birth. The neonates were treated with thyroxine replacement therapy which was discontinued in the three siblings at ages 2 1/2 years, 3 1/2 years, and 13 months. Continuous observation following cessation of therapy revealed clinical and biochemical euthyroidism in the children. Thyroid scanning during the neonatal period in the first child failed to identify functional thyroid tissue, suggesting thyroid agenesis, whereas thyroid scan performed on subsequent follow-up revealed a normal gland. Sequential serum measurements of autoantibodies directed towards the thyrotropin receptor were made in the mother and third child by a cAMP bioassay. High titres (five-six fold above normal) of blocking antibodies (tested by measuring the inhibition of TSH-stimulated cAMP production of cultured human thyroid cells by serum immunoglobulin preparations) were present in the mother and newborn 10 days after birth. The levels remained persistently high in the mother, whereas they declined and were undetectable in the child at four months. Thyroid-stimulating immunoglobulin was absent in both mother and child. The data are compatible with transient neonatal hypothyroidism caused by transplacental transfer of antibodies which block thyroid response to TSH. The half-life of the maternally-derived blocking antibody in the infant was estimated as 1-2 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Autoantibodies↗
PubMed1990

Vitamin B12 and folate levels in long-term vegans.

Serum vitamin B12, serum folate and red blood cell (RBC) folate levels were examined among 36 strict vegans of 5-35 years' duration. Vitamin B12 levels among the vegans were generally lower than in a control population. Most of the vegans had vitamin B12 values less than 200 pg/ml. RBC folate levels were normal but serum folate levels among the vegans were higher than among the controls. None of the vegans had any hematologic evidence of vitamin B12 deficiency, however four of them had neurologic complaints. Long-standing vegans should be monitored for vitamin B12 levels.

Adolescent↗
PubMed1989

[Thyroid function disturbances in an infant following maternal topical use of polydine].

A male infant who had symptoms of transient sinus tachycardia and increased concentrations of blood total and free T4 is reported. The mother had used Polydine (P; povidone iodine) for vaginal douching during pregnancy and during the first few weeks after delivery, during which time the infant was fed mother's milk only. Follow-up showed transient elevation of TSH levels in the infant, but with no signs of hypothyroidism. 2 months after the mother stopped using P, the infant's functions had become normal. P should not be used in the perinatal period.

Breast Feeding↗
PubMed1989

Behcet disease: long-term follow-up of three children and review of the literature.

Behcet disease is rare in children. There are only two reports of Behcet disease in childhood, describing seven patients. Three pediatric patients are described, in whom the age of onset ranged from 6 to 11 years. Aphthous stomatitis and arthritis were present in all of the patients; genital ulcers, iridocylitis, erythema nodosum, and CNS involvement were present in two patients. Other manifestations included Stevens-Johnson-like eruption, fever of unknown origin, and testicular involvement. All of the patients responded to glucocorticoids; two were also treated with colchicine and one was treated with chlorambucil. In two patients, follow-up of more than 10 years was done, with complete cure in one patient and benign course of illness in the other. Because of the rarity of the disease in childhood and the difficulty in making the diagnosis, there is not enough awareness by pediatricians concerning this disease.

Behcet Syndrome↗
PubMed1986

Acute bilateral total deafness complicating mumps.

While it is well known that mumps is a potential cause of deafness, it is not generally appreciated that it can produce total deafness. The damage is usually unilateral but bilateral disease has been recorded. A case is presented of severe bilateral hearing loss during a mumps epidemic in which, in spite of intensive conventional as well as lesser known therapy, no improvement occurred. In the absence of a successful therapeutic regime it is clearly advisable to intensify immunization in non-developed countries.

Child↗
PubMedDate not supplied

Concurrent nonfunctioning parathyroid carcinoma and parathyroid adenoma.

Parathyroid carcinoma is a rare etiology of primary hyperparathyroidism characterized by severe clinical symptoms of hypercalcemia and markedly elevated serum parathormone levels. Nonfunctioning parathyroid carcinoma is an inactive form of the disease. There are less than 30 reports of nonfunctioning parathyroid carcinoma in the English literature and the association with parathyroid adenoma has not been described. This report describes a patient with concurrent nonfunctioning parathyroid carcinoma and a functioning parathyroid adenoma.

Adenoma↗
PubMedDate not supplied

Celiac disease as a cause of transient hypocalcemia and hypovitaminosis D in a 13 year-old girl.

We report a thirteen year-old girl with symptomatic hypocalcemia secondary to celiac disease. Serum vitamin D levels [25OH-VitD3 and 24,25(OH)2-VitD3] were low, whereas 1,25(OH)2D3 and PTH levels were higher than normal. Shortly after introducing a gluten-free diet, the patient became asymptomatic, regaining normal growth and pubertal development and serum calcium levels returned to normal.

Adolescent↗
PubMedDate not supplied

Hirschsprung's disease associated with isolated familial medullary carcinoma of the thyroid.

We present two siblings with neonatal Hirschsprung's disease in whom isolated familial medullary carcinoma of the thyroid was diagnosed at the age of 16 and 19 years. Rectal biopsy in each patient revealed total absence of ganglion cells in the myenteric plexus and hypertrophied nerve fibers characteristic of Hirschsprung's disease. Both underwent total thyroidectomy and histological examination revealed bilateral and multifocal medullary carcinoma of the thyroid. These two patients belong to a large family in whom another 12 affected members with medullary carcinoma of the thyroid were found. Our description is the first report of an association between Hirschsprung's disease and isolated familial medullary carcinoma of the thyroid. We suggest that familial occurrence of Hirschsprung's disease could be an early presentation of familial medullary carcinoma of the thyroid either as the isolated form or as part of multiple endocrine neoplasia type IIa or IIb.

Adolescent↗
PubMedDate not supplied

Vaginal bleeding: presenting symptom of acquired primary hypothyroidism in a seven year-old girl.

A seven year-old girl who presented with vaginal bleeding and a right ovarian cyst was diagnosed as having acquired primary hypothyroidism. She had menstruation in spite of a delayed bone age, absence of pubertal growth spurt and lack of adrenarche. Elevated levels (age-matched) of gonadotropins, normal levels of estradiol, and hyperprolactinemia were documented. The clinical and laboratory findings were reversed by thyroxin treatment. The clinical presentation in this case, and other similar descriptions in the literature, support the mechanism of pseudo-precocious puberty in untreated hypothyroidism.

Child↗
PubMedDate not supplied

Juvenile Behçet's disease in Israel. The Pediatric Rheumatology Study Group of Israel.

OBJECTIVE: Behçet's disease (BD) is a vasculitis mainly observed in young adult males. Juvenile BD is rare and only small series of pediatric cases have been reported. The objective of this study was to define the epidemiology and clinical features of BD among Israeli children. METHODS: A questionnaire was sent to 8 pediatric rheumatology units in Israel and 30 cases of BD diagnosed before the age of 16 years were identified. RESULTS: Fifteen patients fulfilled the International Study Group Criteria for BD, while 15 had an incomplete form of BD. Among the patients with complete BD, stomatitis and skin involvement were the most common manifestations. Other symptoms included genital ulcers, uveitis, CNS involvement, arthritis, and gastrointestinal involvement. A positive family history was elicited in 3 patients. HLA B5 was found in 7 of 12 patients (58%). The 15 patients with incomplete BD all had recurrent stomatitis; other manifestations included uveitis, arthritis, and genital ulcers. HLA B5 was found in 94% of this group. CONCLUSION: Juvenile BD in Israel is not uncommon, and is frequently associated with HLA B5 positivity. This could indicate a genetic susceptibility in our region. Half of the patients in our series had an incomplete form of BD, which may represent a less severe variant of the disease. In any case, careful follow-up is required, since their condition could eventually evolve into complete BD.

Adolescent↗