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Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Thyroid orbitopathy (TO) is an autoimmune disease of unknown etiology. It is a chronic and sometimes subacute or acute edematous and inflammatory disease, the main characteristics of which are eyelid edema, corneal ulcers, ocular hypertension, generally bilateral exophthalmos, restrictive strabismus, diplopia and optic neuropathy. The main purpose of this work is to review and update the current diagnostic and therapeutic approaches. To propose a practical, basic and precocious approach based in the knowledge of the TO. Methods: Literature review and exposition of our experience in the management of TO. Results: TO is an inflammatory orbital disease that probably has an autoimmune origin and most of the time is related to systemic disorders of the thyroid gland. Pathogenesis of the disease is not yet fully understood. Women are more likely to develop TO, and the disease is clearly affected by several factors such as smoking, age, sex and race. It is crucial to determine TO severity and activity for a correct management. Conclusions: Clinical knowledge is essential for the early diagnosis of this disorder, and it is the most important factor for the proper management of the disease. The medical treatment must be initiated promptly and should be aggressive and based in the current phase of the disease, in order to avoid the severe damage that follows TO. The surgical approach must be logical and sequential, but, on the other hand, must be rapid and aggressive in order to return the patient to his/her labour, social and familiar environment. [ABSTRACT FROM AUTHOR]

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Hyperthyroidism is a heterogeneous condition characterized by the excessive production of thyroid hormones. It represents a diagnostic and therapeutic challenge. Objective: To describe the clinical and paraclinical characteristics and the evolution and differences between the main etiologies in patients with hyperthyroidism treated by the Pediatric Endocrinology Service at the Hospital Universitario San Vicente Fundación in Medellín, Colombia, between July 1st., 2015, and June 30th., 2020. Materials and methods: We conducted a cross-sectional observational study with retrospective data collection. Results: We included 54 patients with a mean age of 11.9 years, 72.2% of whom were female; 85.2% had no history of comorbidities related to autoimmunity; 11.1% had a family history of Graves' disease, and 29.6% of other thyroid diseases. Goiter was the most frequent clinical manifestation (83.3%) and 92.6% of the patients received treatment with methimazole, 79.6% required beta-blockers, and 11.2% additional drug therapy. Adverse drug reactions occurred in 16.7% of the patients and in 20.4% there was a resolution of hyperthyroidism (spontaneous: 9.3%; after radio-iodine ablation: 9.3%, and after surgery: 1.9%). Conclusion: Hyperthyroidism is a disease with diverse clinical manifestations. Its most frequent cause is Graves' disease followed by hashitoxicosis, which in this study had a higher frequency than that reported in the literature. The duration and side effects of pharmacological treatment were similar to those previously reported, but the higher frequency of agranulocytosis is noteworthy. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the efficacy and safety of 8 cumulative grams of methylprednisolone combined with doxycycline 50 mg/day for 12 weeks in patients with active Graves orbitopathy. MATERIALS AND METHODS: Quasiexperimental, prospective, longitudinal, before and after, open study, done from November 1st, 2016 to April 30th, 2017 at Endocrinology Department of Centro Medico Nacional La Raza, Mexico City. Patients with Graves orbitopathy with CAS (Clinical Activity Score) ≥ 3 points of the EUGOGO scale were included. RESULTS: There were included 15 patients, 9 women and 6 men, mean age 51.06 ± 9.75 years. The mean decrease in CAS was 2 points (95% CI, p < 0.001), the mean proptosis was 1 mm (95% CI, p = 0.002), the final GO-QOL total was 40-48% (95% CI, p < 0.001), 2 patients had sinusitis (95% CI, p = 0.14), 2 patients uroinfection (95% CI, p = 0.14) and 4 patients hyperglycemia (95% CI, p = 0.03); other side effects of medications there were not observed. CONCLUSIONS: The combined scheme of methylprednisolone plus doxycycline causes a decrease in the severity and activity of Graves orbitopathy and improvement in quality of life without serious side effects. [ABSTRACT FROM AUTHOR]

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Síndrome Cardiometabólico is the property of Sindrome Cardiometabolico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Universitas Médica is the property of Pontificia Universidad Javeriana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Systemic autoimmune diseases including rheumatoid arthritis can coexist with organ-specific autoimmune diseases. OBJECTIVE: To report a case series of rheumatoid arthritis patients who developed autoimmune thyroid disease (Hashimoto's thyroiditis, Graves' disease). MATERIAL AND METHOD: A retrospective study was done from January to December 2017 including patients with rheumatoid arthritis and autoimmune thyroid disease. Rheumatoid arthritis was assessed according to the diagnostic criteria of 2010 (ACR/EULAR). RESULTS: There were identified 26 cases with rheumatoid arthritis and an autoimmune thyroid disease. In 14 cases rheumatoid arthritis was the initial manifestation and in 12 the initial manifestation was hypothyroidism or Graves' disease (GD). All the patients (females, median age: 46) had symmetrical polyarthritis of hands, wrists and knees. In total, serology was positive for rheumatoid factor (21), anti-cyclic citrullinated peptide antibody (11), anti-thyroid peroxidase antibody (21) and elevated levels of TSH in 15 cases. In 5 cases, hyperthyroidism was the initial feature. Palpable abnormality of the thyroid gland was present in 5 cases. The treatment consisted on synthetic thyroid hormones, radioactive iodine therapy, thyroid surgery and disease modifying drugs. CONCLUSION: In this case series, the most common cause of hypothyroidism was Hashimoto's thyroiditis preceding or following rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Autoimmune diseases affect around 3-5% of human beings, especially women. Due to its low prevalence, local clinical data on the behavior of this disease are unknown. OBJECTIVE: To find the prevalence of autoimmune diseases in the University Hospital of Santander, as well as to carry out the clinical and sociodemographic characterization of the diseases. MATERIAL AND METHOD: An observational, descriptive and retrospective crosssectional study on the prevalence of autoimmune diseases was done at the University Hospital of Santander between 2012 and 2016 in patients over 13 years of age who entered to the institution. RESULTS: A total of 1463 autoimmune diseases were found, with a prevalence of 378 cases per 100,000 patients over 13 years of age treated at the University Hospital of Santander and the population with autoimmune disease was 0.4%. The most prevalent diseases were rheumatoid arthritis, psoriasis, Graves' disease, immune thrombocytopenic purpura and systemic lupus erythematosus and the most affected organs were the skin, thyroid gland, hematology system, pancreas and nervous system. CONCLUSIONS: The data suggest that the prevalence in our environment is similar to that of studies in other populations; however, these prevalences are multifactorial and may vary among different populations. [ABSTRACT FROM AUTHOR]

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To describe the clinical features and causes of hospitalization in patients with hyperthyroidism in a general hospital in Lima, Peru. Methods: A retrospective and descriptive study was carried out. The study population was all patients hospitalized with the diagnosis of hyperthyroidism from January 1989 to December 2005 at Hospital Nacional Cayetano Heredia. Source data was the consultation book-record of the Endocrinology service. Clinical and demographic features were gathered. Results: 230 patients were identified, 162 clinical charts were reviewed. Median age was 36 years of age; 79% of patients were female, and Graves disease (GD) was the most common cause of hyperthyroidism (87.65%), followed by nodular thyroid disease (NTD, 12.35%). Patients with GD were younger and had been borne in the coast, while patients with NTD were older and had been born in the highlands. The most common reasons for hospitalization were cardiovascular involvement (heart failure and atrial fibrillation), infections and gyneco-obstetric complications. Most of the patients were treated with thioamides and beta- blockers. Mortality was 1.2%. Conclusions: As reported in other national studies the most common cause for hospitalization was GD with cardiovascular involvement. Mortality was lower than previously reported. [ABSTRACT FROM AUTHOR]

Thyrotoxic periodic paralysis is an unusual complication of hyperthyroidism that frequently presents in a dramatic fashion, needing treatment in an emergency department or admission to an intensive care unit. It is characterized by recurrent episodes of flaccid muscle paralysis, hypokalemia and elevated levels of triiodothyronine (T3) and thyroxine (T4). Potassium supplementation and B-adrenergic blockers are essential in the prevention of cardiopulmonary complications, and the effective control of hyperthyroidism is indicated to prevent the recurrence of paralysis. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Medicina is the property of Revista Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Resumen Se presenta el caso de una niña de 3 años pluripatológica, con una enfermedad genética mitocondrial (encefalomiopatía necrosante subaguda o síndrome de Leigh), insuficiencia renal crónica estadio v por una esclerosis mesangial difusa y alteraciones del desarrollo, que fue diagnosticada de hipertiroidismo autoinmune por enfermedad de Graves-Basedow. A las 6 semanas del inicio terapéutico con neocarbimazol, la paciente presentó un cuadro de agranulocitosis severa que obligó a suspender la medicación con fármacos antitiroideos, motivo por el cual fue tratada de manera eficaz con terapia metabólica con 131 I. La relevancia del artículo radica en la infrecuencia de la enfermedad de Graves en niños prepuberales (especialmente menores de 6 años), las complicaciones en el desarrollo derivadas de un posible diagnóstico tardío, la aparición de agranulocitosis como efecto adverso potencialmente grave tras el uso de antitiroideos y los pocos casos reportados de terapia ablativa con 131 I a esta edad, que otorgan singularidad al caso. The case is presented of a 3 year-old girl with mitochondrial disease (subacute necrotizing encephalomyelopathy of Leigh syndrome), v -stage chronic kidney disease of a diffuse mesangial sclerosis, as well as developmental disorders, and diagnosed with hyperthyroidism Graves-Basedow disease. Six weeks after starting the treatment with neo-carbimazole, the patient reported a serious case of agranulocytosis. This led to stopping the anti-thyroid drugs, and was treated successfully with 131 I ablation therapy. The relevance of the article is that Graves’ disease is uncommon in the paediatric age range (especially in children younger than 6 years old), and developing complications due to a possible late diagnosis. Agranulocytosis as a potentially serious adverse effect following the use of anti-thyroid drugs, and the few reported cases of ablation therapy with 131 I at this age, makes this case unique. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Hashimoto's encephalopathy (HE) is an uncommon clinical entity with a broad clinical presentation and it is often underdiagnosed. It is characterized by the presence of cognitive impairment, neurologic and psychiatric symptoms in the absence of viral, bacterial or inflammatory causes in patients with autoimmune thyroiditis. CASE REPORT: A-38-year old female presented with psychiatric symptoms and hyperthyroidism, for which she received antithyroid treatment and then radioiodine ablation with no improvement of psychiatric symptomatology. Studies revealed high levels of antithyroid antibodies and infectious, vascular and neoplastic etiologies were ruled out. Bearing in mind the possibility of HE, steroids were administered for two weeks without success, and then, electroconvulsive therapy was administered with marked improvement of symptoms after the first session. We present a narrative review with systematic search on the subject. CONCLUSION: Electroconvulsive therapy may be a useful alternative, coupled with the use of steroids, in patients with refractory HE. Lack of knowledge of the disease leads to delayed diagnosis, leading to delays in treatment, and thus, a poor prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Revista Chilena de Pediatría is the property of Revista Chilena de Pediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Salud UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To describe the clinical and epidemiological characteristics of patients with methimazole-induced agranulocytosis. Methods: A retrospective, case series study. We reviewed the medical records of all patients diagnosed with methimazole-induced agranulocytosis treated at Hospital Nacional Arzobispo Loayza between January 2002 and December 2008. We sought association between demographic and clinical variables with mortality and recovery time. Results: Thirty (0.60%) patients with Graves' disease were hospitalized with a diagnosis of methimazole-induced agranulocytosis. The median age was 33,5 years and 86,67% were women. On admission, all patients had fever and sore throat. The treatment included isolation, suspension of methimazole, antibiotics and glucocorticoids. Twelve (40%) patients received GM-CSF. The granulocyte count was normalized after 10,59 days and four (13.33%) patients died from bacterial infections and sepsis. In all cases, the final treatment was radioiodine. There was no significant difference in age, sex, methimazole dose, duration of treatment, and use of stimulating factor, among the patients who died and survivors. Furthermore, the use of stimulating factor did not reduce the recovery time from agranulocytosis. Conclusion: Methimazole-induced agranulocytosis is a serious and potentially deadly adverse event. In this group of patients, mortality was high and the use of stimulating factor did not decrease the recovery time. [ABSTRACT FROM AUTHOR]

A 48-year old woman with a recent diagnosis of Graves' disease arrived at the emergency room with fever, palpitations, and a sore throat. Her regular treatment included methimazole. On admission, laboratory results showed suppressed TSH, elevated free thyroxine, and neutropenia. She was admitted and started on antibiotics and granulocyte-macrophage colony stimulating factor (gm-csf). After ten days, the patient developed leukocytosis, fever, and hemoptysis. Chest CT scan showed a lung cavity with multiple nodules in the upper right lobe. Cultures from a lung biopsy were positive for Aspergillus Fumigatus and Aspergillus Flavus. Amphotericin B was started but then switched to voriconazole, with both treatments failing to result in clinical improvement. The patient died of multi-organ failure [ABSTRACT FROM AUTHOR]

The hypokalemic periodic paralysis associated with thyrotoxicosis (PPHT) is a rare presentation of hyperthyroidism. It12 s a disease prevalent in the asian population, however, is increasingly frequent detection of cases in other parts of the world. We present three cases in a Colombian hospital, three adult male patient in whom periodic paralysis was the mode of presentation of thyroid disease with sudden severe flaccid quadriparesia, they were diagnosed as Graves' disease, and all were managed successfully with potassium, beta blockers and control of thyroid function. The PPHT is a potentially lethal and reversible medical emergency, requiring management in the emergency department admission and occasionally intensive care unit. Should be suspected in young men with acute paralysis and hypokalemia, and thyroid function should be evaluated In all these cases, early detection and timely treatment change the history of the disease, treatment consists in the management of acute paralysis, and the stabilization of thyroid disease to prevent recurrence. [ABSTRACT FROM AUTHOR]

Background: Myxedema is an infiltrative dermopathy, it usually is located at the pretibial region and it is associated to thyroid endocrinopathies; its clinical manifestations indicate the diagnostic guide. Objective: To describe the clinical characteristics of pretibial myxedema at the moment of diagnosis in patients with Graves' disease attended at Dermatological Service consultation of National Institute of Medical Sciences and Nutrition Salvador Zubiran. Patients and methods: A transversal, descriptive and retrolective study was done during 12 years, in which clinical characteristics of patients with Graves' disease and pretibial myxedema are described. Results: In 46% of cases, clinical manifestations of pretibial myxedema were the classical infiltrated plaques denominated "in orange peel"; 27% were en diffuse form with follicular-center papules, and 27% as nodules well delimitated distributed simetrically at pretibial region; in 22% of cases skin manifestations preceded clinical diagnosis. Conclusions: Clinical manifestations of pretibial myxedema described as "atypical" have been subestimated and should be considered in patients with thyroid disease, because they are helpful for the early diagnosis of endocrinopathy. [ABSTRACT FROM AUTHOR]

A 14-year-old woman presented with recent history of heat intolerance, hand tremor and palpitations. Physical examination showed diffuse thyroid enlargement, and thyroid profile, suppressed TSH and elevated thyroid hormones. Anti-TPO antibodies were positive. Initial treatment included methimazole and beta blockers. After twenty days, patient complained of malaise, fever, polyarthralgia, maculopapular rash, and leg swelling. ANA antibodies were negative; however, ANCA antibodies were positive. Methimazole was stopped and prednisone started. Her clinical evolution was good, and she received I 131. ANCA associated vasculitis related to thionamides are infrequent. These vasculitis affect small vessels of skin, however they can also affect kidneys and lungs. Arthralgia and myalgia are the classical symptoms. In most patients, symptoms disappear after cessation of drug. In some cases, glucocorticoid or immunosuppressive therapy are also needed. [ABSTRACT FROM AUTHOR]

A 34-year-old woman came to hospital with a recent history of asymptomatic diffuse thyroid enlargement and normal thyroid profile. Physical examination showed a palpable nodule in the left lobe. Ultrasound confirmed a solid nodule in the left lobe with increased Doppler color flow. The anti TPO antibodies were positive, and fine needle biopsy showed no malignant cells. Six months later, she returned because of weight loss, palpitations, heat intolerance, and hand tremor. Thyroid hormones were TSH 0,01 mIU/dL and free T4 4,59 ng/dL. Thyroid scan identified homogeneously increased uptake throughout the gland, especially in the middle of both lobes. Treatment was started with methimazole and propanolol. After six months of treatment, her symptoms disappeared, and thyroid profile was normal, and she received a high dose of I-131. Graves' disease with functioning nodules is known as Marine-Lenhart syndrome. The frequency is rare, only 1- 2,7% of patients with Graves' disease have concomitant functioning nodules. Functional nodules may be more resistant to radioiodine therapy than the extranodular tissue; generally required higher dose of radioactive iodine for ablation. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical characteristics, thyroid function profile and autoimmune markers in patients with Graves' disease (GD) treated at the endocrine service of a general hospital. Material and methods: Descriptive and retrospective study in patients with GD treated at the Hospital Nacional Cayetano Heredia during 2005, identified in the Daily Registry of Attention and Other Activities of the Endocrine Service. For statistical analysis, SPSS software was used. Results: We reviewed 111 medical charts. The mean age was 40.6 ± 14 years. 71.2% were women. Twenty three patients (20.7%) reported familial history of autoinmune disease. The mean time of disease was 18.9 ± 30.4 months before diagnosis. The most frequent symptoms were: tremor, thin skin, palpitations and weight loss. The mean thyroid weight was 69 ± 27.5 grams. In 38.7% exophthalmos was present and 18.9% had myxedema. Hormonal profile showed suppressed TSH, elevated levels of free T4 and total T3. In 8.6.7% autoantibodies against thyroid peroxidase (anti-TPO) were positive. The initial treatment included thionamides in 95.5% of patients. Further statistical analysis showed that women had more frequent familiar history of autoinmune thyroid disease than men (,27.8% vs. 9.4%) (p = 0.04). Conclusions: Most of our patients with GD were women between third and sixth decade of life. The estimated weight of the thyroid gland was three times the normal weight and ophthalmopathy and myxedema were frequent, Most of our patients had positive autoimmune markers and the initial treatment included thionamides. [ABSTRACT FROM AUTHOR]

BACKGROUND Graves' disease is characterized by a classic triad: hyperthiroidism, ophthalmopaty and dermatopaty. Several symptoms of Graves' ophthalmopaty may be explained mechanically by the increased extraocular muscles and adipose tissue. OBJECTIVE To assess efficacy and safety or endoscopic transnasal orbitary decompression of Graves' disease. MATERIAL AND METHODS A retrospective study was done reviewing 79 orbitary decompressions for 10 years at otorhynolaryngology department, Hospital de Especialidades, Centro Medico Nacional Siglo XXI. Otorhynolaryngology and Ophthalmology services made integral assessment and measurement of decompression. RESULTS Results were analyzed based on Hertel's exophthalmometry; a mean reduction of 4.5 mm of exophthalmos was obtained. CONCLUSIONS Endoscopic transnasal orbitary decompression is just a step for the surgical treatment of Graves' ophthalmopaty, because in case of persistence or postoperative appearance of diplopia, surgery in extraocular muscles is performed [ABSTRACT FROM AUTHOR]

We report two cases of Graves' disease after immune reconstitution following highly active antiretroviral therapy (HAART). We reviewed and abstracted the patients' records and also conducted a review of the pertinent medical literature. Two patients with history of HIV infection developed weight loss, tachycardia, tremor, and diarrhea after 30-48 months of treatment with HAART based on zidovudine, lamivudine, and atazanavir. Their CD4 T cells count was in normal range and viral load was undetectable. Physical examination showed diffuse thyroid enlargement. Thyrotropin was suppressed, free thyroxine was elevated, and anti-TPO antibodies were positive. Both showed clinical improvement with the use methimazole and atenolol. Graves' disease may be a form of immune reconstitution syndrome following HAART. This form of autoimmune thyroid disease is related with the second phase of T-cell repopulation with naive autoreactive CD4 T cells clones. Physicians need to be vigilant in detecting thyrotoxicosis in patients who have immune reconstituted well on HAART, since early diagnosis and treatment alleviates symptoms and may reduce long-term morbidity of Graves' disease. [ABSTRACT FROM AUTHOR]

Background: The methimazole has long been used for treating Graves' disease to decrease thyroid hormone production and obtain a thyroid normofunction, but this drug has also immunosuppressive and immunomodulation effects. Objective: To analyze in patients with Graves' disease treated with methimazole and allergic rhinitis, the clinical evolution of the allergic rhinitis with the immunosuppressive and immunomodulation effects of the methimazole. Patients and methods: A comparative and observational study was done in the Mexico's General Hospital, in twenty-six patients with Graves' disease treated with methimazole 10 mg, thyroid profi le was done, and when subjects obtained a thyroid normofunction continued with the same doses of methimazole and received also 12.5 mcg/day of levothyroxine. All the patients were diagnosed with allergic rhinitis, and they were divided into two groups (11 females and 2 males each). Both groups continued with the same treatment of methimazole and levothyroxine, but group II was given also antihistamines H1 of second-generation (loratadine) daily, and specific immunotherapy during six months. We described and compared the clinical evolution of the allergic rhinitis of the two groups with the treatment. Results: In the group I, changes in the clinical evolution of the allergic rhinitis after six months were not observed. In the group II, by week 10 the symptoms of the allergic rhinitis were controlled in 80% of the patients, and by week 14 all the patients of this group were asymptomatic. Conclusions: In patients with allergic rhinitis and Graves' diseases with methimazole-thyroid normofunction we observed that there is not influence of methimazole on clinical evolution of the allergic rhinitis. [ABSTRACT FROM AUTHOR]

Thyrotoxic hypokalemic periodic paralysis is an acute and reversible episode of muscular weakness associated with a thyrotoxic state. It most commonly occurs in Asiatic patients with Graves' disease, but it can be seen in any ethnic group. The crises are precipitated by b-adrenergic overstimulation or by hyperinsulinemia, factors associated with hyperactivity of the Na-K ATPase pump, a state that produces an intracellular K+ sequestration. Generally, it manifests itself at night or very early in the morning, commonly after a high-carbohydrate diet or intense physical activity. Proximal muscles of the lower extremities are first affected to later extend to the rest; in serious cases cranial nerves and respiratory muscles can be involved. The clinical episode can be spontaneously resolved in 3 to 36 hours but nevertheless, medical treatment is necessary to prevent lethal complications related to hypokalemia, such as cardiac arrhythmias or respiratory arrest. The definitive control of THPP is obtained by avoiding the precipitating events and by seeking a complete suppressive treatment of the hyperthyroid state. Periodic hypokalemic thyrotoxic paralysis is infrequent in clinical practice and as such is not recognized early during the diagnostic approach. It is important to spread its knowledge to all emergency medical services. [ABSTRACT FROM AUTHOR]

Objective: To describe the response and complications in children and teenagers suffering Graves' disease who received radioactive iodine therapy. Material and Methods: The clinical records of the patients attended at Paediatric Endocrinology Unit of Hospital Nacional Cayetano Heredia who received therapy with I131 were reviewed. Demographic characteristics, thyroid weight, radioactive iodine uptake, I131 dose and clinical and thyroid function evolution were registered. Results: We include thirteen patients: 1 male and 12 females. The mean thyroid weight obtained was 47.56 +10.70 gr. Initial calculated dose was 3.92 +0.95 mCi, with a total dose of 4.47 +1.66 mCi, and mean following period of 2.76 years. Ten patients received only one dose, 2 patients received two doses and one patient received three doses; all cases remitted. Patients who received only 1 dose showed disease remission at 13.13 weeks and mean remission period of the population was 24.62 weeks. Hypothyroidism prevalence up to six months from initiating treatment was 66.66%, and up to 257 weeks 83.33%. Conclusions. We conclude that I131 was 100% effective in the treatment of children and adolescents suffering Graves' disease in this small series. [ABSTRACT FROM AUTHOR]

The adverse effects of hyperthyroidism on bone have been described for years. Thyroid hormones are necessary for growth, maturation, metabolism and bone remodelling. However, untreated thyrotoxicosis causes increased remodelling, osteopenia or osteoporosis and increased fracture risk. Since the introduction of antithyroid drugs and radioiodine, hyperthyroid bone disease is less common. Here we present a rare case of an asymptomatic patient with thyrotoxicosis making its debut as increased bone remodelling. [ABSTRACT FROM AUTHOR]