• Title/Summary/Keyword: Myxedema

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A case of hypothyroidism concurrent with myxedema coma in a Cocker spaniel dog

  • Kim, Yun-Hye;Kim, Jun-Hwan;Lee, Hyun-Seok;Cho, Ho-Seong;Park, Jin-Ho;Park, Chul
    • Korean Journal of Veterinary Service
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    • v.35 no.2
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    • pp.159-163
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    • 2012
  • A 4-year-old female Cocker spaniel weighing 7.74 kg was presented with a seven-month history of lethargy and skin problems. On the basis of clinical history, physical examination, laboratory tests, electrocardiogram, radiography, ultrasonography, and thyroid function tests, the dog was diagnosed as hypothyroidism. The dog was administered levothyroxine and presented a good response to the therapy. However, uncontrolled for about 6 months, the dog was re-admitted to hospital with depression and three seizure episodes. The dog was diagnosed as hypothyroidism with concurrent myxedema coma and gallbladder mucocele. With fluid therapy and administration of levothyroxine, the dog was successfully controlled for 3 months after starting treatment. This report describes the clinical features and successful treatment of a Cocker spaniel dog with concurrent hypothyroidism and myxedema coma.

Clinical study of 1 case of patient with Hypothyroidism (갑상선(甲狀腺) 기능저하증(機能低下症) 환자(患者) 1례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Kim, Yong-Sung;Kim, Kyung-Su
    • Herbal Formula Science
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    • v.9 no.1
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    • pp.397-403
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    • 2001
  • Tyroid gland is the biggist endocrine organ which is located in front of trochea. The role of the thyroid gland in the total body economy comprises the synthesis, storage, and secretion of thyroid hormones, which are necessary to growth, development, and normal bodymetabolism. Hypothyroidism is the state of a dificiency in the secretion of Thyroid hormone. This may result from idiopathic myxedema, or distruction or removal of thyroid, or goiter, or thyroid adenomas. Hypothyroidism corresponds to thick lips, dry skin, puffy eyelids, coars hair, megaloglossia, and pudgy hands etc. On one case of Hypothyroidism who was hospitalized for the chief complaints of fatigue, general weakness, coldness, edema in head, neck site, lumbago. I diagnosed this case as dificiency of Qi and blood(氣血兩虛) or dificiency of warm-Qi in spleen and kidney(脾腎陽虛). And then I used Moxa treatment to increase Qi and blood, and Acupuncture treatment to reduce shoulder and neck pain, lumbago. And Herb-med is used to increase Qi and blood, and recover of general condition. As a result, this patient got better more quickly.

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The Roles of the TSH Receptor Antibodies in Autoimmune Thyroid Diseases (자가면역성 갑상선질환에서 TSH 수용체 항체의 역활에 관한 연구)

  • Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.2
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    • pp.85-100
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    • 1986
  • To evaluate the clinical and pathogenetic roles of TSH receptor antibodies in autoimmune thyroid diseases, TBII were measured by TSH-radioreceptor assay methods in 352 patients with Graves' disease, 108 patients with other thyroid diseases and 69 normal persons. The normal range of TBII activity was less than 15%. The frequencies of detectable TBII in 169 patients with untreated Graves' disease, 31 patients with hyperthyroidism under treatment and 70 patients with euthyrodism under treatment were 92.4%, 87.1% and 54.3% respectively. However 12 (21.8%) out of 55 patients who have been in remission more than one year after discontinuation of antithyroid drugs treatment had detectable TBII activities in their sera. In 196 patients with untreated Graves' disease, the frequency of TBII increased by increasing size of goiter and the frequency of proptosis was significantly high in patients whose TBII activities were more than 60%. TBII activities were roughly correlated with total $T_3,\;T_4$ and free $T_4$ index but low $\gamma^2$ value(less than 0.1). In 67 patients with Graves' disease who were positive TBII before antithyroid drugs treatment, TBII activities began to decrease from the third months and it was converted to negative in 35.8% of patients at 12 months after treatment. There were no significant differences of the declining and disappearing rates of TBII activities between high dose and conventional dose groups. TBII activities were significantly increased initially (2-4 months) and then began to decrease from 5-9 months after $^{131}I$ treatment. There were two groups, one whose TBII activities decreased gradually and the other did not change untill 12 months after subtotal thyroidectomy. Although preoperative clinical and laboratory findings of both groups were not different, TBII activities of non-decreasing group were significantly higher than those of decreasing group$(74.6{\pm}18.6%\;vs\;39.2{\pm}15.2%;\;P<0.01)$. Thirty three(55.9%) out of 59 patients with Graves' disease relapsed within 1 year after discontinuation of antithyroid drugs. The positive rate of TBII at the end of antithyroid drug treatment in relapse group(n=33) was significantly higher than those in remission group (n=26) (63.6% vs 23.1%; P < 0.05). The mean value of TBII activities at the end of antithyroid drug treatment in relapse group was significantly elevated $(29.7{\pm}21.4%\;vs\;14.7{\pm}11.1%,\;P<0.05)$. Positive predictive value of TBII for relapse was 77.8%, which was not different from those of TRH nonresponsiveness(78.6%). The frequencies of detectable TBII in 68 patients with Hashimoto's thyroiditis, 10 patients with painless thyroiditis and 5 patients subacute thyroiditis were 14.7%, 20% and 0%, respectively. However in 25 patients with primary nongoitrous myxedema, 11 patients(44%) showed TBII activities in their sera. 9 out of 11 patients who had TBII activities in their sera showed high TBII activities(more than 70% binding inhibition) and their IgG concentrations showing 50% binding inhibition of $^{125}I-bTSH$ to the TSH receptor were ranges of 0.1-2.6 mg/dl. One patient who had high titer of TBII in her serum delivered a hypothyroid baby due to transplacental transfer of maternal TBII. These findings suggested that 1) TSH receptor antibodies are closely related to a pathogenetic factor of Graves' hyperthyroidism and of some patients with primary non-goitrous myxedema, 2) measurement of TSH receptor antibodies is helpful in evaluating the clinical outcome of patients with Graves' disease during antithyroid drug treatment and in predicting the neonatal transient hypothyroidism of baby delivered from primary myxedema patients. 3) there are 2 or more different types of TSH receptor antibodies in autoimmune thyroid diseases including one which stimulates thyroid by binding to the TSH receptor and another which blocks adenylate cyclase stimulation by TSH.

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Clinical Observation on Hyperthyroidism (갑상선기능항진증(甲狀腺機能亢進症)의 임상적(臨床的) 관찰(觀察))

  • Lee, Kyu-Bo;Kang, Bann;Song, Suk-Ho;Park, Hi-Myung;Whang, Kee-Suk
    • The Korean Journal of Nuclear Medicine
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    • v.3 no.2
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    • pp.39-47
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    • 1969
  • A clinical analysis was made on 161 cases of hyperthyroidism seen at the Radioisotope Laboratory of Kyungpook National University Hospital. This series consisted of 144 cases of diffuse goiter and 17 cases of nodular goiter. 1) Hyperthyroidism was most prevalent in the 4th decade and male to female ratio was 1:4.6. 2) Cardinal symptoms in the order of frequency were weakness, easy fatigability, palpitation, weight loss, nervousness, perspiration, heat intolerance, increased appetite, insomnia and dysmenorrhea. 3) Major physical findings in the order of frequency were goiter, fine tremor, tachycardia, wide pulse pressure, emaciation, warm moist skin, exophthalmos, systolic hypertension and atrial fibrillation. 4) The complications were ophthalmopathy (34.2%), thyrotoxic heart disease (5.6%), thyroid crisis (1 case), pretibial myxedema (1 case) and thyrotoxic myopathy (1 case). 5) Mean values of the six hour and twenty-four hour $^{131}I$ uptakes by the thyroid glands were 67.5% and 71.6%, respectively, in diffuse goiter and 64.5% and 65.0%, respectively, in nodular goiter. 6) Mean values of twenty-four hour $PB^{131}I$ conversion ratio were 76.3% in diffuse goiter and 70.2% in nodular goiter and those of the basal metabolic rate was +51% in the former and +41% in the latter. Mean serum cholesterol level was 152mg% in diffuse goiter and that in nodular goiter was 175mg%. 7) Among the 134 cases treated with $^{131}I$, 66 cases (49.3%) were successful1y controlled with single dose and in the majority of the cases the initial therapeutic dose required was $4.1{\sim}5.0mC$ in diffuse goiter and $5.1{\sim}6.0mC$ in nodular goiter. 8) With $^{131}I$ treatment the symptoms improved in the following order: heat intolerance, emaciation, nervousness, insomnia, easy fatigability, weakness, fine tremor, goiter, perspiration, exertional dyspnea and palpitation. And in a few cases improvement of even exophthalmos was seen. 9) Following $^{131}I$ treatment myxedema occurred in 4 cases (3%) and reccurrence in 9 cases (6.8%).

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Three Cases of Thyroid Hemiagenesis (갑상선 일측 무형성증 3예)

  • Kim, Ki-Hyun;Chung, Hyun-Pil;Kim, Jae-Wook;Koh, Yoon-Woo
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.183-187
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    • 2006
  • Thyroid hemiagenesis is a very rare congenital anomaly in which one thyroid lobe fails to develop. The cause of thyroid hemiagenesis is still unknown. The true prevalence of thyroid hemiagenesis is not known, but it is estimated to be from 0.05% to 0.2% in normal children. Thyroid hemiagenesis is common in female with the left lobe being absent. The common disease in the remaining lobe is hyperthyroidism, benign adenoma, a toxic multinodular goiter, chronic thyroiditis, primary myxedema, and rarely carcinoma. Tc-99m pertechnate scintigraphy, ultrasonography and computerized tomography can be used to confirm this anomaly. Here we report three cases with left lobe agenesis. Two of them were euthyroid state while the other hypothyroid patient had a ectopic lingual thyroid.

Clinical Experience with Subxiphoid Drainage of Pericardial Effusions (검상돌기하 심낭절개술에 의한 심낭 삼출액의 치료에 관한 고찰)

  • 김문환
    • Journal of Chest Surgery
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    • v.24 no.4
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    • pp.397-403
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    • 1991
  • From June 1987 to January 1991, 24 patients with moderate or massive pericardial effusion underwent subxiphoid pericardial window procedures for diagnosis and therapy. The patients` ages were ranged from 28 years to 71 years. The underlying diseases were chronic renal failure with long term hemodialysis in 3 cases, malignant lung cancer in 7 cases, stomach cancer in 2 cases, tuberculous pericarditis in 5 cases, pyogenic pericarditis in 2 cases, myxedema in one case, one metastatic squamous cell carcinoma from unknown origin and three of undefined etiology. Preoperative diagnoses of pericardial effusions were confirmed by echocardiogram in all cases. Subxiphoid pericardial drainages were performed under general[n=19] or local anesthesia[n=5]. Histological diagnoses were made from the inferior pericardial tissue in all cases except one. In this one case[tuberculous pericarditis], the subxiphoid pericardial approach was failed from intraoperative bleeding. There were two postoperative death, one[in malignant lung cancer] had postoperative ventricular tachycardia which result in cardiac arrest, and the other[unknown origin metastatic malignant effusion] had persistent tachyarrhythmia postoperatively and died on postoperative 5th days. Twenty three patients were followed up from 3 days to 9 months; mean follow-up day was 43 days. The preoperative and postoperative mean cardiothoracic ratio in chest x-ray were 0.69 and 0.52 respectively. Subxiphoid pericardial drainage may provide definitive diagnosis and treatment for pericardial effusions. The approach through subxiphoid pericardium under general or local anesthesia avoids the complications of pericardiocentesis and is effective for malignant pericardial effusion.

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Clinical Investigation and Treatment of Thyroid Diseases with Radioactive Iodine($^{131}I$) -Report 4- (방사성동위원소옥소(放射性同位元素沃素)($^{131}I$)에 의(依)한 갑상선질환(甲狀腺疾患)의 임상적연구(臨床的硏究) -제 4 보-(第 4 報))

  • Kim, M.H.;Lee, B.H.;Chung, K.T.;Chang, K.J.;Kim, M.J.;Lee, J.K.;Lee, M.
    • The Korean Journal of Nuclear Medicine
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    • v.1 no.1
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    • pp.67-78
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    • 1967
  • Over the past 6 years, from May 1960 to June 1966, 1,716 patients with various diseases of thyroid were examined and thyroid function tests with $^{131}I$ were done. Among them, 545 patients with hyperthyroidism were treated with $^{131}I$. A summary of the clinical data of the $^{131}I$-thyroid function tests and the therapeutic results of $^{131}I$ were presented and discussed. 1. The patients examined consisted of; 596 cases(34.7%) with toxic diffuse goiter, 412 cases(24.0%) with non-toxic nodular goiter, 278 cases(16.2%) with euthyroidism, 236 cases(13.8%) with non-toxic diffuse goiter, 89 cases(5.2%) with hypothyroidism, 53 cases(3.1%) with toxic nodular goiter, 32 cases(1.9%) with thyroiditis and 20 cases(1.2%) with dyshormonogenesis. 2. There were 218(12.7%) male patients and 1,498(87.3%) female patients, showing a ratio of 1:6.9. female predominantly. 3. The majority of patients(79.6%) were in the 3rd through 5th decades of their lives showing the peak in the 4th decades(35.9%). 4. The diagnostic values and normal ranges of $^{131}I$ uptake test, 48 hour serum activity, $T_3$ red blood cell uptake and $PB^{131}I$ conversion ratio were discussed. 5. An attention was given to dyshormonogenesis, a qualitative hypothyroidism, due to its characteristic findings of clinical and $^{131}I$ thyroid function tests, and its pathogenesis was briefly reviewed. 6. Among 545 patients with hyperthyroidism treated with $^{131}I$, 68.3% was cured after single. therapeutic dose and another 24.0% was cured after second dose. 7. The complications of $^{131}I$ therapy were discussed in some details and myxedema had developed. in 3.9% of our cases. No thyroid cancer was found after $^{131}I$ therapy.

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Clinical Investigation and Treatment of Thyroid Diseases with Radioactive Iodine($^{131}I$) (방사성(放射性) 동위원소옥소(同位元素沃素)($^{131}I$)에 의(依)한 갑상선질환(甲狀腺疾患)의 임상적(臨床的) 연구(硏究) - 제 5 보 (第 五 報) -)

  • Lee, Mun-Ho;Koh, Chang-Soon;Ro, Heung-Kyu;Lee, Chung-Sang;Koo, In-Seu;Suh, Hwan-Jo;Lee, Kyung-Ja;Lee, Hong-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.2
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    • pp.29-39
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    • 1970
  • A summary of the clinical data of the $^{131}I$-thyroid function tests and the therapeutic results of $^{131}I$ among the 2,658 patients of various thyroid diseases treated over the past 10 years from May 1960 to Oct. 1969 at the Radioisotope Clinic and Laboratory, SNUH were presented and dscussed. 1. The patients examined consisted of: 929 cases (34.9%) of diffuse toxic goiter, 762 cases (28.7%) of diffuse nontoxic goiter, 699 cases (26.3%) of nodular nontoxic goiter, 58 cases (2.2%) of nodular toxic goiter and 210. cases (7.9%) of hypothyroidism. 2. There were 300 (11.4%) male and 2358 (88.6%) female, showing a ratio of 1:8. 3. The majority of patients (79.1%) were in the 3rd-5th decades of their lives. 4. The normal ranges, diagonstic values of $^{131}I$ uptake test, 48 hrs, serum activity, BMR and main subjective symptoms of various thyroid diseases were discussed. 5. In the 579 patients among 867 cases with hyperthyroidism treated with $^{131}I$, 47.8% were confirmed to be cured completely after single therapeutic doses. 6. The complications of $^{131}I$ therapy were discussed and myxedema had developed in 6.75% of our patients. 7. The results of $^{131}I$ thyroid function tests were analysed among the 160 cases of thyroid diseases which were confirmed the diagnosis with histopathological measures.

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