• Title/Summary/Keyword: 갑상선 기능 저하증

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Concurrent Medullary Carcinoma and Hashimoto's Thyroiditis: A Case Report with an Emphasis on US Features (하시모토 갑상선염과 동반된 갑상선 수질암의 증례 보고: 초음파 소견을 중심으로)

  • Hyoung Yeob Kim;Noh Hyuck Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.1146-1151
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    • 2023
  • Medullary thyroid carcinoma (MTC) is a rare malignancy that originates from the parafollicular cells of the thyroid gland. Hashimoto's thyroiditis (HT) is an autoimmune thyroid disease and is the most common cause of hypothyroidism. Previous studies have frequently discussed the association among HT, papillary thyroid carcinoma, and thyroid lymphoma. However, there have been few reports on the ultrasonographic findings of concomitant HT and MTC. In the present case, a heterogeneous hypoechoic background parenchymal echogenicity, with intraglandular echogenic strands, and increased vascularity were observed. A concurrent, ill-defined, parallel-oriented, heterogeneous hypoechoic mass with central microcalcifications was located at the left thyroid gland, consistent with reported US findings of medullary thyroid carcinoma except for an ill-defined margin in our case.

Secondary Adrenal Insufficiency Initially Misdiagnosed as Depression : A Case Report (우울증으로 오진되었던 이차성 부신기능저하 : 증례 보고)

  • Moon, Duk-Soo;Kang, Won-Sub;Paik, Jong-Woo;Song, Ji-Young;Kim, Jong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.2
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    • pp.109-114
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    • 2011
  • The abnormalities in Hypothalamic-pituitary-adrenal(HPA) axis are associated with many psychiatric symptoms including depression. We present a report of a 71 year old man who was admitted to the psychiatric department presenting symptoms of headache, avolition, loss of energy, psychomotor retardation, poor appetite, insomnia, anxiety resulting from adrenal insufficiency and hypopituitarism. Hypothyroidism and electrolyte disturbance were managed and headache, insomnia, anxiety, GI symptoms were improved. But he remained in anergic state. After discharge, he was readmitted to infection department with high fever and drowsy mentality. Adrenal insufficiency was recognized and he was treated with corticosteroid replacement therapy. Finally his diagnosis was made as panhypopituitarism and overall symptoms were resolved. In this case, we showed how the atypical symptoms resulting from hypopituitarism develop and progress. Hypothyroidism, adrenal insufficiency, and growth hormone deficiency resulting secondarily from panhypopituitarism were associated with various nonspecific symptoms such as loss of energy, fatigue, insomnia, weight loss, decreased appetite etc. In clinical situation, differential diagnosis with depression is needed when clinicians were met a patient with these nonspecific symptoms. It is important that laboratory tests and differential diagnosis with endocrine diseases should be conducted, especially in geriatric patients with nonspecific symptoms like anergia, fatigue, poor appetite and so on.

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A Study on Achiles Tendon Reflex in Normal Korean Persons and Various Thyroid Diseases (정상한국인(正常韓國人) 및 각종갑상선질환(各種甲狀腺疾患)에서의 아킬레스건반사시간(腱反射時間)에 관(關)한 연구(硏究))

  • Kang, Jin-Yung;Kim, Myung-Duk;Lee, Hong-Kyu;Lee, Jung-Sang;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.12 no.1
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    • pp.17-28
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    • 1978
  • A simplified photoelectric apparatus producing graphic records of the free Achilles tendon reflex allowed us to study the reflex quantitatively in subjects with normal and abnormal thyroid function. In this study Achilles tendon reflex times were tested in 340 normal Korean persons, 89 hyperthyroid patients, 19 hypothyroid patients and 85 other thyroid disease patients who were euthyroid in thyroid function tests. In normal Korean persons, the Achilles tendon reflex time was delayed with increasing age and slower in female than in male. They showed good correlationship with various thyroid function tests which included ETR, $T_3RU,\;^{131}I$ thyroid uptake and serum TSH. Diagnostic accuracy of them was 71% in hyperthyroidism and 90% in hypothyroidism. Finally the serial measurements of them were very useful tests in evaluating the clinical coures of hyperthyroidism and hypothyroidism once treatment was begun.

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Study on the Usefulness of Ultrasonography for Postpartum Depression and Thyroid Disease (출산 후 우울증과 갑상선질환에 대한 초음파검사의 유용성에 관한 연구)

  • Lee, Yun-Yi;Lim, Cheong-Hwan;Jung, Hong-Ryang;Park, Mi-Ja;You, In-Gyu
    • Journal of radiological science and technology
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    • v.35 no.3
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    • pp.237-248
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    • 2012
  • Postpartum depression(PPD) of women with depression increased frequency of thyroid disease, and so the correlations for depression and thyroid disease has been the subject of discussed whether. The purpose of this study was to predict the prevalence of PPD and the correlation between PPD and thyroid disease through ultrasonography. January 2010 to November 2011, Obstetrics & Gynecology in M-clinical center admitted 230 patients within 1 year postpartum were enrolled. EPDS by PPD scale depression screening and general characteristics of subjects were investigated and thyroid was examined that ultrasonography and thyroid blood tests. A total of 230 patients non PPD group were 53.0% and PPD group were 47.0%. In ultrasonography, among 27 patients who changed in size of thyroid, non PPD group were 14.8% and PPD group were 85.2%. Among 124 patients who thyroid nodules were presence, non PPD were 35.8% and PPD group were 64.2%. In ultrasonography, PPD group were higher incidence than non PPD group were changes in size of thyroid and the presence of nodules. There was significant difference between the changed in size of thyroid and thyroid nodules were presence the two group. Definitive histopathological diagnosis was benign in 33 patients (non PPD group were 45.5%, PPD group were 54.5%), malignancy in 5 patients (only PPD group were 100%), thyroiditis in 3 patients (non PPD group were 33.3%, PPD group were 66.7%). The results of thyroid blood tests, abnormal TSH level were 7 patients (non PPD group were 28.6%, PPD group were 71.4%) and abnormal Free T4 level were 9 patients (non PPD group were 44.4%, PPD group were 55.6%). There was no significant difference between the abnormal TSH level and Free T4 level of the two group. 5 patients were diagnosed as thyroid dysfunction. Of these, 2 patients were subclinical hyperthyroidism in non PPD group, 2 patients were subclinical hyperthyroidism and 1 patient was subclinical hyperthyroidism in PPD group. This study was significant the correlation between PPD and thyroid gland disease through ultrasonography. And the objective results of this study might be able to provide guideline that understanding, prevention and treatment for PPD and thyroid disease.

A Case Study of Hypothyroidism Patient Using Ortho-Cellular Nutrition Therapy (OCNT) (세포교정영양요법(OCNT)을 이용한 갑상선기능저하증 환자 사례 연구)

  • Sunhee Kang
    • CELLMED
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    • v.13 no.13
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    • pp.52.1-52.4
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    • 2023
  • Objective: Case report of hypothyroidism improved by ortho-cellular nutrition therapy. Methods: A 55-year-old Korean woman diagnosed with hypothyroidism in the past, did not take any Synthyroid medication while undergoing OCNT for a year. Results: A blood test was conducted one year after the initiation of OCNT, and she was diagnosed with normal thyroid hormone level. Conclusion: Applying nutritional therapy to patients with hypothyroidism may assist in the recovery of thyroid hormone levels and the alleviation of symptoms.

Surgical Resection of the Pulmonary Mucormycosis in the Diabetic Patient -1 case report- (당뇨병환자에서 발생한 폐모균증의 외과적 절제)

  • 김석기;서연호;김민호
    • Journal of Chest Surgery
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    • v.33 no.11
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    • pp.915-918
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    • 2000
  • 폐모균증은 드물지만 치명적인 기회감염성 진균증으로 혈액종양, 신부전, 또는 당뇨와 같이 면역기능이 저하된 환자에서 주로 발생한다. 환자는 3년전부터 당뇨병 및 갑상선기능 항진증을 앓아온 32세 남자로 1개월간의 기침, 발열 및 좌측 흉통을 주소로 내원하였다. 기관지 내시경하 경기관지 폐생검상 폐모균증 진단되어 좌폐하엽절제술을 시행하였다. 술후 21일째 흉부방사선 사진 소견상 다수의 국소적인 흉막삼출로 흉강경을 이용한 배약술을 시행하였다. 환자는 술후합병증이 없이 흉강경배액술후 23일째 퇴원하였다. 기왕의 문헌보고에 의하면, 한쪽폐에 국한된 모균증을 가진 수술가능한 환자에서는 조기에 과감한 수술적 처치가 생존율을 높이는 것으로 제안하고 있다.

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Measurements of Actual Effective Half-Life in $^{131}I$ Therapy for Graves' Hyperthyroidism (그레이브스 갑상선기능항진증 환자의 방사성옥소($^{131}I$) 치료시 실제 유효반감기의 측정)

  • So, Yong-Seon;Kim, Myung-Seon;Kwon, Ki-Hyun;Kim, Seok-Whan;Kim, Tae-Hyung;Han, Sang-Woong;Kim, Eun-Sil;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.77-85
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    • 1996
  • Radioiodine($^{131}I$) has been used for the treatment of Graves' hyperthyroidism since the late 1940's and is now generally regarded as the treatment of choice for Graves' hyperthyroidism who does not remit following a course of antithyroid drugs. But for the dose given, several different protocols have been described by different centers, each attempting to reduce the incidence of long-term hypothyroidism while maintaining an acceptable rate control of Graves' hyperthyroidism. Our goals were to evaluate effective half-life and predict absorbed dose in Graves' hyperthyroidism patients, therefore, to calculate and readminister radioiodine activity needed to achieve aimed radiation dose. Our data showed that the mean effective $^{131}I$ half-life for Graves' disease is 5.3 days(S.D=0.88) and mean biologic half-life is 21 days, range 9.5-67.2 days. The mean admininistered activity and the mean values of absorbed doses were 532 MBq(S.D.=254), 112 Gy (S.D.=50.9), respectively. The mean activity needed to achieve aimed radiation dose were 51MBq and marked differences of $^{131}I$ thyroidal uptake between tracer and therapy ocurred in our study. We are sure that the dose calculation method that uses 5 days thyroidal $^{131}I$ uptake measurements after tracer and therapy dose, provides sufficient data about the effective half-life and absorbed dose of $^{131}I$ in the thyroid and predict the effectiveness of $^{131}I$ treatment in Graves' hyperthyroidism.

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Thyrotropin-Binding Inhibiting Immunoglobulin(TBII) in Patients with Autoimmune Thyroid Diseases (자가면역성 갑상선질환에서의 혈청 Thyrotropin-Binding Inhibiting Immunoglobulin치)

  • Jang, Dae-Sung;Ahn, Byeong-Cheol;Sohn, Sang-Kyun;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.65-76
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    • 1996
  • In order to evaluate the significance of thyrotropin-binding inhibiting immunoglobulin (TBII) in the patients with autoimmune thyroid diseases, the authors investigated 402 cases of Graves' disease and 230 cases of Hashimoto's thyroiditis comparing 30 cases of normal healthy adult at Kyung Pook University Hospital from February 1993 to August 1994. The TBII was tested by radioimmunoassay and assesed on the dynamic change with the disease course, thyroid functional parameters, and other thyroid autoantibodies : antithyroglobulin antibody (ATAb) and antimicrosomal antibody (AMAb) including thyroglobulin. The serum level of TBII was $40.82{\pm}21.651(mean{\pm}SD)%$ in hyperthyroid Graves' disease and $8.89{\pm}14.522%$ in Hashimoto's thyroiditis and both were significant different from normal control of which was $3.21{\pm}2.571%$. The frequency of abnormally increased TBII level was 92.2% in hyperthyroid Graves' disease, 46.7% in euthyroid Graves' disease or remission state of hyperthyroidism, and 23.9% in Hashimoto's thyroiditis. The serum levels of increased TBII in Graves' disease were positively correlated with RAIU, serum T3, T4, and FT4, but negatively correlated with serum TSH(each P<0.001). The TBII in Graves' disease had significant positive correlation with serum thyroglobulin and AMAb, but no significant correlation with ATAb. In the Hashimoto's thyroiditis, the serum levels of TBII were positively correlated with RAIU, serum T3, TSH and AMAb, but not significantly correlated with serum T4, FT4, thyroglobulin and ATAb. Therefore serum level of TBII seemed to be a useful mean of assessing the degree of hyperthyroidism in Graves' disease and correlated well with thyroidal stimulation. The serum level of TBII in Hashimoto's thyroiditis is meaningful for the degree of both functional abnormality reflecting either hyperfunction or hypofunction and the immune logic abnormality.

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A Case of Pleural Effusion due to Hypothyroidism (갑상선기능저하증에 의한 흉막액 1예)

  • Oh, Hyung Joong;Park, Sun Young;Byun, Min Kwang;Chung, Woo Young;Park, Moo Suk;Moon, Jin Wook;Gang, Sin-Myeong;Han, Chang-Hun;Kim, Young Sam;Chang, Joon;Kim, Sung Kyu;Kim, Se Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.3
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    • pp.321-325
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    • 2005
  • Serous effusions have been most commonly associated with ascites, pericardial effusion, and heart failure. But, they have been considered to be an unusual form of complication in hypothyroidism and pleural effusion, which has been observed as an isolated finding in hypothyroidism is apparently rare and complete analysis of these types of hypothyroid-associated pleural effusions has yet not been described. We report a case of hypothyroidism associated with unilateral pleural effusion in a 77 year-old male patient who was improved through levothyroxine sodium with brief review of the literature.

A Case of Pseudohypoparathyroidism in a Premature Infant (미숙아에서 발견된 가성부갑상선 기능저하증 1례)

  • Yang, Jong Il;Seo, Jang Won;Kim, Ji Young
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1032-1035
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    • 2003
  • In pseudohypoparathyroidism as reported by Albright in 1942, the parathyroid gland can normally synthesize and secrete parathyroid hormone(PTH). Pseudohypoparathyroidism has a similar biochemical finding with hypoparathyroidisms like hypocalcemia and hyperphosphatemia due to target tissue resistance to PTH. Administered PTH does not raise the serum levels of calcium and urinary phosphate. PTH activates G-protein in peripheral tissue and adenylate cyclase through a second messenger, cAMP. Pseudohypoparathyroidism produces hyperphosphatemia and hypocalcemia because of the resistance to PTH in peripheral tissue due to a defect of G-protein, although it releases PTH normally. According to the mechanism of resistance, pseudohypoparathyroidism is classified into types : Ia, Ib, Ic and psedopseudohypoparathyroism. Type Ia is accompanied by congenital growth retardation and abnormal bony development that shows mental retardation, obesity, low height, round face, short metacarpal bone and metatarsal bone, ectopic calcification, etc. We report a case of pseudohypoparathyroidism in a premature who shows hypocalcemia, hyperphosphatemia, elevation of serum PTH and 24 hr urinary basal c-AMP in biochemical tests without Albright's hereditary osteodystrophy at physical examination, accompanied by a spontaneous fracture in the femur.