Transient hyperthyroidism following L-asparaginase therapy for acute lymphoblastic leukemia.
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The effect of L-asparaginase on the thyroid gland has not been well documented. We report the first two cases of hyperthyroidism associated with thyroid nodule following L-asparaginase therapy for acute lymphoblastic leukemia (ALL). The thyroid function abnormalities were not severe, short-lived and did not require specific therapy. (+info)
Follicular carcinoma of the thyroid with functioning metastases and clinical hyperthyroidism.
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Hyperthyroidism associated with metastatic follicular carcinoma of the thyroid gland is rare. In one patient the mass of functioning follicular tissue in the primary and metastatic tumour was so great that excessive amounts of thyroxine and triiodothyronine were produced and, as a result, clinical hyperthyroidism developed. This was in spite of the fact that the activity per unit of tissue was not supranormal and may even have been slightly subnormal. The initial response of the metastases to 131I ablative therapy was excellent. (+info)
Hyperthyroidism in a patient with TSH-producing pituitary adenoma coexisting with thyroid papillary adenocarcinoma.
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A 27-year-old woman who presented with a left thyroid nodule was found to have hyperthyroidism caused by a syndrome of inappropriate secretion of TSH. The levels of free T3, free T4 and TSH were 9.50 pg/mL, 4.05 ng/dL and 2.16 microU/mL, respectively. Magnetic resonance imaging of the head revealed a pituitary macroadenoma. The TSH response to TRH stimulation was normal and responses of other anterior pituitary hormones to stimulation tests were also normally preserved. Administration of octreotide with iodine successfully reversed hyperthyroidism prior to total resection of pituitary adenoma, which was followed by hemithyroidectomy of the left thyroid five months later. Histologically, the resected pituitary adenoma was a TSH-producing adenoma (TSH-oma) and the thyroid nodule was a papillary adenocarcinoma. Serum TSH diminished to undetectable levels immediately following pituitary adenomectomy but gradually normalized over nine months. Coexistence of a TSH-oma with thyroid cancer is very rare and only two similar cases have previously been documented. This combination raises the possibility that TSH may be involved in tumorigenesis in the thyroid gland. (+info)
Regulation of microglial development: a novel role for thyroid hormone.
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The postnatal development of rat microglia is marked by an important increase in the number of microglial cells and the growth of their ramified processes. We studied the role of thyroid hormone in microglial development. The distribution and morphology of microglial cells stained with isolectin B4 or monoclonal antibody ED1 were analyzed in cortical and subcortical forebrain regions of developing rats rendered hypothyroid by prenatal and postnatal treatment with methyl-thiouracil. Microglial processes were markedly less abundant in hypothyroid pups than in age-matched normal animals, from postnatal day 4 up to the end of the third postnatal week of life. A delay in process extension and a decrease in the density of microglial cell bodies, as shown by cell counts in the developing cingulate cortex of normal and hypothyroid animals, were responsible for these differences. Conversely, neonatal rat hyperthyroidism, induced by daily injections of 3,5,3'-triiodothyronine (T3), accelerated the extension of microglial processes and increased the density of cortical microglial cell bodies above physiological levels during the first postnatal week of life. Reverse transcription-PCR and immunological analyses indicated that cultured cortical ameboid microglial cells expressed the alpha1 and beta1 isoforms of nuclear thyroid hormone receptors. Consistent with the trophic and morphogenetic effects of thyroid hormone observed in situ, T3 favored the survival of cultured purified microglial cells and the growth of their processes. These results demonstrate that thyroid hormone promotes the growth and morphological differentiation of microglia during development. (+info)
Significant effects of mild endogenous hormonal changes in humans: considerations for low-dose testing.
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We review the significant and adverse health effects that can occur with relatively small endogenous hormonal changes in pubertal and adult humans. We discuss the effects of hormonal changes that occur within normal physiologic ranges--such as the rising levels of estrogen in peripuberty, which cause growth spurts at low levels and then the fusion of epiphyses at higher levels--and the hormonal variations during the menstrual cycle and their relation to genital phenotypic changes and intercurrent disease evolution. We turn next to adaptive changes in gonadal and other functions during aging, exercise, stress, starvation, and chronic diseases, which can serve as models for the effects of exogenous, hormonally active compounds. Then we review the states of borderline hormonal imbalances such as subclinical (having few or very mild symptoms, if any) hypothyroidism or hyperthyroidism, glucose intolerance, and other endocrine conditions. Finally, we review the deleterious systemic effects of gonadal imbalance. Information stemming from clinical observations leads to the concept of "no threshold" within the endocrine system and thus illustrates the importance of considering low-dose testing for chemicals that interfere with hormonal activity. We also urge attention to more sensitive, less visible end points such as osteoporosis, increased risk for cardiovascular disease, or cognitive changes. (+info)
Primary Hodgkin's disease of the CNS in an immunocompetent patient: a case study and review of the literature.
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Primary Hodgkin's disease limited to the CNS is exceedingly rare. Little is known regarding etiologic risk factors, optimal management, and prognosis. A case of Hodgkin's disease confined to the CNS, with cerebrospinal fluid negative for cytology, is described in an immunocompetent patient previously treated for hyperthyroidism with 131I. The patient underwent craniotomy, with resection of two lesions in close proximity within the parenchyma of the temporoparietal lobe. Histopathology revealed classic nodular sclerosing Hodgkin's disease, without evidence of Epstein-Barr viral infection. Treatment included radiation to the whole brain with a boost to the tumor bed. The patient made a full neurologic recovery and remains free of disease recurrence 21 months after treatment. A literature review has identified only 9 additional cases. Seven of 8 evaluable patients remain alive and free of recurrence with a median follow-up of 13 months. The risk factors for this presentation remain undefined. Although follow-up is short, radiotherapy alone appears to provide excellent disease-free survival. Chemotherapy may be reserved for patients with positive cerebrospinal fluid, extracranial disease, or subsequent relapse. (+info)
The predictive value of histometry of thyroid tissue in anticipating hypothyroidism after subtoatl thyroidectomy for primary thyrotoxicosis.
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Thyroid tissue removed at partial thyroidectomy from primary thyrotoxicosis patients, after preparation for operation with carbimazole and Lugol's iodine, was studied with the histometric technique. In patients with little or no evidence of autoimmunity before operation, the chance of developing postoperative hypothyroidism was approximately 1 in 2 in those who had volume percentage of epithelium greater than 40, but only approximately 1 in 10 in those who had volume percentage of epithelium less than 40. This approach may ultimately prove of predictive value in a substantial proportion of patients for anticipating hypothyroidism after subtotal thyroidectomy for primary thyrotoxicosis. (+info)
Effect of transient early hyperthyroidism on onset of puberty in Suffolk ram lambs.
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The thyroid function and sexual development of eight 6-week-old Suffolk ram lambs were studied. The lambs were divided into either control or treatment groups and housed indoors. From 6 to 12 weeks of age, four lambs in the treatment group received 15 mg kg(-1) body weight per day of 6-propyl 2-thiouracil orally to suppress normal thyroid function. During the same period, thyroxine and tri-iodothyronine were injected s.c. at the rate of 8 and 16 microg kg(-1) body weight per day, respectively, to induce a hyperthyroid state. Four control lambs received sham injection and oral excipient. Concentrations of thyroxine, tri-iodothyronine, FSH, testosterone and insulin-like growth factor I were determined in blood collected by indwelling jugular catheters once a week, every 20 min from 09:00 to 15:20 h. Scrotal circumference was recorded each week. Semen collection was attempted by electro-ejaculation between weeks 17 and 36. Lambs were castrated at week 36 and testicular histology was examined. During the treatment period only, the concentration of thyroid hormones was higher in treated lambs than in controls (P < 0.05). From week 6 to week 9 only, concentrations of FSH in treated lambs were lower than in controls (P < 0.05). Insulin-like growth factor I concentrations were lower in treated lambs than in controls from week 10 to week 13 (P < 0.05). Frequency of testosterone pulses was higher (P < 0.01) in the treated lambs but concentrations were similar in the control and treated lambs throughout the experiment. Scrotal circumference was greater in treated lambs from week 26 to week 36 (P < 0.05). Treated lambs produced viable spermatozoa earlier than did control lambs. At week 36, sperm concentration in treated lambs was higher than in controls (P < 0.01) but semen volumes were similar (P > 0.1). Diameter of the seminiferous tubules in treated lambs was larger than in controls (P < 0.05). In conclusion, transient neonatal hyperthyroidism decreased FSH and insulin-like growth factor I concentrations temporarily, increased testosterone pulses and sperm production and advanced puberty in Suffolk ram lambs. (+info)