Presence or severity of Hashimoto's thyroiditis does not influence basal calcitonin levels: observations from CROHT biobank.

PURPOSE: The influence of Hashimoto's thyroiditis (HT) on calcitonin (Ct) production is unresolved question. The aim of this study was to explore if basal Ct levels are influenced by the presence/severity of HT or correlated with clinical phenotypes of HT patients. METHODS: We included 467 HT patients and 184 control participants, from Croatian Biobank of HT patients (CROHT), in this retrospective study. Calcitonin levels between HT patients and controls were compared using Mann-Whitney test. Ct levels between two subgroups of HT patients, divided by intake of levothyroxine (LT4) therapy, were additionally tested to take into account the illness severity. Spearman rank correlation test was used to analyze correlations between Ct levels and 14 relevant phenotypes. RESULTS: We have not detected significant differences in median Ct levels between HT patients and controls (2.2 vs 2.35 pg/mL, respectively, P = 0.717) nor in-between two subgroups of HT patients (P = 0.347). We have not detected statistically significant correlations between Ct levels and clinical phenotypes, although we identified three weak nominal correlations: negative correlation of Ct with TgAb in all HT patients (r = - 0.1, P = 0.04); negative correlation of Ct with age in subgroup of HT patients without LT4 therapy (r = - 0.13, P = 0.04); positive correlation of Ct with BSA in subgroup of HT patients on LT4 therapy (r = 0.16, P = 0.042). CONCLUSION: Our results suggest that HT patients of all disease stages preserve Ct production as healthy individuals and there is no need for Ct measurements in the absence of a nodule. Additional confirmation and clarification of observed nominal correlations are needed due to potential clinical relevance of TgAb and age-dependent Ct decrease in HT women.

Paroxysmal non-epileptic events in the pediatric emergency department.

Paroxysmal non-epileptic events (PNEs), or pseudoseizures (PS) resemble epileptic seizures. They are considered part of a personality disorder and have a higher incidence among adolescents. Patients describe episodes (lasting up to 20 minutes) of loss of consciousness, twitching or jerking and unusual emotional states. Unlike epileptic seizures, they are not associated with electroencephalographic abnormalities. Distinguishing epileptic seizures from PNEs is not easy. 20% of patients with seizures have a final PNEs diagnosis but recognizing them on the first examination is difficult. Due to the severe initial clinical presentation, these patients are often admitted in the Pediatric Intensive Care Unit (PICU) and may be over-treated. We report two cases admitted to our PICU for apparent status epilepticus, in which the final diagnosis was PNEs.