Primary amenorrhea-galactorrhea with hyperprolactinemia and huge pituitary enlargement in juvenile primary hypothyroidism.

We report a girl with juvenile primary hypothyroidism revealed by growth retardation and a syndrome of primary amenorrhea-galactorrhea with hyperprolactinemia and suprasellar pituitary enlargement. Resolution of the pituitary enlargement and the amenorrhea-galactorrhea syndrome occurred after thyroid hormone replacement. No similar observation has been reported earlier in juvenile hypothyroidism.

[Antithyroid antibodies. Prevalence in primary hypothyroidism in Central Tunisia]. / Les anticorps antithyroïdiens. Prévalence dans l'hypothyroïdie primaire en Tunisie Centrale.

Thyroid microsomal (AAM) and thyroglobulin antibodies (AAT) were studied in sera of 112 patients with overt primary hypothyroidism in Central Tunisia. Thyroid antibodies were detected by an agglutination method. AAM and AAT were found respectively in 78.6% and 42%. The data confirm that there is a high prevalence of antibodies in primary hypothyroidism of short duration (AAM: 90%, AAT: 56.7%). The study reflect the prevalence of Hashimoto's thyroiditis and point to the usefulness of thyroid auto-antibodies in early screening of symptomless autoimmune thyroiditis.

[Radioimmunoassay of ADH in human urine (author's transl)]. / Dosage radioimmunologique de L'ADH dans les urines chez l'homme.

A simple efficient procedure for extracting and concentrating arginine-8-vasopressin (AVP) from urine has been coupled with a specific and sensitive radioimmunoassay in order to measure antidiuretic hormone (ADH) excretion in normal humans under various physiological stimuli. Antisera have been raised in rabbits injected with lysine-vasopressin (LVP) or AVP coupled with bovine serum albumin. The antiserum selected for the assay which inhibits the antidiuresis induced in the rat by AVP is used at a final dilution of 1 : 50,000 and possesses a high association constant of 1 x 10(11) 1.mol-1. The limit of detection of the RIA system is 0.5 micronUI/ml of urine (1.25 pg). Urinary ADH has been extracted from urine by Miller and Moses method. Mean recovery of added vasopressin averaged 90.2% +/- 11 (SD) and assay of serial dilutions of such extracts showed that they behave in the assay system in the same way as synthetic AVP standards. Moreover comparison of the results obtained by the RIA to those given by the biological method using the ethanol anesthetized rat showed excellent correlation (r = 0.9 p less than 0.001). Under ad libitum fluid and food intake, mean daily urinary excretion of AVP (uncorrected for recovery) determined in 22 subjects was found to be 30.58 +/- 11.64 mU/h with no significant difference between men and women. In response to an oral waterload ADH became undetectable at the peak of diuresis. Following a 16 hr fluid deprivation, ADH rose moderately. A significant correlation has been found between urine osmolality and AVP excretion rate.

[Primary hypothyroidism and glomerular involvement]. / Hypothyroïdie primitive et atteinte glomérulaire.

Association between auto-immune dysthyroidism and glomerulonephritis is quite rare. The authors report 3 cases with proteinuria varying from 2.72 to 6.06 g/day and hypothyroidism. Nephrotic syndrome was found in 2 cases and thyroid auto-antibodies (microsomal and thyroglobulin) and circulating immun complexes (C.I.C.) in 1 case, complement fractions C3 and C4 were normal in all cases. Renal biopsy showed membranous glomerulonephritis in 2 cases and minimal lesions in the third case. Proteinuria disappeared with glucocorticoids and thyroxine in 1 case, with thyroxine alone in an other case and persisted in the third case with normal thyroid function.

[Sheehan's syndrome followed by spontaneous pregnancy. Apropos of 2 cases]. / Syndrome de Sheehan suivi d'une grossesse spontanée. A propos de deux observations.

There are few reports of spontaneous pregnancies in patients with Sheehan's syndrome. We describe two cases which exhibited adrenal and thyroid insufficiency but not amenorrhea, return of the menstrual periods being at the expected time after delivery. Endocrinologic studies confirmed thyrotropin and corticotropin insufficiency. Clinical evidence of preserved gonadotropin secretion was supported by the response of LH and FSH to acute administration of synthetic LHRH and by the fact that thyroid and corticoid hormonal replacement resulted in a spontaneous pregnancy with successful outcome.

[Werner's syndrome and endocrine disorders]. / Syndrome de Werner et atteintes endocriniennes.

Werner's syndrome is a rare autosomal recessive disease caused by the mutation of DNA helicase gene (WRN), characterized by the premature onset of multiple age-related disorders and skin changes similar to those observed in scleroderma. Some endocrinologic and metabolic disorders have been described in patients with Werner's syndrome. We report one case in a 41-year-old man issuing from consanguineous parents, who presented for exploration of hypoglycemic episodes and sexual impotence. Werner's syndrome was diagnosed on the basis of his characteristic clinical appearance. Metabolic disorders were insulin-requiring diabetes and hypertriglyceridemia. Endocrinologic investigation revealed nodular goiter, sub clinical primary hypothyroidism, hypergonadotrophic hypogonadism,adrenal cortical hypofunction and GH deficiency. Pathology examination of the skin biopsy showed a scleroderma-like aspect. Finally, osteoporosis, atherosclerosis and sub-capsular cataract were associated. Thus, in Werner's syndrome metabolic and endocrinologic investigation is necessary in order to treat these disorders and improve the patient's prognosis and life.