ABSTRACT
A 60-year-old Japanese man diagnosed with acromegaly at 28 years old had difficulty walking due to worsening back pain. He had been treated with somatostatin analog since 57 years old, but his pain and numbness continued to worsen. Lumbar magnetic resonance imaging showed disc bulging at L3/4 and L4/5, and he was diagnosed with lumbar spinal canal stenosis due to hypertrophy of the yellow ligament. Patients with acromegaly may complain of osteoarthropathy, so we must pay attention to the symptoms of spinal canal stenosis in collaboration with orthopedic specialists.
Subject(s)
Acromegaly , Spinal Stenosis , Male , Humans , Adult , Middle Aged , Acromegaly/complications , Acromegaly/diagnosis , Constriction, Pathologic , Lumbar Vertebrae/diagnostic imaging , Spinal Stenosis/complications , Spinal Stenosis/diagnostic imaging , Back Pain , Magnetic Resonance Imaging , Spinal Canal/diagnostic imagingABSTRACT
We herein report a 31-year-old Japanese woman with evolving hypopituitarism due to pituitary stalk transection syndrome. She had a history of short stature treated with growth hormone (GH) in childhood and had hypothyroidism and primary amenorrhea at 20 years old. Levothyroxine replacement and recombinant follicle stimulating hormone-human chorionic gonadotropin (FSH-hCG) therapy for ovulation induction were started. GH replacement therapy (GHRT) was resumed when she was 26 years old. She developed mild adrenocortical insufficiency at 31 years old. She succeeded in becoming pregnant and delivered twice. GHRT was partially continued during pregnancy and stopped at the end of the second trimester without any complications.
Subject(s)
Human Growth Hormone/therapeutic use , Hypopituitarism/drug therapy , Pituitary Gland/injuries , Pregnancy Complications/drug therapy , Adult , Delivery, Obstetric , Drug Administration Schedule , Female , Hormone Replacement Therapy/methods , Human Growth Hormone/administration & dosage , Human Growth Hormone/deficiency , Humans , Hypopituitarism/etiology , Hypothyroidism/complications , Ovulation Induction/methods , Perinatal Care/methods , Pregnancy , Pregnancy Trimester, Second , Syndrome , Thyroxine/therapeutic useSubject(s)
Vascular Cell Adhesion Molecule-1 , Biomarkers/blood , Diabetes Mellitus/metabolism , Diabetic Angiopathies/diagnosis , Diabetic Angiopathies/etiology , Diabetic Nephropathies/diagnosis , Diabetic Nephropathies/etiology , Diabetic Neuropathies/diagnosis , Diabetic Neuropathies/etiology , Endothelium, Vascular/metabolism , Epoprostenol/pharmacology , Epoprostenol/therapeutic use , Fenofibrate/pharmacology , Fenofibrate/therapeutic use , Humans , NF-kappa B/physiology , Solubility , Vascular Cell Adhesion Molecule-1/bloodABSTRACT
A 54-year-old man with Graves' disease had been treated with thiamazole (5 mg/day). His thyroid hormone level was increased after exodontia in February 2006. Although his prescribed dose of thiamazole was increased after exodontia on the fourth day, he developed thyroid crisis on exodontia 52 nd day. Laboratory findings also showed renal dysfunction (from Cr 1.0 mg/dL in July 2005 to Cr 1.8 mg/dL on exodontia 37th day). His thyroid hormone level was normalized after subtotal thyroidectomy; however, serum Cr level was still high. He was diagnosed with interstitial nephritis as a result of renal biopsy, and he was treated with prednisolone 30 mg/day. This present case developed thyroid crisis even though the quantity of thiamazole was increased after exodontia. It seems that interstitial nephritis, as well as exodontia, is an aggravation factor of thyroid function. After a poor response to anti-thyroid drugs, it is necessary to prevent thyroid crisis by determining the aggravating factor and to then provide appropriate treatment.