Graves' disease in a Down's syndrome patient.

Thyroid dysfunction in patients with Down's syndrome is well known. Although the majority of children with Down's syndrome appear to have normal thyroid function, however, hypothyroidism is commonly seen. The presence of hyperthyroidism is rare. The etiology is believed to be autoimmune. We report a patient with Down syndrome and Graves' disease who responded well to antithyroid drugs. The rarity of this association, especially in a child younger than eight years of age, has prompted us to report this case.

Tuberculous cervical lymphadenitis masquerding as metastatis from papillary thyroid carcinoma.

Clinically apparent cervical lymphadenopathy has been found at the initial presentation in 23 to 56 % of cases of papillary thyroid carcinoma. Here we report tuberculous lymphadenitis mimicking metastatic lymph nodes from papillary thyroid carcinoma and suggest that tuberculosis apart from metastasis in papillary thyroid carcinoma should also be considered in the etiology of enlarged lymph nodes in such patients, especially in those with risk factors for tuberculosis. Therefore, the importance of careful pre-operative evaluation of cervical lymph node metastasis cannot be overestimated, so that patients do not undergo unnecessary neck dissection for other benign conditions.

Rhino-orbital-mucormycosis as a presenting manifestation of gestational diabetes mellitus.

Rhino-orbital mucormycosis is an uncommon and aggressive, angioinvasive fungal infection that occurs in immunocompromised states like diabetes mellitus, chronic renal failure, hematological malignancies and deferroxamine therapy. We report a patient who presented with rhino-orbital mucormycosis at six months of gestation and was incidentally detected to have diabetes. She was successfully treated with amphotericin B and appropriate surgery. To the best of our knowledge, there is no such report in the literature.

Cabergoline-induced tricuspid regurgitation: Case report and review of literature.

The increased risk of cardiac valve disease in patients treated for Parkinson's disease with cabergoline has raised concerns about the safety of treatment with ergot-derived dopamine agonists in patients with endocrine diseases, especially prolactinoma. Concern is raised because the use of cabergoline was associated in one study with an increased prevalence of moderate tricuspid regurgitation, and in two other studies with mild tricuspid regurgitation. Furthermore, the use of cabergoline was associated with increased frequencies of valvular thickening, calcifications, and increased mitral tenting area.