Long-term effects of radioiodine treatment on thyroid functions and ultrasonographic features in patients with toxic adenoma and toxic multinodular goitre.

OBJECTIVE: This study aimed to investigate the long-term effect of radioiodine (RAI) treatment on thyroid functions and ultrasonographic changes in the thyroid gland and toxic nodules. METHODS: Thyroid function tests and ultrasonography reports of patients diagnosed with toxic adenoma (TA) or toxic multinodular goitre (TMNG) between 2000 and 2021 were retrospectively analysed. RESULTS: We included 100 patients whom thyroid function and ultrasonography results were obtained from our outpatient clinic before and at least 36 months post-RAI. At the end of the follow-up period, the mean thyroid volume reduction in patients with TA and TMNG was 56.6% ± 3.1% and 51.1% ± 6.7%, respectively; the mean volume decrease of all toxic nodules was 80.5% ± 1.9%. The volume of the thyroid and toxic nodules was significantly reduced up to 12 years (p < 0.01). Between 3 and 10 years after RAI therapy, the annual incidence of hypothyroidism was 2.0% and 1.5% in the TA and TMNG groups, respectively. Toxic nodules were more frequently solid and hypoechoic in post-RAI ultrasounds (p < 0.01). CONCLUSIONS: The volume of thyroid gland and toxic nodules continuously decreases, as the risk of hypothyroidism increases up to 10 years after RAI treatment. After RAI treatment, patients should be followed up to check their thyroid functions. In post-RAI examinations, toxic nodules may show ultrasonographic features suspicious for malignancy. History taking should include previous RAI therapies and old scintigraphy scans should be evaluated to avoid unnecessary procedures and non-diagnostic biopsy results.

Evaluation of chronic pruritus and associated skin findings in patients with diabetes mellitus.

Background/aim: To explore the dermatological lesions associated with chronic pruritus in patients who were followed up at our clinic for type 1 and type 2 diabetes mellitus (DM). Materials and methods: The study population consisted of 249 patients with DM, who presented to the endocrinology clinic at Ankara University Faculty of Medicine between January 2022, and March 2022, regardless of whether they had reported experiencing pruritus symptoms. The visual analog scale and 5-D itch scale were used to determine the severity of itching in patients. Dermatological examination findings were also evaluated. Results: Of the 249 patients with DM, mean duration since diabetes was diagnosed was 12 ± 9.2 [median 10 (0.3-46)] years, and the mean HbA1c levels were 8.1% ± 2.1%. Pruritus was detected in 77 (30.9%) patients and the mean duration of diabetes diagnosis was 13.4 ± 9.7 years. Examination of the microvascular and macrovascular complications showed that the incidence of retinopathy, nephropathy, neuropathy and peripheral arterial disease was 31.2% (p = 0.003), 31.2% (p = 0.005), 66.2% (p < 0.001) and 10.4% (p = 0.038), respectively, in the group with pruritus. These incidences were significantly higher in the group with pruritus than in those without pruritus. Dermatological examination showed that the most common condition was xerosis (64%), followed by fungal skin infection (16%) and bullous pemphigoid (8%). No skin findings were noted in 7% of patients who complained of itching. Conclusion: Chronic pruritus may be associated with several factors such as poor glycemic control, high BMI and microvascular and macrovascular complications in patients with DM. Especially in patients with severe generalized pruritus who do not respond to standard antipruritic treatments, the use of DPP-4 inhibitors, a class of oral antidiabetic agents, should be questioned and all medications being used by the patient should be reviewed.

A Rare Cause of Hypereosinophilia: A Case Report.

Toxocariasis is a parasitic disease caused by the larval stage of Toxocara cati and T. canis, which live in the intestinal system of cats (T. cati) and dogs (T. canis). Infective eggs can enter the gastrointestinal system by the oral route via foods contaminated with feces of dogs or cats or via dirty contaminated hands. The larvae penetrate the small intestine and migrate to visceral organs by systemic circulation. Hypereosinophilia is a common finding in the tissue invasion of parasites. Serological methods are the principle diagnostic methods for toxocariasis. In this study, we reported a toxocariasis patient presented with hypereosinophilia, hepatomegaly, and intestinal involvement. Computed tomography showed diffuse thickening of the ileal bowel loop walls around the umbilicus. Endoscopic ultrasonography revealed an enlarged periduodenal lymph node. Symptoms improved with albendazole treatment with a subsequent flare.

[Renal cyst hydatid]. / Renal Kist Hidatik.

Hydatid cyst disease is an oral transmitted parasitosis caused by the larval form of the Echinococcus granulosus tapeworm that penetrates the intestinal mucosa and reaches the internal organs via the blood and lymphatic stream. Hydatid cyst disease is an important health problem, especially in developing countries, such as Turkey. Renal hydatid cyst is extremely rare, and kidney involvement is seen in only 2% of all cases. In this study, we present two patients with renal hydatid cyst. Hydatid cyst was not suspected before pathological diagnosis in both patients. At first, the patients were suspected of having malignancy, and the treatment modality was made accordingly. When the pathology results revealed hydatid cyst, the treatment of the patients was modified. Renal hydatid disease should be kept in mind in the differential diagnosis of patients presenting with renal cyst in Turkey.