RESUMO
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Assuntos
Humanos , Masculino , Adolescente , Displasia Fibrosa Poliostótica/diagnóstico , Hipocalcemia/diagnóstico , Hiperfosfatemia/diagnóstico , Hiperparatireoidismo/diagnóstico , Diagnóstico Diferencial , Pseudo-Hipoparatireoidismo/diagnósticoRESUMO
We report a case of a fifty year old woman with Graves' disease with positive AntiTPO antibodies and positive AntiTSH receptor antibodies, who was hospitalized with a right cardiac failure. A pulmonary hypertension was discovered on echocardiography. After adequate antithyroid therapy, the right cardiac failure regressed rapidly and pulmonary pressure normalised. An autoimmune process has often been proposed to explain the association between pulmonary hypertension and hyperthyroidism. We report the arguments supporting this autoimmune etiopathogenesis. We also discuss an other hypothesis based on a direct effect of thyroid hormones on the pulmonary circulation and the effects of high cardiac output associated with hyperthyroidism.
Assuntos
Doença de Graves/complicações , Insuficiência Cardíaca/diagnóstico por imagem , Hipertensão Pulmonar/diagnóstico por imagem , Autoanticorpos/análise , Ecocardiografia , Feminino , Doença de Graves/tratamento farmacológico , Doença de Graves/imunologia , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/imunologia , Humanos , Hipertensão Pulmonar/tratamento farmacológico , Hipertensão Pulmonar/imunologia , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
We report the case of a 53 year old patient who was admitted with polyuria, polydipsia associated with fatigue, depression and sexual dysfunction. Central diabetes insipidus with hypogonadotrophic hypogonadism was diagnosed by a water restriction test and different static and dynamic hormonal dosages. Nodular thickening of the pituitary stalk was noted on the MRI and the biopsy permitted a histological diagnosis of infundibulitis.