Endocrinology and Metabolism

Case Reports

Partial Androgen Insensitivity Syndrome Presenting with Gynecomastia: Sung Won Lee, Dong Shin Kwak, In Sub Jung, Joo Hee Kwak, Jung Hwan Park, Sang Mo Hong, Chang Bum Lee, Yong Soo Park, Dong Sun Kim, Woong Hwan Choi, You Hern Ahn; Endocrinol Metab. 2015;30(2):226-230. Published online June 30, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.2.226

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Gynecomastia is a benign enlargement of the male breast caused by the proliferation of glandular breast tissue. Determining the various causes of gynecomastia such as physiological causes, drugs, systemic diseases, and endocrine disorders is important. Androgen insensitivity syndrome (AIS) is a rare endocrine disorder presenting with gynecomastia and is a disorder of male sexual differentiation caused by mutations within the androgen receptor gene. All individuals with AIS have the 46 XY karyotype, although AIS phenotypes can be classified as mild, partial or complete and can differ among both males and females including ambiguous genitalia or infertility in males. We experienced a case of partial AIS presenting with gynecomastia and identified the androgen receptor gene mutation.

Citations

Citations to this article as recorded by

A case of mild partial androgen insensitivity syndrome in a juvenile boy
Fen Wang, Shiying Shao, Wentao He, Shuhong Hu
Journal of International Medical Research.2024;[Epub] CrossRef
Gynecomastia in adolescent males: current understanding of its etiology, pathophysiology, diagnosis, and treatment
Kotb Abbass Metwalley, Hekma Saad Farghaly
Annals of Pediatric Endocrinology & Metabolism.2024; 29(2): 75. CrossRef
Clinical outcomes and genotype-phenotype correlations in patients with complete and partial androgen insensitivity syndromes
Nae-yun Lee, Ja Hye Kim, Ji-Hee Yoon, Soojin Hwang, Gu-Hwan Kim, Han-Wook Yoo, Jin-Ho Choi
Annals of Pediatric Endocrinology & Metabolism.2023; 28(3): 184. CrossRef
The Impact and Management of Gynaecomastia in Klinefelter Syndrome
Amr Abdel Raheem, Ahmed Said Zaghloul, Ahmed M. G. Sadek, Bilal Rayes, Tarek M. Abdel-Raheem
Frontiers in Reproductive Health.2021;[Epub] CrossRef
Identification of Potential Genes in Pathogenesis and Diagnostic Value Analysis of Partial Androgen Insensitivity Syndrome Using Bioinformatics Analysis
Yajie Peng, Hui Zhu, Bing Han, Yue Xu, Xuemeng Liu, Huaidong Song, Jie Qiao
Frontiers in Endocrinology.2021;[Epub] CrossRef
Adolescent Gynecomastia due to Minimal Androgen Resistance Syndrome: A Case Report and Literature Review
Aureliano Fiorini, Margherita Sepich, Margherita Pontrelli, Giorgio Sangriso, Mirna Cosci o Di Coscio, Marcella Lauletta, Fulvia Baldinotti, Diego Peroni, Maria Rosaria Ambrosio, Silvano Bertelloni
Sexual Development.2020; 14(1-6): 21. CrossRef
Endocrine and molecular investigations in a cohort of 25 adolescent males with prominent/persistent pubertal gynecomastia
F. Paris, L. Gaspari, F. Mbou, P. Philibert, F. Audran, Y. Morel, A. Biason‐Lauber, C. Sultan
Andrology.2016; 4(2): 263. CrossRef

Thyroid
A Case of Acute Suppurative Thyroiditis with Thyrotoxicosis in an Elderly Patient: Bo Sang Kim, Kil Woo Nam, Jeong Eun Kim, Ji Hoon Park, Jun Sik Yoon, Jung Hwan Park, Sang Mo Hong, Chang Bum Lee, Yong Soo Park, Woong Hwan Choi, You Hern Ahn, Dong Sun Kim; Endocrinol Metab. 2013;28(1):50-54. Published online March 25, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.1.50

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Abstract PDF PubReader

Acute suppurative thyroiditis (AST) is a rare condition, as the thyroid gland is relatively resistant to infection. Thyroid function tests are usually normal in AST. A few cases of AST associated with thyrotoxicosis have been reported in adults. We report a case of AST that was associated with thyrotoxicosis in a 70-year-old woman. We diagnosed AST with thyroid ultrasonography and fine needle aspiration of pus. The patient improved after surgical intervention and had no anatomical abnormality. Fine needle aspiration is the best method for the difficult task of differentiating malignancy and subacute thyroiditis from AST with thyrotoxicosis. Earlier diagnosis and proper treatment for AST might improve the outcome.

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Acute suppurative thyroiditis with Graves disease – A very rare association
Inês Damásio, Joana Maciel, Maria Manuel Costa, Luisa Raimundo
Archives of Endocrinology and Metabolism.2023;[Epub] CrossRef
Thyrotoxicosis as a rare presentation in acute suppurative thyroiditis: a case report
Zeynab Seyedjavadeyn, Seyed Amir Miratashi Yazdi, Alireza Samimiat, Matin Vahedi
Journal of Medical Case Reports.2023;[Epub] CrossRef
Subakute Thyreoiditis und akute suppurative Thyreoiditis
Christian Trummer, Verena Theiler-Schwetz, Stefan Pilz
Journal für Klinische Endokrinologie und Stoffwechsel.2020; 13(3): 124. CrossRef
Infection of Thyroid Cyst Occurring 1 Month after Fine-Needle Aspiration in an Immunocompetent Patient
Jung Kyu Park, Eon Ju Jeon
International Journal of Thyroidology.2018; 11(2): 182. CrossRef
Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
Won-Young Lee
Endocrinology and Metabolism.2014; 29(3): 251. CrossRef

A Case of Pseudohypoparathyroidism with Graves' Disease.: Gil Woo Lee, Jae Hoon Kim, Kang Won Lee, Sa Il Kim, Sang Mo Hong, Dong Sun Kim, Woong Hwan Choi, You Hern Ahn, Tae Wha Kim; Endocrinol Metab. 2010;25(3):221-225. Published online September 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.3.221

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Abstract PDF: Pseudohypoparathyroidism is a rare disease that is characterized by target cell resistance to the effects of parathyroid hormone and this disease is classified into various types depending on the phenotypic and biochemical findings. The patients with pseudohypoparathyroidism present with the clinical and biochemical features of hypoparathyroidism, but they have an increased serum level of parathyroid hormone. We experienced a case of pseudohypoparathyroidism in a 24 years old woman who had Graves' disease at that time. She had hypocalcemia, hyperphosphatemia, an elevated serum parathyroid hormone level and a normal urinary basal cyclic AMP(adenosine monophosphate) level. She also had a normal phenotypic appearance. Therefore, she was classified as suffering with pseudohypoparathyroidism type II. The clinical and laboratory abnormalities were improved by calcium supplementation in addition to vitamin D. To the best of our knowledge, this is the first case of pseudohypoparathyroidism combined with Graves' disease in Korea.

Original Articles

Prevalence of Thyroid Nodules Detected by Ultrasonography in Adults for Health Check-Ups and Analysis of Fine Needle Aspiration Cytology.: Won Jun Kim, Joo Hyong Kim, Dong Won Park, Chang Beom Lee, Yong Soo Park, Dong Sum Kim, Woong Hwan Choi, Tae Wha Kim, You Hern Ahn; J Korean Endocr Soc. 2008;23(6):413-419. Published online December 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.6.413

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Abstract PDF

BACKGROUND
The purpose of this study was to assess the prevalence of thyroid nodules in healthy adults without a history of thyroid disease and the results of fine needle aspiration cytology (FNAC). METHODS: We retrospectively studied 4,832 adults (2,427 women, 2,405 men) over the age of 20 who had visited our health care center from January, 2005, to March, 2008. Subjects with previous thyroid disease were excluded. All were screened by thyroid ultrasonography and FNAC was performed on large or potentially malignant nodules. RESULTS: Thyroid nodules were present in 686 women (28.3%) and 396 men (16.5%), with a female predominance (odds ratio = 1.47, 95% CI = 1.35~1.60). The prevalence of a thyroid nodule was significantly correlated with age in both women and men (P < 0.001). Multinodularity also increased according to age in both groups. Ninety patients were tested with conventional FNAC and 195 underwent ultrasonography-guided FNAC. The rate of inadequate cytology by ultrasonographic guidance was lower than by freehand methods, and the total rate of malignant cytology per patient was 17.9%. Ultrasonographic characteristics that significantly correlated with histologically-confirmed papillary carcinoma included a solid component, hypoechogenecity, irregular margin, and the presence of microcalcification or macrocalcification. CONCLUSION: The prevalence of thyroid nodules detected by ultrasonography was 28.3% in healthy women and 16.5% in healthy men population. The prevalence and multinodularity was significantly correlated with age in both groups. It's useful to examine thyroid by ultrasonography because of detecting more nodules, providing guidance of FNAC, achieving more adequate sampling and not missing small malignant nodules.

Citations

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The Prevalence of Thyroid Nodules and the Morphological Analysis of Malignant Nodules on Ultrasonography
An Hyun, Ji Tae-jeong, Lee Hyo-young, Im In-chul
Journal of Radiological Science and Technology.2019; 42(3): 201. CrossRef
Ultrasonographic Characteristics of the Hyperfunctioning Thyroid Nodule and Predictive Factors for Thyroid Stimulating Hormone Suppression
Won Sang Yoo, Hoon Sung Choi
International Journal of Thyroidology.2019; 12(1): 35. CrossRef
Prevalence and Annual Incidence of Thyroid Disease in Korea from 2006 to 2015: A Nationwide Population-Based Cohort Study
Hyemi Kwon, Jin-hyung Jung, Kyung-Do Han, Yong-Gyu Park, Jung-Hwan Cho, Da Young Lee, Ji Min Han, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
Endocrinology and Metabolism.2018; 33(2): 260. CrossRef
Prevalence of thyroid nodules and their associated clinical parameters: a large-scale, multicenter-based health checkup study
Jae Hoon Moon, Min Kyung Hyun, Ja Youn Lee, Jung Im Shim, Tae Hyuk Kim, Hoon Sung Choi, Hwa Young Ahn, Kyung Won Kim, Do Joon Park, Young Joo Park, Ka Hee Yi
The Korean Journal of Internal Medicine.2018; 33(4): 753. CrossRef
Analysis of Fine Needle Aspiration Results of Thyroid Nodules in Ultrasonography
Jong-Gil Kwak, Jae-Bok Han, Jong-Nam Song, Il-Bong Moon, Nam-Gil Choi
The Journal of the Korea Contents Association.2016; 16(5): 290. CrossRef
Clinical Characteristics and Incidence of Thyroid Nodule in the Male Population for Health Check-up
Yeon Jin Jeon, Young Teag Koh, Seung Jong Oh, Min Young Koo
Korean Journal of Endocrine Surgery.2015; 15(4): 93. CrossRef
Clinical Characteristics and Incidence of Thyroid Nodule in the Male Population for Health Check-up
Yeon Jin Jeon, Young Teag Koh, Seung Jong Oh, Min Young Koo
Korean Journal of Endocrine Surgery.2015; 15(4): 93. CrossRef
Management of Thyroid Nodules and Cancers Arising in the Elderly
Eunyoung Kim, June Young Choi, Kyu Eun Lee
Journal of Korean Thyroid Association.2012; 5(2): 99. CrossRef
Screening of Thyroid Cancer and Management of Thyroid Incidentaloma
Jung Jin Cho
Korean Journal of Family Medicine.2010; 31(2): 87. CrossRef

Epidemiology and Biological Correlation Between Osteoporosis and Atherosclerosis .: Woong Hwan Choi; J Korean Endocr Soc. 2005;20(6):535-542. Published online December 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.6.535

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Effects of a Low Calcium Diet and Oxalate Intake on Calcium Deposits in Soft Tissues and Bone Metabolism in Ovariectomized Rats
Mi-Rin Lee, Mi-Na Park, Ji-Young Mun, Yeon-Sook Lee
The Korean Journal of Nutrition.2011; 44(2): 101. CrossRef

Case Report

A Case of Thyrotoxicosis Presented as Rhabdomyolysis.: Yil Sik Hyun, Chang Beom Lee, Yong Soo Park, Dong Sun Kim, Woong Hwan Choi, Tae Wha Kim, You Hern Ahn; J Korean Endocr Soc. 2005;20(4):381-384. Published online August 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.4.381

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Abstract PDF

There have been a few reports on rhabdomyolysis caused by thyroid storm, but no cases of thyrotoxicosis related rhabdomyolysis have been reported until now. Here, a rare case of rhabdomyolysis, accompanied by thyrotoxicosis, is reported. A 21-year-old man was admitted to our hospital with severe pain and weakness in both legs. The initial laboratory findings revealed a high muscle enzyme level and severe hypokalemia. In evaluation of the rhabdomyolysis, the thyroid function test was compatible with that of Graves' disease, with the rhabdomyolysis subsequently diagnosed, presenting as thyrotoxicosis. The possible mechanisms for this complaint were hypokalemia-induced muscle ischemia, a thyrotoxicosis-induced excessive hypermetabolic state and pressure-induced muscle ischemia. Therefore, the work up for the cause of rhabdomyolysis should include thyrotoxicosis. The management of rhabdomyolysis is hydration, prevention of acute renal failure, correction of aggravating factors and treatment of the underlying cause, for example, thyrotoxicosis.

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A Case of Thyrotoxic Periodic Paralysis with Rhabdomyolysis
Seo Hee Lee, Seong Yeol Kim, Hae Ri Lee, Jun Goo Kang, Ohk Hyun Ryu, Chul Sik Kim, Byung Wan Lee, Seong Jin Lee, Eun-Gyoung Hong, Hyeon Kyu Kim, Doo-Man Kim, Jae Myung Yu, Sung-Hee Ihm, Moon Gi Choi, Hyung Joon Yoo
Journal of Korean Endocrine Society.2008; 23(6): 425. CrossRef

Original Article

A Clinical Observation on Twelve Cases of Primary Aldosteronism.: Seung Chul Cho, Yong Soo Park, Hwon Gyum Park, Sung Hee Lee, Soon Gil Kim, Woong Hwan Choi, Yu Hern Ahn, Pa Jong Jung, Tae Wha Kim; J Korean Endocr Soc. 2004;19(2):194-202. Published online April 1, 2004

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Abstract PDF: BACKGROUND
Primary aldosteronism describes a group of disorders characterized by long-standing aldosterone excess, with suppressed renin activity, resulting in hypertension and hypokalemia. The protean clinical and biochemical characteristics of this syndrome have important implications regarding its pathophysiology and responsiveness to treatment. METHODS: The cases of 12 primary aldosteronisms, diagnosed at Hanyang University Hospital between 1996 and 1999, were reviewed. RESULTS: The 12 cases were composed of 9 aldosterone-producing adenoma, 2 adrenal hyperplasia and a case of idiopathic hyperaldosteronism. There were 9 women and 3 men. The mean age was 46 yrs (range, 23 to 64 yrs). At the initial visit, the mean blood pressure was 160+/-26/104+/-14 mmHg, and one case of idiopathic hyperplasia had normal blood pressure. The mean serum K+ level was 2.6+/-0.5 mEq/L (range, 1.5 to 3.5 mEq/L). The mean plasma renin activity and plasma aldosterone concentration were 0.4+/-0.4 ng/ml/hr (range, 0.2 to 1.6 ng/ml/hr) and 407.5+/-199.8 pg/mL (range, 225 to 800 pg/mL), respectively. Different steps of diagnostic modalities were applied for the preoperative differential diagnosis. All patients, with the exception of the one with idiopathic hyperaldosteronism, were managed by a unilateral laparoscopic adrenalectomy, as they were all diagnosed under the impression of adrenal adenomas. Ultimately, 9 cases were proven to have adrenal adenomas. One hypertensive case, with hypokalemia, had adrenal hyperplasia, and the case with normotension was found to have adrenal nodular hyperplasia from the pathology. The size of the tumors ranged from 1.4 to 2.4 cm in diameter. Among the 11 cases that underwent an adrenalectomy, the blood pressures in 6 cases normalized after the operation, while the other 5, including the one with unilateral hyperplasia, were still in need of antihypertensives for the control of elevated blood pressures, even after the operation. The other case of idiopathic hyperaldosteronism was managed by the prescription of spironolactone. CONCLUSION: From these, it can be suggested that the clinical diversity of the syndrome, especially in the pathophysiology and response to operation, awaits the development of a better preoperative lateralization procedure

Case Reports

A Case of Lymphocytic Hypophysitis in a Postmenopausal Woman.: Sang Hyun Baik, Dong Sun Kim, Yoon Kyoung Sung, Jong Pyo Kim, Chang Beom Lee, Yong Soo Park, Woong Hwan Choi, You Hern Ahn, Tae Wha Kim, Yong Ko, Moon Hyang Park; J Korean Endocr Soc. 2002;17(5):713-719. Published online October 1, 2002

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Abstract PDF: A 64-year-old Korean woman presented with a 3-week history of severe headache and ocular pain. Her brain MRI showed a cystic pituitary mass compressing the optic chiasm. A hormonal study revealed anterior pituitary insufficiency and a slightly increased prolactin level. We performed a transsphenoidal resection of the pituitary mass. A pathological examination revealed the presence of a heavy inflammatory infiltrate, composed of lymphocytes and plasma cells, and destruction of the adenohypophysial structures. Five months after surgery, her hormonal levels had nearly normalized, without hormone replacement therapy. A follow-up MRI showed no recurrence. We conclude that lymphocytic hypophysitis should be included in the differential diagnosis of pituitary mass at any age. We discuss the features that can help to make a preoperative differential diagnosis, and selection of the appropriate treatment.

A Case of Steroid induced Myopathy in Patient with Iatrogenic Cushing Syndrome.: Jun Goo Kang, You Hern Ahn, Joon Sung Park, Chang Beom Lee, Yong Soo Park, Dong Sun Kim, Woong Hwan Choi, Tae Wha Kim, Joon Soo Hahm, Yong Wook Park, Eun Kyung Hong; J Korean Endocr Soc. 2002;17(2):275-279. Published online April 1, 2002

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Abstract PDF: Many endocrinologic diseases can induce muscular diseases. Myopathy caused by exogenous steroid is a common problem in patients prescribed steroids as therapy. We report a case of iatrogenic steroid myopathy in a 55-year-old female who had taken steroids under her own volition at a local pharmacy for more than 3 months due to skin rash and itching. She complained of severe proximal muscle wasting and weakness in the lower extremities and also exhibited other stigmata of Cushing's syndrome such as moon face, buffalo hump or easy bruising. Needle electromyography showed the typical pattern of myopathy. Muscle biopsy revealed intermixed numerous, markedly atrophic and angulated basophilic fibers and a few fat cells without inflammation. In addition there was marked and selective atrophy of type II fiber on ATPase staining in pH 9.4 buffer. After discontinuation of steroid treatment, she has experienced slow improvement through physical therapy, including isotonic exercise.

Original Article

Long-Term Effect of Glucocorticoid on Differentiation of Bone Marrow Stromal Cells .: Long Term Lee, Yong Soo Park, Dong Sun Kim, Woong Hwan Choi, Yon Hern Ahn, Tae Wha Kim; J Korean Endocr Soc. 2001;16(1):85-96. Published online February 1, 2001

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Abstract PDF: BACKGROUND
Glucocorticoid-induced osteoporosis is characterized by decreased osteoblastic activity and replacement of bone marrow with adipocytes. Since osteoblast and adipocytes are derived from the same mesenchymal stem cell, one might speculate that there is an interaction between these two cells types. In fact, leptin that is secreted from adipocytes is known to stimulate differentiation of osteoblasts, while it inhibits the differentiation of adipocytes. Furthermore, it has been demonstrated that PPAR is present in osteoblasts and it is increased by leptin in adipocytes. However, the role of PPAR and leptin remains unknown in glucocorticoid-induced osteoporosis. The aims of this study are to investigate the effect of glucocorticoid on bone mineral density and gene expression in osteoblasts and adipocytes, and to study the role of PPAR and leptin in the mechanism of glucocorticoid-induced osteoporosis. METHODS: Methylprednisolone, 1 mg/200 g-weight, was injected into five rats (steroid group) and saline was given to five rats (control group) for eight weeks. The bone mineral density was determined by dual energy X-ray absoptiometry. Gene expression of osteocalcin, alkaline phosphatase, lipoptrotein lipase, and PPAR -2 was assessed by RT-PCR. Serum leptin level was measured using a commercial radioimmunoassay kit. RESULTS: 1) The body weight of the steroid group was significantly lower than that of the control group (451.4+/-12.9 g vs. 247.6+/-19.8 g, p<0.05). The bone mineral density of the steroid group tended to be lower than that of the control group (0.27+/-0.01 g/cm2 vs. 0.26+/-0.01 g/cm2, p>0.05). 2) In the steroid group, the gene expressions of osteocalcin (1.00+/-0.08 vs. 0.23+/-0.16, p<0.05) and alkaline phosphatase (0.47+/-0.07 vs. 0.33+/-0.18, p<0.05) were decreased significantly compared to those in controls. 3) In the steroid group, the gene expression of lipoprotein lipase (0.23+/-0.06 vs. 0.39+/-0.12, p>0.05) and+/-PAR 2 (0.17+/-0.08 vs. 0.22+/-0.12, p>0.05) tended to be increased compared to that in the contol group. 4) The serum leptin level of the steroid group tended to be lower than that of the control group (0.20+/-0.12 g/L vs. 0.10+/-0.09 g/L, p>0.05). CONCLUSION: These data suggest that long-term administration of a large dose of glucocorticoid suppresses differentiation of osteoblasts and enhances the differentiation of adipocytes, which may be mediated by increased expression of PPAR and decreased synthesis of leptin.

Case Report

A Case of Pulmonary Metastasis of Thyroid Papillary Carcinoma Which was Mistaken for Miliary Tuberculosis.: Chang Beom Lee, Seok Cheul Yang, Yong Soo Park, Dong Sun Kim, Woong Hwan Choi, You Hern Ahn, Tae Wha Kim; J Korean Endocr Soc. 2000;15(4-5):600-605. Published online January 1, 2001

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Abstract PDF: Thyroid cancer is the fourth most common malignant tumor in Korean women. It has been acknowledged for a long time that differentiated thyroid cancers have two basic ways of dissemination, lymphtic and hematogenous. Though lymphatic spread to regional lymph nodes is the typical presentation of papillary thyroid cancer of young patients, pulmonary metastasis are not uncommon in this age group. And it is interesting that almost all the patient with metastases to lung showed metastases to the regional neck lymph node. Abnormal chest X-ray of the patient of pulmonary metastasis shows only nonspecific diffuse micronodular pattern which is not easy to be differentiated. And here we report a case of pulmonary metastasis of thyroid papillary carcinoma which was mistaken for pulmonary miliary tuberculosis. It is suggested that more intensive consideration will be necessary for the diagnosis of pulmonary miliaria of children who shows neck mass.

Review Article

What is the Uncoupling Protein?.: Woong Hwan Choi; J Korean Endocr Soc. 2000;15(4-5):453-462. Published online January 1, 2001

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Abstract PDF: No Abstract Available.

Original Articles

A Case of Osteomalacia with Long Term Carbamazepine Therapy.: Hee Soo Kim, Dong Sun Kim, Nak Won Choi, Sang Hyun Baik, Sung Hoon Kim, Chang Beom Lee, Yong Soo Park, Woong Hwan Choi, You Hern Ahn, Tae Hwa Kim; J Korean Endocr Soc. 2000;15(2):286-290. Published online January 1, 2001

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Abstract PDF: Anticonvusant therapy with any of several agents, especially phenytoin, phenobarbital, and primidone causes disturbances in bone mineral metabolism. Anticonvulsants stimulate the hepatic microsomal mixed-oxidase enzymes and hence increase the rate of clearance of vitamin D and its metabolism. The severity of clinical manifestations in any given individual appears to be a function of the combined effects of variety of factors including drug type and total drug dose, dietary vitamin D intake, sunlight exposure, and physical activity level. We report a case of osteomalacia associated with long term carbamazepine therapy in a 21-year-old male with less exposure to sunlight.

Measurement of Anti-GAD65 Autoantibodies in Patients with Type 1 Diabetes Mellitus with / without Autoimmune Thyroid Diseases (Immunoblotting followed by Immunoprecipitation).: Yong Soo Park, Hye Won Park, Jin Bae Kim, Dong Sun Kim, Woong Hwan Choi, Tae Hwa Kim, Joon Yong Chung, Sei Won Yang, Won Bae Kim; J Korean Endocr Soc. 2000;15(2):190-203. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Type 1 diabetes mellitus is frequently associated with other autoimmune diseases. The broad concept of polyendocrinopathies takes into consideration that patients affected by at least one endocrine disease may have another autoimmune disorder or express specific autoantibodies. Anti-glutamic acid decarboxylase autoantibodies, now recognized as one of the major serological markers for type 1 diabetes has been reported to be higher in type 1 diabetes patients with autoimmune thyroid diseases (ATD) than in those without ATD. The objective of the present study was to evaluate the prevalences of GAD65 antibodies applying a newly developed assay(anti-GAD65) in type 1 diabetes patients with and without ATD. METHODS: We developed a new anti-GAD65 assay after mammalian expression of a recombinant GAD65 antigen. Since the detection of anti-GAD65 is rather complicated and insensitive due to inherent antigenic difference of antibody recognition in conventional assays, we applied this new approach in measuring anti-GAD autoantibodies and compared the result with ICA and anti-GAD measurement using the purified porcine GAD (anti-GAD) in 109 cases of type 1 diabetes, 29 of whom had concomitant ATD (mean age at diagnosis: 7.9 yr, mean duration of type 1 diabetes: 4.5 yrs). RESULTS: The overall prevalence of anti-GAD65 antibodies was 65% (71 of 109) in patients with Korean type 1 diabetes. Prevalences and titers of anti-GAD65 had not changed much after controlling for the duration and the status of concomitant ATD. In contrast, the prevalence of anti-GAD was 56%(61 of 109), while that of ICA(+) WAS 36% in type 1 diabetes patients. We found significant, but not strong association of anti-GAD65 either with anti-GAD(r=0.4, p<0.01) or with ICA(r=0.6, p< 0.001). CONCLUSION: From this, we could assess that autoantibodies are present at comparable sensitivity and specificity in Korean type 1 diabetes patients. This anti-GAD65 assay, another immunologic marker for type 1 diabetes might also confer disease susceptibility among Koreans, but no increase in the prevalence or in the titer in patients with ATD may suggest that this marker is unlikely to give much benefit, for the detection of the overlapping disease of type 1 diabetes and ATD.

A case report of insulin autoimmune syndrome in graves' disease.: Kyung Sang Lee, Ji Hoon Kim, Woong Hwan Choi, Tae Wha Kim, Mok Hyun Kim; J Korean Endocr Soc. 1993;8(4):451-455. Published online January 1, 2001

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Abstract PDF: No abstract available.

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