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- COVID-19 Vaccination for Endocrine Patients: A Position Statement from the Korean Endocrine Society
- Cheol Ryong Ku, Kyong Yeun Jung, Chang Ho Ahn, Jun Sung Moon, Ju Hee Lee, Eun Heui Kim, Hyemi Kwon, Hee Kyung Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Eun Roh, Jin Hwa Kim, Mi-kyung Kim, the Committee of Clinical Practice Guideline of the Korean Endocrine Society
- Endocrinol Metab. 2021;36(4):757-765. Published online August 17, 2021
- DOI: https://doi.org/10.3803/EnM.2021.404
- 10,540 View
- 420 Download
- 19 Web of Science
- 21 Crossref
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ePub - Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.
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Citations
Citations to this article as recorded by
- COVID-19 mRNA vaccine may trigger subacute thyroiditis
Mehmet Sözen, Ömercan Topaloğlu, Berrin Çetinarslan, Alev Selek, Zeynep Cantürk, Emre Gezer, Damla Köksalan, Taner Bayraktaroğlu
Human Vaccines & Immunotherapeutics.2024; 17(12): 5120. CrossRef - The role of co-morbidities in the development of an AEFI after COVID-19 vaccination in a large prospective cohort with patient-reported outcomes in the Netherlands
C. Ouaddouh, J.W. Duijster, T. Lieber, F.P.A.M. van Hunsel
Expert Opinion on Drug Safety.2024; 23(3): 323. CrossRef - Thyroid dysfunction in COVID-19
David Tak Wai Lui, Chi Ho Lee, Yu Cho Woo, Ivan Fan Ngai Hung, Karen Siu Ling Lam
Nature Reviews Endocrinology.2024; 20(6): 336. CrossRef - Adult-Onset Type 1 Diabetes Development Following COVID-19 mRNA Vaccination
Hyeyeon Moon, Sunghwan Suh, Mi Kyoung Park
Journal of Korean Medical Science.2023;[Epub] CrossRef - Prior immunization status of COVID-19 patients and disease severity: A multicenter retrospective cohort study assessing the different types of immunity
Javaria Aslam, Faisal Shahzad Khan, Muhammad Talha Haris, Hewad Hewadmal, Maryam Khalid, Mohammad Y. Alshahrani, Qurrat-ul-ain Aslam, Irrum Aneela, Urooj Zafar
Vaccine.2023; 41(2): 598. CrossRef - Mortality and Severity of Coronavirus Disease 2019 in Patients with Long-Term Glucocorticoid Therapy: A Korean Nationwide Cohort Study
Eu Jeong Ku, Keeho Song, Kyoung Min Kim, Gi Hyeon Seo, Soon Jib Yoo
Endocrinology and Metabolism.2023; 38(2): 253. CrossRef - Pituitary Diseases and COVID-19 Outcomes in South Korea: A Nationwide Cohort Study
Jeonghoon Ha, Kyoung Min Kim, Dong-Jun Lim, Keeho Song, Gi Hyeon Seo
Journal of Clinical Medicine.2023; 12(14): 4799. CrossRef - Inactivated SARS-CoV-2 vaccination does not disturb the clinical course of Graves’ disease: An observational cohort study
Shichen Xu, Huixin Yu, Xian Cheng, Jing Wu, Jiandong Bao, Li Zhang
Vaccine.2023; 41(38): 5648. CrossRef - Adrenal Crisis Associated With COVID-19 Vaccination in Patients With Adrenal Insufficiency
Yukako Kurematsu, Takako Mohri, Sadanori Okada, Yutaka Takahashi
JCEM Case Reports.2023;[Epub] CrossRef - Adverse Events Associated with COVID-19 Vaccination in Adolescents with Endocrinological Disorders: A Cross-Sectional Study
İbrahim Mert Erbaş, İrem Ceren Erbaş, Gözde Akın Kağızmanlı, Kübra Yüksek Acinikli, Özge Besci, Korcan Demir, Ece Böber, Nurşen Belet, Ayhan Abacı
Journal of Clinical Research in Pediatric Endocrinology.2023; 15(3): 248. CrossRef - Neue Aspekte der Glukokortikoidsubstitution bei Nebennierenrindeninsuffizienz
Tina Kienitz, Gesine Meyer
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Rimesh Pal, Ameya Joshi, Sanjay K. Bhadada, Mainak Banerjee, Suresh Vaikkakara, Satinath Mukhopadhyay
Endocrine Practice.2022; 28(4): 425. CrossRef - Safety of Inactivated and mRNA COVID-19 Vaccination Among Patients Treated for Hypothyroidism: A Population-Based Cohort Study
Xi Xiong, Carlos King Ho Wong, Ivan Chi Ho Au, Francisco Tsz Tsun Lai, Xue Li, Eric Yuk Fai Wan, Celine Sze Ling Chui, Esther Wai Yin Chan, Franco Wing Tak Cheng, Kristy Tsz Kwan Lau, Chi Ho Lee, Yu Cho Woo, David Tak Wai Lui, Ian Chi Kei Wong
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Mihaela Popescu, Adina Ghemigian, Corina Maria Vasile, Andrei Costache, Mara Carsote, Alice Elena Ghenea
Diagnostics.2022; 12(4): 960. CrossRef - Adrenal Crisis Secondary to COVID-19 Vaccination in a Patient With Hypopituitarism
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LingHong Huang, ZhengRong Jiang, JingXiong Zhou, YuPing Chen, HuiBin Huang
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Yue Ma, Shui Qiu, Renyi Zhou
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Ach Taieb, El Euch Mounira
Vaccines.2022; 10(12): 2004. CrossRef - Forty Years Together, New Leap Forward! The 40th Anniversary of the Korean Endocrine Society
Jong Chul Won, Ki-Hyun Baek
Endocrinology and Metabolism.2022; 37(6): 851. CrossRef - No need of glucocorticoid dose adjustment in patients with adrenal insufficiency before COVID-19 vaccine
Tania Pilli, Cristina Dalmiglio, Gilda Dalmazio, Alfonso Sagnella, Raffaella Forleo, Lucia Brilli, Fabio Maino, Cristina Ciuoli, Maria Grazia Castagna
European Journal of Endocrinology.2022; 187(1): K7. CrossRef - Diabetes and COVID-19 Vaccination
Hae Dong Choi, Jun Sung Moon
The Journal of Korean Diabetes.2021; 22(4): 221. CrossRef
- COVID-19 mRNA vaccine may trigger subacute thyroiditis
Original Article
- Spontaneous Recovery from Hypothyroidism in Autommune Thyroiditis.
- Bo Youn Cho, Jae Hoon Chung, Kwang Won Kim, Kyu Jeung Ahn, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee
- J Korean Endocr Soc. 1996;11(1):30-40. Published online November 7, 2019
- 2,220 View
- 35 Download
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Abstract
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- Background
A lifelong thyroxine therapy is indicated in all patients who have hypothyroidism as a result of autoimmune thyroiditis. However, it has been reported that some hypothyroid patients with autoimmune thyroiditis have spontaneous remission with restriction of iodine intake instead of thyroxine therapy. The purpose of study was to investigate how many hypothyroid patients with autoimmune thyroiditis can recover from hypothyroidism with restriction of iodine intake instead of thyroxine therapy and which factors predict recovery from hypothyroidism. Methods: We studied 64 patients with autoimmune thyroiditis(goitrous autoimmune thyroiditis 56, atrophic autoimmune thyroiditis 8). Thyroxine therapy was discontinued in patients with goitrous autoimmune thyroiditis on the way(group 1, n=32) or from the beginning(group 2, n=24) and atrophic autoimmune thyroiditis on the way(group 3, n-8). All patients were asked to avoid iodine-rich foods and thyroid function was monitored every one to two months for up to 35 months. Serum T3, T4, TSH concentrations, antithyroglobulin and antimicrosomal antibodies were measured by radioimmunoassay(RIA). TSH binding inhibitor immunoglobulin(TBII) was measured in serum using radioreceptor assay. Two hundred micrograms of thyrotropin releasing hormone (TRH) were given as intravenous bolus and TSH levels were measured in blood samples taken at 0, 30, and 60 minutes. All values were expressed as mean+-SEM. Statistical analysis was done with paired or non-paired t-test, ANOVA, and the Chi-square test. Statistical significance was defined as p-value below 0.05. Results: Thirteen(40.6%) of 32 patients in group 1 remained euthyroid after 12-35 months of discontinuation of thyroxine therapy. The other 19(59.4%) patients in group 1 had recurrences of hypothyroidism within 3 months after discontinuation of thyroxine therapy. In 11(45.8%) out of 24 patients in group 2, serum TSH concentrations declined below 5 mU/L within 3 months without thyroxine therapy. The other 13(54.2%) patients in group 2 remained hypothyroid till 2-16 months and the thyroxine was given. In contrast, all 8 patients in group 3 had recurrences of hypothy- roidism within 3 months after stopping thyroxine therapy. When we compared the recovered patients of goitrous autoimmune thyroiditis with the non-recovered patients of goitrous autoimmune thyroiditis, regardless of thyroxine therapy from the beginning, age at onset of disease of the 24 recovered patients was significantly younger than the 32 non-recovered patients(30.1+2.0 years vs. 40.2+ 2.4 years; p=0.004). Concl#usion: These findings suggest that 42.9% of hypothyroid patients with goitrous autoim- mune thyroiditis remain or become spontaneously euthyroid with restriction of iodine intake instead of thyroxine therapy. Young age may be a predicting factor of recovery from hypothyroidism in goitrous autoimmune thyroiditis.
Case Reports
- A Korean Pedigree of Paget Bone Disease: Including a Case of Panostotic Paget Bone Disease complicated with Giant Cell Reparative Granuloma.
- Eui Tae Jeong, Jae Hong Park, Do Hyeong Kim, Byoung Oh Jeong, Kyung Soo Ko, Byoung Doo Rhee
- J Korean Endocr Soc. 1995;10(4):456-466. Published online November 7, 2019
- 970 View
- 20 Download
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Abstract
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- The polyglandular autoimmune syndrome designates the dysfunction of endocrine and nonendocrine system involving two or more organs on the basis of an autoimmune mechanism. The autoimmune nature of these diseases has been based on the presence of lymphocytic infiltration in the affected gland, organ specific autoantibodies in the serum, cellular immune defects and an association with the HLA DR/DQ genes or immune response genes. This syndrome is usually classified into three classes and their etiology or pathogenesis is still not completely understood. A 28-year-old woman developed vitiligo and insulin dependent diabetes mellitus during the treatment of Graves' disease with antithyroid drug. She had a tendency of spontaneous ketonemia and serum c-peptide levels were low(0.21, 0.16ng/mL: fasting and glucagon stimulated). Thyrotrophin binding inhibitor immunoglobulin and pancreas iIslet cell cytoplasmic antibody were positive. We report here a case of polyglandular autoimmune syndrome, type III manifesting Graves' disease, vitiligo, and insulin dependent diabetes mellitus.
- A Case of Polyglandular Autoimmune Syndrome.
- In Pyo Jun, Suck Hwan Lim, Won Hyep Bae, Seung Jun Kim, Youn Ho Lee, Sun Ho Kim, Jung Kyu Lim, Jin Duk Hur
- J Korean Endocr Soc. 1994;10(2):142-147. Published online November 6, 2019
- 1,172 View
- 20 Download
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Abstract
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- Polyglandular autoimmune(PGA) syndrome designates the dysfunction of endocrine and nonendocrine system involving two or more glands on the basis of autoimmunity. There are three types of PGA syndrome and their pathogenesis is still not completely understood. A 27-year-old woman developed polyglandular autoimmune syndrome manifesting insulin-dependent diabetes mellitus, myasthenia gravis and Graves' disease associated papillary thyroid carcinoma. The thyroid antimicrosomal antibody and antiacetylcholine receptor antibody were positive. Her HLA serotype was A2, A11, A62, B60, CW3, CW4, DR4, DR9.We report here a case of polyglandular autoimmune syndrome, type III manifesting insulin-dependent diabetes mellitus, myasthenia gravis and Graves' disease associated with papillary thyroid carcinoma.
Review Article
- Diabetes
- Latent Autoimmune Diabetes in Adults: Current Status and New Horizons
- Paolo Pozzilli, Silvia Pieralice
- Endocrinol Metab. 2018;33(2):147-159. Published online June 21, 2018
- DOI: https://doi.org/10.3803/EnM.2018.33.2.147
- 14,308 View
- 385 Download
- 52 Web of Science
- 46 Crossref
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Abstract
PDFPubReader ePub
Autoimmune diabetes is a heterogeneous disease which can arise at any age. Subjects with adult-onset autoimmune diabetes who do not necessitate insulin-therapy for at least 6 months after diagnosis are demarcated as having latent autoimmune diabetes in adults (LADA). This condition is more heterogeneous than young-onset autoimmune diabetes and shares clinical and metabolic characteristics with both type 2 and type 1 diabetes. Patients with LADA are considered by having highly variable β-cell destruction, different degrees of insulin resistance and heterogeneous titre and pattern of islet autoantibody, suggesting different pathophysiological pathways partially explaining the heterogeneous phenotypes of LADA. To date the heterogeneity of LADA does not allow to establish
a priori treatment algorithm and no specific guidelines for LADA therapy are available. These subjects are mostly treated as affected by type 2 diabetes, a factor that might lead to the progression to insulin-dependency quickly. A personalised medicine approach is necessary to attain optimal metabolic control and preserve β-cell function to decrease the risk of long-term diabetes complications. Recent data concerning the use of oral antidiabetic agents as dipeptidyl peptidase 4 inhibitors and glucagon-like peptide 1 receptor agonists indicate up-and-coming results in term of protect C-peptide levels and improving glycaemic control. This review summarises current knowledge on LADA, emphasising controversies regarding its pathophysiology and clinical features. Moreover, we discuss data available about novel therapeutic approaches that can be considered for prevention of β-cell loss in LADA.-
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Original Article
- Clinical Study
- Characteristics of Korean Patients with Primary Adrenal Insufficiency: A Registry-Based Nationwide Survey in Korea
- A Ram Hong, Ohk-Hyun Ryu, Seong Yeon Kim, Sang Wan Kim
- Endocrinol Metab. 2017;32(4):466-474. Published online December 14, 2017
- DOI: https://doi.org/10.3803/EnM.2017.32.4.466
- 5,824 View
- 64 Download
- 14 Web of Science
- 12 Crossref
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Abstract
PDF
Supplementary MaterialPubReader Background Primary adrenal insufficiency (PAI) is a rare, potentially life-threatening condition. There are few Korean studies on PAI, and most have had small sample sizes. We aimed to examine the etiology, clinical characteristics, treatment, and mortality of PAI in Korean patients.
Methods A nationwide, multicenter, registry-based survey was conducted to identify adults diagnosed with or treated for PAI at 30 secondary or tertiary care institutions in Korea between 2000 and 2014.
Results A total of 269 patients with PAI were identified. The prevalence of PAI was 4.17 per million. The estimated incidence was 0.45 per million per year. The mean age at diagnosis was 49.0 years, and PAI was more prevalent in men. Adrenal tuberculosis was the most common cause of PAI in patients diagnosed before 2000; for those diagnosed thereafter, adrenal metastasis and tuberculosis were comparable leading causes. The etiology of PAI was not identified in 34.9% of cases. Of the patients receiving glucocorticoid replacement therapy, prednisolone was more frequently administered than hydrocortisone (69.4% vs. 26.5%, respectively), and only 27.1% of all patients received fludrocortisone. We observed an increased prevalence of metabolic disease and osteoporosis during the follow-up period (median, 60.2 months). The observed overall mortality and disease-specific mortality rates were 11.9% and 3.1%, respectively.
Conclusion The prevalence of PAI is significantly lower in Koreans than in reports from Western countries. The high frequency undetermined etiology in patients with PAI suggests the need to reveal accurate etiology of PAI in Korea.
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Citations
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Review Articles
- Thyroid
- Recent Advances in Autoimmune Thyroid Diseases
- Won Sang Yoo, Hyun Kyung Chung
- Endocrinol Metab. 2016;31(3):379-385. Published online August 26, 2016
- DOI: https://doi.org/10.3803/EnM.2016.31.3.379
- 6,046 View
- 126 Download
- 31 Web of Science
- 33 Crossref
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Abstract
PDFPubReader
Autoimmune thyroid disease (AITD) includes hyperthyroid Graves disease, hypothyroid autoimmune thyroiditis, and subtle subclinical thyroid dysfunctions. AITD is caused by interactions between genetic and environmental predisposing factors and results in autoimmune deterioration. Data on polymorphisms in the AITD susceptibility genes, related environmental factors, and dysregulation of autoimmune processes have accumulated over time. Over the last decade, there has been progress in the clinical field of AITD with respect to the available diagnostic and therapeutic methods as well as clinical consensus. The updated clinical guidelines allow practitioners to identify the most reasonable and current approaches for proper management. In this review, we focus on recent advances in understanding the genetic and environmental pathogenic mechanisms underlying AITD and introduce the updated set of clinical guidelines for AITD management. We also discuss other aspects of the disease such as management of subclinical thyroid dysfunction, use of levothyroxine plus levotriiodothyronine in the treatment of autoimmune hypothyroidism, risk assessment of long-standing antithyroid drug therapy in recurrent Graves' hyperthyroidism, and future research needs.
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- Thyroid
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Abstract
PDFPubReader
Genetic factors contribute for about 70% to 80% and environmental factors for about 20% to 30% to the pathogenesis of autoimmune thyroid disease (AITD). Relatives of AITD patients carry a risk to contract AITD themselves. The 5-year risk can be quantified by the so-called Thyroid Events Amsterdam-score, based on serum thyroid-stimulating hormone, thyroid peroxidase (TPO)-antibodies and family history. Subjects at risk may ask what they can do to prevent development of AITD. This review summarizes what is known about modulation of exposure to environmental factors in terms of AITD prevention. To stop smoking decreases the risk on Graves disease but increases the risk on Hashimoto disease. Moderate alcohol intake provides some protection against both Graves and Hashimoto disease. Low selenium intake is associated with a higher prevalence of thyroid autoimmunity, but evidence that selenium supplementation may lower TPO antibodies and prevent subclinical hypothyroidism remains inconclusive. Low serum vitamin D levels are associated with a higher prevalence of TPO antibodies, but intervention studies with extra vitamin D have not been done yet. Stress may provoke Graves hyperthyroidism but not Hashimoto thyroiditis. Estrogen use have been linked to a lower prevalence of Graves disease. The postpartum period is associated with an increased risk of AITD. Taking together, preventive interventions to diminish the risk of AITD are few, not always feasible, and probably of limited efficacy.
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Case Reports
- Obesity and Metabolism
- Recurrent Insulin Autoimmune Syndrome Caused by α-Lipoic Acid in Type 2 Diabetes
- Sang Mook Bae, Myoung Nam Bae, Eun Young Kim, Il Kyu Kim, Min Woo Seo, Jin Kyeong Shin, Sung Rae Cho, Gui Hwa Jeong
- Endocrinol Metab. 2013;28(4):326-330. Published online December 12, 2013
- DOI: https://doi.org/10.3803/EnM.2013.28.4.326
- 3,858 View
- 50 Download
- 17 Crossref
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Abstract
PDFPubReader
Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia caused by insulin autoantibodies in the absence of exogenous insulin administration. Some drugs containing sulfhydryl compounds are known to initiate the onset of IAS. A 67-year-old female who had diabetes for 5 years visited the outpatient clinic at our institution due to diabetic peripheral polyneuropathy. She was prescribed α-lipoic acid (ALA), which contains two sulfur atoms. Two weeks later, she complained of recurrent hypoglycemic symptoms. We detected a high level of insulin and high titers of insulin autoantibodies. Her human leukocyte antigen (HLA) genotype included the DRB1*0406 allele, which indicates a high level of susceptibility to IAS. She was treated with prednisolone. After this episode, she experienced two more hypoglycemic events after taking ALA for diabetic neuropathy in other hospitals. As ALA can be used to treat diabetic peripheral polyneuropathy, physician discretion is advised based on the possibility of IAS due to ALA in diabetic patients.
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Citations
Citations to this article as recorded by- Long-term follow-up after discharge witnesses a slow decline of insulin autoantibodies in patients with insulin autoimmune syndrome complicated with Grave’s disease: a report of two cases
Lili Zhao, Jinzhi He, Shandong Ye, Chao Chen, Jie Zhu, Chunchun Xiao, Tingni Wu, Zhicheng Liu
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Umberto Capece, Simona Moffa, Ilaria Improta, Gianfranco Di Giuseppe, Enrico Celestino Nista, Chiara M. A. Cefalo, Francesca Cinti, Alfredo Pontecorvi, Antonio Gasbarrini, Andrea Giaccari, Teresa Mezza
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Zuojun Li, Yanhong Su, Dan Yi, Cuifang Wu, Weijin Fang, Chunjiang Wang
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- Polyglandular Autoimmune Syndrome Type III with Primary Hypoparathyroidism
- Sang Jin Kim, Sang-Yoon Kim, Han-Byul Kim, Hyukwon Chang, Ho-Chan Cho
- Endocrinol Metab. 2013;28(3):236-240. Published online September 13, 2013
- DOI: https://doi.org/10.3803/EnM.2013.28.3.236
- 4,087 View
- 34 Download
- 5 Crossref
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Abstract
PDFPubReader
Polyglandular autoimmune syndrome is defined as multiple endocrine gland insufficiencies accompanied by autoimmune diseases of the endocrine and nonendocrine system. After Schmidt introduced a case of nontuberculosis adrenal gland dysfunction with thyroiditis in 1926, Neufeld defined polyglandular autoimmune syndrome by I, II, and III subtypes in 1980 by their presentation of occurrence age, heredity methods, relationship with human leukocyte antigen, and accompanying diseases. We report a case of a 32-year-old female with polyglandular autoimmune syndrome III accompanied by type 1 diabetes mellitus that was treated with insulin (36 units per day) for 11 years. She had insulin deficiency and Hashimoto thyroiditis as an autoimmune disorder. In addition, she had several features similar to Albright's hereditary osteodystrophy including short stature, truncal obesity, round face, short neck, low intelligence (full IQ 84), and decreased memory. Although Albright's hereditary osteodystrophy is morphological evidence of pseudohypoparathyroidism or pseudopseudohypoparathyroidism, she had primary hypoparathyroidism on laboratory results. Here, we report a case of polyglandular autoimmune syndrome III with type 1 diabetes mellitus, autoimmune thyroiditis, and primary hypoparathyroidism, accompanied by clinical features similar to Albright's hereditary osteodystrophy.
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- Thyroid
- Steroid Responsive Xanthomatous Hypophysitis Associated with Autoimmune Thyroiditis: A Case Report
- Ji Young Joung, Hyemin Jeong, Yoon Young Cho, Kyoungmin Huh, Yeon-Lim Suh, Kwang-Won Kim, Ji Cheol Bae
- Endocrinol Metab. 2013;28(1):65-69. Published online March 25, 2013
- DOI: https://doi.org/10.3803/EnM.2013.28.1.65
- 3,539 View
- 30 Download
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Abstract
PDFPubReader
We report the case of a 36-year-old woman who presented with headache, fever, and amenorrhea. Laboratory analysis revealed hypopituitarism and autoimmune thyroiditis, while a cerebrospinal fluid study suggested concurrent aseptic meningitis. A magnetic resonance image (MRI) scan revealed a 1.0×0.9 cm cystic mass enlarging the sella turcica. Surgical resection via an endoscopic transsphenoidal route was performed. The histological finding of the excised tissue revealed foamy histiocytes with vacuolated cytoplasm, supporting the diagnosis of xanthomatous hypophysitis. Although a residual soft lesion was observed on the MRI image postoperatively, the patient's headache and fever improved. Ten months after surgery, the patient complained of visual impairment and headache, and the residual mass had enlarged into the suprasellar area. High dose (500 mg intravenous) methylprednisolone was administered for 3 days. During the methylprednisolone pulse therapy, the patient's visual acuity and headache improved. A follow-up MRI taken after methylprednisolone therapy showed a marked mass reduction. Our case supports an autoimmune pathophysiology for xanthomatous hypophysitis and suggests that high dose glucocorticoid therapy as a treatment option.
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B.K. Kleinschmidt‐DeMasters, Kevin O. Lillehei, Todd C. Hankinson
Brain Pathology.2017; 27(3): 377. CrossRef - Xanthomatous hypophysitis
Bishoy Hanna, Yan M. Li, Timothy Beutler, Parul Goyal, Walter A. Hall
Journal of Clinical Neuroscience.2015; 22(7): 1091. CrossRef - Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis
Sun Mi Park, Ji Cheol Bae, Ji Young Joung, Yoon Young Cho, Tae Hun Kim, Sang-Man Jin, Sunghwan Suh, Kyu Yeon Hur, Kwang-Won Kim
Endocrinology and Metabolism.2014; 29(4): 470. CrossRef - Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
Won-Young Lee
Endocrinology and Metabolism.2014; 29(3): 251. CrossRef
- Xanthomatous hypophysitis causing hypogonadotropic hypogonadism resulting in delayed presentation of slipped capital femoral epiphysis
- Thyroid
- Two Cases of Methimazole-Induced Insulin Autoimmune Syndrome in Graves' Disease
- Eun Roh, Ye An Kim, Eu Jeong Ku, Jae Hyun Bae, Hye Mi Kim, Young Min Cho, Young Joo Park, Kyong Soo Park, Seong Yeon Kim, Soo Heon Kwak
- Endocrinol Metab. 2013;28(1):55-60. Published online March 25, 2013
- DOI: https://doi.org/10.3803/EnM.2013.28.1.55
- 6,489 View
- 72 Download
- 15 Crossref
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Abstract
PDFPubReader
We report here the cases of two females with Graves' disease who developed insulin autoimmune syndrome after treatment with methimazole. The patients exhibited a sudden altered mental state after treatment with methimazole for approximately 4 weeks. Patients had hypoglycemia with serum glucose below 70 mg/dL, and laboratory findings showed both high levels of serum insulin and high titers of insulin autoantibodies. The two women had never been exposed to insulin or oral antidiabetic agents, and there was no evidence of insulinoma in imaging studies. After glucose loading, serum glucose, and total insulin levels increased abnormally. One of the patient was found to have HLA-DRB1*0406, which is known to be strongly associated with methimazole-induced insulin autoimmune syndrome. After discontinuation of methimazole, hypoglycemic events disappeared within 1 month. Insulin autoantibody titer and insulin levels decreased within 5 months and there was no further development of hypoglycemic events. We present these cases with a review of the relevant literature.
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Citations
Citations to this article as recorded by- Insulin Autoimmune Syndrome: A Systematic Review
MingXu Lin, YuHua Chen, Jie Ning, Tatsuya Kin
International Journal of Endocrinology.2023; 2023: 1. CrossRef - Safety of Antithyroid Drugs in Avoiding Hyperglycemia or Hypoglycemia in Patients With Graves’ Disease and Type 2 Diabetes Mellitus: A Literature Review
Yu-Shan Hsieh
Cureus.2023;[Epub] CrossRef - Case report: hypoglycemia secondary to methimazole-induced insulin autoimmune syndrome in young Taiwanese woman with Graves’ disease
Hsuan-Yu Wu, I-Hua Chen, Mei-Yueh Lee
Medicine.2022; 101(25): e29337. CrossRef - Analysis of the clinical characteristics of insulin autoimmune syndrome induced by methimazole
Linli Sun, Weijin Fang, Dan Yi, Wei Sun, Chunjiang Wang
Journal of Clinical Pharmacy and Therapeutics.2021; 46(2): 470. CrossRef - Preoperative plasmapheresis experience in Graves’ disease patients with anti-thyroid drug-induced hepatotoxicity
Tugce Apaydın, Onur Elbasan, Dilek Gogas Yavuz
Transfusion and Apheresis Science.2020; 59(5): 102826. CrossRef - Glycemic variation in uncontrolled Graves’ disease patients with normal glucose metabolism: Assessment by continuous glucose monitoring
Gu Gao, Feng-fei Li, Yun Hu, Reng-na Yan, Bing-li Liu, Xiao-mei Liu, Xiao-fei Su, Jian-hua Ma, Gang Hu
Endocrine.2019; 64(2): 265. CrossRef - Insulin autoimmune syndrome induced by exogenous insulin injection: a four-case series
Yimin Shen, Xiaoxiao Song, Yuezhong Ren
BMC Endocrine Disorders.2019;[Epub] CrossRef - Assessment and Management of Anti-Insulin Autoantibodies in Varying Presentations of Insulin Autoimmune Syndrome
David Church, Luís Cardoso, Richard G Kay, Claire L Williams, Bernard Freudenthal, Catriona Clarke, Julie Harris, Myuri Moorthy, Efthmia Karra, Fiona M Gribble, Frank Reimann, Keith Burling, Alistair J K Williams, Alia Munir, T Hugh Jones, Dagmar Führer,
The Journal of Clinical Endocrinology & Metabolism.2018; 103(10): 3845. CrossRef - MANAGEMENT OF ENDOCRINE DISEASE: Pathogenesis and management of hypoglycemia
Nana Esi Kittah, Adrian Vella
European Journal of Endocrinology.2017; 177(1): R37. CrossRef - Insulin autoimmune syndrome during the administration of clopidogrel
Eijiro Yamada, Shuichi Okada, Tsugumichi Saito, Aya Osaki, Atushi Ozawa, Masanobu Yamada
Journal of Diabetes.2016; 8(4): 588. CrossRef - Hyperinsulinemic hypoglycemia associated with insulin antibodies caused by exogenous insulin analog
Chih-Ting Su, Yi-Chun Lin
Endocrinology, Diabetes & Metabolism Case Reports.2016;[Epub] CrossRef - Anti-tuberculosis Treatment-Induced Insulin Autoimmune Syndrome
Jung Suk Han, Han Ju Moon, Jin Seo Kim, Hong Il Kim, Cheol Hyeon Kim, Min Joo Kim
The Ewha Medical Journal.2016; 39(4): 122. CrossRef - 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis
Douglas S. Ross, Henry B. Burch, David S. Cooper, M. Carol Greenlee, Peter Laurberg, Ana Luiza Maia, Scott A. Rivkees, Mary Samuels, Julie Ann Sosa, Marius N. Stan, Martin A. Walter
Thyroid.2016; 26(10): 1343. CrossRef - Insulin Autoimmune Syndrome in a Patient with Hashimoto's Thyroiditis
In Wook Song, Eugene Han, Nan Hee Cho, Ho Chan Cho
Journal of Korean Thyroid Association.2014; 7(2): 180. CrossRef - Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
Won-Young Lee
Endocrinology and Metabolism.2014; 29(3): 251. CrossRef
- Insulin Autoimmune Syndrome: A Systematic Review
Review Article
- Vitamin D: A D-Lightful Vitamin for Health.
- Michael F Holick
- Endocrinol Metab. 2012;27(4):255-267. Published online December 20, 2012
- DOI: https://doi.org/10.3803/EnM.2012.27.4.255
- 2,185 View
- 43 Download
- 9 Crossref
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Abstract
PDF
- Vitamin D is a sunshine vitamin that has been produced on this earth for more than 500 million years. Because foods contain so little vitamin D most humans have always depended on sun exposure for their vitamin D requirement. Vitamin D deficiency has been defined as a serum 25-hydroxyvitamin D concentration < 20 ng/mL (50 nmol/L); vitamin D insufficiency as a serum 25-hydroxyvitamin D of 21-29 ng/mL and vitamin D sufficiency as a serum 25-hydroxyvitamin D of 30-100 ng/mL whereas toxicity is usually not seen until blood levels are above 150 ng/mL. Vitamin D deficiency is a global health problem that increases risk for metabolic bone diseases in children and adults as well as many chronic illnesses including autoimmune diseases, type 2 diabetes, cardiovascular disease, infectious disease, and cancer. The major causes of vitamin D deficiency are lack of adequate sensible exposure to sunlight, inadequate dietary intake and obesity. The United States Endocrine Society recommended that to prevent vitamin D deficiency in those at risk, children 1 year and older require 600-1,000 international unit (IU) of vitamin D daily and adults require 1,500-2,000 IU of vitamin D daily. Obese patients require 2-3 times more vitamin D to both treat and prevent vitamin D deficiency.
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Citations
Citations to this article as recorded by- Higher intakes of dietary caffeine are associated with 25-hydroxyvitamin D deficiency
Qiwei Chen, Hamed Kord-Varkaneh, Heitor O. Santos, Rafael Genario, Minyan Dang
International Journal for Vitamin and Nutrition Research.2022; 92(2): 85. CrossRef - WITHDRAWN: Higher intakes of dietary caffeine are associated with 25-hydroxyvitamin D deficiency: a study from the NHANES
Fang Yang, Ning Wang
Nutrition.2021; : 111380. CrossRef - Association of metabolic syndrome and 25‐hydroxyvitamin D with cognitive impairment among elderly Koreans
Eun Young Lee, Su Jin Lee, Kyoung Min Kim, Young Mi Yun, Bo Mi Song, Jong Eun Kim, Hyeon Chang Kim, Yumie Rhee, Yoosik Youm, Chang Oh Kim
Geriatrics & Gerontology International.2017; 17(7): 1069. CrossRef - Korean Society for Bone and Mineral Research Task Force Report: Perspectives on Intermittent High-dose Vitamin D Supplementation
Han Seok Choi, Yong-Ki Min, Dong Won Byun, Myung Hoon Hahn, Kyoung Min Kim, Beom Jun Kim, Ki-Won Oh
Journal of Bone Metabolism.2017; 24(3): 141. CrossRef - Efficacy and safety of vitamin D3 B.O.N intramuscular injection in Korean adults with vitamin D deficiency
Han Seok Choi, Yoon-Sok Chung, Yong Jun Choi, Da Hea Seo, Sung-Kil Lim
Osteoporosis and Sarcopenia.2016; 2(4): 228. CrossRef - Endocrine Risk Factors for Cognitive Impairment
Jae Hoon Moon
Endocrinology and Metabolism.2016; 31(2): 185. CrossRef - The effect of thyroid stimulating hormone suppressive therapy on bone geometry in the hip area of patients with differentiated thyroid carcinoma
Jae Hoon Moon, Kyong Yeun Jung, Kyoung Min Kim, Sung Hee Choi, Soo Lim, Young Joo Park, Do Joon Park, Hak Chul Jang
Bone.2016; 83: 104. CrossRef - Serum 25‐hydroxyvitamin D level and the risk of mild cognitive impairment and dementia: the Korean Longitudinal Study on Health and Aging (KLoSHA)
J.H. Moon, S. Lim, J.W. Han, K.M. Kim, S.H. Choi, K.W. Kim, H.C. Jang
Clinical Endocrinology.2015; 83(1): 36. CrossRef - Vitamin D Status in Korea
Han Seok Choi
Endocrinology and Metabolism.2013; 28(1): 12. CrossRef
- Higher intakes of dietary caffeine are associated with 25-hydroxyvitamin D deficiency
Case Reports
- Autoimmune Thyroiditis during Antiviral Therapy with Peginterferon.
- Jung Min Roh, Jeong Seon Yoo, Yoon Bum Lee, Hye Rim An, Hong Kyu Choi, Kyo Tae Jung, Jong Suk Park, Kwan Sik Lee, Kyung Rae Kim
- J Korean Endocr Soc. 2010;25(1):68-71. Published online March 1, 2010
- DOI: https://doi.org/10.3803/jkes.2010.25.1.68
- 1,626 View
- 25 Download
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Abstract
PDF
- Combination treatment with pegylated interferon and ribavirin has been established as a standard therapy for chronic hepatitis C. Although interferon therapy is relatively safe, an important side effect is the induction of autoantibodies and autoimmune disease, especially autoimmune thyroid disease. Interferon associated autoimmune thyroid disease can consist of autoimmune hypothyroidism, Graves' disease, and destructive thyroiditis. Thyroid disease may lead to dose reduction or discontinuation of therapy.
- A Case of Hashimoto's Thyroiditis Accompanied by Autoimmune Hepatitis Diagnosed with Liver Biopsy.
- Young Jun Lee, Ji Yoon Sung, Sei Hyun Kim, Hyon Seung Yi, Yun Soo Kim, Sihoon Lee, Ie Byung Park
- J Korean Endocr Soc. 2009;24(4):287-292. Published online December 1, 2009
- DOI: https://doi.org/10.3803/jkes.2009.24.4.287
- 1,927 View
- 23 Download
- 2 Crossref
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Abstract
PDF
- Autoimmune thyroid diseases, including Hashimoto's thyroiditis (HT), are common organ-specific autoimmune disorders that often occur in conjunction with other autoimmune diseases. Autoimmune hepatitis (AIH) is a relatively rare disease of unknown etiology. In this condition, progressive destruction of the liver parenchyma occurs. Without proper treatment with immunosuppressive agents, such as prednisone and azathioprine, this condition leads to cirrhosis and liver failure. Timely detection and appropriate treatment of the AIH is prerequisite for the long-term survival of affected patients. We report here a case of HT accompanied by AIH confirmed by liver biopsy. On the basis of this case report, we suggest that, a sustained elevation of aminotransferases refractory to thyroid dysfunction correction should result in a liver biopsy to differentiate AIH from other forms of liver dysfunction or secondary to thyroid disorders. Treatment should commence promptly.
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Citations
Citations to this article as recorded by- Autoimmune Hashimoto thyroiditis with concomitant autoimmune hepatitis
Nevena Manevska, Natasa Stojkovska, Ljubica Tasheva, Marija Jovanovski-Srceva, Tanja Makazlieva, Sinisha Stojanoski
Archives of Public Health.2022;[Epub] CrossRef - A Case of Demyelinating Peripheral Neuropathy Associated with Hashimoto`s Thyroiditis
Jung Hwan Park M.D., Sang Mo Hong M.D., Chang Bum Lee M.D., Yong Soo Park M.D., Dong Sun Kim M.D., Woong Hwan Choi M.D., You Hern Ahn M.D.
Journal of the Korean Geriatrics Society.2011; 15(4): 234. CrossRef
- Autoimmune Hashimoto thyroiditis with concomitant autoimmune hepatitis
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