- A Case of Simultaneous Presentation of Thyroid Crisis and Diabetic Ketoacidosis.
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Kyung Ae Lee, Kyung Taek Park, Hea Min Yu, Heung Yong Jin, Ji Hyun Park, Hong Sun Baek, Tae Sun Park
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Endocrinol Metab. 2012;27(1):63-67. Published online March 1, 2012
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DOI: https://doi.org/10.3803/EnM.2012.27.1.63
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- Two important endocrine emergencies, thyroid crisis and diabetic ketoacidosis (DKA), are uncommon when presented together, but pose serious complications. Without appropriate management, they may result in high mortality. Although several cases of simultaneous presentation of thyroid crisis and DKA have been reported, it is a clinically unusual situation and remains a diagnostic and management challenge in clinical practice. We report rare case with simultaneous presentation of thyroid crisis and DKA without previous warning symptoms. A 23-year-old-woman was brought to the emergency department presenting with acute abdominal pain for one day. She was healthy and there was no personal history of diabetes or thyroid disease. Through careful physical examination and laboratory tests, the patient was diagnosed with thyroid crisis combined with DKA. Concomitance of these two endocrine emergencies led to sudden cardiac arrest, but she was successfully resuscitated. This emphasizes the importance of early recognition and prompt management when the two diseases are presented concomitantly.
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Citations
Citations to this article as recorded by  - Health Behaviors and Risk Factors Associated with Chronic Kidney Disease in Korean Patients with Diabetes: The Fourth Korean National Health and Nutritional Examination Survey
Suk Jeong Lee, Chae Weon Chung
Asian Nursing Research.2014; 8(1): 8. CrossRef
- A Case of Concurrent Papillary Thyroid Carcinoma in Familial Medullary Thyroid Microcarcinoma with a Germline C634W Mutation.
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Ji Hye Kim, Ji Hyun Park, Tae Sun Park, Hong Sun Baek, Myoung Ja Chung, Ki Hwan Hong
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Endocrinol Metab. 2010;25(4):354-359. Published online December 1, 2010
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DOI: https://doi.org/10.3803/EnM.2010.25.4.354
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- The origins of medullary carcinoma (MTC) and papillary carcinoma (PTC) of the thyroid are embryologically different. Tumors showing concurrent medullary and papillary features are rare and they represent less than 1% of all thyroid malignancies. Hereditary MTC is an autosomal dominantly inherited disease which is genetically determined as part of the MEN 2A, MEN 2B, or variants of MEN 2A such as familial MTC. Germline mutations of the RET gene are the underlying cause of the majority of cases of hereditary medullary carcinomas. The pathogenesis of concurrent PTC with familial MTC has rarely been known. Genetic analysis of the RET oncogene has so far provided conflicting results. Here we describe a family whose sibling was affected by both PTC & MTC, and the family carried a germ-line point mutation in the RET extracellular domain that converted cysteine 634 into tryptophan (C634W).
- Primary Pituitary Abscess: An Unusual Case of Diabetes Insipidus.
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Ji Hye Kim, Ji Hyun Park, Tae Sun Park, Hong Sun Baek
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J Korean Endocr Soc. 2006;21(5):408-413. Published online October 1, 2006
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DOI: https://doi.org/10.3803/jkes.2006.21.5.408
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- A 58-year-old man was investigated for his complaints of chronic frontal headache. The endocrinologic hormone studies were compatible with diabetes insipidus and suggestive of panhypopituitarism. Sellar MRI showed a cystic sellar lesion with peripheral rim enhancement after contrast injection, and this led to an initial diagnosis of pituitary adenoma with hemorrhagic necrosis. He underwent an operation via the transsphenoidal approach to access the pituitary gland. During the operation, purulent materials were obtained and no tumor or other associated lesions were detected. There was no evidence of current or previous septicemic illness, meningitis, cavernous sinus thrombosis or sinus infection. All the cultures we obtained were negative. He was put on antibiotics and discharged after 4 weeks. Now, 18 months after treatment, he is doing well.
- A Case of Wernicke's Encephalopathy Caused by Hyperemesis Gravidarum Complicated with Thyroid Storm and Abnormal Liver Function.
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Sang In Choi, Chul Soo Lim, Chi Young Moon, Hong Sun Baek
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J Korean Endocr Soc. 1998;13(2):247-251. Published online January 1, 2001
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- A 27-year-old woman developed Wemicke's encephalopathy in the 16th week of her first pregnaney. She had thyroid storm and abnormal liver function. Her thyrotoxic symptom and abncemal liver function was recovered after medication of antithyroid drug, steroid, hepatotonic drug and administration of thiamine(fursulthiamin), but the fetus was lost, Thereafter her thyroid function returned to normal and euthyroid state was maintained without medication of antithyroid drug, but her neurological defect was remained. We suggest that severe hyperemesis gravidarum is a possible risk factor of the thyroid storm and Wemicke's encephalopathy in patients with hyperthyroidism, and consider the check of the thyroid function. The need for parenteral thiamine supplementation and medication of antithyroid drug is warranted in patients with severe hyperemesis gravidarum which lasts longer than 3 weeks and abnormal thyroid function.
- Serum Insulin-like Growth Factor-1(IGF-1) and Insulin-like Growth Factor Binding Proteins in Hyperthyroidism and Hypothyroidism.
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Hyun Mo Song, Sang Seok Park, Tae Seon Park, Hong Sun Baek, Dae Yeol Lee
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J Korean Endocr Soc. 1996;11(1):52-60. Published online November 7, 2019
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- Background
s: Thyroid hormones play a fundamental role in the initiation and maintenance of somatic growth in mammalian species, and the insulin-like growth factors(IGFs) occupy a position of central importance in the growth of all tissues. To evaluate the changes in serum insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding proteins in hyperthyroid and hypothyroid patients, sera was obtained from 19 hyperthyroid patients, 9 hypothyroid patients, and 10 healthy volunteers. Methods: IGF-I concentration was determined by radioimmunoassay, and changes in IGFBPs were assesed by Western Ligand Blotting. To evaluate the binding pattern of IGF-I & IGFBPs, autoradiographs were obtained. Results & Conclusion: IGF-I levels were increased significantly in hyperthyroid patients(mean ±SE, 267.88±9.80 ng/ml, p<0.05) and decreased significantly in hypothyroid patients(154.81±1.43 ng/ml, p<0.01) compaired to healthy control group(209.45±.60 ng/ml). Autoradiograph of serum IGFBPs from patients with hyperthyroidism and hypothyroidism did not show any change in the intensity of IGFBP-3 bands(40-45 KD) and IGFBP-1 bands, but in hyperthyroid patients, it showed increased intensity of IGFBP-2 band compared to healthy control group and hypothyroid patients.
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