- A Case of Thyroid Storm Developed after Dilatation and Curettage for Invasive Molar Pregnancy.
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Joon Sung Park, Jun Goo Kang, Chang Beom Lee, Yong Soo Park, Dong Sun Kim, Tae Wha Kim, Joon Soo Hahm, Jung Han Lee, Jung Hyae Hwang, Seung Ryong Kim, You Hern Ahn
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J Korean Endocr Soc. 2002;17(4):589-595. Published online August 1, 2002
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- Thyroid dysfunction is one of the more prevalent clinical situations encountered by primary care physicians. Thyroid storm is defined as a life-threatening exacerbation of the hyperthyroid state in which there is evidence of decompensation of one or more organ systems. Common precipitants include infection, surgery, diabetic ketoacidosis, vascular accidents, non-compliance with antithyroid medication, and emotional stress, but rarely develop in invasive molar pregnancy. An 18-year-old woman presented to the emergency department complaining of lower abdominal pain and vaginal spotting. She had no previous history of hyperthyroidism. Under the diagnosis of invasive molar pregnancy, dilatation and curettage was performed. However, right after the procedure the patient developed a semi-coma metal status, high grade fever, and tachycardia. Prompt diagnosis of thyroid storm was made and treatment followed immediately. We present a case of thyroid storm and a review of thyroid storm precipitated by invasive molar pregnancy.
- A Case of Steroid induced Myopathy in Patient with Iatrogenic Cushing Syndrome.
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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
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J Korean Endocr Soc. 2002;17(2):275-279. Published online April 1, 2002
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- 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.
- A Case of Methimazole Induced Agranulocytosis Complicated with Deep Neck Abscess.
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Kwan Woo Lee, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Yoon Jung Kim, Eun Kyung Hong, Bong Nam Chae, Jin Ho Lee, Chang Young Ha, Joon Sung Park
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J Korean Endocr Soc. 1998;13(4):617-621. Published online January 1, 2001
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- The thiourea derivatives, propylthiouracil and methimazole are in widespread use for the treatment of hyperthyroidism. The untoward side effects of these drugs are not infrequent and agranulocytosis is the most serious side effect them. We observed one case of methimazole induced agranulocytosis complicated by deep neck abscess. A 54-year-old woman was admitted because of fever, chilling and sore throat for 1 week. The symptom was developed after receiving methimazole 30mg daily day due to hyperthyroidism during last 3 months. Physical examination revealed hyperemic, enlarged tonsils and tender swelling of the right lower neck The peripheral blood total leukoeyte count was 1,500/mm' (absolute neutrophil count, ANC 9) and a peripheral blood smear revealed few neutrophil. The patient was administered G-CSF 2 mg/kg daily, and on the fifth day of hospitalization, fever subsided and ANC increased to 3,431. On the 11th day, fever developed again and the tenderness and swelling in both lower neck area were aggrevated. Computed tomography of the neck was performed, and revealed a large deep neck abscess. After pus aspiration and antibiotics therapy, the neck abscess was disappeared.
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