- Three Cases of Primary Hypothyroidism with Down Syndrome in Adult.
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Kwan Woo Lee, Young Goo Shin, Sung Keun Lee, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim
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J Korean Endocr Soc. 1998;13(3):453-458. Published online January 1, 2001
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- Down syndrome is perhaps the most common genetic condition associated with mental retardation. In cytogenetic examination, trisomy 21 is in 95% of Down syndrome, and the others are mosaicism, translocation or deletion. There are many associated diseases with Down syndrome such as, thyroid function abnormality, congenital heart disease, intestinal blockage, and so on. Hypothyroidism appeared in 15% before adolescent in Down syndrome patients. In Korea, there were several reports of Down syndrome with hypothyroidism in childhood but not in adulthood. And we had three cases of hypothyroidism with Down syndrome in adulthood. Cytogenetic examination revealed trisomy 21 in the 2 cases and 1 case of mosaicism. Antithyroid antibody was positive in one case. None of these cases was admitted due to symptoms of hypothyroidism. It is very difficult to make the diagnosis of hypothyroidism in Down syndrome because of similarity in symptoms between Down syndrome and hypothyroidism. Thus, periodic thyroid function test should be made in Down syndrome, and this could be a part of improving quality of life in Down syndrome.
- A Case of Surgically Treated Insulinoma in Pregnancy.
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Kwan Woo Lee, Euy Young Soh, Young Goo Shin, Sung Keun Lee, So Yun Park, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Kyung Joo Hwang, Yun Mi JIn
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J Korean Endocr Soc. 1998;13(2):288-294. Published online January 1, 2001
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- Insuliin secreting tumor is 70% prevalent disease in female and predoadnant in forth and sixth deeade. The incidence of insulinoma is one case per 250,000 patient-years. Insulinoma in pregnancy was extremely rare, and the prevalence was not reported. The diagnosis of an insulinoma is depend on demonstration of hypoglycemia with high insulin and C-peptide levels. Immunoreactive insulin/plasma glucose ratio0.3 in particular support the diagnosis of an insulinoma. Fetal complication would be developed because of hypoglycemia. In approximately half of the cases reported, surgical exploration was done during pregrancy, the remainder were treated after delivery. Insulinoma poses serious diagnostic and therapeutic problems when she is pregnant. We experienced a case of insulinoma in pregnancy that represented Whipples triad and was treated by surgical intervention.
- A Case of Thymic Carcinoid Tumor Associated with Ectopic ACTH Syndrome.
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Kwan Woo Lee, Young Goo Shin, Sung Keun Lee, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Yo Han Cho, Kwang Hyun Ko, Jung Sun Kim, Chul Shim
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J Korean Endocr Soc. 1997;12(4):647-654. Published online January 1, 2001
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- The syndrome of ectopic production of ACTH by non-pituitary neoplasm occurs with various types of tumors. ACTH-producing thymic carcinoid tumor is rare and has not been reported in Korea. We have experienced a 36-year-old male patient with ACTH-producing thymic carcinoid tumor, presenting symptoms of generalized weakness and weight gain. Clinical presentation, radiologic and hormonal evaluation, and pathologic examination were compatible with ACTH-producing thymic carcinoid tumor. The immunohistochemical staining of the thymic carcinoid tumor showed positivity for ACTH. Primary and metastatic tumor and both adrenal glands were resected. Radiation therapy and chemotherapy were performed. The prognosis of this patient is thought to be poor.
- Four Cases of Newly Developing Goiter During Lithium Carbonate Therapy.
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Kwan Woo Lee, Young Goo Shin, Sung Keun Lee, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim
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J Korean Endocr Soc. 1997;12(4):621-626. Published online January 1, 2001
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- Since 1949, lithium has been widely used for treatment of manic depressive disorder. It has also been used for agranulocytosis after anticaneer chemotherapy and partially for hyperthyroidism. But it is well known that the long term administration of this drug is associated wih various antithyroid effects such as hypothyroidism, simple goiter, nodules and even thyrotoxicosis. Although the exact mechanism for leading hypothyroidism or goiter is still unknown, the incidence of lithium-induced hypothyroidism is 1-37% during lithium atment. We had an experience of newly developing goiter with or without hypothyroidism during lithium treatment in 4 MDP patients. Among our patients, the duration of lithium administration was from 0.7 months to 11 years, and the development of thyroid abnormality was impossible to predict. They were treated with thyroxine while lithium was discontinued causing favorable outcome. We suggest that routine thyroid function test include thyroid autoimmune antibody screening in patients planning to undergo lithium treatment.
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