Endocrinology and Metabolism

Tuberculosis of the Thyroid Gland.: Chang Ho Song, Choon Hee Chung, Young Joon Weon, Mi Deok Lee, Seong Jin Park, Won Sik Lee, Mee Yon Cho, Young Kyung Kim, Seung Min Kim, Seong Joon Kang; J Korean Endocr Soc. 1995;10(4):428-433. Published online November 7, 2019

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Abstract PDF: Tuberculosis the thyroid gland occurs only rarely and a few records are available in Korea, despite of high prevalence of tuberculosis. The authors experienced a case of young woman with tuberculosis of the thyroid gland and meninges. Tuberculosis of the thyroid gland was confirmed by demonstration of acid-fast bacilli and granuloma with caseation necrosis on surgical specimen. Description of case profile and a brief review of literature are made.

Two Cases of Tubereuloeis of the Thyroid Gland with Euthyroidism.: Jae Bok Lee, Seok Man Son, Kyoung Seog Lee, Yeong Tae Jeong, In Joo Kim, Yong Ki Kim; J Korean Endocr Soc. 1994;9(4):380-384. Published online November 6, 2019

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Abstract PDF: Tuberculosis of the thyroid gland is extremely rare with few cases reported in recent years. Tuberculosis may involve the thyroid gland in two main forms. The more common of theses is miliary spread to the thyroid as part of generalized dissemination and less commonly focal or caseous tuberculosis of the thyroid may occur, presenting as a nodule, as a thyroiditis, as a abscess, or as carcinoma like.We experienced two cases of tuberculosis of the thyroid gland presenting with palpable thyroid nodule in 26 year-old female and 65 year-old female patients. They have been clinically and biochemically euthyroid and their thyroid scans demonstrated a cold nodule at right thyroid gland. We found no evidence of tuberculosis elsewhere. The goiter was removed surgically and confirmed to be tuberculosis. They were medicated antituberculous agents after operation and followed up regulary out patient department.We report the cases of two patients with tuberculosis involving thyroid with reviews of literature.

A Case of Addison's Disease due to Tuberculosis.: Ji Young Kim, Ho Choon Jeon, Kyeong Young Kim, Sung Eun Cha, Hyung Seok Choi, In Sohn, Ka Hee Yi; J Korean Endocr Soc. 1994;10(3):306-310. Published online November 6, 2019

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Abstract PDF: We reported a case of Addison's disease due to tuberculosis, which was pathologically confirmed by fine-needle aspiration biopsy. In a 39-year-old man with fatigue, weakness, and generalized cutaneous pigmentation, the diagnosis of Addison's disease was made by the finding of elevated plasma ACTH level and subnormal response to rapid ACTH test. Computed tomographic scan revealed bilateral adrenal mass with heterogenous uptake and peripheral rim enhancement, and calcification. Ultrasoundguided fine-deedle aspiration biopsy of the left adrenal mass disclosed granulomatous inflammation with caseation necrosis. The patient also had active tuberculosis in the right inguinal lymph node.

A Case of True Precocious Puberty Associated with Pituitary Microadenoma Treated with LHRH Agonist.: Ho Jung Kim, In Soon Kim, You Hern Ahn, Mok Hyun Kim, Jea Ung Lee, Jin Ho Kim, Ik Soo Park, Ho Joo Yoon, Choon Suhk Kee, Sung Soo Park, Jung Hee Lee; J Korean Endocr Soc. 1994;9(3):239-243. Published online November 6, 2019

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Abstract PDF: Although tubercrlosis is one of the recognized causes of adrenal insufficiency, little is known about adrenal function in patients with active pulmonary tuberculosis. Patients with active pulmonary tuberculosis are at risk from sudden and unexpected death which can occur during the first few weeks of treatment. There are many reports that patients who received rifampicin as a part of their treatment appeared to show impairment in adrenocortical function when compared to a group who received anti-tuberculosis chemotherapy which did not include rifampicin. Adrenocortical function was studied in 15 patients(7 males, 8 females) with active pulmonary tuberculosis, before and 2-weeks after the anti-tuberculosis chemotherapy including rifampicin. At 08: 00 hour a base-line sample of venous blood was taken. One hour after the administration of 0.25mg of Synacthen, a further blood specimen was taken. The base-line and 1-hour specimens were analysed for plasma cortisol and electrolytes.All were initially found to have a normal cortisol response to rapid ACTH stimulation test. Following a 2-week course of anti-tuberculosis chemotherapy including rifampicin there was 1 case(6.6%) of a suboptimal response.Rifampicin, a powerful anti-tuberculosis drug, is a known inducer of the hepatic microsomal enzyme system and has been shown to cause an enhanced clearance of endogenous cortisol. Findings reported in this paper suggest that the adrenocortical function is compromised in some case(6.6%) of tuberculosis patients. It will therefore be necessary to undertake detailed investigations on the effect of treatment with daily and fully intermittent regimens containing rifampicin on the function of this endocrine gland.

A Case of Hypercalcemia Associated with Hepatic Tuberculosis.: So Young Park, Eun Seok Kang, So Hun Kim, Mi Young Do, Kyu Yeon Hur, Bong Soo Cha, Sung Kil Lim, Hyun Chul Lee, Sang Hoon Ahn, Young Myoung Moon, Young Nyun Park; J Korean Endocr Soc. 2004;19(1):64-68. Published online February 1, 2004

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Abstract PDF: In this report, a 70-year-old female patient was detected with laboratory findings of hypercalcemia. The most common causes of hypercalcemia are primary hyperparathyroidism and malignant disease. Her laboratory tests did not show any evidence for neither primary hyperparathyroidism nor malignant diseases. Thus, granulomatous disease was suspected as the cause of the hypercalcemia. Liver MRI (magnetic resonance image) was performed on the subject, which suggested the presence of hepatic tuberculosis and sarcoidosis. Because the chest x-ray did not show a definite tuberculous lesion, we performed a laparoscopic liver biopsy for a final diagnosis. Findings from the biopsy specimen showed typical tuberculosis. After treatment with tuberculosis medication, hypercalcemia of the subject was resolved. Hypercalcemia is a well recognized as a possible complication of active pulmonary tuberculosis. But one should consider hepatic tuberculosis without pulmonary tuberculosis as a cause of hypercalcemia.

A Case with Thyroid Tuberculosis Diagnosed by Non-operative Method.: Dong Hun Lee, Hee Sun Chung, Hyoung Suk Lee, Mee Jung Kim, Jung Eun Kim, Yoon Sok Chung, Kwan Woo Lee, Hyeon Man Kim; J Korean Endocr Soc. 2002;17(4):572-575. Published online August 1, 2002

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Abstract PDF: Tuberculosis of the thyroid gland is extremely rare, with a few surgically removed cases having been reported. The differential diagnosis, from malignancies and other non tuberculous granulomatous lesions, is impossible clinical grounds. We experienced a case of tuberculosis of the thyroid gland with palpable thyroid nodules, in a 23 year-old female patient. She was clinical and biochemically euthyroid. US and CT scans demonstrated a low density mass in the left low lobe of the thyroid gland. An FNAB showed caseous necrosis, and AFB stains demonstrated tuberculosis bacilli. We report a case of tuberculosis of the thyroid gland, diagnosed by a non-operative method.

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.

A Case of Secondary Amyloid Goiter with Hypothyroidism.: Cheul Kag Park, Yeun Cheul Yang, Cheul Hee Lee, Jae Rak Jeong, Do Ha Kim, Jae Hee Suh, Jae Hoo Park, Young II Kim; J Korean Endocr Soc. 1999;14(4):752-756. Published online January 1, 2001

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Abstract PDF: Amyloidosis results from the deposition of insoluble, fibrous amyloid proteins, nearly always in the extracellular spaces of organs and tissues. There are several varieties of amyloidosis, each of which is identified by the immunochemical nature of amyloid protein fibrils. Amyloid goiter is a very rare clinical entity and can be confused with a neoplasm. We have experienced a case of amyloid goiter with hypothyroidism secondary to tuberculosis. A 20 years old women with 5 months history of pulmonary tuberculosis was admitted with complaints of diarrhea, abdominal pain, weight loss at one year ago. She had a non-tender, diffuse and firm goiter. Also she had normal thyroid function at the first admission but was found to be hypothyroid at the second admission, 10 months later. Histologic examination revealed amyloid deposition in thyroid gland, stomach, colon and rectum.

A Case of Polygrandular Automune type II syndrome associated empty sella.: Jin Soo Kim, Mi Duk Lee, Hong Seung Kim, Choon Hee Chung; J Korean Endocr Soc. 1998;13(2):295-300. Published online January 1, 2001

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Abstract PDF: The polyglandular autoimmune(PGA) syndrome designate as the dysfimction of endocrine and nonendocrine systems involving two or more organs on the basis of an autoimmune mechanism. There are 3 types of PGA syndrome and their etiology or pathogenesis is still not complete by understood. Type I PGA is present in the patients who have at least two of the triad of Addison's disease, hypopacathyroidism, and chronic mucocutaneous candidiasis. Type II PGA is present in the those who have Addisons disease with autoimmune thyroid disease and/or insulin dependent diabetes mellitus, but who do not have hypoparathyroidism or candidiasis. Type III PGA is present in the one who have autoimmune thyroid disease, without Addisons disease, but with another autoimmune disease report a case of autoimmune polyglandular syndrome type II in a seventy-three years old female patient who had primary adrenal insufficiency, primary hypothyroidism, and empty sella, pulmonary tuberculosis.

A Case of Addison's Disease: Partial Recovery of Adrenocortical Function Following Antituberculous Medication.: Kang Seo Park, Jong Il Jun, Kyung Keun Cho, Mi Sook Kim, Jin Man Huh, Man Soon Baek, Moon Jun Na; J Korean Endocr Soc. 1997;12(4):642-646. Published online January 1, 2001

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Abstract PDF: Addisons disease is relatively rare than secondary adrenal insufficiency and result from progressive adrenocortical destruction. The common causes are idiopathic autoimmune atrophy and tuberculosis of adrenal glands. It is generally regarded as incurable in the sense that substitution therapy is required for the rest of the patients life. We report a case of tuberculous primary adrenal insufficiency which was confirmed by biopsy. This case was treated with antituberculous medication and showen to have improved adrenocortical function after six months.

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