A case of long-term hypothyroidism converted to hyperthyroidism secondary to an autoimmune trigger

Primary hypothyroidism is a common endocrine condition that is encountered. Graves disease and Hashimoto抯 thyroiditis are the most common autoimmune conditions in which conversion of hyperthyroidism to hypothyroidism is seen. Chances of conversion of hypothyroidism to hyperthyroidism is extremely rare. This case highlights that there should be a high index of suspicion for a possible conversion of hypothyroidism to hyperthyroidism. The etiology being an autoimmune switch by an external stimulus in genetically susceptible individuals. Hereby, presenting a case of 53-years female, who is a known case of type II diabetes mellitus, chronic kidney disease, nephrotic syndrome diagnosed with minimal change disease who presented with a hormonal profile showing hyperthyroidism. She had a history of hypothyroidism in the past for 12-years and was treated with levothyroxine and was off treatment for the past 2 years. Further evaluation showed presence of primary Sjogren抯 syndrome which has let to this conversion.

An interesting case of dermatomyositis with classical presentation

Dermatomyositis, a connective tissue disorder, is an idiopathic inflammatory myopathy characterised by skin manifestation.The diagnosis of dermatomyositis is based on rashes on the skin, progressive muscle weakness, elevated serum muscle enzymes, abnormal electromyogram, and abnormal findings on muscle biopsy. Hereby presenting this rare case of a 57-year-old female with dermatomyositis with all the typical clinical findings with interstitial lung disease.

Analysis of Clinical Characteristics and Outcome of Pulmonary Thromboembolism in a Tertiary Care Hospital

Introduction: Pulmonary embolism is a potentially lethalcondition that is frequently underdiagnosed. The severityand clinical presentation of PE are variable, hence clinchingthe correct diagnosis is difficult. Prompt diagnosis of PE isessential to reduce morbidity and mortality. Current researchaimed to study the clinical characteristics, risk factors andclinical outcomes of patients diagnosed with pulmonarythromboembolism.Material and Methods: In this retrospective study data werecollected from baseline clinical characteristics, presentingsigns and symptoms, results of echocardiography and imagingstudies, therapeutic modality and in-hospital course.Results: 52 cases of Pulmonary embolism were reportedwith an incidence of 0.33%. Male predominance (58%) wasnoted. Associated comorbid conditions like HT was presentin 24 patients and DM was present in15 patients. The mostcommon symptom at presentation was dyspnea (31 patients).The overall mortality rate was 3.8% (2 patients).Conclusion: The outcome of PE is improving; however, itremains an important risk factor for mortality in hospitalizedpatients.