ABSTRACT
Concurrent Graves' disease and primary hyperparathyroidism in the same patient is rare, probably accounts for hypercalcemia in no more than 1 percent of thyrotoxic patients. Hypercalcemia may be noted during the course of hyperthyroidism in as many as 22 percent of cases. The cause of hypercalcemia in a thyrotoxic patient might be due to the activation of osteoclastic bone resorption by the excess thyroid hormone, as the severity of hyperthyroidism correlates positively with osteoclastic activity in trabecular and cortical bone. In 1936, Noble JF et al reported the first case in the world. To our knowledge, only 49 such cases have been described in the literature until the year of 1989. No case has been reported again afterward. The occurrence of hypercalcemia in a patient with hyperthyroidism may present a challenging diagnostic problem. In this communication, we described the first case in mainland of China with hypercalcemia caused by concurrent hyperthyroidism and primary hyperparathyroidism, and the clinical and laboratory characteristics were studied before and after therapy with anti-thyroid medication.
Subject(s)
Female , Humans , Middle Aged , Graves Disease , Pathology , Hyperparathyroidism , PathologyABSTRACT
Objective To investigate the potential association among urinary albumin excretion rate(U_(AER)), 24h ambulatory blood pressure(ABP) and erythrocyte sodium-lithium countertransport(SLC) in non-insulin dependent diabetes mellitus (NIDDM). Methods U_(AER), SLC were determined with radioimmunoassay and modified method of Canessa respectively, and 24h ABP profiles were recorded in 69 NIDDM subjects. Results NIDDM patients with increased U_(AER) had higher prevalence of hypertension and higher prevalence of abnormal circadian rhythm of blood pressure. Blood pressure(BP), particularly nighttime systolic BP was also significantly increased. U_(AER) was positively correlated to mean nighttime BP, mean daytime and 24h systolic BP, while inversely related to day-night dip in systolic BP. However, there was no significant difference in SLC between NIDDM subjects with and without increased U_(AER). Futhermore, neither U_(AER) nor all ABP indices were correlated to SLC. Conclusion Close association exists among diabetic nephropathy and increased BP and abnormal diumal BP rhythm, while either SLC and U_(AER) or SLC and BP is significantly correleted. Increased rate of SLC is not likely a marker for diabetic nephropathy in NIDDM, and it seems not to be involved in the pathogenesis of diabetic hypertension.
ABSTRACT
Twenty-five type II diabetics failed to be controlled by diet therapy alone were treated with glipizide and followed-up for 6 months. The daily dose of glipizide ranged from 5-30 mg. The excellent or good glycemic control occurred in 88% and 72% of the patients respectively. No hypoglycemia and other side effects were observed. The areas of glipizide-glucose mediated insulin secretion did not show significant change before and after glipizide therapy, but the areas of glucose-mediated insulin secretion, the insulin sensitivity, and the glucose disposal constant(KI)were significantly higher after glipizide therapy. Our study indicated that the hypoglycemic effect of glipizide was not only due to improved islet B cell function in insulin secretion, but also due to enhanced insulin-induced glucose utilization and insulin sensitivity.