ABSTRACT
Objective:To explore the predictive value of serum thyroglobulin autoantibody (TgAb) for recurrence / metastasisin of thyroglobulin (TG)-negative and TgAb-positive patients with differentiated thyroid carcinoma(DTC) after thyroid ablation.Methods:The clinical data of 57 patients with DTC,undergoing complete resection of thyroid tissue,TG negative and TgAb positive,who were reviewed in Liaocheng People's Hospital during April 2013 to April 2015,were selected and divided into recurrence/metastasis group (n=20) and no recurrence/metastasis group (n=37).The TG and TgAb levels in the two groups were detected and compared by the electrochemical luminescence method,the sensitivity,specificity,positive predictive value and negative predictive value of TgAb in the diagnosis of DTC recurrence / metastasis were analyzed;the independent risk factors of DTC recurrence / metastasis were analyzed by Logistic regression.Results:The TgAb levels(72～3850 IU/mL) in the recurrence/metastasis group was higher than that(18～3638 IU/mL) in the no recurrence/metastasis group,the difference was statistically significant (P＜0.05).The sensitivity,specificity,positive predictive value,negative preictive value of TgAb in the diagnosis of recurrence/metastasis of DTC were 85.71％,83.33％,75.00％,90.91％,respectively.Logistic Regression analysis showed that the 100≤ TgAb ＜204 IU/mL,204≤ TgAb≤ 1000IU/mL,and ＞ 1000IU/rnL levels of TgAb were the independent risk factors of rucurrence/metastasis ofDTC (OR=1.267,2.853,6.791,P＜0.05).Conclusion:TgAb can be used as evaluation of an important index of the recurrence/metastasis of patients with DTC when serum thyroglobulin (TG) was negative and TgAb was positive after thyroid ablation.The higher the TgAb levels,the more probability of the recurrence/metastasis.
ABSTRACT
Six cases of Paget′s disease of bone, including 5 males and 1 female, aged (57. 7 ±11. 8) years old, were recruited. Mean duration of disease was (7. 5±6. 5) years. Clinical manifestations were bone pain and bone deformity. The lesions mainly reside in the pelvis and femur. X-ray film showed typical lesion of Paget′s disease of bone, such as impaired bone trabecular structure with coarseness and disorder, cortical thickening, medullary cavity narrowing and skeletal deformation. Bone scan revealed abnormal radionuclide concentration in the involved bone. Serum alkaline phosphatase ( ALP) in 6 patients was increased ( median 235 U/ L). 5 patients received zoledronic acid sodium intravenous infusion therapy. Bone pain was relieved obviously in 5 patients after treatment for 2-3 months. Physical activity was greatly improved, and serum ALP levels significantly decreased.
ABSTRACT
A 47-year-old Chinese man with hypophosphatemic osteomalacia suffered from bone pain, difficulty in walking and pseudo-fractures. Biochemical examination showed a lowered serum phosphorus level and an elevated alkaline phosphatase level. The X-ray examination showed pseudo-fractures of multiple ribs, low bone density, biconcave deformities of the lumbar vertebrae, and pseudo-fracture of the right superior ramus of the pubis. A diagnosis of hypophosphatemic osteomalacia was made. The case was treated with oral neutral phosphate solution, calcitriol and Caltrate D. After treatment for two years, biochemical indicators were improved, and pseudo-fractures healed. Clinically, hypophosphatemic osteomalacia is often overlooked or misdiagnosed. In addition, the duration and dosage of these drugs should be appropriate, in order to avoid tertiary hyperparathyroidism or poor response to treatment.
ABSTRACT
The data of 6 patients with tertiary hyperparathyroidism were retrospectively analyzed.The first symptom in 3 patients was bone ache,1 with lower extremity weakness,1 with swelling of lower limbs,and 1 with increase serum alkaline phosphatase.5 patients had past history of renal failure,1 case suffered from severe intestinal malabsorption,and 4 of them had renal transplantation.X-ray showed subperiosteal bone resorption,bone demineralization,or cellulose osteitis.5 subjects presented with osteoporosis,and 1 of them had fractures.Left atrioventricular membrane calcification and gluteal calcification were found in each of 2 cases.4 patients suffered from hypercalcaemia,2 patients with normal serum calcium,4 with hypophosphataemia,and 6 with high levels of PTH.Pathological results showed adenoma in parathyroid gland in 4 patients and enlarged parathyroid glands in 2 patients.Serum calcium and PTH levels returned to normal after operation and calcium supplement.
ABSTRACT
Sixty-four patients with Graves' diseases were divided into methimazole group ( n =30 ) and propylthiouracil group( n =34 ).20 healthy volunteers were used as the control group.The levels of interleukin (IL) -2,IL-6,and TSH receptor antibody (TRAb) were determined by ELISA after serum samples were eollected before treatment and after treatment for 3 and 6 months.The results showed that the general data of two groups were not significantly different before treatment.IL-2 and IL-6 levels at 6 months after treatment were significantly different from the baseline (P＜ 0.05 ),IL-2 being gradually increased while IL-6 decreased with time.The level of IL-6 in methimazole group was lower than that in propylthiouracil group after treatment for 6 months ( P＜ 0.05 ).There was no significant difference in TRAb levels between two groups before treatment while differences became significant at 3 and 6 months of treatment ( all P＜ 0.01 ),being gradually decreased with time. IL-2/IL-6 ratio became significantly greater at 3 and 6 months of treatment compared with that before treatment in the same treatment group( P＜0.05 ) and the ratio in methimazole group was higher than that in propylthiouracil group by 6 months of treatment ( P＜0.05 ).IL-6level was positively correlated with FT3 and FT4 levels,and IL-2 level was negatively correlated with FT3,FT4,and TRAb levels in GD patients before treatment.The correlations of IL-2 and IL-6 with FT3 and FT4 disappeared by 3 and 6 months of treatment.IL-2 and IL-6 levels were related with TRAb level before and after treatment in methimazole group. These results suggest that the immunosuppressive effect of methimazole is more evident than that of propylthiouracil in patients with Graves' disease.