[Autoimmune thyroid disease. Clinical and biological correlations]

In this article, we analyze the clinical and biological data concerning the autoimmune thyroid diseases in patients recruited in an endocrinology clinic at the university hospital center of Hotel-Dieu de France between March 2005 and November 2005. We studied 121 patients [51 with Basedow disease and 70 with Hashimoto thyroiditis], between 13 and 68 years old, with a BMI of 24.68 kg/m[2] and with a female predominance [105 women]. Symptoms of hyperthyroidism represented the most frequent cause of consultation. The distribution of patients regarding their thyroid disease showed that 42.1% of patients had hyperthyroidism [only one patient had subclinical hyperthyroidism], 21.5% had a subclinical hypothy-roidism, 28.1% had clinical hypothyroidism and 83% had euthyroid goiter. Half of the patients had at least a member of their family whith a thyroid disease. The autoimmune thyroid diseases are strongly associated to other autoimmune diseases and to repetitive spontaneous abortion. Thus, 39% of the married women had had at least one spontaneous abortion and 26.4% of the patients had one or more autoimmune disease associated to their thyroid disease; diabetes mellitus type 1 representing the most frequent one. Concerning the treatment, we remarked a remission of 30 patients [66.7%] with Basedow disease after 18 months of anti-thyroid drug treatment of 45 patients. In Hashimoto thyroiditis, we remarked a frequent evolution of patients with subciinical hypothyroidism to overt hypothyroidism when medical treatment was not initiated

Tumeur surrenalienne de decouverte fortuite: le myelolipome

The wider application of increasingly sensitive ultrasonography and CT scanning has created a new problem for clinical management: the incidental discovery of asymptomatic adrenal lesions. These lesions, also called "incidentalomas" may be due to a large variety of etiologies, and although most of them prove to be benign cortical adenomas, diagnostic confirmation is frequently impossible preoperatively. For this reason, a general approach, based on the relative prevalence of benign and malignant, clinically silent adrenal masses, has been defined. This same approach is usually needed in the case of myelolipoma, a rare form of benign and silent adrenal neoplasms, containing hematopoietic and fatty elements. Actually, computed tomographic aspect of such tumors is very evocative but not pathognomonic, so it doesn't eliminate the possibility of malignant lesions, especially in the presence of heterogeneities. Because of these limitations and awaiting the development of more specific diagnostic procedures, it seems cautious to approach these tumors like incidentalomas in general