ABSTRACT
Background: Renal complications in Graves' disease are rare and may be related either to the disease itself or secondary to antithyroid drugs
Aim: We report 6 cases of renal damage in patients with Graves' disease treated with Benzylthiouracil collected over a period of 14 years
Methods: There were 6 women with a mean age of 37.86 +/- 14.25 years. All patients developed renal vasculitis associated with ANCA. The signs were dominated by renal proteinuria and renal failure associated with hematuria in all cases. The lung involvement was the most common extrarenal manifestation occurred in 4 patients [alveolar hemorrhage in 2 cases, lymphocytic alveolitis in 1 case and pleurisy in 1 case]. The benzylthiouracil was discontinued in 3 patients still under treatment. Corticosteroid therapy was used alone or in combination with cyclophosphamide in all cases. Plasmapheresis sessions were made during the alveolar hemorrhage. A complete remission was obtained in one case and incomplete remission in 2 cases. The other 3 patients required chronic hemodialysis. One patient died of sepsis
Conclusion: The possibility of renal impairment in antithyroid drugs treated Graves' disease requires monitoring to detect urinary abnormalities in order to early initiate therapy and improve patient's outcome
ABSTRACT
Evaluate the assay of urinary metanephrines in diagnosis of pheochromocytoma [PH] and determine diagnostic cut-off values.This is a retrospective study about 87 patients suspected of pheochromocytoma,whose of 24-h urinary fractionated metanephrine was measured. These cases were collected from Internal Medecine Departments [A and B] at Charles Nicolle's Hospital. Two groups of patients were studied: a pheochromocytoma group [n=33] with a histologically-proven pheochromocytoma and a control group of 54 patients. Receiver Operating Characteristic [ROC] curves were used to determine the best sensitivities and specificities. The analysis of biological parameters showed that means and standard deviation of urinary fractionated metanephrines in pheochromocytoma group were significantly higher than those of control group. Sensitivity and specificity of urinary normetanephrine test [95% and 98.1% respectively] were higher than those of urinary metanephrine and 3-methoxytyramine. A correlation between urinary normetanephrine and tumor size of pheochromocytoma was found. Urinary fractionated metanephrines is an efficient biochemical test for the diagnosis of pheochromocytoma
ABSTRACT
We report a retrospective study about 18 Cushing's diseases colliged in the department of endocrinology at Charles Nicolle hospital in 24 years. The mean age was 33, 7 years with a male-female ratio of 4/14 Diagnosis was established on adrenocorticotropin hormone analysis and pituitary imaging. Transsphenoidal adenomectomy was related in 8 cases of Cushing's disease, it was sussessful in 5 patients [62.5%]. Bilateral adrenalectomy was performed in three cases