Clinical And Laboratory Profile Of Patients With Subclinical Hypothyroidism

INTRODUCTION:Subclinical hypothyroidism is a biochemical diagnosis where TSH is elevated with a normal FT4 and normal FT3. It is associated with signs and symptoms of hypothyroidism like fatigue, weight loss, constipation, menstrual irregularity, depression etc. It is also associated with comorbiditieslike DM, HTN.It is also associated with dylipidemia, pregnancy, infertility, etc. AIMS AND OBJECTIVES:1. To study clinical and laboratory profile of patients with subclinical hypothyroidism. 2. To assess the comorbid diseases associated with subclinical hypothyroidism.3. To find the age group andgender in which it is common. 4. To find the comorbidities associated with it. 5. The conditions in which sub clinical hypothyroidism should be treated.Results: In our study, the total population studied was 50 cases of subclinical hypothyroidism. In our study, female population (40 cases) (80%) was dominant than male population (10 cases) (20%).The most common age group affected was 35-56yr –30 (60%) cases, followed by 25-34 yr-16 (32%) cases, and the least affected group was <=24 yr –4 (8%) cases.[1] Tapper et al had evaluated thyroid function in the clinical laboratory which had similar results.Conclusion: Subclinical hypothyroidism (SCH) is a biochemical diagnosis with subtle symptoms, likely to be missed and it can progress to overt hypothyroidism, if not treated in time. It is also associated with conditions like dyslipidemia, pregnancy, infertility, goiter and some symptoms where it should be treated, as treating it will be beneficial.[8] Therefore, subclinical hypothyroidism is an entity which should be looked for carefully and treated as and when needed. However, the above results and interpretations are restricted to the small sample size of 50 patients that were included in this study. These results and interpretation may vary to certain extent when compared to a study which includes a bigger sample size.

Enteropathy associated T cell lymphoma-monomorphic variant, presenting as bilateral ovarian masses.

Enteropathy associated T cell lymphoma (EATL) is a rare type of T-cell lymphoma, often associated with a history of celiac disease. It usually arises in the jejunum, but can involve other gastrointestinal tract sites such as stomach and colon. Monomorphic variant of EATL often occurs without a history of celiac disease, has variable histologic evidence of enteropathy, and is usually CD56+. We report a case of EATL in a 49-year-old female presenting as bilateral ovarian masses. The morphology and immunophenotypic features were compatible with monomorphic variant of EATL.

Evaluating the efficacy of tumor markers CA 19-9 and CEA to predict operability and survival in pancreatic malignancies.

Aim: Using CA 19-9 and CEA (elevated >2times of normal) as predictors in determining operability and survival in pancreatic tumors. Methods: Levels of CA 19-9 and CEA were measured (pre and post operatively) in 49 patients of pancreatic malignancy. CECT was performed for diagnosis and staging. An experienced surgeon determined the operability. The levels of tumor markers were correlated with the operability and the survival based on CECT and intra-operative findings. Results: 16/24 (67%) patients with CA 19-9 levels (<2times) and 19/24 (79%) patients with CEA levels (<2times) were found to be resectable. 22/25 (88%) patients having elevated CA 19-9 levels (p=0.0002-t) and 17/25(70%) patients having elevated CEA levels (p =0.003) were found to be non-resectable. Of the 27 patients, found resectable on CECT, 5 were non-resectable intra-operatively. All of these had elevated levels of CA 19-9 and 4/5 (80%) had elevated levels of CEA. Only 5/21 (23%) non-resectable patients, with elevated levels of CA 19-9 reported at 1 year follow up. None of the non-resectable patients with CA 19-9 levels >1000U/ml reported at 6 month follow-up. None of the resectable patients pre-operatively showed evidence of recurrence. All achieved normal values post surgery. Conclusion: Elevated levels of CA 19-9 and CEA (>2 times) predict increased chances of inoperability and poor survival in pancreatic tumors. Levels >3times had increased risk of inoperability even in patients deemed resectable on CT-Scan. Diagnostic laparoscopy would be beneficial in these patients. Levels of CA 19-9 (>1000U/ml) indicate a dismal survival in non-resectable group of patients.

Primary pulmonary choriocarcinoma--a series of 7 cases.

Primary pulmonary choriocarcinoma is a rare manifestation of extra-genital malignant germ cell tumour. This is a report of seven such cases, seen in autopsy and surgical materials in a span of 20 years. The age range was from 25 to 60 years, affecting six women and one male. These are aggressive tumours requiring prompt therapy. Only one among the seven survived.