Does systemic sclerosis affect thyroid functions? A study upholding association

Objective To study the association of clinical and subclinical thyroid dysfunction in patients of systemic sclerosis and compare with age and sex matched controls without systemic sclerosis

Methods This hospital-based study involved 56 patients of systemic sclerosis and 300 age and sex matched controls without systemic sclerosis. Thyroid function tests, such as thyroid-stimulating hormone [TSH], free tri-iodothyronine [T3], free thyroxine [T4], were advised in all cases, and anti thyroid peroxidase [anti-TPO] antibody, thyroid gland ultrasonography and fine needle aspiration cytology in selected patients only

Results Abnormal thyroid functions were found in 37.5% cases compared to 18.7% in control group, and 26.78% of cases had hypothyroidism compared to 16.7% among the controls. 21.4% patients among cases had subclinical hypothyroidism [SCH] compared to 13.33% among controls

Conclusion Thyroid dysfunctions are common in systemic sclerosis and the same should be evaluated as routine clinical profiling of patients with systemic sclerosis

Generalized morphea and hypothyroidism: case report of a rare association

Morphea is a localized form of scleroderma in which there is predominant skin involvement, with occasional involvement of subjacent muscles and usually spares the internal organs. Thyroid dysfunction has been reported in systemic sclerosis but it has been rarely reported in morphea. There are few case reports of plaque-type morphea associated with autoimmune thyroiditis but generalized morphea with hypothyroidism has been rarely reported. We report a 55-year-old female with generalized morphea involving trunk and proximal limbs who revealed hypothyroidism on laboratory screening. Due to the rarity of this association we were obliged to report the same

First reported case of reactive airway dysfunction syndrome in a laborer due to porcelain tile dust

Reactive airway dysfunction syndrome [RADS] is a type of non-immunologically mediated asthma-like disease. It usually occurs after a massive exposure to an irritating substance in the atmosphere in the form of smoke, fumes, gases, and vapor. Unlike bronchial asthma, there is no latency to the symptoms seen in RADS. A number of agents are known to cause RADS, but tile dust, as an etiological agent, has not been previously reported. We report a 45-year-old male laborer, who presented with an acute onset of cough, chest tightness, breathlessness, and audible wheeze after his first time exposure to porcelain tile dust within 5 hours of exposure. Lab tests, including, chest X-ray, electrocardiogram, air blood gas analysis, and serum IgE, were unremarkable. Spirometry showed a mild obstruction [forced expiratory volume in 1 second [FEV1]=72% of predicted], while the bronchodilator reversibility test was significant[14% increase in FEV1 above the baseline].Bronchial biopsy revealed a chronic inflammatory reaction with lymphocytic and plasma cell infiltration and more importantly a striking absence of eosinophils. To t he best of our knowledge, this is the first reported case of RADS as a result of exposure to tile dust [porcelain ceramics]

Sheehan's syndrome presenting as psychosis: a rare clinical presentation

Sheehan's syndrome [SS] refers to the occurrence of varying degree of hypopituitarism after parturition [1]. It is a rare cause of hypopituitarism in developed countries owing to advances in obstetric care and its frequency is decreasing worldwide. However, it is still frequent in underdeveloped and developing countries. Sheehan's syndrome is often diagnosed late as it evolves slowly [2, 3]. Reports of psychoses in patients with Sheehan's syndrome are rare. Herein, a case report of psychosis in a 31 year old woman who developed Sheehan's syndrome preceded by postpartum haemorrhage is presented. Treatment with thyroxine and glucocorticoids resulted in complete remission after attaining euthyroid and eucortisolemic state

case report on bronchoalveolar carcinoma presenting as non-resolving consolidation

Bronchoalveolar carcinoma presenting as non-resolving consolidation is an uncommon presentation. The typical presentation of bronchoalveolar carcinoma is asymptomatic [solitary nodule] and remains without symptoms even as disease disseminates. We report a case of bronchoalveolar carcinoma presenting as non-resolving consolidation in a young male with productive cough, exertional breathlessness and physical examination revealing the features of right lower consolidation on x-ray chest, with subsequent CT of the chest and bronchoscopic examination revealed bronchoalveolar carcinoma. Patient had good score and was managed conservatively