Peak expiratory flow [PEF] and serum levels of cortisol as well as IgE in bronchial asthma

Patients with cryptogenic asthma treated for long periods with corticosteroids had low plasma cortisol levels during the attack and during the remission. Such a low cortisol level indicates a state of adrenal insufficiency which could result from long term and irregular therapy with corticosteroids. These patients are usually in continuous need for corticosteroid therapy. Low doses and alternate day steroid administration are the most desirable modalities of therapy long as there are no contraindications to its administration. Cases of extrinsic asthma on corticosteroid therapy did not show better improvement than those on bronchodilators alone. On the other hand, those on bronchodilators had the benefit that their serum cortisol level was steady during the attack and during the remission and within normal levels. Concerning IgE and PEF [Peak Expiratory Flow] the improvement was nearly the same in both groups [cryptogenic and extrinsic], whether on corticosteroids or on bronchodilators

Thyroid hormonal profile and a new strategy for thyroid function testing in bilharzial patients

The aim of this work is to study the thyroid hormonal profile in early and advanced bilharziasis whether pure or combined with other chronic liver diseases and to evaluate the thyroid function tests in bilharzial patients. Seventy-six human subjects [56 males and 20 females] were the subject of this study. The subjects were classified into the following groups: Group 1- Normal control subjects, Group 2- Simple bilharziasis, Group 3- Pure bilharzial hepatosplenomegaly and Group 4- Combined bilharzial hepatosplenomegaly. The following thyroid function tests were performed by radioimmunoassay techniques for both patients and normal controls: Serum total [T4] and free thyroxine [FT4], total [T3] and free tri-iodothyronine [FT3] reverse tri-iodothyronine [rT3], thyroid stimulating hormone [TSH] and thyroxine binding globulin, [TBG]. The results of the present study showed that simple bilharzial infestation without liver involvement had no effect on thyroid hormone secretions, regulation or peripheral tissue metabolism, since no significant change in serum thyroid hormones, TSH or TBG levels was detected in these patients compared to controls Patients with bilharzial hepatosplenomegaly [pure or combined with other chronic liver diseases] show tendency for hypothyroidism, as indicated by low serum levels of FT4, T3 and FT3 the pituitary and hypothalamic responses to the low thyroid hormones levels are normal as indicated