RESUMO
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
RESUMO
Fasting during Ramadan may be a cause of poor glycaemic control in diabetic patients. To assess glucose excursions during Ramadan by using a continuous glucose monitoring system [CGMS]. The interstitial glucose level was recorded over 72 hours during Ramadan and three months later, in five type 2 diabetic patients, aged 56 +/- 5, treated with glimepiride and metformin. During Ramadan, four patients experienced at least one episode of low glucose level [<0.7 g/l] during the monitoring. The frequency of these episodes was 0.6 episode/d with an average duration of 36 mn / d. These episodes occurred in the morning in half of the cases and in the hour before breaking the fast in 37.5% of the cases. Four patients experienced at least one episode of high glucose level [>1.8 g/l], with an average duration of 403 mn /d and with a frequency of two episodes /d. More than half episodes [53] occurred after the breaking of the fast. After Ramadan, CGM records showed at least one episode of low glucose in two patients with an average duration of 58 mn /d and a frequency of 1.3 episodes/d. Three patients experienced at least one episode of high glucose level with an average duration of 525 mn /d and a frequency of 1.46 episodes/day. The blood glucose profile of our patients during Ramadan is characterized by important glycaemic excursions