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1.
Yeungnam University Journal of Medicine ; : 125-129, 2016.
Artigo em Coreano | WPRIM | ID: wpr-90944

RESUMO

Stress induced cardiomyopathy (SC) is characterized by transient left ventricular (LV) dysfunction in the absence of coronary artery disease. We report on a patient with panhypopituitarism who developed SC resulting from withdrawal of hormonal replacement therapy (HRT). A 52-year-old male visited our hospital for progressively worsening dyspnea. The patient had discontinued HRT 7 days ago, which had been administered for 18 months after transsphenoidal adenomectomy for pituitary macroadenoma. Initial electrocardiogram showed marked sinus bradycardia. Transthoracic echocardiography showed apical ballooning with an LV ejection fraction of 25%. No significant obstructive lesions were observed on coronary angiography. With a clinical diagnosis of SC associated with panhypopituitarism, HRT was restarted, including glucocorticoid and thyroxine, along with standard heart failure management. His LV function had normalized at 2-month follow-up. He remains asymptomatic and administration of beta-blocker and angiotensin converting enzyme inhibitor were discontinued He currently only requires HRT.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Bradicardia , Cardiomiopatias , Angiografia Coronária , Doença da Artéria Coronariana , Diagnóstico , Dispneia , Ecocardiografia , Eletrocardiografia , Seguimentos , Insuficiência Cardíaca , Terapia de Reposição Hormonal , Hipopituitarismo , Peptidil Dipeptidase A , Cardiomiopatia de Takotsubo , Tiroxina
2.
Korean Journal of Pancreas and Biliary Tract ; : 42-45, 2015.
Artigo em Coreano | WPRIM | ID: wpr-209578

RESUMO

Rarely, surgical clips can migrate into the biliary tract after laparoscopic cholecystectomy and work as a nidus for biliary stone formation. We report a case of the development of a common bile duct (CBD) stone induced by surgical clip in a 57-year-old man who underwent laparoscopic cholecystectomy 10 years ago. On computed tomography, a CBD stone with a metallic material was found, and endoscopic retrograde cholangiopancreatography (ERCP) revealed a CBD stone including a metallic clip. The stone was removed completely by ERCP, and the surgical clip was found along with the stone.


Assuntos
Humanos , Pessoa de Meia-Idade , Sistema Biliar , Colangiopancreatografia Retrógrada Endoscópica , Colecistectomia , Colecistectomia Laparoscópica , Ducto Colédoco , Cálculos Biliares , Instrumentos Cirúrgicos
3.
Keimyung Medical Journal ; : 176-182, 2015.
Artigo em Coreano | WPRIM | ID: wpr-12455

RESUMO

Agranulocytosis is a rare but the most serious life-threatening complication of antithyroid drug therapy. Most cases of agranulocytosis occur within the first 3 months of antithyroid drug therapy, but some cases happen several years after starting treatment. However, there is a paucity of data on the delayed onset of agranulocytosis. We report a case of methimazole-induced agranulocytosis with suppurative pharyngotonsillitis occurring during the long-term treatment. A 48-year-old woman with Graves' disease visited our hospital with sore throat and high fever (39.2degrees C). She had continuously been treated with methimazole for the preceding 7 years-15 to 40 mg daily from Jul 2007 until Apr 2014 and 50 mg daily from May 2014 until September 2014. A month ago, the dose of methimazole had been reduced to 10 mg daily due to transient neutropenia. Her initial blood tests showed an absolute neutrophil count of 40/microL. Moreover, physical examination showed right neck enlargement. We stopped methimazole, and she was empirically treated with broad-spectrum antibiotics and granulocyte colony stimulating factor. Neck CT scan detected enlarged right tonsils and lymph node. Cervical lymph node biopsy only showed acute and chronic inflammation. About 3 weeks after she recovered, 10 mCi of radioiodine ablation therapy was performed. This case suggests that the sign of agranulocytosis should be carefully monitored in patients with Graves' disease, throughout the course of treatment with methimazole, even under the long-term therapy.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Agranulocitose , Antibacterianos , Biópsia , Fatores Estimuladores de Colônias , Tratamento Farmacológico , Febre , Granulócitos , Doença de Graves , Testes Hematológicos , Inflamação , Linfonodos , Metimazol , Pescoço , Neutropenia , Neutrófilos , Tonsila Palatina , Faringite , Exame Físico , Tomografia Computadorizada por Raios X
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