RESUMO
Objective: To investigate the clinical characteristics of patients with antithyroid drug (ATD)-induced agranulocytosis in the treatment of hyperthyroidism and analyze factors associated with the death rate of patients with fatal outcomes. Methods:Patients diagnosed with ATD-induced agranulocytosis in Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University from January 2000 to December 2018, were included in this study and their medical records were reviewed retrospectively. We compared the clinical characteristics of patients in death group and survival group. Results: We recruited 70 patients with ATD-induced agranulocytosis in the study. Five of them died. All fatal cases were females, aged between 33 to 54 years. Three patients also had hyperthyroidism crisis, and two had hyperthyroid heart disease. Compared with the survival cases of ATD-induced agranulocytosis, patients with fatal agranulocytosis were elderly [47.00±8.12)years vs. (35.58±11.10) years, P=0.028] and had a longer duration of hyperthyroidism [1 800 (315-2 880)d vs. 60(40-120)d, P=0.002]. The interval days between symptoms and the diagnosis of agranulocytosis were significantly longer in patients with fatal cases than the survival ones[5.0(3.5-11.0)d vs. 0(0-2.5) d, P=0.002]. In addition, the proportion of patients with hyperthyroid crisis was greater in the death group (60% vs. 0%, P<0.001). Conclusion: Age, duration of hyperthyroidism, and timely diagnosis of agranulocytosis could affect the mortality of agranulocytosis. Mortality in patients with hyperthyroidism was significantly increased. It is recommended that patients with hyperthyroidism should be reminded to monitor routine blood cells immediately. In the event of agranulocytosis, other methods should be chosen as soon as possible to treat hyperthyroidism and avoid serious outcomes.
RESUMO
<p><b>OBJECTIVE</b>To explore the relationship between metabolic syndrome and chronic kidney disease (CKD) in a rural adult population of Hunan province.</p><p><b>METHODS</b>1953 residents (older than 18 years) from the same village were randomly selected, using a stratified, multistage sampling method. All residents were interviewed and tested for albuminuria with morning spot urine albumin to creatinine ratio (abnormal: >/= 30 mg/g), reduced renal function with estimated glomerular filtration rate by modified MDRD equation [abnormal: < 60 ml/min (1.73 m(2))]. The associations of kidney damage indicators with demographic characteristics (age, gender, smoking status), indicators on health (diabetes, hypertension) and metabolic syndrome traits were examined.</p><p><b>RESULTS</b>Eligible data of 1709 subjects were enrolled in the study. After the adjustment of age, gender and other metabolic syndrome traits, participants with metabolic syndrome had a higher prevalence of CKD (19.3% vs. 13.2%, P < 0.001) than those without the syndrome. As the number of metabolic syndrome traits increased, so did the prevalence of CKD. There seemed to be a strong and independent association between metabolic syndrome and chronic kidney disease. For participants without hypertension and diabetes, metabolic syndrome was also associated with CKD (OR value 1.733, 95%CI: 1.20 - 2.41, P = 0.004).</p><p><b>CONCLUSION</b>In these 1709 adults under this study from a village of southern China, metabolic syndrome seemed to be associated with CKD.</p>