Therapeutic effects of lithium carbonate combined with 131I on incipient Graves disease accompanied by leukopenia / 中华核医学与分子影像杂志

Objective To compare therapeutic effects of lithium carbonate administration (LCA) given in 2 methods and combined with 131I treatment in patients with incipient Graves disease (IGD) accompanied by leukopenia.Methods From January 2014 to January 2016,192 IGD patients with leukopenia were enrolled in this retrospective study,including 49 males,143 females (average age:(39.65 ± 12.18) years).All patients did not receive antithyroid drugs (ATD) therapy and were divided into 3 groups by random number table method:group A(131I treatment plus LCA given at the same time for 2 weeks;n=65),group B (LCA given at a week before and after 131I treatment;n=67),control group (only treated with 131I;n=60).Cure rate (3 and 6 months after treatment),WBC (2 weeks,1,3 and 6 months after treatment) and adverse reaction rate (ADR;within 2 weeks after treatment) of 3 groups were analyzed before and after treatment.One-way analysis of variance,the least significant difference t test,x2 test were used.Results Compared with control group,group A and group B showed higher cure rates (3 months after treatment:87.7％ (57/ 65),88.1％(59/67),70.0％(42/60);6 months:89.2％(58/65),89.6％(60/67),71.7％(43/60);x2 values:9.05,9.58,both P＜0.05),higher increasing rates of WBC (3 months after treatment:(38.9± 5.1)％,(39.8±6.3)％,(20.2±3.3)％;F=19.87,t values:12.15,11.56,all P＜0.01),lower ADR (3.1％(2/65),14.9％ (10/67),30.0％(18/60);x2=17.19,P＜0.05).The ADR of group A was lower than that of group B (x2=4.26,P＜0.05).Conclusion For IGD patients with leukopenia and normal kidney function,the treatment of LCA combined with 131I at the same time for 2 weeks is safe and effective,and patients have less ADR.

Change of serum 25-(OH)D3 levels in patients with different subtypes of autoimmune thyroid diseases / 中国综合临床

Objective To investigate the relationship between serum 25-(OH) D3 and autoimmune thyroid diseases (AITD).Methods Serum levels of 25-(OH) D3, thyroid antibodies (thyroid stimulating hormone receptor antibody (TRAb), TGAb (thyroid globulin antibody), thyroid peroxidase antibody (TPOAb) and thyroid function of 32 cases patients with Graves' diseases (GD), 17 cases patients without remission of GD,10 cases patients with remission of GD,35 cases patients with Hashimoto's thyroiditis (HT),and 58 cases healthy subjects were measured,and the relationships between serum 25-(OH) D3 and the above clinical index were analyzed.Results The serum level of 25-(OH) D3 in patients with GD or HT were obviously lower than that in healthy subjects((50.75±17.60) μg/L, (36.40±21.65) μg/L, (43.05±19.53) μg/L,P＜0.05).No significant difference of the serum level of 25-(OH) D3 was found between patients refractory of GD and those with GD in remission((32.43±17.50) μg/L, (31.88±14.48) μg/L,P=0.866).However,compared with the normal control group,both diseased groups showed significantly decrease (P＜0.05).No correlation was found between serum 25-(OH) D3 and TRAb, FT3, Fr4 as well as TSH in GD group.No correlation was found between serum 25-(OH) D3 and TGAb, TPOAb (P＞ 0.05).Conclusion Serum vitamin D levels are decreased in patients with AITD, which has been speculated as a potential therapeutic method for AITD, though further investigations are needed to establish the precise role of 25-(OH) D3 in AITD.

Análise morfométrica da fenda palpebral de pacientes com retração palpebral na fase aguda da orbitopatia distireoidiana submetidos à injeção palpebral de toxina botulínica tipo A / Morphometric analysis of eyelid fissure in patients with eyelid retraction in acute stage of dysthyroid orbitopathy after treatment with botulinum toxin type A

OBJETIVO: Apresentar dados morfométricos da fenda palpebral, antes e após a aplicação da toxina botulínica tipo A em pacientes com retração palpebral na fase aguda da orbitopatia distireoidiana. MÉTODOS: Estudo prospectivo com 12 indivíduos submetidos à aplicação de 5 UI/0,1 ml de toxina botulínica tipo A em uma das pálpebras superiores. O seguimento mínimo foi de 6 meses. A avaliação palpebral foi registrada por meio de captação de imagens com uma câmera filmadora de vídeo conectada a um microcomputador. RESULTADOS: As medidas da fenda palpebral vertical, distância da margem palpebral superior reflexo, área total da fenda palpebral e função do músculo levantador da pálpebra superior, apresentaram diminuição após a aplicação da droga. Houve diminuição, nos olhos tratados, da diferença entre a área lateral e a área medial da fenda palpebral. A distância margem palpebral inferior reflexo não mostrou alterações. No olho contralateral, houve aumento das medidas (fenda palpebral vertical, distância margem palpebral superior reflexo, área total da fenda palpebral) até 2 semanas após a aplicação. CONCLUSÕES: Estes resultados mostram uma melhora da retração e do contorno palpebral superior, sem alterar o posicionamento da pálpebra inferior.

PURPOSE: To compare morphometric data of eyelid fissure using computerized image analysis before and after application of botulinum toxin type A in patients with eyelid retraction caused by dysthyroid orbitopathy in acute stage. METHODS: This was a prospective study with 12 individuals that received transcutaneous 5 UI/0.1 ml injection of botulinum toxin in the upper eyelid. They were examined periodically for 6 months. Clinical eyelid examination was performed and re corded using a video camera connected to a microcomputer. RESULTS: Vertical eyelid fissure, upper eyelid margin to reflex distance and the eyelid area showed reduction in the treated eye. A decrease in the levator function of the upper eyelid was observed, and also, a reduction in the difference between the lateral and medial areas. The lower eyelid margin reflex distance did not show any significant differences after the application. Measurements of the contralateral eye increased up to 2 weeks after the application. CONCLUSIONS: These results showed a reduction in eyelid retraction and improving the upper eyelid contour, without changes in the lower eyelid position.

Relationship between serum concentrations of interleukin-6 (IL-6), soluble IL-6 receptor and the activity of Graves′ ophthalmopathy / 中华内分泌代谢杂志

Serum concentrations of interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R) were determined in patients with Graves′ ophthalmopathy (GO), Graves′disease without GO (NGO) and controls. Patients with GO treated by corciosteroids were assessed by the clinical activity score (CAS). The results suggested that serum levels of both IL-6, sIL-6R and CAS could reflect the activity of GO and predict the outcome of corcicosteroid therapy.