Juvenile hyperthyroidism: an experience.

OBJECTIVE: To analyze the clinical profile of juvenile hyperthyroidism at presentation, their treatment outcome; predictors of remission and relapse. METHODS: Retrospective analysis of medical records of 56 patients with juvenile hyperthyroidism seen over a period of 16 years. A cohort of 38 females and 18 males with mean (+/-SD) age of 14.9 +/- 3.4 years (range 3 to 18 years) was analyzed. RESULTS: Majority of patients was in the age group of 12-16 years. Common symptoms observed at presentation were weight loss (82.1%), excessive sweating (78.6%), heat intolerance (76.8%), increased appetite (73.2%) and diarrhea in 48.2%. In addition, accelerated linear growth was observed in 7.1% of patients. Goiter was present in 98.2% of children; 94.5% of which was diffuse and 4.8% was multinodular. The mean ((+/-SD) T3 was 4.8 +/- 3.4 ng/mL (N, 0.6-1.6), T4 was 218 +/- 98 ng/mL (N, 60-155) and TSH was 0.44 +/- 0.36 (N, 0.5-5.5 microIU/mL). TMA positivity seen in 36.9% of patients. All patients were treated with carbimazole; subsequently 4 patients required thyroidectomy and one required radioactive iodine ablation. Mean (+/-SD) duration of follow-up in our patients was 4.9 +/- 3 years, ranging between 1.6 to 16 years and mean (+/-SD) duration of treatment was 34.4 +/- 22.6 months (range 12 to 120 months). Mean (+/-SD) duration to achieve euthyroidism was 5.2 +/- 4.7 months, ranging between 1-33 months. On intention to treat analysis, remission with carbimazole was achieved in 47.6%, remaining patients failed to achieve remission with drug treatment. CONCLUSION: Graves disease is the commonest cause of juvenile hyperthyroidism. Carbimazole is safe, effective, cheap, and easily available form of therapy. It is occasionally associated with serious side effects but requires prolonged follow up.

Use of Iodine containing salt and preparations

It is necessary to use the iodine containing salt and preparation for disease prevention and control. However, we should not forget or consider the adverse effects of iodine containing salt and preparation in case of overdose. It should know the adverse effects of iodine containing salt and preparation and implement correctly the physician's indication to limit and control these adverse effects

rapeutic efficiency of iodine 131 in thyroid adenoma-About 59 cases

Our study dealt with 81 patients treated by iodine 131 for autonomous goiter. We have followed 59 patients during a year approximately.The global therapeutic efficiency is of 73% and the risk of hypothyroidism is very weak. The administration of a high activity [> 15mCi] of iodine allows go get a faster recovery, a better therapeutic efficiency and permits to reduce the number of cures [therefore, to reduce the irradiation of the disease], nevertheless, the risk of hypothyroidism is very slight. The advantages of metabolic rediotherapy [low cost, facility of administration, efficiency] make it preferable to surgery, above all with patients that are more than 40 years old, for whom the radiation risk is practically of no account [hereditary diseases, cancer]

Mise au point: protocole de surveillance isotopique des cancers differencies du corps thyroide au service des isotopes au CHUIbn Sina

Each patient presenting a differenciaded Carcinoma must have an iodine 131 test for reference 25 day after the surgical operation. Patients having high risk of local-re ional recurrence and/or metastasis require special attention subjects whose cancer has been discorvered after the age of 45 independently of its histological form. subjects presenting follicular cancere especially a moderatly-differentiated form, at any age For these patients, a semi-annual isotopic check-up must be imposed for minimum 5 years, but only 2 years, for patients presenting pure of mixed papillary cancers discovered before 45 years. The check-up includes a delicat clinic contrrol radiologic examination [and control of the TSH] Which is accompaned with a total scaning, 2 or 3 days after an oral drink of 2 or 3 mCi [74-101 MBq] of iodine 131. The patient must have stopped therapy 30 days before the isotopic check-up. I If this general check-up shows any active metastasis, a therapeutic decision is taken and consists of a new carcionologic dose of iodine 131 This treatment is always followed by a post therapeutic scanning 5 days later and then another new general check-up 3 or 5 months later in order to assess the efficiency of the treatment. The clinical and radiologic check-up must be semi-annual during all the life of the patient, in case of any doubt, the balance sheet must be stopped and the patient who accused an iodine desaturation is submitted for a total scanning

Medición de la respuesta inmune anti-insulina en diabéticos mediante un ensayo radioinmunométrico normalizado / Measurement of insulin antibodies immune response from diabetic patients by a solid-phase radiocompetition assay

Se presenta un método simple y reproducible de radiocompetición en fase sólida para detectar anticuerpos anti-insulina en el suero de pacientes bajo terapia insulínica. El método utiliza un trazador de mono I-insulina purificada por electroforesis en gel de poliacrilamida. Este trazador tiene como característica una notable estabilidad que permite su uso por lapsos prolongados. El control de la constancia en la masa de trazador inmunorreactivo empleado en cada ensayo, evita la principal fuente de variación interensayo. Estas características del método permiten asegurar la comparación de los valores obtenidos en estudios longitudinales, en los cuales las determinaciones de anticuerpos se realizan en diferentes ensayos. Las propiedades mencionadas y la utilidad práctica del método se corroboraron determinando los anticuerpos específicos en el suero de 54 pacientes diabéticos tratados con distintos preparados farmacéuticos de insulina bovina y porcina