Subject(s)
Carcinoma, Papillary/diagnostic imaging , Neoplasms, Multiple Primary/diagnostic imaging , Parathyroid Neoplasms/diagnostic imaging , Schizophrenia/complications , Thyroid Neoplasms/diagnostic imaging , Aged , Carcinoma, Papillary/complications , Carcinoma, Papillary/pathology , Female , Humans , Neoplasms, Multiple Primary/complications , Neoplasms, Multiple Primary/pathology , Parathyroid Glands/pathology , Parathyroid Neoplasms/complications , Parathyroid Neoplasms/pathology , Thyroid Cancer, Papillary , Thyroid Gland/pathology , Thyroid Neoplasms/complications , Thyroid Neoplasms/pathologyABSTRACT
Few studies have examined the clinical features and long-term outcomes of isolated pituitary hormone deficiencies after traumatic brain injury (TBI). Such deficiencies typically present at time intervals after TBI, especially after mild injuries such as concussions, which makes their diagnosis difficult without careful history taking. It is necessary to improve diagnosis and prevent life threatening or morbid conditions such as those that may occur in deficiencies of adrenocorticotropic hormone (ACTH) or thyroid-stimulating hormone (as known as thyrotropin, TSH), the two most important pituitary hormones in hypopituitarism treatment. Here, we report two cases of isolated ACTH deficiency and one case of isolated TSH deficiency. These patients presented at different time points after concussion and underwent long-term follow-ups.
Subject(s)
Graves Disease/complications , Infarction/etiology , Kidney/blood supply , Thyroid Gland , Thyrotoxicosis/etiology , Anticoagulants/therapeutic use , Antithyroid Agents/therapeutic use , Graves Disease/diagnosis , Graves Disease/drug therapy , Humans , Infarction/diagnosis , Infarction/drug therapy , Kidney/diagnostic imaging , Male , Middle Aged , Radionuclide Imaging , Thyroid Gland/diagnostic imaging , Thyrotoxicosis/diagnosis , Thyrotoxicosis/drug therapy , Tomography, X-Ray Computed , Treatment Outcome , UltrasonographyABSTRACT
The aim is to investigate whether there is a difference in CA 19-9 levels between diabetes and healthy subjects except malignancies and associated factors with CA 19-9 in diabetes. We performed a retrospective analysis in 146 type 2 diabetes and 154 healthy subjects who visited our medical institution from 2005 to 2009. We compared the CA 19-9 in each group, and analyzed clinical and biochemical variables in diabetes. The average value of CA 19-9 in diabetes was higher than that of healthy subjects significantly (14.1 vs 8.1 U/mL, p < 0.01). CA 19-9 had a positive correlation with HbA1c (r = 0.22), fasting plasma glucose (r = 0.24), and C-reactive protein (r = 0.38) in diabetes (p < 0.05). 48 type 2 diabetes who showed decreased CA 19-9 during follow-up of 1.8 ± 1.0 years were also improved in glucose control state. The proportion of insulin use for glucose control was significantly higher in the group of CA 19-9 ≥ 37 U/mL (75.0 %) as compared with the group of CA 19-9 < 37 U/mL (34.0 %). CA 19-9 was significantly higher in the patients with diabetic peripheral neuropathy (DPN) as compared with those without DPN (p = 0.02). However, after excluding the influences from glycemic control state, significant difference was not observed. Our results indicate not only that CA 19-9 is influenced by glycemic control state but also can be elevated irrespective of any malignancy in diabetes. Therefore, CA 19-9 should be interpreted carefully in diabetic patients when CA 19-9 is used as the tool for malignancy screening.
