Fibrosis quística, bocio e hipertiroidismo / Cystic fibrosis, goiter and hyperthyroidism

El aumento de tamaño de la glándula tiroidea por depósito de material amiloide, conocido como bocio amiloide, es una rara entidad clínica. En la mayoría de los casos publicados, los pacientes presentan una función tiroidea normal; menos frecuente es la presencia de hipofunción tiroidea, y aún más infrecuente la asociación con hiperfunción tiroidea. Comunicamos un caso de bocio amiloide e hipertiroidismo primario, secundario a amiloidosis sistémica, en un paciente con fibrosis quística, sin síntomas compresivos y clínica de hiperfunción tiroidea. A continuación, realizamos una breve revisión de este proceso y su tratamiento (AU)

Thyroid gland enlargement due to amyloid infiltration, known as amyloid goitre, is a rare clinic entity. In most reported cases, patients' thyroid function is normal; less frequent is the presentation with thyroid hypofunction, and exceedingly rare is its association with thyroid hyperfunction. We hereby report a case of amyloid goitre and primary hyperthyroidism, due to systemic amyloidosis, in a patient with cystic fibrosis, without compressive symptoms. Then, we provide a brief review of this entity and its therapeutic management (AU)

Acute pancreatitis, hepatic cholestasis, and erythema nodosum induced by carbimazole treatment for Graves' disease.

A 33-year old female was diagnosed as Graves' disease and started on carbimazole. One month later when she was already euthyroid only on carbimazole therapy, she developed acute pancreatitis associated with mild cholestatic hepatitis and erythema nodosum. Carbimazole therapy was interrupted, pancreatic and liver function gradually improved and became normalized two weeks later. Other potential etiological causes of acute pancreatitis, hepatitis and erythema nodosum were excluded. Rechallenge with a single dose of carbimazole led to a new episode of acute pancreatitis and cholestatic hepatitis one day later. The appearance of different hypersensitivity reactions including pancreatitis, hepatitis and erythema nodosum, together with the observation that the interval between drug intake and onset of symptoms became shorter with repeated exposure to carbimazole, point to an immune-mediated mechanism. Carbimazole has to be added to the list of drugs capable of inducing acute pancreatitis, and should be emphasized the need to discontinue this medication as soon as there is evidence of pancreatic dysfunction.