Subject(s)
Jejunal Neoplasms , Leiomyosarcoma , Leukemia, Promyelocytic, Acute , Neoplasms, Second Primary , Humans , Male , Middle AgedABSTRACT
We report a case of 26-year-old woman with Graves' disease and idiopathic hypoparathyroidism diagnosed at 11 years of age, who subsequently developed insulin-dependent diabetes mellitus (IDDM) at 17 years of age. Treatment with antithyroid agents had failed to control her Graves' disease and her IDDM was unmanageable despite insulin therapy. Surgical intervention was carried out, resulting in an improvement of both her hyperthyroidism and IDDM. This case is the first report of polyglandular autoimmune (PGA) syndrome, presenting the association of IDDM, Graves' disease and idiopathic hypoparathyroidism.
Subject(s)
Diabetes Mellitus, Type 1/complications , Graves Disease/complications , Hypoparathyroidism/complications , Adult , Diabetes Mellitus, Type 1/surgery , Diabetes Mellitus, Type 1/therapy , Diabetic Ketoacidosis/therapy , Female , Glycosuria/metabolism , Graves Disease/drug therapy , Graves Disease/surgery , Humans , Hypoparathyroidism/surgery , Hypoparathyroidism/therapy , Insulin/therapeutic use , Propylthiouracil/therapeutic use , Thyroid Hormones/bloodABSTRACT
A 61-year-old man was admitted to our hospital because of fever and general malaise. We diagnosed his condition as cytomegalovirus (CMV) mononucleosis by hematological testing. His platelet count was decreased in spite of collection with several anticoagulants at room temperature (20 degrees C); no decrease was observed at 37 degrees C. Mixed cryoglobulinemia, monoclonal IgM and polyclonal IgG, which acted as anti-platelet antibodies in cold condition, were found in the patient's serum. With the resolution of CMV infection, the cryoglobulins disappeared and the platelet count returned to normal without platelet agglutination. This is the first report of transient pseudothrombocytopenia in CMV mononucleosis with mixed cryoglobulinemia.
Subject(s)
Antigens, Human Platelet/immunology , Autoantibodies/immunology , Cryoglobulinemia/microbiology , Cryoglobulins/immunology , Cytomegalovirus Infections/blood , Thrombocytopenia/etiology , Autoantibodies/blood , Cryoglobulinemia/complications , Cytomegalovirus Infections/complications , Cytomegalovirus Infections/immunology , Humans , Immunoglobulin G/immunology , Immunoglobulin M/immunology , Male , Middle Aged , Platelet Aggregation , Thrombocytopenia/immunologyABSTRACT
Leukocyte elastase (LE) plays a role in the development of shock. Therefore, we examined the effects of urinastatin, a protease inhibitor, on LE in 7 patients with sepsis. LE levels before the administration of urinastatin were high in all patients, especially those in shock. Administration of urinastatin markedly decreased LE levels, with the decrease being more remarkable in patients showing high LE levels before treatment. These results suggest that urinastatin not only reduces LE levels but also suppresses factors that are involved in the development of septic shock.
