RESUMEN
According to recent studies, the immunogenetic factors are thought to be account for a part of the etiopathogenesis of autoimmune thyroid disease. In Korea, there was one report on the relationship between HLA DR5, DR8, B13 and autoimmune thyroid disease. There were also several reports on a familial hereditary transmission of autoimmune thyroid disease in other countries but not in Korea. We describe the occurrence of autoimmune thyroid disease that affected three members of a family through three generations. This is the first report on familial hereditary transmission of autoimmune thyroid disease in Korea. We report on an 80-year-old woman who presented with Hashimoto's thyroiditis, her 53-year-old daughter who had Graves' disease, and her 29-year-old grand-daughter who had Graves' disease. In order to identify the immunogenetic influence in these cases, HLA haplotypes & thyroid autoantibody were studied. HLA DRB3*02 was obseved in each of the patents. HLA DQB1*0301, DR11, DQB1*05031 and DR14 were observed in the two cases. However, HLA B13, DR5 and DR8 were not observed. The patients are currently undergoing follow-up using PTU, methimazole and synthyroid medication.
Asunto(s)
Adulto , Anciano de 80 o más Años , Femenino , Humanos , Persona de Mediana Edad , Composición Familiar , Estudios de Seguimiento , Enfermedad de Graves , Haplotipos , Antígeno HLA-B13 , Inmunogenética , Corea (Geográfico) , Metimazol , Núcleo Familiar , Enfermedades de la Tiroides , Glándula Tiroides , TiroiditisRESUMEN
We report an unusual case of metastatic thyroid papillary carcinoma directly invades the esophagus presenting as an intraluminal polypoid mass which causes hematemesis. The patient had a past medical history of thyroid nodule. Physical examination was unremarkable except the palpable thyroid mass. Esophagoscopy and esophagography revealed an intraluminal polypoid mass to the left of the cervical esophagus. Chest computed tomography showed round, homogenous, well-enhancing mass and calcifying thyroid nodule is found in front of the mass. Thyroid lobectomy and partial esophageal resection was performed. Microscopic finding showed typical features of thyroid papillary carcinoma. Metastatic thyroid papillary carcinoma should be included in the differential diagnosis of an intraluminal polypoid esophageal mass, particularly if the patient has a known thyroid tumor.
Asunto(s)
Humanos , Carcinoma Papilar , Diagnóstico Diferencial , Esofagoscopía , Esófago , Hematemesis , Examen Físico , Tórax , Glándula Tiroides , Nódulo TiroideoRESUMEN
Chemical pneumonitis induced by hydrocarbon ingestion is rare in Korea. Cresol and xylenol, commonly used hydrocarbon disinfectants, can cause chemical burn on skin, gastrointestinal corrosive injury, central nervous system disturbance, and multiorgan failure including acute respiratory failure and chemical pneumonitis following intoxication1, 2, 8). We will report a case of chemical pneumonitis induced by ingestion of a hydrocarbon disinfectant as suicidal attempt.A 39-years-old female was found unconscious after ingestion of 100-200mL of solution containing cresol (5.5 g/100 mL), xylenol (7.5 g/100 mL), and benzene (37.5 g/100 mL).Upon arriving at emergency room the patient was in coma, had undectable blood pressure (0/0) and had no self respiration. Cardiopulmonary resuscitation were given immediately, resulting in reversed her consciousness and elevated blood pressure.The patient had dermal burn on face, erosion of oral and gastric mucosa, impairment of liver function, leukocytosis, metabolic acidosis with hypoxemia, chemical pneumonitis, and spontaneous pneumothorax. The patient survived after artificial ventilation, intensive general supportive treatment and wound care. She was discharged in relatively good clinical condition with minimal sequele.