Hodgkin's lymphoma of the thyroid in a woman with autoimmune thyroiditis / / Linfoma Hodgkin de tiroides en una mujer con tiroiditis autoinmune

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Hipocalcemia secundaria a déficit de vitamina D / Hypocalcemia due to vitamin D deficiency

El déficit de vitamina D es una causa poco frecuente de hipocalcemia en nuestro país, dada la ubicuidad de la vitamina D en los alimentos y la síntesis cutánea en presencia de radiación ultravioleta. Ocurre por lo general en personas ancianas sin exposición solar y con déficit en la dieta, y suele ser parcial, sin repercusiones clínicas importantes. Presentamos un caso de hipocalcemia grave por déficit de vitamina D asociado a tratamiento con fenitoína (AU)

Association between diabetic ketoacidosis and thyrotoxicosis.

Three cases of diabetic ketoacidosis precipitated by thyrotoxicosis are presented. Two of them are young women with type 1 diabetes mellitus; the third case is a middle-aged woman with type 2 diabetes mellitus. All of them were diagnosed with Graves' disease. They typically showed tachycardia at rest in spite of correction of the metabolic disorder. Hyperthyroidism worsens glycemic control in diabetic patients and may precipitate diabetic ketoacidosis. On the other hand, women with diabetes have a higher prevalence of Graves' disease. Thus, in diabetic ketoacidosis without an obvious triggering factor, the presence of hyperthyroidism should be investigated, particularly in women.

Adenoma paratiroideo asociado a tratamiento prolongado con litio / Parathyroid adenoma and lithium therapy

El hiperparatiroidismo inducido por litio es una causa poco frecuente de hipercalcemia. Normalmente es una situación reversible que remite tras suspender el tratamiento, aunque, en un grupo reducido de pacientes, la estimulación continuada de las glándulas paratiroides conlleva la formación de adenomas. Presentamos un caso de hiperparatiroidismo asociado a tratamiento prolongado con litio. (AU)

[Uro-andrologic alterations in Wolfram syndrome]. / Alteraciones uroandrológicas del síndrome de Wolfram.

The association of diabetes mellitus, diabetes insipidus, neurosensory changes and optic atrophy is known as Wolfram's syndrome. Herein we report on a patient with hypogonadism, pyelocaliceal ectasia and anejaculation. Although associated urological disorders have been reported before, this is the first case of anejaculation coexisting in the same patient reported in the literature. The possible etiopathogenesis is discussed.

[Vesico-uterine fistula. Conservative treatment]. / Fístula vesicouterina. Tratamiento conservador.

We report on a case of vesicouterine fistula following cesarean section in a 26-year-old patient. This rare complication can be initially treated noninvasively with contraceptive steroids combined with other conservative therapeutic methods such as placement of a bladder catheter and electrocoagulation of the borders of the fistula.