Pharmacological treatment of hyperthyroidism during lactation: review of the literature and novel data.

Antithyroid drugs (ATD) are used as a first line treatment in thyrotoxicosis. Propylthiouracil (PTU), carbimazole (CMZ) and methimazole (MMI) are available. During absorption CMZ is bioactivated to MMI. Initially, mothers were not allowed to breastfeed during treatment with ATD. Newer studies minimized the risk for mother and infant. PTU should be preferred over MMI due to its lower milk concentration. Recent studies have shown severe hepatic dysfunction for both ATD, but especially for PTU, in hyperthyroid patients. Most of those cases were idiosyncratic, not-dose related and presented a latent period of occurrence. No biomarkers could predict hepatic damage. The American Thyroid Association (ATA) has recommended that PTU should not be prescribed as the first line agent in children and adolescents. Its use might be accepted in the first trimester of pregnancy for severe thyrotoxicosis or for patients with previous MMI adverse reactions. Considering the potential harmful effects of PTU, MMI should be used instead during lactation.

A boy with McCune-Albright syndrome associated with GH secreting pituitary microadenoma. Clinical findings and response to treatment.

The McCune-Albright Syndrome (MAS) is a sporadic rare disease first described in 1936 by McCune and separately by Albright. MAS is characterized by a triad of physical signs: café-au-lait spots, polyostotic fibrous dysplasia and autonomous endocrine hyperfunction. MAS is predominantly observed in girls and is rarely reported in males. We report the case of a 9-year old boy with gonadotropin independent precocious puberty, café-au-lait spots, polyostotic fibrous dysplasia and growth hormone hypersecretion.

Decrease in adiponectin levels in women with polycystic ovary syndrome after an oral glucose tolerance test.

Adiponectin levels are decreased after an oral glucose tolerance test. At t = 2 hours, they are increased in obese and overweight women with polycystic ovary syndrome, compared with controls matched for body mass index.

Consequences of an intracranial germ cell-tumor in a young adolescent.

Germ cell tumors (GCTs) are relatively rare tumors, which arise in patients of all ages. They are most common in the first and second decades of life with a male predominance. The most frequent tumors arise in the pineal and suprasellar region. The long-term consequences of these tumors have not been very well characterized, as few series with a limited number of patients have reported on the neuro-endocrine development and quality of life of these young people. In this communication we present a male patient who was diagnosed clinically in 1998 at the age of 17 years to have a GCT and subsequently treated with radiotherapy. Today, 6 years after the initial diagnosis his neuro-endocrine and neuro-cognitive outcomes are quite good, while his quality of life is poor mainly due to many psychological problems that he experiences in his every day life. However, it has to be noted that 6 years is insufficient follow-up to assess late post radiation effects.