[Development of sarcoidosis after successful treatment of Cushing's disease].

Cushing's disease is a rare severe neuroendocrine disorder caused by chronic overproduction of adrenocorticotropic hormone by a pituitary tumor. Supraphysiological concentrations of cortisol in endogenous hypercortisolism have an immunosuppressive and anti-inflammatory effect similar to therapy with systemic glucocorticosteroids. This may reduce the activity of the patient's concomitant autoimmune inflammatory diseases. On the other hand, a decrease in cortisol levels during treatment for Cushing's disease may be associated with a reactivation of the immune system that pose a risk of onset or recurrence of an autoimmune disorder. We present our own clinical case demonstrating the development of sarcoidosis after surgical treatment of Cushing's disease.

[Impact of adjuvant therapy with lithium carbonate on the results of radioiodine treatment in patients with diffuse toxic goiter].

Thirty-eight patients with diffuse toxic goiter (Graves' disease) were treated with radioiodine. Before 131I therapy thyrotoxicosis compensation was achieved by antithyroid medication in all the patients. Antithyroid medication was discontinued 10 days before radioiodine treatment. After its withdrawal, the use of lithium carbonate successfully prevented the development of thyrotoxicosis before 131I therapy. The administration of the agent caused a reduction in the proportion of patients with thyrotoxicosis 1.5 months after 131I therapy. Lithium carbonate used 10 days before and 4 days after 131Itherapy exerted the most considerable effect, by reducing the volume of the thyroid gland. By month 3, hypothyroidism more promptly developed in lithium carbonate-untreated patients; by month 6, the rate of different treatment outcomes (hypothyroidism, euthyroidism, or thyrotoxicosis) did not virtually depend on any lithium carbonate treatment regiment.

[Efficiency of treatment for diffuse toxic goiter in relation to the estimated therapeutic activity of radioactive iodine].

Forty-eight patients with diffuse toxic goiter (Graves's disease) were treated with radioactive iodine in a dose of 5.3-30.0 mCi. A special formula considering the volume of the thyroid and post-24-hour capture of the diagnostic activity of radioactive iodine was used to calculate the optimum therapeutic activity. As a result, specific therapeutic activity (STA) correlated with specific activity and with the volume of thyroid. The high rate (33.3%) of recurrent thyrotoxicosis was observed when the calculated STA was less than 0 3 mCi/ml and reduced to 11.1% if a greater activity was applied. The use of the standard activity of radioactive iodine (10mCi) with a thyroid volume of up to 40 ml, as compared to that calculated by the formula results in the similar rate of ineffective radioiodine therapy for thyrotoxicosis at a lower incidence of euthyrosis.