Objective: The purpose of this study was to investigate the effect of high-intensity exercise training on appetite, body mass, maximal aerobic capacity (VO2max), leptin, and acylated ghrelin in overweight women.Methods: Twenty-five women aged 25-45 years (35.4 +/- 6.9 years; 74.2 +/- 7.6 kg) were randomly assigned into high-intensity exercise training (n = 15) and control (n = 10) groups. Data assessment included body mass, skinfolds, appetite questionnaire, 1-mile Rockport Walk Test, and blood sample collection. High-intensity exercise training consisted of running an intensity corresponding to 80%-85% maximal heart rate, 3 times/week for 8 weeks.Results: Estimated maximal aerobic capacity increased in high-intensity exercise training vs. controls (P = .01). Body mass, estimated fat percentage, plasma leptin, and acylated ghrelin remained stable. No difference pre-vs. post-intervention in appetite scores was detected between groups (P = .33).Conclusions: In conclusion, high-intensity exercise training was effective to improve aerobic capac-ity, but did not elicit enough negative energy balance to reduce fat mass or promoting appetite compensatory responses, nor changes in acylated ghrelin and leptin concentrations in overweight women. Further studies with longer duration and greater training volumes are warranted to ratify these findings.
Objective: Energy deprivation induces changes in various components ofthe"growth hormone"/"insul in-like growth factor-I" axis; however, it remains unclear whether Ramadan fasting could alter which ones in response to food deprivation. In this study, changes in the components of the mentioned axis during the fasting month of Ramadan are assessed. Methods: Sixty-nine healthy men were studied while fasting during Ramadan. Participants are divided into 2 groups of control (without risk of diabetes mellitus [n = 30]) and cases (with risk factors of DM [n = 39]). Serum growth hormone, insulin-like growth factor-I, and "insulin-like growth factor-binding protein-3" were assessed using the enzyme-linked immunosorbent assay (ELISA) kit. The "homeostasis model assessment to quantify insulin resistance" was also calculated. Results: Fasting increased circulating growth hormone, while decreased serum insulin and homeostasis model assessment to quantify insulin resistance index levels in both groups significantly. Plasma insulin-like growth factor-I and homeostasis model assessment to quantify insulin resistance index were found to be significantly higher in the cases group than in the controls at baseline. Fasting induced a more prominent reduction in serum insulin-like growth factor-I in the cases group than in the controls (P =.014 vs. P =.257). Although serum insulin-like growth factor-binding protein-3 level was not different between groups at baseline or 1 month after Ramadan fasting, the insulin-like growth factor-I:insulin-like growth factor-binding protein-3 ratio was decreased more in the cases group than the control group during fasting (P <.001 vs. P =.070). Conclusion: Fasting plays an effective role in regulating the studied elements of the growth hormone/insulin-like growth factor-I axis which may help improve the metabolic status induced by insulin resistance in men at risk of diabetes mellitus.
Brown tumors can be found in any bone, during the course of primary hyperparathyroidism and may be misdiagnosed as tumors of bone origin. In this case report, we emphasized the importance of considering primary hyperparathyroidism in the differential diagnosis of a patient who presented with a mass in the mandible and was thought to have a malignant mass lesion originating from the mandible on tomography. A 27-year-old male patient applied to an external center due to enlargement of the left jaw and swelling in the mouth, which started 2 months ago and increased over time. Based on the biopsy and mandibular tomography results taken from the intraoral lesion, he was referred to our hospital from the external center for excision, considering a bone orginated malignant mass in the mandible. Laboratory examinations of the patient revealed a calcium serum level of 13.6 mg/dL and the parathyroid hormone level of 508 ng/L. In parathyroid ultrasonography, hypoechoic nodular formation adjacent to the thyroid capsule on the left inferior posterior, was evaluated as a parathyroid adenoma. Histopathological diagnosis from parathyroid ademocectomy, and the the mandibular mass, revealed a parathyroid adenoma and brown tumour respectively. We have compiled 5 cases in the literature, initially thought to be malignant bone tumors but later turned out to be brown tumors due to primary hyperparathyroidism. Increasing surgeons' awareness about primary hyperparathyroidism is important as patients with brown tumors are first admitted to surgeons. Considering primary hyperparathyroidism in masses of bone origin avoids unnecessary surgeries.
Maturity-onset diabetes of the young is the most common monogenic diabetes form affecting between 1% and 5% of all diabetes cases. Clinical characteristics include young onset (usually before 45 years), autosomal dominant inheritance, absence of autoantibodies and metabolic syndrome, and impaired glucose-dependent insulin secretion. To date, at least 14 maturity-onset diabetes of the young subtypes have been identified, harboring numerous mutations that contribute to highly heterogeneous clinical phenotypes. While much is known about the common subtypes of maturityonset diabetes of the young linked to mutations in HNF4A, GCK, HNF1A, and HNF1B; little is known about relatively rare mutations in IPF1/PDX1, NEUROD1, KLF11, PAX4, INS, BLK, ABCC8, KCNJ11, and APPL1 genes. However, with the advent of next-generation sequencing, rare maturity-onset diabetes of the young subtypes are being increasingly reported worldwide. Although nearly 6 decades have passed since the first cases were identified, maturity-onset diabetes of the young is often misdiagnosed as type 1 or type 2 diabetes mellitus due to overlapping clinical features, limited use of genetic testing, and lack of awareness of this type of diabetes. Although there are many clinical characteristics suggesting the diagnosis of maturity-onset diabetes of the young, there is no single criterion. Identifying clinical features of different maturity-onset diabetes of the young subtypes can reduce the number and cost of genetic testing; On the other hand, early diagnosis will reduce the risks of inappropriate treatment and related side effects. The aim of this review is to highlight the role of clinical features, demonstrate the effectiveness of clinical biomarkers in the differential diagnosis of maturity-onset diabetes of the young subtypes, and identify the most suitable candidates for genetic testing.
Objective: This study aims to evaluate the presence of multiple endocrine neoplasia-1 mutations in patients with primary hyperparathyroidism detected on clinical and sonographical suspicion. Methods: We scanned the medical records of 361 patients with primary hyperparathyroidism between January 2010 and December 2017. Results: Fourteen of 361 patients (i.e., 2 males and 12 females) with primary hyperparathyroidism were evaluated genetically upon clinical and sonographical suspicion. Menin gene mutations were found in 3 of 14 patients (21.4%) patients. The frequency of multiple endocrine neoplasia-1 (n = 3) was estimated to be 0.83% in all patients with primary hyperparathyroidism (n = 361). Data of 4 patients with menin mutation analyses were as follows: case 1: A 37-year-old man presented with a 14-year history of recurring nephrolithiasis. He was diagnosed with primary hyperparathyroidism. Genetic analysis was reported as multiple endocrine neoplasia-1: c.643_646delACAG (p.Thr215Serfs*13) heterozygote; case 2: A 35-year-old man with primary hyperparathyroidism and prolactinoma was diagnosed. Genetic analysis was reported as multiple endocrine neoplasia-1: c.654+1G>A heterozygote; case 3: A 26-year- old woman with hyperammonemia, partial empty sella, and hyperprolactinemia was evaluated. Genetic testing revealed heterozygote genomic changes in c984c>a in the multiple endocrine neoplasia-1 gene on the seventh exon; case 4: A 27-year-old man was diagnosed with nephrolithiasis when he was 19 years old. He had both primary hyperparathyroidism and prolactinoma. Multiple endocrine neoplasia-1 and CDKN1B genetic mutation analyses were negative. Because mutation-negative syndromes could not be ruled out, a neck exploration was performed, and a parathyroid adenoma was excised. Conclusions: Patients with primary hyperparathyroidism should be evaluated for multiple endocrine neoplasia-1 mutations upon clinical and sonographical suspicion. It should be noted that an individual with the multiple endocrine neoplasia-1 gene mutation has a 100% penetrance up to the age of 40-50 years. Additionally, 2 novel multiple endocrine neoplasia-1 mutations were identified.
Objective: Normocalcemic hyperparathyroidism is characterized by elevated parathormone levels persisting for 3 months or longer despite normal serum Ca levels. This study aimed to retrospectively compare the prevalence of individual metabolic syndrome components between patients with normocalcemic hyperparathyroidism and an age- and sex-matched control group. Methods: Data of 82 normocalcemic hyperparathyroidism patients and 80 control subjects with normal parathormone and calcium levels were reviewed retrospectively. Those meeting 3 or more of the 2001 metabolic syndrome diagnostic criteria of the US National Cholesterol Education Program Adult Treatment Panel III were considered as having metabolic syndrome. Also, Turkish waist circumference cutoff values were used to identify abdominal obesity and to estimate the metabolic syndrome frequency. Results: Considering that higher body mass index of normocalcemic patients would confound the analysis, analysis of covariance adjusted for body mass index was used to compare the groups, which showed increased waist circumference, waist/hip ratio, parathormone, 25 OH vitamin D3, fasting plasma glucose, and total cholesterol and low- density lipoprotein- cholesterol levels in normocalcemic hyperparathyroidism patients than controls. The prevalence of metabolic syndrome among normocalcemic hyperparathyroidism patients was 32.9% (22.5% in controls) using the National Cholesterol Education Program Adult Treatment Panel III criteria versus 34.1% (23.8% in controls) using the Turkish waist circumference cutoff values. Conclusion: The percentage of patients meeting the metabolic syndrome criteria was higher compared to the control group. Even in the case of normocalcemic hyperparathyroidism, which is considered to be a milder condition, the prevalence of metabolic syndrome was relatively higher than in the control group, suggesting that normocalcemic hyperparathyroidism may be a cardiovascular risk factor by predisposing to metabolic syndrome.
Objective: Many non-occupational and occupational metabolic syndrome risk factors have been identified. In this study, we examined some occupational risk factors of metabolic syndrome. Methods: 3537 employees of Tehran University of Medical Sciences, (1388 male and 2139 female) participated in this cross-sectional study. The prevalence of metabolic syndrome was measured using the International Diabetes Federation criteria, and then we evaluated the association between some job variables such as work-family conflict, shift working, occupational groups and employment sta-tus, and metabolic syndrome.Result: According to the International Diabetes Federation criteria, the prevalence of metabolic syn-drome among employees of Tehran University of Medical Sciences was 22.1%, which was 25.3% and 20.0% for men and women, respectively. In the regression model without the presence of metabolic syndrome component, age, occupational groups, and having a permanent job were predictors of metabolic syndrome. In the model with the presence of metabolic syndrome components, in addi-tion to the metabolic syndrome components, gender and having a permanent job were observed as metabolic syndrome predictors. The study found no association between work-family conflict and metabolic syndrome.Conclusion: Having a permanent job is introduced as an occupational predictor of metabolic syndrome.
Objective: There is a link between thyroid-associated ophthalmopathy and Graves' disease; however, the exact pathophysiological mechanism remains unclear. Galectin-3 expressed by immune and inflammatory cells plays a role in various vital cellular functions as well as supports angiogenesis and fibroblastic activity. The role of Galectin-3 in thyroid-associated ophthalmopathy has not been studied yet, so we aimed to evaluate the alteration of Galectin-3 level in thyroid-associated ophthalmopathy.Methods: This cross-sectional descriptive study was conducted from May 2018 to April 2020. This study consisted of 63 participants, who were divided into 3 groups: group 1 was composed of 21 patients with Graves' disease with thyroid-associated ophthalmopathy, group 2 consisted of 21 patients with Graves' disease without orbitopathy, and group 3 consisted of 21 healthy individuals.Results: Although the mean Galectin-3 levels in group 1 (8.6 +/- 4.1 ng/mL) and group 2 (7.1 +/- 5.4 ng/mL) were higher than group 3 (3.7 +/- 2.8 ng/mL), there was no significant difference in Galectin-3 levels between groups 1 and 2 (P =.001 and P =.030, respectively). In Pearson's correlation analyses, there was a significantly positive correlation between Galectin-3 and thyroid-stimulating hormone (r= 0.452, P =.003) and a negative correlation between Galectin-3 and thyrotropin receptor autoantibody (r= -.318, P = .040). Conclusion: In this study, it is shown for the first time that Galectin-3 levels are higher in patients with Graves' disease than in healthy individuals. Increasing Galectin-3 levels may trigger autoimmunity or may lead to the development of thyroid hyperplasia. Although Galectin-3 level was found to be high in patients with Graves, we did not find any relationship between Galectin-3 and thyroid-associated ophthalmopathy.
Objective: This study aimed to evaluate hand function and hand function-related factors in patients with hypothyroidism and to investigate the relationship between hand function and activities of daily living. Methods: This cross-sectional study included 103 patients with hypothyroidism (53 with Hashimoto thyroiditis, 50 with postoperative hypothyroidism) and 50 controls. Hand function was evaluated with the Duruoz Hand Index, and the Nottingham Extended Activities of Daily Living Scale was used to assess activities of daily living. Results: The mean Duruoz Hand Index scores were higher in the Hashimoto group (1.70 +/- 4.71) (P =.02) and postsurgical group (2.16 +/- 4.37) (P =.002) than in the control group (0.24 +/- 1.02). The median Nottingham Extended Activities of Daily Living Scale score was 65 (45-66) in patients with Hashimoto thyroiditis, 63 (43-66) in patients with postsurgical hypothyroidism, and 66 (46-66) in the control group (P =.009). The difference was statistically significant between the control group and Hashimoto (P =.037) and postsurgical (P =.001) groups. The cut-off value of the Nottingham Extended Activities of Daily Living Scale determined with receiver operating characteristics analysis for poor and good activities of daily living status was 63.5 with a sensitivity of 70% and a specificity of 54% (area under the curve: 0.643, 95% Cl: 0.553-0.733, P =.004) for this study. Logistic regression analysis showed that Duruoz Hand Index (B = -0.695, P =.011) and female gender (B = -2.477, P =.028) were predictive variables for activities of daily living (R-2 = 0.43). Conclusion: Hand function was worse, and activities of daily living were lower in patients with hypothyroidism. Since poor hand function may affect activities of daily living, clinicians should routinely assess hand function and activities of daily living in patients with hypothyroidism. A multidisciplinary approach including rehabilitation programs, must be considered if hand dysfunction is detected.
Objective: In this study, we aimed to demonstrate the presence of liver fibrosis in patients with poly -cystic ovary syndrome at a relatively early stage of the disease using biochemical data and 2 -dimen-sional shear wave elastography techniques.Methods: The study included 33 women with polycystic ovary syndrome and 33 healthy women volunteers. Serum androgen and sex hormone binding globulin levels were measured, and then free androgen index was calculated. Periostin and matrix metalloproteinase-3 levels were measured by ELISA method. Sterling formula was used to calculate FIB-4 score. Liver elasticity was evaluated using shear wave elastography.Results: Periostin and matrix metalloproteinase-3 levels were found to be significantly higher in the polycystic ovary syndrome group compared to the control group (P < .001 and P < .001, respectively). Serum testosterone level and free androgen index were also significantly higher in the polycystic ovary syndrome group (P = .044 and P = .037, respectively). However, there was no significant differ-ence between the groups in terms of liver velocity and elasticity (P = .185 and P = .172, respectively). A positive correlation was found between FIB-4 score and periostin (r = 0.433, P = .012) and between FIB-4 score and liver elasticity in the PCOS group (r = 0.374, P = .032). Conclusion: FIB-4 score was positively correlated with periostin and liver elasticity. These data sug-gest that in addition to FIB-4 score, serum periostin level and shear wave elastography may help us clinically in the detection of liver fibrosis at patients with polycystic ovary syndrome.
Hypocalcemia is a disorder that may develop in cancer patients as a result of chemotherapeutic agents or tumor lysis syndrome. In rare situations, hypocalcemia may be due to hypoparathyroidism associated with bone-metastatic malignancy. Here, we report a 54-year-old woman with a known case of breast cancer, who presented to the hospital with numbness and paresthesia of the distal extremities 1 year after mastectomy and chemotherapy. She had low plasma calcium and parathy-roid hormone levels, as well as a high serum phosphate level. Finally, she was treated with calcium gluconate infusion and calcitriol with a diagnosis of primary hypoparathyroidism. Overall, this case emphasizes the importance of measuring serum calcium levels in patients with metastatic bone carcinoma since this could affect their symptoms. Moreover, we should consider the probability of hypoparathyroidism in the differential diagnosis of hypocalcemic symptoms, even in patients with known malignancy.
Objective:The aim of this study is to evaluate the efficacy of glycemic control of Care Connect, a pro-gram based on digital tools designed for remote monitoring of type 1 diabetes patients. Methods: This is a retrospective cohort study that assesses glycemic control, at baseline and after 3 months, in patients included in the first 45 days whose data were downloaded at least twice during the observation period. Results: Fifty-three subjects were included in the portal in the first 45 days after implantation, 27 men and 26 women, mean age 44.5 +/- 11.69 years, all of them were closed-loop system users. Three months after starting remote monitoring, the glucose management indicator decreased from 7.04% +/- 0.53% to 6.89% +/- 0.45%, the percentage of time in hyperglycemia> 250 mg/dL reduced from 7.83% +/- 8.13% to 5.04% +/- 5.9% and the percentage of time in hyperglycemia> 180 mg/dL reduced from 23.06% +/- 12.92% to 19.17% +/- 9.71% while the percentage of time in range increased from 65.52% +/- 17.80% to 73.60% +/- 13.98%, all these differences being statistically significant. Conclusions: A care program based on digital tools can improve glycemic control in type 1 diabetic patients using a closed-loop system. This type of digital health technology could be useful to opti-mize control in this patient profile.
Objective: Anthropometric quantities were calculated to evaluate the growth kinetics in children and health-related diseases in adults. Dual-energy x-ray absorptiometry is highly valuable to measure the effectiveness of three-dimensional body image. This study aims to investigate the clinical relevance of the three-dimensional body scanners in providing direct anthropometrics for estimations related to body composition. Methods: In this analytical cross-sectional study, 2 significant groups were recruited through purpo-sive sampling. The first included the calibration group, where 38 participants were recruited based on the age groups between 20 and 60 years. Besides, age, body mass, height, and body mass index calculations were examined by using dual-energy x-ray absorptiometry and three-dimensional scans to provide valuable results. Results: Differences in measurements were observed between the calibration group and the valida-tion group. Linear models were used to predict dual-energy x-ray absorptiometry body composition from three-dimensional scan measurements. High clinical relevance for three-dimensional optical measurements related to height (0.02 m2), right arm (0.02m2), and left leg (0.05 m2) was observed. The highest coefficient variation of 3.46% was achieved for the average left/right arm. The body mass index values were indicated by the mean values of 25.6 kg/m2 and 24.5 kg/m2, respectively. Conclusions: The mass of individuals in both groups was provided at the mean values of 80.0 kg and 79.5 kg, respectively. Test-retest measurements showed a strong association for whole body fat, fat -free mass, and arms, legs, and trunk. Three-dimensional body scanners were found effective in clinical settings for treatment procedures.
Objective: The conventional approach to brittle diabetes is the treatment of underlying causes and optimization with multiple-dose insulin injections. The goal of multiple- dose insulin therapy is to exactly mimic physiological insulin secretion; however, it often results in hypoglycemia. This study investigates the effectiveness of continuous subcutaneous insulin infusion therapy with a patch pump with the sensor augmented with predictive low- glucose suspend algorithm system in patients with uncontrolled type 1 diabetes who were treated with multiple-dose insulin and have high glycated hemoglobin values. Methods: The data of patients whose glycemic control could not be achieved with multiple-dose insulin therapy and who were switched to sensor-augmented tubeless pump with predictive lowglucose suspend feature (Medtrum A7+ TouchCare patch pump and integrated A7+ continuous glucose monitoring system) were analyzed retrospectively. Results: A total of 16 patients (male: 9; 56.3%) were included. After 3 months of the sensor-augmented pump with predictive low-glucose suspend treatment, patients'median (interquartile range) glycated hemoglobin level decreased to 7.55 (1.43) from 9.20 (3.55) (P =.008). Time below 56 mg/dL was 0.34%, time between 56 and 70 mg/dL was 1.01%, time between 70 and 180 mg/dL was 72.90%, time above 180 mg/dL was 25.67%, time between 70and 250 mg/dL was 95.98%, and time above 250 mg/dL was 2.76%. Conclusions: A pump system with predictive low-glucose suspend feature improves glycemic targets in patients with brittle uncontrolled type 1 diabetes without the expense of hypoglycemia compared to multiple-dose insulin treatment.
The COVID-19 pandemic has deeply affected the whole world in the last 3 years due to the mortality and morbidity it causes. Billions of doses of vaccines have been administered to overcome the pandemic. The increased incidence of various autoimmune diseases during the pandemic has given rise to the thought that COVID-19 infection or vaccine may be the triggering factor. Recently, new-onset autoimmune phenomena after COVID-19 vaccination have been reported for some autoimmune diseases like Guillain-Barre syndrome and other neurological autoimmune diseases, IgA nephropathy, rheumatoid arthritis and systemic lupus erythematosus, immune thrombotic thrombocytopenia, autoimmune liver diseases, and autoimmune thyroid diseases. Here, we present a case of newly diagnosed type 1 diabetes that developed 1 month after the SARS-CoV-2 vaccine.
Myxedema coma is a rare but life-threatening endocrinological emergency condition that may present with serious conditions such as sudden cardiac arrest or acute coronary syndrome. In this context, 2 cases are presented in this case report as examples of how deadly complications of myx-edema coma can be prevented with rapid diagnosis and intervention. A 58-year-old female patient was admitted to the emergency service with complaints of altered consciousness and speech and balance disorders. She was hypothermic at admission. Her electrocardiogram was compatible with complete atrioventricular block. The patient who developed cardiac arrest during the follow-up was intubated, and spontaneous circulation was restored after 28 minutes of cardiopulmonary resusci-tation. The patient's thyroid function tests were compatible with hypothyroidism. The patient was diagnosed with myxedema coma, and treatment for myxedema coma was started. The patient was discharged after 40 days. A 55-year-old male patient presented to the emergency department with chest pain. His electrocardiogram was compatible with first-degree atrioventricular block. There was ST segment elevation in D2, D3, and aVF derivations. The patient's thyroid function tests were com-patible with hypothyroidism. The patient was diagnosed with myxedema coma and was immediately started treatment. The patient was discharged after 18 days. Myxedema coma is rarely seen due to the easy accessibility and feasibility of hypothyroidism treatment, however, in cases when it is seen it may present with mortal manifestations. Hence, it is of utmost importance that clinicians take this serious condition into consideration and initiate treatment without delay.
Objective: The aim of this study was to investigate the role of vitamin D replacement therapy on advanced glycation end-products in prediabetes and type 2 diabetes mellitus patients with vitamin D deficiency. Methods: One hundred twenty subjects with serum 25-hydroxyl vitamin D levels less than 20 ng/mL were included in the study. Forty type 2 diabetes mellitus patients (type 2 diabetes mellitus group), 40 prediabetes patients (prediabetes group), and 40 non-diabetes controls (non-diabetes group) were given oral vitamin D3 50 000 units/week for 8 weeks as loading and followed by 1500 U/day as a maintenance dose. We measured serum 25-hydroxyl vitamin D, glycated hemoglobin, carboxymethyl lysine levels, and skin autofluorescence before and on the fourth month of the therapy. Results: Basal serum carboxymethyl lysine and skin autofluorescence measurement in type 2 diabe-tes mellitus and prediabetes groups were significantly higher than the non-diabetes group. While no difference was found between glycated hemoglobin and skin autofluorescence, serum carboxy-methyl lysine levels were significantly elevated for each group following vitamin D replacement. Conclusions: Vitamin D loading did not affect skin advanced glycation end-product levels and gly-cated hemoglobin but was associated with increased serum carboxymethyl lysine levels in all groups.
Subacute thyroiditis (SAT) has been recently associated with severe acute respiratory syndrome-coronavirus-2 infection or vaccines against it. We report a case of a 41-year-old male patient who developed persistent SAT after the coronavirus disease-2019 (COVID-19) vaccination. He presented with sore throat and neck pain after the first dose of the COVID-19 vaccine (CoronaVac®). There was no history of a recent viral infection. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated, thyroidstimulating hormone (TSH) and free thyroxine (fT4) were normal, COVID-19 polymerase chain reaction test was negative, and sonography showed thyroiditis in the right lobe. The symptoms resolved after treatment with methylprednisolone. However, 2 weeks after the second dose of the vaccine, the patient suffered from neck pain and hoarseness. TSH and fT4 were normal, but anti-thyroid peroxidase (anti- TPO), anti-thyroglobulin (anti-Tg), ESR, and CRP were elevated. Sonography revealed thyroiditis in the left lobe. The patient was treated with ibuprofen. On follow-up, hypothyroidism was diagnosed, and levothyroxine started. Hence, the clinicians should suspect the possibility of SAT in the vaccinated subjects. (English) [ FROM AUTHOR] Subakut tiroidit (SAT), son zamanlarda şiddetli akut solunum sendromu-koronavirüs-2 enfeksiyonu veya buna karşı geliştirilen aşılarla ilişkilendirilmektedir. Koronavirüs hastalığı- 2019 [coronavirus disease-2019 (COVID-19)] aşılaması sonrasında persistan SAT gelişen 41 yaşında erkek hastamızı sunuyoruz. COVID-19 aşısının (CoronaVac®) ilk dozundan sonra boğaz ağrısı ve boyun ağrısı ile başvurdu. Yakın zamanda viral enfeksiyon öyküsü yoktu. Eritrosit sedimentasyon hızı (ESH) ve C-reaktif protein (CRP) yüksekti, tiroidstimüle edici hormon (TSH) ve serbest tiroksin (sT4) normaldi, COVID-19 polimeraz zincir reaksiyonu testi negatifti ve sonografide sağ lobta tiroidit mevcuttu. Metilprednizolon tedavisi ile semptomlar geriledi. Ancak aşının 2. dozundan 2 hafta sonra hasta boyun ağrısı ve ses kısıklığından yakındı. TSH ve sT4 normaldi, anti-tiroid peroksidaz, anti-tiroglobülin, ESH ve CRP yükseldi. Sonografide sol lobta tiroidit izlendi. Hasta ibuprofen ile tedavi edildi. Takipte, hipotiroidizm tanısıyla levotiroksin başlandı. Dolayısıyla klinisyenler aşılanmış kişilerde SAT olasılığını akılda tutmalıdır. (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Endocrinology & Metabolism is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
Lymphomas are the rare causes in the differential diagnosis of pituitary masses. While pituitary infiltration by lymphomas is relatively more frequent, isolated lymphoma associated with the pituitary gland is much rarer. We presented a case of a 64-year-old female patient who was admitted to the hospital due to headache, diplopia and decreased visual acuity. Although the stated preoperative diagnosis was parasellar meningioma, the pathological diagnosis was given as isolated primary pituitary lymphoma after ruling out any other foci. After the definitive diagnosis, the patient underwent chemoradiotherapy. However, despite treatment, the patient died due to pulmonary sepsis. Primary pituitary lymphoma is an extremely rare condition generally seen in elderly and/or immunosuppressive patients. In order to establish an effective therapeutic strategy, it is extremely crucial to distinguish between primary and secondary lymphomas. However, the recent evidence for a standardized treatment protocol is still limited due to the small number of cases reported to date.
