Get A Synopsis of Endocrinology and Metabolism PDF

By David G. Ferriman

ISBN-10: 0723602050

ISBN-13: 9780723602057

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Extra resources for A Synopsis of Endocrinology and Metabolism

Example text

Inherited enzyme or related defects in synthesis of thyroxine. —Patients have been reported with defects at various points in the synthesis of thyroxine. 1. Failure of iodide trapping. 2. Failure of incorporation. a. —Associated nerve deafness. Dominant inheritance. b. A group showing recessive inheritance. 3. Failure of conversion of iodotyrosines to iodothyronines. 4. Deficiency of de-iodotyrosinase. 5. Formation and release of abnormal biologically inactive iodinated proteins. —Goitre production is compensatory.

6. —Probably due to aggravation of a latent diabetes. — 1. BMR elevated in hyperthyroidism. Method unreliable. 38 DISEASES OF T H E THYROID Hyperthyroidism—Diagnosis, continued. 2. THYROIDAL 132 I AND 131 I UPTAKES and 48-hour PBI 1 3 1 high. Forty-eight-hour 131 I excretion low. 3. T3 SUPPRESSION TEST useful when 132 I or 131 I uptakes in border-line range, and in cases presenting with proptosis with absence of signs and symptoms due to the overproduction of thyroxine. 131 4. I SCAN OF THYROID shows uptake confined to nodule in toxic adenoma.

A change in antithyroid agent is called for. (iv) Enlargement of retrosternal goitre, with pressure phenomena. c. —Acceptability. —(i) Assessment of correct dosage difficult. HYPERTHYROIDISM 39 (ii) Maximum effect not visible for 3 months, (in) High incidence of long-term hypothyroidism, caused by radioactive damage to regenerative capacity of thyroid cells. At one time it was feared that 131I therapy might predispose to carcinoma of the thyroid. This is not now considered likely. However, it is best avoided in younger subjects, and particularly in children.

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A Synopsis of Endocrinology and Metabolism by David G. Ferriman


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