Hypocalcemia After Thyroidectomy and Parathyroidectomy in a Pregnant Woman

Endocrinology ◽  
2020 ◽  
Vol 161 (7) ◽  
Author(s):  
Benjamin Lebrun ◽  
Christophe De Block ◽  
Yves Jacquemyn
Keyword(s):  
Pregnant Woman ◽  
Fetal Death ◽  
Perinatal Death ◽  
Serum Levels ◽  
Premature Delivery ◽  
Normal Range ◽  
Search Terms ◽  
Time Period ◽  
In Pregnancy

Abstract Hypoparathyroidism during pregnancy is a very rare endocrine disorder. The majority of cases are postsurgical (75%). Managing pregnant or nursing women with hypoparathyroidism is challenging due to complications arising from either under- or overtreatment, including premature delivery or fetal death, abortion, stillbirth, perinatal death, and neonatal tetany. Specific adaptations are needed within each time period to meet the fetal, neonatal, and maternal calcium requirements. A systematic search was performed on PubMed using the search terms “pregnancy” and “hypoparathyroidism.” Included were articles published in English between January 1, 1966, and January 1, 2018. We provide an overview of all published cases (n = 43) of hypoparathyroidism in pregnancy, including a case report of a 29-year-old pregnant woman who underwent a total thyroidectomy before her current pregnancy because of a therapy-resistantant Graves’ disease. The procedure was complicated by postsurgical hypoparathyroidism. She carried out the pregnancy to term with minor complaints of paresthesia and muscle cramps. Furthermore, we discuss treatment, complications, and follow-up of hypoparathyroidism in pregnancy. Treatment of hypoparathyroidism in pregnancy should still be individualized, depending on the patient’s complaints and serum levels of calcium, which should be maintained in the lower normal range of 2.15 to 2.55 mmol/l, according to the literature. We recommend monitoring calcium levels every 3 to 4 weeks throughout the pregnancy, within 1 week postpartum, and monthly during lactation to ensure normocalcemia.

Obstetric antiphospholipid syndrome: still a challenge

Lupus ◽  
2010 ◽  
Vol 19 (4) ◽  
pp. 457-459 ◽  
Author(s):  
RA Levy ◽  
GRR Jesús ◽  
NR Jesús
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Antiphospholipid Syndrome ◽  
Fetal Death ◽  
Obstetric Complications ◽  
Premature Delivery ◽  
Thrombotic Risk ◽  
Recurrent Abortions ◽  
Obstetric Antiphospholipid Syndrome

Obstetric complications such as fetal death, premature delivery, preeclampsia and recurrent abortions (since chromosomal or anatomic defects have been excluded) are characteristic manifestations of antiphospholipid syndrome (APS). They can occur in patients with known APS with previous arterial or venous events in any tissue or organ, or be its first and only manifestation. Pregnancy in a patient with APS is considered high risk and the full prenatal clinical follow-up must be carried with this in mind, eliminating or minimizing concomitant thrombotic risk factors.

Primary Solitary Extramedullary Plasmacytoma Involving the True Vocal Cords in a Pregnant Woman

2013 ◽  
Vol 99 (1) ◽  
pp. e14-e18 ◽  
Author(s):  
Soumya Ghatak ◽  
Mainak Dutta ◽  
Indranath Kundu ◽  
Rajendra Prasad Ganguly
Keyword(s):  
Pregnant Woman ◽  
Subsequent Treatment ◽  
Extramedullary Plasmacytoma ◽  
Rare Entity ◽  
Vocal Cords ◽  
First Time ◽  
Solitary Extramedullary Plasmacytoma ◽  
Bence Jones Proteinuria ◽  
In Pregnancy

Primary solitary extramedullary plasmacytoma of the larynx involving the true vocal cords is an extremely rare entity. Extramedullary plasmacytoma has the potential to transform into multiple myeloma and mandates strict vigilance and routine follow-up. We describe such a case in a 29-year-old pregnant woman who presented with progressive hoarseness, dysphagia and intermittent respiratory difficulty. Fiberoptic laryngoscopy revealed a fleshy mass involving the posterior third of the true vocal cords, encroaching on the ventricle and false cords. Histopathology and immunohistochemistry revealed extramedullary plasmacytoma of a monoclonal nature. In spite of Bence Jones proteinuria and a rising serum β2-microglobulin level, a thorough search for metastasis and subsequent treatment with radiotherapy were delayed due to the patient's pregnancy. She is the youngest adult ever reported with primary solitary extramedullary plasmacytoma involving the true cords. Described for the first time in pregnancy, the relevant issues in management are highlighted.

Management in cases of large uterine myomas in pregnancy

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Aleksandra Stupak ◽  
Marcin Bobiński ◽  
Andrzej Miturski ◽  
Barbara Kalbarczyk ◽  
Anna Kwaśniewska ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pain Control ◽  
Clinical Observation ◽  
Uterine Fibroids ◽  
Reproductive Organs ◽  
Benign Tumors ◽  
Premature Delivery ◽  
Case Presentation ◽  
Uterine Myomas ◽  
In Pregnancy

AbstractObjectivesUterine fibroids are the most common benign tumors in women of procreative age. The effects of their occurrence affect the course of pregnancy by increasing the frequency of abortions, premature delivery or premature abruption of the placenta. Medical treatment includes clinical observation, pharmacological pain control, myomectomy during pregnancy or perinatal hysterectomy.Case presentationWe present a survey of literature and the case of a pregnant woman with an enormous uterine fibroid 23×13×16 cm on the basis of which a diagnostic-therapeutic scheme for tumors of the reproductive organs during pregnancy has been developed.ConclusionsThe study presents improved recommendations for management the pregnancies in presence of the uterine myomas based on clinical practice.

Gross pericardial effusion with tamponade in 2nd trimester of pregnancy

Open Medicine ◽  
2010 ◽  
Vol 5 (3) ◽  
pp. 369-371
Author(s):  
Talay Kudaiberdiev ◽  
Gulzad Imanalieva ◽  
Gulbarchin Usupbaeva ◽  
Rahat Kalieva ◽  
Elmira Tukusheva
Keyword(s):  
Pregnant Woman ◽  
Pericardial Effusion ◽  
Pregnant Women ◽  
Cardiac Complications ◽  
Functional Tests ◽  
Careful Monitoring ◽  
Life Threatening ◽  
Term Baby ◽  
In Pregnancy

AbstractHypothyroidism in pregnancy is associated with serious maternal and fetal risk. Rarely, it is manifested by life-threatening cardiac complications, such as gross pericardial effusion and tamponade. We present a case of successfully treated gross pericardial effusion and tamponade in a 22-week pregnant woman with hypothyroidism. The patient was treated by pericardial drainage with further treatment of hypothyroidism with levothyroxine. During the follow-up pregnancy was uncomplicated without recurrence of pericardial effusion and successful delivery of full-term baby. We conclude that careful monitoring of thyroid functional tests and proper management should be performed in pregnant women with hypothyroidism to prevent cardiac complications of the disease, like pericardial effusion and tamponade.

S263 – Serum IGF-1 Changes in Early Post-Adenotonsillectomy Period

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P163-P163
Author(s):  
Mohammadreza Majidi ◽  
Ghafarzadegan Kamran ◽  
Pourhamzeh Mosugan ◽  
Hassanzadeh Nadia
Keyword(s):  
Early Stage ◽  
Serum Insulin ◽  
Upper Airway ◽  
Serum Levels ◽  
Early Postoperative Period ◽  
Wilcoxon Test ◽  
Normal Range ◽  
Time Period ◽  
Study Population ◽  
The Mean

Objectives Increase in serum insulin-like growth factor-1(IGF-1)level is one of the proposed mechanisms for growth improvement after adenotonsillectomy, but time period for this increase is unclear. This study was conducted to determine the effect of adenotonsillectomy on serum IGF1 level in early postoperative period. Methods Children 3 to 10 years of age who underwent adenotonsillectomy because of upper airway obstruction entered the study; weight and height were recorded at the time of surgery. Serum IGF-1 level was measured before and 3 weeks after surgery. Wilcoxon test was used for comparison of preoperative and postoperative IGF-1 levels. Results The study population included 14 boys and 9 girls with the mean age of 6.74±1.76 years. Serum IGF-1 levels increased significantly (p<0.001)from 159.08± 79.83 ng/ml before adenotonsillectomy to 252.26± 131.17 ng/ml three weeks after surgery. All patients (3 girls and 3 boys) with serum levels below normal range had normal values 3 weeks after surgery. Conclusions This study showed that the effect of adenotonsillectomy on growth improvement based on hormonal factor is initiated in early stage after surgery.

Prognostic Value of Early Postoperative Calcitonin Level in Medullary Thyroid Carcinoma

1994 ◽  
Vol 80 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Maria Elisa Girelli ◽  
Silvia Dotto ◽  
Davide Nacamulli ◽  
Michele Piccolo ◽  
Daniele De Vido ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Cervical Lymphadenopathy ◽  
Distant Metastases ◽  
Serum Levels ◽  
Normal Range ◽  
Neoplastic Tissue ◽  
Serum Calcitonin ◽  
Medullary Thyroid

Aims Serum calcitonin (CT) assay is commonly used in the diagnosis and follow-up of medullary thyroid carcinoma (MTC). The aim of this study was to ascertain whether serum CT levels, measured in the first few days after surgery, could be used to evaluate the efficacy of treatment. Methods A group of 33 patients was studied. In all patients the follow-up was more than 20 months. Results Preoperatively basal CT serum levels were high in all patients. Twenty-four hours after surgery CT serum levels dropped to within the normal range in 8 patients and 72 hours after operation in 7 others. In this group 1 patient was at stage I, 11 at stage II and 3 at stage III. Basal and pentagastrin stimulated CT levels continued to be in the normal range in these 15 patients 6 and 12 months after surgery and at the subsequent year by follow-up visits. No clinical or radiological evidence of disease was found during the follow-up in this group. In the other 18 patients CT was reduced but still high 72 hours after surgery; 6 months later basal serum CT levels continued to be elevated or responsive to pentagastrin stimulation. In this group restaging showed tumor relapse in the thyroid bed in 2 patients, cervical lymphadenopathy in 11, and distant metastases (bone, liver) in 3. Conclusions Immediate postoperative CT serum levels seem to be the most useful index to evaluate the efficacy of surgical treatment and the presence of residual neoplastic tissue.

scholarly journals Predictive values of multiple serum biomarkers in women with suspected preeclampsia: a prospective study

2020 ◽  
Author(s):  
Jing Wang ◽  
Honghai Hu ◽  
Xiaowei Liu ◽  
Shenglong Zhao ◽  
Yuanyuan Zheng ◽  
...  
Keyword(s):  
Medical Records ◽  
Serum Levels ◽  
Serum Markers ◽  
Serum Biomarkers ◽  
Serum Samples ◽  
Predictive Values ◽  
Independent Risk Factors ◽  
A Prospective Study ◽  
In Pregnancy

Abstract Background Early preeclampsia (PE) prediction has been shown to improve the maternal and fetal outcomes in pregnancy. We aimed to evaluate the PE prediction values of a series of serum biomarkers. Methods The singleton pregnant women with PE-related clinical and/or laboratory presentations were recruited and had the blood drawn at their first visits. The prospective cohort was further divided into the PE-positive and PE-negative groups based on the follow-up results. The following markers were tested with the collected serum samples: sFlt-1, PlGF, M, tPAI-C, compliment factors C1q, B, H, BUN, GlyFn, PAPP-A2, BUN, Cre, UA and Cysc. Results Totally 196 women suspected for PE were recruited with follow-up medical records. Twenty-five percent of the recruited subjects developed PE before delivery and 75% remained PE-negative. The serum levels of sFlt-1, BUN, Cre, UA, Cysc and PAPP-A2 were significantly elevated and the PlGF was significantly decreased in the PE-positive patients. The AUCs were listed in the order of decreasing values: UA (AUC = 0.73), sFlt-1/PlGF (AUC = 0.67), Cysc (AUC = 0.66), GlyFn/PlGF (AUC = 0.65), PlGF (AUC = 0.64), PAPP-A2/PlGF (AUC = 0.64), sFlt-1 (AUC = 0.63), BUN (AUC = 0.63), Cre (AUC = 0.63), and PAPP-A2 (AUC = 0.60) in the ROC analyses. The Logistic regression analysis showed that UA and PAPP-A2 were independent risk factors for PE development with the odds ratios of 3.3 and 2.2 respectively. Moreover, the PPVs of UA and PAPP-A2 were 48.9%, and 40.4%; the NPVs of UA and PAPP-A2 were 82.1% and 81.9%. Conclusions Further studies are warranted to confirm the clinical utilities of the serum markers in PE prediction.

Renal Effects of Diazoxide and Frusemide and Interrelattonships

1974 ◽  
Vol 19 (1_suppl) ◽  
pp. 17-24
Author(s):  
J. E. F. Pohl ◽  
J. D. Swales ◽  
H. Thurston
Keyword(s):  
Renal Failure ◽  
Ethacrynic Acid ◽  
Serum Levels ◽  
Normal Range ◽  
Severe Renal Failure ◽  
Hypertensive Patients ◽  
Daily Dose ◽  
The Mean

The successful long-term control of diazoxide-induced Na retention in 52 hypertensive patients (mean creatinine clearance (Ccr) 38 ± 30.6 ml/min, range 1–123 ml/min) by the use of potent diuretics is reported. The mean duration of follow-up was 26.2± 14.4 months with a range of 3–52 months. The mean daily dose of frusemide was 344 mg (range 40–1000 mg). The mean daily dose of ethacrynic acid was 318 mg (range 100–800 mg). Rashes necessitating change of therapy were attributed to frusemide in seven patients. Diuretic dosage, corrected for patient Na intake, was independent of diazoxide serum levels (S.L.) below 100 mg/litre but was inversely correlated with CCI (rdiuretic, NaCCI(S.L. constant)= −0.33 2P<0.05). Concordant estimates of patient Na intake were obtained and the estimated mean daily Na intake of 121.2 ±62.1 mEq falls within the normal range. The eight patients with estimated mean Na intakes < 50 mEq/day (mean: 35 mEq/day) had a mean Ccr of 11.04 ± 5.98 ml/min whilst the 31 patients with estimated mean Na intakes > 100 mEqjday (mean: 158.9 mEqjday) had a mean Ccr of 48.92 ± 5.05 ml/min. This discrepancy was interpreted as due to a limitation in the ability to correct diazoxide-induced Na retention in patients with severe renal failure. In practice such patients are kept in balance by the use of more than one diuretic combined with a restricted Na intake.

Vitamin D Supplementation and Serum Levels of Magne-sium and Selenium in Type 2 Diabetes Mellitus Patients: Gender Dimorphic Changes

2014 ◽  
Vol 84 (1-2) ◽  
pp. 27-34 ◽  
Author(s):  
Nasser M. Al-Daghri ◽  
Khalid M. Alkharfy ◽  
Nasiruddin Khan ◽  
Hanan A. Alfawaz ◽  
Abdulrahman S. Al-Ajlan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
Serum Selenium ◽  
Dependent Manner

The aim of our study was to evaluate the effects of vitamin D supplementation on circulating levels of magnesium and selenium in patients with type 2 diabetes mellitus (T2DM). A total of 126 adult Saudi patients (55 men and 71 women, mean age 53.6 ± 10.7 years) with controlled T2DM were randomly recruited for the study. All subjects were given vitamin D3 tablets (2000 IU/day) for six months. Follow-up mean concentrations of serum 25-hydroxyvitamin D [25-(OH) vitamin D] significantly increased in both men (34.1 ± 12.4 to 57.8 ± 17.0 nmol/L) and women (35.7 ± 13.5 to 60.1 ± 18.5 nmol/L, p < 0.001), while levels of parathyroid hormone (PTH) decreased significantly in both men (1.6 ± 0.17 to 0.96 ± 0.10 pmol/L, p = 0.003) and women (1.6 ± 0.17 to 1.0 ± 0.14 pmol/L, p = 0.02). In addition, there was a significant increase in serum levels of selenium and magnesium in men and women (p-values < 0.001 and 0.04, respectively) after follow-up. In women, a significant correlation was observed between delta change (variables at six months-variable at baseline) of serum magnesium versus high-density lipoprotein (HDL)-cholesterol (r = 0.36, p = 0.006) and fasting glucose (r = - 0.33, p = 0.01). In men, there was a significant correlation between serum selenium and triglycerides (r = 0.32, p = 0.04). Vitamin D supplementation improves serum concentrations of magnesium and selenium in a gender-dependent manner, which in turn could affect several cardiometabolic parameters such as glucose and lipids.

Recovery of thyroid function with a decreased titre of antimicrosomal antibody in a hypothyroid man with Hashimoto's thyroiditis

1983 ◽  
Vol 102 (4) ◽  
pp. 531-534 ◽  
Author(s):  
Makiko Yamamoto ◽  
Kazuro Kaise ◽  
Hirofumi Kitaoka ◽  
Katsumi Yoshida ◽  
Nobuko Kaise ◽  
...  
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Serum Levels ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Normal Range ◽  
Surgical Biopsy ◽  
Low Levels ◽  
Serum Thyroid Hormones ◽  
Antimicrosomal Antibody ◽  
Serum Tsh

Abstract. A 36 year old man with a diffuse goitre, signs of mild hypothyroidism, strikingly low levels of T4 (0.9 μg/dl) and T3 (24 ng/dl), elevated TSH (140 μU/ml) and elevated microsomal haemagglutination antibody (MCHA, 1:409 600), subsequently became non-goitrous and euthyroid with a decreased titre of antimicrosomal antibody without any medication. At the time of surgical biopsy, serum levels of T4 and T3 had risen to the normal range (4.6 μg/dl and 73 ng/dl, respectively), serum TSH had decreased to 30 μU/ml and the titre of MCHA to 1:25 600. Thyroid specimens showed Hashimoto's thyroiditis. The activity of thyroid peroxidase (TPO) was normal. The latest examination, 1 year and 3 months after initial evaluation, showed that the patient remained euthyroid with no goitre, that serum thyroid hormones were within the normal range (T4 7.7 μg/dl and T3 97 ng/dl), and that TSH was not detectable. The titre of MCHA decreased strikingly to 1:400.

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