scholarly journals Fetal Tachycardia Treated Successfully with Maternally Administered Propylthiouracil

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Barbara V. Parilla ◽  
Farhan Hanif ◽  
Keren Hasbani ◽  
Thomas Iannucci
Keyword(s):  
Normal Sinus Rhythm ◽  
Clinical Signs ◽  
Serum Levels ◽  
Graves Disease ◽  
Transplacental Passage ◽  
Normal Sinus ◽  
Thyroid Stimulating Immunoglobulins ◽  
History Of ◽  
Maternal Thyroid ◽  
Fetal Tachycardia

Background. Fetal tachycardia may result from the transplacental passage of thyroid stimulating immunoglobulins in a patient with hypothyroidism secondary to ablation of Graves’ disease.Case. A 32-year-old woman, gravida 4, para 2, and abortus 1, with hypothyroidism and a history of Graves’ disease, presented at 23 6/7 weeks of gestation with a persistent fetal tachycardia. The treatment of the fetal tachycardia with maternally administered digoxin and Sotalol was unsuccessful. Maternal thyroid stimulating immunoglobulins were elevated, and treatment with maternally administered propylthiouracil (PTU) resulted in a normal sinus rhythm for the remainder of the pregnancy. An induction of labor was performed at 37 weeks. Four to five days after delivery, the neonate exhibited clinical signs of hyperthyroidism necessitating treatment.Conclusion. Fetal tachycardia resulting from the transplacental passage of thyroid stimulating immunoglobulins can be successfully treated with maternally administered PTU. The neonate needs to be followed up closely as clinical signs of hyperthyroidism may occur as thyroid stimulating immunoglobulins continue to circulate in the neonate, while the serum levels of PTU decline.

Neonatal Hyperthyroidism m Infants of Mothers Previously Thyroidectomized due to Graves’ Disease

2001 ◽  
Vol 14 (8) ◽  
Author(s):  
Maria Victoria Borras-Perez ◽  
David Moreno-Pérez ◽  
Amalia Zuasnabar-Cotro ◽  
Juan P. López-Siguero
Keyword(s):  
Total Thyroidectomy ◽  
Radioiodine Therapy ◽  
Graves Disease ◽  
Transplacental Passage ◽  
The Third ◽  
Thyroid Stimulating Immunoglobulins ◽  
Thyroid Ablation ◽  
Neonatal Hyperthyroidism ◽  
History Of

AbstractNeonatal hyperthyroidism generally arises as a result of active maternal Graves’ disease via transplacental passage of thyroid stimulating immunoglobulins (TSI). On occasions, production of these antibodies may continue after thyroid ablation, either surgically or with radioiodine therapy. We present data concerning three patients (two of them twins) whose mothers had previously undergone near-total thyroidectomy prior to conception. Two of the neonates had neonatal hyperthyroidism due to persistence of TSI in the mother, and the third due to relapse of the maternal Graves’ disease during pregnancy. We recommend monitoring TSI during pregnancy in mothers with a history of Graves’ disease, even if they are in a state of post-surgical hypothyroidism.

Thyroid Stimulating Immunoglobulins: Measurement and Clinical use

1985 ◽  
Vol 69 (2) ◽  
pp. 113-121 ◽  
Author(s):  
C. A. Ollis ◽  
S. Tomlinson ◽  
D. S. Munro
Keyword(s):  
Thyroid Hormones ◽  
Elevated Serum ◽  
Serum Levels ◽  
The Other ◽  
Graves Disease ◽  
Clinical Use ◽  
Hormone Production ◽  
Skin Changes ◽  
Thyroid Stimulating Immunoglobulins ◽  
Eye Involvement

Graves’ disease is the commonest form of hyperthyroidism in which excessive production of thyroid hormones by the hyperplastic overactive thyroid gland produces elevated serum levels of the thyroid hormones tri-iodothyronine (T3) and thyroxine (T4). Many of the manifestations of Graves’ disease, increased basal metabolic rate, increased heart rate, heat intolerance, sweating and nervousness, can be attributed to the peripheral actions of the excess thyroid hormones. The pathogenesis of many of the other dramatic features of Graves’ disease, such as the eye involvement or localized skin changes, is not fully understood, but circulating immunoglobulins with thyroid stimulating activity are almost certainly linked to excess thyroid hormone production and thereby cause the hyperthyroidism.

scholarly journals TREMORS MIMICKING ATRIAL FLUTTER IN AN ELDERLY LADY

2022 ◽  
Vol 54 (4) ◽  
pp. 370-372
Author(s):  
Intisar Ahmed ◽  
Hunaina Shahab ◽  
Aamir Hameed Khan
Keyword(s):  
Chest Pain ◽  
Sinus Rhythm ◽  
Hospital Stay ◽  
Atrial Flutter ◽  
Normal Sinus Rhythm ◽  
Correct Diagnosis ◽  
Normal Sinus ◽  
Inappropriate Treatment ◽  
History Of

A 77 -year-old lady with history of hypertension and Parkinson`s disease was admitted with cough and fever and diagnosed as pneumonia. On second day of admission, she started having chest pain, initial ECG was interpreted as atrial flutter. When her ECG was reviewed by a cardiologist, ECG features were found to be consistent with artifacts due to tremors. A repeat 12 leads ECG clearly demonstrated normal sinus rhythm and the patient remained completely asymptomatic throughout the hospital stay. Tremor induced artifacts can be mistaken for arrhythmias. Correct diagnosis is important, in order to avoid inappropriate treatment and unnecessary interventions.

scholarly journals Rhabdomyolysis Induced by Nonstrenuous Exercise in a Patient with Graves’ Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Sarawut Summachiwakij ◽  
Issac Sachmechi
Keyword(s):  
Differential Diagnosis ◽  
Periodic Paralysis ◽  
Graves Disease ◽  
Past Medical History ◽  
Thyrotoxic Periodic Paralysis ◽  
Radioiodine Uptake ◽  
Thyroid Stimulating Immunoglobulins ◽  
History Of ◽  
Brown Urine ◽  
Thyroid Ophthalmopathy

Hyperthyroidism can result in several musculoskeletal conditions such as thyrotoxic periodic paralysis, thyrotoxic myopathy, and thyroid ophthalmopathy. Rhabdomyolysis has been rarely reported to be associated with hyperthyroidism. We describe a 33-year-old man who presented with bilateral thigh pain and dark brown urine after regular squatting. He had a past medical history of hyperthyroidism but stopped taking it 2 months prior to admission. He was found to have rhabdomyolysis, myoglobinuria, and thyrotoxicosis. Presence of thyroid-stimulating immunoglobulins (TSI) and high radioiodine uptake confirmed a diagnosis of Graves' disease. He received aggressive fluid resuscitation and sodium bicarbonate intravenously along with monitoring fluid and electrolyte. Methimazole was also resumed. The patient responded to treatment and rhabdomyolysis gradually resolved. Therefore, nonstrenuous exercise can potentially induce rhabdomyolysis in patients with hyperthyroidism. Although hyperthyroidism is not widely recognized as a cause of rhabdomyolysis, it should be considered in the differential diagnosis of rhabdomyolysis.

scholarly journals THYROID ACROPACHY: A RARE MANIFESTATION OF GRAVES DISEASE IN JOINTS

2019 ◽  
Vol 5 (6) ◽  
pp. e369-e371 ◽  
Author(s):  
Nicolas Perini ◽  
Roberto Bernardo Santos ◽  
João Hamilton Romaldini ◽  
Danilo Villagelin
Keyword(s):  
Elevated Serum ◽  
Clinical Signs ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Free T4 ◽  
Tissue Edema ◽  
Rare Manifestation ◽  
Small Joint ◽  
History Of ◽  
Hands And Feet

Objective: The objective of this report was to describe a patient with Graves acropachy, a rare manifestation of Graves disease (GD) that is clinically defined by skin tightness, digital clubbing, small-joint pain, and soft tissue edema progressing over months or years with gradual curving and enlargement of the fingers. Methods: The patient was evaluated regarding thyroid function (serum free T4 [FT4] and thyroid-stimulating hormone [TSH] quantifications) and autoimmunity biomarkers (thyroid receptor antibody [TRAb]) as well as radiographic investigation of the extremities. Results: A 52-year-old man presented with a history of thyrotoxicosis and clinical signs of Graves orbitopathy. Laboratory tests showed suppressed TSH (0.01 UI/L; normal, 0.4 to 4.5 UI/L) and elevated serum FT4 (7.77 ng/dL; normal, 0.93 to 1.7 ng/dL), with high TRAb levels (40 UI/L; normal, <1.75 UI/L). A diagnosis of thyrotoxicosis due to GD was made and the patient was treated with methimazole. After the patient complained of swelling in hands and feet, X-ray evaluation was conducted and established the thyroid acropachy. Conclusion: We present a case of a patient with GD associated with worsening extrathyroid manifestations during orbitopathy, dermopathy, and developed acropachy in hands and feet.

A Case Report of Atrial Fibrillation Potentially Induced by Hydroxycut

2010 ◽  
Vol 23 (3) ◽  
pp. 245-249 ◽  
Author(s):  
Abigail Karth ◽  
Noa Holoshitz ◽  
Clifford J. Kavinsky ◽  
Richard Trohman ◽  
Brian F. McBride
Keyword(s):  
Atrial Fibrillation ◽  
Weight Loss ◽  
De Novo ◽  
Normal Sinus Rhythm ◽  
Regulatory Oversight ◽  
Normal Sinus ◽  
Patients At Risk ◽  
Ventricular Response ◽  
History Of ◽  
Dietary Weight Loss

Multicomponent dietary weight loss supplements comprise the single largest segment of herbal preparations available to the public. As a result of limited de novo regulatory oversight, supplement-related adverse events are underreported secondary to the lack of adequate pharmacodynamic, pharmacokinetic, and clinical data. Here we report the case of an obese 63-year-old caucasian female with a 2-day history of symptomatic paroxysmal atrial fibrillation (AF) with rapid ventricular response following a 2-week course of therapy with hydroxycut, a multicomponent dietary weight loss supplement devoid of sympathomimetic amines. Upon presentation, the patient received 2 doses of intravenous diltiazem, was loaded with intravenous digoxin, and spontaneously converted to normal sinus rhythm 36 hours following her last dose of the product. Epigallocatechin (EGCG), a principal ingredient in the hydroxycut preparation is the suspected causative component. EGCG blocks the atrial-specific KCNA5 potassium channel. Loss of KCNA5 function has been reported in patients with familial lone AF. Thus, causal relationship between hydroxycut and AF in this patient is probable. Given the serious risks associated with AF, patients at risk of developing AF should avoid dietary supplements containing EGCG until more information on the adverse effects of EGCG is known.

Ventricular activation in normal sinus rhythm: Abnormalities with recurrent sustained tachycardia and a history of myocardial infarction

1985 ◽  
Vol 55 (8) ◽  
pp. 974-979 ◽  
Author(s):  
William J. Untereker ◽  
Scott R. Spielman ◽  
Harvey L. Waxman ◽  
Leonard N. Horowitz ◽  
Mark E. Josephson
Keyword(s):  
Myocardial Infarction ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
Normal Sinus ◽  
Ventricular Activation ◽  
History Of

scholarly journals Endocan - a potential diagnostic marker for early onset sepsis in neonates

2019 ◽  
Vol 13 (04) ◽  
pp. 311-317 ◽  
Author(s):  
Gabriela Ildiko Zonda ◽  
Radu Zonda ◽  
Andrei Tudor Cernomaz ◽  
Luminita Paduraru ◽  
Andreea Luciana Avasiloaiei ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Early Onset ◽  
Neonatal Intensive Care ◽  
Clinical Signs ◽  
Serum Levels ◽  
Clinical Suspicion ◽  
Low Concentrations ◽  
Early Onset Sepsis ◽  
Pregnancy And Delivery ◽  
History Of

Introduction: Neonatal early onset sepsis assessment is based on the history of pregnancy and delivery and nonspecific clinical signs. None of the biomarkers currently in use for clinical practice has adequate prognostic value, so it is not possible to clearly distinguish neonates with culture-proven sepsis from those with only risk factors or clinical suspicion. Endocan is an endothelial mediator involved in the inflammatory response that is present in low concentrations in the serum of healthy subjects, and in much higher concentrations in patients with SIRS and septic shock. The purpose of this study is to evaluate the utility of serum endocan serum levels as a biomarker for the diagnosis of neonatal early onset sepsis (EOS). Methodology: Serum endocan concentration was measured in newborns with clinical suspicion of EOS admitted to the Neonatal Intensive Care Unit on day 1, 3 and 7. Results: Serum endocan levels were significantly increased in septic compared to non-septic neonates in the early stages of sepsis (2.43 ± 0.95 vs. 1.77 ± 0.57, p = 0.004), continued to rise up to 72 hours from onset and then decreased by the seventh day under treatment. Conclusions: These results suggest a potential role for endocan as an early marker for diagnosis and follow-up in neonatal EOS. Studies on a larger number of cases are needed in order to establish the practical utility of this molecule as a diagnostic tool for clinical practice.

scholarly journals A Case report of hemodynamic instability, cardiac arrest, and acute severe dyspnea subsequent to inhalation of crystal methamphetamine

2019 ◽  
Author(s):  
Farhad Gholami ◽  
Seyed Hamzeh Hosseini ◽  
Amirhossein Ahmadi ◽  
Maryam Nabati
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Normal Sinus Rhythm ◽  
Hemodynamic Instability ◽  
Acute Dyspnea ◽  
Crystal Methamphetamine ◽  
Electrical Shock ◽  
Mechanically Ventilated ◽  
Normal Sinus ◽  
History Of

Misuse of stimulants similar to amphetamine is a universal problem. These stimulants cause many complications in their abusers. However, myocardial infarction is rarely reported as a complication of amphetamine abuse. Herein, we report a man aged 42 years presented at the Emergency Department with the chief complaint of acute dyspnea following ice inhalation without history of dyspnea. Within the first hour and a half of admission, the patient was treated by nasal oxygen and bronchodilator aminophylline. However, he did not respond to the initial treatment and lost his consciousness; showed ventricular fibrillation, cardiac arrest, and hemodynamic instability. So, cardiopulmonary resuscitation was immediately initiated for him. The patient was intubated, mechanically ventilated. Also, the synchronized electrical shock was delivered 5 times (200-360 J) along with amiodarone (300 mg intravenously [IV] stat, then 1 mg/min IV infusion for 6 hours and next 0.5 mg/min for 18 hours) to treat the ventricular fibrillation. The arrhythmia was subsequently controlled, and his normal sinus rhythm was resumed. Two hours later, condition of the patient improved, and he was extubated. After two days, when the patient got stable, the echocardiography was performed, which was completely normal.

scholarly journals TO DETERMINE THE ROLE OF RANOLAZINE FOR RHYTHM CONTROL STRATEGY IN PATIENTS WITH NON- VALVULAR ATRIAL FIBRILLATION- AN OBSERVATIONAL STUDY FROM A TERTIARY CARE CENTER. (RANOVA STUDY)

2020 ◽  
pp. 48-53
Author(s):  
Praveen Shukla ◽  
Awadhesh Kumar Sharma ◽  
Biswajit Majumder ◽  
Pritam Kumar Chatterjee ◽  
Vinay Krishna ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Control Strategy ◽  
Normal Sinus Rhythm ◽  
Rhythm Control ◽  
Normal Sinus ◽  
History Of ◽  
Group A ◽  
Group B

Objectives – Non- valvular atrial fibrillation (NVAF) is the most commonly occurring arrhythmia worldwide .Ranolazine is an emerging drug with a ray of hope in the management of NVAF. This is the first large observational study with longer follow up of one year. Methods - It is a hospital based observational prospective study. A total of 100 patients was recruited for the study .The primary objective was to determine the efficacy of ranolazine in converting NVAF to sinus rhythm & the secondary objective was to study epidemiological aspects of NVAF. Results –After 1 month of follow up conversion to normal sinus rhythm was 12% in group A & 6% in group B (6%), it was not significant statistically (Z=1.48p=0.13). After 6 months, conversion to normal sinus rhythm was increased from 12% to 18% in group A which was preserved at 12 months of follow up and statistically significant and higher than that of group B (6.0%) (Z=2.61p=0.009). In predisposing risk factors & other co-morbidities HTN was present in 61%, obesity together with overweight in 37%, smoking in 44%, history of moderate amount of alcohol intake in 35%, history of CVA/TIA in 13%, DM in 11%, CKD in 4%, CAD in 30%, COPD in 20% and congestive heart failure in 15% of the patients. Conclusion- Ranolazine is an effective option when used for rhythm control strategy in NVAF. HTN is the predominant predisposing risk factor.

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