Endocrinology and Metabolism

Original Articles

Clinical Study
Obesity and Hyperglycemia in Korean Men with Klinefelter Syndrome: The Korean Endocrine Society Registry: Seung Jin Han, Kyung-Soo Kim, Wonjin Kim, Jung Hee Kim, Yong-ho Lee, Ji Sun Nam, Ji A Seo, Bu Kyung Kim, Jihyun Lee, Jin Ook Chung, Min-Hee Kim, Tae-Seo Sohn, Han Seok Choi, Seong Bin Hong, Yoon-Sok Chung; Endocrinol Metab. 2016;31(4):598-603. Published online December 20, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.4.598

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Background

The aim of this study was to investigate the prevalence of obesity in Korean men with Klinefelter syndrome (KS) and the associated risk factors for obesity and hyperglycemia.

Methods

Data were collected retrospectively from medical records from 11 university hospitals in Korea between 1994 and 2014. Subjects aged ≥18 years with newly diagnosed KS were enrolled. The following parameters were recorded at baseline before treatment: chief complaint, height, weight, fasting glucose level, lipid panel, blood pressure, testosterone, luteinizing hormone, follicle-stimulating hormone, karyotyping patterns, and history of hypertension, diabetes, and dyslipidemia.

Results

Data were analyzed from 376 of 544 initially enrolled patients. The rate of the 47 XXY chromosomal pattern was 94.1%. The prevalence of obesity (body mass index ≥25 kg/m²) in Korean men with KS was 42.6%. The testosterone level was an independent risk factor for obesity and hyperglycemia.

Conclusion

Obesity is common in Korean men with KS. Hypogonadism in patients with KS was associated with obesity and hyperglycemia.

Citations

Citations to this article as recorded by

A dual-center study of predictive factors for sperm retrieval through microdissection testicular sperm extraction and intracytoplasmic sperm injection outcomes in men with non-mosaic Klinefelter syndrome
Jong Hyeun Baeck, Tae Jin Kim, Tae Heon Kim, Seung-Ryeol Lee, Dong Soo Park, Hwang Kwon, Ji Eun Shin, Dong Hyeon Lee, Young Dong Yu
Investigative and Clinical Urology.2023; 64(1): 41. CrossRef
Cardiorespiratory fitness in adolescents and young adults with Klinefelter syndrome – a pilot study
Julia Spiekermann, Kathrin Sinningen, Beatrice Hanusch, Michaela Kleber, Michael M. Schündeln, Cordula Kiewert, Heide Siggelkow, Jakob Höppner, Corinna Grasemann
Frontiers in Endocrinology.2023;[Epub] CrossRef
Metabolic Profile in a Cohort of Young Sicilian Patients with Klinefelter’s Syndrome: The Role of Irisin
Stefano Radellini, Valentina Guarnotta, Vincenzo Sciabica, Giuseppe Pizzolanti, Carla Giordano, Vito Angelo Giagulli
International Journal of Endocrinology.2022; 2022: 1. CrossRef
Metabolic and Nutritional Aspects in Paediatric Patients with Klinefelter Syndrome: A Narrative Review
Chiara Mameli, Giulia Fiore, Arianna Sangiorgio, Marta Agostinelli, Giulia Zichichi, Gianvincenzo Zuccotti, Elvira Verduci
Nutrients.2022; 14(10): 2107. CrossRef
Klinefelter syndrome in an adolescent with severe obesity, insulin resistance, and hyperlipidemia, successfully treated with testosterone replacement therapy
Shota Fukuhara, Jun Mori, Hisakazu Nakajima
Clinical Pediatric Endocrinology.2021; 30(3): 127. CrossRef
Glucose metabolic disorder in Klinefelter syndrome: a retrospective analysis in a single Chinese hospital and literature review
Shixuan Liu, Tao Yuan, Shuoning Song, Shi Chen, Linjie Wang, Yong Fu, Yingyue Dong, Yan Tang, Weigang Zhao
BMC Endocrine Disorders.2021;[Epub] CrossRef
What Every Internist-Endocrinologist Should Know about Rare Genetic Syndromes in Order to Prevent Needless Diagnostics, Missed Diagnoses and Medical Complications: Five Years of ‘Internal Medicine for Rare Genetic Syndromes’
Anna G. W. Rosenberg, Minke R. A. Pater, Karlijn Pellikaan, Kirsten Davidse, Anja A. Kattentidt-Mouravieva, Rogier Kersseboom, Anja G. Bos-Roubos, Agnies van Eeghen, José M. C. Veen, Jiske J. van der Meulen, Nina van Aalst-van Wieringen, Franciska M. E. H
Journal of Clinical Medicine.2021; 10(22): 5457. CrossRef
Klinefelter Syndrome and Diabetes
Mark J. O’Connor, Emma A. Snyder, Frances J. Hayes
Current Diabetes Reports.2019;[Epub] CrossRef
Endocrine aspects of Klinefelter syndrome
Adriana Herrera Lizarazo, Michelle McLoughlin, Maria G. Vogiatzi
Current Opinion in Endocrinology, Diabetes & Obesity.2019; 26(1): 60. CrossRef
Sex differences in metabolism and cardiometabolic disorders
Karthickeyan Chella Krishnan, Margarete Mehrabian, Aldons J. Lusis
Current Opinion in Lipidology.2018; 29(5): 404. CrossRef
Klinefelter Syndrome: Integrating Genetics, Neuropsychology, and Endocrinology
Claus H Gravholt, Simon Chang, Mikkel Wallentin, Jens Fedder, Philip Moore, Anne Skakkebæk
Endocrine Reviews.2018; 39(4): 389. CrossRef
Sex differences in obesity, lipid metabolism, and inflammation—A role for the sex chromosomes?
Temeka Zore, Maria Palafox, Karen Reue
Molecular Metabolism.2018; 15: 35. CrossRef
Klinefelter syndrome, insulin resistance, metabolic syndrome, and diabetes: review of literature and clinical perspectives
Andrea Salzano, Roberta D’Assante, Liam M. Heaney, Federica Monaco, Giuseppe Rengo, Pietro Valente, Daniela Pasquali, Eduardo Bossone, Daniele Gianfrilli, Andrea Lenzi, Antonio Cittadini, Alberto M. Marra, Raffaele Napoli
Endocrine.2018; 61(2): 194. CrossRef
Síndrome de Klinefelter y riesgo cardiovascular
A. Yamaguchi, P. Knoblovits
Hipertensión y Riesgo Vascular.2018; 35(4): 195. CrossRef
Articles inEndocrinology and Metabolismin 2016
Won-Young Lee
Endocrinology and Metabolism.2017; 32(1): 62. CrossRef
Sex differences in obesity: X chromosome dosage as a risk factor for increased food intake, adiposity and co-morbidities
Karen Reue
Physiology & Behavior.2017; 176: 174. CrossRef
Klinefelter Syndrome with Morbid Obesity Before Bariatric Surgery: A Case Report
Parisa Janmohammadi, Gholamreza Mohammadi-Farsani, Hana Arghavani, Mahmoud Arshad, Tayebeh Mokhber
Journal of Minimally Invasive Surgical Sciences.2017;[Epub] CrossRef
Klinefelter Syndrome and Metabolic Disorder
Ji Cheol Bae
Endocrinology and Metabolism.2016; 31(4): 535. CrossRef

Clinical Study
Electrolyte Imbalance in Patients with Sheehan's Syndrome: Chur Hoan Lim, Ji Hyun Han, Joon Jin, Ji Eun Yu, Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; Endocrinol Metab. 2015;30(4):502-508. Published online December 31, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.4.502

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Abstract PDF PubReader

Background

We investigated the prevalence of electrolyte imbalance and the relationship between serum electrolyte and anterior pituitary hormone levels in patients with Sheehan's syndrome.

Methods

In a retrospective study, we investigated 78 patients with Sheehan's syndrome. We also included 95 normal control subjects who underwent a combined anterior pituitary hormone stimulation test and showed normal hormonal responses.

Results

In patients with Sheehan's syndrome, the serum levels of sodium, potassium, ionized calcium, magnesium, and inorganic phosphate were significantly lower than those in control subjects. The prevalence of hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia, and hypophosphatemia in patients with Sheehan's syndrome was 59.0% (n=46), 26.9% (n=21), 35.9% (n=28), 47.4% (n=37), and 23.1% (n=18), respectively. Levels of sodium and ionized calcium in serum were positively correlated with levels of all anterior pituitary hormones (all P<0.05). Levels of potassium in serum were positively correlated with adrenocorticotrophic hormone (ACTH) and growth hormone (GH) levels (all P<0.05). Levels of inorganic phosphate in serum were positively correlated with levels of thyroid-stimulating hormone, prolactin, and GH (all P<0.05), and levels of magnesium in serum were positively correlated with delta ACTH (P<0.01).

Conclusion

Electrolyte imbalance was common in patients with Sheehan's syndrome. Furthermore, the degree of anterior pituitary hormone deficiency relates to the degree of electrolyte disturbance in patients with this disease.

Citations

Citations to this article as recorded by

Myopathic syndrome revealing a rare condition: Sheehan syndrome, a case-based review
Elena Gradinaru, Catalin Furculescu, Andreea Trandafir, Daniela Opris-Belinski, Ioana Cristina Saulescu
Clinical Rheumatology.2023; 42(6): 1705. CrossRef
Partial Sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report
Prashant Yadav, Md Anwarul Bari, Akash Saha, Sushmita Yadav, Amzad H. Khan
Annals of Medicine & Surgery.2023; 85(3): 548. CrossRef
Acute pituitary crisis after lumbar surgery: A case report
Hui Wang, Xingrui Gong
Medicine.2023; 102(48): e36294. CrossRef
Long-term hepatic and cardiac health in patients diagnosed with Sheehan’s syndrome
Liza Das, Jayaprakash Sahoo, Neelam Dahiya, Sunil Taneja, Sanjay Kumar Bhadada, Mohammad Hayat Bhat, Paramjeet Singh, Vanita Suri, Bashir Ahmad Laway, Pinaki Dutta
Pituitary.2022; 25(6): 971. CrossRef
Clinical, endocrine, metabolic profile, and bone health in Sheehan's syndrome
Soumita Mandal, Pradip Mukhopadhyay, Mainak Banerjee, Sujoy Ghosh
Indian Journal of Endocrinology and Metabolism.2020; 24(4): 338. CrossRef
A rare endocrine cause of electrical storm - a case report
Sunny D Shinde, Girish R Sabnis, Charan P Lanjewar, Prafulla G Kerkar
European Heart Journal - Case Reports.2017;[Epub] CrossRef
Sheehan syndrome
Züleyha Karaca, Bashir A. Laway, Hatice S. Dokmetas, Hulusi Atmaca, Fahrettin Kelestimur
Nature Reviews Disease Primers.2016;[Epub] CrossRef

Increased Carotid Intima-Media Thickness is Associated with Progression of Diabetic Nephropathy in Patients with Type 2 Diabetes.: Dong Hyeok Cho, Jin Ook Chung, Dong Jin Chung, Min Young Chung; Endocrinol Metab. 2011;26(4):310-316. Published online December 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.4.310

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Abstract PDF

BACKGROUND
Cardiovascular risk is higher among people with diabetic nephropathy than among those with normal renal function. Carotid intima-media thickness (IMT) is an independent predictor of cardiovascular mortality in type 2 diabetic patients. However, the relationship between carotid IMT and diabetic nephropathy is not well known. The aim of our study was to elucidate whether carotid IMT is associated with progression of diabetic nephropathy in type 2 diabetic patients. METHODS: We recruited a total of 354 type 2 diabetic patients with diabetic nephropathy. Renal function was evaluated by serum creatinine levels, estimated glomerular filtration rate (eGFR), and urinary albumin/creatinine ratio (ACR). Carotid IMT was assessed using B-mode ultrasound by measuring generally used parameters. Baseline-to-study end changes in eGFR were calculated, and the yearly change of eGFR (mL/min/yr) was computed. RESULTS: Age, diabetes duration, ACR, and eGFR were significantly correlated with mean or maximal carotid IMT; however, lipid profiles, HbA1c, and blood pressure were not correlated. The mean yearly eGFR change was -4.9 +/- 5.3 mL/min/yr. The yearly eGFR change was negatively correlated with mean and maximal carotid IMT. After adjusting for age and diabetes duration, the mean IMT is an independent predictor of yearly eGFR change. CONCLUSION: Carotid IMT may be a predictor of diabetic nephropathy progression in patients with type 2 diabetes.

Citations

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Cardiovascular disease and stroke risk assessment in patients with chronic kidney disease using integration of estimated glomerular filtration rate, ultrasonic image phenotypes, and artificial intelligence: a narrative review
Ankush D. JAMTHIKAR, Anudeep PUVVULA, Deep GUPTA, Amer M. JOHRI, Vijay NAMBI, Narendra N. KHANNA, Luca SABA, Sophie MAVROGENI, John R. LAIRD, Gyan PAREEK, Martin MINER, Petros P. SFIKAKIS, Athanasios PROTOGEROU, George D. KITAS, Andrew NICOLAIDES, Aditya
International Angiology.2021;[Epub] CrossRef
Proteinuria as a significant predictive factor for the progression of carotid artery atherosclerosis in non-albuminuric type 2 diabetes
Young-eun Kim, Minyoung Lee, Yong-ho Lee, Eun Seok Kang, Bong-soo Cha, Byung-Wan Lee
Diabetes Research and Clinical Practice.2021; 181: 109082. CrossRef

Case Report

Spontaneous Hypoglycemia due to Insulin Antibody after Insulin Treatment of Diabetic Ketoacidosis.: Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; Endocrinol Metab. 2010;25(3):217-220. Published online September 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.3.217

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Abstract PDF

Hypoglycemia in diabetic patients is usually caused by excessive exogenous insulin or the administration of an insulin secretagogue relative to the prevailing glucose concentration. Thus, the clinical manifestations of hypoglycemia are usually not observed in diabetic patients after either insulin or an oral hypoglycemic agent is discontinued. In contrast, diabetic ketoacidosis results from relative or absolute insulin deficiency. Although about 40% of diabetic patients who inject human insulin have insulin antibodies, these antibodies seldom significantly affect the glycemic control. It has not been reported in the literature that insulin antibody in the setting of human insulin therapy is associated with diabetic ketoacidosis and subsequent hypoglycemia. We describe here a rare case of spontaneous hypoglycemia due to insulin antibody after the improvement of diabetic ketoacidosis in a patient with type 2 diabetes mellitus and who had been treated with human insulin.

Citations

Citations to this article as recorded by

Type 1 diabetes complicated with cyclic vomiting syndrome and exogenous insulin antibody syndrome: A case report
Leiluo Geng, Xue Diao, Hao Han, Ying Lin, Wei Liang, Aimin Xu
Frontiers in Endocrinology.2022;[Epub] CrossRef
Insulin Glulisine May Cause a Disease Resembling Insulin Autoimmune Syndrome: Case Report
Maki Kawasaki, Yoichi Oikawa, Takeshi Katsuki, Yusuke Kabeya, Masuomi Tomita, Mari Okisugi, Akira Shimada
Diabetes Care.2013; 36(12): e195. CrossRef
Insulin Autoimmune Syndrome with Diabetic Ketoacidosis
Yeong Geol Jo, Young Il Kim, Su Jin Lee, Ki Won Kim, Sung Wan Chun, Yeo Joo Kim, Sang Jin Kim
Journal of Korean Diabetes.2012; 13(2): 105. CrossRef

Original Article

Determining the Factors that Influence the Insulin Requirements in Type 2 Diabetic Patients.: Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; Endocrinol Metab. 2010;25(2):110-118. Published online June 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.2.110

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Abstract PDF

BACKGROUND
The initial insulin dose is often determined by clinical experience or with a formula using the body weight. However, it may be difficult to determine the initial insulin dose because various factors such as insulin sensitivity and the glycemic status can influence the insulin requirement. The purpose of this study was to assess the factors that influence the initial insulin requirement in insulin naive patients with type 2 diabetes mellitus. METHODS: A total 128 patients who were admitted for glycemic control were investigated. The patients were managed with long-acting insulin glargine and rapid-acting insulin lispro. RESULTS: The basal insulin requirement was positively correlated with waist circumference, body mass index (BMI), the HbA1C, AST, ALT, fasting plasma glucose and 2-hour postprandial glucose levels and the homeostasis model assessment of insulin resistance (HOMA-IR), but it was negatively correlated with age and the stimulated C-peptide level. The daily insulin requirement was positively correlated with waist circumference, BMI, the HbA1C, AST, ALT, triglyceride, fasting plasma glucose and 2-hour postprandial glucose level and HOMA-IR, but it was negatively correlated with age. On the multiple linear regression analysis, the basal insulin requirement was independently associated with BMI (beta = 0.507, p < 0.001), the 2-hour postprandial glucose level (beta = 0.307, p < 0.001), the ALT level (beta = 0.214, P = 0.015) and the meal-stimulated C-peptide level (beta = -0.209, P = 0.010). The daily insulin requirement was independently associated with BMI (beta = 0.508, p < 0.001) and the 2-hour postprandial glucose level (beta = 0.404, p < 0.001). CONCLUSION: Our results show that the BMI and 2-hour postprandial glucose level are useful predictors of the initial insulin requirement in insulin naive type 2 diabetic patients. It may be prudent to consider the other various factors that influence the insulin requirement together when insulin therapy is required.

Citations

Citations to this article as recorded by

Effects of Sunsik Prepared through Steaming-Drying Cycles on Blood Glucose and Inflammatory Marker in Rats Fed High Fat
Kyung-Hee Hwang
Journal of the East Asian Society of Dietary Life.2015; 25(1): 111. CrossRef
The Effects of Chungkukjang Powder Supplements on the Regulation of Blood Glucose and Inflammation in Diabetic Rats
Kyung-Mi Yang
Korean journal of food and cookery science.2015; 31(2): 118. CrossRef

Case Report

Aortic Intramural Hematoma Associated with Primary Aldosteronism.: Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; J Korean Endocr Soc. 2009;24(3):217-220. Published online September 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.3.217

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Abstract PDF: Intramural hematoma of the aorta is a variant of aortic dissection characterized by the absence of direct communication between the false lumen and the true lumen of the aorta. Primary aldosteronism, which is an uncommon cause of hypertension, may direct alter arterial structure through the pleiotropic effects of aldosterone as well as pressure-mediated indirect alterations. There have been several reported cases of aortic dissection in patients with primary aldosteronism, which suggests a causal relationship between the two diagnostic entities. However, intramural hematoma has not been described in a patient with primary aldosteronism. We describe a case of aortic intramural hematoma in a patient with primary aldosteronism and speculate about the causal relationship between these two entities.

Original Article

Glucose Counterregulatory Hormone Response During Hypoglycemia due to Endogenous Hyperinsulinemia.: Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; J Korean Endocr Soc. 2009;24(3):174-180. Published online September 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.3.174

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Abstract PDF

BACKGROUND
In patients with hypoglycemia due to endogenous hyperinsulinemia such as insulinoma or insulin autoimmune syndrome, little is known about the counterregulatory hormone response to spontaneous hypoglycemia. We therefore compared hormone responses during spontaneous hypoglycemia due to endogenous hyperinsulinemia with those at the end of a 72-hour fast. METHODS: We measured glucagon, epinephrine, cortisol, and growth hormone responses during spontaneous hypoglycemia in 8 patients with insulinoma and 18 patients with insulin autoimmune syndrome. We also assessed these responses in 13 normal control subjects who underwent a 72-hour fast. RESULTS: In patients with insulinoma (median serum glucose level, 35.0 mg/dL), plasma glucagon levels (median, 42.9 vs. 76.2 pg/mL, respectively; P < 0.05) were lower than those in control subjects (serum glucose level, 62.5 mg/dL), whereas, there were no statistically significant differences in the other hormone responses between the two groups. In contrast, in the patients with insulin autoimmune syndrome (median serum glucose level, 34.5 mg/dL), plasma glucagon levels (median, 73.7 vs. 76.2 pg/mL, respectively) were lower than those in the control subjects, but there was no statistically significant difference between the two groups. There were no statistically significant differences in counterregulatory hormone responses during spontaneous hypoglycemia between patients with insulinoma and patients with insulin autoimmune syndrome. CONCLUSION: Our results suggest that defective glucagon secretion in patients with insulinoma rather than insulin autoimmune syndrome may contribute to hypoglycemia in addition to hyperinsulinemia.

Citations

Citations to this article as recorded by

Glycogenic hepatopathy in a Korean girl with poorly controlled type 1 diabetes mellitus
Hwal Rim Jeong, Young Seok Shim, Young Bae Kim, Hae Sang Lee, Jin Soon Hwang
Annals of Pediatric Endocrinology & Metabolism.2014; 19(1): 49. CrossRef
Glucose Counterregulatory Hormone Response During Hypoglycemia due to Endogenous Hyperinsulinemia
Jung Guk Kim
Journal of Korean Endocrine Society.2009; 24(3): 162. CrossRef

Case Reports

A Case of Slipped Capital Femoral Epiphysis in Association with Panhypopituitarism after Treatment of Craniopharyngioma.: Jin Ook Chung, Se In Hong, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; J Korean Endocr Soc. 2008;23(3):193-198. Published online June 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.3.193

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Abstract PDF

Craniopharyngioma accounts for 2~5% of all primary intracranial neoplasms. It may present with a variety of manifestations including neurological, visual, and/or hypothalamic-pituitary dysfunction. Treatment options include radical surgery or radiotherapy, or a combination of these modalities. Craniopharyngioma ablation results in anterior and/or posterior pituitary hormone deficits. Slipped capital femoral epiphysis (SCFE), in which the femoral head slips downward and backward on the femoral neck at the epiphyseal plate, most commonly occurs during the rapid growth phase of puberty. Its actual cause is unknown, but the clinical association between SCFE and endocrine disorders is well known. We report a case of an adult male patient who developed SCFE in association with panhypopituitarism after treatment of a craniopharyngioma.

Citations

Citations to this article as recorded by

A Case of Slipped Capital Femoral Epiphysis in Association With Craniopharyngioma
Mehran Soleymanha, Ali Karimi, Seyed Mojtaba Mehrdad
Trauma Monthly.2015;[Epub] CrossRef
Panhypopituitarism due to craniopharyngioma with bilateral slipped capital femoral epiphysis
Sun Woo Kim, Young-Jin Song, Eun Jeong Choi, Dong Hee Han, Hyun Yon Jung, Sung Hoon Yu, Hyung Joon Yoo, Jae Myung Yu
Yeungnam University Journal of Medicine.2014; 31(1): 61. CrossRef

A Case of Adrenal Angiomyolipoma.: Sung Kyun Kim, Woo Seok Lee, Gwi Hong Jeong, Hee Kyung Kim, Dae Sung Myung, Jin Ook Chung, Dong Jin Chung, Min Young Chung, Ho Cheol Kang; J Korean Endocr Soc. 2007;22(5):371-375. Published online October 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.5.371

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Abstract PDF: An angiomyolipoma is a benign mesenchymal neoplasm that typically occurs in the kidney of patients with tuberous sclerosis. Extrarenal angiomyolipomas are uncommon, and the adrenal gland is an extremely rare site for the tumor. An incidental adrenal mass is the usual presentation of an adrenal angiomyolipoma, as most of the tumors are hormonally inactive. Recently we experienced one case of a right adrenal angiomyolipoma that presented with an adrenal incidentaloma. To the best of our knowledge, this is the first case of an adrenal angiomyolipoma described in the Korean medical literature. We report the case with a special emphasis on the differential imaging findings of fat-containing adrenal tumors.

A Case of Primary Hyperparathyroidism due to Cystic Parathyroid Adenoma Presenting as Hypercalcemic Crisis Associated with Intracranial Hemorrhage.: Jin Ook Chung, Gwi Hong Jeong, Se In Hong, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; J Korean Endocr Soc. 2007;22(4):292-298. Published online August 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.4.292

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Abstract PDF

Most patients with hypercalcemia are asymptomatic or they have non-specific symptoms at diagnosis. Yet hypercalcemic crisis is a potentially fatal complication of hyperparathyroidism. Cystic parathyroid adenoma is a rare cause of primary hyperparathyroidism and hypercalcemic crisis. A 52-year-old woman was transferred to our hospital due to her relapsed drowsy mental state and renal insufficiency that occurred in course of her management for intracranial hemorrhage with manitol. The total serum calcium was 16.2 mg/dL and the intact parathyroid hormone was 546 pg/mL. Neck computed tomography showed a 3.1 x 1.8 cm sized cystic mass on the right thyroid lower pole. 99mTc-labelled sestamibi scintigraphy showed no significant uptake. In addition to prompt saline infusion and loop diuretics, the patient was given pamidronate to lower the serum calcium, and she was improved to an alert mental state with normal renal function. Surgical excision of the parathyroid cyst was performed. A histological examination confirmed a cystic parathyroid adenoma. The levels of plasma PTH and serum calcium were normalized after resection.

Citations

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Can Biochemical Markers and Ultrasonographical Diameters Be Used to Predict Histopathological Diagnosis in Patients with Primary Hyperparathyroidism?
Ahmet Dirikoc, Husniye Baser, Burcak Polat, Cevdet Aydin, Aylin Kilic Yazgan, Mehmet Kilic, Didem Ozdemir, Bekir Cakir
Indian Journal of Surgery.2022;[Epub] CrossRef
Preoperative Predictive Factors for Parathyroid Carcinoma in Patients with Primary Hyperparathyroidism
Jae Hyun Bae, Hyung Jin Choi, Yenna Lee, Min Kyong Moon, Young Joo Park, Chan Soo Shin, Do Jun Park, Hak Chul Jang, Seong Yeon Kim, Sang Wan Kim
Journal of Korean Medical Science.2012; 27(8): 890. CrossRef

Papillary Thyroid Cancer Arising in Lateral Aberrant Thyroid Presenting with Multiple Metastases.: Nam Il Cheon, Chang Hun Lee, Se In Hong, Jin Ook Chung, In Seok Yoon, Dong Hyeok Cho, Ho Cheol Kang, Dong Jin Chung, Min Young Chung; J Korean Endocr Soc. 2001;16(4-5):494-501. Published online October 1, 2001

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Abstract PDF: Carcinoma of the thyroid usually presents as a palpable thyroid mass. However, in rare cases patients with thyroid cancer present with metastases of the cervical lymph node as the initial manifestation. The metastatic papillary tumor in cervical lymph nodes stained positive for thyroglobulin indicates the presence of a thyroid carcinoma, usually in the ipsilateral lobe. We herein report a case of multiple metastases in papillary thyroid carcinoma arising in the lateral aberrant thyroid with no evidence of thyroid carcinoma in the thyroid lobe.

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