- A Case of Adrenal Insufficiency Associated with Antiphopholipid Syndrome with SLE.
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Sun Hye Shin, Jung Hee Kim, Jung Min Son, Jeong Su Kim, Min Ah Na, Yang Ho Kang, Ok Nyu Kong, Seok Dong Yoo, Seok Man Son, In Ju Kim, Yong Ki Kim
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J Korean Endocr Soc. 2004;19(5):542-545. Published online October 1, 2004
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- Systemic lupus erythematosus (SLE) is autoimmune disease that often develops antiphopholipid syndrome (APS). Lupus anticoagulant and anticardiolipin antibodies are the hallmarks of APS. The hypercoagulable state in APS may lead to adrenal vein thrombosis, and subsquently lead to hemorrhagic necrosis of the adrenal gland. Adrenal hemorrhage is a very rare complication of APS. Although there have been some reports about adrenal hemorrhage associated with primary APS, adrenal hemorrhage associated secondary APS in SLE has not yet been reported. We describe the adrenal hemorrhage associated with secondary APS in SLE, and the patient which complained of general weakeness, nausea, vomiting and diffuse abdominal pain. Abdominal magnetic resonance imaging (MRI) showed hemorrhage, of both renal glands, and clinical features and immunological studies were consistent with APS in SLE. The acute adrenal insufficiency was much improved after the patient was treated with glucocorticoids
- Usefulness of Thallium-201 Scintigraphy for Differentiating Benign and Malignant Thyroid Nodules in Inconclusive Cases with Fine Needle Aspiration.
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Young Sil Lee, Chang Won Lee, Mi Hwa Jang, Ju Won Seok, Seok Man Son, Seok Dong Yoo, In Joo Kim, Yong Ki Kim
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J Korean Endocr Soc. 2001;16(4-5):447-456. Published online October 1, 2001
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Abstract
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- BACKGROUND
Although fine needle aspiration(FNA) is recognized as the most accurate procedure in the differential diagnosis of thyroid nodules, about 20~30% of nodules remain inconclusive in FNA. Therefore, we assessed the usefulness of Thallium-201 scintigraphy in differentiating benign from malignant thyroid nodules in patients with inconclusive diagnosis by FNA. METHODS: We studied 43 patients with inconclusive diagnosis(29 of follicular neoplasm, 11 of cystic change and 3 of inadequate) by FNA, with the results being confirmed histopathologically by operation. Thallium-201 scintigraphy was performed at 15 minutes(early scan) and 2-3 hours(late scan) after the intravenous administration of 37 MBq of thallium-201. Malignant nodules were defined by the retention of Thallium-201 on delayed images. RESULTS: In the 43 patients with inconclusive FNA diagnosis, Thallium-201 scan had a sensitivity of 75.0%, specificity of 62.9% and accuracy of 65.1%. The positive and negative predictive values were 31.6% and 91.7%, respectively. In the 29 patients with follicular neoplasm by FNA, Thallium-201 scan had a sensitivity of 83.3%, specificity of 60.9% and accuracy of 65.5%. The positive and negative predictive values were 35.7% and 93.3%, respectively. CONCLUSION: In particular, Thallium-201 scintigraphy demonstrated a high negative predictive value, Therefore, for patients with inconclusive FNA findings, Thallium-201 scintigraphy might be useful in differentiating between benign and malignant thyroid nodules, and has the potential to reduce the rate of unnecessary operations in benign nodules.
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