- The Change of Pulmonary Artery Pressure in Graves'Disease Before and After Treatment.
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Taek Man Nam, Han Soo Cho, Jin Seo Lee, Young Rim Song, Doo Man Kim, Young Cheoul Doo, Cheol Young Park, In Kyung Jeong, Eun Gyung Hong, Seong Jin Lee, Gi Weon Oh, Hyeon Kyu Kim, Jae Myung Yu, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park
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J Korean Endocr Soc. 2003;18(5):465-472. Published online October 1, 2003
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 Abstract
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- BACKGROUND
Exertional symptoms, dyspnea and impaired effort tolerance are common in patients with Graves' disease. Proposed explanations include: high-output left heart failure, ineffective oxygen utilization and respiratory muscle weakness. In addition, pulmonary hypertension has also been reported in patients with Graves' disease. A high prevalence of hypothyroidism and positive thyroid autoantibody were also observed in patients with pulmonary arterial hypertension. Therefore, the pulmonary artery pressure in patients with Graves' disease was evaluated. METHODS: Two-dimensional and Doppler echocardiographic examinations (Hewlett Packard Sonos 2500) were performed to determine the pulmonary artery (PA) pressure in 26 Graves' disease patients, both before and after treatment (23 patients with propylthiouracil and 3 with RAI), and in 10 euthyroid controls. The changes in the PA pressure after treatment were evaluated in 13 patients with Graves' disease, who became euthyroid after treatment. RESULTS: The pulmonary artery pressure was increased in the untreated Graves' disease patients compared to the normal controls (23.5+/-2.32 vs. 29.6+/-10.3 mmHg). 38.5% of the Graves' disease patients (10/26) showed pulmonary arterial hypertension (PA>30 mmHg) and the serum TBII levelwas higher in the Graves' disease patients with pulmonary arterial hypertension than in those with normal PA pressure (P<0.05). In the Graves' patients who became euthyroid after treatment, the PA pressure was significantly decreased. CONCLUSION: 38.5% of the untreated Graves' disease patients showed pulmonary arterial hypertension, and the pulmonary artery pressure was significantly decreased in those who became euthyroid after treatment. The pathogenesis and clinical importance of pulmonary arterial hypertension in Graves' disease requires further studies.
- A Case of Cerebral Salt Wasting Syndrome associated with Tuberculous Meningitis.
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Seung Hyuk Rho, Ji Yong Choi, Taek Man Nam, Hyeon Kyu Kim, Seong Jin Lee, In Kyung Jeong, Eun Gyung Hong, Cheol Soo Choi, Doo Man Kim, Jae Myung Yu, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park, Hyoung Cheol Kim
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J Korean Endocr Soc. 2002;17(5):698-704. Published online October 1, 2002
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Abstract
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- Hyponatremia in patients with central nervous system disorders is suggestive of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and volume restriction is recommended for its correction. However, if volume depletion is present in a situation otherwise compatible with SIADH, cerebral salt wasting syndrome (CSWS) should be considered as the cause of the hyponatremia to avoid hypovolemic shock that may be induced by the standard management of SIADH, i.e. volume restriction. We present a case of a 17-year-old male patient with CSWS associated with tuberculous meningitis. The clinical feature of the patient comprised hyponatremia, excessive natriuresis, polyuria, and hypovolemia. Following the administration of saline and fludrocortisone, natriuresis and polyuria were decreased, and the hyponatremia improved
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