Our findings supported the hypothesis of antioxidant beneficial effects of Se in AIT. However, it was not superior to vitamin C, regarding its effects on thyroid-specific antibodies.

IntroductionPrimary adrenal lymphoma is rare, with a few cases reported in the literature. Most often it manifests as bilateral adrenal lesions and adrenal insufficiency is a common complication.Case PresentationA 53-year-old male was referred with abdominal discomfort and darkening of the skin since 1 month prior to admission. His workups detected large bilateral adrenal masses. The patient was admitted due to hypotension, and was diagnosed with adrenal insufficiency. Laboratory studies showed high erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), and adrenocorticotropin levels. There was no other organ involvement and computed tomography (CT)-guided percutaneous biopsy of the adrenal gland revealed B-cell type of non-Hodgkin lymphoma. Replacement therapy with glucocorticoid and mineralocorticoid was initiated with remission of symptoms. After 3 months of chemotherapy his condition improved, but the patient worsened thereafter and died 2 months later.ConclusionsHowever, this case reminded the importance of considering primary adrenal lymphoma in the differential diagnosis of bilateral adrenal masses, especially if the patient presents with adrenal insufficiency.

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Background: Thyroid nodules are common in clinical practice. They are usually benign, but malignancy must be ruled out. Fine needle aspiration (FNA) biopsy of the thyroid is a rapid and cost-effective procedure in the initial evaluation of a thyroid nodule, but its results may be inaccurate in 10% to 30% of cases. This prospective observational study was conducted to determine the prevalence of thyroid cancer, its related findings, and the diagnostic accuracy of preoperative FNA in a tertiary care center. Methods: We prospectively studied the medical records of 345 subjects, who underwent thyroid resection in the university hospital setting over a 4-year period. Age, gender, FNA and pathologic reports, and whether the lesion was multinodular or a solitary nodule were determined. Results: The sensitivity and specificity of FNA were 64.96% and 62.76%, respectively. The positive predictive value of the test for the diagnosis of malignant nodules was 59.30% and its negative predictive value was 68.20%. In 63.5% of the patients, the preoperative FNA matched the surgical histopathology results. The presence of multinodular goiter was an important risk factor for thyroid malignancy. Fifty-two subjects had papillary microcarcinoma and the rate of aggressive behavior was considerable in this group. Conclusions: Although fine needle aspiration biopsy is the most important step in the workup of the thyroid nodules, it may miss a significant number of malignant lesions. Therefore, there is a mandatory need to evolve other clinical and laboratory adjuncts, which assists the clinicians with the interpretation of FNA more accurately.

Background Recurrent aphthous stomatitis (RAS), a common disease of the oral mucosa, can be painful and reduce the quality of life. Since many investigations have focused on the autoimmune origins of RAS, we aimed to investigate the relationship between RAS and autoimmune thyroid diseases (ATDs) in an Iranian population. Methods A cross-sectional study was done on 102 patients diagnosed with ATD (case) and 102 healthy patients (control) who had been referred for their routine dental treatments. All participants were asked for the history of RAS and their age, gender, other systemic diseases, medications, and frequency of RAS in a year. Matching was done based on propensity score for age and gender. Also, the number of lesions in each recurrence in both groups has been assessed and compared. The type of thyroid disease has been assessed for case participants and has been confirmed by the endocrinologist. The chi-square test, T-test, and Man-Whitney test were used to analyze the data by SPSS 18. Results The patients with ATD had more RAS in comparison to healthy controls (P = 0.040). ATD patients had 1.93times more risk for RAS, and the frequency of RAS in a year was 3.15times higher in these patients (P = 0.011). Moreover, the frequency of RAS was higher in patients with hypothyroidism than in patients with hyperthyroidism (P = 0.03). However, there were no significant differences regarding the size and the number of lesions between the groups. Conclusion The risk and frequency of RAS was significantly higher in patients with ATDs. However, the size and the number of lesions had no relationship to ATD.

Backgrounds: Increasing age is the most significant risk factor for Alzheimerʾs disease and depletion of sex hormones is an important consequence of normal aging. This study aimed to investigate the serum level of sex hormones and gonadotropins in patients with Alzheimerʾs disease in comparison with the control group. Materials and Methods: This case-control study was conducted between October 2010 and November 2011 in Shiraz Mottahari Clinic. Fifty-one patients with Alzheimer’s disease and 49 age-matched volunteers without dementia participated in this survey. Both groups were evaluated by two neurologists according to DSM- IV criteria. Blood samples were taken after 12 hours fasting to measure serum levels of estradiol, testosterone, gonadotropins and sex hormone binding globulin (SHBG). Results: Eighteen females and 33 males in the patient group, and 23 females and 26 males in the control group participated. There were no significant differences between the two groups regarding their gonadotropins, estradiol, free androgen index and body mass index, but the mean level of SHBG in patients was significantly higher than the control group (P=0.03). In addition, male patients had a higher total testosterone mean compared to male subjects in the control group (P=0.02). Conclusion: Our findings regarding testosterone levels in males of two groups were contrary to some of the previous surveys in this area. Moreover, we found higher levels of SHBG in patients compared to the control subjects. Further investigation is needed to define whether and how changes of sex hormones can affect brain health and vulnerability to Alzheimer’s disease.[GMJ.2015;4(4):139-45]