Maintenance haemodialysis patients with symptoms of depression may have higher serum IL-6 and lower serum albumin levels. The prevalence of depression was lower in elderly patients at or above 75 years old, and no correlation was found with socio-economic status. Factors including co-morbid conditions, serum IL-6, albumin and age may help predict which patients may be predisposed to develop symptoms of depression.

Background: Elevated alanine aminotransferase (e-ALT) and abnormal liver echogenicity (ab-echo), as determined by sonography, have been linked to metabolic syndrome (MetS). However, which of these is more closely related to MetS, especially among older men, remains unknown.Methods: Data from 3065 men aged 65 years or older who were undergoing a routine health examination and who were not taking any medications for MetS were analyzed retrospectively. The patients were divided into 4 groups: group N (n ‫؍‬ 1228; patients have normal ALT and liver echogenicity); group A (n ‫؍‬ 110; patients have e-ALT but normal liver echogenicity); group E (n ‫؍‬ 1381; patients have ab-echo but normal ALT); group AE (n ‫؍‬ 346; patients have both e-ALT and ab-echo).Results: Among the 3065 subjects, 714 participants were found to have MetS (23.3%). It is not surprising that MetS components were highest in group AE. More interestingly, compared with group A, group E had higher levels of MetS components (except that high-density lipoprotein cholesterol levels were lower). Similar findings were confirmed by logistic regression. Group E had a significantly higher odds ratio of having MetS than group A (2.73; 95% CI, 1.565-4.763).Conclusions: Our data confirm that both e-ALT and ab-echo are related to a higher incidence of MetS among Taiwanese older men. Of these 2 abnormalities, ab-echo seems to be more closely related to MetS. Further studies are needed to elucidate the complex relationships between these factors in other age and ethnic groups. (J Am Board Fam Med 2011;24:407-414.)

The pathogenesis of adult-onset Still's disease (AOSD), which is currently thought to be an autoimmune disorder, may share similarities with autoimmune hyperthyroidism. This report describes a middle-aged woman in whom hyperthyroidism and Still's disease developed concurrently. During the course of her illness, the hyperthyroidism was observed to be aggravated whenever her AOSD was in the active stage. After her AOSD activity was controlled, her hyperthyroidism improved clinically. The extent of activation of her hyperthyroidism was observed in parallel to the extent of activation of her AOSD. Furthermore, the patient developed neutropenia after receiving either propylthiouracil (PTU) or methimazole, both of which are standard accepted medications for treatment of hyperthyroidism. Immune mechanisms contributed to PTU induced neutropenia have been proposed, and hyperthyroid patients treated with standard antithyroid agents should be monitored for blood cell counts especially for AOSD patients. Corticosteroid may effect Graves' disease activity, and steroids may play a role in the treatment of hyperthyroidism if a patient had drug allergies to antithyroid agents.