Takotsubo syndrome, which has been recently described by Japanese authors, is characterized by a reversible abnormality of the ventricular wall movement, with a morphological aspect similar to a balloon, or more precisely, from a semantic point of view, to an amphora-like octopus trap, at the apical segment levels of the heart and hypercontraction of the basal segments observed during the coronary arteriography with ventriculography, associated with electrocardiographic ST-T segment alterations, similar to an acute myocardial infarction episode, with minimal elevation of cardiac enzymes, affecting preferentially elderly females and being induced by physical or emotional stress 1 . The diagnosis of this entity is reinforced by the almost complete absence of coronary circulation morphostructural alterations. Another aspect that is noteworthy is the rapid duration of the asynergy of the ventricular wall movement, eventually contrasting with the longer duration of the clinical manifestations. The etiology of the disease is not fully known, and the role of coronary microcirculation involvement at a multivascular level (severe expression of microvascular angina), and, more recently, the possibility of the participation of altered adrenergic catecholamine dynamics at myocardial level has been hypothesized 2,3 . The exceptional circumstances of the case reported here are due to the simultaneous presence of two conditions that are potentially harmful to the heart, i.e., systemic lupus erythematosus and morbid obesity, associated with this unusual form of cardiomyopathy induced by acute stress. Pericardial and endocardial alterations, vasculitis of the coronary circulation as well as congenital heart block in neonatal lupus briefly constitute the classical cardiac alterations of this auto-immune disease. The impact of morbid obesity on the cardiovascular system is basically caused by the effect of systemic arterial hypertension, dyslipidemia, diabetes and hypoxemic pulmonary arterial hypertension, being broadly known aspects of the disease in the specialized literature.
SUMMARY -Peripheral neuropathy is a rare manifestation in hyperthyroidism. We describe the neurological manifestations of a 38 year old female with Graves' disease who developed peripheral neuropathy in the course of her treatment with propylthiouracil. After the drug was tapered off, the neurological signs disappeared. Therefore, we call attention for a possible toxic effect on peripheral nervous system caused by this drug.KEY WORDS: hyperthyroidism, peripheral neuropathy, propylthiouracil.Neuropatía periférica induzida por propiltiouracil.RESUMO -Os autores descrevem o caso de urna paciente de 38 anos de idade, com doença de Graves, que desenvolveu sinais e sintomas compatíveis a polineuropatia sensitivomotora durante o tratamento com propiltiouracil. Após a retirada gradual da referida droga, o quadro neurológico desapareceu por completo. Sendo extremamente incomum o surgimento de neuropatía periférica secundaria ao hipertiroidismo e em vista do uso corriqueiro do propiltiouracil no tratamento dessa enfermidade endocrina, os autores chamam a atenção para a possível participação do fármaco como agente etiológico de neuropatía periférica em enfermos usuários do propiltiouracil. PALAVRAS-CHAVE: hipertiroidismo, neuropatía periférica, propiltiouracil.Hyperthyoroidism is a common disease in medical practice and is frequently associated to various neurological and neuromuscular disorders, the commonest of them is proximal myopathy 1. Thyrotoxic neuropathy is extremely rare and this association is questioned by several authors. Some publications describe this entity clinically and electrophysiologically i» 2 .5. It was first described as Basedow's paraplegia by Charcot in 1889, and Joffroy in 18941.Neurological disturbances associated to propylthiouracil (PTU) are rare. Vertigo, paresthesia, dysesthesia are described but there is no known direct neurotoxic effect of the drug capable of determining neuropathy i.Meyer-Gessner and colleagues 4 , in a series of 1256 patients during antithyroid treatment, reported peripheral neuropathy in 0.7%, of cases, not mentioning which drug was implicated in this disorder. In this brief report
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.