The Influence of Thyroidectomy on Alimentary Glycosuria

McCurdy, J. D.

doi:10.1084/jem.11.6.798

Cited by 9 publications

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“…Environmental factors, such as stress (9) , smoking (10) , and dietary iodine intake (3) have been implicated in the development of Graves ' disease in genetically susceptible individuals. As early as 1909, studies have provided evidence suggesting that thyroid hormone has an oppositional effect on glucose utilization and catabolism (11) . Although there is very little in the pediatric literature displaying this effect, glucose derangements have been well demonstrated in adult patients diagnosed with Graves ' hyperthyroidism (12) .…”

Section: Discussionmentioning

confidence: 99%

Hyperthyroidism presenting with hyperglycemia in an adolescent female

Wintergerst

Rogers

Foster

2011

Journal of Pediatric Endocrinology and Metabolism

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A 15-year-old female presented to a pediatric emergency department with glycosuria, ketonuria, and hyperglycemia and was admitted with a presumed diagnosis of diabetes mellitus. The patient required no insulin therapy and only minor dietary modifi cation to maintain euglycemia. Clinical examination and laboratory fi ndings revealed a primary diagnosis of Graves ' hyperthyroidism with associated impaired glucose tolerance. Here, we review the mechanisms of thyrotoxicosis resulting in impaired glucose metabolism.A 15-year-old white female presented to her pediatrician ' s offi ce for a routine sports physical examination where a urine dipstick analysis detected 2 + glycosuria and 1 + ketonuria. A blood glucose measurement was obtained by glucometer and was found to be 154 mg/dL (8.6 mmol/L) at 08:52 h. At this time, her blood pressure was 130/74 with a heart rate of 100, and the physical examination was reported as normal. Presuming a diagnosis of diabetes mellitus, she was referred for direct admission to Kosair Children ' s Hospital for inpatient education and management. Upon admission, at 11:52 h, her initial bedside blood glucose was 102 mg/dL (5.7 mmol/L) with serum laboratory studies obtained 1 h later that revealed normal electrolytes, including a glucose level of 106 mg/dL (5.9 mmol/L). As per the hospital protocol for patients with new-onset diabetes mellitus, a hemoglobin A1c (HbA1c), c-peptide level, glutamic acid decarboxylase (GAD) 65 antibody, insulin autoantibody, islet cell antibody, and thyroid function studies were drawn (Tables 1 and 2 ). Insulin was withheld due to euglycemia.A detailed medical history revealed no evidence of polyuria, nocturia, polydipsia, polyphagia, or weight loss. In fact, her mother reported a 10 -15 (~5-7 kg) pound weight gain along with an apparent three inch growth spurt over the past year. Her mother had also noted an increased level of anxiety over this past year, but the patient denied a history of any other symptoms, including heart palpitations, tremors, heat or cold intolerance, gastrointestinal complaints, fatigue, or sleep disturbances. She reported no recent or chronic illnesses, medical problems, prior hospitalizations or surgeries, and was taking no home medications, vitamins or herbal supplements. The family history was signifi cant for asthma, type 2 diabetes mellitus, and Hashimoto ' s thyroiditis.The admission physical examination revealed a well-developed and nourished adolescent female with a weight of 61 kg (79 % ), height of 164.5 cm (67 % ), and a body mass index (BMI) of 22.5 (76 % ). Blood pressure was 128/82 (90 % -95 % for height-age), heart rate was 83, and her temperature was 98.2 ° F. Abnormal examination fi ndings included a symmetrically enlarged thyroid gland that was fi rm to palpation, mobile with swallowing, and without evidence of dominant modularity. No thyroid bruit was auscultated. Her ophthalmic, cardiovascular and neurologic examinations were normal.Shortly after admission, thyroid study results revealed an underlying diagnosis of ...

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Section: Discussionmentioning

confidence: 99%

Hyperthyroidism presenting with hyperglycemia in an adolescent female

Wintergerst

Rogers

Foster

2011

Journal of Pediatric Endocrinology and Metabolism

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Adiposis and Lipomatosis

Lyon¹

1910

Arch Intern Med (Chic)

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BUFFALO, N. Y. SynopsisIntroduction. Personal observations (20 cases, 19 photographs). Consideration of special clinical varieties or syndromes\p=m-\groups of cases. Group I. Adiposis dolorosa. Group II. Obesity. Group III. Nodular circumscribed lipomatosis. Group IV. Diffuse symmetrical lipomatosis (Fetthals, Madelung; ad\l=e'\no-lipomatosesym\l=e'\trique \l =a`\ pr\l=e'\dominance cervicale, Launois and Bensaude). Group V. Neuropathic edema, pseudoedema, pseudolipoma and lipoma. Group VI. Adipositas cerebralis (Fr\l=o"\hlich,Madelung and others). Consideration of the combined groups.General summary (including special subjects, arthritism, heredity, etc.). Etiology (including glands of internal secretion). Treatment. Conclusions. Bibliography. PERSONAL OBSERVATION Case 1.\p=m-\Summary.\p=m-\Typical case of Dercum's syndrome, elephantiac form. Woman, 61; family history of insanity; enormous diffuse adiposity limited to legs, thighs and hips; marked tenderness; asthenia; deafness; rheumatoid pains; insanity; suicide.

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