Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
43 巻, 4 号
選択された号の論文の20件中1~20を表示しています
EDITORIALS
CASE REPORTS
Gastrointestinal Diseases
Cardiovascular Diseases
Endocrine-Metabolic Diseases
  • Shigenori NAKAMURA, Mako ISAJI, Masatoshi ISHIMORI
    2004 年 43 巻 4 号 p. 306-309
    発行日: 2004年
    公開日: 2005/02/04
    ジャーナル オープンアクセス
    A 28-year-old woman with thyroid hemiagenesis, who had been diagnosed as having Graves’ disease, became pregnant during the course of methimazole treatment. The treatment was terminated in the second trimester. She delivered a normal infant at full term. She became thyrotoxic 3 months after the delivery, hypothyroid 6 months after the delivery, and finally euthyroid 11 months after the delivery without undergoing any treatment. This clinical course indicates that she developed silent thyroiditis after the delivery. A diagnosis of thyroid hemiagenesis was made on the basis of ultrasonography of the thyroid and 99mTc-pertechnetate thyroid scintiscan.
  • Munehiro HONDA, Toshihiko TSUKADA, Toshimitsu HORIUCHI, Reiko TANAKA, ...
    2004 年 43 巻 4 号 p. 310-314
    発行日: 2004年
    公開日: 2005/02/04
    ジャーナル オープンアクセス
    A rare case of primary hyperparathyroidism associated with primary aldosteronism and breast cancer is reported. A 44-year-old woman was admitted to our hospital to undergo surgical removal of breast cancer. She had hypertension with low serum potassium, and slightly but significantly elevated serum calcium levels. Further studies demonstrated an enlarged left superior parathyroid gland and a left aldosterone-producing adrenocortical adenoma. Blood pressure was controlled with spironolactone and nifedipine, and left mastectomy was done for breast cancer. The pathological diagnosis was scirrhous breast carcinoma. Although the postoperative course was uneventful, her serum calcium gradually and progressively rose to higher levels. Left superior parathyroidectomy and left adrenalectomy were then performed simultaneously. The pathological diagnoses of the resected parathyroid gland and adrenal gland were parathyroid chief cell adenoma and adrenocortical adenoma with hyperplasia of zona glomerulosa, respectively. To clarify if the occurence of these tumors may be related to MEN1 gene mutations, we analyzed MEN1 gene in this patient, and found a loss of heterozygosity of the MEN1 locus in the parathyroid adenoma and breast cancer. Thus, we conclude that an alteration of the MEN1 gene and/or another tumor suppressor gene located at the MEN1 locus on chromosome 11q13 may be responsible for the development of parathyroid adenoma and breast cancer in our patient suggesting that the clinical spectrum of MEN1 might include breast cancer. In addition, serum calcium should be interpreted with caution in primary aldosteronism, because hypercalcemia may be masked in the presence of aldosterone excess.
Renal Diseases
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SHORT COMMUNICATION
Cardiovascular Disease
PICTURES IN CLINICAL MEDICINE
Endocrine-Metabolic Disease
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