[Pericardial effusions in the course of thyroid insufficiency. A new case and value of gammagraphy for the diagnosis of pericardial effusion].
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Biomedical subjects
Publications and source records attributed to L M Wolf.
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Hypoglycaemia induced by class IA antiarrhythmic agents has been described. A case of cibenzoline-induced hypoglycaemia with favourable outcome is reported. The patient's age (84 years), increased renal impairment and malnutrition acted as facilitating factors. Blood insulin levels were normal in both absolute and relative values. Therapeutic overdosage in relation to age and renal function has been found in 20 out of 24 cases published or recorded by the French pharmacovigilance system. The mechanism of this hypoglycaemia is uncertain; absolute or relative hyperinsulinism has been detected in only 5 out of 14 controlled cases.
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A 25 year old woman had galactorrhea and secondary amenorrhea since her first pregnancy at 20 years. After several treatments with Clomiphene, menses reappeared for 2 months and she became pregnant. At admission, she was in her 4th pregnancy month and had headaches and bitemporal hemianopsia. Hypophysectomy was performed during 5th pregnancy month. Prolactin adenoma with hemorragic lesions was found. Parturition of normal twins occurred 8th month. Partial hypophyseal recovery took place for the following 2 years, but hyperprolactinemia reappeared too.
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Four cases are reported, of an association between a thyroidal illness (1 hypothyroidism, 3 hyperthyroidism) on one hand, and a lymphocytic proliferation and/or monoclonal gammapathy on the other. The following findings: HLA B8 or DrW3 in 3, antithyroid antibodies at a very high level in 2, and thyroid stimulating immunoglobulin in 2 support the conclusion of thyroidal diseases of auto-immune nature. Simultaneous appearance of both thyroidal and hematologic illness favors the hypothesis of a non coincidental association. A direct thyroidal activity of the monoclonal paraprotein has been found only once among the 4 published and our 2 cases in which it has been studied. A more likely link would be a common physiopathology: a functional deficiency of T suppressor lymphocytes allowing the proliferation of a cellular clone producing an abnormal immunoglobulin, would also allow the development of a thyroidal illness when favored by a genetic predisposition.
The present study aimed at testing the hypothesis that l-dopa could obtain a better growth hormone (G.H.) stimulation than metabolic stimuli in obese patients. Arginine (30 g i-v) and l-dopa (1 g per os) were used in 12 obese, non diabetic, female in patients. No significant difference of plasma G.H. peak level (arginine : 11,3 ng/ml +/- 8.6. L-dopa : 9.2 +/- 5.6) appeared between these two types of stimulation