Biomedical subjects
Publications and source records attributed to M Izembart.
Authors have selected 1928 measurements of thyroglobulin and studied their value in the thyroid pathology. They show that elevated values of thyroglobulin, the only one response in this pathology, can, even if isolated, be the mode of revelation of thyroid illness. They insist, in order to explain this fact, on the presence of a "sixth factor" which depends upon the quality of the thyroid tissue.
A systematic study of antibodies directed against thyroglobulin on one side, and against microsomes on the other side, was made during two consecutive years on a hospital population of out patients supposed to suffer from a thyroid affection: about one fourth of the serums is positive for at least one of the two antibodies; the benefit of searching antimicrosomal antibodies is capital, but the simultaneous research of thyroglobulin antibodies is necessary. The consequences of this screening are developed in three main pathologic fields: hypothyroidism (real frequency of Hashimoto's disease in spontaneous myxodema); hyperthyroidism (prognostic implications of antibodies presence); normothyroid subjects (screening of clinical thyroid abnormalities).
The objective of this retrospective survey is a mini-computer system conceived ten years ago to treat all numerical information coming from a hospital unit of clinical biology. The options that we chose for its function remain valid on at least two patients: the necessity, for the hardware, to dissociate the treatment of information from the listing of voluminous files (the former should be done in the real time, using a mini-computer system situated inside the department, and the latter should be done in differed time, using a more sophisticated machine situated in a common computer center); the necessity, for the software, to use a common global system, but it cn be cut down to suit the particular need of individual user with whom there should be a permanent collaboration. The results obtained during this time are discussed. They seem sufficiently positive to invite a appraisal re-examination of the use of such systems (in spite of some disenchantment at present), in the light of new possibilities from present progress in shared time computer system.
Thyroid function was studied in 3 groups of adults (group I = 13 burned patients treated with non iodinated antiseptic, group II = 15 burned patients treated with polyvidone iodine, group III = 50 control subjects) in order to examine: the thyroid hormone status in burned patients, the possible incidence of plasma iodine overload on these endocrine parameters. Burned skin area and thyroid function were measured before treatment, then weekly for 3 weeks. Before treatment a decrease in plasma T4 and T3 with an increase in reverse T3 (rT3) and a decrease in plasma thyroxin binding globulin (TBG) were observed in burned patients. Free T4 index (T4/TBG) was normal, but T3 resin uptake (T3RU) was elevated. During treatment, plasma iodine increase sharply from 6.4 +/- 0.4 to 20.7 +/- 4.7 micrograms/100 ml (p less than 0.02) in group II. Endocrine parameters (not different between group I and II) progressively returned to normal, except for T3RU which remained elevated until the third week. rT3, T4 and T3RU correlated (p less than 0.001) with burned skin area. To conclude, the reversible particularities of thyroid function in burned patients are positively correlated with burned area. The thyroid function does not seen to be modified by plasma iodine overload.
OBJECTIVE: To determine the prognostic value of suppressed thyrotropin (TSH) level and positive TSH-receptor antibodies (TSH-R Ab) in patients with Graves' disease who have long-lasting clinical remission. METHODS: We retrospectively studied patients with Graves' disease who underwent follow-up for a mean of 55 months after the withdrawal of antithyroid drug treatment. Study patients were 84 consecutive subjects in clinical remission, with normal serum free thyroxine (FT(4)) and free triiodothyronine (FT(3)) levels, regardless of serum TSH levels, a mean of 35 months (range, 6 to 135) after discontinuation of carbimazole therapy. Eighty-seven euthyroid subjects were used as control study participants. All subjects had serum determinations of FT(4) and FT(3) (radioimmunoassay), TSH (highly sensitive immunoradiometric method), TSH-R Ab (radioreceptor assay), and microsomal antibodies (M Ab, passive hemagglutination method). RESULTS: In the study patients, serum TSH was suppressed (</=0.10 mU/L) in 13 cases (15%), TSH-R Ab were positive (>/=15%) in 11 cases (13%), and M Ab were positive (>/=1:100) in 54 cases (64%). Simultaneous suppressed TSH and positive TSH-R Ab levels were present in six patients. During the follow-up, 11 patients had a relapse, demonstrated by above-normal values for serum FT(4) and FT(3) in association with clinical symptoms of hyperthyroidism. Five of them had a previously suppressed TSH level, three had a positive TSH-R Ab level, and six had a positive M Ab titer. Relapse was significantly more likely in patients with a previously suppressed TSH level (P<0.02) but not in patients with a previously positive TSH-R Ab level or positive M Ab titer. CONCLUSION: Patients with Graves' disease and long-lasting clinical remission after discontinuation of carbimazole therapy may have a suppressed TSH level, a positive TSH-R Ab level, or a positive M Ab titer (or some combination of these findings). Although positive TSH-R Ab and M Ab have no significant prognostic value, a suppressed TSH level is indicative of subclinical hyperthyroidism and higher risk of relapse.
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