Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present the clinical description of a 70-year-old man with parkinsonian tremor, which was severely exaggerated by hyperthyroidism. Clinical diagnosis of hyperthyroidism was overshadowed by the parkinsonian symptoms. Anti-thyroid treatment had a beneficial effect on the exaggerated parkinsonian tremor. This case report highlights that thyroid dysfunction should be considered in the differential diagnosis of aggravated tremor in Parkinson's disease which seems refractory to increased dosages of anti-parkinsonian drugs.
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PMID:Hyperthyroidism exaggerating parkinsonian tremor: a clinical lesson. 1597 Apr 53

The aim of this observational prospective study was to assess the incidence rate and the characteristics of adverse drug reactions (ADRs) induced by amiodarone during the long-term follow-up of 98 French patients. Inclusions were performed between March 1994 and April 1997. Eligible patients were consecutive outpatients for whom amiodarone was initiated for the first time. The treatment had to be taken for at least 6 months if no ADR required its withdrawal. A cohort of 57 men and 41 women, mean age 72.6 years (SD: 8.6), was followed for a mean period of 38 months. The incidence rate of ADRs during the overall follow-up period was 13.91 cases for 100 person-years. Recorded ADRs were 13 hypothyroidism (incidence rate for 100 person-years: 4.61 [95% confidence interval: 4.58-4.63], 5 hyperthyroidism (1.62 [1.60-1.63]), 10 bradycardia and/or conduction ADRs (3.48 [3.46-3.50]), 7 photosensitivity (2.27 [2.25-2.28]), 1 storage disease (0.33 [0.32-0.33]), 3 interstitial pneumonitis (0.97 [0.96-0.98]), 2 peripheral neuropathies (0.65 [0.64-0.66]), 1 tremor (0.32 [0.32-0.33]) and 1 gastrointestinal disturbances (0.32 [0.32-0.33])). Thyroid and cardiac ADRs occurred mainly during the first 6 months. According to the French system of pharmacovigilance, 27 ADRs were "probable/likely" and 14 were "possible." Hypothyroidism, cardiac ADRs, and photosensitivity were the most frequent ADRs. None of the ADRs had a fatal outcome in this study.
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PMID:Incidence rate of adverse drug reactions during long-term follow-up of patients newly treated with amiodarone. 1685 66

A 47-year old man presented with atrial fibrillation, weight loss, hand tremor, and hyperperspiration concurrent with the reactivation of the disease activity of myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-associated glomerulonephritis. Laboratory findings indicated that the hyperthyroidism had already existed when glomerulonephritis was detected, and Graves' disease became evident while decreasing the dose of prednisolone. Although the levels of thyroid-stimulating hormone receptor antibody, antithyroid peroxidase antibody, and myeloperoxidase antibody increased, both disease activities were suppressed by increasing the dose of prednisolone. This case indicates that MPO-ANCA-associated glomerulonephritis and Graves' disease may share a common pathogenesis.
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PMID:The onset of Graves' disease during the clinical course of myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-associated glomerulonephritis. 1702 81

A 50-year-old woman was admitted to our hospital because of severe diarrhea, irritableness, and severe pitting edema of the legs. The patient had been well until 5 years before admission, when a tremor and tachycardia developed and a diagnosis of Graves' disease was made. Treatment with methimazole was effective in reducing her tremor and tachycardia; however, she was often nonadherent with her antithyroid medication because of improvement of her symptoms. On admission, a thyroid swelling, exophthalmos, a pleural effusion, and ascites were observed. The results of thyroid function tests (free triiodothyronine: 21.5 pg/mL; free thyroxine: 7.17 ng/dL; thyroid-stimulating hormone (TSH): <0.01 microIU/mL; TSH receptor antibodies: 95.9%) were consistent with Graves' disease. Biochemical analysis of pleural and ascitic fluid was consistent with chylothorax and chylous ascites, respectively. Serum calcium, total protein, and albumin were very low. Her symptoms and signs except severe diarrhea, edema, pleural effusion, and ascites disappeared after receiving intravenous drip infusion of fluid replacement, and methimazole and iodine. Because of malnutrition, she was given a high-calorie intravenous infusion. Three months after admission, her pleural effusion and ascites began to improve, as did her diarrhea and hypoalbuminemia. An appropriate treatment of Graves' disease is crucial to avoid serious sequelae of longstanding, poorly controlled hyperthyroidism.
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PMID:Graves' disease with intractable diarrhea, chylous ascites, and chylothorax: a case report. 1804 23

Typical presentations of hyperthyroidism are palpitation, nervousness, tremor, malaise, and weight loss. Hyperthyroidism affects nearly every system in the body, and some patients may manifest neurologic or hematologic symptoms. Atypical presentations of hyperthyroidism often pose a great challenge in diagnosis and treatment. We report a case of Basedow's paraplegia and pancytopenia that was precipitated by hyperthyroidism. The unusual manifestations led to unnecessary examinations and delayed the treatment of hyperthyroidism. The classical symptoms of Basedow's paraplegia are subacute symmetric weakness of the lower extremities with areflexia and sparing sensation or sphincter involvement. Control of the hyperthyroidism mitigated the neurologic and hematologic complications and prevented unnecessary studies.
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PMID:Rare presentations of hyperthyroidism--Basedow's paraplegia and pancytopenia. 1937 62

Thyroid hemiagenesis is a rare anomaly due to failure of development of one thyroid lobe during embryological life. A lot of thyroid disorders may accompany thyroid hemiagenesis. In this report, we present a case of thyroid hemiagenesis, who had moderate hypercalcemia due to Graves' disease. A 43-year-old woman presented with weight loss of more than 5 kg within one month, heat intolerance, and increased sweating. For the past month, she had been troubled by intermittent symptoms of vomiting, thirst, and constipation. On examination, she had tachycardia with no signs of dehydration. Pulse rate was 110 per minute. She had fine tremor, proximal muscle weakness, and asymmetric smooth goiter and hyperplasia in the right thyroid gland. Thyroid function tests confirmed the diagnosis of hyperthyroidism. Although hypercalcemia may be detected in patients with thyrotoxicosis, to the best of our knowledge, this is the first case report of thyroid hemiagenesis accompanying hypercalcemia due to thyrotoxicosis.
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PMID:Hypercalcemia due to Graves' disease in a patient with thyroid hemiagenesis. 1985 96

A case is presented of a rare complication of hyperthyroidism, known as thyrotoxic hypokalaemic periodic paralysis, in a man from Nepal. A 26-year-old Nepalese man, with known hypokalaemia, was referred to the clinical laboratory services for electrolyte analysis. Results showed Na(+) 120 mmol/l and K(+) 2.8 mmol/l, and he was prescribed potassium chloride. In fact, he had previously been receiving potassium supplementation periodically and his history revealed that he had experienced the same type of attack and was hospitalised 6 months earlier. He had profound tremor and was agitated and irritable during his visit to this hospital. Thyroid function testing showed high T3 (tri-iodothyronine) and T4 (thyroxine) with low thyroid stimulating hormone (TSH) concentration in the serum, indicating thyrotoxic hypokalaemic periodic paralysis. Treatment with neomercazole resulted in an improvement during the follow up visit. Hypokalaemia is believed to be a consequence of a massive shift due to increased sodium-potassium-adenosine triphosphatase (Na(+)K(+)ATPase ) pump activity in the presence of elevated thyroid hormones.
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PMID:Thyrotoxic hypokalaemic periodic paralysis in a man from Nepal. 2189 47

A 50-year-old lady presented with chest pain, tremor, weight loss and intermittent ST elevation in her ECG associated with elevated markers of myocardial injury. She was diagnosed with Graves' disease and coronary angiogram showed normal coronary arteries. It was felt coronary artery spasm secondary to thyrotoxicosis was the cause for her ECG changes and pain. She was successfully treated with diltiazem, metoprolol and carbimazole. This case highlights the importance of considering hyperthyroidism in the diagnosis of chest pain with normal coronary arteries.
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PMID:Coronary artery spasm due to thyrotoxicosis. 2338 37

Hyperthyroidism is an important inducing factor in patients with atrial fibrillation, and may trigger heart failure. Thyrotropin (thyroid stimulating hormone, TSH)-secreting pituitary tumors are rare causes of hyperthyroidism. Here, we report a 66-year-old man with a pituitary TSH-secreting tumor who presented with hyperthyroidism and congestive heart failure. Endonasal trans-sphenoidal pituitary adenomectomy was performed. After the operation, the symptoms of hyperthyroidism and congestive heart failure were relieved, associated with normalization of thyroid function tests. Unfortunately, hand tremor and progressively elevated free T4 and TSH concentrations recurred 5 months after surgery. A dopaminergic agonist, cabergoline was administered and euthyroidism was restored for at least 11 months.
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PMID:Thyrotropin-secreting pituitary tumor presenting with congestive heart failure and good response to dopaminergic agonist cabergoline. 2418 2

Both severe thyrotoxicosis and hypothyroidism may affect brain function and cause a change in consciousness, as seen with a thyroid storm or myxedema coma. However, encephalopathy may also develop in patients with autoimmune thyroid diseases independent of actual thyroid function level, and this is known as Hashimoto's encephalopathy. Although most patients are found to have Hashimoto's thyroiditis, less frequently they have Graves' disease. Clinical manifestations include epilepsy, disturbance of consciousness, cognitive impairment, memory loss, myoclonus, hallucinations, stroke-like episodes, tremor, involuntary movements, language impairment, and gait impairment. Hashimoto's encephalopathy is a relatively rare disease. As a good response can be obtained with corticosteroid therapy, early diagnosis and treatment is very beneficial for patients. Here we report three patients with Hashimoto's encephalopathy with typical manifestations of hallucinations that were associated with hypothyroidism, hyperthyroidism, and euthyroid status, respectively. They all showed a dramatic response to methylprednisolone pulse therapy.
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PMID:Hashimoto's encephalopathy: report of three cases. 2544 53


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