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

Graves' disease was found in a 41-year-old, married male patient with Klinefelter's syndrome. The patient began having finger tremor 5 years previously, and developed palpitation and weight loss 3 months prior to examination. He had a diffuse goiter, exophthalmos, and atrial fibrillation. Plasma levels of T3, T4 and free T4 were 2.8 ng/ml, 16.6 micrograms/dl and 4.5 ng/dl respectively. [123I] uptake was 53%, and TSH receptor antibody was 75%. Although he had no gynecomastia, his general physical appearance was that of typical eunuchoism. Chromosome studies showed a karyotype of 47,XXY. A diagnosis of Graves' disease associated with Klinefelter's syndrome was made.
 ...
PMID:A case of Graves' disease associated with Klinefelter's syndrome. 212 24

An 11-year-old girl with diffuse goiter is presented. She had no clinical evidence of thyrotoxic symptoms or signs of palpitation, excessive sweating, tachycardia or finger tremor. Both the serum T4 (24.0 micrograms/dl) and T3 (282ng/dl) were high, and thyroid 131I uptake rate (63.2%) was significantly elevated, but T3/T4 ratio was not elevated (11.8). BMR was measured three times and remained within normal limits. Her serum TSH was 1.9 microU/ml, and a TRH stimulation test resulted in a normal rise of serum TSH (13.4 microU/ml). The TSH secretion was not suppressed by medication (p.o.) of 75 micrograms of L-triiodothyronine given for 8 days. The autoantibodies of T4, T3 and TSH were negative. No sign of pituitary tumor was observed by plain X-ray film. No defect in her sight-field was found. From these clinical figures and data, Refetoff's syndrome was suspected. She was eumetabolic without any treatment, but the goiter gradually enlarged and dysphagia developed. A large dose of L-thyroxine (450 micrograms/day) was given for a period of one year and four months. She has been eumetabolic. Her goiter disappeared and the dysphagia completely subsided. After she was given large doses of L-T4, her serum TSH was reduced to 0.07 microU/ml and was slightly elevated to 0.24 microU/ml at 30 min after i.v. infusion of 500 micrograms TRH. Thyroid 123I uptake rate was suppressed to 8.3%. According to Refetoff's papers, this case was classified as being in the group with generalized resistance to thyroid hormone.
 ...
PMID:[A case report of Refetoff's syndrome]. 259 12

We report a rare case of Basedow's disease associated with high output heart failure and angina pectoris over the age of 80 years. An 85-year-old woman was admitted with palpitation, finger tremor, hyperidrosis and weight loss. Basedow's disease was diagnosed by physical (diffuse goiter) and laboratory (free T3 19.4 pg/ml, free T4 > 8.0 ng/dl, TSH < 0.1 microU/ml, TRAb positive, 123I uptake high) findings and was treated with methimazole. Chest oppression and dyspnea on exertion with negative T wave, cardiomegaly and pulmonary congestion appeared after methimazole. Cardiac catheterization showed a high cardiac output (CI 5.01/min/m2, PCW 26 mmHg, PA 57/26 mmHg, RA 15 mmHg) and a significant coronary stenosis (LAD [symbol: see text] 99%). High output heart failure and angina pectoris responded to treatment. They subsequently worsened, because she stopped taking methimazole for a month and serum levels of thyroid hormones increased again. After retreatment with methimazole, serum levels of thyroid hormones decreased to within normal limits, and high output heart failure and angina pectoris also improved.
 ...
PMID:[An 85-year-old case of Basedow's disease associated with high output heart failure and angina pectoris]. 864 96

A 50-year-old woman was transported to a hospital complaining of marked general malaise and epigastralgia with diarrhea and vomiting. Her electrocardiogram showed sinus arrest with a duration of nearly 8 sec. Atrial pacing with an external pacemaker improved her symptoms promptly. Following transfer to our hospital 3 days later, bradyarrhythmia was not detected despite the removal of the external pacemaker. Transient atrial fibrillation was found in our hospital, and she was diagnosed as hyperthyroidism based on findings of finger tremor, exophthalmos, diffuse goiter and an abnormally high level of thyroid hormone. On cardiac catheterization, left ventriculography showed anterior wall hypokinesis and mild mitral regurgitation. Coronary arteriography showed the absence of organic stenosis. Right ventricular endomyocardial biopsy showed myocardial hypertrophy and partial disarray, but no findings of myocarditis. Electrophysiological study showed the normal upper range of AH-time (120 msec) and HV-time (50 msec), and prolongation of corrected sinus recovery time (CSRT, 955 msec). After a euthyroid state was successively induced for about 10 days by methylmercaptoimidazole therapy, AH-time, HV-time and CSRT were shortened to 85, 35 and 290 msec respectively. Her complaints and sick sinus syndrome disappeared after the treatment of hyperthyroidism without a pacemaker.
 ...
PMID:Hyperthyroidism complicated with sick sinus syndrome. 878 74

A 39-year-old female suffered from diffuse goiter, palpitation, finger tremor and body weight loss for about one year. Then she developed acute onset of myalgia and swelling of calves, and muscle weakness of proximal limbs. She could not walk because of myalgia and muscle weakness, and was admitted to our hospital 4 days after the onset of muscle symptoms. On admission, her pulse was 110 per minute and she had finger tremor of 11-12 Hz. The thyroid gland was markedly and diffusely enlarged with an elastic soft surface. She presented muscle weakness of proximal limbs and neck, and had intermittent swelling and myalgia on calves. Deep tendon reflexes were increased in all extremities. The erythrocyte sedimentation rate was 22 mm per hour. Eosinophilia was not recognized. Serum CK level was elevated to 671 IU/l. Serum free T3 was higher than 21.7 pg/ml and free T4 was also elevated to 10.19 ng /dl. Serum TSH was lower than 0.05 microU/ml and thyroid stimulating antibody was 1,302.0%. Muscle biopsy of her left gastrocnemius muscle revealed markedly hypertrophic fascia with inflammatory cellular infiltration on HE staining. Inflammatory change was also recognized in muscle tissue and in perivascular region of perimysium. Variation of fiber size, necrotic fibers, and central nuclei were also seen. From these clinical and laboratory findings she was diagnosed as having Basedow's disease associated with fasciitis and polymyositis. Her thyroid function was improved by anti-thyroid drug, and swelling and myalgia of sural regions and weakness of proximal limbs were also improved by steroid therapy. Only one case of Basedow's disease associated with fasciitis and seven cases of that associated polymyositis have so far been reported. This is the first case report of fasciitis associated with Basedow's disease and polymyositis.
 ...
PMID:[A case of fasciitis associated with Basedow's disease and polymyositis]. 959 6

Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare hyperthyroidism complication much more frequent in Asians and Caucasians. We present 3 cases of THPP occurring in Brazilian male patients with 28 years old (y) (Case 1), 29 y (Case 2) and 60 y (Case 3), respectively. They were admitted following an episode of flacid paralysis of extremities. Whereas case 1 reported recurring episodes of paralysis crises, cases 2 and 3 reported only one episode. Signs and symptoms of thyrotoxicosis, such as weigh loss, diaphoresis, extremities tremor, palpitation and mild diffuse goiter were present in the first case; while the second case only presented ophthalmopathy and the third patient referred that 2 years before his admission he presented an episode of cardiac arrhythmia but did not have thyroid function evaluation at that time. Their laboratory findings were hypokalemia, low TSH and raised free T4. They were treated with intravenous potassium, oral propranolol and tiamazol with remission of the symptoms. We report these cases to emphasize the importance of recognizing hyperthyroid periodic paralyses to avoid missing a treatable and curable condition.
 ...
PMID:[Thyrotoxic hypocalemic periodic paralysis: report of 3 cases]. 1576 66

We analyzed the clinical and laboratory data of 106 children (17 boys and 89 girls, 11.7 +/- 3.4 years old) with newly diagnosed Graves' disease at Chang-Gung Children's Hospital in Taiwan from 1995 to 2005. The earliest age of disease onset was 3.36 years old, and incidence progressively increased throughout childhood, with a peak at 15 years old. Forty-six (48%) of 95 children had a positive family history of thyroid disorders. We divided the children into three groups according to pubertal stage: prepubertal (Tanner stage 1), 34 (32%); pubertal (Tanner stage 2-4), 13 (12%); and postpubertal (Tanner stage 5), 59 (56%). The most common presentations were diffuse goiter, heat intolerance, sweating, palpitations, and weight loss despite an increase in appetite, but there were no significant differences among the three groups. Neuropsychiatric symptoms such as nervousness, hyperactivity and poor school performance are common features in these children. Height standard deviation score (0.33 +/- 1.35) revealed tall stature (0.39 +/- 1.66 in the prepubertal group, -0.066 +/- 0.63 in the pubertal group, and 0.40 +/- 1.23 in the postpubertal group). Bone maturation also was accelerated in all three groups (bone age/chronological age 1.09 +/- 0.22, 1.07 +/- 0.20, and 1.08 +/- 0.08), but there were no significant differences between groups. Body mass index (standard deviation score) was low in all three groups (-0.49 +/- 1.10, -0.68 .0.63, and -0.13 +/- 0.98), with no significant differences between groups. Tachycardia (96%), goiter (94%), fine tremor (92%), bruit (66%), hypertension (63%), and exophthalmos (60%) were the most frequent symptoms. Laboratory findings yielded undetectable TSH levels (<0.03 microIU/mL), increased FT4 (5.54 +/- 2.26 ng/dL), TT4 (18.37 +/- 4.79 microg/dL), and TT3 (450.4 +/- 202.2 ng/dL), with no significant differences between groups. The prevalences of positive TBII, AMCA, and TGAB were 96%, 95%, and 71%, respectively. In conclusion, we did not find any differences in the presentation of Graves' disease among prepubertal, pubertal, and postpubertal patients. An awareness of symptoms is necessary for prompt diagnosis and management of Graves' disease because the disease can seriously interfere with children's growth and development.
 ...
PMID:Clinical and laboratory findings at initial diagnosis in pediatric Graves' disease in Taiwan. 1692 32