Onset of Marine-Lenhart syndrome and Graves' ophthalmopathy in a female patient treated with alemtuzumab for multiple sclerosis.

CONCLUSION: We present a case of Graves' disease with active, moderate-to-severe Graves' ophthalmopathy in a patient with pre-existing AFTN presenting with a coexisting, rare case of Marine-Lenhart syndrome associated with immune reconstitution after alemtuzumab treatment. PMID: 32500462 [PubMed - as supplied by publisher]
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research

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CONCLUSION: The discrepancy between a clinical exam which is not indicative of thyrotoxicosis and markedly abnormal thyroid function tests should lead to a search for biotin intake, which can interfere with thyroid function tests. PMID: 31813616 [PubMed - as supplied by publisher]
Source: Revue de Medecine Interne - Category: Internal Medicine Tags: Rev Med Interne Source Type: research
ConclusionAmong different categories of ATEs, Graves ’ hyperthyroidism was the most common thyroid dysfunction, occurring in more than half of cases. Antithyroid drugs should represent the first-line treatment for ALZ-induced GD patients. However, alemtuzumab-induced GD could not be considered as having a more favourable outcome than conventional GD , given the substantial chance to encounter a fluctuating and unpredictable course.
Source: Journal of Endocrinological Investigation - Category: Endocrinology Source Type: research
AbstractSelective immunoglobulin A deficiency (SIgAD) is the most common primary immunodeficiency, defined as an isolated deficiency of IgA (less than 0.07  g/L). Although the majority of people born with IgA deficiency lead normal lives without significant pathology, there is nonetheless a significant association of IgA deficiency with mucosal infection, increased risks of atopic disease, and a higher prevalence of autoimmune disease. To explain thes e phenomena, we have performed an extensive literature review to define the geoepidemiology of IgA deficiency and particularly the relative risks for developing systemic...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research
Conclusions: Seizures and encephalopathy are not rare in MOG encephalomyelitis, and are commonly associated with cortical and subcortical brain lesions. MOG-encephalomyelitis often presents with clinical meningoencephalitis symptoms and abnormal CSF findings mimicking central nervous system infection in pediatric and young adult patients. Background Immunoglobulin-G against myelin oligodendrocyte glycoprotein (MOG-IgG) is considered a potential demyelinating disease-associated autoantibody. Previous experimental studies have established MOG-IgG as a pathogenic antigen rather than an epiphenomenal bystander or a secon...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Qiancheng Deng1, Yangyang Luo1,2, Christopher Chang3, Haijing Wu1, Yan Ding4* and Rong Xiao1* 1Hunan Key Laboratory of Medical Epigenetics, Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, China 2Department of Dermatology, Hunan Children's Hospital, Changsha, China 3Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, Davis, CA, United States 4Department of Dermatology, Hainan Provincial Dermatology Disease Hospital, Haikou, China Autoimmune diseases are usually complex and multifactorial, characterized by aberrant produc...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Publication date: Available online 11 January 2019Source: Autoimmunity ReviewsAuthor(s): Silvia Martina Ferrari, Poupak Fallahi, Ilaria Ruffilli, Giusy Elia, Francesca Ragusa, Salvatore Benvenga, Alessandro AntonelliAbstractGraves' disease (GD) and autoimmune thyroiditis (AT) are the two main clinical presentations of AITD, and their clinical hallmarks are thyrotoxicosis and hypothyroidism, respectively. GD, and AT, can be associated with other organ specific, or systemic autoimmune diseases in the same patient. However discordant results have been reported in the literature about the possible associations. Here, we review...
Source: Autoimmunity Reviews - Category: Allergy & Immunology Source Type: research
Conclusions: Despite routine use of alemtuzumab, clinical presentations of AITD seem to be uncommon in CIT patients receiving immunosuppression. However, AITD can develop following withdrawal of immunosuppression, highlighting the need for careful thyroid surveillance in this population. PMID: 30398662 [PubMed - as supplied by publisher]
Source: The Journal of Clinical Endocrinology and Metabolism - Category: Endocrinology Authors: Tags: J Clin Endocrinol Metab Source Type: research
CONCLUSIONS We present evidence that TRAb measured with custom-made assays can be detected prior to any change in thyroid function in up to a third of cases of ALTZ-related TD. Furthermore, The presence of ihTRAb prior to ALTZ treatment was strongly predictive of subsequent TD. Our findings suggest that a period of affinity maturation of TRAb may precede clinical disease onset in some cases. Combined testing of TPOAb and ihTRAb may increase our ability to predict those who will develop thyroid dysfunction post ALTZ. PMID: 30351224 [PubMed - as supplied by publisher]
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
We report on a 47 year old male patient with multiple sclerosis (MS) presenting in our outpatient neurology clinic in Frankfurt/Main for therapy evaluation. Before change of treatment laboratory investigations were performed. Thyroid function tests (TFTs) with a streptavidin/biotin based immunoassay revealed severe hyperthyroidism with positive thyroid autoantibodies suggestive for Graves' disease. Clinical presentation and thyroid sonography were unremarkable. Due to the discordance between clinical presentation and TFTs, we repeated medical history, in which the patient reported taking high-doses of biotin (300 mg/da...
Source: Clinica Chimica Acta - Category: Laboratory Medicine Source Type: research
Biotin is commonly used in immunoassays to measure several hormones and non-hormone analytes, including thyroxine (T4), thyrotropin (TSH), parathyroid hormone, and ferritin [1]. Cases of thyroid function test assay interference have been documented in patients taking high doses of biotin for the treatment of inborn errors of metabolism and progressive multiple sclerosis; euthyroid patients appeared hyperthyroid and a newborn baby with hypothyroidism was misdiagnosed due to the spurious lowering of TSH [2 –4].
Source: Nutrition - Category: Nutrition Authors: Tags: International Ward Rounds Source Type: research
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