Document Detail


Clinical presentation of thyroid dysfunction and Addison's disease in young adults with type 1 diabetes.
MedLine Citation:
PMID:  10646024     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In a clinic population of 509 type 1 diabetic patients aged 16-45 years, 5.5% had received treatment for thyroid disorders (20 hypothyroid, three males; eight thyrotoxicosis, four males), and Addison's disease was present in four patients (0.8%, one male). In all patients, type 1 diabetes preceded the diagnosis of the other autoimmune disorder. The clinical presentation of hypothyroidism was usually insidious with few symptoms, although an increased frequency of hypoglycaemic symptoms and/or raised serum cholesterol levels often prompted thyroid function testing. In contrast, the patients with thyrotoxicosis had florid symptoms, weight loss (mean 8.12 kg), palpable goitres, increasing insulin requirements, and low cholesterol levels. Six patients did not achieve remission or had recurrent thyrotoxicosis after oral antithyroid treatment and required 131I or thyroid surgery. A family history of autoimmune disease was present in 25% of patients with thyroid disorders (seven thyrotoxic and one hypothyroid) and in three of the four patients with Addison's disease. In this population of young adult type 1 diabetic patients, appropriate tests for thyroid dysfunction and Addison's disease should be carried out if there is clinical suspicion and/or unexplained changes in diabetic metabolic control or serum cholesterol. Careful follow-up of patients with a family history of these conditions is recommended.
Authors:
K S Leong; M Wallymahmed; J Wilding; I MacFarlane
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Postgraduate medical journal     Volume:  75     ISSN:  0032-5473     ISO Abbreviation:  Postgrad Med J     Publication Date:  1999 Aug 
Date Detail:
Created Date:  2000-02-10     Completed Date:  2000-02-10     Revised Date:  2012-05-09    
Medline Journal Info:
Nlm Unique ID:  0234135     Medline TA:  Postgrad Med J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  467-70     Citation Subset:  IM    
Affiliation:
University Clinical Departments at Aintree, University Hospital Aintree, Liverpool, UK.
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MeSH Terms
Descriptor/Qualifier:
Addison Disease / complications*,  diagnosis,  therapy
Adolescent
Adult
Cholesterol / blood
Diabetes Mellitus, Type 1 / complications*
Female
Hemoglobin A / analysis
Humans
Hypothyroidism / etiology
Male
Middle Aged
Thyroid Diseases / complications*,  diagnosis,  therapy
Thyrotoxicosis / etiology
Chemical
Reg. No./Substance:
57-88-5/Cholesterol; 9034-51-9/Hemoglobin A
Comments/Corrections

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