RESUMEN
This corrects the authors listed in "Takotsubo syndrome and hyperthyroidism: a case report" published in volume 42(2) pages 215-220, doi: 10.23938/ASSN.0713.
RESUMEN
La miocardiopatía de estrés o síndrome de Takotsubo cursa clínicamente igual que un síndrome coronario agudo, con cambios eléctricos compatibles con isquemia y elevación de troponinas, aunque, en la coronariografía las arterias son normales. Su principal característica es el trastorno de la motilidad apical en el ecocardiograma. Se ha descrito en relación a trastornos tiroideos, aunque la relación causal no está claramente establecida. Se presenta el caso de una mujer que comenzó súbitamente con clínica de dolor torácico agudo, con cambios eléctricos y analíticos. Se objetivó una disfunción ventricular severa y un árbol coronario libre de lesiones, compatible con una miocardiopatía de estrés. Como desencadenante, presentó un hipertiroidismo por enfermedad de Graves. La identificación y manejo de los factores clínicos que podrían predisponer a los pacientes a esta miocardiopatía de estrés es fundamental para su prevención y tratamiento
Stress cardiomyopathy, or Takotsubo syndrome, is similar to that of an acute coronary syndrome, with electrocardiographic changes and an increase in troponin levels; however, coronary arteriography typically shows no obstructive lesions. One of the characteristic patterns are regional wall motion abnormalities identified by echocardiography. It has been described in association with thyroid disorders, although the causal mechanism is not clearly established. We present the case of a woman with acute chest pain and electrical and analytical changes. A severe ventricular dysfunction was observed but the coronary tree was free of lesions, all of which was compatible with a stress cardiomyopathy. Hyperthyroidism due to Graves' disease was observed as a trigger. The identification and management of clinical factors that might predispose patients to Takotsubo syndrome or impact on subsequent clinical outcome is mandatory
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Enfermedad de Graves/complicaciones , Hipertiroidismo/complicaciones , Cardiomiopatía de Takotsubo/diagnóstico , Dolor en el Pecho/etiología , Ecocardiografía , Hipertiroidismo/etiología , Cardiomiopatía de Takotsubo/etiologíaRESUMEN
Stress cardiomyopathy, or Takotsubo syndrome, is similar to that of an acute coronary syndrome, with electrocardiographic changes and an increase in troponin levels; however, coronary arteriography typically shows no obstructive lesions. One of the characteristic patterns are regional wall motion abnormalities identified by echocardiography. It has been described in association with thyroid disorders, although the causal mechanism is not clearly established. We present the case of a woman with acute chest pain and electrical and analytical changes. A severe ventricular dysfunction was observed but the coronary tree was free of lesions, all of which was compatible with a stress cardiomyopathy. Hyperthyroidism due to Graves' disease was observed as a trigger. The identification and management of clinical factors that might predispose patients to Takotsubo syndrome or impact on subsequent clinical outcome is mandatory.
Asunto(s)
Enfermedad de Graves/complicaciones , Hipertiroidismo/complicaciones , Cardiomiopatía de Takotsubo/diagnóstico , Dolor en el Pecho/etiología , Ecocardiografía , Femenino , Humanos , Hipertiroidismo/etiología , Persona de Mediana Edad , Cardiomiopatía de Takotsubo/etiologíaRESUMEN
Purpose: Anti-thyroglobulin antibodies (TgAb) can be used as a surrogate tumor marker in the follow-up of papillary thyroid carcinoma (PTC). We try to determine if the change in TgAb levels in the first post-operative year is a good predictor of persistence/recurrence risk in TgAb-positive PTC patients. Methods/patients: 105 patients with PTC who underwent thyroidectomy between 1988 and 2014 were enrolled. We calculated the percentage of change in TgAb levels with the first measurement at 1-2 months after surgery and the second one at 12-14 months. Results: TgAb negativization was observed in 29 patients (27.6%), a decrease of more than 50% was observed in 57 patients (54.3%), less than 50% in 12 patients (11.4%) and in 7 patients (6.7%) the TgAb level had increased. The percentage of persistence/recurrence was 0, 8.8, 16.7 and 71.4% in each group, respectively (p < 0.001). In the multivariate analysis, only the percentage of change in TgAb showed a significant association with the risk of persistence/recurrence, regardless of other factors such as age, size and TNM stages. Conclusions: Changes in TgAb levels in the first year after surgery can predict the risk of persistence/recurrence of TgAb-positive PTC patients. Patients who achieved negativization of TgAb presented an excellent prognosis
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Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Neoplasias de la Tiroides/patología , Tiroidectomía/estadística & datos numéricos , Carcinoma Papilar/patología , Tiroglobulina/antagonistas & inhibidores , Neoplasias de la Tiroides/cirugía , Inmunoglobulinas Estimulantes de la Tiroides/análisis , Carcinoma Papilar/cirugía , Pruebas de Función de la Tiroides/estadística & datos numéricos , Biomarcadores de Tumor/análisis , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
PURPOSE: Anti-thyroglobulin antibodies (TgAb) can be used as a surrogate tumor marker in the follow-up of papillary thyroid carcinoma (PTC). We try to determine if the change in TgAb levels in the first post-operative year is a good predictor of persistence/recurrence risk in TgAb-positive PTC patients. METHODS/PATIENTS: 105 patients with PTC who underwent thyroidectomy between 1988 and 2014 were enrolled. We calculated the percentage of change in TgAb levels with the first measurement at 1-2 months after surgery and the second one at 12-14 months. RESULTS: TgAb negativization was observed in 29 patients (27.6%), a decrease of more than 50% was observed in 57 patients (54.3%), less than 50% in 12 patients (11.4%) and in 7 patients (6.7%) the TgAb level had increased. The percentage of persistence/recurrence was 0, 8.8, 16.7 and 71.4% in each group, respectively (p < 0.001). In the multivariate analysis, only the percentage of change in TgAb showed a significant association with the risk of persistence/recurrence, regardless of other factors such as age, size and TNM stages. CONCLUSIONS: Changes in TgAb levels in the first year after surgery can predict the risk of persistence/recurrence of TgAb-positive PTC patients. Patients who achieved negativization of TgAb presented an excellent prognosis.