P.B.S. Fowler

HYPERCHOLESTEROLÆMIA IN BORDERLINE HYPOTHYROIDISM STAGE OF PREMYXŒDEMA

Abstract Hypercholesterolaemia precedes all evidence of thyroid failure in patients with autoimmune thyroiditis. This stage of autoimmune thyroiditis has been called premyxœdema. Fifty euthyroid patients are described in whom hypercholesterolaemia was considered to be due to autoimmune thyroiditis. Coronary-artery disease was common in these patients and their relatives.

ASSOCIATION BETWEEN EXAGGERATED RESPONSIVENESS TO THYROTROPHIN-RELEASING HORMONE AND HYPERCHOLESTEROLÆMIA

Thyroid-function tests were performed on one hundred patients with suspected premyxoedema and the results compared with those in twenty age and sex matched controls. The increase in thyroid-stimulating hormone (T.S.H.) in response to thyrotrophin-releasing hormone (T.R.H.) was exaggerated in eighty-eight of the hundred patients with suspected premyxoedema. These included twenty-five with normal basal T.S.H. and sixty-three with a raised basal T.S.H. Serum-cholesterol concentration was significantly higher in those in whom premyxoedema was suspected than in the controls, even when patients presenting with degenerative arterial disease were excluded.

DIAGNOSTIC INDEX FOR PREMYXŒDEMA

Abstract A diagnostic index for premyxœdema was used to assess 100 patients in whom premyxœdema had already been diagnosed. 7 of the 100 patients did not attain a diagnostic score when assessed by the index. 5 of the 7 were in the equivocal range (80-100). Myxœdema later developed in 1 of the 2 with scores below the equivocal range. There was no significant difference between the scores for 25 patients with premyxœdema who later progressed to overt hypothyroidism and 75 patients who remained in the premyxœdema stage. Patients with idiopathic familial hypercholesterolaemia, anorexia nervosa with hypercholesterolaemia, endogenous obesity, and other miscellaneous conditions in which thyroid function was assessed had a very low or even negative score.

PROLONGED ANKLE REFLEX IN ANOREXIA NERVOSA

Abstract The duration of the ankle reflex was measured in sixteen successive patients with anorexia nervosa, and was 360 milliseconds to half relaxation, or greater, in fifteen out of the sixteen patients. Thirteen controls, consisting of four healthy nurses weighing under 45 kg. and nine patients with weight loss due to organic disease, had ankle reflexes of normal duration.