Toshio Mukuta

Iodine-induced hypothyroidism as a result of excessive intake of confectionery made with tangle weed, Kombu, used as a low calorie food during a bulimic period in a patient with anorexia nervosa

A 20-year-old Japanese female anorectic patient developed primary hypothy roidism associated with generalized edema because of excessive daily intake (40 to 50 g) o confectionery made with tangle weed, Kombu, which she substituted to food during bulimic periods; TSH 60.35 mcU/ml, free T3 1.19 pg/ml, and free T4 0.48 ng/dl, and her weigh increased by 12 kg to 45 kg over 4 months. After withdrawal of Kombu her thyroid function returned to normal, and her weight decreased by 7 kg to 38 kg along with disappearance o edema. In conclusion, the physician noticed that susceptible anorectic patients may sometime develop hypothyroidism or hyperthyroidism because of excessive iodine intake of sea-weed confectionery as a substitute of high calorie cakes during bulimic period.

The role of thyroid stimulating antibody (TSAb) in the thyroid function of patients with post‐partum hypothyroidism

objective We investigated the association between thyroid function and the biological activities of thyroid stimulating antibodies (TSAb) and thyroid stimulation blocking antibodies (TSBAb) in patients with post‐partum hypothyroidism.

Alterations in endothelium-associated proteins and serum thyroid hormone concentrations in anorexia nervosa

Plasma concentrations of endothelium-associated proteins (EAP) (plasma fibronectin (PFN), angiotensin-converting enzyme, factor VIII-related antigen (F VIII-R:Ag)) and tissue plasminogen activator and serum thyroid hormone concentrations were studied in nine patients with anorexia nervosa (AN), before and after weight gain. Before weight gain (-35.9 (SE 2.3)% of standard body-weight) PFN was significantly reduced and F VIII-R:Ag was significantly increased in AN patients compared with the concentrations in control subjects (211.5 (SE 14.9) v. 274.7 (SE 16.6) micrograms/ml, P < 0.05; 129.2 (SE 14.1) v. 88.2 (SE 9.7) %, P < 0.05 respectively). Serum triiodothyronine (T3) and free T3 levels were also significantly lower before weight gain in AN patients (0.85 (SE 0.07) v. 1.53 (SE 0.08) nmol/l, P < 0.001; 2.57 (SE 0.23) v. 5.31 (SE 0.34) pmol/l, P < 0.001 respectively), although serum thyroxine (T4), free T4, and thyrotropin concentrations were within the normal range throughout the study periods. Following weight gain, PFN and F VIII-R:Ag concentrations normalized as did the thyroid hormone levels. The incremental changes in PFN levels correlated significantly with those in serum thyroid hormone concentrations (T3, r 0.79, P < 0.01; free T3, r 0.84, P < 0.01). These findings suggest that PFN levels may be directly related to serum T3 concentrations in AN patients.

A long-term follow-up study of patients with non-toxic diffuse goitre in Japan.

OBJECTIVE Although non‐toxic diffuse goitre is a common disorder, little is known of the clinical course of patients. We therefore decided to investigate the long‐term clinical outcome of patients with non‐toxic diffuse goitre.