THYROID STIMULATING ANTIBODIES AND METASTATIC THYROID CARCINOMA

A patient with previously treated follicular carcinoma of the thyroid developed Graves' disease with a high titre of thyroid-stimulating antibodies (TSAb). He developed functioning pulmonary metastases leading to hyperthyroidism. Levels of TSAb paralleled the functional status of the metastases suggesting that hyperfunction of the neoplastic tissues was caused by TSAb.     

REDUCED DOPAMINERGIC INHIBITION OF THYROTROPHIN RELEASE IN STATES OF PHYSIOLOGICAL HYPERPROLACTINAEMIA

We have tested the hypothesis that physiological puerperal hyperprolactinaemia may be secondary to reduced hypothalamic dopaminergic inhibition of prolactin (PRL) release. Nine post-partum females with physiological hyperprolactinaemia (aged 19–40 years; mean basal PRL±SE, 2099±257 mU/l, range 1002–3762 mU/l) were studied and results compared with fourteen normoprolactinaemic females (basal PRL<400 mU/l; aged 18–36 years). Puerperal hyperprolactinaemic females showed a reduced TSH response to dopamine (DA) receptor blockade with metoclopramide (10 mg i.v.) compared with normal females over a 60-min period following drug administration (total incremental TSH change, mean ±SE, mU/l; 0.5±0.3 v. 3.1±1.0, P<0.005). This finding of reduced dopaminergic inhibition of TSH release in females with physiological puerperal hyperprolactinaemia supports the view that an overall reduction in hypothalamic dopaminergic tone may contribute towards hyperprolactinaemia in post-partum women.     

Are Decreases in Liver Cirrhosis Rates a Result of Increased Treatment for Alcoholism?★

In Ontario, liver cirrhosis mortality and morbidity have decreased substantially in recent years. Over the corresponding period, substantial increases have occurred in the number of people receiving treatment for an alcohol problem. The potential contributions of both changes in alcoholism treatment and changes in per capita consumption of alcohol to declines in hospital discharges for liver cirrhosis were examined with regression analyses. The results indicate that, with the exception of one area of the province, increases in treatment were linearly related to decreases in cirrhosis discharges.