Thyroid clinical picture

Kifor et al. (2003) found autoantibodies to the CaR in four patients who had a clinical picture resembling that of FHH in the setting of other autoimmune conditions (e.g., Hashimoto s thyroiditis and sprue). The patients sera stimulated PTH secretion and inhibited high calcium-stimulated inositol phosphate accumulation and MAPK activation, presumably owing to antibody-mediated inhibition of the CaR. Further studies of a larger number of patients are required to determine the incidence of autoimmune, PTH-dependent hypocalciuric hypercalcemia in the presence of various types of autoimmunity. 

The production of thyroid disorders by lithium is common and requires constant concern throughout the treatment. Lithium-induced hypothyroidism can produce depression and other mental dysfunction, greatly confusing and complicating the patient s clinical picture. 

Though less frequently sought, endocrine disturbances form an essential part of the clinical picture in malnutrition. Their importance has been emphasized by Samuels (1948), Zubirdn (1949), and by Gillman and Gillman (1951). The similarity between the clinical manifestations of malnutrition and those of altered endocrine function are evidenced by the frequency of serious sexual disturbances, pigmentations of the skin, lowered metabolic rates, gynecomastia, asthenia, hypotension, and other symptoms which could be attributed to dysfunction of the thyroid, the adrenals, the pituitary, or the gonads in undernourished individuals. 

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