CC: Patient presents with cough, rash, dyspnea, syncope, and abdominal pain.
Dx: Colchicine poisoning
Syncope
Temporary loss of consciousness caused by a fall in blood pressure.
aka fainting, passing out
Hypothyroidism
Reduction in the production of the two hormones produced by the thyroid, T3 (triiodothyronine) and T4 (thyroxine).
The two hormones regulate the body’s temperature, metabolism, and heart rate.
T3 is the active hormone, T4 is the precursor, both circulate through the bloodstream.
T3 functions include the 6 B’s:
Brain maturation
Bone growth
Beta-adrenergic effects
Basal metabolic rate
Blood sugar (glycogenolysis, gluconeogenesis)
Break down lipids (lipolysis)
Most commonly affects women above the age of 50.
Symptoms include:
Goiter: enlargement of the thyroid gland, it’s the characteristic neck mass shown in most tv shows, not to be confused with enlargement of salivary glands which show growth more along the jawline.
Metabolic: Cold intolerance, hypohidrosis (reduction in sweat production), weight gain, hyponatremia (reduced sodium in the bloodstream)
Neuropsychiatric: Hypoactivity, lethargy, fatigue, weakness, central nervous system (CNS) depression, reduced reflexes
Cardiovascular: Bradycardia, dyspnea on exertion
Common underlying causes:
Iodine deficiency - because the hormones are basically composed of iodine with some extra spice.
Malfunctioning pituitary gland - because the pituitary gland signals the thyroid to produce hormones (through TSH-Thyroid stimulating hormone), classified as Secondary Hypothyroidism because the problem does not directly derive from the thyroid.
Trauma to the thyroid gland.
There are a lot of other etiologies/causes that I can’t go over one by one just by necessity because the list would add another 10 pages. But my favorite is definitely cretinism (congenital hypothyroidism) just because it was actually mentioned in Paternity (s01e02) as part of a crossword puzzle.
Colchicine poisoning
Pharmacy error in this case, a switch-up with the cough medicine.
Used to treat gout: a form of inflammatory arthritis, characterized by recurrent attacks of red, tender, hot and swollen joints. Due to persistently elevated levels of uric acid in the blood which form crystals within joints and kidneys.
Overdose begins with a gastrointestinal phase 10-24 hours after ingestion, followed by multiple organ dysfunction 24 hours to 7 days after ingestion.
Symptoms include:
Burning in the mouth and throat, fever, vomiting, and abdominal pain.
Hypovolemic shock due to extreme blood/fluid loss through the gastrointestinal tract.
Kidney failure follows
Alopecia: loss of hair, aka baldness
Bone marrow depression: decrease in production of cells responsible for providing immunity, carrying oxygen, and/or those responsible for normal blood clotting.
Agranulocytosis: lowered white blood cell count
Aplastic anemia: failure of production of blood cells
Iodine is essential for health, but both deficiency and excess can pose problems due to its unique nature as an element. Particularly, if pregnant women do not consume enough iodine, there is a risk of the fetus developing cretinism. Cretinism is a condition that hampers brain and intellectual development in children, with iodine deficiency being one of the major causes. To address this issue, iodine-fortified salt is sold in Europe to prevent such problems. In Africa, iodine-containing salt is also distributed to tackle these issues, but adequate distribution is still lacking, leaving approximately 30% of the world's population iodine deficient.
Iodine Intake in Asia
In Asian regions, iodine supplementation is not necessary as iodine can be adequately obtained through seaweed consumption. Seaweeds such as kelp, nori, and wakame are included in various foods, ensuring that Asians generally do not have issues with iodine intake.
Radioactive Iodine and Thyroid Health
There are 46 types of iodine, with iodine-131 being a significant concern. Iodine-131 is a radioactive substance generated when uranium or plutonium undergo nuclear fission, such as during detonation of an atomic bomb or accidents at nuclear power plants. If ingested and accumulated in the thyroid gland, iodine-131 can pose problems. Although iodine-131 has a short half-life of only eight days, it emits significant...
reference:
Explore the critical role of iodine in health, from deficiency risks to radioactive iodine concerns, unraveling its impact and preventive me
A congenital condition caused by a deficiency of thyroid hormone during prenatal development and characterized in childhood by dwarfed stature, mental retardation, dystrophy of the bones, and a low basal metabolism.
In pathology, a condition of imperfect mental development or idiocy, with a corresponding lack of physical development, or deformity, arising from endemic causes, found among the inhabitants of the valleys of Switzerland and Savoy, and elsewhere.
A condition of endemic or inherited idiocy, accompanied by physical degeneracy and deformity (usually with goiter), frequent in certain mountain valleys, esp. of the Alps.
A condition of severely stunted physical and mental growth due to the untreated congenital deficiency of thyroidhormones.
severe hypothyroidism resulting in physical and mental stunting
Her 4years in kindergarten has been passing extremely fast if looking back like a short race. She defeated cretinism, got her brother, and many friends. Whatever we’re all miraculously impressive. 君の4年間は奇跡に溢れていた。 駆け抜ける様に過ぎていった時間だったな…。 クレチン症を克服し、弟を授かり、友達を得た。 2年連続でチームワークで勝ち取ったリレーは叫び倒していた大人達にも多くを気づかせてくれたと思う。 ありがとう。 #fatheranddaughter #athletic #race #defeatcretinism #cretinism #クレチン症完治 #クレチン症 (Ikebukuro) https://www.instagram.com/p/CGhZmTGDjIS/?igshid=9hmlru6ec4ya
I like the movie which ends by the result pays all the efforts of main character did. 報われる結末の映画が好きだ。 報われないのも現実かもしれないが、何のために映画を観るのかと言えば、報われる様を見て励みにしたい人は多いからだろうよ。 ちなみに、俺が最も報われたのは今のところ、娘の症状。 #cretinism #cretin #daughter #fatheranddaughter #fatherandson #fatherandkids #fatherandchild #Tokyo #farmer #lifestyle #agriculture #organicfarm #soil #seed #compost #vegetable #green #flower #herb #honeybee #beekeeping #rawhoney #beautiful #nature #healthy #foodie #クレチン症 #クレチン症完治 (Ikebukuro) https://www.instagram.com/p/CDOtTyWjDMR/?igshid=1uv0r3myjt9i2
