Followed by 1.11 GBq, a very low dose of 0.005 mg rhTSH was equally safe and effective as 0.1 mg rhTSH. Both doses increased the efficacy of radioiodine. Adverse events were mild, transient and readily treatable.

RESUMOSelecionamos mulheres pré-menopausadas com redução da DMO encaminhadas ao ambulatório de Metabolismo Ósseo do Hospital de Clínicas da UFPR, com o objetivo de definirmos o perfil destas pacientes em relação aos fatores de risco e prováveis causas secundárias de osteoporose. Trinta e quatro mulheres foram estudadas (19-48 anos). Em 29 pacientes (85,3%) a coluna lombar estava acometida, 8 (23,5%) apresentaram Z-score < -2,5 e 21 (61,8%) Z-score entre -1,0 e -2,5. Vinte pacientes (58,8%) apresentaram redução da DMO em fêmur, 2 (6,2%) com Z-score < -2,5 e 18 (56,2%) com Z-score entre -1,0 e -2,5. Causa secundária foi identificada em 26 pacientes (76,5%). Este estudo demonstra que a realização de densitometria óssea é importante em mulheres na pré-menopausa com fatores de risco para redução da massa óssea, uma vez que permite o início precoce do tratamento e a prevenção das complicações relacionadas. ABSTRACT Main Causes of Low Bone Mass in Premenopausal Women Referred to a Metabolic Bone Clinic of Curitiba.We conducted a chart review of premenopausal women with low bone mineral density referred to the Metabolic Bone Clinic of Federal University of Paraná, to determine the outline of these patients regarding their risk factors and secondary causes of osteoporosis. Thirty-four women (19-48 years old) were evaluated. Twenty nine (85.3%) patients presented a low bone mineral density (BMD) in lumbar spine, 8 (23.5%) had Zscore < -2.5 and 21 (61.8%) had Z-score between -1.0 and -2.5. Twenty patients (58.8%) had a low bone mass in total femur, 2 (6.2%) with Z-score < -2.5 and 18 (56.2%) with Z-score between -1.0 and -2.5. A secondary cause could be identified in 26 patients (76.5%). This study shows that DMO is important in premenopausal women with risk factors of low BMD because it leads to the best treatment option and follow-up.

Among the amiodarone-induced thyroid dysfunctions, thyrotoxicosis is the most troublesome and with the highest rate of morbidity and mortality. Treatment consists in the use of a high dose of anti-thyroid drugs and steroids in an isolated form or in combination. Association of several other drugs have been proposed for the treatment of refractory cases. In this study we report the case of a 40 y.o. patient, with a history of idiopatic dilated miocardiopathy, who developed severe amioradone-induced thyrotoxicosis after heart transplantation. Since the patient did not respond to an initial treatment consisting of a high dose of anti-thyroid drugs combined with steroids, a low dose of lithium carbonate was added for a short period of time, which resulted in normalization of the thyroid function. In this case, the addition of lithium carbonate to the two other drugs resulted in a successful and safety therapy in controlling amiodarone-induced thyrotoxicosis.