Anorexia nervosa (AN) is typically associated with altered thyroid function tests, notably a low total and free T3 , and lower, but within normal range, free T4 and TSH. A 16-year-old girl with a four-year history of AN presented with elevated TSH that fluctuated with changes in weight. TSH was within normal limits (1.7-3.64 mIU/L) following periods of weight loss and elevated with weight gain (5.9-21.66 mIU/L). Antithyroperoxidase antibodies were markedly elevated, suggesting chronic Hashimoto's thyroiditis. Of note, the elevated TSH that would be expected in Hashimoto's thyroiditis was blunted by weight loss associated with AN. Physicians should be aware that AN may contribute to masking thyroid abnormalities in Hashimoto's thyroiditis.
M.P.), New YorkSixty diabetic males complaining of impotence were administered a structured interview and completed nocturnal penile tumescence (NPT) monitoring to categorize their impotence as either organic, psychogenic, or undetermined. A summary score of seven sexual symptoms was found to be effective in differentiating organic from psychogenic impotence. By relying upon these seven sexual symptoms as a screening test, 38% of male impotent diabetics can be spared the expense of NFT monitoring, since the outcome of such monitoring can be predicted from the summary score of these seven symptoms. The correlation between the seven sexual symptoms and the subjects' NPT monitoring results was 0.78, accounting for 61 96 of the variance. Therefore the seven sexual symptoms can be useful in predicting NPT monitoring results before the monitoring is completed. The sensitivity, specificity, and efficiency of the seven sexual symptoms is discussed, as well as the cost efficiency of utilizing this screening device.
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