Decreased Muscular Radionuclide Uptake in Tc-99m MIBI Scintigraphy During Paralytic Phase of Thyrotoxic Periodic Paralysis

Abstract

The underlying pathophysiology of thyrotoxic periodic paralysis (TPP) is still obscure. From histologic surveys, vacuole formation and abundant mitochondrial abnormalities ranged from swelling, matrical pallor, pleomorphism, and reduced cristae were often disclosed in the muscle fibers during paralytic periods. In a 47-year-old man experiencing 2 episodes of transient paralysis, hyperthyroidism with TPP was diagnosed. During the acute paralytic phase, a significant reduction of radionucleotide uptake in the quadriceps on Tc-99m sestamibi scintigraphy was found, aside from the previous morphologic findings, that it further suggests impaired mitochondrial integrity and cellular viability in TPP.

Eubiotic properties of rifaximin: Disruption of the traditional concepts in gut microbiota modulation

“…As a consequence of the negligible systemic absorption (< 0.4%)[63], rifaximin reaches high tissue concentrations, as high as 8000 mcg/g in fecal samples after a 3-d regimen of 800 mg daily[64], far beyond the minimal inhibitory concentrations observed for local microbial isolates. Another characteristic of rifaximin is bile acids-dependent solubility; this makes the drug more effective in the small intestine while colonic bacteria are poorly inhibited[65].…”

Parálisis periódica tirotóxica

“…La electromiografía muestra un compromiso miopático que desaparece durante la remisión de la debilidad (6), en la biopsia muscular hay anormalidad en 75% de los casos con atrofia, proliferación nuclear, vacuolización, entre otros, pero en la microscopía se observa además compromiso mitocondrial y granulaciones de glucógeno en todas las fibras musculares, hallazgos también vistos en captación con tc99m (6,21).…”