Subclinical hypothyroidism in a patient affected by advanced AIDS and visceral leishmaniasis

Canine visceral leishmaniosis: the relationship of blood serum thyroid hormones, lipids, and lipoproteins with clinical status

The objective of the present study was to investigate the role of thyroid hormones and lipid profile in development and outcome of canine visceral leishmaniosis (CVL). We therefore studied the relationships between blood serum thyroid hormones [total T4, free T4, total T3, and free T3], lipids, and lipoproteins [total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)] and clinical status in dogs naturally infected with Leishmania infantum. Two groups of Leishmania-infected dogs [with no clinical signs (NCS; n = 15), and with clinical signs (CS; n = 16)] were assessed and compared with a group of healthy control dogs (n = 15). A significant decrease in serum total T4 (p < 0.05) concentration in the CS group was observed when compared to the NCS and control groups. The dogs in CS group revealed a significant decrease (p < 0.05) in free T4 concentration in comparison to the control group. The CS group presented a significant decrease in HDL-C (p < 0.01) concentrations, when compared to NCS and control groups. The observed findings in the present study suggested that thyroid hormone and lipoprotein alterations may have a role in susceptibility of dogs with Leishmania infection.

The effects of HIV-1 infection on endocrine organs

Early in the HIV epidemic, multiple endocrine and metabolic abnormalities were observed in HIV-infected patients. These abnormalities were either related glandular infection or infiltration with opportunistic diseases or the effects of systemic inflammation and severe illness on hormonal function and metabolic homeostasis. This review describes the epidemiology and pathogenesis of dyslipidemia, disorders of bone homeostasis, and dysfunction of the adrenal, gonadal, and thyroid axes in the untreated HIV-infected patient. While this review is most applicable to the HIV epidemic in the developing world where effective antiretroviral therapy is not available, understanding the effect of systemic inflammation on endocrine and metabolic function in the untreated HIV-infected person has valuable lessons for the pathogenesis of endocrine disease in HIV-infected patients receiving antiretroviral treatment.

Fever of unknown origin due to zoonoses

Fevers of unknown origin have been classified as classic, nosocomial, immune-deficient, and HIV-related. More than half of the 1407 human pathogens are zoonotic, making zoonotic infections an important subcategory in each of the classifications. This article describes both common and unusual zoonoses causing fevers of unknown origin. Simian immune virus is considered as a possible emerging infection. For special populations (the homeless, zoophiliacs, those whose occupation or leisure brings them in close contact with oceans or lakes, and veterinarians), zoonotic infection potentials are discussed.

Thyroid function abnormalities in HIV-infected patients

Abnormal thyroid function test results are common among human immunodeficiency virus (HIV)-infected patients. Although the prevalence of overt thyroid disease does not appear to be significantly increased in HIV-infected patients, compared with the general population, specific patterns of abnormal thyroid function test findings are more frequently identified among HIV-infected patients. Among patients with advanced acquired immunodeficiency syndrome, nonthyroidal illness (i.e., euthyroid sick syndrome) is common. During antiretroviral therapy, the prevalence of 2 generally asymptomatic conditions (subclinical hypothyroidism, which is characterized by isolated elevated thyroid-stimulating hormone levels, and isolated low free thyroxine levels) is increased. In addition, Graves disease, which is marked by low thyroid-stimulating hormone and elevated thyroxine levels, may occur during immune reconstitution. Testing for thyroid disease among symptomatic patients should begin with measurement of the thyroid-stimulating hormone level. However, there is insufficient evidence to recommend routine thyroid screening of asymptomatic HIV-infected individuals. This review summarizes the current evidence regarding the optimal laboratory evaluation of thyroid function; highlights the causes, presentation, and treatment of thyroid dysfunction in HIV-infected patients; and discusses the controversies regarding screening.