Endocrine Abstracts

We present a case of a 56-year-old male who reported to us with history of instability of gait since one year which was acute in onset and progressive, there was also history of hearing impairment and constipation since 3 years without improvement despite several symptomatic treatments. There was no history of weakness in any part of body, headache, vomiting, convulsions or alteration of sensorium. There was no history of trauma to the head, fever or drug intake. On examination, his vitals were normal. Cognitive functions were normal. Neurological examination showed gait ataxia, dysarthria and dysmetria on finger-nose and heel-to-knee tests. The gait was wide-based and there was a tendency to fall to right side. His fundus was normal. His power was normal but had hung up reflexes. Sensory system was normal. His hemogram was normal. Serum electrolytes, blood sugar, renal and liver function tests were normal. Total cholesterol: 191 mg/dl, triglycerides: 345 mg/dl, HDL cholesterol: 45 mg/dl, LDL cholesterol: 77 mg/dl. viral serologies were negative. T3:0,1 (0,3-5 pmol/dl) T4: 1.5 pmol/dl (12-22), TSH: >100 uIU/ml (0.27-5.5). The Serum anti-TPO antibody was not available. Cervical ultrasound showed an appearance related to thyroiditis: Reduced thyroid with heterogeneous echo structure size, alternating hypo and hyperechogenic range producing a tabby aspect of the gland and hypervascularization on Doppler. MRI brain was normal (Figures 1 and 2). Electrocardiogram and trans-thoracic ultrasound were normal with left ventricular ejection fraction below 50%.