Thyroid Disease Around the World.

Science.gov (United States)

Maniakas, Anastasios; Davies, Louise; Zafereo, Mark E

2018-06-01

Thyroid disease is one of the most common pathologies in the world, with two of the most clinically important subgroups being iodine deficiency and thyroid goiter, and thyroid cancer. This review looks at the current state of thyroid disease in the world and evaluates the future direction in terms of thyroid disease treatment and prevention. Several of the most impactful epidemiologic studies are presented and analyzed, as well as a brief overview of the current socioeconomic burden of disease. Copyright © 2018 Elsevier Inc. All rights reserved.

Thyroid diseases

International Nuclear Information System (INIS)

Noma, Koji

1992-01-01

This chapter reviews the correlation between thyroid disease, other than cancer, and radiation in the literature. Radiation-induced thyroid disturbance is discussed in the context of external and internal irradiation. External irradiation of 10 to 40 Gy may lower thyroid function several months or years later. Oral administration of I-131 is widely given to patients with Basedow's disease; it may also lower thyroid function with increasing radiation doses. When giving 70 Gy or more of I-131, hypothyroidism has been reported to occur in 20-30% and at least 10%. Thyroiditis induced with internal I-131 irradiation has also been reported, but no data is available concerning external irradiation-induced thyroiditis. The incidence of nodular goiter was found to be several ten times higher with external irradiation than internal irradiation. Thyroid disturbance is correlated with A-bomb survivors. A-bomb radiation can be divided into early radiation within one minute after A-bombing and the subsequent residual radiation. Nodular goiter was significantly more frequent in the exposed group than the non-exposed group; it increased with increasing radiation doses and younger age (20 years or less) at the time of exposure. The incidence of decrease in thyroid function was higher with increasing radiation doses. However, in the case of Nagasaki, the incidence of hypothyroidism was significantly higher in the low-dose exposed group, especially A-bomb survivors aged 10-39 at the time of exposure and women. (N.K.)

Age impact on autoimmune thyroid disease in females

Science.gov (United States)

Stoian, Dana; Craciunescu, Mihalea; Timar, Romulus; Schiller, Adalbert; Pater, Liana; Craina, Marius

2013-10-01

Thyroid autoimmune disease, a widespread phenomenon in female population, impairs thyroid function during pregnancy. Identifying cases, which will develop hypothyroidism during pregnancy, is crucial in the follow-up process. The study group comprised 108 females, with ages between 20-40 years; with known inactive autoimmune thyroid disease, before pregnancy that became pregnant in the study follow-up period. They were monitored by means of clinical, hormonal and immunological assays. Supplemental therapy with thyroid hormones was used, where needed. Maternal age and level of anti-thyroid antibodies were used to predict thyroid functional impairment.

Thyroid carcinoma in Graves' disease: A meta-analysis.

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Staniforth, Joy U L; Erdirimanne, Senarath; Eslick, Guy D

2016-03-01

The incidence of thyroid carcinoma is increasing worldwide. Graves' disease is the most common hyperthyroid disease. Studies have suggested an increased risk of thyroid malignancy in Graves' disease: there has not yet been a meta-analysis to allow quantitative comparison. The purpose of this study was to determine the risk of thyroid carcinoma in Graves' disease, and to gather information on the histological subtypes of carcinoma and the co-existence of thyroid nodules. Several databases and article reference lists were searched. Inclusion criteria included appropriate diagnostic criteria for thyroid conditions and a diagnoses of carcinoma based on histology. 33 studies were selected, all reporting on surgically-resected specimens. The event rate of thyroid carcinoma in Graves' disease was 0.07 (95% CI 0.04 to 0.12). There was no data to allow comparison with patients without hyperthyroid diseases. There was no increase in the odds of developing carcinoma in Graves' disease compared to toxic multinodular goitre and toxic uninodular goitre. 88% of thyroid carcinomas in Graves' disease were papillary, with solitary papillary micro-carcinoma (diameter 10 mm or less) comprising 23% of all detected thyroid carcinomas. Patients with Graves' disease and co-existing thyroid nodules were almost 5 times more likely to be diagnosed with thyroid carcinoma than those without nodules. Thyroid malignancy in Graves' disease requiring surgical treatment should be considered as likely as in other hyperthyroid diseases needing surgical treatment. Clinicians should consider screening selected patients with Graves' disease for nodules whilst being aware of potentially over-diagnosing papillary micro-carcinoma. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Thyroid diseases and cerebrovascular disease

NARCIS (Netherlands)

Squizzato, A.; Gerdes, V. E. A.; Brandjes, D. P. M.; Büller, H. R.; Stam, J.

2005-01-01

Background and Purpose-Acute cerebral ischemia has been described in different diseases of the thyroid gland, and not only as a result of thyrotoxic atrial fibrillation and cardioembolic stroke. The purpose of this review is to summarize the studies on the relationship between thyroid diseases and

[Thyroid cancer in patients with Grave's Disease].

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Mssrouri, R; Benamr, S; Essadel, A; Mdaghri, J; Mohammadine, El H; Lahlou, M-K; Taghy, A; Belmahi, A; Chad, B

2008-01-01

To evaluate the incidence of thyroid carcinoma in patients operated on for Graves' disease, to identify criteria which may predict malignancy, and to develop a practical approach to determine the extensiveness of thyroidectomy. Retrospective study of all patients who underwent thyroidectomy for Graves' disease between 1995 and 2005. 547 patients underwent subtotal thyroidectomy for Graves' disease during this period. Post-operative pathology examination revealed six cases of thyroid cancer (1.1%). All six cases had differentiated thyroid carcinoma (papillary carcinoma in 3 cases, follicular carcinoma in 2 cases and papillo-follicular carcinoma in 1 case). The indication for initial thyroidectomy was a palpable thyroid nodule in 3 cases (50%), failure of medical treatment for Grave's disease in 2 cases (33%), and signs of goiter compression in 1 case (17%). Five patients underwent re-operative total thyroidectomy. This study shows that while malignancy in Grave's disease is uncommon, the presence of thyroid nodule(s) in patients with Grave's disease may be considered as an indication for radical surgery. The most adequate radical surgery in this situation is to perform a total thyroidectomy.

[Autoimmune diseases of the thyroid gland].

Science.gov (United States)

Allelein, S; Feldkamp, J; Schott, M

2017-01-01

Autoimmune diseases of the thyroid gland are considered to be the most frequent cause of thyroid gland disorders. Autoimmune thyroid diseases consist of two subgroups: autoimmune thyroiditis (AIT) and Graves' disease. The AIT is the most common human autoimmune disease. Infiltration of the thyroid gland with cytotoxic T‑cells can lead to an initial thyrotoxicosis und during the course to hypothyroidism due to destruction of the thyroid gland. Substitution with Levothyroxine is indicated for manifest hypothyroidism and subclinical hypothyroidism with increased thyroid antibodies with the intention of normalizing the serum thyroid stimulating hormone (TSH). Graves' disease is characterized by the appearance of stimulating TSH receptor antibodies leading to hyperthyroidism. Endocrine ophthalmopathy may also occur. Ablative therapy with radioiodine therapy or thyroidectomy is administered to patients with Graves' disease without remission after at least 1 year of antithyroid drug therapy.

Metabolic disorders and nutritional status in autoimmune thyroid diseases

Directory of Open Access Journals (Sweden)

Anna Kawicka

2015-01-01

Full Text Available In recent years, the authors of epidemiological studies have documented that autoimmune diseases are a major problem of modern society and are classified as diseases of civilization. Autoimmune thyroid diseases (ATDs are caused by an abnormal immune response to autoantigens present in the thyroid gland – they often coexist with other autoimmune diseases. The most common dysfunctions of the thyroid gland are hypothyroidism, Graves-Basedow disease and Hashimoto’s disease. Hashimoto’s thyroiditis can be the main cause of primary hypothyroidism of the thyroid gland. Anthropometric, biochemical and physicochemical parameters are used to assess the nutritional status during the diagnosis and treatment of thyroid diseases. Patients with hypothyroidism are often obese, whereas patients with hyperthyroidism are often afflicted with rapid weight loss. The consequence of obesity is a change of the thyroid hormones’ activity; however, weight reduction leads to their normalization. The activity and metabolic rate of thyroid hormones are modifiable. ATDs are associated with abnormalities of glucose metabolism and thus increased risk of developing diabetes mellitus type 1 and type 2. Celiac disease (CD also increases the risk of developing other autoimmune diseases. Malnutrition or the presence of numerous nutritional deficiencies in a patient’s body can be the cause of thyroid disorders. Coexisting deficiencies of such elements as iodine, iron, selenium and zinc may impair the function of the thyroid gland. Other nutrient deficiencies usually observed in patients suffering from ATD are: protein deficiencies, vitamin deficiencies (A, C, B6, B5, B1 and mineral deficiencies (phosphorus, magnesium, potassium, sodium, chromium. Proper diet helps to reduce the symptoms of the disease, maintains a healthy weight and prevents the occurrence of malnutrition. This article presents an overview of selected documented studies and scientific reports on the

[Metabolic disorders and nutritional status in autoimmune thyroid diseases].

Science.gov (United States)

Kawicka, Anna; Regulska-Ilow, Bożena; Regulska-Ilow, Bożena

2015-01-02

In recent years, the authors of epidemiological studies have documented that autoimmune diseases are a major problem of modern society and are classified as diseases of civilization. Autoimmune thyroid diseases (ATDs) are caused by an abnormal immune response to autoantigens present in the thyroid gland - they often coexist with other autoimmune diseases. The most common dysfunctions of the thyroid gland are hypothyroidism, Graves-Basedow disease and Hashimoto's disease. Hashimoto's thyroiditis can be the main cause of primary hypothyroidism of the thyroid gland. Anthropometric, biochemical and physicochemical parameters are used to assess the nutritional status during the diagnosis and treatment of thyroid diseases. Patients with hypothyroidism are often obese, whereas patients with hyperthyroidism are often afflicted with rapid weight loss. The consequence of obesity is a change of the thyroid hormones' activity; however, weight reduction leads to their normalization. The activity and metabolic rate of thyroid hormones are modifiable. ATDs are associated with abnormalities of glucose metabolism and thus increased risk of developing diabetes mellitus type 1 and type 2. Celiac disease (CD) also increases the risk of developing other autoimmune diseases. Malnutrition or the presence of numerous nutritional deficiencies in a patient's body can be the cause of thyroid disorders. Coexisting deficiencies of such elements as iodine, iron, selenium and zinc may impair the function of the thyroid gland. Other nutrient deficiencies usually observed in patients suffering from ATD are: protein deficiencies, vitamin deficiencies (A, C, B6, B5, B1) and mineral deficiencies (phosphorus, magnesium, potassium, sodium, chromium). Proper diet helps to reduce the symptoms of the disease, maintains a healthy weight and prevents the occurrence of malnutrition. This article presents an overview of selected documented studies and scientific reports on the relationship of metabolic

[Characteristics of thyroid carcinoma in Grave's disease Hashimoto's thyroiditis and nodular goiter].

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Filipović, A; Paunović, I

2003-01-01

The biology of thyroid cancer represents a spectrum of behavior ranging from well-differentiated lesions with an excellent prognosis to anaplastic carcinoma, which is almost fatal. For this reason, it is important that clinicians have methods at their disposal to asses the characteristics of patient's thyroid malignancy. In this work we discuss the behavior of differentiated thyroid cancer in associated diseases of thyroid as: Graves' disease, chronic lymphocytic thyroiditis--Hashimoto and nodular goiter. This is retrospectively reviewing of 50 patients treated for differentiated thyroid carcinoma at Department of surgery, Clinical Centre of Montenegro in Podgorica from 1998 until 2003. We evaluated occurrence, as well as the role of this diseases in patients with thyroid cancer. We found a more favorable course of thyroid cancer in the presence of chronic lymphocytic thyroiditis and nodular goiter, a contrary Graves' disease. In associated diseases of thyroid, a significantly greater proportion of patients with thyroid cancer, have modular goiter.

Thyroid disease: thyroid function tests and interpretation

African Journals Online (AJOL)

Diseases of the thyroid are among the most prevalent of medical conditions, especially in women, but the symptoms can be relatively nonspecific or mild. For this reason, clinicians have been placing increased reliance on the laboratory for assistance in the diagnosis of thyroid disorders. In the 1950s, only one thyroid.

Evaluation of diffuse thyroid diseases and thyroid nodules by CT

International Nuclear Information System (INIS)

Okamoto, Kyoko; Imanishi, Yoshimasa; Nakaji, Shunsuke; Shinagawa, Toshihito

2007-01-01

Imanishi et al. have previously reported that the changes in CT values reveal not only the change in iodine concentration in thyroid follicles, but also represent secondary changes in follicular content and follicular cells and/or interstitial structures. Thus, we performed thyroid CT without contrast material in 138 controls, 417 cases with diffuse thyroid diseases, and 279 cases with thyroid nodules, and evaluated the CT images based on the relation between the change in CT values and pathological changes. In 89% of the controls and 43% of patients with diffuse thyroid diseases, the thyroid CT revealed diffuse high density. In contrast, the 94% of thyroids that demonstrated diffuse low density were from patients with diffuse thyroid diseases. Eighty-four percent of malignant nodules and 64% of benign nodules had inhomogeneous densities, and only 26% of benign thyroid nodules had homogeneous density. However, 71% of nodules that showed high and low densities with regular and clear borders, and 82% of nodules that showed papillary proliferation in a cyst pattern were benign. Although only 58% of nodules with calcification were malignant, 66% of nodules with calcification in the central portion, and 86% of nodules with calcification of a disseminated and convergent pattern in distribution were malignant. Sixty-two percent of thyroids that surrounded nodules had chronic thyroiditis, hypoplasia and/or adenomatous goiter. Thus, unclear borders between a nodule and the surrounding thyroid tissue did not increase the possibility of malignancy. However, the unclear and/or lobulated border between a nodule and extra thyroid tissue increased the possibility of malignancy. We concluded that thyroid CT without contrast material is useful for the diagnosis of thyroid diseases. (author)

Hodgkin's disease: thyroid dysfunction following external irradiation

International Nuclear Information System (INIS)

Tamura, K.; Shimaoka, K.

1981-01-01

The thyroid gland is commonly included in the field of radiation therapy for patients with malignant lymphoma and with head and neck tumors. The radiation dose for malignant diseases varies considerably depending on the purpose of treatment and the institutional policies. A substantial number of these patients are developing subclinical and clinical hypothyroidism. The risk of developing hypothyroidism after a moderate radiation dose of 2000 to 4500 rads has been reported to be 10 to 20 percent. In addition, subclinical hypothyroidism is induced further in one third of the patients. There are also suggestions that external irradiation of the thyroid gland in patients with malignant lymphomas, as well as internal irradiation with radioiodine of the normal and hyperthyroid human thyroid glands, would induce elevations of serum antithyroid autoantibody titers. However, only a few cases of Graves disease following irradiation to the thyroid gland have been reported. We encountered a young woman who received radiation therapy to the mantle field for her Hodgkin's disease and developed hypothyroxinemia without overt signs and symptoms of hypothyroidism, followed by appearance of nodular goiter and then full-blown Graves disease

Thyroid-specific questions on work ability showed known-groups validity among Danes with thyroid diseases

DEFF Research Database (Denmark)

Nexo, Mette A.; Watt, Torquil; Bonnema, Steen Joop

2014-01-01

and interviews with thyroid patients, 24 work ability items were selected from previous questionnaires, revised, or developed anew. Items were tested among 632 patients with thyroid disease (non-toxic goiter, toxic nodular goiter, Graves' disease (with or without orbitopathy), autoimmune hypothyroidism...

Ultrasonography of various thyroid diseases in children and adolescents: A pictorial essay

Energy Technology Data Exchange (ETDEWEB)

Hong, Hyun Sook; Lee, Eun Hye; Jeong, Sun Hye; Park, Ji Sang; Lee, Heon [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

2015-04-15

Thyroid imaging is indicated to evaluate congenital hypothyroidism during newborn screening or in cases of a palpable thyroid mass in children and adolescents. This pictorial essay reviews the ultrasonography (US) of thyroid diseases in children and adolescents, including normal thyroid gland development, imaging features of congenital thyroid disorders (dysgenesis, [aplasia, ectopy, hypoplasia], dyshormonogenesis, transient hypothyroidism, thyroglossal duct cyst), diffuse thyroid disease (Grave's disease, Hashimoto's thyroiditis, and suppurative thyroiditis), and thyroid nodules. The primary imaging modalities for evaluating thyroid diseases are US and radionuclide scintigraphy. Additionally, US can be used to guide aspiration of detected nodules.

Thyroid Diseases and Treatment in Pregnancy

Directory of Open Access Journals (Sweden)

Aynur Aktaş

2016-03-01

Full Text Available Assessment of thyroid disease in pregnancy is important for gestational maternal health, obstetric outcome and, subsequent development of child. Pregnancy has pro­found effects on the regulation of thyroid function, and on thyroidal functional disorders, that need to be recognized, carefully evaluated and correctly managed. In women with normal thyroid function there is an increase in thyroxine (T4 and triiodothyronine (T3 production and inhibition of thyroid-stimulating hormone (TSH in the first trimester of pregnancy,. In the pregnant woman, elevated thyroxine-binding globulin (TGB and concomitant increases in total T4 and T3 levels plateau at 12-14 weeks of pregnancy, and free T4 measurements slowly decrease. The most frequent thyroid disorder in pregnancy is maternal hy­pothyroidism. It is associated with fetal loss, placental abruptions, preeclampsia, preterm delivery and reduced intellectual function in the offspring. Hyperthyroidism dur­ing pregnancy is relatively uncommon, with a prevalence estimated to range between 0.1% and 1%. The most common cause of hyperthyroidism is Graves disease, as this etiology accounts for 85% of clinical hyperthyroid­ism in pregnancy. Another cause of hyperthyroidism is hyperemesis gravidarum. This is common and requires differentiation from Graves disease. There has been much discussion and many publications on the optimal management of pregnant women who are hyperthyroid or hypothyroid. Despite the lack of consensus organiza­tions, which are based on analyses, support screening in all pregnant women in the first trimester for thyroid disease. In this article, we provide information about the current approaches of thyroid dysfunction in pregnancy. J Clin Exp Invest 2016; 7 (1: 120-124

Development of Grave's disease seven months after Hashimoto's thyroiditis: a rare occurrence.

Science.gov (United States)

Bravo-Llerena, Wilfredo Eddy; Valderrabano-Wagner, Rodrigo J; Quevedo-Quevedo, Juan; Reyes-Ortiz, Luis M

2010-01-01

Hashimoto's thyroiditis (HT) and Graves' disease (GD) are two opposite poles in the spectrum of autoimmune thyroid disease. On one extreme, HT or Chronic Lymphocytic thyroiditis (CLT) courses, as its name implies, with lymphocytic infiltrates replacing thyroid follicles, resulting in a loss of hormone-producing cells and, thus, primary hypothyroidism. On the other extreme, GD is characterized by primary hyperthyroidism due to stimulating autoantibodies against thyroid-stimulating hormone receptors (TSHRs) localized on thyrocytes' membranes of intact thyroid follicles. The presence of HT after GD or the concomitant combination of these two autoimmune entities ending in HT-depending hypothyroid state is well known. However, occurrence of GD after primary hypothyroidism due to CLT is very rare since thyrocytes with their TSHRs are promptly lost. We report a case in which hyperthyroidism occurred seven months after presentation of primary hypothyroidism and discuss potential mechanisms involved.

Clinical studies on thyroid diseases

NARCIS (Netherlands)

Eskes, S.A.

2014-01-01

This thesis focuses on some aspects of thyroid disease: prevention of autoimmune thyroid disease (AITD), diagnosis of related conditions as autoimmune hypophysitis in autoimmune hypothyroidism (Hashimoto’s disease), and treatment of amiodarone-induced thyrotoxicosis (AIT).

Targeting thyroid diseases with TSH receptor analogs.

Science.gov (United States)

Galofré, Juan C; Chacón, Ana M; Latif, Rauf

2013-12-01

The thyroid-stimulating hormone (TSH) receptor (TSHR) is a major regulator of thyroid function and growth, and is the key antigen in several pathological conditions including hyperthyroidism, hypothyroidism, and thyroid tumors. Various effective treatment strategies are currently available for many of these clinical conditions such as antithyroid drugs or radioiodine therapy, but they are not devoid of side effects. In addition, treatment of complications of Graves' disease such as Graves' ophthalmopathy is often difficult and unsatisfactory using current methods. Recent advances in basic research on both in vitro and in vivo models have suggested that TSH analogs could be used for diagnosis and treatment of some of the thyroid diseases. The advent of high-throughput screening methods has resulted in a group of TSH analogs called small molecules, which have the potential to be developed as promising drugs. Small molecules are low molecular weight compounds with agonist, antagonist and, in some cases, inverse agonist activity on TSHR. This short review will focus on current advances in development of TSH analogs and their potential clinical applications. Rapid advances in this field may lead to the conduct of clinical trials of small molecules related to TSHR for the management of Graves' disease, thyroid cancer, and thyroid-related osteoporosis in the coming years. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

Thyroid hormones and fetal brain development.

Science.gov (United States)

Pemberton, H N; Franklyn, J A; Kilby, M D

2005-08-01

Thyroid hormones are intricately involved in the developing fetal brain. The fetal central nervous system is sensitive to the maternal thyroid status. Critical amounts of maternal T3 and T4 must be transported across the placenta to the fetus to ensure the correct development of the brain throughout ontogeny. Severe mental retardation of the child can occur due to compromised iodine intake or thyroid disease. This has been reported in areas of the world with iodine insufficiency, New Guinea, and also in mother with thyroid complications such as hypothyroxinaemia and hyperthyroidism. The molecular control of thyroid hormones by deiodinases for the activation of thyroid hormones is critical to ensure the correct amount of active thyroid hormones are temporally supplied to the fetus. These hormones provide timing signals for the induction of programmes for differentiation and maturation at specific stages of development. Understanding these molecular mechanisms further will have profound implications in the clinical management of individuals affected by abnormal maternal of fetal thyroid status.

New Genetic Insights from Autoimmune Thyroid Disease

Directory of Open Access Journals (Sweden)

Terry F. Davies

2012-01-01

Full Text Available The autoimmune thyroid diseases (AITDs (Graves’ disease and Hashimoto’s thyroiditis are complex genetic diseases which most likely have more than 20 genes contributing to the clinical phenotypes. To date, the genes known to be contributing fall into two categories: immune regulatory genes (including HLA, CTLA4, PTPN22, CD40, CD25, and FCRL3 and thyroid-specific genes (TG and TSHR. However, none of these genes contribute more than a 4-fold increase in risk of developing one of these diseases, and none of the polymorphisms discovered is essential for disease development. Hence, it appears that a variety of different gene interactions can combine to cause the same clinical disease pattern, but the contributing genes may differ from patient to patient and from population to population. Furthermore, this possible mechanism leaves open the powerful influence of the environment and epigenetic modifications of gene expression. For the clinician, this means that genetic profiling of such patients is unlikely to be fruitful in the near future.

Evaluation of diffuse thyroid diseases by computed tomography and 123I thyroidal uptake

International Nuclear Information System (INIS)

Kurihara, Yoshiko; Imanishi, Yoshimasa; Ehara, Norishige

1991-01-01

Understanding the iodine kinetics in the thyroid is useful for the diagnosis of a patient with diffuse thyroid disease. In this study, 9 controls and 50 patients with diffuse thyroid diseases, we evaluated diffuse thyroid diseases with 123 I thyroidal uptake and volume, iodine concentration, and net iodine content measured by computed tomography. There was no significant correlation between volume, iodine concentration, and net iodine content of the thyroid and 123 I thyroidal uptake. The thyroid volume in Graves' and Hashimoto's diseases was significantly larger than that in the control group. The thyroid iodine concentration in Graves' and Hashimoto's diseases was significantly smaller than that in the control group. The thyroid net iodine content in Hashimoto's disease was significantly smaller than that in the control group. Although most of the patients with Graves' disease had more increased radioiodine thyroidal uptake than the control group, there was no significant difference between them in the mean of the thyroid net iodine content. But the variance of net iodine contents in the former was significantly larger than that in the latter. The thyroid net iodine content was very low in all patients with very high thyroglobulin hemaggrugated antibody (TGHA) value although it was nearly normal in some patients with normal TGHA value. It was suggested that iodine concentration and net iodine content might be determined not only by iodine uptake but also by release and/or leakage of iodine compounds from the thyroid, which might depend on some antithyroid antibodies. (author)

Challenges in interpretation of thyroid function tests in pregnant women with autoimmune thyroid disease

DEFF Research Database (Denmark)

Feldt-Rasmussen, Ulla; Bliddal, Sofie; Rasmussen, Åse Krogh

2011-01-01

Physiological changes during gestation are important to be aware of in measurement and interpretation of thyroid function tests in women with autoimmune thyroid diseases. Thyroid autoimmune activity is decreasing in pregnancy. Measurement of serum TSH is the first-line screening variable...... for thyroid dysfunction also in pregnancy. However, using serum TSH for control of treatment of maternal thyroid autoimmunity infers a risk for compromised foetal development. Peripheral thyroid hormone values are highly different among laboratories, and there is a need for laboratory-specific gestational age......-related reference ranges. Equally important, the intraindividual variability of the thyroid hormone measurements is much narrower than the interindividual variation (reflecting the reference interval). The best laboratory assessment of thyroid function is a free thyroid hormone estimate combined with TSH...

Thyroid dysfunction after mantle irradiation of Hodgkin's disease patients

International Nuclear Information System (INIS)

Khoo, V.S.; Liew, K.H.; Crennan, E.C.; D'Costa, I.M.; Quong, G.

1998-01-01

Thyroid dysfunction can develop in patients with Hodgkin's disease who are treated with mantle irradiation. During the period 1970-89, the records of 320 patients who received mantle irradiation and who had thyroid function tests (TFT) were retrospectively reviewed. The median age was 30 years (range, 7-69 years). The median mantle and thyroid dose was 36 Gy (range, 30-40 Gy) and 39.8 Gy (range, 32-65 Gy), respectively. Overall thyroid dysfunction was present in 39% of the patients. Clinical hypothyroidism was seen in 10% and biochemical hypothyroidism was noted in 25%. Hyperthyroidism was found in 4% of patients. Thyroid nodules had developed in six patients (2%), of which those in four patients were malignant. Age, sex, histological subtype, stage of disease, dose, Iymphangiogram and treatment with chemotherapy were not significant factors in the development of thyroid dysfunction. The narrow dose range prevented adequate analysis of dose effect. The results indicate that the incidence of thyroid abnormalities is high enough to warrant regular TFT assessment with pre-irradiation levels and follow-up testing for life because the development of abnormalities can occur many years later. Thyroid examination should form part of the routine follow-up examination and any abnormality should be promptly investigated. Copyright (1998) Blackwell Science Pty Ltd

Thyroid volume in hypothyroidism due to autoimmune disease follows a unimodal distribution: evidence against primary thyroid atrophy and autoimmune thyroiditis being distinct diseases

DEFF Research Database (Denmark)

Carlé, Allan; Pedersen, Inge Bülow; Knudsen, Nils

2009-01-01

CONTEXT: Primary overt autoimmune hypothyroidism is often divided into primary idiopathic hypothyroidism with thyroid atrophy (Ord's disease) and hypothyroidism with goitre (Hashimoto's disease). OBJECTIVE: The aim of the present study was to characterize the two subtypes of disease. DESIGN...... program including thyroid ultrasonography and measurements of thyroid autoantibodies. Of the 144 patients investigated (58% of all invited), 139 were compared with 556 sex-, age-, and region-matched controls from the cohort. RESULTS: Patients had lower median (11.6 ml vs. 13.5 ml, P = 0.001) and a more...... dispersed distribution of thyroid volumes compared with controls (P thyroid volume showed a Gaussian distribution in both males and females with no bimodal pattern. Nearly all patients had measurable thyroid autoantibodies, but with increasing thyroid volume (quartile I, II, III, and IV...

Thyroid-specific questions on work ability showed known-groups validity among Danes with thyroid diseases.

Science.gov (United States)

Nexo, Mette Andersen; Watt, Torquil; Bonnema, Steen Joop; Hegedüs, Laszlo; Rasmussen, Åse Krogh; Feldt-Rasmussen, Ulla; Bjorner, Jakob Bue

2015-07-01

We aimed to identify the best approach to work ability assessment in patients with thyroid disease by evaluating the factor structure, measurement equivalence, known-groups validity, and predictive validity of a broad set of work ability items. Based on the literature and interviews with thyroid patients, 24 work ability items were selected from previous questionnaires, revised, or developed anew. Items were tested among 632 patients with thyroid disease (non-toxic goiter, toxic nodular goiter, Graves' disease (with or without orbitopathy), autoimmune hypothyroidism, and other thyroid diseases), 391 of which had participated in a study 5 years previously. Responses to select items were compared to general population data. We used confirmatory factor analyses for categorical data, logistic regression analyses and tests of differential item function, and head-to-head comparisons of relative validity in distinguishing known groups. Although all work ability items loaded on a common factor, the optimal factor solution included five factors: role physical, role emotional, thyroid-specific limitations, work limitations (without disease attribution), and work performance. The scale on thyroid-specific limitations showed the most power in distinguishing clinical groups and time since diagnosis. A global single item proved useful for comparisons with the general population, and a thyroid-specific item predicted labor market exclusion within the next 5 years (OR 5.0, 95 % CI 2.7-9.1). Items on work limitations with attribution to thyroid disease were most effective in detecting impact on work ability and showed good predictive validity. Generic work ability items remain useful for general population comparisons.

[Impact of thyroid diseases on bone].

Science.gov (United States)

Tsourdi, E; Lademann, F; Siggelkow, H

2018-05-09

Thyroid hormones are key regulators of skeletal development in childhood and bone homeostasis in adulthood, and thyroid diseases have been associated with increased osteoporotic fractures. Hypothyroidism in children leads to an impaired skeletal maturation and mineralization, but an adequate and timely substitution with thyroid hormones stimulates bone growth. Conversely, hyperthyroidism at a young age accelerates skeletal development, but may also cause short stature because of a premature fusion of the growth plates. Hypothyroidism in adults causes an increase in the duration of the remodeling cycle and, thus, leads to low bone turnover and enhanced mineralization, but an association with a higher fracture risk is less well established. In adults, a surplus of thyroid hormones enhances bone turnover, mostly due to an increased bone resorption driven by osteoclasts. Thus, hyperthyroidism is a well-recognized cause of high-bone turnover secondary osteoporosis, resulting in an increased susceptibility to fragility fractures. Subclinical hyperthyroidism, especially resulting from endogenous disease, also has an adverse effect on bone mineral density and is associated with fractures. In most patients with overt or subclinical hyperthyroidism restoration of the euthyroid status reverses bone loss. In postmenopausal women who receive thyroid-stimulating hormone suppression therapy because of thyroid cancer, antiresorptive treatments may be indicated. Overall, extensive data support the importance of a euthyroid status for bone mineral accrual and growth in childhood as well as maintenance of bone health in adulthood.

Thyroid gland in chronic obstructive pulmonary disease.

Science.gov (United States)

Miłkowska-Dymanowska, Joanna; Białas, Adam J; Laskowska, Paulina; Górski, Paweł; Piotrowski, Wojciech J

2017-01-01

The risk of chronic obstructive pulmonary disease (COPD), as well as thyroid diseases increases with age. COPD is a common systemic disease associated with chronic inflammation. Many endocrinological disorders, including thyroid gland diseases are related to systemic inflammation. Epidemiological studies suggest that patients with COPD are at higher risk of thyroid disorders. These associations are not well-studied and thyroid gland diseases are not included on the broadly acknowledged list of COPD comorbidities. They may seriously handicap quality of life of COPD patients. Unfortunately, the diagnosis may be difficult, as many signs are masked by the symptoms of the index disease. The comprehension of the correlation between thyroid gland disorders and COPD may contribute to better care of patients. In this review, we attempt to revise available literature describing existing links between COPD and thyroid diseases.

Recent tendency in diagnosis of thyroid diseases

International Nuclear Information System (INIS)

Koizumi, Kiyoshi; Ito, Hiroshi; Tatsuno, Ikuro

1979-01-01

Various new approaches have been recently investigated in diagnosis of thyroid diseases with the progress of nuclear medicine. sup(99m)TcO 4 - has become a routinely used radiopharmaceutical in thyroid scan. sup(99m)TcO 4 - thyroid uptake was evaluated by using thyroid-t-high ratio. 123 I thyroid scan is more valuable than 131 I scan because of its short half time and low radiation exposure. We use 123 I particulary in functional analysis of thyroid hot nodule. 201 Tl scans were performed in patients with cold nodule. All thyroid cancer patients showed 201 Tl positive accumulation in thyroid nodule. However, even in benign diseases 201 Tl was accumulated. 201 Tl scan will be most effectively used in detecting the metastatic lesions from thyroid cancer. Serum rT 3 concentration in various diseases was evaluated by RIA method. Serum TBG concentration in various diseases was evaluated by RIA method and T 4 /TBG ratio was evaluated. Serum anti-thyroglobulin antibody titer in thyroid diseases was evaluated by RIA method. It was more objective than widely used tanned red cell hemagglutinin method. (author)

Interactions between thyroid disorders and kidney disease

Directory of Open Access Journals (Sweden)

Gopal Basu

2012-01-01

Full Text Available There are several interactions between thyroid and kidney functions in each other organ′s disease states. Thyroid hormones affect renal development and physiology. Thyroid hormones have pre-renal and intrinsic renal effects by which they increase the renal blood flow and the glomerular filtration rate (GFR. Hypothyroidism is associated with reduced GFR and hyperthyroidism results in increased GFR as well as increased renin - angiotensin - aldosterone activation. Chronic kidney disease (CKD is characterized by a low T3 syndrome which is now considered a part of an atypical nonthyroidal illness. CKD patients also have increased incidence of primary hypothyroidism and subclinical hypothyroidism. The physiological benefits of a hypothyroid state in CKD, and the risk of CKD progression with hyperthyroidism emphasize on a conservative approach in the treatment of thyroid hormone abnormalities in CKD. Thyroid dysfunction is also associated with glomerulonephritis often by a common autoimmune etiology. Several drugs could affect both thyroid and kidney functions. There are few described interactions between thyroid and renal malignancies. A detailed knowledge of all these interactions is important for both the nephrologists and endocrinologists for optimal management of the patient.

Trends in Costs of Thyroid Disease Treatment in Denmark during 1995-2015.

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Møllehave, Line Tang; Linneberg, Allan; Skaaby, Tea; Knudsen, Nils; Ehlers, Lars; Jørgensen, Torben; Thuesen, Betina Heinsbæk

2018-03-01

Iodine fortification (IF) may contribute to changes in costs of thyroid disease treatment through changes in disease patterns. From a health economic perspective, assessment of the development in costs of thyroid disease treatment in the population is pertinent. To assess the trends in annual medicine and hospital costs of thyroid disease treatment during 1995-2015 in Denmark, i.e., before and after the introduction of mandatory IF in 2000. Information on treatments for thyroid disease (antithyroid medication, thyroid hormone therapy, thyroid surgery, and radioiodine treatment) was obtained from nationwide registers. Costs were valued at 2015 prices using sales prices for medicines and the Danish Diagnosis-Related Group (DRG) and Danish Ambulatory Grouping System (DAGS) tariffs of surgeries/radioiodine treatments. Results were adjusted for changes in population size and age and sex distribution. The total direct medicine and hospital costs of thyroid disease treatment increased from EUR ∼190,000 per 100,000 persons in 1995 to EUR ∼270,000 per 100,000 persons in 2015. This was mainly due to linearly increased costs of thyroid hormone therapy and increased costs of thyroid surgery since 2008. Costs of antithyroid medication increased slightly and transiently after IF, while costs of radioiodine treatment remained constant. Costs of thyroid hormone therapy and thyroid surgery did not follow the development in the prevalence of hypothyroidism and structural thyroid diseases observed in concurrent studies. The costs of total direct medicine and hospital costs for thyroid disease treatment in Denmark increased from 1995 to 2015. This is possibly due to several factors, e.g., changes in treatment practices, and the direct effect of IF alone remains to be estimated.

Identification of Novel Genetic Loci Associated with Thyroid Peroxidase Antibodies and Clinical Thyroid Disease

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Teumer, Alexander; Brown, Suzanne J.; Jensen, Richard A.; Rawal, Rajesh; Roef, Greet L.; Plantinga, Theo S.; Vermeulen, Sita H.; Lahti, Jari; Simmonds, Matthew J.; Husemoen, Lise Lotte N.; Freathy, Rachel M.; Shields, Beverley M.; Pietzner, Diana; Nagy, Rebecca; Broer, Linda; Chaker, Layal; Korevaar, Tim I. M.; Plia, Maria Grazia; Sala, Cinzia; Völker, Uwe; Richards, J. Brent; Sweep, Fred C.; Gieger, Christian; Corre, Tanguy; Kajantie, Eero; Thuesen, Betina; Taes, Youri E.; Visser, W. Edward; Hattersley, Andrew T.; Kratzsch, Jürgen; Hamilton, Alexander; Li, Wei; Homuth, Georg; Lobina, Monia; Mariotti, Stefano; Soranzo, Nicole; Cocca, Massimiliano; Nauck, Matthias; Spielhagen, Christin; Ross, Alec; Arnold, Alice; van de Bunt, Martijn; Liyanarachchi, Sandya; Heier, Margit; Grabe, Hans Jörgen; Masciullo, Corrado; Galesloot, Tessel E.; Lim, Ee M.; Reischl, Eva; Leedman, Peter J.; Lai, Sandra; Delitala, Alessandro; Bremner, Alexandra P.; Philips, David I. W.; Beilby, John P.; Mulas, Antonella; Vocale, Matteo; Abecasis, Goncalo; Forsen, Tom; James, Alan; Widen, Elisabeth; Hui, Jennie; Prokisch, Holger; Rietzschel, Ernst E.; Palotie, Aarno; Feddema, Peter; Fletcher, Stephen J.; Schramm, Katharina; Rotter, Jerome I.; Kluttig, Alexander; Radke, Dörte; Traglia, Michela; Surdulescu, Gabriela L.; He, Huiling; Franklyn, Jayne A.; Tiller, Daniel; Vaidya, Bijay; de Meyer, Tim; Jørgensen, Torben; Eriksson, Johan G.; O'Leary, Peter C.; Wichmann, Eric; Hermus, Ad R.; Psaty, Bruce M.; Ittermann, Till; Hofman, Albert; Bosi, Emanuele; Schlessinger, David; Wallaschofski, Henri; Pirastu, Nicola; Aulchenko, Yurii S.; de la Chapelle, Albert; Netea-Maier, Romana T.; Gough, Stephen C. L.; Meyer zu Schwabedissen, Henriette; Frayling, Timothy M.; Kaufman, Jean-Marc; Linneberg, Allan; Räikkönen, Katri; Smit, Johannes W. A.; Kiemeney, Lambertus A.; Rivadeneira, Fernando; Uitterlinden, André G.; Walsh, John P.; Meisinger, Christa; den Heijer, Martin; Visser, Theo J.; Spector, Timothy D.; Wilson, Scott G.; Völzke, Henry; Cappola, Anne; Toniolo, Daniela; Sanna, Serena; Naitza, Silvia; Peeters, Robin P.

2014-01-01

Autoimmune thyroid diseases (AITD) are common, affecting 2-5% of the general population. Individuals with positive thyroid peroxidase antibodies (TPOAbs) have an increased risk of autoimmune hypothyroidism (Hashimoto's thyroiditis), as well as autoimmune hyperthyroidism (Graves' disease). As the possible causative genes of TPOAbs and AITD remain largely unknown, we performed GWAS meta-analyses in 18,297 individuals for TPOAb-positivity (1769 TPOAb-positives and 16,528 TPOAb-negatives) and in 12,353 individuals for TPOAb serum levels, with replication in 8,990 individuals. Significant associations (Phyperthyroidism, goiter and thyroid cancer were studied. Individuals with a high genetic risk score had, besides an increased risk of TPOAb-positivity (OR: 2.18, 95% CI 1.68–2.81, P = 8.1×10−8), a higher risk of increased thyroid-stimulating hormone levels (OR: 1.51, 95% CI 1.26–1.82, P = 2.9×10−6), as well as a decreased risk of goiter (OR: 0.77, 95% CI 0.66–0.89, P = 6.5×10−4). The MAGI3 and BACH2 variants were associated with an increased risk of hyperthyroidism, which was replicated in an independent cohort of patients with Graves' disease (OR: 1.37, 95% CI 1.22–1.54, P = 1.2×10−7 and OR: 1.25, 95% CI 1.12–1.39, P = 6.2×10−5). The MAGI3 variant was also associated with an increased risk of hypothyroidism (OR: 1.57, 95% CI 1.18–2.10, P = 1.9×10−3). This first GWAS meta-analysis for TPOAbs identified five newly associated loci, three of which were also associated with clinical thyroid disease. With these markers we identified a large subgroup in the general population with a substantially increased risk of TPOAbs. The results provide insight into why individuals with thyroid autoimmunity do or do not eventually develop thyroid disease, and these markers may therefore predict which TPOAb-positives are particularly at risk of developing clinical thyroid dysfunction. PMID:24586183

Evaluation of diffuse thyroid diseases by computed tomography and sup 123 I thyroidal uptake

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Kurihara, Yoshiko (Saint Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine); Imanishi, Yoshimasa; Ehara, Norishige (and others)

1991-10-01

Understanding the iodine kinetics in the thyroid is useful for the diagnosis of a patient with diffuse thyroid disease. In this study, 9 controls and 50 patients with diffuse thyroid diseases, we evaluated diffuse thyroid diseases with {sup 123}I thyroidal uptake and volume, iodine concentration, and net iodine content measured by computed tomography. There was no significant correlation between volume, iodine concentration, and net iodine content of the thyroid and {sup 123}I thyroidal uptake. The thyroid volume in Graves' and Hashimoto's diseases was significantly larger than that in the control group. The thyroid iodine concentration in Graves' and Hashimoto's diseases was significantly smaller than that in the control group. The thyroid net iodine content in Hashimoto's disease was significantly smaller than that in the control group. Although most of the patients with Graves' disease had more increased radioiodine thyroidal uptake than the control group, there was no significant difference between them in the mean of the thyroid net iodine content. But the variance of net iodine contents in the former was significantly larger than that in the latter. The thyroid net iodine content was very low in all patients with very high thyroglobulin hemaggrugated antibody (TGHA) value although it was nearly normal in some patients with normal TGHA value. It was suggested that iodine concentration and net iodine content might be determined not only by iodine uptake but also by release and/or leakage of iodine compounds from the thyroid, which might depend on some antithyroid antibodies. (author).

Correlation between serum lead and thyroid diseases: papillary thyroid carcinoma, nodular goiter, and thyroid adenoma.

Science.gov (United States)

Li, Hui; Li, Xiang; Liu, Jie; Jin, Langping; Yang, Fan; Wang, Junbo; Wang, Ouchen; Gao, Ying

2017-10-01

Studies have showed that lead was associated with human health. However, the effects of lead on thyroid functions are inconsistent, and studies based on Chinese population are fragmentary. To evaluate the correlation between lead and thyroid functions of Chinese with different thyroid diseases, we conducted a hospital-based study. Ninety-six papillary thyroid carcinoma (PTC), 10 nodular goiter (NG), and 7 thyroid adenoma (TA) patients were recruited from the First Affiliated Hospital of Wenzhou Medical University, China. Serum triiodothyronine (T3), free triiodothyronine (FT3), free thyroxin (FT4), and thyroid stimulating hormone (TSH) were evaluated with chemiluminescent microparticle immunoassay. Serum lead was assessed with ICP-MASS. Partial correlation was used to explore the correlations of serum lead and thyroid diseases. Compared to PTC, the level of lead was significantly higher in TA, and lower in NG (p lead was negatively correlated with TSH (r s  =  - 0.27, p lead at quartile4 (r s  = 0.61, p lead and FT3 or FT4 in any group. The results suggested that lead might have different etiological roles in these three thyroid diseases.

Thyroid disease and the cardiovascular system.

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Danzi, Sara; Klein, Irwin

2014-06-01

Thyroid hormones, specifically triiodothyronine (T3), have significant effects on the heart and cardiovascular system. Hypothyroidism, hyperthyroidism, subclinical thyroid disease, and low T3 syndrome each cause cardiac and cardiovascular abnormalities through both genomic and nongenomic effects on cardiac myocytes and vascular smooth muscle cells. In compromised health, such as occurs in heart disease, alterations in thyroid hormone metabolism may further impair cardiac and cardiovascular function. Diagnosis and treatment of cardiac disease may benefit from including analysis of thyroid hormone status, including serum total T3 levels. Copyright © 2014 Elsevier Inc. All rights reserved.

Environmental Issues in Thyroid Diseases.

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Ferrari, Silvia Martina; Fallahi, Poupak; Antonelli, Alessandro; Benvenga, Salvatore

2017-01-01

Environmental factors are determinant for the appearance of autoimmune thyroid diseases (AITD) in susceptible subjects. Increased iodine intake, selenium, and vitamin D deficiency, exposure to radiation, from nuclear fallout or due to medical radiation, are environmental factors increasing AITD. Cigarette smoking is associated with Graves' disease and Graves' ophthalmopathy, while it decreases the risk of hypothyroidism and thyroid autoimmunity. Viral infections are important environmental factors in the pathogenesis of AITD, too, particularly human parvovirus B19 (EVB19) and hepatitis C virus. Among the many chemical contaminants, halogenated organochlorines and pesticides variably disrupt thyroid function. Polychlorinated biphenyls and their metabolites and polybrominated diethyl ethers bind to thyroid transport proteins, such as transthyretin, displace thyroxine, and disrupt thyroid function. Among drugs, interferon- and iodine-containing drugs have been associated with AITD. Moreover intestinal dysbiosis causes autoimmune thyroiditis. To reduce the risk to populations and also in each patient, it is necessary to comprehend the association between environmental agents and thyroid dysfunction.

The interventional diagnosis and therapy for thyroid disease should be studied deeply and developed prudently

International Nuclear Information System (INIS)

Zhao Wei; Cheng Yongde

2007-01-01

Many details concerning the interventional diagnosis and therapy of thyroid disease need to be studied deeply and carefully; for example, the thyroid applied anatomy, especially the anatomical imageology study of the thyroid arterial anastomosis involving the therapeutic effects and complications, the thyroid artery embolization treatment, presently as a substitution or the supplement therapy for the traditional classical therapy of Graves disease. There are many exploration to extend the indication scope, the therapeutic effect, embolization scope in intervention for Graves disease due to having no accurate individual quantification standard, and so on. The thyroid arterial embolization for Graves disease is to reduce the main cause of thyroxin secretion. Simultaneously, the comprehensive therapeutic effects might have possibly produce the thyroidcytic apoptosis and immune adjustments. Serious complications such as the cerebral infarction, the hyperthyroidism crisis, the hypocalcemia, the periodic paralysis, and so on commonly occured in thyroid arterial embolization. It is necessary to keep strictly the procedure rule and the indication. The mid-and long- term therapeutic effect of thyroid artery embolization for Graves disease is good, but still need more extensive and prudent research for the prospective achievement. (authors)

The Role of Vitamin D in Thyroid Diseases.

Science.gov (United States)

Kim, Dohee

2017-09-12

The main role of vitamin D is regulating bone metabolism and calcium and phosphorus homeostasis. Over the past few decades, the importance of vitamin D in non-skeletal actions has been studied, including the role of vitamin D in autoimmune diseases, metabolic syndromes, cardiovascular disease, cancers, and all-cause mortality. Recent evidence has demonstrated an association between low vitamin D status and autoimmune thyroid diseases such as Hashimoto's thyroiditis and Graves' disease, and impaired vitamin D signaling has been reported in thyroid cancers. This review will focus on recent data on the possible role of vitamin D in thyroid diseases, including autoimmune thyroid diseases and thyroid cancers.

Nodular Graves' disease with medullary thyroid cancer.

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Khan, Shoukat Hussain; Rather, Tanveer Ahmed; Makhdoomi, Rumana; Malik, Dharmender

2015-01-01

Co-existence of thyroid nodules with Graves' disease has been reported in various studies. 10-15% of such nodules harbor thyroid cancer with papillary thyroid cancer being the commonest. Medullary thyroid cancer (MTC) in nodules associated with Graves' disease is rare. On literature survey, we came across 11 such cases reported so far. We report a 62-year-old female with Graves' disease who also had a thyroid nodule that on fine-needle aspiration cytology and the subsequent postthyroidectomy histopathological examination was reported to be MTC.

ULTRASOUND EVALUATION OF THYROID DISEASES

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Battula

2016-04-01

Full Text Available AIMS & OBJECTIVES: 1. To differentiate cystic lesions from solid lesions. 2. The possibility to differentiate the intrinsic thyroid lesions from those arising from adjoining structures. 3. To evaluate the neoplasms and to differentiate benign from malignant lesions by USG characteristics and to correlate with FNAC reports. 4. Role of USG in rapidly growing thyroid lesions: To differentiate haemorrhage into the cystic lesions and rapidly growing malignant tumours. 5. Compare the results of our study with similar studies available in the present literature. MATERIALS & METHODS This study included 75 patients who attended outpatient departments of the Endocrinology, Medical and Surgical Units and also those who were inpatients. RESULTS Broadly pathological conditions of thyroid glands can be divided into nodular and diffuse thyroid diseases. Among Nodular Diseases Majority are benign, only few are malignant. Characteristics of benign lesions are: 1. Well-differentiated margins. 2. Thin complete peripheral sonolucent halo. 3. Coarse peripheral calcifications. Characteristics of malignant nodules are: 1. Ill-defined margins. 2. Thick incomplete peripheral halo. 3. Fine punctuate calcifications. Diffuse Thyroid Diseases 1. Hashimoto’s thyroiditis: Painless diffuse enlargement of thyroid gland usually in women with coarse echotexture and no normal gland tissue. There may be discrete hypoechoic nodules within it with cervical lymphadenopathy. 2. Goitres: a Simple diffuse goitre: Symmetrical enlargement of gland without tenderness or bruit or lymphadenopathy, T3, T4 and TSH are within normal limits and no thyroid autoantibodies in the serum. a Diffuse Toxic goitre: Diffuse enlargement of gland with increased vascularity on colour Doppler study. b Multinodular goitre: Multiple hypoechoic nodule within normal thyroid parenchyma. c Colloid goitre: Present as single or multiple swellings in the thyroid gland. CONCLUSION USG is the fast and cost effective

Thyroid Ultrasonography in Differentiation between Graves' Disease and Hashimoto's Thyroiditis.

Science.gov (United States)

Pishdad, P; Pishdad, G R; Tavanaa, S; Pishdad, R; Jalli, R

2017-03-01

Graves' disease and Hashimoto's thyroiditis are the most common causes of hyper and hypothyroidism, respectively. Differentiation of these 2 diseases, if the patient is euthyroid, may sometimes be extremely difficult on the basis of clinical and laboratory findings. The purpose of this study was to determine the sensitivity and specificity of gray scale sonography in differentiation of Graves' disease from Hashimoto's thyroiditis. This study included 149 patients divided into three groups, patients with Graves' disease (34 patients, mean age = 36.8 ± 10.17 years), Patients with Hashimoto's thyroiditis (62 patients, mean age = 33.4 ± 12.16 years) and control group (53 healthy people, mean age = 34.74 ± 16.87 years). Members of all groups were referred to a single radiologist for thyroid sonography for evaluation of thyroid echogenicity pattern. A total of 117 women and 32 men were examined by sonography. The most common sonographic pattern in Hashimoto and Graves' was homogenous hypo-echogenicity which was observed in 45.2% and 47.1% of cases, respectively. Peripheral hypo-echogenicity pattern was seen in 40.3% of Hashimoto's group with 100% specificity and 40.3% sensitivity. Central-hypoechogenic pattern was observed in 17.6% of Graves' group with 100% and 17.6% specificity and sensitivity, respectively. Our findings indicate that sonography has high specificity but low sensitivity in the diagnosis of either Graves' disease or Hashimoto's thyroiditis. It is therefore not possible to differentiate between these two diseases using sonography alone. Confirmation by laboratory data is also needed.

Reevaluation of the Thyroid Scan for the Assessment of Pathophysiologic Status of Thyroid Disease

International Nuclear Information System (INIS)

Woo, In Sook; Nah, Jung Il; Kim, Deog Yoon

1991-01-01

To diagnosis and understand the pathophysiologic status of thyroid disease, not only hormonal measurements but also thyroid scan is believed to have a unique role. Especially in the cases of the change of the thyroid function by thyroiditis, it is emphasized that thyroid scan can be helpful in differential diagnosis, Discordant results of thyroid hormone levels and thyroid scan are found in transient hyperthyroidism, or in transient hypothyroidism. We analysed and reevaluated thyroid scan to look at the importance of thyroid scan. The results are summarised as follows: 1) 80%. of hyperthyroid patients had hyperthyroidism increased RAIU with even density, they are compatible with Graves' disease. 2) 2.1% of hyperthyroid patients had normal or decreased RAIU, which are classified as high iodine turn over genuine hyperthyroidism. 3) 8.5% of hyperthyroid patients had markedly decreased RAIU at both 2 hour and 24 hour, whose pathologic processes are suggested to be heterogenous namely subacute thyroiditis, postpartum thyroiditis, Hashimoto's thyroiditis, and pamless thyroiditis. 4) 45% of hypothyroid patients had increased 24 hr RAIU, 30% of hypothyroid patients were normal, 25%, decreased. In conclusion, thyroid scan should be reevaluated its useful role to asses the pathophysiologic status of thyroid disease. Especially in cases of transient thyrotoxicosis, thyroid scan is essential to diagnose and follow up the disease process.

Reevaluation of the Thyroid Scan for the Assessment of Pathophysiologic Status of Thyroid Disease

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Woo, In Sook; Nah, Jung Il; Kim, Deog Yoon [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

1991-03-15

To diagnosis and understand the pathophysiologic status of thyroid disease, not only hormonal measurements but also thyroid scan is believed to have a unique role. Especially in the cases of the change of the thyroid function by thyroiditis, it is emphasized that thyroid scan can be helpful in differential diagnosis, Discordant results of thyroid hormone levels and thyroid scan are found in transient hyperthyroidism, or in transient hypothyroidism. We analysed and reevaluated thyroid scan to look at the importance of thyroid scan. The results are summarised as follows: 1) 80%. of hyperthyroid patients had hyperthyroidism increased RAIU with even density, they are compatible with Graves' disease. 2) 2.1% of hyperthyroid patients had normal or decreased RAIU, which are classified as high iodine turn over genuine hyperthyroidism. 3) 8.5% of hyperthyroid patients had markedly decreased RAIU at both 2 hour and 24 hour, whose pathologic processes are suggested to be heterogenous namely subacute thyroiditis, postpartum thyroiditis, Hashimoto's thyroiditis, and pamless thyroiditis. 4) 45% of hypothyroid patients had increased 24 hr RAIU, 30% of hypothyroid patients were normal, 25%, decreased. In conclusion, thyroid scan should be reevaluated its useful role to asses the pathophysiologic status of thyroid disease. Especially in cases of transient thyrotoxicosis, thyroid scan is essential to diagnose and follow up the disease process.

Thyroid diseases after Chernobyl accident

International Nuclear Information System (INIS)

Nagataki, Shigenobu

1993-01-01

Radioactive iodine is released at every atomic-bomb testings and nuclear plants accidents and radioactive iodine is taken up by thyroid glands (internal radiation). In addition to the internal radiation, radioactive fallout causes the external radiation and thyroid glands are known to be sensitive to the external radiation. Furthermore, patients with radiation-induced thyroid disease can survive for a long time regardless of the treatment. The survey of thyroid diseases, therefore, is very sensitive and reliable ways to investigate the effects of radiation caused by atomic bomb explosion, testing and various types of nuclear plants' accidents. Our group from Nagasaki University was asked to investigate the thyroid diseases and jointed to the Sasakawa Project. In order to investigate the effects of radiation on thyroid disease, it is essential 1) to make a correct diagnosis in each subject, 2) to calculate a correct radiation dose in each subject and finally, 3) to find out the correlation between the radiation dose and thyroid diseases including age-, sex- and area-matched controls. We have established 5 centers (1 in Russia, 2 in Belarus, 2 in Ukraine) and supplied the most valuable ultrasonography instruments, commercial kits for the determination of serum free T 4 and TSH level and for the autoantibodies, instrument for urinary iodine measurements, syringers, tubes, refrigerators, etc. We visit each center often and asked people at centers to come to Japan for training. Protocol of investigation is essentially the same as that in Nagasaki, and we are planning to investigate more than 50,000 children within 5 years. We are hoping to show a definite conclusion in the near future. Recent articles are also discussed. (author)

[Immunohistochemical profile of angiogenesis in the thyroid gland in various thyroid diseases].

Science.gov (United States)

Rurua, N Z; Gogiashvili, L E; Tsagareli, Z G

2013-12-01

The purpose of the study - to determine the feature of the vascular endothelial growth factor (VEGF) and thyroid-stimulating hormone (TSH) expression in the thyroid gland (TG) in various thyroid diseases. Material - thyroid tissue (operative material) with histologically confirmed diagnosis: 10 - follicular adenoma, 17 - multinodular goiter, 8 - thyroiditis Hashimoto, 8 - papillary carcinoma, 10 - intact (normal) thyroid samples (forensic autopsy). The immunohistochemical study of the material showed the following results: the increase of the Hürtle cells population 40 % or more indicates a hyperthyroidism tendency despite TSH+ receptor status. Under the thyroid pathology TSH and VEGF expression appears in thyrocytes and also in microvascular endothelial cells. VEGF expression is below the norm in the Hashimoto thyroiditis. VEGF is involved not only in angiogenesis, but in pathophysiological shifts in thyroid tissue. Microvessel density (MVD) and TSH positive receptor status under the thyroid pathology testify the absence of the endothelial cells transformation, however, this index can not serve as a biopothential prognostic marker of thyroid disease.

Thyroid Dysfunction and Autoimmune Thyroid Diseases Among Atomic Bomb Survivors Exposed in Childhood.

Science.gov (United States)

Imaizumi, Misa; Ohishi, Waka; Nakashima, Eiji; Sera, Nobuko; Neriishi, Kazuo; Yamada, Michiko; Tatsukawa, Yoshimi; Takahashi, Ikuno; Fujiwara, Saeko; Sugino, Keizo; Ando, Takao; Usa, Toshiro; Kawakami, Atsushi; Akahoshi, Masazumi; Hida, Ayumi

2017-07-01

The risk of thyroid cancer increases and persists for decades among individuals exposed to ionizing radiation in childhood, although the long-term effects of childhood exposure to medium to low doses of radiation on thyroid dysfunction and autoimmune thyroid diseases have remained unclear. To evaluate radiation dose responses for the prevalence of thyroid dysfunction and autoimmune thyroid disease among atomic bomb survivors exposed in childhood. Hiroshima and Nagasaki atomic bomb survivors who were younger than 10 years old at exposure underwent thyroid examinations at the Radiation Effects Research Foundation between 2007 and 2011, which was 62 to 66 years after the bombing. Data from 2668 participants (mean age, 68.2 years; 1455 women) with known atomic bomb thyroid radiation doses (mean dose, 0.182 Gy; dose range, 0 to 4.040 Gy) were analyzed. Dose-response relationships between atomic bomb radiation dose and the prevalence of hypothyroidism, hyperthyroidism (Graves' disease), and positive for antithyroid antibodies. Prevalences were determined for hypothyroidism (129 cases, 7.8%), hyperthyroidism (32 cases of Graves' disease, 1.2%), and positive for antithyroid antibodies (573 cases, 21.5%). None of these was associated with thyroid radiation dose. Neither thyroid antibody-positive nor -negative hypothyroidism was associated with thyroid radiation dose. Additional analyses using alternative definitions of hypothyroidism and hyperthyroidism found that radiation dose responses were not significant. Radiation effects on thyroid dysfunction and autoimmune thyroid diseases were not observed among atomic bomb survivors exposed in childhood, at 62 to 66 years earlier. The cross-sectional design and survival bias were limitations of this study. Copyright © 2017 Endocrine Society

The environment and autoimmune thyroid diseases

NARCIS (Netherlands)

Prummel, Mark F.; Strieder, Thea; Wiersinga, Wilmar M.

2004-01-01

Genetic factors play an important role in the pathogenesis of autoimmune thyroid disease (AITD) and it has been calculated that 80% of the susceptibility to develop Graves' disease is attributable to genes. The concordance rate for AITD among monozygotic twins is, however, well below I and

Identification of novel genetic Loci associated with thyroid peroxidase antibodies and clinical thyroid disease.

Directory of Open Access Journals (Sweden)

Marco Medici

2014-02-01

individuals with thyroid autoimmunity do or do not eventually develop thyroid disease, and these markers may therefore predict which TPOAb-positives are particularly at risk of developing clinical thyroid dysfunction.

Ultrasound diagnostics of thyroid diseases

International Nuclear Information System (INIS)

Kharchenko, Vladimir P.; Kotlyarov, Peter M.; Mogutov, Mikhail S.; Sencha, Alexander N.; Patrunov, Yury N.; Belyaev, Denis V.; Alexandrov, Yury K.

2010-01-01

This book is based on the authors' extensive practical experience in the use of modern ultrasound, and other radiological methods, in the diagnosis of thyroid diseases. The authors have analyzed more than 100,000 ultrasound examinations performed between 1995 and 2008 in patients with thyroid and parathyroid disease, as well as many thousands of diagnostic and therapeutic ultrasound-guided minimally invasive procedures. The opening chapters include discussion of current ultrasound techniques, pitfalls, and the specifics of ultrasound examination of the thyroid in children. Detailed attention is then devoted to findings in the normal thyroid and in the presence of diffuse and focal changes. Further chapters focus on such topics as ultrasound examination after thyroid surgery and ultrasound diagnosis of parathyroid disease, recurrent goiter, and neck masses. Ultrasound-guided minimally invasive techniques, such as fine-needle aspiration biopsy, percutaneous laser ablation, and ethanol and glucocorticoid injections, are considered in depth. This up-to-date and richly illustrated book will interest and assist specialists in ultrasound diagnostics, radiologists, endocrinologists, and neck surgeons. (orig.)

pattern of subclinical thyroid disease

International Nuclear Information System (INIS)

Ijaz, A.; Marri, M.H.; Qureshi, A.H.; Qamar, M.A.; Ali, N.

2002-01-01

Objective: To evaluate the prevalence of subclinical thyroid disease (SCTD) in local population visiting a hospital laboratory for thyroid function tests. Design: It was a hospital - based study carried in consecutive patients who reported for thyroid function tests in the hospital laboratory. Place and duration of study: The study was conducted in combined military Hospital, Quetta during June 1999 to September 2000. Subject and methods: Serum samples of 917 patients living in Quetta and its surrounding were analysed for thyroid stimulating hormone (TSH) free thyroxin (FT4), and total tri-iodothyronine (T3) concentration using chemiluminescence technique on hormone auto analyser (LIA-Mat - Sangtech Germany). Results: Out of 917 patients, 287 (23%) were found to be having SCTD while overt thyroid disease was found in 288 (31%) patients. Prevalence of sub-clinical hypothyroidism (SCO) and sub-clinical hyperthyroidism (sce) was found to be almost equal with a profound female preponderance in both the groups. SCO was more common in children (<12 years of age). Conclusion: Almost every fourth patient reporting for thyroid function tests was diagnosed as having SCTD - a disease entity that is still not well known and that poses diagnostic and management problems for the pathologists and clinicians. (author)

Thyroid dysfunction after mantle irradiation of Hodgkin`s disease patients

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Khoo, V.S.; Liew, K.H.; Crennan, E.C.; D`Costa, I.M. [Peter MacCallum Caner Institute, East Melbourne, VIC (Australia). Department of Radiation Oncology; Quong, G. [Austin and Repatriation Medical Centre, West Heidelberg, VIC (Australia). Department of Radiation Oncology

1998-02-01

Thyroid dysfunction can develop in patients with Hodgkin`s disease who are treated with mantle irradiation. During the period 1970-89, the records of 320 patients who received mantle irradiation and who had thyroid function tests (TFT) were retrospectively reviewed. The median age was 30 years (range, 7-69 years). The median mantle and thyroid dose was 36 Gy (range, 30-40 Gy) and 39.8 Gy (range, 32-65 Gy), respectively. Overall thyroid dysfunction was present in 39% of the patients. Clinical hypothyroidism was seen in 10% and biochemical hypothyroidism was noted in 25%. Hyperthyroidism was found in 4% of patients. Thyroid nodules had developed in six patients (2%), of which those in four patients were malignant. Age, sex, histological subtype, stage of disease, dose, Iymphangiogram and treatment with chemotherapy were not significant factors in the development of thyroid dysfunction. The narrow dose range prevented adequate analysis of dose effect. The results indicate that the incidence of thyroid abnormalities is high enough to warrant regular TFT assessment with pre-irradiation levels and follow-up testing for life because the development of abnormalities can occur many years later. Thyroid examination should form part of the routine follow-up examination and any abnormality should be promptly investigated. Copyright (1998) Blackwell Science Pty Ltd 32 refs., 3 tabs.

Thyroid hormone action in postnatal heart development

Directory of Open Access Journals (Sweden)

Ming Li

2014-11-01

Full Text Available Thyroid hormone is a critical regulator of cardiac growth and development, both in fetal life and postnatally. Here we review the role of thyroid hormone in postnatal cardiac development, given recent insights into its role in stimulating a burst of cardiomyocyte proliferation in the murine heart in preadolescence; a response required to meet the massive increase in circulatory demand predicated by an almost quadrupling of body weight during a period of about 21 days from birth to adolescence. Importantly, thyroid hormone metabolism is altered by chronic diseases, such as heart failure and ischemic heart disease, as well as in very sick children requiring surgery for congenital heart diseases, which results in low T3 syndrome that impairs cardiovascular function and is associated with a poor prognosis. Therapy with T3 or thyroid hormone analogs has been shown to improve cardiac contractility; however, the mechanism is as yet unknown. Given the postnatal cardiomyocyte mitogenic potential of T3, its ability to enhance cardiac function by promoting cardiomyocyte proliferation warrants further consideration.

Pathological evaluation of thyroid glands in Graves' disease after thyroid arteries embolization

International Nuclear Information System (INIS)

Zhuang Wenquan; Xiao Haipeng; Cheng Wei; Yang Jianyong; Chen Guorui; Ling Qibo

2003-01-01

Objective: To study the pathological morphology of thyroid specimen after thyroid arteries embolization. In order to select appropriate size of embolizing granules, the diameters of thyroid arteries in Graves' disease were measured. Methods: Multiple slides of embolized thyroid tissues from superior pole, body and inferior pole of the resected thyroid glands were made. After being embedded and stained, pathological morphology was observed and diameters of arteries in various parts of thyroid glands were measured under microscopy. Results: Pathological examination of thyroid glands showed that superior and inferior thyroid arteries and most of their branches were embolized with ischemic necrosis and fibrosis in the embolized thyroid tissue. Follicular epithelium appeared as flat or cubic shapes with colloid reduction. Average diameter of main branches of superior artery was 440-550 μm and that of inferior artery was 300-375 μm. The diameters of capillary network in the thyroid body was 120-250 μm, and the non-embolized ones was 40-110 μm. The diameter of isthmus was 130-150 μm. Conclusions: Pathological morphology of Graves' disease after thyroid arteries embolization showed that the excretion of thyroid glands would be decreased and equivalents to subtotal thyroidectomy

Thyroid cancer in Graves' disease: is surgery the best treatment for Graves' disease?

Science.gov (United States)

Tamatea, Jade A U; Tu'akoi, Kelson; Conaglen, John V; Elston, Marianne S; Meyer-Rochow, Goswin Y

2014-04-01

Graves' disease is a common cause of thyrotoxicosis. Treatment options include anti-thyroid medications or definitive therapy: thyroidectomy or radioactive iodine (I(131) ). Traditionally, I(131) has been the preferred definitive treatment for Graves' disease in New Zealand. Reports of concomitant thyroid cancer occurring in up to 17% of Graves' patients suggest surgery, if performed with low morbidity, may be the preferred option. The aim of this study was to determine the rate of thyroid cancer and surgical outcomes in a New Zealand cohort of patients undergoing thyroidectomy for Graves' disease. This study is a retrospective review of Waikato region patients undergoing thyroid surgery for Graves' disease during the 10-year period prior to 1 December 2011. A total of 833 patients underwent thyroid surgery. Of these, 117 were for Graves' disease. Total thyroidectomy was performed in 82, near-total in 33 and subtotal in 2 patients. Recurrent thyrotoxicosis developed in one subtotal patient requiring I(131) therapy. There were two cases of permanent hypoparathyroidism and one of permanent recurrent laryngeal nerve palsy. Eight patients (6.8%) had thyroid cancer detected, none of whom had overt nodal disease. Five were papillary microcarcinomas (one of which was multifocal), two were papillary carcinomas (11 mm and 15 mm) and one was a minimally invasive follicular carcinoma. Thyroid cancer was identified in approximately 7% of patients undergoing surgery for Graves' disease. A low complication rate (<2%) of permanent hypoparathyroidism and nerve injury (<1%) supports surgery being a safe alternative to I(131) especially for patients with young children, ophthalmopathy or compressive symptoms. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Total thyroidectomy as primary elective procedure in multinodular thyroid disease

International Nuclear Information System (INIS)

Sheikh, I.A.; Haider, I.Z.; Haroon, A.; Ashfaq, M.

2009-01-01

Multinodular goitre is one of the commonest thyroid diseases encountered in the practice of surgery. The most common surgery being performed for multinodular goitre is subtotal thyroidectomy. Total thyroidectomy is designed to remove all of the thyroid tissue. The objective of this study was to evaluate total thyroidectomy as a primary elective procedure for treatment of multinodular thyroid disease. This descriptive study was carried out at Combined Military Hospital Rawalpindi from June 2003 to September 2006. 88 patients of multinodular thyroid disease were included. Patients having evidence of recurrent laryngeal nerve damage, recurrent goitre, evidence of altered parathyroid functions or evidence of malignancy were excluded. All patients underwent total thyroidectomy by the same team of surgeons and the patients were closely followed up for postoperative complications especially in terms of recurrent laryngeal nerve damage and hypocalcaemic tetany. No major postoperative complication was noted. Only 1 patient (1.14%) developed unilateral recurrent laryngeal nerve damage and 2 patients (2.27%) developed transient hypocalcaemia that recovered quickly. Total thyroidectomy as a primary elective procedure in multinodular thyroid disease is a safe option and it removes the disease process completely, lowers local recurrence rates and avoids the substantial risks of re operative surgery. (author)

Thyroid Ultrasonography in Differentiation between Graves’ Disease and Hashimoto’s Thyroiditis

Science.gov (United States)

Pishdad, P.; Pishdad, G.R.; Tavanaa, S.; Pishdad, R.; Jalli, R.

2017-01-01

Objective: Graves’ disease and Hashimoto’s thyroiditis are the most common causes of hyper and hypothyroidism, respectively. Differentiation of these 2 diseases, if the patient is euthyroid, may sometimes be extremely difficult on the basis of clinical and laboratory findings. The purpose of this study was to determine the sensitivity and specificity of gray scale sonography in differentiation of Graves’ disease from Hashimoto’s thyroiditis. Methods: This study included 149 patients divided into three groups, patients with Graves’ disease (34 patients, mean age = 36.8 ± 10.17 years), Patients with Hashimoto’s thyroiditis (62 patients, mean age = 33.4 ± 12.16 years) and control group (53 healthy people, mean age = 34.74 ± 16.87 years). Members of all groups were referred to a single radiologist for thyroid sonography for evaluation of thyroid echogenicity pattern. Results: A total of 117 women and 32 men were examined by sonography. The most common sonographic pattern in Hashimoto and Graves’ was homogenous hypo-echogenicity which was observed in 45.2% and 47.1% of cases, respectively. Peripheral hypo-echogenicity pattern was seen in 40.3% of Hashimoto’s group with 100% specificity and 40.3% sensitivity. Central-hypoechogenic pattern was observed in 17.6% of Graves’ group with 100% and 17.6% specificity and sensitivity, respectively. Conclusion: Our findings indicate that sonography has high specificity but low sensitivity in the diagnosis of either Graves’ disease or Hashimoto’s thyroiditis. It is therefore not possible to differentiate between these two diseases using sonography alone. Confirmation by laboratory data is also needed. PMID:28451576

Thyroid Follicular Carcinoma in a Fourteen-year-old Girl with Graves' Disease.

Science.gov (United States)

Kojima-Ishii, Kanako; Ihara, Kenji; Ohkubo, Kazuhiro; Matsuo, Terumichi; Toda, Naoko; Yamashita, Hiroyuki; Kono, Shinji; Hara, Toshiro

2014-04-01

Here we present the case of a 14-yr-old girl who developed thyroid follicular carcinoma accompanied by Graves' disease. She was diagnosed with Graves' disease at 10 yr of age and soon achieved a euthyroid state after starting treatment. When she was 13 yr of age, her hyperthyroidism and goiter worsened despite medical therapy. Multiple nodules were found in her enlarged thyroid gland by ultrasonography. Her serum Tg level seemed within the normal range. She underwent near-total thyroidectomy for control of thyroid function. Histopathological study demonstrated that multiple oxyphilic follicular neoplasms were surrounded by the thyroid tissue compatible with Graves' disease. Capsular invasion was identified in one of the nodules, and thus the histological diagnosis was minimally invasive follicular carcinoma. She did not have signs suggesting metastasis, and has had no relapse for 18 mo after the operation. Although some previous studies showed a high prevalence of thyroid cancer with an aggressive nature in adult patients with Graves' disease, few reports about thyroid cancer accompanied by Graves' disease are available in children. The present case, however, suggests that careful investigation is needed when we detect thyroid nodules or progressive thyroid enlargement, especially in children with Graves' disease.

Identification of novel genetic Loci associated with thyroid peroxidase antibodies and clinical thyroid disease

NARCIS (Netherlands)

Medici, M.; Porcu, E.; Pistis, G.; Teumer, A.; Brown, S.J.; Jensen, R.A.; Rawal, R.; Roef, G.L.; Plantinga, T.S.; Vermeulen, S.; Lahti, J.; Simmonds, M.J.; Husemoen, L.L.; Freathy, R.M.; Shields, B.M.; Pietzner, D.; Nagy, R.; Broer, L.; Chaker, L.; Korevaar, T.I.; Plia, M.G.; Sala, C.; Volker, U.; Richards, J.B.; Sweep, F.C.; Gieger, C.; Corre, T.; Kajantie, E.; Thuesen, B.; Taes, Y.E.; Visser, W.E.; Hattersley, A.T.; Kratzsch, J.; Hamilton, A.; Li, W.; Homuth, G.; Lobina, M.; Mariotti, S.; Soranzo, N.; Cocca, M.; Nauck, M.; Spielhagen, C.; Ross, A.; Arnold, A.; Bunt, M. van de; Liyanarachchi, S.; Heier, M.; Grabe, H.J.; Masciullo, C.; Galesloot, T.E.; Lim, E.M.; Reischl, E.; Leedman, P.J.; Lai, S.; Delitala, A.; Bremner, A.P.; Philips, D.I.; Beilby, J.P.; Mulas, A.; Vocale, M.; Abecasis, G.; Forsen, T.; James, A.; Widen, E.; Hui, J.; Prokisch, H.; Rietzschel, E.E.; Palotie, A.; Feddema, P.; Fletcher, S.J.; Schramm, K.; Rotter, J.I.; Kluttig, A.; Radke, D.; Traglia, M.; Surdulescu, G.L.; He, H.; Franklyn, J.A.; Tiller, D.; Vaidya, B.; Meyer, T.; Jorgensen, T.; Eriksson, J.G.; O'Leary, P.C.; Wichmann, E.; Hermus, A.R.M.M.; Psaty, B.M.; Ittermann, T.; Hofman, A.; Bosi, E.; Schlessinger, D.; Wallaschofski, H.; Pirastu, N.; Aulchenko, Y.S.; Chapelle, A. dela; Netea-Maier, R.T.; Gough, S.C.; Meyer Zu Schwabedissen, H.; Frayling, T.M.; Kaufman, J.M.; Smit, J.W.; Kiemeney, B.; et al.,

2014-01-01

Autoimmune thyroid diseases (AITD) are common, affecting 2-5% of the general population. Individuals with positive thyroid peroxidase antibodies (TPOAbs) have an increased risk of autoimmune hypothyroidism (Hashimoto's thyroiditis), as well as autoimmune hyperthyroidism (Graves' disease). As the

Identification of Novel Genetic Loci Associated with Thyroid Peroxidase Antibodies and Clinical Thyroid Disease

NARCIS (Netherlands)

Medici, M.; Porcu, E.; Pistis, G.; Teumer, A.; Brown, S.J.; Jensen, R.A.; Rawal, R.; Roef, G.L.; Plantinga, T.S.; Vermeulen, S.H.; Lahti, J.; Simmonds, M.J.; Husemoen, L.L.N.; Freathy, R.M.; Shields, B.M.; Pietzner, D.; Nagy, R.; Broer, L.; Chaker, L.; Korevaar, T.I.M.; Plia, M.G.; Sala, C.; Volker, U.; Richards, J.B.; Sweep, F.C.; Gieger, C.; Corre, T.; Kajantie, E.; Thuesen, B.; Taes, Y.E.; Visser, W.E.; Hattersley, A.T.; Kratzsch, J.; Hamilton, A.; Li, W.; Homuth, G.; Lobina, M.; Mariotti, S.; Soranzo, N.; Cocca, M.; Nauck, M.; Spielhagen, C.; Ross, A.; Arnold, A.; van de Bunt, M.; Liyanarachchi, S.; Heier, M.; Grabe, H.J.; Masciullo, C.; Galesloot, T.E.; Lim, E.M.; Reischl, E.; Leedman, P.J.; Lai, S.; Delitala, A.; Bremner, A.P.; Philips, D.I.W.; Beilby, J.P.; Mulas, A.; Vocale, M.; Abecasis, G.; Forsen, T.; James, A.; Widen, E.; Hui, J.; Prokisch, H.; Rietzschel, E.E.; Palotie, A.; Feddema, P.; Fletcher, S.J.; Schramm, K.; Rotter, J.I.; Kluttig, A.; Radke, D.; Traglia, M.; Surdulescu, G.L.; He, H.L.; Franklyn, J.A.; Tiller, D.; Vaidya, B.; Meyer, T.; Jorgensen, T.; Eriksson, J.G.; O'Leary, P.C.; Wichmann, E.; Hermus, A.R.; Psaty, B.M.; Ittermann, T.; Hofman, A.; Bosi, E.; Schlessinger, D.; Wallaschofski, H.; Pirastu, N.; Aulchenko, Y.S.; de la Chapelle, A.; Netea-Maier, R.T.; Gough, S.C.L.; Meyer zu Schwabedissen, H.; Frayling, T.M.; den Heijer, M.; Naitza, S.; Peeters, R.P.

2014-01-01

Autoimmune thyroid diseases (AITD) are common, affecting 2-5% of the general population. Individuals with positive thyroid peroxidase antibodies (TPOAbs) have an increased risk of autoimmune hypothyroidism (Hashimoto's thyroiditis), as well as autoimmune hyperthyroidism (Graves' disease). As the

Thyroid-disrupting chemicals and brain development: an update

Directory of Open Access Journals (Sweden)

Bilal B Mughal

2018-04-01

Full Text Available This review covers recent findings on the main categories of thyroid hormone–disrupting chemicals and their effects on brain development. We draw mostly on epidemiological and experimental data published in the last decade. For each chemical class considered, we deal with not only the thyroid hormone–disrupting effects but also briefly mention the main mechanisms by which the same chemicals could modify estrogen and/or androgen signalling, thereby exacerbating adverse effects on endocrine-dependent developmental programmes. Further, we emphasize recent data showing how maternal thyroid hormone signalling during early pregnancy affects not only offspring IQ, but also neurodevelopmental disease risk. These recent findings add to established knowledge on the crucial importance of iodine and thyroid hormone for optimal brain development. We propose that prenatal exposure to mixtures of thyroid hormone–disrupting chemicals provides a plausible biological mechanism contributing to current increases in the incidence of neurodevelopmental disease and IQ loss.

Thyroid diseases among atomic bombs survivors in Nagasaki, 2

International Nuclear Information System (INIS)

Yokoyama, Naokata; Toyama, Kyoko; Ochi, Yoshimichi; Morimoto, Isao; Izumi, Motomori; Nagataki, Shigenobu.

1986-01-01

This is an interim report of the population-based study on the incidence of thyroid diseases in Nagasaki prefecture. Included in this study were 885 patients receiving detailed examination for suspected thyroid disease, consisting of 575 exposed persons (Group I) and 310 non-exposed persons (Group II). Thyroid diseases occurred in 157 (27 %) of Group I and in 65 (21 %) of Group II. According to the type of thyroid disease, thyroid cancer, thyroid adenoma, non-toxic uninodular and multinodular goiters were more common in Group I than Group II. The incidence of hypothyroidism was higher in Group I than Group II; however, the incidence of Graves' disease or chronic thyroiditis did not differ in the two groups. A trend toward a slightly higher incidence of thyroid cyst was observed in Group I than Group II. (Namekawa, K.)

Benign breast disease and risk of thyroid cancer.

Science.gov (United States)

Luo, Juhua; Hendryx, Michael; Nassir, Rami; Cheng, Ting-Yuan David; Lane, Dorothy; Margolis, Karen L

2017-09-01

It has been suggested that breast and thyroid diseases may be linked. The aim of this study was to investigate the association between benign breast disease and subsequent risk of thyroid cancer. Postmenopausal women (n = 133,875) aged 50-79 years were followed up for a mean of 14 years. Benign breast disease was defined by history of biopsy. Incident thyroid cancer cases were confirmed by medical record review. Multivariable Cox proportional hazard modeling was used to estimate hazard ratios. There were 370 incident thyroid cancer cases during the follow-up period. Compared to women without BBD, women with BBD had a significant increased risk of thyroid cancer after adjusting for potential confounders (HR 1.38 95% CI 1.10-1.73), especially for women with more than two biopsies (HR 1.59 95% CI 1.10-2.26). There were no significant differences in thyroid tumor size, stage or histologic types between women with and without BBD. Our large prospective study observed that postmenopausal women with BBD had an increased risk for thyroid cancer compared with women without BBD. A more detailed investigation of thyroid cancer risk according to different subtypes of benign breast disease is needed to better understand the association observed between thyroid and benign breast diseases.

[Atypical subacute thyroiditis in combination with Grave's disease:Diagnostic difficulties in a case report].

Science.gov (United States)

Koutouridou, Emmanouela; Planck, Tereza; Uddman, Erik; Lantz, Mikael

2018-04-13

Subacute thyroiditis is a common inflammatory disorder of the thyroid gland, possibly of viral etiology, that typically presents with neck pain, fever and tenderness on palpation of the thyroid gland. Graves' disease is an autoimmune thyroid disorder caused by stimulation of the thyroid gland by thyrotropin receptor antibodies (TRAb). The development of Graves´ disease and subacute thyroiditis simultaneously is an uncommon condition and only a few cases have been reported. In this article we present a case of a 46-year old woman diagnosed with Graves´ disease who was started on thiamazole and weeks later developed high fever. Several differential diagnoses were considered such as infection, lymphoma and vasculitis due to thiamazole. Finally, the fine needle aspiration of the thyroid gland displayed histopathological features of subacute thyroiditis. Remarkably, our patient did not have neck pain or tenderness on palpation of the thyroid gland and overall the clinical presentation of subacute thyroiditis was atypical. Thus, subacute thyroiditis may be considered as a potential cause of fever of unknown origin.

Thyroid dysfunction after radiotherapy in children with Hodgkin's disease

International Nuclear Information System (INIS)

Constine, L.S.; Donaldson, S.S.; McDougall, I.R.; Cox, R.S.; Link, M.P.; Kaplan, H.S.

1984-01-01

Thyroid function was measured in 119 children, 16 years of age or less, after radiotherapy (XRT) for Hodgkin's disease. Thyroid abnormalities developed in 4 of 24 children (17%) who received 2600 rad or less, and in 74 of 95 children (78%) who received greater than 2600 rad to the cervical area, including the thyroid. The abnormality in all but three (one with hyperthyroidism and two with thyroid nodules) included the development of elevated levels of thyroid stimulating hormone (TSH). Age, sex, and administration of chemotherapy were not significant factors in the development of thyroid dysfunction. All children had lymphangiograms (LAG) and no time relationship was noted between thyroid dysfunction and LAG-XRT interval. The mean interval from radiotherapy to documented thyroid dysfunction was 18 months in the low-dose group and 31 months in the high-dose group, with most patients becoming abnormal within 3 to 5 years. Of interest was a spontaneous return of TSH to within normal limits in 20 children and substantial improvement in another 7. This study confirms the occurrence of dose-related occult hypothyroidism in children following external irradiation of the neck

Explanation of diagnostic criteria for radiation thyroid diseases

International Nuclear Information System (INIS)

Liu Libo; Luo Yunxiao; Wang Jianfeng; Chen Dawei; Cheng Guanghui; Jin Yuke

2012-01-01

National occupational health standard-Diagnostic Criteria for Radiation Thyroid Diseases has been approved and issued by the Ministry of Health. Based on the extensive research of literature, this standard was enacted according to the relevant laws and regulations. It is mainly used for diagnosis of thyroid diseases caused by occupational radiation, and it also can serve as a guide to diagnose thyroid disease induced by medical radiation. To implement this standard, and to diagnose and treat the radiation thyroid diseases patient correctly and timely, the contents of this standard were interpreted in this article. (authors)

[Maternal autoimmune thyroid disease: relevance for the newborn].

Science.gov (United States)

Temboury Molina, M Carmen; Rivero Martín, M José; de Juan Ruiz, Jesús; Ares Segura, Susana

2015-04-08

Autoimmune thyroid disease is amongst the most frequent endocrine disorders during pregnancy. It is associated with an increase in perinatal morbidity, congenital defects, neurological damage, fetal and neonatal thyroid dysfunction. Maternal thyroid hormones play a key role in child neurodevelopment. We aimed to evaluate the thyroid function and the clinical course of neonates born from mothers with autoimmune thyroid disease during the first months of life in order to define the follow-up. We monitored thyroid function and clinical status during the first months in 81 newborns of mothers with autoimmune thyroid disease; 16 had Graves disease and 65 autoimmune thyroiditis. A percentage of 4.93 newborns had congenital defects, and 8.64% neonates showed an increase in thyrotropin (TSH) (>9.5 μUI/mL 2 times) and required thyroxin within the first month of life. A 85.7% of these showed a negative newborn screening (due to a later increase of TSH). A higher TSH value in the newborn was related to an older age of the mother, higher levels of thyroid peroxidase (TPO) antibody during pregnancy and lower birth weight. A higher free thyroxine (FT4) value in the newborn was related to fewer days of life and mothers with Graves disease. We recommend the evaluation of TSH, T4 and TPO antibodies before 10 weeks in all pregnant women with follow-up if maternal thyroid autoimmunity or disorders is detected. It is also recommended to test children's serum TSH and FT4 at 48 h of life in newborns of mothers with autoimmune thyroid disease and repeat them between the 2nd and 4th week in children with TSH>6 μUI/mL. Careful endocrine follow-up is advised in pregnant women and children if hyperthyroidism is detected. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

[Hashimoto Thyroiditis and Periodontal Disease: A Narrative Review].

Science.gov (United States)

Morais, Ana; Resende, Marta; Pereira, José

2016-10-31

Currently there is a growing interest in studying systemic conditions with impact on the periodontium. The aim of this article is to determinate if there is a relation between Hashimoto's thyroiditis and periodontal disease. Founded on periodontology based on evidence and in the combination of the keywords: 'Hashimoto disease'; 'Hypothyroidism'; 'Periodontal disease'; 'Systemic Diseases'; a search and evaluation of articles was conducted in Medline, Scopus and Thomson Reuters databases, selecting 30 articles for integral analysis. There have been developed several studies, searching for a better comprehension about the complexity and pathogenesis of periodontal diseases, associated them to multiple systemic conditions. Actually, the relationship that is best described in the literature is the one with rheumatoid arthritis; however, other relations have been pointed, such as Hashimoto's thyroiditis. The identification of multiple etiopathogenic mechanisms common to Hashimoto's thyroiditis and periodontal disease allow to suspect of a relation between them. Some of these mechanisms include the proliferation of lymphocytes T helper 1 and T helper 17 and their impact on the periodontium, the dysfunction of vascular endothelium in gingival microcirculation and the influence of hypothyroidism on bone metabolism, namely on the alveolar bone. There is biological plausibility to support the establishment of an association between Hashimoto's thyroiditis and periodontal disease. However, there are not enough studies to support the existence of a causal nexus between these two pathologies, so, in the future, more studies should be conducted to determinate there relation and interaction.

Thyroid autoimmunity

NARCIS (Netherlands)

Wiersinga, Wilmar M.

2014-01-01

Autoimmune thyroid disease (AITD) is a multifactorial disease in which autoimmunity against thyroid antigens develops against a particular genetic background facilitated by exposure to environmental factors. Immunogenicity of the major thyroid antigens thyroid peroxidase, thyroglobulin (TG) and

Predictive factors of thyroid cancer in patients with Graves' disease.

Science.gov (United States)

Ren, Meng; Wu, Mu Chao; Shang, Chang Zhen; Wang, Xiao Yi; Zhang, Jing Lu; Cheng, Hua; Xu, Ming Tong; Yan, Li

2014-01-01

The best preoperative examination in Graves' disease with thyroid cancer still remains uncertain. The objectives of the present study were to investigate the prevalence of thyroid cancer in Graves' disease patients, and to identify the predictive factors and ultrasonographic features of thyroid cancer that may aid the preoperative diagnosis in Graves' disease. This retrospective study included 423 patients with Graves' disease who underwent surgical treatment from 2002 to 2012 at our institution. The clinical features and ultrasonographic findings of thyroid nodules were recorded. The diagnosis of thyroid cancer was determined according to the pathological results. Thyroid cancer was discovered in 58 of the 423 (13.7 %) surgically treated Graves' disease patients; 46 of those 58 patients had thyroid nodules, and the other 12 patients were diagnosed with incidentally discovered thyroid carcinomas without thyroid nodules. Among the 58 patients with thyroid cancer, papillary microcarcinomas were discovered in 50 patients, and multifocality and lymph node involvement were detected in the other 8 patients. Multivariate regression analysis showed younger age was the only significant factor predictive of metastatic thyroid cancer. Ultrasonographic findings of calcification and intranodular blood flow in thyroid nodules indicate that they are more likely to harbor thyroid cancers. Because the influencing factor of metastatic thyroid cancers in Graves' disease is young age, every suspicious nodule in Graves' disease patients should be evaluated and treated carefully, especially in younger patients because of the potential for metastasis.

The Study on the Thyroglobulin in Thyroid Diseases

International Nuclear Information System (INIS)

Kim, Suk Keun; Lim, Soo Duk; Lee, Mun Ho

1970-01-01

In recent with development of immuno-electrophoresis, more accurate analysis of the serum protein became possible. However, there is few reports in the literature which investigated the changes of the immunoglobulin compared with electrophoretically fractioned serum thyroglobulin in the patients with various thyroid diseases. The purpose of this report is to investigate the changes of thyroglobulin in various thyroid diseases by the method of immuno-electrophoresis and to compare the results with serum protein fractionated by the method of agar-gel micro-electrophoresis. Sera from 9 patients with diffuse toxic goiter, 2 nodular nontoxic goiter, 2 thyroiditis, 3 hypothyroidism, 1 thyroid cancer, 7 cystic degeneration of the thyroid gland, and 10 normal subject were taken. All cases were confirmed by various laboratory thyroid function tests and thyroid needle biopsy. Immuno-electrophoretic analysis of the serum were performed by Scheidegger's modified micro-immuno-electrophoretic method. The antiserum was obtained from the Travenol Laboratories International, Hyland Products Division and was rabbit anti-human thyroglobulin. Microscope slide agar-gel electrophoresis for serum protein fractionation was performed at 4 .deg. C using veronal buffer, pH 8.6 and ionic strength 0.05, with 54 volts and 2.8 mA for 60 minutes. The fractionated slide was stained with 0.1% thiazine red. The results were as follows: 1) Increase of immune-globulin macroglobulin (IgM), alphaglobulin, and immune-globulin A (IgA) by 95.8%, 100%, 29.2% respectively was found in the serum from various thyroid diseases. 2) Thyroglobulin fraction was found to be increased in 50%, no change in 41.7%, and no line in 8.3% with all of the various goiter patients. On the other hand, 10 normal control group showed only 2 cases of increase, 5 cases of no change and 3 cases of no line.

[Subclinical and manifested hypothyroidism as a consequence of thyroid autoimmune disease].

Science.gov (United States)

Milosević, Dragoslav P; Djurica, Snezana; Davidović, Mladen; Stević, Radmila; Rajić, Miodrag; Marković, Natasa

2005-10-01

Chronic thyroiditis (Hashimoto's disease) is a slowly developing persistent inflamation of the thyroid gland, which frequently leads to hypothyroidism. Some of the up-to-date knowledge about hypothyroidism, both subclinical and manifested, caused by autoimmune disease, was presented. Autoimmune thyroid gland disease can occur at any age, but predominantly affects women after periods of high emotional and physical stress or accidents, as well as during periods of hormonal changes. It can also develop in families, and having an autoimmune disease slightly increases the risk of developing another. This paper showed an increasing incidence of subclinical hypothyroidism (4.17%) in elderly, and, at the same time, the incidence of primary hypothyroidism accounting for 1%. It is very usefull to estimate the stimulated thyrotropin (TSH) response, as well as the value of fast, short time thyroid gland reserves, analyzed by T3 and T4 serum level at 60th minute after TRH stimulation. Treatment of choice for HT (hypothyroidism of any cause) is thyroid hormone replacement. Drug of choice is orally administered levothyroxine sodium, usually for life-time. The standard dose is 1.6-1.8 mcg/kg body weight per day, but is in most cases patient dependent. Elderly patients usually require smaller replacement dose of levothyroxine, sometimes less than 1 mcg/kg body weight per day with coronary dilatator at the same time.

Thyroid disease and the nervous system.

Science.gov (United States)

Wood-Allum, Clare A; Shaw, Pamela J

2014-01-01

Thyroid disorders are common in the general population and in hospitalized patients. Thyroid disease may present first with neurological complications or else may occur concurrently in patients suffering other neurological disorders, particularly those with an autoimmune etiology. For this reason neurologists will commonly encounter patients with thyroid disease. This chapter provides an overview of the neurological complications and associations of disorders of the thyroid gland. Particular emphasis is placed on conditions such as thyrotoxic periodic paralysis and myxedema coma in which the underlying thyroid disorder may be occult leading to a first, often emergency, presentation to a neurologist. Information about clinical features, diagnosis, pathogenesis, therapy, and prognosis is provided. Emphasis is placed on those aspects most likely to be relevant to the practicing neurologist and the interested reader is directed to references to good, recent review articles for further information. © 2014 Elsevier B.V. All rights reserved.

Identification of Novel Genetic Loci Associated with Thyroid Peroxidase Antibodies and Clinical Thyroid Disease

DEFF Research Database (Denmark)

Medici, Marco; Porcu, Eleonora; Pistis, Giorgio

2014-01-01

, goiter and thyroid cancer were studied. Individuals with a high genetic risk score had, besides an increased risk of TPOAb-positivity (OR: 2.18, 95% CI 1.68-2.81, P = 8.1×10(-8)), a higher risk of increased thyroid-stimulating hormone levels (OR: 1.51, 95% CI 1.26-1.82, P = 2.9×10(-6)), as well......Autoimmune thyroid diseases (AITD) are common, affecting 2-5% of the general population. Individuals with positive thyroid peroxidase antibodies (TPOAbs) have an increased risk of autoimmune hypothyroidism (Hashimoto's thyroiditis), as well as autoimmune hyperthyroidism (Graves' disease.......12-1.39, P = 6.2×10(-5)). The MAGI3 variant was also associated with an increased risk of hypothyroidism (OR: 1.57, 95% CI 1.18-2.10, P = 1.9×10(-3)). This first GWAS meta-analysis for TPOAbs identified five newly associated loci, three of which were also associated with clinical thyroid disease...

Radioiodine treatment for malignant thyroid disease

Energy Technology Data Exchange (ETDEWEB)

Berg, Gertrud [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Oncology

2006-12-15

Radioiodine treatment for thyroid disease has been given for half a decade in Sweden. The most common indication for treatment is hyperthyroidism, when iodine uptake is high. The situation in which radioiodine treatment is used in thyroid cancer is less favourable and measures therefore have to be taken to optimize the treatment. Treatment should be performed early in the course of the disease to achieve the highest possible differentiation. Before treatment the iodine and goitrogen intake should be kept low. Stimulation of the thyrocytes by thyroid-stimulating hormone (TSH) should be high. It is conventionally achieved by thyroid hormone withdrawal rendering the patient hypothyroid, or by the recently available recombinant human TSH (rhTSH) which can be recommended for ablation of the thyroid remnant after thyroidectomy and for treatment of metastases in fragile patients unable to undergo hypothyroidism. Finally, stunning - the negative effect of a prior test dose from radioactive iodine - should be avoided.

Thyroid Disease and Complementary and Alternative Medicine (CAM)

Science.gov (United States)

... Alternative Medicine in Thyroid Disease Complementary and Alternative Medicine in Thyroid Disease (CAM) WHAT IS COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM)? Complementary and Alternative Medicine (CAM) is defined ...

Thyroid storm following radioactive iodine (RAI) therapy for pediatric graves disease.

Science.gov (United States)

Rohrs, Henry J; Silverstein, Janet H; Weinstein, David A; Amdur, Robert J; Haller, Michael J

2014-01-01

Female, 11 FINAL DIAGNOSIS: Thyroid storm Symptoms: Diarrhea • tachycardia • tachypnea • tremor • wheezing - Clinical Procedure: - Specialty: - Rare disease. A growing number of pediatric endocrinologists treat Graves disease with radioactive iodine (RAI) therapy due to the typically definitive nature of I-131 therapy. Given the published benefits and perceived low risks of RAI when compared to surgery or long-term anti-thyroid medication, the trend towards therapy with RAI is likely to continue. Nevertheless, RAI is not without significant risk. An 11-year-old girl with newly diagnosed Graves disease received RAI for definitive treatment of her hyperthyroidism. Within 24 hours of receiving I-131, she developed increasing sleepiness and eventually became unresponsive. Upon arrival at the emergency department she had a tonic-clonic seizure and was diagnosed with thyroid storm. Despite best efforts to manage her hyperthyroidism, she suffered a stroke of the left cerebral hemisphere that left her with persistent neurological deficits. Although thyroid storm after thyroid ablation is rare, the significant morbidity and potential mortality of pediatric thyroid storm warrant further studies to determine if children with markedly elevated thyroid hormone concentrations at diagnosis should receive prolonged pretreatment with anti-thyroid drugs. While such an approach may reduce the efficacy of I-131 ablation, it can also reduce and hopefully eliminate the risk of post-ablative thyroid storm.

Ultrasound assessment of thyroid gland volume in diabetic patients without overt thyroid disease.

Science.gov (United States)

Nduka, Christopher C; Adeyekun, Ademola A

2016-01-01

Diabetes mellitus and thyroid disease are known to mutually influence each other. Thyroid disease can worsen glycaemic control in diabetes, and patients with diabetes mellitus have increased incidence of thyroid disorders such as increase in size, compared to the normal population. The aim of the study was to sonographically assess thyroid gland volume in Nigerian adult diabetic patients and compare with apparently healthy adults (controls). The study setting was the Department of Radiology, University of Benin Teaching Hospital (UBTH) Nigeria. The thyroid gland in 120 diabetic subjects and equal number of apparently healthy controls was scanned with a 5-12 MHz linear transducer of a SONOACE X4 Machine. Thyroid gland volume was assessed. Statistical analysis was done with Statistical Package for the Social Sciences (SPSS) version 17 (SPSS Inc, Chicago, IL, USA). Diabetics had significantly increased thyroid volume compared to age matched male and female control subjects (11.5 ± 5.2 cm3 vs 7.4 ± 1.9 cm3; Pthyroid volume among diabetics. Diabetics have higher thyroid gland dimensions, compared to apparently healthy subjects. Gland proliferation from circulating insulin may play a role. This is not influenced by gender.

Thyroid disease among the Rongelap and Utirik population - an update

International Nuclear Information System (INIS)

Howard, J.E.; Vaswani, A.; Heotis, P.

1997-01-01

In 1954, 253 Marshallese were accidentally exposed to fallout radiation from the hydrogen bomb, BRAVO. The Marshall Islands Medical Program (MIMP) was established by the Department of Energy in 1955 to monitor and treat radiation-related disease pursuant to this accident. Medical teams from Brookhaven National laboratory, a federal institution, regularly visit the Marshall Islands to give medical care to the exposed population. The most significant complication of the exposure has been found to be thyroid disease due to the ingestion of radioactive iodides from the fallout. In 1963 the first thyroid nodules were found in Rongelap subjects and in 1969 in Utirik. Non-neoplastic adenomatous nodules were associated with higher doses of radiation and neoplastic nodules developed in individuals receiving lower doses of radiation. Women were more susceptible to the development of palpable thyroid nodules than men. In 1994 the MIMP initiated examination of the thyroid by ultrasound to supplement the clinical examination. One hundred and sixty-four patients were evaluated. No significant differences were found in the incidence of thyroid nodules or the mean nodule count between the three groups of Rongelap and Utirik exposed and a comparison patient population. There was no significant difference in the incidence of thyroid nodules in males vs. females. Five exposed patients were referred for surgical excision of a nodule detected only by ultrasound. These ultrasound findings are unexpected in that females are known to have a higher incidence of thyroid disease than males and we expected that the incidence of ultrasound nodules would be higher in the exposed population. 36 refs., 2 figs., 8 tabs

Serum TBG and T4 concentration in non-thyroidal diseases

International Nuclear Information System (INIS)

Sasaki, Y.; Tobari, C.; Sekita, N.; Onodera, Y.; Asazu, M.; Someya, K.

1983-01-01

Routinely available radioassay kits have recently enabled the measurement of serum concentrations of thyroxine binding globulin (TBG) and thyroxine (T 4 ), both total (TT 4 ) and free (FT 4 ) in various disease conditions. Serum TBG and T 4 level were measured in variety of non-thyroidal diseases, of which significance was evaluated in comparison with that in thyroidal diseases. Abnormal serum TBG concentrations in various non-thyroidal diseases and pregnancy result in abnormal serum TT 4 levels, which may cause difficulty in differentiation of these conditions from hyper- or hypothyroidal states. Serum FT 4 levels give better indicator than TT 4 , though the difference among RIA kits are considerably large. However, measurement of serum FT 4 levels alone is not sufficient to distinguish non-thyroidal disease from thyroidal diseases with abnormal thyroidal function. The differentiation has to be based on the combination of clinical findings and results of multiple thyroidal function tests

Graves' disease: thyroid function and immunologic activity

International Nuclear Information System (INIS)

Gossage, A.A.; Crawley, J.C.; Copping, S.; Hinge, D.; Himsworth, R.L.

1982-01-01

Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [/sup 99m/Tc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity--TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p less than 0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

Graves' disease: thyroid function and immunologic activity

International Nuclear Information System (INIS)

Gossage, A.A.R.; Crawley, J.C.W.; Copping, S.; Hinge, D.; Himsworth, R.L.

1982-01-01

Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [ 9 -9μTc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity - TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p<0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

Clinical evaluation of echography in diagnosis of thyroid disease

International Nuclear Information System (INIS)

Fritzsche, H.; Braendle, J.

1983-01-01

In 63 patients echography of thyroid was performed additionally to case history, palpation, scintigraphy and hormone tests for evaluating clinical significance of this method. The benefit of this technique is rapid measurement of thyroid size, demonstration of nodules in palpable diffuse goiters and differentiating of solid or cystic nodules of the thyroid. For diagnosis of autonomous areas in the thyroid scintigrahy remains the method of choice. Also there is no correlation of ultrasound findings and thyroid function. In routine diagnostic procedure of thyroid disease echography may replace scintigraphy only in diffuse goiter and if radionuclide imaging is not possible. Nevertheless ultrasonic evaluation of the thyroid is an important additional method in diagnostic of thyroid diseases. (Author)

Identification of Novel Genetic Loci Associated with Thyroid Peroxidase Antibodies and Clinical Thyroid Disease

NARCIS (Netherlands)

M. Medici (Marco); E. Porcu (Eleonora); G. Pistis (Giorgio); A. Teumer (Alexander); S.J. Brown (Stephen); R.A. Jensen (Richard); R. Rawal (R.); G.L. Roef (Greet); T.S. Plantinga (Theo S.); S.H.H.M. Vermeulen (Sita); J. Lahti (Jari); M.C. Simmonds (Mark); L.L.N. Husemoen (Lise Lotte); R.M. Freathy (Rachel); B.M. Shields (Beverley); D. Pietzner (Diana); R. Nagy (Rebecca); L. Broer (Linda); L. Chaker (Layal); T.I.M. Korevaar (Tim); M.G. Plia (Maria Grazia); C. Sala (Cinzia); U. Völker (Uwe); J.B. Richards (Brent); F.C. Sweep (Fred); C. Gieger (Christian); T. Corre (Tanguy); E. Kajantie (Eero); L. Thuesen (Leif); Y.E. Taes (Youri); W.E. Visser (Wil Edward); A.T. Hattersley (Andrew); J. Kratzsch (Jürgen); A. Hamilton (Amy); W. Li (Wei); G. Homuth (Georg); M. Lobina (Monia); S. Mariotti (Stefano); N. Soranzo (Nicole); M. Cocca (Massimiliano); M. Nauck (Matthias); C. Spielhagen (Christin); H.A. Ross (Alec); A.M. Arnold (Alice); M. van de Bunt (Martijn); S. Liyanarachchi (Sandya); M. Heier (Margit); H.J. Grabe (Hans Jörgen); C. Masciullo (Corrado); T.E. Galesloot (Tessel); E.M. Lim (Ee Mun); G. Reischl (Gunilla); P.J. Leedman (Peter); S. Lai (Sandra); A. Delitala (Alessandro); A. Bremner (Alexandra); D.I.W. Philips (David I.); J.P. Beilby (John); A. Mulas (Antonella); M. Vocale (Matteo); G.R. Abecasis (Gonçalo); T. Forsen (Tom); A. James (Alan); E. Widen (Elisabeth); J. Hui (Jennie); H. Prokisch (Holger); E.E. Rietzschel (Ernst); A. Palotie (Aarno); W. Feddema (Wouter); S.J. Fletcher (Stephen); K. Schramm (Katharina); J.I. Rotter (Jerome); A. Kluttig (Alexander); D. Radke (Dörte); M. Traglia (Michela); G. Surdulescu (Gabriela); H. He (Hao); J.A. Franklyn (Jayne); D. Tiller (Daniel); B. Vaidya (Bijay); T. Meyer (Thorsten); T. Jorgensen (Torben); K. Hagen (Knut); P.C. O'Leary (Peter); E. Wichmann (Eric); A.R.M.M. Hermus (Ad); B.M. Psaty (Bruce); T. Ittermann (Till); A. Hofman (Albert); E. Bosi (Emanuele); D. Schlessinger (David); H. Wallaschofski (Henri); N. Pirastu (Nicola); Y.S. Aulchenko (Yurii); A. de la Chapelle (Albert); R.T. Netea-Maier (Romana ); J.E. Gough (Julie); H. Meyer zu Schwabedissen (Henriette); T.M. Frayling (Timothy); J.-M. Kaufman (Jean-Marc); A. Linneberg (Allan); K. Räikkönen (Katri); J.W.A. Smit (Jan); L.A.L.M. Kiemeney (Bart); F. Rivadeneira Ramirez (Fernando); A.G. Uitterlinden (André); J.P. Walsh (John); C. Meisinger (Christa); M. den Heijer (Martin); T.J. Visser (Theo); T.D. Spector (Timothy); S.G. Wilson (Scott); H. Völzke (Henry); A.R. Cappola (Anne); D. Toniolo (Daniela); S. Sanna (Serena); S. Naitza (Silvia); R.P. Peeters (Robin)

2014-01-01

textabstractAutoimmune thyroid diseases (AITD) are common, affecting 2-5% of the general population. Individuals with positive thyroid peroxidase antibodies (TPOAbs) have an increased risk of autoimmune hypothyroidism (Hashimoto's thyroiditis), as well as autoimmune hyperthyroidism (Graves'

Genetic disorders of thyroid metabolism and brain development

Science.gov (United States)

Kurian, Manju A; Jungbluth, Heinz

2014-01-01

Normal thyroid metabolism is essential for human development, including the formation and functioning of the central and peripheral nervous system. Disorders of thyroid metabolism are increasingly recognized within the spectrum of paediatric neurological disorders. Both hypothyroid and hyperthyroid disease states (resulting from genetic and acquired aetiologies) can lead to characteristic neurological syndromes, with cognitive delay, extrapyramidal movement disorders, neuropsychiatric symptoms, and neuromuscular manifestations. In this review, the neurological manifestations of genetic disorders of thyroid metabolism are outlined, with particular focus on Allan-Herndon-Dudley syndrome and benign hereditary chorea. We report in detail the clinical features, major neurological and neuropsychiatric manifestations, molecular genetic findings, disease mechanisms, and therapeutic strategies for these emerging genetic ‘brain-thyroid’ disorders. PMID:24665922

Is selenium supplementation in autoimmune thyroid diseases justified?

Science.gov (United States)

Winther, Kristian H; Bonnema, Steen J; Hegedüs, Laszlo

2017-10-01

This review provides an appraisal of recent evidence for or against selenium supplementation in patients with autoimmune thyroid diseases, and discusses possible effect mechanisms. Epidemiological data suggest an increased prevalence of autoimmune thyroid diseases under conditions of low dietary selenium intake. Two systematic reviews have evaluated controlled trials among patients with autoimmune thyroiditis and report that selenium supplementation decreases circulating thyroid autoantibodies. The immunomodulatory effects of selenium might involve reducing proinflammatory cytokine release. However, clinically relevant effects of selenium supplementation, including improvement in quality of life, are more elusive. In Graves' disease, some, but not all, trials indicate that adjuvant selenium supplementation enhances the restoration of biochemical euthyroidism, and might benefit patients with mild Graves' orbitopathy. The use of selenium supplementation as adjuvant therapy to standard thyroid medication may be widespread, but a growing body of evidence yields equivocal results. The available evidence from trials does not support routine selenium supplementation in the standard treatment of patients with autoimmune thyroiditis or Graves' disease. However, correction of moderate to severe selenium deficiency may offer benefits in preventing, as well as treating, these disorders. Molecular mechanisms have been proposed, but further studies are needed.

In vitro radioassays for thyroid diseases analysis

International Nuclear Information System (INIS)

Hegesippe, M.; Le Gallic, Y.

1979-01-01

Some technical aspects of the current and less current tests for thyroid function evaluation and for immunological and cancerous thyroid diseases, were reviewed. This large review was done to confirm that at present, nearly all the parameters playing a role in thyroid disease are measured by RIA technique with an acceptable precision and specificity. It is now possible to study a particular problem of thyroid with a particular assay. The review was illustrated by a certain number of precision profile which are, in our opinion, one of the most important informations to have before adopting a technique. It allows to appreciate what can be obtained -and cannot be obtained- as a reliable response

Is selenium supplementation in autoimmune thyroid diseases justified?

DEFF Research Database (Denmark)

Winther, Kristian H.; Bonnema, Steen; Hegedüs, Laszlo

2017-01-01

PURPOSE OF REVIEW: This review provides an appraisal of recent evidence for or against selenium supplementation in patients with autoimmune thyroid diseases, and discusses possible effect mechanisms. RECENT FINDINGS: Epidemiological data suggest an increased prevalence of autoimmune thyroid...... diseases under conditions of low dietary selenium intake. Two systematic reviews have evaluated controlled trials among patients with autoimmune thyroiditis and report that selenium supplementation decreases circulating thyroid autoantibodies. The immunomodulatory effects of selenium might involve reducing...... proinflammatory cytokine release. However, clinically relevant effects of selenium supplementation, including improvement in quality of life, are more elusive. In Graves’ disease, some, but not all, trials indicate that adjuvant selenium supplementation enhances the restoration of biochemical euthyroidism...

Thyroid Autoantibodies in the Cerebrospinal Fluid of Subjects with and without Thyroid Disease: Implications for Hashimoto’s Encephalopathy

Directory of Open Access Journals (Sweden)

Ioannis Ilias

2015-01-01

Full Text Available Introduction. Plasma antithyroid peroxidase (anti-TPO and anti-thyroglobulin antibodies (anti-Tg are widely used in the diagnosis of autoimmune thyroiditis. No research has compared anti-TPO and anti-Tg both in plasma and cerebrospinal fluid (CSF of healthy individuals vis-à-vis patients with thyroid disease. Methods. We measured anti-TPO and anti-Tg antibodies in plasma and CSF in nine subjects (mean age ± SD: 73 ± 6 years with hypothyroidism and nine subjects (mean age ± SD: 73 ± 8 years without thyroid disease. Results. The concentration of anti-TPO autoantibodies in CSF was very low compared to plasma in both subjects with thyroid and without thyroid disease (P=0.007. CSF anti-Tg autoantibodies titers were very low compared to the plasma in subjects with thyroid disease (P=0.004, whereas, in subjects without thyroid disease, this difference did not reach statistical significance (P=0.063. Conclusions. Thyroid autoantibodies levels were low in plasma and CSF; we did not observe any transfer of thyroid autoantibodies from the peripheral blood to the CSF. Therefore, regarding Hashimoto’s encephalopathy, where elevated antithyroid autoantibodies are often measured in blood, it is more likely that thyroiditis and encephalopathy represent nonspecific, but distinct, events of an aggressive immune system.

PREVALENCE OF AUTOANTIBODIES TO THYROID PEROXIDASE AND AUTOIMMUNE THYROID DISEASE IN GIRLS WITH TURNER’S SYNDROME

Directory of Open Access Journals (Sweden)

H. Moayeri Z. Oloomi

2006-07-01

Full Text Available Patients with Turner’s syndrome (TS are at an increased risk of developing autoimmune thyroid disease (ATD. The aim of this study was to determine the frequency of anti-thyroid peroxidase (anti-Tpo antibodies and ATD in children and adolescent girls with TS. It also assessed the influence of karyotype on the development of thyroid disease. Sixty eight patients with TS were compared with 68 age matched healthy unrelated girls in this study. They were screened for anti-Tpo antibodies, free T4 and TSH levels. Sign and symptoms of hypothyroidism and hyperthyroidism and the presence of goiter were also investigated. Anti-Tpo antibodies were found in 18 (26.4% TS patients and 1 (1.4% patient in the control group (P < 0.001, evenly distributed between the karyotypes 45X, 46X, isoXq and mosaicism. Out of 68 TS patients, 8 (11.7% had visible goiter. Subclinical hypothyroidism and hypothyroidism both occurred in 2 patients (5.9%. These patients were characterized by higher levels of anti-Tpo antibodies. Visible goiter was found in 3 (4.4% subjects of the control group, but all of them were euthyroid. We found that younger patients were more likely to be anti-Tpo negative (P < 0.001. Our data demonstrated a high frequency of ATD in a representative sample of Iranian girls with TS which is in accordance with previous observations. Regular follow up assessment of thyroid autoantibodies and thyroid function in patients with TS is recommended for timely diagnosis of thyroid dysfunction and treatment.

Hyperparathyroidism and thyroid disease. A study of their association

International Nuclear Information System (INIS)

Stoffer, S.S.; Szpunar, W.E.; Block, M.

1982-01-01

The incidence of hyperparathyroidism was prospectively evaluated in a group of patients with thyroid disease, and the incidence of thyroid disease was retrospectively evaluated in a group of patients specifically referred for evaluation of hyperparathyroidism. Hyperparathyroidism was ten times more frequent in thyroid patients than expected in a general medical population and was especially prevalent in patients with nodular goiter. The incidence of thyroid disease in patients with hyperparathyroidism was 38.8%. Although radiation therapy was shown to be a factor in these associations, it alone could not explain the observed frequency

[Application of iodine metabolism analysis methods in thyroid diseases].

Science.gov (United States)

Han, Jian-hua; Qiu, Ling

2013-08-01

The main physiological role of iodine in the body is to synthesize thyroid hormone. Both iodine deficiency and iodine excess can lead to severe thyroid diseases. While its role in thyroid diseases has increasingly been recognized, few relevant platforms and techniques for iodine detection have been available in China. This paper summarizes the advantages and disadvantages of currently iodine detection methods including direct titration, arsenic cerium catalytic spectrophotometry, chromatography with pulsed amperometry, colorimetry based on automatic biochemistry, inductively coupled plasma mass spectrometry, so as to optimize the iodine nutrition for patients with thyroid diseases.

Real-time shear wave elastography may predict autoimmune thyroid disease.

Science.gov (United States)

Vlad, Mihaela; Golu, Ioana; Bota, Simona; Vlad, Adrian; Timar, Bogdan; Timar, Romulus; Sporea, Ioan

2015-05-01

To evaluate and compare the values of the elasticity index as measured by shear wave elastography in healthy subjects and in patients with autoimmune thyroid disease, in order to establish if this investigation can predict the occurrence of autoimmune thyroid disease. A total of 104 cases were included in the study group: 91 women (87.5%), out of which 52 (50%) with autoimmune thyroid disease diagnosed by specific tests and 52 (50%) healthy volunteers, matched for age and gender. For all the subjects, three measurements were performed on each thyroid lobe and a mean value was calculated. The data were expressed in kPa. The investigation was performed with an Aixplorer system (SuperSonic Imagine, France), using a linear high-resolution 15-4 MHz transducer. The mean value for the elasticity index was similar in the right and the left thyroid lobes, both in normal subjects and in patients with autoimmune thyroid disease: 19.6 ± 6.6 vs. 19.5 ± 6.8 kPa, p = 0.92, and 26.6 ± 10.0 vs. 25.8 ± 11.7 kPa, p = 0.71, respectively. This parameter was significantly higher in patients with autoimmune thyroid disease than in controls (p < 0.001). For a cut-off value of 22.3 kPa, which resulted in the highest sum of sensitivity and specificity, the elasticity index assessed by shear wave elastography had a sensitivity of 59.6% and a specificity of 76.9% (AUROC = 0.71; p < 0.001) for predicting the presence of autoimmune thyroid disease. Quantitative elasticity index measured by shear wave elastography was significantly higher in autoimmune thyroid disease than in normal thyroid parenchyma and may predict the presence of autoimmune thyroid disease.

Thyroid Diseases

Science.gov (United States)

... beats. All of these activities are your body's metabolism. Thyroid problems include Goiter - enlargement of the thyroid gland Hyperthyroidism - when your thyroid gland makes more thyroid hormones ...

Clinical course of thyroid function and thyroid associated-ophthalmopathy in patients with euthyroid Graves’ disease

Directory of Open Access Journals (Sweden)

Suzuki N

2018-04-01

Full Text Available Nami Suzuki,1 Jaeduk Yoshimura Noh,1 Toshiaki Kameda,1 Ai Yoshihara,1 Hidemi Ohye,1 Miho Suzuki,1 Masako Matsumoto,1 Yo Kunii,1 Kenji Iwaku,1 Natsuko Watanabe,1 Koji Mukasa,1 Ai Kozaki,2 Toshu Inoue,2 Kiminori Sugino,1 Koichi Ito1 1Department of Internal Medicine, Ito Hospital, Tokyo, Japan; 2Department of Ophthalmology, Olympia Eye Hospital, Tokyo, Japan Background: Euthyroid Graves’ disease (EGD is a rare condition defined as the presence of thyroid-associated ophthalmopathy (TAO in patients with normal thyroid function. Due to the rarity of this disease, only a limited number of studies and case reports are available for further evaluation of the characteristics of the disease. The aim of this study was to examine the changes in the thyroid function, thyrotropin receptor antibodies (TRAb and eye symptoms, and then determine whether TRAb is related to TAO in EGD patients. TRAb in this study was defined as including both thyrotropin-binding inhibitory immunoglobulin (TBII and thyroid-stimulating immunoglobulin (TSAb. Patients and methods: Medical records of patients diagnosed with EGD were reviewed. Ophthalmologists specializing in TAO examined the eyes of all subjects. Results: Of the 58 patients diagnosed with EGD, 24.1% developed hyperthyroidism, while 3.4% developed hypothyroidism. A total of 72.4% of the 58 patients remained euthyroid throughout the entire follow-up period. At the initial presentation, TBII and TSAb were positive in 74.5% and 70.5%, respectively. Ophthalmic treatments were administered to 30 (51.7% out of the 58 patients. A significant spontaneous improvement of the eye symptoms was found in 28 of the EGD patients who did not require eye treatments. EGD patients exhibited positive rates for both TBII and TSAb, with the number of the TRAb-positive patients gradually decreasing while the eye symptoms spontaneously improved over time. There were no correlations found between TRAb at initial presentation and the eye symptoms

Thyroid cancer following radiotherapy for Hodgkin's disease: a case report and review of the literature

International Nuclear Information System (INIS)

Moroff, S.V.; Fuks, J.Z.

1986-01-01

Improved survival resulting from advances in therapy in patients with Hodgkin's disease is associated with long-term morbidity, including the potential for the development of a second solid malignancy. We report a 44-year-old man with an unusually aggressive course of thyroid carcinoma 15 years after treatment for Hodgkin's disease. In a review of the English-language literature, we found 21 cases of thyroid cancer following radiotherapy for Hodgkin's disease, with latency periods ranging from 6 to 48 years. The development of secondary thyroid cancer after high-dose neck irradiation may be related to hypothyroidism, itself a complication of radiotherapy. Thyroid function should be measured at least once a year in all patients given neck irradiation, with initiation of thyroid hormone replacement if there is evidence of sustained hypothyroidism

Relational Stability of Thyroid Hormones in Euthyroid Subjects and Patients with Autoimmune Thyroid Disease

Science.gov (United States)

Hoermann, Rudolf; Midgley, John E.M.; Larisch, Rolf; Dietrich, Johannes W.

2016-01-01

Background/Aim Operating far from its equilibrium resting point, the thyroid gland requires stimulation via feedback-controlled pituitary thyrotropin (TSH) secretion to maintain adequate hormone supply. We explored and defined variations in the expression of control mechanisms and physiological responses across the euthyroid reference range. Methods We analyzed the relational equilibria between thyroid parameters defining thyroid production and thyroid conversion in a group of 271 thyroid-healthy subjects and 86 untreated patients with thyroid autoimmune disease. Results In the euthyroid controls, the FT3-FT4 (free triiodothyronine-free thyroxine) ratio was strongly associated with the FT4-TSH ratio (tau = −0.22, p < 0.001, even after correcting for spurious correlation), linking T4 to T3 conversion with TSH-standardized T4 production. Using a homeostatic model, we estimated both global deiodinase activity and maximum thyroid capacity. Both parameters were nonlinearly and inversely associated, trending in opposite directions across the euthyroid reference range. Within the panel of controls, the subgroup with a relatively lower thyroid capacity (<2.5 pmol/s) displayed lower FT4 levels, but maintained FT3 at the same concentrations as patients with higher functional and anatomical capacity. The relationships were preserved when extended to the subclinical range in the diseased sample. Conclusion The euthyroid panel does not follow a homogeneous pattern to produce random variation among thyroid hormones and TSH, but forms a heterogeneous group that progressively displays distinctly different levels of homeostatic control across the euthyroid range. This suggests a concept of relational stability with implications for definition of euthyroidism and disease classification. PMID:27843807

Metaiodobenzylguanidine (MIBG) uptake in Parkinson's disease also decreases at thyroid

International Nuclear Information System (INIS)

Matsui, Hideaki; Udaka, Fukashi; Oda, Masaya; Tamura, Akiko; Kubori, Tamotsu; Nishinaka, Kazuto; Kameyama, Masakuni

2005-01-01

Decreased cardiac metaiodobenzylguanidine (MIBG) uptake was reported in Parkinson's disease and this contributes to the differential diagnosis between Parkinson's disease and other forms of parkinsonism such as multiple system atrophy. However, decreased MIBG uptake of the thyroid has not been demonstrated. The objective of this study was to compare MIBG uptake of the thyroid among Parkinson's disease, multiple system atrophy and controls. Twenty-six patients with Parkinson's disease, 11 patients with multiple system atrophy and 14 controls were examined in this study. Planar images were taken 15 minutes (early images) and 3 hours (late images) after intravenous injection of 111 MBq 123 I-MIBG. MIBG uptake of the thyroid on early images decreased significantly in Parkinson's disease compared to controls (p<0.0001) and multiple system atrophy (p=0.018). MIBG uptake of the thyroid on early images decreased significantly also in multiple system atrophy compared to controls (p=0.027). On late images, thyroid uptake differed significantly only between Parkinson's disease and controls (p=0.010). Our study is the first to demonstrate decreased MIBG uptake of the thyroid in Parkinson's disease. Sympathetic nervous denervation of Parkinson's disease occurred not only in the heart but also in the thyroid. (author)

Autoimmune thyroiditis in antinuclear antibody positive children without rheumatologic disease

Directory of Open Access Journals (Sweden)

Arkachaisri Thaschawee

2010-05-01

Full Text Available Abstract Background Children are commonly referred to a pediatric rheumatology center for the laboratory finding of an Anti-nuclear antibody (ANA of undetermined significance. Previous studies regarding adult rheumatology patients have supported an association between ANA and anti-thyroid antibodies, with the prevalence of thyroid antibodies being significantly higher in patients referred to a rheumatology center for an ANA without evidence of connective tissue disease compared to the general population. The purpose of the present study was to determine the frequency of thyroid antibodies in children referred to a pediatric rheumatology center for a positive ANA without evidence of a connective tissue disease. Methods A retrospective chart review was performed on children who were referred to our pediatric rheumatology center between August 2003 and March 2007 for positive ANA with concurrent thyroid antibody and thyroid function tests performed who did not fulfill criteria for a specific connective tissue disease. Laboratory and clinical features were recorded and analyzed. Mean and standard deviation were used to describe continuous data. Chi-square or Fisher's exact tests were used to compare proportions between variables. Results One-hundred and four ANA-positive patients with concurrent thyroid studies were evaluated (88% female, 93% Caucasian, mean age 11.9 ± 4.0 years. Half of patients had an ANA titer ≥ 1:320. The ANA pattern was speckled in 60% of the patients. Thyroid antibodies were detected in 30% of the patients. Anti-Thyroglobulin (ATG was detected in 29% and Anti-thyroid peroxidase (ATPO in 21% of the patients; of these children, 14% had hypothyroidism. ANA pattern and titer were not associated with anti-thyroid antibody positivity. Conclusion Thyroid antibodies associated with chronic lymphocytic thyroiditis, ATG and ATPO, were detected significantly higher in ANA-positive children without a rheumatologic condition (30% as

Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes.

LENUS (Irish Health Repository)

Tamagno, Gianluca

2012-02-01

BACKGROUND: The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological\\/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto\\'s thyroiditis (HT), although fourteen EAATD patients with Graves\\' disease (GD) have been also reported. METHODS: We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. RESULTS: Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. CONCLUSIONS: GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.

Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes

LENUS (Irish Health Repository)

Tamagno, Gianluca

2010-04-28

Abstract Background The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological\\/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto\\'s thyroiditis (HT), although fourteen EAATD patients with Graves\\' disease (GD) have been also reported. Methods We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. Results Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. Conclusions GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.

Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes.

LENUS (Irish Health Repository)

Tamagno, Gianluca

2010-01-01

BACKGROUND: The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological\\/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto\\'s thyroiditis (HT), although fourteen EAATD patients with Graves\\' disease (GD) have been also reported. METHODS: We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. RESULTS: Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. CONCLUSIONS: GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.

Prediction of thyroidal 131I effective half-life in patients with Graves' disease.

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Zhang, Ruiguo; Zhang, Guizhi; Wang, Renfei; Tan, Jian; He, Yajing; Meng, Zhaowei

2017-10-06

Calculation of effective thyroidal half-life (Teff) of iodine-131( 131 I) is cumbersome and tedious. The aim of this study was to investigate factors that could be used to predict Teff and to develop a Teff prediction model in Graves' disease patients. A total of 256 patients with GD were involved in this study. We investigated the influences of age, gender, disease duration, thyroid weight, antithyroid drugs, antithyroid drugs discontinuation period (ADP), thyroid function indexes, thyroid autoantibodies, thyroid-stimulating hormone receptor antibody (TRAb) level and radioactive iodine uptake (RAIU) values before 131 I therapy on Teff, applying univariate and multivariate analyses. Teff correlated negatively with thyroid peroxidase antibody, TRAb and thyroid weight, as well as positively with 24-hour, 48-hour, and 72-hour RAIU. Additionally, a longer ADP (especially≥ 14d) or without antithyroid drugs before 131 I therapy led to a longer Teff. Stepwise multiple linear regression analysis showed that 24-hour and 72-hour RAIU were statistically significant predictors of Teff ( P Graves' disease, with high prediction accuracy.

High frequency of positive anti-thyroid peroxidase antibodies (ATPO) in adult subjects without known thyroid disease, Santiago de Chile

International Nuclear Information System (INIS)

Lanas, Alejandra; Letelier, Carolina; Caamano, Edgardo; Massardo, Teresa; Gonzalez, Patricio; Araya, Veronica

2010-01-01

Background: Anti-thyroid peroxidase antibodies have a pathogenic role in Hashimoto thyroiditis. Between 10 and 19% of individuals without thyroid disease, have positive titers of these antibodies. Aim: To study the frequency of positive titers of anti-thyroid peroxidase antibodies in healthy individuals. Material and Methods: A blood sample, to measure anti-thyroid peroxidase antibodies and thyroid stimulating hormone (TSH) by chemiluminescence assay, was obtained from 67 women and 62 men aged 45 ± 14 years, without a personal or familiar history of thyroid diseases and normal thyroid palpation. The cutoff point of the manufacturer to consider positive a titer of anti-thyroid peroxidase antibodies was set at 35 IU/ml. Results: Twenty-eight women and 28 men had positive antibody titers (43% of the sample). Subjects in the upper tercile of anti-thyroid peroxidase antibody titers had a higher TSH than those in the second tercile, although within normal limits (1.73 ± 0.74 and 1.37 ± 0.59 mlU/L, respectively p = 0.02) Conclusions: Forty three percent of the studied subjects without personal or familial history of thyroid diseases had positive titers of anti-thyroid peroxidase antibodies. Further prospective studies should evaluate whether this observation discloses an increase in thyroid autoimmune disease in a population with increased iodine intake

Thyroid Disease

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... Institute. (2014). Thyroid Cancer . Bomeli, S.R., LeBeau, S.O., Ferris, R.L. (2010). Evalution of a Thyroid Nodule . ... Institute. (2014). Thyroid Cancer . Bomeli, S.R., LeBeau, S.O., Ferris, R.L. (2010). Evalution of a Thyroid Nodule . ...

Study on serum thyroid peroxidase antibody levels in autoimmune thyroid disease

International Nuclear Information System (INIS)

Zhang Zhixiang; Zheng Lan; Xu Shujin; Guan Jinghua

2008-01-01

Objective: To investigate the clinical significance of changes of serum thyroid peroxidase antibody (TPO-Ab) in patients with hyperthyroidism, hypothyroidism and simple goiter. Methods: Serum TPO-Ab, TMA,TGA and FT 3 , FT 4 , TSH levels were measured with radioimmunoassay(RIA) in 69 patients with hyperthyroidism, 53 patients with hypothyroidism, 45 patients with simple goiter and 20 controls. Results: The positive rate of thyroid peroxidase antibody (TPO-Ab) (82%-92.5%) was higher than that of thyroidglobulim antibody(TGA) (44.2%) and thyroid microsome antibody(TMA) (60.4-69.8%) in all patients with AICD. Conclusion: TPO-Ab could be taken as an important indicator in assessment of treatment and prognosis in patients with auto- immune thyroid diseases. (authors)

Punction methods of diagnostics and treatment of thyroid diseases

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A.S. Tolstokorov

2010-06-01

Full Text Available The object of this research is to study the punction methods role under diagnostics and treatment of different thyroid diseases. The authors of this article present treatment methods of 121 patients with different thyroid diseases. The received results allow to draw a conclusion, that punction methods of diagnostics and treatment of thyroid disease can be used as independent methods of treatment and in a complex with other medication remedies

Thyroid storm associated with Graves' disease covered by diabetic ketoacidosis: A case report

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Osada Erika

2011-04-01

Full Text Available Abstract Background Thyroid storm is a condition in which multiple organ dysfunction results from failure of the compensatory mechanisms of the body owing to excessive thyroid hormone activity induced by some factors in patients with thyrotoxicosis. While diabetic ketoacidosis (DKA is an important trigger for thyroid storm, simultaneous development of DKA and thyroid storm is rare. Case presentation A 59-year-old woman with no history of either diabetes mellitus or thyroid disease presented to our hospital because of developing nausea, vomiting and diarrhea for 2 days. Physical examination showed mild disturbance of consciousness, fever, and tachycardia. There were no other signs of thyrotoxicosis. Laboratory studies revealed elevation of random blood glucose and glycosylated hemoglobin, strongly positive of urine acetone, and metabolic acidosis. Since DKA was diagnosed, we initiated the patient on treatment with administration of insulin and adequate fluid replacement. Although the hyperglycemia and acidosis were immediately relieved, the disturbance of consciousness and tachycardia remained persistent. Levels of FT3 and FT4 were extremely high and TSH was below the detectable limit. TRAb was positive. The thyroid storm score of Burch & Wartofsky was 75/140, and the thyroid storm diagnostic criteria of the Japan Thyroid Association were satisfied. Oral administration of thiamazole, potassium iodide and propranolol resulted in immediate relief of the tachycardia. Discussion We encountered a case of thyroid storm associated with Graves' disease covered by DKA. Thyroid storm and DKA are both potentially fatal, and the prognosis varies depending on whether or not these conditions are detected and treated sufficiently early. The thyroid storm diagnostic criteria prepared in 2008 by the Japan Thyroid Association are very simple as compared to the Burch & Wartofsky scoring system for thyroid storm. The Japanese criteria may be useful in the diagnosis

Thyroid storm associated with Graves' disease covered by diabetic ketoacidosis: A case report.

Science.gov (United States)

Osada, Erika; Hiroi, Naoki; Sue, Mariko; Masai, Natsumi; Iga, Ryo; Shigemitsu, Rika; Oka, Reiko; Miyagi, Masahiko; Iso, Kaoru; Kuboki, Koji; Yoshino, Gen

2011-04-14

Thyroid storm is a condition in which multiple organ dysfunction results from failure of the compensatory mechanisms of the body owing to excessive thyroid hormone activity induced by some factors in patients with thyrotoxicosis. While diabetic ketoacidosis (DKA) is an important trigger for thyroid storm, simultaneous development of DKA and thyroid storm is rare. A 59-year-old woman with no history of either diabetes mellitus or thyroid disease presented to our hospital because of developing nausea, vomiting and diarrhea for 2 days. Physical examination showed mild disturbance of consciousness, fever, and tachycardia. There were no other signs of thyrotoxicosis. Laboratory studies revealed elevation of random blood glucose and glycosylated hemoglobin, strongly positive of urine acetone, and metabolic acidosis. Since DKA was diagnosed, we initiated the patient on treatment with administration of insulin and adequate fluid replacement. Although the hyperglycemia and acidosis were immediately relieved, the disturbance of consciousness and tachycardia remained persistent. Levels of FT3 and FT4 were extremely high and TSH was below the detectable limit. TRAb was positive. The thyroid storm score of Burch & Wartofsky was 75/140, and the thyroid storm diagnostic criteria of the Japan Thyroid Association were satisfied. Oral administration of thiamazole, potassium iodide and propranolol resulted in immediate relief of the tachycardia. We encountered a case of thyroid storm associated with Graves' disease covered by DKA. Thyroid storm and DKA are both potentially fatal, and the prognosis varies depending on whether or not these conditions are detected and treated sufficiently early. The thyroid storm diagnostic criteria prepared in 2008 by the Japan Thyroid Association are very simple as compared to the Burch & Wartofsky scoring system for thyroid storm. The Japanese criteria may be useful in the diagnosis of this condition since they enable clinicians to identify a broad

Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease

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Wilmar M. Wiersinga

2016-06-01

Full Text Available Genetic factors contribute for about 70% to 80% and environmental factors for about 20% to 30% to the pathogenesis of autoimmune thyroid disease (AITD. Relatives of AITD patients carry a risk to contract AITD themselves. The 5-year risk can be quantified by the so-called Thyroid Events Amsterdam-score, based on serum thyroid-stimulating hormone, thyroid peroxidase (TPO-antibodies and family history. Subjects at risk may ask what they can do to prevent development of AITD. This review summarizes what is known about modulation of exposure to environmental factors in terms of AITD prevention. To stop smoking decreases the risk on Graves disease but increases the risk on Hashimoto disease. Moderate alcohol intake provides some protection against both Graves and Hashimoto disease. Low selenium intake is associated with a higher prevalence of thyroid autoimmunity, but evidence that selenium supplementation may lower TPO antibodies and prevent subclinical hypothyroidism remains inconclusive. Low serum vitamin D levels are associated with a higher prevalence of TPO antibodies, but intervention studies with extra vitamin D have not been done yet. Stress may provoke Graves hyperthyroidism but not Hashimoto thyroiditis. Estrogen use have been linked to a lower prevalence of Graves disease. The postpartum period is associated with an increased risk of AITD. Taking together, preventive interventions to diminish the risk of AITD are few, not always feasible, and probably of limited efficacy.

The role of selenium, vitamin C, and zinc in benign thyroid diseases and of selenium in malignant thyroid diseases: Low selenium levels are found in subacute and silent thyroiditis and in papillary and follicular carcinoma

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Starzinger Matthias

2008-01-01

Full Text Available Abstract Background Thyroid physiology is closely related to oxidative changes. The aim of this controlled study was to evaluate the levels of nutritional anti-oxidants such as vitamin C, zinc (Zn and selenium (Se, and to investigate any association of them with parameters of thyroid function and pathology including benign and malignant thyroid diseases. Methods This controlled evaluation of Se included a total of 1401 subjects (1186 adults and 215 children distributed as follows: control group (n = 687, benign thyroid disease (85 children and 465 adults; malignant thyroid disease (2 children and 79 adults. Clinical evaluation of patients with benign thyroid disease included sonography, scintigraphy, as well as the determination of fT3, fT4, TSH, thyroid antibodies levels, Se, Zn, and vitamin C. Besides the routine oncological parameters (TG, TSH, fT4, ultrasound Se was also determined in the cases of malignant disease. The local control groups for the evaluation of Se levels were taken from a general practice (WOMED as well as from healthy active athletes. Blood samples were collected between 8:00 and 10:30 a.m. All patients lived in Innsbruck. Statistical analysis was done using SPSS 14.0. The Ho stated that there should be no differences in the levels of antioxidants between controls and thyroid disease patients. Results Among the thyroid disease patients neither vitamin C, nor Zn nor Se correlated with any of the following parameters: age, sex, BMI, body weight, thyroid scintigraphy, ultrasound pattern, thyroid function, or thyroid antibodies. The proportion of patients with benign thyroid diseases having analyte concentrations below external reference cut off levels were 8.7% of cases for vitamin C; 7.8% for Zn, and 20.3% for Se. Low Se levels in the control group were found in 12%. Se levels were significantly decreased in cases of sub-acute and silent thyroiditis (66.4 ± 23.1 μg/l and 59.3 ± 20.1 μg/l, respectively as well as in

Excess iodine promotes apoptosis of thyroid follicular epithelial cells by inducing autophagy suppression and is associated with Hashimoto thyroiditis disease.

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Xu, Chengcheng; Wu, Fei; Mao, Chaoming; Wang, Xuefeng; Zheng, Tingting; Bu, Ling; Mou, Xiao; Zhou, Yuepeng; Yuan, Guoyue; Wang, Shengjun; Xiao, Yichuan

2016-12-01

The incidence of the autoimmune thyroid disease Hashimoto thyroiditis (HT) has increased in recent years, and increasing evidence supports the contribution of excess iodine intake to thyroid disease. In this study, we examined the status of autophagy and apoptosis in thyroid tissues obtained from patients with HT, and we determined the effects of excessive iodine on the autophagy and apoptosis of thyroid follicular cells (TFCs) in an attempt to elucidate the effects of excess iodine on HT development. Our results showed decreases in the autophagy-related protein LC3B-II, and increases in caspase-3 were observed in thyroid tissues from HT patients. Interestingly, the suppression of autophagy activity in TFCs was induced by excess iodine in vitro, and this process is mediated through transforming growth factor-β1 downregulation and activation of the Akt/mTOR signaling pathway. In addition, excess iodine induced autophagy suppression and enhanced reactive oxygen species (ROS) production and apoptosis of TFCs, which could be rescued by the activation of autophagy. Taken together, our results demonstrated that excess iodine contributed to autophagy suppression and apoptosis of TFCs, which could be important factors predisposing to increased risk of HT development. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease

OpenAIRE

Wiersinga, Wilmar M.

2016-01-01

Genetic factors contribute for about 70% to 80% and environmental factors for about 20% to 30% to the pathogenesis of autoimmune thyroid disease (AITD). Relatives of AITD patients carry a risk to contract AITD themselves. The 5-year risk can be quantified by the so-called Thyroid Events Amsterdam-score, based on serum thyroid-stimulating hormone, thyroid peroxidase (TPO)-antibodies and family history. Subjects at risk may ask what they can do to prevent development of AITD. This review summar...

[100 years of Hashimoto thyroiditis, still an intriguing disease].

Science.gov (United States)

Baretić, Maja

2011-12-01

one was that residual placental mass could cause prolonged exposure to beta- HCG. Beta- HCG causes hyperthyroidism mimicking action of TSH. The second explanation was that sepsis changes the nature of antibodies directed to the TSH receptor - thyrotrophin binding inhibitory antibodies become thyroid stimulating antibodies. The last explanation pointed to the pregnancy as a trigger itself that influenced on the immune events. Hyperthyreosis was followed by hypothyreosis and substitution with previous dosage of levothyroxine was continued. The answer of the sudden hyperthyreosis was given in subsequent pregnancy that happened 2,5 years later. The following one was free of complications, but postpartum hyperthyroidism occurred again. Further course of disease suited to lymphocytic thyroiditis with hypothyroidism, and she is substituted with levothyroxine until now. During normal pregnancy it is expected to have decreased ratio of CD4+/CD8+ lymphocyte subpopulation. Studies showed that women who developed postpartum thyroiditis had a higher ratio of CD4+/CD8+ and they were generally anti-TPO positive. It is considered that the lack of the expected suppression of immune function during pregnancy leads to postpartum thyroiditis. In this case Hashimoto thyroiditis showed two different faces: it was presented with long term hypothyroidism, but in postpartum period it converted to hyperthyroidism - a typical picture of postpartum thyroiditis. Pregnancy as a trigger can reveal till then unrecognized autoimmune disorder, or modify its course from hypothyroidism to hyperthyroidism. Hashimoto disease even 100 years after the discovery may surprise with one of its many faces.

Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes

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Lee Byung I

2010-04-01

Full Text Available Abstract Background The encephalopathy associated with autoimmune thyroid disease (EAATD is characterized by neurological/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto's thyroiditis (HT, although fourteen EAATD patients with Graves' disease (GD have been also reported. Methods We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. Results Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. Conclusions GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.

The effect of chemoradiation therapy on pituitary-thyroid system function in children suffering Hodgkin's disease

International Nuclear Information System (INIS)

Konoplya, N.E.; Sachivko, N.V.; Zhavrid, Eh.A.

1997-01-01

The functional status of the thyroid gland was evaluated in 63 children with Hodgkin's disease, aged 4-15 years, before, in the course of and 5 years after chemoradiation therapy. Thyroxin (T4), triiodothyronine (T) and thyroid-stimulating hormone (TSH) in the blood were assayed. The disease was shown to disrupt the pituitary-thyroid system leading to hypothyroidism development which progressed as the disease advanced. While chemotherapy brought the balance between the peripheral thyroid hormone levels and TSH back to normal, thyroid function decrease again following radiotherapy of the neck. The most pronounced and persistent failure of the pituitary-thyroid system was registered with the total target dose of 30 Gy and higher. Irradiation in a dose of 20 Gy caused less disruption and the function was spontaneously restored within 12 months after the treatment

Graves' Disease Patients with Persistent Hyperthyroidism and Diffuse Lymphoplasmacytic Infiltration in the Thyroid Show No Histopathological Compatibility with IgG4-Related Disease.

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Eijun Nishihara

Full Text Available IgG4-related disease is a novel disease entity characterized by diffuse lymphoplasmacytic infiltration rich in IgG4-positive plasma cells and fibrosis into multiple organs. There is still controversy over whether some thyroid diseases are actually IgG4-related disease. The objective of this study was to elucidate the clinicopathological features of Graves' disease with diffuse lymphoplasmacytic infiltration in the thyroid.Among 1,484 Graves' disease patients who underwent thyroidectomy, we examined their histopathological findings including the degree of lymphoplasmacytic and fibrotic infiltration and levels of IgG4-positive plasma cells in the thyroid. Their clinical pictures were defined by laboratory and ultrasonographic evaluation.A total of 11 patients (0.74% showed diffuse lymphoplasmacytic infiltration in the stroma of the thyroid gland. Meanwhile, other patients showed variable lymphoid infiltration ranging from absent to focally dense but no aggregation of plasma cells in the thyroid gland. Based on the diagnostic criteria of IgG4-related disease, 5 of the 11 subjects had specifically increased levels of IgG4-positive plasma cells in the thyroid. Fibrotic infiltration was present in only 1 patient developing hypothyroidism after anti-thyroid drug treatment for 4 years, but not in the other 10 patients with persistent hyperthyroidism. Obliterative phlebitis was not identified in any of the 11 subjects. Thyroid ultrasound examination showed 1 patient developing hypothyroidism who had diffuse hypoechogenicity, but the other hyperthyroid patients had a coarse echo texture.In our study, Graves' disease patients with persistent hyperthyroidism who had diffuse lymphoplasmacytic infiltration rich in IgG4-positive plasma cells in the thyroid showed no concomitant fibrosis or obliterative phlebitis.

Impact of month of birth on the development of autoimmune thyroid disease in the United Kingdom and Europe

NARCIS (Netherlands)

Hamilton, Alexander; Newby, Paul R.; Carr-Smith, Jacqueline D.; Disanto, Giulio; Allahabadia, Amit; Armitage, Mary; Brix, Thomas H.; Chatterjee, Krishna; Connell, John M.; Hegedüs, Laszlo; Hunt, Penny J.; Lazarus, John H.; Pearce, Simon H.; Robinson, Bruce G.; Taylor, Jenny C.; Vaidya, Bijay; Wass, John A. H.; Wiersinga, Wilmar M.; Weetman, Anthony P.; Ramagopalan, Sreeram V.; Franklyn, Jayne A.; Gough, Stephen C. L.; Simmonds, Matthew J.

2014-01-01

Viral/bacterial infection is proposed as a trigger for the autoimmune thyroid diseases (AITD): Graves' disease (GD) and Hashimoto's thyroiditis (HT). Previous studies in European Caucasian AITD subjects found higher birth rates in the autumn/winter, suggesting those born in the autumn/winter

Less aggressive disease in patients with primary squamous cell carcinomas of the thyroid gland and coexisting lymphocytic thyroiditis.

Science.gov (United States)

Asik, Mehmet; Binnetoglu, Emine; Sen, Hacer; Gunes, Fahri; Muratli, Asli; Kankaya, Duygu; Uysal, Fatma; Sahin, Mustafa; Ukinc, Kubilay

2015-01-01

Primary squamous cell carcinoma (SCC) of the thyroid gland is extremely rare. Infrequently, primary SCC of the thyroid gland is accompanied by other thyroid diseases such as Hashimoto's thyroiditis (HT). Recently, studies have demonstrated that differentiated thyroid cancer with coexisting HT has a better prognosis. However, the prognosis of patients with primary SCC of the thyroid gland and coexistent HT has not been clearly identified. We compared the clinical characteristics and disease stages of patients with primary SCC with and without lymphocytic thyroiditis (LT). We reviewed reports of primary SCC of the thyroid gland published in the English literature. We identified 46 papers that included 17 cases of primary SCC of the thyroid gland with LT and 77 cases of primary SCC of the thyroid gland without LT. Lymph node metastasis and local invasion rates did not differ between these two groups. Distant metastases were absent in patients with LT, and were observed in 13 (16.9%) patients without LT. A greater proportion of patients without LT had advanced stage disease (stage IV A-B-C) than patients with LT (p thyroid gland and coexisting LT had lower tumour-node-metastasis stage and frequency of distant metastasis than those without LT. Lymphocytic infiltration in patients with SCC appears to limit tumour growth and distant metastases.

The impact of thyroid diseases on bone metabolism and fracture risk.

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Amashukeli, M; Giorgadze, E; Tsagareli, M; Nozadze, N; Jeiranashvili, N

2010-01-01

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. One of the leading causes of secondary osteoporosis are thyroid diseases; this fact carries special importance for Georgia because of thyroid disease prevalence in Georgian population. In the present article we discuss the mechanisms, by which thyroid hormones and thyroid stimulating hormone (TSH) act on bone. We also present the data of meta-analysis of large studies, which demonstrate the complex relationship between the thyroid diseases and bone mineral density as well as the fracture risk; namely by overt and subclinical thyrotoxicosis, hypothyroidism and the treatment with the suppressive doses of levothyroxine. Beside that, we review the related data and the possible reasons, why different treatment regimens of Grave's disease: conservative, operative and radioiodine are related to different fracture risks. Finally, we discuss briefly the practical aspects of the treatment of secondary osteoporosis, related with thyroid diseases.

Hydatid cyst disease of the thyroid gland: report of two cases.

Science.gov (United States)

Akbulut, Sami; Demircan, Firat; Sogutcu, Nilgun

2015-04-01

Hydatid cyst disease may develop in any organ of the body, most frequently in the liver and lung, but occasionally can affect other organs such as the thyroid gland. Although the prevalence of thyroidal cyst disease varies by region, literature data suggest that it ranges between 0% and 3.4%. The aim of this report was to share 2 cases with thyroid hydatid cyst. Two female patients aged 26 and 57 years were admitted to our outpatient clinic with different complaints. While the first case presented with front of the neck swelling and pain, the second case presented with hoarseness, sore throat, and neck swelling. Both patients were living in a rural area in the southeastern region of Turkey and had had a long history of animal contact. Both patients had undergone previous surgeries for hydatid cyst disease. Both patients presented with a clinical picture consistent with typical multinodular goiter, and both underwent total thyroidectomy after detailed examinations and tests. The exact diagnosis was made after histopathologic examination in both patients. They both had a negative indirect hemagglutination test studied from blood samples. They both have had no recurrences during a 4-year follow-up. In conclusion, although thyroid gland is rarely affected, hydatid cyst disease should not be overlooked in differential diagnosis of cystic lesions of thyroid gland in patients who live in regions where hydatid cyst disease is endemic and who had hydatid cysts in other regions of their body.

Crohn's disease and risk of fracture: does thyroid disease play a role?

Institute of Scientific and Technical Information of China (English)

Nakechand Pooran; Pankaj Singh; Simmy Bank

2003-01-01

AIM: To assess the role of thyroid disease as a risk for fractures in Crohn's patients.METHODS: A cross-sectional study was conducted from 1998 to 2000. The study group consisted of 210 patients with Crohn's disease. A group of 206 patients without inflammatory bowel disease served as controls. Primary outcome was thyroid disorder. Secondary outcomes included use of steroids, immunosuppressive medications, surgery and incidence of fracture.RESULTS: The prevalence of hyperthyroidism was similar in both groups. However, the prevalence of hypothyroidism was lower in Crohn's patients (3.8 % vs 8.2 %, P=0.05).Within the Crohn's group, the use of immunosuppressive agents (0 % vs11 %), steroid usage (12.5 % vs37 %), small bowel surgery (12.5 % vs 28 %) and large bowel surgery (12.5 % vs27 %) were lower in the hypothyroid subset as compared to the euthyroid subset. Seven (3.4 %) Crohn'spatients suffered fracture, all of whom were euthyroid.CONCLUSION: Thyroid disorder was not found to be associated with Crohn's disease and was not found to increase the risk for fractures. Therefore, screening for thyroid disease is not a necessary component in the management of Crohn's disease.

Interphase ribosomal RNA cistron staining in thyroid epithelial cells in Grave's disease, Hashimoto's thyroiditis and benign and malignant tumours of the thyroid gland

OpenAIRE

Mamaev, N N; Grynyeva, E N; Blagosklonnaya, Y V

1996-01-01

Aim—To evaluate the expression of ribosomal cistrons in human thyroid epithelial cells (TECs) of patients with Grave's disease, Hashimoto's thyroiditis and benign and malignant tumours of the thyroid gland.

Characteristics of patients with graves disease and intrathyroid hypovascularity compared to painless thyroiditis.

Science.gov (United States)

Uchida, Toyoyoshi; Shigihara, Nayumi; Takeno, Kageumi; Komiya, Koji; Goto, Hiromasa; Abe, Hiroko; Sato, Junko; Honda, Akira; Fujitani, Yoshio; Watada, Hirotaka

2014-10-01

The purpose of this study was to assess the frequency and sonographic and laboratory characteristics of Graves disease with intrathyroid hypovascularity in Japanese patients and to compare these characteristics in patients with painless thyroiditis. A total of 194 consecutive patients with Graves disease and 21 patients with painless thyroiditis were enrolled. The patients underwent thyroid volume measurement, mean superior thyroid artery peak systolic velocity (PSV) measurement, power Doppler sonography, and proper blood testing to discriminate between Graves disease and painless thyroiditis. Based on the power Doppler sonographic findings, they were divided into 4 groups: from pattern 0 (most hypovascular thyroid) to pattern III (most hypervascular thyroid). Comparisons of multiple thyroid parameters were made among the groups. The prevalence of Graves disease with pattern 0 (n = 27) was 13.9% among the patients with Graves disease. The sonographic and laboratory data for patients with Graves disease and pattern 0 were compared to those of the 21 patients with painless thyroiditis, which typically shows intrathyroid hypovascularity. Free triiodothyronine and thyroxine levels and the superior thyroid artery PSV were significantly lower in patients with Graves disease and pattern 0 than those with patterns I, II, and III (P thyroid volume and thyrotropin receptor antibody level were significantly lower in patients with Graves disease and pattern 0 than those with pattern III. In the comparison between patients with Graves disease and pattern 0 and those with painless thyroiditis and pattern 0, apart from thyrotropin receptor antibody, only the superior thyroid artery PSV was different. Although the clinical features of patients with Graves disease and intrathyroid hypovascularity were similar to those patients with painless thyroiditis, the superior thyroid artery PSV showed a moderate ability to discriminate these patients. © 2014 by the American Institute of

Using fractal analysis of thermal signatures for thyroid disease evaluation

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Gavriloaia, Gheorghe; Sofron, Emil; Gavriloaia, Mariuca-Roxana; Ghemigean, Adina-Mariana

2010-11-01

The skin is the largest organ of the body and it protects against heat, light, injury and infection. Skin temperature is an important parameter for diagnosing diseases. Thermal analysis is non-invasive, painless, and relatively inexpensive, showing a great potential research. Since the thyroid regulates metabolic rate it is intimately connected to body temperature, more than, any modification of its function generates a specific thermal image on the neck skin. The shapes of thermal signatures are often irregular in size and shape. Euclidean geometry is not able to evaluate their shape for different thyroid diseases, and fractal geometry is used in this paper. Different thyroid diseases generate different shapes, and their complexity are evaluated by specific mathematical approaches, fractal analysis, in order to the evaluate selfsimilarity and lacunarity. Two kinds of thyroid diseases, hyperthyroidism and papillary cancer are analyzed in this paper. The results are encouraging and show the ability to continue research for thermal signature to be used in early diagnosis of thyroid diseases.

Suppressive therapy for radiation-associated nodular thyroid disease

International Nuclear Information System (INIS)

Tamura, Kazuo; Shimaoka, Katsutaro; Tsukada, Yoshiaki; Razack, M.S.; Sciasicia, Michael.

1981-01-01

A thyroid screening program for individuals who had irradiation to the head and neck areas was started at Roswell Park Memorial Institute in February 1977 and by June 1979, 1,071 patients were seen in the clinic. Three hundred and ninety-six patients were found to have palpable abnormalities of the thyroid, and following pretreatment evaluation, suppressive therapy with triiodothyronine (T3) (50 μg/day) or DT (desiccated thyroid) (120 mg/day) was administered in a double-blind fashion. Two hundred fifty patients with nodular disease completed 6 mo of treatment and are analyzed in this paper. Pretreatment thyroid function tests showed that two patients had hypothyroidism with a high thyroid-stimulating hormone (TSH) and a low thyroxine level. A high incidence of thyroid autoantibodies was also noted and surgical findings confirmed a high incidence of chronic thyroiditis. Complete disappearance of the nodules was seen in 29% of the patients, and in addition, 38% of the patients were seen to have significant shrinkage of the nodules, indicating that radiation-associated thyroid nodules were as sensitive to the thyroactive agents as nonirradiated nodular thyroid disease. There was little difference in the response rate between T3 and DT. Both agents suppressed circulating TSH levels to an unmeasurable level in 76% of the patients. There was no correlation between scan findings and response rates. Thyroid carcinoma was found in 19% of the patients who underwent surgery; although all were well-differentiated carcinomas, two-thirds of the patients already had evidence of dissemination and/or invasion suggesting the aggressive nature of postirradiation thyroid carcinoma. (author)

Ultrasonographic assessment of the thyroid gland structure in inflammatory bowel disease patients.

Science.gov (United States)

Neubauer, Katarzyna; Woźniak-Stolarska, Barbara

2012-01-01

The etiopathogenesis of inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is still not fully elucidated and seems to be multifactorial. It has been suggested that genetic, immunological and environmental factors participate in IBD development. IBD extraintestinal manifestations include rheumatic, metabolic, dermatologic, ophthalmologic, hepatobiliary, pancreatic, urologic, pulmonary, neurological, hematological and thromboembolic complications. Thyroid gland diseases have not been confirmed as extraintestinal manifestations of IBD. However, it is known that some thyroid diseases share an immunological background with IBD, and that dysfunction of the thyroid gland may induce gastrointestinal symptoms. Ultrasound examination is the gold standard for evaluation of thyroid gland morphology. This study was designed to assess the prevalence of abnormalities in the structure of the thyroid gland in IBD patients and to compare it to the control group. The study group consisted of 199 consecutive IBD patients (80 CD patients and 119 UC patients) hospitalized at the Department of Gastroenterology and Hepatology of Wroclaw Medical University (Poland). The control group consisted of 42 healthy volunteers and patients with functional gastrointestinal disorders. The most common finding in the ultrasound examination in IBD patients were tumors. Tumors, which were smaller than or equal to 10 mm were present in 11.5% of IBD patients; and tumors larger than 10 mm were present in 13.1%. These results show that small tumors (less than 10 mm in diameter) of the thyroid gland are more frequent among patients with CD and UC compared to the control group (p = 0.0001 and p = 0.001, respectively). Additionally, enlargement of the thyroid gland occurs more often in UC patients compared to the control group (p = 0.003). There was no difference in the frequency of thyroid abnormalities between UC and CD patients. In patients with inflammatory

Antithyroglobulin Antibodies and Antimicrosomal Antibodies in Various Thyroid Diseases

International Nuclear Information System (INIS)

Lee, Gwon Jun; Hong, Key Sak; Choi, Kang Won; Lee, Kyu; Koh, Chang Soon; Lee, Mun Ho; Park, Sung Hoe; Chi, Je Geun; Lee, Sang Kook

1979-01-01

The authors investigated the incidence of antithyroglobulin antibodies and antibodies and antimicrosomal antibodies measured by tanned red cell hemagglutination method in subjects suffering from various thyroid disorders. 1) In 15 normal patients, neither suffering from any thyroid diseases nor from any other autoimmune disorders, the antithyroglobulin antibodies were all negative, but the antimicrosomal antibody was positive only in one patient (6.7%). 2) The antithyroglobulin antibodies were positive in 31.5% (34 patients) of 108 patients with various thyroid diseases, and the antimicrosomal antibodies were positive in 37.0% (40 patients). 3) of the 25 patients with Graves' diseases, 7 patients (28.0%) showed positive for the antithyroglobulin antibodies, and 9 (36.0%) for the antimicrosomal antibodies. There was no definite differences in clinical and thyroid functions between the groups with positive and negative results. 4) Both antibodies were positive in 16 (88.9%) and 17 (94.4%) patients respectively among 18 patients with Hashimoto's thyroiditis, all of them were diagnosed histologically. 5) Three out of 33 patients with thyroid adenoma showed positive antibodies, and 3 of 16 patients with thyroid carcinoma revealed positive antibodies. 6) TRCH antibodies demonstrated negative results in 2 patients with subacute thyroiditis, but positive in one patient with idiopathic primary myxedema. 7) The number of patients with high titers(>l:802) was 16 for antithyroglobulin antibody, and 62.5% (10 patients) of which was Hashimoto's thyroiditis. Thirteen (65.0) of 20 patients with high titers (>l:802) for antimicrosomal antibody was Hashimoto's thyroiditis. TRCH test is a simple, sensitive method, and has high reliability and reproducibility. The incidences and titers of antithyroglobulin antibody and antimicrosomal antibody are especially high in Hashimoto's thyroiditis.

Scintigraphy and ultrasonography of various thyroid diseases

International Nuclear Information System (INIS)

Ban, Yoshio; Nagakura, Hozumi; Kawauchi, Akihiro; Fukunari, Nobuhiro; Itoh, Kunihiko; Higashi, Tomomitsu.

1987-01-01

We reported the usefulness of scintigraphy and ultrasonography of various thyroid diseases. The scintigraphy were useful information in the determination of functioning adenoma, location of ectopic thyroid glands and appearance of lang and bone metastasis of thyroid carcinoma. As ultrasonography were able to be observation of internal structure of thyroid gland, that maight be used to determined associated nodular lesions in diffuse goiter and differentiation between benign and malignant tumor in nodular goiter. In observation of calcifications of goiter, soft X rays apparatus were usefull tool. US, as initial diagnostic test before scintiscanning, provided useful information and minimized radiation exposure. (author)

Significant clinical differences in primary hyperparathyroidism between patients with and those without concomitant thyroid disease

International Nuclear Information System (INIS)

Masatsugu, Toshihiro; Kuroki, Syoji; Tanaka, Masao

2005-01-01

We evaluated the differences in diagnosis and treatment for primary hyperparathyroidism (pHPT) in patients with and those without concomitant thyroid disease. One hundred and ten patients with pHPT underwent parathyroid localization and thyroid examination by ultrasonography (US) and sestamibi scintigraphy (MIBI). The clinical and biochemical findings, parathyroid localization, and operations performed were compared in 49 patients without thyroid disease and 61 patients with thyroid disease. Asymptomatic hypercalcemia was significantly more prevalent in patients with concomitant thyroid disease (88.5%) than in those without thyroid disease (49.0%) (P<0.01). The mean serum calcium was significantly higher and the inorganic phosphate level was significantly lower in patients without concomitant thyroid disease than in those with concomitant thyroid disease (P<0.05, P<0.01, respectively). The pathologic parathyroid gland was identified significantly more often in patients without concomitant thyroid disease than in those with concomitant thyroid disease both by US and MIBI (P<0.05). Unilateral exploration was performed more often in patients without thyroid disease than in those with thyroid disease (P<0.01). Primary hyperparathyroidism was diagnosed at an earlier stage in patients with concomitant thyroid disease. Thyroid disease concomitant with pHPT influenced parathyroid localization as well as the indication for minimally invasive parathyroidectomy. (author)

Dendritic cells and veiled accessory macrophages : hormonal influences and autoimmune thyroid disease

NARCIS (Netherlands)

M.O. Canning (Martha)

2005-01-01

textabstractImmune responses to thyroid specific autoantigens form the basis of autoimmune thyroid disease pathogenesis. Two polar forms of autoimmune reactivity of the thyroid gland exist in this disease spectrum: a catabolic form characterized by gradual inflammatory destruction of thyroid

Thyroid mass estimation in Grave's disease by SPECT

International Nuclear Information System (INIS)

Pant, G.S.; Sharma, S.K.; Kumar, R.; Pandey, A.K.; Gupta, A.K.

2002-01-01

Aim: One of the important parts of treatment of Grave's disease with I-131 is the delivery of accurate dose to the target volume. Three important parameters that need to be accurately measured for dosimetry are; the 24 hr thyroid uptake (%), the thyroid mass and effective half life of I-131 in the gland. In this presentation we describe the estimation thyroid mass by SPECT. We have standardised a method to estimated thyroid volume by SPECT using thyroid phantoms of different sizes and then used them for routine thyroid mass estimation in patients with Graves' disease. Materials and Methods: Due to variation in thyroid weight in patients with Grave's disease, we standardised the scintigraphic (SPECT) technique using thyroid phantoms of different volumes such as 5 ml, 9.5 ml, 10.5 ml, 35 ml, 80 ml, 101ml and 110 ml. Each phantom was filled with 99 mTc solution with different activity concentration (100 μCi, 300 μCi, 600 μCi and 1.0 μCi) and SPECT images were acquired on a VARICAM dual head camera in 128x128 matrix. The acquired data was processed using a standardised Metz filter but without attenuation or scatter correction. Coronal slices were used with suitable threshold for edge detection. An irregular ROI was plotted around each lobe and isthmus of the thyroid gland and the enclosed slice area was measured. The area measured from all the frames was added and multiplied by the slice thickness to get the volume of the thyroid gland. The estimated volume of each phantom was compared and correlated with its actual volume. The thyroid mass in 40 patients was estimated by SPECT and compared with that estimated by ultrasonography.Results and Conclusion: The results of thyroid mass estimation with SPECT in phantom study suggested a 30% threshold for all phantom volumes. However, 35% threshold was used in patients' images for estimating thyroid volume. The estimated volumes by scintigraphy were compared with that estimated by ultrasonography. A correlation coefficient

Thyrotropin - Binding Inhibiting Immunoglobulin (TBII) in Patients with Autoimmune Thyroid Diseases

International Nuclear Information System (INIS)

Jang, Dae Sung; Ahn, Byeong Cheol; Sohn, Sang Kyun; Lee, Jae Tae; Lee, Kyu Bo

1996-01-01

In order to evaluate the significance of thyrotropin-binding inhibiting immunoglobulin (TBII) in the patients with autoimmune thyroid diseases, the authors investigated 402 cases of Graves' disease and 230 cases of Hashimoto's thyroiditis comparing 30 cases of normal healthy adult at Kyung Pook University Hospital from February 1993 to August 1994. The TBII was tested by radioimmunoassay and assessed on the dynamic change with the disease course, thyroid functional parameters, and other thyroid autoantibodies; antithyroglobulin antibody(ATAb) and antimicrosomal antibody(AMAb) including thyroglobulin. The serum level of TBII was 40.82 ± 21.651(mean ± SD)% in hyperthyroid Graves' disease and 8.89 ± 14.522% in Hashimoto's thyroiditis and both were significant different from normal control of which was 3.21 ± 2.571%. The frequency of abnormally increased TBII level was 92.2% in hyperthyroid Craves' disease, 46.7% in euthyroid Graves' disease or remission state of hyperthyroidism, and 23.9% in Hashimoto's thyroiditis. The serum levels of increased TBII in Graves' disease were positively correlated with RAIU, serum T3, T4, and FT4, but negatively correlated with serum TSH(each p<0.001). The TBII in Graves' disease had significant positive correlation with serum thyroglobulin and AMAb, but no significant correlation with ATAb. In the Hashimoto's thyroiditis, the serum levels of TBII were positively correlated with RAIU, serum T3, TSH and AMAb, but not significantly correlated with serum T4, FT4, thyroglobulin and ATAb. Therefore serum level of TBII seemed to be a useful mean of assessing the degree of hyperthyroidism in Graves' disease and correlated well with thyroidal stimulation. The serum level of TBII in Hashimoto's thyroiditis is meaningful for the degree of both functional abnormality reflecting either hyperfunction or hypofunction and the immunologic abnormality.

Thyrotropin - Binding Inhibiting Immunoglobulin (TBII) in Patients with Autoimmune Thyroid Diseases

Energy Technology Data Exchange (ETDEWEB)

Jang, Dae Sung; Ahn, Byeong Cheol; Sohn, Sang Kyun; Lee, Jae Tae; Lee, Kyu Bo [Kyungpook National University School of Medicine, Taegu (Korea, Republic of)

1996-03-15

In order to evaluate the significance of thyrotropin-binding inhibiting immunoglobulin (TBII) in the patients with autoimmune thyroid diseases, the authors investigated 402 cases of Graves' disease and 230 cases of Hashimoto's thyroiditis comparing 30 cases of normal healthy adult at Kyung Pook University Hospital from February 1993 to August 1994. The TBII was tested by radioimmunoassay and assessed on the dynamic change with the disease course, thyroid functional parameters, and other thyroid autoantibodies; antithyroglobulin antibody(ATAb) and antimicrosomal antibody(AMAb) including thyroglobulin. The serum level of TBII was 40.82 +- 21.651(mean +- SD)% in hyperthyroid Graves' disease and 8.89 +- 14.522% in Hashimoto's thyroiditis and both were significant different from normal control of which was 3.21 +- 2.571%. The frequency of abnormally increased TBII level was 92.2% in hyperthyroid Craves' disease, 46.7% in euthyroid Graves' disease or remission state of hyperthyroidism, and 23.9% in Hashimoto's thyroiditis. The serum levels of increased TBII in Graves' disease were positively correlated with RAIU, serum T3, T4, and FT4, but negatively correlated with serum TSH(each p<0.001). The TBII in Graves' disease had significant positive correlation with serum thyroglobulin and AMAb, but no significant correlation with ATAb. In the Hashimoto's thyroiditis, the serum levels of TBII were positively correlated with RAIU, serum T3, TSH and AMAb, but not significantly correlated with serum T4, FT4, thyroglobulin and ATAb. Therefore serum level of TBII seemed to be a useful mean of assessing the degree of hyperthyroidism in Graves' disease and correlated well with thyroidal stimulation. The serum level of TBII in Hashimoto's thyroiditis is meaningful for the degree of both functional abnormality reflecting either hyperfunction or hypofunction and the immunologic abnormality.

Prediction of Thyroid Disease Using Data Mining Techniques

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Irina Ioniţă

2016-08-01

Full Text Available Recently, thyroid diseases are more and more spread worldwide. In Romania, for example, one of eight women suffer from hypothyroidism, hyperthyroidism or thyroid cancer. Various research studies estimate that about 30% of Romanians are diagnosed with endemic goiter. The factors that affect the thyroid function are: stress, infection, trauma, toxins, low-calorie diet, certain medication etc. It is very important to prevent such diseases rather than cure them, because the majority of treatments consist in long term medication or in chirurgical intervention. The current study refers to the thyroid disease classification in two of the most common thyroid dysfunctions (hyperthyroidism and hypothyroidism among the population. The authors analyzed and compared four classification models: Naive Bayes, Decision Tree, Multilayer Perceptron and Radial Basis Function Network. The results indicate a significant accuracy for all the classification models mentioned above, the best classification rate being that of the Decision Tree model. The data set used to build and to validate the classifier was provided by the UCI machine learning repository and by a website with Romanian data. The framework for building and testing the classification models was KNIME Analytics Platform and Weka, two data mining software.

Cardiovascular Disease and Thyroid Function

DEFF Research Database (Denmark)

Faber, Jens; Selmer, Christian

2014-01-01

Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones at the ce......Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones...... at the cellular level. Subclinical hyperthyroidism is associated with increased left ventricular mass of the heart, which reverts after obtaining euthyroidism. Mortality and risk of major cardiovascular events are increased. Subclinical hypothyroidism is also associated with subtle changes in the heart, e.g. its...

Antithyroglobulin Antibodies and Antimicrosomal Antibodies in Various Thyroid Diseases

Energy Technology Data Exchange (ETDEWEB)

Lee, Gwon Jun; Hong, Key Sak; Choi, Kang Won; Lee, Kyu; Koh, Chang Soon; Lee, Mun Ho; Park, Sung Hoe; Chi, Je Geun; Lee, Sang Kook [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1979-03-15

The authors investigated the incidence of antithyroglobulin antibodies and antibodies and antimicrosomal antibodies measured by tanned red cell hemagglutination method in subjects suffering from various thyroid disorders. 1) In 15 normal patients, neither suffering from any thyroid diseases nor from any other autoimmune disorders, the antithyroglobulin antibodies were all negative, but the antimicrosomal antibody was positive only in one patient (6.7%). 2) The antithyroglobulin antibodies were positive in 31.5% (34 patients) of 108 patients with various thyroid diseases, and the antimicrosomal antibodies were positive in 37.0% (40 patients). 3) of the 25 patients with Graves' diseases, 7 patients (28.0%) showed positive for the antithyroglobulin antibodies, and 9 (36.0%) for the antimicrosomal antibodies. There was no definite differences in clinical and thyroid functions between the groups with positive and negative results. 4) Both antibodies were positive in 16 (88.9%) and 17 (94.4%) patients respectively among 18 patients with Hashimoto's thyroiditis, all of them were diagnosed histologically. 5) Three out of 33 patients with thyroid adenoma showed positive antibodies, and 3 of 16 patients with thyroid carcinoma revealed positive antibodies. 6) TRCH antibodies demonstrated negative results in 2 patients with subacute thyroiditis, but positive in one patient with idiopathic primary myxedema. 7) The number of patients with high titers(>l:802) was 16 for antithyroglobulin antibody, and 62.5% (10 patients) of which was Hashimoto's thyroiditis. Thirteen (65.0) of 20 patients with high titers (>l:802) for antimicrosomal antibody was Hashimoto's thyroiditis. TRCH test is a simple, sensitive method, and has high reliability and reproducibility. The incidences and titers of antithyroglobulin antibody and antimicrosomal antibody are especially high in Hashimoto's thyroiditis.

Vitiligo and overt thyroid diseases: A nationwide population-based study in Korea.

Science.gov (United States)

Bae, Jung Min; Lee, June Hyunkyung; Yun, Jae Seung; Han, Byeol; Han, Tae Young

2017-05-01

Associations between vitiligo and thyroid diseases have been reported repeatedly. We investigated the associations between vitiligo and overt autoimmune thyroid diseases and thyroid cancer using the Korean National Health Insurance claims database. We defined patients with vitiligo as those whose records showed ≥4 physician contacts between 2009 and 2013 in which vitiligo was the principal diagnosis. We also established an age- and sex-matched control group without vitiligo (2 per 1 vitiligo patient). The outcomes of interest were concurrent Graves disease and Hashimoto thyroiditis (the patients were taking relevant thyroid medications) and thyroid cancer. The study enrolled 73,336 vitiligo patients and 146,672 controls. Patients with vitiligo were at increased risks of Graves disease (odds ratio [OR] 2.610 [95% confidence interval {CI} 2.319-02.938]), Hashimoto thyroiditis (OR 1.609 [95% CI 1.437-1.802]), and thyroid cancer (OR 1.127 [95% CI 1.022-1.242]), compared with the controls. The associations were consistently stronger in males and younger patients. Individual clinical information was not available, and the homogeneous population may limit the generalizability of the results. Vitiligo was significantly associated with overt autoimmune thyroid diseases and overt thyroid cancer. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Self-perception of swallowing by patients with benign nonsurgical thyroid disease.

Science.gov (United States)

Pernambuco, Leandro; Silva, Marlisson Pinheiro da; Almeida, Marluce Nascimento de; Costa, Erika Beatriz de Morais; Souza, Lourdes Bernadete Rocha de

2017-02-23

To verify the frequency of swallowing complaints in patients with benign nonsurgical thyroid disease and compare the self-perception of swallowing disorder intensity between different types of thyroid disease. The study sample comprised 39 women aged 19-58 years (38.54 ± 10.74) with hypothyroidism (n=22; 56.4%) or thyroid nodules (n=17; 43.6%). Presence and type of swallowing complaint and self-perception of swallowing disorder intensity were investigated by means of self-ratings recorded on a 100-millimeter visual analog scale. The data were analyzed by descriptive measures and the Mann-Whitney nonparametric test was used to compare the self-perception of swallowing disorder intensity between both clinical diagnoses of thyroid disease. The level of 5% was adopted for statistical significance. Twenty-six (66.7%) individuals reported the following swallowing complaints: pharyngolaryngeal stasis sensation (37.15%), chocking (34.29%), and odynophagia (28.57%). The mean value of self-perception of swallowing disorder intensity by the visual analog scale was 59.35 (± 27.38) millimeters. No difference in self-perception was reported between the clinical diagnoses of thyroid disease. In this sample, swallowing complaint was frequently observed in patients with benign nonsurgical thyroid disease. Moderate self-perception of swallowing disorder intensity was reported regardless of the clinical diagnosis of thyroid disease.

Recombinant Protein Production from TPO Gen Cloning and Expression for Early Detection of Autoimmune Thyroid Diseases

Science.gov (United States)

Aulanni'am, Aulanni'am; Kinasih Wuragil, Dyah; Wahono Soeatmadji, Djoko; Zulkarnain; Marhendra, Agung Pramana W.

2018-01-01

Autoimmune Thyroid Disease (AITD) is an autoimmune disease that has many clinical symptoms but is difficult to detect at the onset of disease progression. Most thyroid autoimmune disease patients are positive with high titre of thyroid autoantibodies, especially thyroid peroxidase (TPO). The detection AITD are still needed because these tests are extremely high cost and have not regularly been performed in most of clinical laboratories. In the past, we have explored the autoimmune disease marker and it has been developed as source of polyclonal antibodies from patient origin. In the current study, we develop recombinant protein which resulted from cloning and expression of TPO gene from normal person and AITD patients. This work flows involves: DNA isolation and PCR to obtain TPO gene from human blood, insertion of TPO gene to plasmid and transformation to E. coli BL21, Bacterial culture to obtain protein product, protein purification and product analysis. This products can use for application to immunochromatography based test. This work could achieved with the goal of producing autoimmune markers with a guaranteed quality, sensitive, specific and economically. So with the collaboration with industries these devices could be used for early detection. Keywords: recombinant protein, TPO gene, Autoimmune thyroid diseases (AITD)ction of the diseases in the community.

Clinical studies on thyroid CT number in Graves' disease and destructive thyrotoxicosis

International Nuclear Information System (INIS)

Kamijo, Keiichi

1994-01-01

The purpose of the present study was to investigate CT Hounsfield unit (H.U.) of the thyroid in hyperthyroid and euthyroid Graves' disease and destructive thyrotoxicosis. The mean thyroid CT number in 95 controls was 122±18 H.U.(±SD) and did not change significatly with advancing age. The mean thyroid CT number (±SD) of 85±22 H.U. in 60 patients with hyperthyroid Graves' disease was significantly lower than either in normal controls or 116±22 H.U. in 11 patients with euthyroid Graves' disease. Comparison of thyroid hormones and TSH receptor Ab values of untreated patients with a normal and an abnormally low thyroid CT number showed that serum total and free T 3 were significantly higher in the latter group than the former group. With respect to the effect of methimazol (MMI) on the thyroid CT number, in the untreated 10 patients with a low thyroid CT number, the initial mean CT number was 65±11 H.U. and increased significantly to 76±14 H.U. after treatment with MMI. In contrast, in 6 patients with a normal thyroid CT number prior to therapy, the initial mean thyroid CT number was 102±11 H.U. and fell significantly to 84±16 H.U. after treatment with MMI. The thyroid CT number in destructive thyrotoxicosis is markedly decreased to less than 70 H.U. and the mean values of 57±7 H.U. in 6 patients with silent thyroiditis and of 61±5 H.U. in 7 with subacute thyroiditis differ significantly from Graves' disease. In conclusion, the thyroid CT number is significantly reduced in hyperthyroid Graves' disease, normal in euthyroid Graves' disease and markedly decreased in destructive thyrotoxicosis. The high T-3 value seemed to play an important role in the pathogenesis of a decline in the thyroid CT number in Graves' disease. An antithyroid drug therapy caused two different changes in the thyroid CT number, depending on whether the thyroid CT number prior to therapy was normal or low. (author)

PREGNANCY AND THYROID

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Simona Gaberšček

2004-01-01

Full Text Available Background. In conditions with appropriate iodine intake, thyroid gland adapts to changes during pregnancy without any consequences. Fetal need for thyroid hormones in the first trimester is directly connected with transplacental transport of thyroid hormones. Fetal synthesis of thyroid hormones depends on availability of iodine in the feto-placental unit. Hypo- and hyperthyroidism during pregnancy are risk factors for pregnant woman and for normal development of fetus and child.Conclusions. Pregnant women with appropriately treated thyroid diseases have the same outcome of pregnancy as healthy women, and neuroendocrinological development of children is not impaired. If the disease is unrecognized or untreated, complications of pregnancy and delivery occur more frequently. Therefore, timely recognition and treatment of the diseases with appropriate drugs during pregnancy and, also, after delivery is very important.

G raves’ disease – anti-thyroid autoantibodies and function thyroid status

International Nuclear Information System (INIS)

Slavova, M.; Rusev, T; Donchev, M.; Dekova, M.; Tsarovska, T

2013-01-01

Full text: Introduction: Hyperthyroidism is an autoimmune disease in the pathogenesis of which a key role play the antibodies against the thyroid stimulating hormone receptor (TRAb). The aim of this study is to analyze the immune and hormonal status in patients with Graves' disease, who are on thyreostatic therapy and in remission. Materials and methods: 67 patients were studied - 11 men and 56 women - with Graves' disease, mean age 49.7 years (range - 20-76 ). Of these, 55 were on thyreostatic therapy (two subgroups: 27 - treated up to 24 months , and 28 with relapsed disease ) and 12 were in remission up to a year. Patient's condition is assessed as a complex of clinical, biochemical, including hormonal, immune status and ultrasonography of the thyroid gland. We examined thyroid stimulating hormone, free thyroxine, free triiodothyronine, antityreoperoxidase antibodies (Anti-TPO) and TRAb. The patients on therapy are: in hyperthyroidism - 10/ 14 with subclinical hyperthyroidism - 9/8, euthyroid - 7/6 and with subclinical hypothyroidism - 1/0. Results: The patients with hyperthyroidism ( 43.6% ) in both thyreostatic therapy groups have a significantly higher average values of TRAb. The patients with subclinical hyperthyroidism and relapse showed higher levels of TRAb in comparison with those undergoing therapy to 24 months after diagnosing. The values of TRAb in the euthyroid patients in both groups of treatment were 1,5 IU / l. The Anti-TPO values were increased in 78.2% of the patients on therapy and 55.5% of those in remission. Conclusion: With the decrease of thyroid hormones during treatment of Hyperthyroidism the levels of TRAb and Anti-TPO decrease. The TRAb values are useful for the monitoring the effect of the thyreostatic treatment, determining the therapeutic approach in patients with a sustained reduction of TRAb in the course thyreostatic therapy and particularly for relapse

Hashimoto’s Thyroiditis and Graves’ Disease in One Patient: The Extremes of Thyroid Dysfunction Associated with Interferon Treatment

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R. H. Bishay

2016-01-01

Full Text Available Autoimmune thyroid disease associated with interferon therapy can manifest as destructive thyroiditis, Graves’ Hyperthyroidism, and autoimmune (often subclinical hypothyroidism, the latter persisting in many patients. There are scare reports of a single patient developing extremes of autoimmune thyroid disease activated by the immunomodulatory effects of interferon. A 60-year-old man received 48 weeks of pegylated interferon and ribavirin therapy for chronic HCV. Six months into treatment, he reported fatigue, weight gain, and slowed cognition. Serum thyroid stimulating hormone (TSH was 58.8 mIU/L [0.27–4.2], fT4 11.1 pmol/L [12–25], and fT3 4.2 pmol/L [2.5–6.0] with elevated anti-TPO (983 IU/mL [<35] and anti-TG (733 U/mL [<80] antibodies. He commenced thyroxine with initial clinical and biochemical resolution but developed symptoms of hyperthyroidism with weight loss and tremor 14 months later. Serum TSH was <0.02 mIU/L, fT4 54.3 pmol/L, and fT3 20.2 pmol/L, with an elevated TSH receptor (TRAb, 4.0 U/L [<1.0], anti-TPO (1,163 IU/mL and anti-TG (114 U/mL antibodies. Technetium scan confirmed Graves’ Disease with bilateral diffuse increased tracer uptake (5.9% [0.5–3.5%]. The patient commenced carbimazole therapy for 6 months. Treatment was ceased following spontaneous clinical and biochemical remission (TSH 3.84 mIU/L, fT4 17pmol/L, fT3 4.5 pmol/L, and TRAb <1 U/L. This raises the need to monitor thyroid function closely in patients both during and following completion of interferon treatment.

Concurrence of Grave's disease and Hashimoto's thyroiditis.

Science.gov (United States)

Sato, T; Takata, I; Taketani, T; Saida, K; Nakajima, H

1977-01-01

Early histological changes in the thyroid gland were examined in 30 patients with juvenile thyrotoxicosis, by means of needle biopsy. Based on the degree of lymphocytic infiltration and degenerative changes in follicular epithelium, results were classified into four groups. A: hyperplastic changes without cellular infiltration (6 patients, 20%); B: hyperplastic changes with areas of focal thyroiditis less than 30% of specimen (10 patients, 33%); C: those with 30 to 60% areas ot thyroiditis (10 patients, 33%); D: almost diffuse thyroiditis (4 patients, 13%). Moderate to severe lymphocytic thyroiditis was frequently present in the early stage of hyperplastic thyroid glands. The clinical significance of the 4 histological groups was evaluated. Neither clinical signs nor routine laboratory tests could differentiate these groups except group D, in which thyrotoxic signs were mild and transient. However, serum antithyroid antibodies tended to increase in accordance with severity of thyroiditis. The rate of remission was high in groups C and D, whereas relapse was frequent in group A. These results suggest that Grave's disease and chronic lymphocytic thyroiditis are closely related in the early stage of thyrotoxicosis in children, and that the clinical course may be considerably altered by the degree of associated thyroiditis. Images Fig. 1 Fig. 2 Fig. 3 Fig. 3 PMID:580172

Search for relevant indications for selenium supplementation in thyroid diseases.

Science.gov (United States)

Wojciechowska-Durczynska, Katarzyna; Lewinski, Andrzej

2017-08-01

Selenium plays a significant role in the thyroid function and its deficiency is considered by some authors to be a cause of thyroid disorders. The potential therapeutic influence of selenium supplementation in thyroid disease was investigated in several studies and some results were encouraging, however results were inconsistent and did not allow conclusion to be drawn. For that reason, we have performed a review study on relevance of selenium supplementation in thyroid disease. Till now, there is no strong evidence that selenium supplementation leads to clinical improvement in the course of autoimmune thyroiditis, nodular goitre or thyroid cancer. On the other hand, there is some evidence that selenium is effective in the treatment of orbitopathy; thus, the European Group on Graves' Orbitopathy (EUGOGO) recommends selenium administration in mild active orbitopathy.

Thyroid function after mantle irradiation in Hodgkin's disease

International Nuclear Information System (INIS)

Smith, R.E. Jr.; Adler, R.A.; Clark, P.; Brinck-Johnsen, T.; Tulloh, M.E.; Colten, T.

1981-01-01

The thyroid function of 64 patients with Hodgkin's disease who received mantle irradiation during the period 1966 to 1976 was studied. More than two-thirds (44 to 64) had some thyroid dysfunction. Twenty had mild dysfunction manifested by an abnormal thyroid-stimulating hormone response to thyrotropin-releasing hormone. Twenty had what could be termed compensated hypothyroidism while four were overtly hypothyroid. The severity of dysfunction was not related to age, sex, or chemotherapy. We found, however, that decreased thyroid function was inversely proportional to the length of time between a diagnostic lymphangiogram and the radiation therapy. These results are consistent with the hypothesis that the iodine load of the lymphangiogram renders the thyroid gland more radiosensitive. Thyroxine suppression of the thyroid gland during the period from the lymphangiogram through the termination of radiation therapy is suggested as a means of avoiding thyroid injury

Clinical Update in Aspects of the Management of Autoimmune Thyroid Diseases

Directory of Open Access Journals (Sweden)

Duncan J. Topliss

2016-12-01

Full Text Available Aspects of autoimmune thyroid disease updated in this review include: immunoglobulin G4 (IgG4-related thyroid disease (Riedel's thyroiditis, fibrosing variant of Hashimoto's thyroiditis, IgG4-related Hashimoto's thyroiditis, and Graves' disease with elevated IgG4 levels; recent epidemiological studies from China and Denmark indicating that excess iodine increases the incidence of Hashimoto's thyroiditis and hypothyroidism; immunomodulatory agents (ipilimumab, pembrolizumab, nivolumab activate immune response by inhibiting T-cell surface receptors which down-regulate immune response, i.e., cytotoxic T-lymphocyte antigen 4 and programmed cell death protein 1 pathways; alemtuzumab is a humanised monoclonal antibody to CD52 which causes immune depletion and thyroid autoimmune disease especially Graves' hyperthyroidism; small molecule ligand (SML agonists which activate receptors, SML neutral antagonists, which inhibit receptor activation by agonists, and SML inverse agonists which inhibit receptor activation by agonists and inhibit constitutive agonist independent signaling have been identified. SML antagonism of thyroid-stimulating hormone-receptor stimulatory antibody could treat Graves' hyperthyroidism and Graves' ophthalmopathy; and thyroxine treatment of subclinical hypothyroidism can produce iatrogenic subclinical hyperthyroidism with the risk of atrial fibrillation and osteoporosis. The increased risk of harm from subclinical hyperthyroidism may be stronger than the potential benefit from treatment of subclinical hypothyroidism.

Increased risk of thyroid diseases in patients with systemic lupus erythematosus: A nationwide population-based Study in Korea.

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Jae-Seung Yun

Full Text Available We investigated the association between autoimmune thyroid disease and systemic lupus erythematosus (SLE using nationwide insurance claims data for the entire Korean population. Claims data for the period 2009-2013 were retrieved from the National Health Insurance System database. SLE and thyroid disease were identified using the International Classification of Diseases codes and medication information. Logistic regression analyses were used to evaluate the association between SLE and thyroid disease. The study used records from 17,495 patients with SLE and 52,485 age- and sex-matched control subjects. A greater prevalence of Graves' disease (0.94% vs. 0.46%, P < 0.001, Hashimoto's thyroiditis (2.68% vs. 0.80%, P < 0.001, and thyroid cancer (1.81% vs. 1.30%, P < 0.001 was observed in SLE patients than in control subjects. Multivariate regression analyses demonstrated that SLE was significantly associated with an increased risk of both autoimmune thyroid disease and thyroid cancer (Graves' disease: odds ratio [OR] 2.07, 95% confidence interval [CI] 1.70-2.53; Hashimoto's thyroiditis: OR 3.42, 95% CI 3.00-3.91; thyroid cancer: OR 1.40, 95% CI 1.22-1.60. Age- and sex- stratified analyses revealed that the risk of autoimmune thyroid disease in SLE patients was increased for all age groups and the female group. An association between thyroid cancer and SLE was identified only in the 20- to 59-year-old age group and in the female group. Using a large population-based study, we demonstrated that patients with SLE are at a greater risk of developing thyroid disease than matched control individuals.

Applied anatomy of thyroid arteries for interventional embolization of Graves' disease

International Nuclear Information System (INIS)

Ding Zhongxiang; Zhao Wei; Hou Jialin; Xiang Shutian; Li Liyuan; Zou Zhirong; Li Xingguo; Song Dianping; Yuan Jianhua

2007-01-01

Objective: To explore the anatomy and imaging manifestations of thyroid arteries for improving the efficiency and lowering the complication in interventional embolization of Graves' disease. Methods: Thyroid arteries were investigated, including 16 adult cadavers (Cadaver group), 8 non-thyropathic patients (Normal group)and 17 Graves patients (Graves group). The inner diameters of the trunk and supplying branches of thyroid artery, the angles between the origination of branches and the beginning of the trunk, and the angles between the trunk of thyroid artery and carotid or subclavian artery were measured. In addition, data of the three groups were statistically analyzed. Results: Many non-thyroid arterial branches arose from thyroid artery, with no statistical difference in their indexes between Cadaver group and Normal group. The thyroid arteries showed much longer, obviously wider in diameter, and larger angles between the trunk of thyroid artery and carotid artery in Graves group than those of Cadaver group and Normal group; outcoming with significant statistical differences; and furthermore, with increase of interglandular branches and dangerous internal and external anastomoses. Conclusions: The specific thyroid arterial changes of Graves' disease are helpful for the interventional embolization. Non-thyroid branches and dangerous anastomoses should not be embolized as far as possible, for decreasing the complications of the interventional procedure for Graves' disease. (authors)

Rheumatic Disease Autoantibodies in Patients with Autoimmune Thyroid Diseases.

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Nisihara, Renato; Pigosso, Yasmine; Prado, Nathalia; Utiyama, Shirley R R; Carvalho, Gisah; Skare, Thelma

2018-06-04

Patients with autoimmune thyroid diseases (ATD) such as Graves' disease (GD) and Hashimoto thyroiditis (HT) may have non-organ specific autoantibodies such as ANA (antinuclear antibodies) and RF (rheumatoid factor). To study the prevalence of rheumatic autoantibodies in a group of ATD patients without known rheumatic diseases and to evaluate its association with the patients' epidemiological and treatment profile. To follow positive non-organ specific autoantibody-positive ATD individuals to investigate whether they will develop a rheumatic disorder. A sample of 154 ATD patients (70 HT and 84 GD; mean age 45.3 ± 14.2) had determination of ANA by immunofluorescence, using hep-2 cells as substrate, extractable nuclear antigen (ENA) profile by ELISA kits and RF by latex agglutination. Epidemiological and treatment profile were obtained through chart review. These patients were followed for the mean period of five years, between 2010 to 2015. Positive ANA was found in 17.5% (27/154) of the patients: anti-Ro/SS-A in 4/154 (2.5%); anti-RNP in 4/154 (2.5%) and anti-La/SS-B in 3/154 (1.9%). None had anti-Sm antibodies. RF was detected in 12/154 (7.7%) of ATD patients and was more common in older individuals (p = 0.007). There was a positive association between the presence of RF and ANA (p = 0.03; OR = 3.89; 95% CI = 1.1-13.3). None of the patients with positive autoantibodies developed clinical rheumatic diseases during the period of observation. We found rheumatic autoantibodies in 17.5% of ATD patients without rheumatic diseases. None of them were associated with the appearance of clinical rheumatic disorder during the period of five years. ©2018The Author(s). Published by S. Karger AG, Basel.

Probable reasons of thyroid gland diseases in people suffered from Chernobyl accident

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Poverennyj, A.M.; Ryabukhin, Yu.S.; Tsyb, A.F.

1994-01-01

Ideas about the thyroid gland diseases development in people suffered from the Chernobyl accident explaining the absence of straight dose dependence of pathologies raise from the irradiation were elaborated. It is supposed that the probable reason for a number of these pathologies can be the unadecvate and inopportune preventive iodine administration. A simple immunological method of autoimmune thyroiditis diagnostics was developed which informativity is comparable with the method of ultra-sound diagnosis

Recent advances in understanding autoimmune thyroid disease

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Bliddal, Sofie; Nielsen, Claus Henrik; Feldt-Rasmussen, Ulla

2017-01-01

Autoimmune thyroid disease (AITD) is often observed together with other autoimmune diseases. The coexistence of two or more autoimmune diseases in the same patient is referred to as polyautoimmunity, and AITD is the autoimmune disease most frequently involved. The occurrence of polyautoimmunity h...

Clinical studies on thyroid CT number in Graves' disease and destructive thyrotoxicosis

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Kamijo, Keiichi (Kamijo Thyroid and Pituitary Clinic, Sapporo (Japan))

1994-02-01

The purpose of the present study was to investigate CT Hounsfield unit (H.U.) of the thyroid in hyperthyroid and euthyroid Graves' disease and destructive thyrotoxicosis. The mean thyroid CT number in 95 controls was 122[+-]18 H.U.([+-]SD) and did not change significatly with advancing age. The mean thyroid CT number ([+-]SD) of 85[+-]22 H.U. in 60 patients with hyperthyroid Graves' disease was significantly lower than either in normal controls or 116[+-]22 H.U. in 11 patients with euthyroid Graves' disease. Comparison of thyroid hormones and TSH receptor Ab values of untreated patients with a normal and an abnormally low thyroid CT number showed that serum total and free T[sub 3] were significantly higher in the latter group than the former group. With respect to the effect of methimazol (MMI) on the thyroid CT number, in the untreated 10 patients with a low thyroid CT number, the initial mean CT number was 65[+-]11 H.U. and increased significantly to 76[+-]14 H.U. after treatment with MMI. In contrast, in 6 patients with a normal thyroid CT number prior to therapy, the initial mean thyroid CT number was 102[+-]11 H.U. and fell significantly to 84[+-]16 H.U. after treatment with MMI. The thyroid CT number in destructive thyrotoxicosis is markedly decreased to less than 70 H.U. and the mean values of 57[+-]7 H.U. in 6 patients with silent thyroiditis and of 61[+-]5 H.U. in 7 with subacute thyroiditis differ significantly from Graves' disease. In conclusion, the thyroid CT number is significantly reduced in hyperthyroid Graves' disease, normal in euthyroid Graves' disease and markedly decreased in destructive thyrotoxicosis. The high T-3 value seemed to play an important role in the pathogenesis of a decline in the thyroid CT number in Graves' disease. An antithyroid drug therapy caused two different changes in the thyroid CT number, depending on whether the thyroid CT number prior to therapy was normal or low. (author).

An analysis of preoperative localization of parathyroid glands in hyperparathyroidism associated with thyroid diseases

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Komatsu, Makoto; Inoue, Kazuaki; Itoh, Atsuko.

1996-01-01

Recently hyperparathyroidism associated with some thyroid diseases, especially nonmedually thyroid carcinoma has been payed attention to. In this study we analyzed 12 cases of hyperparathyroidism (6 cases independent of thyroid diseases and 6 cases associated with thyroid diseases) and estimated the affect of association with thyroid diseases on the preoperative localization of the parathyroid glands. The results of preoperative localization of the parathyroid glands in cases independent of thyroid diseases were relatively satisfactory. On the other hand, the preoperative localization in cases associated with thyroid diseases came to false result in about half of them. It was far from satisfactory. Association of thyroid diseases strongly affected the preoperative localization of the parathyroid glands in hyperparathyroidism. Conventional imaging such as ultrasonography, CT, MRI and 201 Tl- 99m TC subtraction scintigraphy alone were not satisfactory. Now 99m Tc-MIBI scintigraphy is expected to be one of reliable imaging methods for progress in the preoperative localization. (author)

Cost-of-Illness Trends Associated with Thyroid Disease in Korea

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Kyung-Rae Hyun

2014-09-01

Full Text Available BackgroundThe purpose of this study is to analyze the scale of and trends associated with the cost-of-illness of thyroid disease in Korea at 2-year intervals during the last 10 years for which data are available.MethodsCost-of-illness was estimated in terms of direct and indirect costs. Direct costs include direct medical costs due to hospitalization, outpatient and pharmacy sectors, transportation, and care-giver costs. Indirect costs include future income loss due to premature death and loss of productivity as a result of absence from work.ResultsThe cost-of-illness of thyroid disease in Korea was estimated at 224.2 billion won in 2002, 303.4 billion won in 2004, 400.3 billion won in 2006, 570.4 billion won in 2008, and 762.2 billion won in 2010. For example, the cost-of-illness of thyroid disease in 2010 was 3.4 times greater compared to 2002. The direct cost of the total cost-of-illness was 69.7%, which accounted for the highest proportion of costs. Cost-of-illness for individuals between the ages of 30 and 50 accounted for the greatest share of costs.ConclusionThe cost-of-illness of thyroid disease was relatively large in economically active age groups, and demonstrated a very rapid growth rate compared to other major diseases in Korea. Therefore, we suggest nationwide recognition of the importance of prevention and management of thyroid disease and prioritization of the management of thyroid disease among current and future health promotion policies in Korea.

Post partum lymphocytic thyroiditis in North Indian population: a spectrum of thyroid dysfunction

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Sharma, Rajnish; Mondal, Anupam; Taneja, Vijay; Bansal, J.K.; Khanna, C.M.; Sharma, Manisha

1999-01-01

Two hundred and sixty one Indian women from Delhi and surrounding territory were prospectively evaluated to determine the frequency of post-partum thyroiditis upto 12 weeks of postpartum. Thirty one (11.8%) of the 261 cases included in our study developed thyroid disease. Twenty four (77%) of the patients who developed thyroiditis were found to have high titres of thyroid antibodies. Of these 24 patients, 21 (67.7%) tested positive for antimicrosomal antibodies and 17 (54.8%) tested positive for antithyroglobulin antibodies. Patients were found to have a spectrum of thyroid dysfunction. Transient hypothyroidism developed in 17 patients, I patient developed persistent hypothyroidism, 7 had transient thyrotoxicosis and 6 developed euthyroid goiters. Twenty two patients had goiters ranging from grade OB to grade II. Fine needle aspiration cytology showed chronic lymphocytic thyroiditis in 20 patients, while 2 had colloid goiter. It is concluded from our study that there is a significant incidence of post partum thyroid disease in the female population representative of North India, and most of the patients (93.5%) develop transient thyroid disorder. (author)

Management of thyroid eye disease in the United Kingdom: A multi-centre thyroid eye disease audit.

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Mellington, F E; Dayan, C M; Dickinson, A J; Hickey, J L; MacEwen, C J; McLaren, J; Perros, P; Rose, G E; Uddin, J; Vaidya, B; Foley, P; Lazarus, J H; Mitchell, A; Ezra, D G

2017-06-01

This article aims to provide baseline data and highlight any major deficiencies in the current level of care provided for adult patients with thyroid eye disease (TED). We undertook a prospective, nonrandomized cross-sectional multicenter observational study. During a 3-month period June-August 2014, consecutive adult patients with TED who presented to nominated specialist eye clinics in the United Kingdom, completed a standardized questionnaire. Main outcome measures were: demographics, time from diagnosis to referral to tertiary centre, time from referral to review in specialist eye clinic, management of thyroid dysfunction, radioiodine and provision of steroid prophylaxis, smoking, and TED classification. 91 patients (mean age 47.88 years) were included. Female-to-male ratio was 6:1. Mean time since first symptoms of TED = 27.92 (73.71) months; from first visit to any doctor with symptoms to diagnosis = 9.37 (26.03) months; from hyperthyroidism diagnosis to euthyroidism 12.45 (16.81) months. First, 13% had received radioiodine. All those with active TED received prophylactic steroids. Seven patients who received radioiodine and did not have TED at the time went on to develop it. Then, 60% patients were current or ex-smokers. 63% current smokers had been offered smoking cessation advice. 65% patients had active TED; 4% had sight-threatening TED. A large proportion of patients (54%) were unaware of their thyroid status. Not enough patients are being provided with smoking cessation advice and information on the impact of smoking on TED and control of thyroid function.

Systemic lupus erythematosus and thyroid disease - Experience in a single medical center in Taiwan.

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Liu, Yu-Chuan; Lin, Wen-Ya; Tsai, Ming-Chin; Fu, Lin-Shien

2017-06-28

To investigate the association of systemic lupus erythematosus (SLE) with thyroid diseases in a medical center in central Taiwan. This is a retrospective cohort of 2796 SLE patients in a tertiary referral medical center from 2000 to 2013. We screened SLE by catastrophic illness registration from national insurance bureau; and thyroid diseases by ICD 9 codes, then confirmed by thyroid function test, auto-antibody, medical and/or surgical intervention. We compared the rate of hyperthyroidism, hypothyroidism and autoimmune thyroid disease (AITD) in SLE patients and the 11,184 match controls. We calculated the rate of these thyroid diseases and positive antibodies to thyroglobulin (ATGAb), thyroid peroxidase (TPOAb) in SLE patients grouped by the presence of overlap syndrome and anti-dsDNA antibody. We also compared the association of thyroid diseases to severe SLE conditions, including renal, central nervous system (CNS) involvement, and thrombocytopenia. Compared to the matched controls, the cumulative incidence of thyroid disease, including hyperthyroidism, hypothyroidism and AITD, were all higher in SLE patients (p hyperthyroidism. SLE patients with thyroid diseases also carry higher risk for severe complications such as renal involvement (p = 0.024) central nervous system involvement (p hyperthyroidism, hypothyroidism, and AITD than the matched control. Among lupus patients, the risks of thyroid diseases are even higher in the presence of overlap syndrome. SLE patients with thyroid diseases had higher risk of renal and CNS involvement. Copyright © 2017. Published by Elsevier B.V.

Thyroid function and some related biochemical parameters in bilharzial liver disease

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Ibrahim, W. Abdel Massih

1983-01-01

Bilharziasis in its different forms is estimated to affect at least 200 million people in the world (W.H.O., 1973). In egypt, it affects 60 - 70% of the rural population (WcMullen, 1963). Bilharzial ova reaches the liver with the portal blood stream causing a fibro - cellular reaction in and around the portal tract resulting in hepatic periportal fibrosis with various clinical stages (Abdalla et al., 1978 b). The effect of liver disease on thyroid function is still a subject of controversy and contradiction. While some reports are published on the effect of non-bilharzial liver disease on thyroid function, there is scanty studies as regards to bilharzial liver diseases . Most of the studies carried out to evaluate thyroid function in bilharzial liver disease, were focused on the estimation of one or two parameters of thyroid function e.g., T 3 and TSH. The available review of literature was focused on some parameters of thyroid function ignoring the others thyroid function tests and not considering the hormone carrier proteins. Thus resulting inconsistent and contradictory results (Ghareeb, 1962; El Haieg and Ibrahim, 1977)

Histologic Findings and Cytological Alterations in Thyroid Nodules After Radioactive Iodine Treatment for Graves' Disease: A Diagnostic Dilemma.

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El Hussein, Siba; Omarzai, Yumna

2017-06-01

Unlike the well-documented relation between radiation to the neck and development of papillary thyroid carcinoma, a causal association between radioactive iodine treatment for Graves' disease and development of thyroid malignancy is less defined. However, patients with a background of thyroid dysfunction presenting with clinically palpable thyroid nodules are followed more closely than the average population, and fine needle aspiration is recommended in such circumstances. Cytological examination of aspirates, and histologic examination of tissue provided from patients with a known history of Graves' disease, managed by radioactive iodine therapy can create a diagnostic dilemma, as the distinction between radiation effect and a malignant primary thyroid neoplasm can be very challenging. Thus, pathologists should be aware of the existence of these changes in the setting of radiation therapy for Graves' disease. Providing pathologists with appropriate clinical history of Graves' disease treated with radioactive iodine is of paramount importance in order to prevent an overdiagnosis of malignancy.

Mixed Connective Tissue Disease and Papillary Thyroid Cancer: A Case Report.

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Thongpooswan, Supat; Tushabe, Rachel; Song, Jeffrey; Kim, Paul; Abrudescu, Adriana

2015-08-06

Mixed connective tissue disease (MCTD) is a connective tissue disorder characterized by high titers of distinct antibodies: U1 ribonucleoprotein with clinical features seen in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), dermatomyositis (DM), polymyositis, and scleroderma. The association of SLE and DM with various cancers of the thyroid has been reported in the literature. However, there have been no reports associating MCTD with thyroid cancer. We present a 58-year-old woman diagnosed with MCTD with co-morbid interstitial lung disease that has remained stable for 10 years, who developed papillary thyroid carcinoma (PTC) 10 years after initial diagnosis. We theorize that: 1) MCTD may have been a primary diagnosis complicated by PTC, or 2) MCTD may have been an initial presentation of paraneoplastic syndrome of silent PTC, because her symptoms of MCTD significantly improved after total thyroidectomy. To the best of our knowledge, this is the first case report to associate MCTD with PTC. It highlights the importance of maintaining a high index of suspicion for thyroid malignancy in MCTD patients.

Viruses and thyroiditis: an update

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Hober Didier

2009-01-01

Full Text Available Abstract Viral infections are frequently cited as a major environmental factor involved in subacute thyroiditis and autoimmune thyroid diseases This review examines the data related to the role of viruses in the development of thyroiditis. Our research has been focused on human data. We have reviewed virological data for each type of thyroiditis at different levels of evidence; epidemiological data, serological data or research on circulating viruses, direct evidence of thyroid tissue infection. Interpretation of epidemiological and serological data must be cautious as they don't prove that this pathogen is responsible for the disease. However, direct evidence of the presence of viruses or their components in the organ are available for retroviruses (HFV and mumps in subacute thyroiditis, for retroviruses (HTLV-1, HFV, HIV and SV40 in Graves's disease and for HTLV-1, enterovirus, rubella, mumps virus, HSV, EBV and parvovirus in Hashimoto's thyroiditis. However, it remains to determine whether they are responsible for thyroid diseases or whether they are just innocent bystanders. Further studies are needed to clarify the relationship between viruses and thyroid diseases, in order to develop new strategies for prevention and/or treatment.

Viruses and thyroiditis: an update

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Desailloud, Rachel; Hober, Didier

2009-01-01

Viral infections are frequently cited as a major environmental factor involved in subacute thyroiditis and autoimmune thyroid diseases This review examines the data related to the role of viruses in the development of thyroiditis. Our research has been focused on human data. We have reviewed virological data for each type of thyroiditis at different levels of evidence; epidemiological data, serological data or research on circulating viruses, direct evidence of thyroid tissue infection. Interpretation of epidemiological and serological data must be cautious as they don't prove that this pathogen is responsible for the disease. However, direct evidence of the presence of viruses or their components in the organ are available for retroviruses (HFV) and mumps in subacute thyroiditis, for retroviruses (HTLV-1, HFV, HIV and SV40) in Graves's disease and for HTLV-1, enterovirus, rubella, mumps virus, HSV, EBV and parvovirus in Hashimoto's thyroiditis. However, it remains to determine whether they are responsible for thyroid diseases or whether they are just innocent bystanders. Further studies are needed to clarify the relationship between viruses and thyroid diseases, in order to develop new strategies for prevention and/or treatment. PMID:19138419

Impact of month of birth on the development of autoimmune thyroid disease in the United Kingdom and Europe

DEFF Research Database (Denmark)

Hamilton, Alexander; Newby, Paul R; Carr-Smith, Jacqueline D

2014-01-01

detected in GD females or males across all three collections. In HT females from the OXAGEN AITD Caucasian Family Collection, slightly higher birth rates were detected in autumn (Walter's test statistic = 7.47, P = .024) however, this was not seen in the HT females from the case-control cohort. CONCLUSION......CONTEXT: Viral/bacterial infection is proposed as a trigger for the autoimmune thyroid diseases (AITD): Graves' disease (GD) and Hashimoto's thyroiditis (HT). Previous studies in European Caucasian AITD subjects found higher birth rates in the autumn/winter, suggesting those born in the autumn....../winter experience increased viral/bacterial exposure after birth, impacting upon immune system development and predisposing to AITD later in life. OBJECTIVE: Month of birth effects were investigated in three independent European Caucasian AITD datasets. DESIGN: Variation in GD and HT onset was compared across...

Associations between Systemic Sclerosis and Thyroid Diseases

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Poupak Fallahi

2017-10-01

Full Text Available We have reviewed scientific literature about the association of systemic sclerosis (SSc and thyroid disorders. A high incidence, and prevalence, of new cases of autoimmune thyroiditis (AT and/or hypothyroidism have been shown in sclerodermic patients (overall in the female gender. An association among a Th1 immune-predominance, low vitamin D levels, and AT have been also shown in SSc patients. Cases of Graves’ disease (GD have been described in SSc patients, too, according with the higher prevalence of thyroid autoimmunity. It has been also shown a higher prevalence of papillary thyroid cancer (PTC, in association with AT, in SSc patients. However, in order to confirm results about GD and thyroid cancer, studies in larger number of patients with SSc are needed. During the follow-up of SSc patients it would be appropriate to monitor carefully their thyroid status. The abovementioned data strongly suggest a periodic thyroid function follow-up in female SSc patients [showing a borderline high (although in the normal range thyroid-stimulating hormone level, antithyroid peroxidase antibody positivity, and a small thyroid with a hypoechoic pattern], and, when necessary, appropriate treatments. In conclusion, most of the studies show an association among SSc, AT, and hypothyroidism, such as an increased prevalence of TC overall in SSc patients with AT. Only few cases of GD have been also described in SSc.

Celiac-Associated Autoimmune Thyroid Disease: A Study of 16 Patients with Overt Hypothyroidism

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Hugh J Freeman

1995-01-01

Full Text Available Previous reports have suggested that autoimmune thyroid disorders (including Hashimoto’s or lymphocytic thyroiditis may occur in patients with celiac disease. In this study, the prevalence of thyroid disease was explored in a series of 96 consecutive patients seen with biopsy-defined adult celiac disease (average age 47.3 years. Sixteen celiac patients (average age 58.1 years were detected with hypothyroidism, including four treated with radio-iodine ablation or thyroidectomy for Grave’s disease. In addition to celiac disease, almost half had dermatitis herpetiformis, a small intestinal neoplasm (particularly lymphoma or both. Diagnosis of thyroid disease preceded diagnosis of celiac disease in 13 patients or was made concurrently in two patients. In only one patient was thyroid disease detected after celiac disease was diagnosed. This indicates that thyroid diseases occur more commonly in celiac disease than is currently appreciated, possibly due to shared embryological origins or common immunopathological features, and may be the presenting clinical manifestation in adults especially if there is coexistent dermatitis herpetiformis. Careful monitoring of this subgroup may be warranted because of the frequency of neoplastic intestinal diseases, particularly lymphoma.

Surgery versus pharmacotherapy of benign thyroid diseases

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Younes, Nidal A.; Albousal, Abla M.

2003-01-01

Surgical management of thyroid diseases (BTDs) has been a topic of interest and confusion for many years. Almost 80% of thyroidectomies at an average endocrine surgical unit are carried out for BTDs.Resistance to surgical intervention in BTDs has been based on the belief that increased complication rate is inherent in its use, this is despite thepotential advatages in terms of confirming the benign nature of the lesion, controlling the disease, and relieving of local symptoms of large neck mass. Benign thyroid diseases are more likely to occur in middle-aged woman living in iodine deficient areas, or have a family history of goiter, or in patients taking iodine-containig drugs, like amoidarone, or in patients with previous history of x-ray exposure. However, the physician must be carefull in making the diagnosis of BTDsin patients of extremes of age or in presence of positive history of radiation, or in patients with family history of thyroid or colon cancer . In this atricle we will review the etiology,epidemiology , diagonastic methodologiesand the recent trends in the sugical and medical mangement of BTDs. (author)

The Interaction Between Thyroid and Kidney Disease: An Overview of the Evidence

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Rhee, Connie M.

2016-01-01

Purpose of Review Hypothyroidism is highly prevalent in chronic kidney disease (CKD) patients, including those receiving dialysis. This review examines potential mechanistic links between thyroid and kidney disease; current evidence for hypothyroidism as a risk factor for de novo CKD and CKD progression; and studies of thyroid functional disorders, cardiovascular disease, and death in the CKD population. Recent Findings Epidemiologic data have demonstrated an incrementally higher prevalence of hypothyroidism with increasing severity of kidney dysfunction. Various thyroid functional test abnormalities are also commonly observed in CKD, due to alterations in thyroid hormone synthesis, metabolism, and regulation. While the mechanistic link between thyroid and kidney disease remains unclear, observational studies suggest hypothyroidism is associated with abnormal kidney structure and function. Previously thought to be a physiologic adaptation, recent studies show that hypothyroidism is associated with higher risk of cardiovascular disease and death in CKD. Summary A growing body of evidence suggests that hypothyroidism is a risk factor for incident CKD, CKD progression, and higher death risk in kidney disease patients. Rigorous studies are needed to determine impact of thyroid hormone replacement upon kidney disease progression, cardiovascular disease, and mortality, which may shed light into the causal implications of hypothyroidism in CKD. PMID:27428519

[Thyroid nodules and differentiated thyroid cancer: Brazilian consensus].

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Maia, Ana Luiza; Ward, Laura S; Carvalho, Gisah A; Graf, Hans; Maciel, Rui M B; Maciel, Léa M Zanini; Rosário, Pedro W; Vaisman, Mario

2007-07-01

Thyroid nodules are a common manifestation of thyroid diseases. It is estimated that approximately 10% of adults have palpable thyroid nodules with the frequency increasing throughout life. The major concern on nodule evaluation is the risk of malignancy (5-10%). Differentiated thyroid carcinoma accounts for 90% of all thyroid malignant neoplasias. Although most patients with cancer have a favorable outcome, some individuals present an aggressive form of the disease and poor prognostic despite recent advances in diagnosis and treatment. Here, a set of clinical guidelines for the evaluation and management of patients with thyroid nodules or differentiated thyroid cancer was developed through consensus by 8 member of the Department of Thyroid, Sociedade Brasileira de Endocrinologia e Metabologia. The participants are from different reference medical centers within Brazil, to reflect different practice patterns. Each committee participant was initially assigned to write a section of the document and to submit it to the chairperson, who revised and assembled the sections into a complete draft document, which was then circulated among all committee members for further revision. All committee members further revised and refined the document. The guidelines were developed based on the expert opinion of the committee participants, as well as on previously published information.

Increased lymphangiogenesis in Riedel thyroiditis (Immunoglobulin G4-related thyroid disease).

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Cameselle-Teijeiro, José; Ladra, María Jesús; Abdulkader, Ihab; Eloy, Catarina; Soares, Paula; Barreiro, Francisco; Sobrinho-Simões, Manuel; Beiras-Iglesias, Andrés

2014-09-01

The present study describes in depth a case of Riedel thyroiditis (RT) to clarify its pathogenesis and its putative inclusion in the spectrum of IgG4-related disease. We report the clinicopathological, immunohistochemical, and ultrastructural features of a case of RT in a 39-year-old white Spanish woman, admitted with a hard goiter and cold nodule in the left thyroid lobe. This case represents 0.05 % of a series of 1,973 consecutive thyroidectomies performed in our hospital. More than 80 % of the left thyroid lobe was effaced by fibrosis and inflammation (lymphocytes, 57 IgG4+ plasma cells per 1 high-power field, an IgG4/IgG ratio of 0.67, and eosinophils) with extension into the surrounding tissues and occlusive phlebitis. Immunostaining for podoplanin (D2-40) detected signs of increased lymphangiogenesis in the fibroinflammatory areas that were confirmed by electron microscopy. A strong, diffuse stain for podoplanin and transforming growth factor ß1 was also detected in the same areas. The increased number of lymphatic vessels in RT is reported for the first time. Our findings support the inclusion of RT within the spectrum of IgG4-related thyroid disease (IgG4-RTD). Although the etiology and physiopathology of IgG4-RTD still remain elusive, the results obtained in the present case suggest the participation of lymphatic vessels in the pathogenesis of RT.

Kinetics of the human thyroid trap: experience in normal subjects and in thyroid disease

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Hays, M.T.

1979-03-01

Kinetics of the thyroid pertechnetate trap were assessed in 39 normal subjects, five untreated patients with Graves' disease (two before and after treatment), two hypothyroid patients, and in one patient each with Hashimoto's thyroiditis of recent onset, subacute thyroiditis, and massive anaplastic carcinoma. In normal subjects, the effects of sex, time of day, and order of experimental sessions were studied. A three-compartment model was assumed for all studies. Data on thyroidal and neck-background pertechnetate were collected with a multicrystal camera during 40 min after iv injection. The two thyroidal compartments in the model - the follicular cell, v/sub 2/, and the colloidal plasma-equivalent space, V/sub 3/ - is a multi-exponential function of plasma radioactivity, V/sub 1/. None of the model parameters was systematically affected by sex and order of session did not consistently alter any parameter, except for V/sub 3/, which was greater in session 2 than in session 1. That increase was not consistent and is believed to be spurious. Time of day affected only the exit rate constant from the colloid ..lambda../sub 23/, which was increased later in the day (P < 0.02). Distribution of the normal parameters was more log-normal than normal. After 5% were excluded at the high end and at the low end, the range for a parameter, p, was found empirically to be: antiln (mean ln p - 1.7 s.d. ln p), and antiln (mean ln p + 1.5 s.d. ln p). In Graves' disease, V/sub 2/ is increased (P < 0.02), but the increases in V/sub 3/ and in ..lambda../sub 21/ (the clearance into the thyroid from serum) are more dramatic (P < 10/sup -8/). After treatment, V/sub 3/ and ..lambda../sub 21/ fell toward normal. The hypothyroid patients showed no trap activity, and the trap was normal in the patient with early Hashimoto's thyroiditis. The patients with subacute thyroiditis and anaplastic carcinoma had increases in V/sub 2/, V/sub 3/, and ..lambda../sub 21/, but the

(131)I treatment in Differentiated Thyroid Cancer and End-Stage Renal Disease.

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Ortega, A J M; Vázquez, R G; Cuenca, J I C; Brocca, M A M; Castilla, J; Martínez, J M M; González, E N

2016-01-01

Radioiodine (RAI) is a cornerstone in the treatment of Differentiated Thyroid Cancer (DTC). In patients on haemodialysis due to End-Stage Renal Disease (ESRD), it must be used cautiously, considering the renal clearance of this radionuclide. Also, the safety of the procedure and subsequent long-term outcome is still not well defined. In 2001, we described a dosimetric method and short-term results in three patients, with a good safety profile. We hypothesize that our method is safe in a long-term scenario without compromising the prognosis of both renal and thyroid disease. Descriptive-retrospective study. A systematic search was carried out using our clinical database from 2000 to 2014. DTC and radioiodine treatment while on haemodialysis. peritoneal dialysis. Final sample n=9 patients (n=5 males), age 48 years (median age 51 years males, 67 years female group); n=8 papillary thyroid cancer, n=1 follicular thyroid cancer; n=5 lymph node invasion; n=1 metastatic disease. Median RAI dose administered on haemodialysis 100mCi. 7.5 years after radioiodine treatment on haemodialysis, n=7 deemed free of thyroid disease, n=1 persistent non-localised disease. No complications related to the procedure or other target organs were registered. After 3.25 years, n=4 patients underwent successful renal transplantation; n=4 patients did not meet transplantation criteria due to other conditions unrelated to the thyroid disease or its treatment. One patient died due to ischemic cardiomyopathy (free of thyroid disease). Radioiodine treatment during haemodialysis is a long-term, safe procedure without worsening prognosis of either renal or thyroid disease. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

Clinical Investigation and Treatment of Thyroid Disease with Radioactive Iodine (131I)

International Nuclear Information System (INIS)

Lee, Mun Ho; Koh, Chang Soon; Ro, Heung Kyu; Koo, In Seu; Suh, Whan Jo; Lee, Kyung Ja; Lee, Hong Kyu; Lee, Chung Sang

1970-01-01

A summary of the clinical data of the 131 I-thyroid function tests and the therapeutic results of 131 I among the 2,658 patients of various thyroid diseases treated over the past 10 years from May 1960 to Oct. 1969 at the Radioisotope Clinic and Laboratory, SNUH were presented and discussed. 1) The patients examined consisted of 929 cases (34.9%) of diffuse toxic goiter, 762 cases (28.7%) of diffuse nontoxic goiter, 699 cases (26.3%) of nodular nontoxic goiter, 58 cases (2.2%) of nodular toxic goiter and 210 cases (7.9%) of hypothyroidism. 2) There were 300 (11.4%) male and 2358 (88.6%) female, showing a ratio of 1 : 8. 3) The majority of patients (79.1%) were in the 3rd-5th decade of their lives. 3) The normal ranges, diagnostic values of 131 I uptake test, 48 hrs serum activity, BMR and main subjective symptoms of various thyroid diseases were discussed. 5) In the 579 patients among 867 cases with hyperthyroidism treated with 131 I, 47.8% were confirmed to be cured completely after single therapeutic doses. 6) The complications of 131 I therapy were discussed and myxedema had developed in 6.75% of our patients. 7) The results of 131 I thyroid function tests were analysed among the 160 cases of thyroid diseases which were confirmed the diagnosis with histopathological measures.

Fetal microchimeric cells in autoimmune thyroid diseases

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Lepez, Trees; Vandewoestyne, Mado; Deforce, Dieter

2013-01-01

Autoimmune thyroid diseases (AITD) show a female predominance, with an increased incidence in the years following parturition. Fetal microchimerism has been suggested to play a role in the pathogenesis of AITD. However, only the presence of fetal microchimeric cells in blood and in the thyroid gland of these patients has been proven, but not an actual active role in AITD. Is fetal microchimerism harmful for the thyroid gland by initiating a Graft versus Host reaction (GvHR) or being the target of a Host versus Graft reaction (HvGR)? Is fetal microchimerism beneficial for the thyroid gland by being a part of tissue repair or are fetal cells just innocent bystanders in the process of autoimmunity? This review explores every hypothesis concerning the role of fetal microchimerism in AITD. PMID:23723083

Estrogen exposure, obesity and thyroid disease in women with severe pulmonary hypertension

Directory of Open Access Journals (Sweden)

Sweeney Lori

2009-09-01

Full Text Available Abstract Severe pulmonary hypertension is a lethal group of disorders which preferentially afflicts women. It appears that in recent years the patient profile has shifted towards older, obese, and postmenopausal women, suggesting that endocrine factors may be important. Several studies have revealed an increased prevalence of thyroid disease in these patients, but no studies have evaluated for a coexistence of endocrine factors. In particular, no studies have attempted to evaluate for concurrent thyroid disease, obesity and long-term estrogen exposure in patients. 88 patients attending the Pulmonary Hypertension Association 8th International meeting completed a questionnaire and were interviewed. Information was collected regarding reproductive history, height, weight, and previous diagnosis of thyroid disease. 46% met criteria for obesity. 41% reported a diagnosis of thyroid disease. 81% of women reported prior use of hormone therapy. 70% reported greater than 10 years of exogenous hormone use. 74% of female patients reported two or more of potentially disease modifying endocrine factors (obesity, thyroid disease or estrogen therapy. The coexistent high prevalence in our cohort of exogenous estrogen exposure, thyroid disease and obesity suggests that an interaction of multiple endocrine factors might contribute to the pathogenesis of pulmonary hypertension and may represent epigenetic modifiers in genetically-susceptible individuals.

Celiac disease in children and adolescents with Hashimoto Thyroiditis.

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Tuhan, Hale; Işık, Sakine; Abacı, Ayhan; Şimşek, Erdem; Anık, Ahmet; Anal, Özden; Böber, Ece

2016-06-01

The aim of this study was to evaluate clinical and laboratory findings and determine the prevalence of celiac disease (CD) in children with Hashimoto thyroiditis (HT). The data of a total of 80 patients with positive anti-thyroid antibodies who were aged between 6 and 17.9 years were retrospectively studied. Age, gender, complaints at the time of presentation, family history of thyroid disorders, clinical and laboratory findings were recorded. The levels of thyrotropin, free thyroxin, thyroid autoantibodies (thyroid peroxidase and thyroglobulin antibodies), immunoglobulin A (IgA), anti-tissue transglutaminase antibodies (IgA-tTG), and thyroid ultrasonography findings were enrolled. Eighty patients (65 females (81.2%) and 15 males (18,8%)) were included in the study. Family history of thyroid disease was present in 38 (47.5%) patients. The most common complaints at the time of presentation were goiter (%30) and weight gain (%25). Forty three (53.8%), 23 (28.7%), and 14 (17.5%) patients presented with euthyroidism, subclinical hypothyroidism and obvious hypothyroidism. Thirty seven (46.2%) patients had goiter. IgA-tTG was found to be positive after a diagnosis of HT was made in only one patient (1.25%) and the diagnosis of CD was confirmed when intestinal biopsy of this patient revealed villus atrophy, crypt hyperplasia and increase in the intraepithelial lymphocyte count. In our study, it was found that the most common complaints at presentation in patients with a diagnosis of hashimoto thyroiditis included goiter, weakness and weight gain and the prevalence of celiac diseases was found to be 1.25% (1/80). This study shows that the prevalence of CD in patients with a diagnosis of HT is higher compared to the prevalence in the healthy pediatric population.

Study on the Usefulness of Ultrasonography for Postpartum Depression and Thyroid Disease

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Lee, Yun Yi; Lim, Cheong Hwan; Jung, Hong Ryang; Park, Mi Ja; You, In Gyu [Dept. of Radiological Science, Hanseo University, Seosan (Korea, Republic of)

2012-09-15

Postpartum depression(PPD) of women with depression increased frequency of thyroid disease, and so the correlations for depression and thyroid disease has been the subject of discussed whether. The purpose of this study was to predict the prevalence of PPD and the correlation between PPD and thyroid disease through ultrasonography. January 2010 to November 2011, Obstetrics and Gynecology in M-clinical center admitted 230 patients within 1 year postpartum were enrolled. EPDS by PPD scale depression screening and general characteristics of subjects were investigated and thyroid was examined that ultrasonography and thyroid blood tests. A total of 230 patients non PPD group were 53.0% and PPD group were 47.0%. In ultrasonography, among 27 patients who changed in size of thyroid, non PPD group were 14.8% and PPD group were 85.2%. Among 124 patients who thyroid nodules were presence, non PPD were 35.8% and PPD group were 64.2%. In ultrasonography, PPD group were higher incidence than non PPD group were changes in size of thyroid and the presence of nodules. There was significant difference between the changed in size of thyroid and thyroid nodules were presence the two group. Definitive histopathological diagnosis was benign in 33 patients (non PPD group were 45.5%, PPD group were 54.5%), malignancy in 5 patients (only PPD group were 100%), thyroiditis in 3 patients (non PPD group were 33.3%, PPD group were 66.7%). The results of thyroid blood tests, abnormal TSH level were 7 patients (non PPD group were 28.6%, PPD group were 71.4%) and abnormal Free T4 level were 9 patients (non PPD group were 44.4%, PPD group were 55.6%). There was no significant difference between the abnormal TSH level and Free T4 level of the two group. 5 patients were diagnosed as thyroid dysfunction. Of these, 2 patients were subclinical hyperthyroidism in non PPD group, 2 patients were subclinical hyperthyroidism and 1 patient was subclinical hyperthyroidism in PPD group. This study was

Study on the Usefulness of Ultrasonography for Postpartum Depression and Thyroid Disease

International Nuclear Information System (INIS)

Lee, Yun Yi; Lim, Cheong Hwan; Jung, Hong Ryang; Park, Mi Ja; You, In Gyu

2012-01-01

Postpartum depression(PPD) of women with depression increased frequency of thyroid disease, and so the correlations for depression and thyroid disease has been the subject of discussed whether. The purpose of this study was to predict the prevalence of PPD and the correlation between PPD and thyroid disease through ultrasonography. January 2010 to November 2011, Obstetrics and Gynecology in M-clinical center admitted 230 patients within 1 year postpartum were enrolled. EPDS by PPD scale depression screening and general characteristics of subjects were investigated and thyroid was examined that ultrasonography and thyroid blood tests. A total of 230 patients non PPD group were 53.0% and PPD group were 47.0%. In ultrasonography, among 27 patients who changed in size of thyroid, non PPD group were 14.8% and PPD group were 85.2%. Among 124 patients who thyroid nodules were presence, non PPD were 35.8% and PPD group were 64.2%. In ultrasonography, PPD group were higher incidence than non PPD group were changes in size of thyroid and the presence of nodules. There was significant difference between the changed in size of thyroid and thyroid nodules were presence the two group. Definitive histopathological diagnosis was benign in 33 patients (non PPD group were 45.5%, PPD group were 54.5%), malignancy in 5 patients (only PPD group were 100%), thyroiditis in 3 patients (non PPD group were 33.3%, PPD group were 66.7%). The results of thyroid blood tests, abnormal TSH level were 7 patients (non PPD group were 28.6%, PPD group were 71.4%) and abnormal Free T4 level were 9 patients (non PPD group were 44.4%, PPD group were 55.6%). There was no significant difference between the abnormal TSH level and Free T4 level of the two group. 5 patients were diagnosed as thyroid dysfunction. Of these, 2 patients were subclinical hyperthyroidism in non PPD group, 2 patients were subclinical hyperthyroidism and 1 patient was subclinical hyperthyroidism in PPD group. This study was

Chronic thyroiditis (Hashimoto disease)

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Hashimoto thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis; Chronic autoimmune thyroiditis; Lymphadenoid goiter - Hashimoto; Hypothyroidism - Hashimoto; Type 2 polyglandular autoimmune ...

A case of metastatic follicular thyroid carcinoma complicated with Graves' disease after total thyroidectomy.

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Aoyama, Mariko; Takizawa, Hiromitsu; Tsuboi, Mitsuhiro; Nakagawa, Yasushi; Tangoku, Akira

2017-12-28

Thyroid cancer and Graves' disease may present simultaneously in one patient. The incidence of the development of hyperthyroidism from metastatic differentiated thyroid carcinoma is rare. We herein report a case of metastatic follicular carcinoma complicated with Graves' disease after total thyroidectomy. A 57-year-old woman underwent right hemithyroidectomy for follicular carcinoma. Metastatic lesions appeared in the lungs and skull two years after the first surgery, and remnant thyroidectomy was performed for radioactive iodine-131 (RAI) therapy, during which the TSH receptor antibody (TRAb) was found to be negative. The patient was treated with RAI therapy four times for four years and was receiving levothyroxine suppressive therapy. Although radioiodine uptake was observed in the lesions after the fourth course of RAI therapy, metastatic lesions had progressed. Four years after the second surgery, she had heart palpitations and tremors. Laboratory data revealed hyperthyroidism and positive TRAb. She was diagnosed with Graves' disease and received a fifth course of RAI therapy. 131I scintigraphy after RAI therapy showed strong radioiodine uptake in the metastatic lesions. As a result, the sizes and numbers of metastatic lesions decreased, and thyroid function improved. Metastatic lesions produced thyroid hormone and caused hyperthyroidism. RAI therapy was effective for Graves' disease and thyroid carcinoma.

Role of Thyroid Hormones in Skeletal Development and Bone Maintenance.

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Bassett, J H Duncan; Williams, Graham R

2016-04-01

The skeleton is an exquisitely sensitive and archetypal T3-target tissue that demonstrates the critical role for thyroid hormones during development, linear growth, and adult bone turnover and maintenance. Thyrotoxicosis is an established cause of secondary osteoporosis, and abnormal thyroid hormone signaling has recently been identified as a novel risk factor for osteoarthritis. Skeletal phenotypes in genetically modified mice have faithfully reproduced genetic disorders in humans, revealing the complex physiological relationship between centrally regulated thyroid status and the peripheral actions of thyroid hormones. Studies in mutant mice also established the paradigm that T3 exerts anabolic actions during growth and catabolic effects on adult bone. Thus, the skeleton represents an ideal physiological system in which to characterize thyroid hormone transport, metabolism, and action during development and adulthood and in response to injury. Future analysis of T3 action in individual skeletal cell lineages will provide new insights into cell-specific molecular mechanisms and may ultimately identify novel therapeutic targets for chronic degenerative diseases such as osteoporosis and osteoarthritis. This review provides a comprehensive analysis of the current state of the art.

Trends in Costs of Thyroid Disease Treatment in Denmark during 1995-2015

DEFF Research Database (Denmark)

Møllehave, Line Tang; Linneberg, Allan; Skaaby, Tea

2018-01-01

treatment) was obtained from nationwide registers. Costs were valued at 2015 prices using sales prices for medicines and the Danish Diagnosis-Related Group (DRG) and Danish Ambulatory Grouping System (DAGS) tariffs of surgeries/radioiodine treatments. Results were adjusted for changes in population size...... and age and sex distribution. Results: The total direct medicine and hospital costs of thyroid disease treatment increased from EUR ∼190,000 per 100,000 persons in 1995 to EUR ∼270,000 per 100,000 persons in 2015. This was mainly due to linearly increased costs of thyroid hormone therapy and increased...... costs of thyroid surgery since 2008. Costs of antithyroid medication increased slightly and transiently after IF, while costs of radioiodine treatment remained constant. Costs of thyroid hormone therapy and thyroid surgery did not follow the development in the prevalence of hypothyroidism and structural...

CT evaluation of optic nerve compression in thyroid eye disease

International Nuclear Information System (INIS)

Barrett, L.; Giatt, H.J.; Burde, R.M.; Gado, M.

1986-01-01

In thyroid eye disease, visual loss due to optic nerve compression by enlarged muscles near the orbital apex requires prompt surgical decompression and must be differentiated from visual loss due to other mechanisms. Seventy-two high-resolution orbital CT scans of patients with thyroid eye disease were analyzed. From a coronal reconstruction, an easily measured ''apical index'' was determined. Average apical indices for orbits without optic neuropathy (41.0%) and with optic neuropathy (70.2%) were significantly different (P < .001). With the aid of the apical index, CT findings can be used to predict which patients with thyroid eye disease have optic nerve compression

Seven newly identified loci for autoimmune thyroid disease.

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Cooper, Jason D; Simmonds, Matthew J; Walker, Neil M; Burren, Oliver; Brand, Oliver J; Guo, Hui; Wallace, Chris; Stevens, Helen; Coleman, Gillian; Franklyn, Jayne A; Todd, John A; Gough, Stephen C L

2012-12-01

Autoimmune thyroid disease (AITD), including Graves' disease (GD) and Hashimoto's thyroiditis (HT), is one of the most common of the immune-mediated diseases. To further investigate the genetic determinants of AITD, we conducted an association study using a custom-made single-nucleotide polymorphism (SNP) array, the ImmunoChip. The SNP array contains all known and genotype-able SNPs across 186 distinct susceptibility loci associated with one or more immune-mediated diseases. After stringent quality control, we analysed 103 875 common SNPs (minor allele frequency >0.05) in 2285 GD and 462 HT patients and 9364 controls. We found evidence for seven new AITD risk loci (P test derived significance threshold), five at locations previously associated and two at locations awaiting confirmation, with other immune-mediated diseases.

Outcomes of surgical treatment of thyroid disease in children

Directory of Open Access Journals (Sweden)

Olga S. Rogova

2017-01-01

Full Text Available Background. In recent years there has been a tendency of increase in the proportion of nodular goiter and Graves’ disease in thyroid pathology in children, which necessitates a choice of rational tactics for treatment of these diseases. At present there is no optimal method of treatment for thyroid gland pathology, but one of the methods is surgery. Thyroid surgery due to the determination of the indications and choice of the optimal volume of the surgical intervention continues to be under debate as postoperative complications of surgical treatment of thyroid diseases in children are possible.Aim: to study the outcomes of surgical treatment for thyroid pathology in children, depending on the volume of operation.Materials and methods. This article presents the results of a survey of 77 children operated on in the period of 2002–2016 for Graves’ disease, single-node goiter, and multinodular goiter. The examination included the determination of the levels of ionized calcium and TSH, FT4, FT3 in the blood serum, the evaluation of the functional state of the pituitary-thyroid system, thyroid ultrasound examination, and examination by an otolaryngologist.Results. The incidence of adverse outcomes of surgical treatment in children with nodular goiter was 27%. Adverse outcomes were observed equally often after organ-preserving operations and after thyroidectomy, but they were of different structure. The frequency of postoperative complications after thyroidectomy performed on the nodular goiter was 27%. Complications presented as postsurgical hypoparathyroidism and vocal cord paresis. In children with nodular goiter, after thyroidectomy hypoparathyroidism occurred more frequently than paresis of the vocal folds. Symptomatic hypocalcemia was observed more frequently than the asymptomatic variant, and in most cases hypoparathyrodism was transient. Among children with a single-node goiter who underwent organ-preserving surgery on the thyroid gland

Comparison of Na+/I- symporter expression rate in malignant and benign thyroid diseases: immunohistochemical study

International Nuclear Information System (INIS)

Kang, Do Young; Jeong, Young Jin; Lee, Kyung Eun; Park, Heon Soo; Yoo, Young Hyun; Roh, Mee Sook

2006-01-01

Previous studies have not showed consistent results for the level of expression of sodium/iodide symporter (NIS) in thyroid diseases, especially malignant tumor. We undertook this study to evaluate the distribution of NIS expression in malignant thyroid diseases and compare with that in benign thyoid disease. Total patients were 119 cases (Men 15, 48±13 yrs). Total number of samples were 205 pieces. In malignant thyroid disease, there were 153 samples: 90 in papillary carcinoma, 4 in follicular carcinoma, 2 in medullary carcinoma and 57 in metastatic lymph node. In benign thyroid disease, there were 52 samples: 36 in goiter/cyst, 11 in thyroiditis and 5 in follicular adenoma. Using immunohistochemical methods, we probed 205 samples with monoclonal anti-NIS Ab. Grading of staining was scored as 0 (negative or absent), 1 (weakly positive), 2 (moderately positive) or 3 (strongly positive). Expression rate (ER) of NIS positivity in individual disease entity was expressed as percentage of total number divided by number in 2 plus 3 grade. ERs of malignant thyroid diseases were 63% in papillary carcinoma, 81% in metastatic lymph node, 71% in follicular carcinoma and 100% in medullary carcinoma. ERs of benign thyroid disease were 53% in goiter/cyst, 64% in thyroiditis and 40% in follicular adenoma. ER of benign thyroid deceases was higher than benign thyroid diseases (71% vs 54%). Grading of NIS expression in papillary carcinoma or goiter/cyst was heterogeneously distributed in considerable cases. Normal tissue also showed heterogeneous distribution or NIS expression, which was not correlated with that of primary lesion. In papillary thyroid carcinoma, distribution of NIS expression was heterogeneous and increased, and not different compared with that of benign thyroid disease

Interphase ribosomal RNA cistron staining in thyroid epithelial cells in Grave's disease, Hashimoto's thyroiditis and benign and malignant tumours of the thyroid gland

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Mamaev, N N; Grynyeva, E N; Blagosklonnaya, Y V

1996-01-01

Aim—To evaluate the expression of ribosomal cistrons in human thyroid epithelial cells (TECs) of patients with Grave's disease, Hashimoto's thyroiditis and benign and malignant tumours of the thyroid gland. Methods—TEC nucleoli were investigated in fine needle biopsy specimens from 10 controls, 39 patients with Grave's disease, 15 with Hashimoto's thyroiditis, 56 with benign, and 15 with malignant tumours of the thyroid. A one step silver staining method was applied. In most cases serum concentrations of thyroxine and triiodothyronine as well as goitre size were determined. In every case 100 TECs were evaluated for the mean numbers of nucleoli and for the average number of argyrophilic nucleolar organiser regions (AgNORs) per nucleus. Results—NORs were activated in all patients, but not in controls. The numbers of AgNORs in patients with Grave's disease were closely correlated with thyroxine or triiodothyronine, or both, concentrations and with the size of the thyroid. In patients with Hashimoto's thyroiditis about 30% of TECs nucleoli did not contain AgNORs, whereas others were heavily impregnated with silver. Compared with controls and benign tumours, the nucleoli of carcinomatous TECs were larger and irregular in shape. The mean number of AgNORs per nucleus in malignant cells was higher than that in their benign counterparts. Conclusions—The mechanism by which NORs are activated in TECs varies depending on the type of lesion. The higher AgNOR score in TECs from malignant tumours can be used to distinguish them from their benign counterparts. Images PMID:16696083

Thyroid nodules and thyroid autoimmunity in the context of environmental pollution.

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Benvenga, Salvatore; Antonelli, Alessandro; Vita, Roberto

2015-12-01

Evidence suggests that in most industrialized countries autoimmune disorders, including chronic lymphocytic thyroiditis, are increasing. This increase parallels the one regarding differentiated thyroid cancer, the increment of which is mainly due to the papillary histotype. A number of studies have pointed to an association between chronic lymphocytic thyroiditis and differentiated thyroid cancer. The upward trend of these two thyroid diseases is sustained by certain environmental factors, such as polluting substances acting as endocrine disrupting chemicals. Herein we will review the experimental and clinical literature that highlights the effects of environmental and occupational exposure to polluting chemicals in the development of autoimmune thyroid disease or differentiated thyroid cancer. Stakeholders, starting from policymarkers, should become more sensitive to the consequences for the thyroid resulting from exposure to EDC. Indeed, the economic burden resulting from such consequences has not been quantified thus far.

Association between thyroid function and gallstone disease

Institute of Scientific and Technical Information of China (English)

Henry V(o)lzke; Daniel M Robinson; Ulrich John

2005-01-01

AIM: To investigate those associations using data of the population-based Study of Health in Pomerania.METHODS: A study population of 3 749 residents aged 20-79 years without previously diagnosed thyroid disease was available for analyses. Serum TSH was used to assess thyroid function. Cholelithiasis was defined by either a prior history of cholecystectomy or the presence of gallstones on ultrasound. Logistic regression was performed to analyze independent associations between thyroid function and cholelithiasis.RESULTS: There were 385 persons (10.3%) with low (＜0.3 mIU/L), 3 321 persons (88.6%) with normal and 43 persons (1.2%) with high serum TSH levels (＞3 mIU/L).The proportion of cholelithiasis among males and females was 14.4% and 25.3%, respectively. Among males, there was an independent relation between high serum TSH and cholelithiasis (OR 3.77; 95%-CI 1.06-13.41; ,P＜0.05). zAlso among males, there was a tendency towards an elevated risk of cholelithiasis in persons with low serum TSH (OR 1.40; 95%-CI 0.96-2.02; P = 0.07). In the female population, no such relation was identified.CONCLUSION: There is an association between thyroid and gallstone disease with a gender-specific relation between hypothyroidism and cholelithiasis.

[Triggering role of emotional stress and childbirth. Unexpected occurrence of Graves' disease compared to 96 cases of Hashimoto thyroiditis and 97 cases of thyroid nodules].

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Martin-du Pan, R C

1998-07-01

98 patients with Graves' disease have been compared to 95 patients with Hashimoto's thyroiditis and to 97 patients with benign thyroid nodules (control group) in order to evaluate the triggering role of major stressors and pregnancy in the occurrence of autoimmune thyroid diseases. A stress factor has been encountered in 11% cases of Graves' disease and in 6% of Hashimoto's and thyroid nodes (chi 2 test, not different). Graves' disease occurred after a pregnancy in 25% of the women in child bearing age versus 10% of the cases of Hashimoto's (p thyroid nodes. The role of stressors, if any, in triggering Graves' disease seems to be weak and dubious compared to the role of pregnancy and post-partum. It is assumed that the decrease of immunosuppressive hormones occurring after stress or delivery could induce a rebound autoimmune reaction responsible for the thyroid disease. In Hashimoto's thyroiditis, stress and pregnancies do not seem to have any triggering role.

Role of color Doppler in differentiation of Graves' disease and thyroiditis in thyrotoxicosis

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Donkol, Ragab Hani; Nada, Aml Mohamed; Boughattas, Sami

2013-01-01

AIM: To evaluate the role of thyroid blood flow assessment by color-flow Doppler ultrasonography in the differential diagnosis of thyrotoxicosis and compare it to technetium pertechnetate thyroid scanning. METHODS: Twenty-six patients with thyrotoxicosis were included in the study. Clinical history was taken and physical examination and thyroid function tests were performed for all patients. Thyroid autoantibodies were measured. The thyroid glands of all patients were evaluated by gray scale ultrasonography for size, shape and echotexture. Color-flow Doppler ultrasonography of the thyroid tissue was performed and spectral flow analysis of both inferior thyroid arteries was assessed. Technetium99 pertechnetate scanning of the thyroid gland was done for all patients. According to thyroid scintigraphy, the patients were divided into two groups: 18 cases with Graves’ disease and 8 cases with Hashimoto’s thyroiditis. All patients had suppressed thyrotropin. The diagnosis of Graves’ disease and Hashimoto’s thyroiditis was supported by the clinical picture and follow up of patients. RESULTS: Peak systolic velocities of the inferior thyroid arteries were significantly higher in patients with Graves’ disease than in patients with thyroiditis (P = 0.004 in the right inferior thyroid artery and P = 0.001 in left inferior thyroid artery). Color-flow Doppler ultrasonography parameters demonstrated a sensitivity of 88.9% and a specificity of 87.5% in the differential diagnosis of thyrotoxicosis. CONCLUSION: Color Doppler flow of the inferior thyroid artery can be used in the differential diagnosis of thyrotoxicosis, especially when there is a contraindication of thyroid scintigraphy by radioactive material in some patients. PMID:23671754

The thyroid gland in postmenopausal women: physiology and diseases.

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Gietka-Czernel, Małgorzata

2017-06-01

The incidence of most thyroid diseases: hypothyroidism, nodular goitre, and cancer is highest among postmenopausal and elderly women. The diagnosis of thyroid dysfunction in this group of patients is difficult because the symptoms can be nonspecific or common with menopausal and ageing complaints. In the interpretation of thyroid function tests the physiological changes in secretion and metabolism of thyrotropin (TSH) and thyroid hormones must be considered, as well as the influence of comorbidities. Unrecognised thyroid dysfunction leads to increased: cardiovascular risk, bone fractures, cognitive impairment, depression, and mortality. Therapy of thyroid dysfunction is different in postmenopausal and elderly women than in young people; hypothyroidism should be treated with caution, because high doses of L-thyroxine can lead to cardiac arrhythmias and increased bone turnover, and hyperthyroidism should be preferentially treated with radioiodine. Thyroid status beneficially influencing longevity relates to low thyroid function. Thyroid nodules and cancer often affect women over 50 years old; the diagnostic and therapeutic approach is the same as in the general population, but the surgical risk and cancer prognosis is worse than in young patients.

Management of concomitant hyperparathyroidism and thyroid diseases in the elderly patients: a retrospective cohort study.

Science.gov (United States)

Panarese, Alessandra; D'Andrea, Vito; Pontone, Stefano; Favoriti, Pasqualino; Pironi, Daniele; Arcieri, Stefano; Filippini, Angelo; Sorrenti, Salvatore

2017-02-01

Thyroid disease and hyperparathyroidism are the most common endocrine disorders. The incidence of thyroid disease in patients with hyperparathyroidism ranges in the different series from 17 to 84%, and thyroid cancer occurs with an incidence ranging from 2 to 15%. The aim of our study was to analyze the management of elderly patients with concomitant thyroid and parathyroid disease in order to define the best surgical therapeutic strategy and avoid reoperations associated with a higher risk of complications. All consecutive patients (64 patients, age range 60-75 years), undergoing surgery for hyperparathyroidism, from January 2011 to June 2014, were retrospectively evaluated. Enrolled patients were divided into two study groups of patients affected by hyperparathyroidism with or without a concomitant thyroid disease. Out of 64 patients enrolled in our study (24 men, age range 60-75 years), affected by hyperparathyroidism, 34 had an associated thyroid disease and were treated with total thyroidectomy and parathyroidectomy. The group, who underwent parathyroidectomy associated with thyroidectomy, had no greater complications than the group receiving only parathyroidectomy. Thyroid disease must be excluded in patients affected by hyperparathyroidism. It is difficult to determine whether hyperparathyroidism can be considered a risk factor for thyroid disease, but an accurate preoperative study is essential for a surgery able to treat both thyroid and parathyroid disease. In this way, we avoid the elderly patient, with associated morbidity and increased surgical risk, to undergo a reoperation for thyroid disease, burdened with major complications.

ABCC-NIH adult health study Hiroshima 1958 to 1959 thyroid disease

Energy Technology Data Exchange (ETDEWEB)

Hollingsworth, D R; Hamilton, H B; Tamagaki, Hideya; Beebe, G W

1962-04-01

In the matched sample for the Adult Health Study 5553 participants were examined in the ABCC clinic in Hiroshima, Japan during the sixteen month period from July 1958 through October 1959. Thyroid disease was diagnosed for 169 subjects, 152 of whom were female. Simple nontoxic goiter was the most frequently seen thyroid disorder comprising 47 percent of the total, with a sex ratio of 8 to 1 in favor of females. Hiroshima is a coastal city where iodine deficiencies seem unlikely and the various etiological possibilities responsible for nontoxic goiter were reviewed and discussed. Hyperthyroidism was observed in 16 patients of whom 13 were females. One patient with hypothyroidism and 5 with chronic thyroiditis diagnosed by biopsy were seen in the study. Single thyroid nodules were found in 39 patients; the biopsy diagnoses of 19 were listed, 8 of whom were shown to have thyroid carcinoma. Carcinoma of the thyroid was diagnosed microscopically in 12 patients, constituting 7 percent of the total number with thyroid disorders. It was concluded that thyroid disease in Hiroshima warrants further study and it will be of particular interest to carefully observe the Adult Health Study group for the incidence of thyroid nodules and thyroid carcinoma.

Remission of Grave's disease after oral anti-thyroid drug treatment.

Science.gov (United States)

Ishtiaq, Osama; Waseem, Sabiha; Haque, M Naeemul; Islam, Najmul; Jabbar, Abdul

2009-11-01

To evaluate remission rate of anti-thyroid drug treatment in patients with Grave's disease, and to study the factors associated with remission. A cross sectional study. The Endocrine Department of the Aga Khan University Hospital, Karachi from 1999 to 2000. Seventy four patients of Grave's disease were recruited who were prescribed medical treatment. Grave's disease was diagnosed in the presence of clinical and biochemical hyperthyroidism along with anti-microsomal (AMA) and anti-thyroglobulin antibodies (ATA) and thyroid scan. These patients were prescribed oral anti-thyroid drugs using titration regime and followed at 3, 6, 12 and 18 months. Patients were categorized into two groups: "remission group" and "treatment failure group" and results were compared using a chi-square test, t-test and logistic regression model with significance at p disease on initial presentation.

Foetal and neonatal thyroid disorders.

Science.gov (United States)

Radetti, G; Zavallone, A; Gentili, L; Beck-Peccoz, P; Bona, G

2002-10-01

Thyroid hormones have been shown to be absolutely necessary for early brain development. During pregnancy, both maternal and foetal thyroid hormones contribute to foetal brain development and maternal supply explains why most of the athyreotic newborns usually do not show any signs of hypothyroidism at birth. Foetal and/or neonatal hypothyroidism is a rare disorder. Its incidence, as indicated by neonatal screening, is about 1:4000. Abnormal thyroid development (i.e. agenesia, ectopic gland, hypoplasia) or inborn errors in thyroid hormone biosynthesis are the most common causes of permanent congenital hypothyroidism. Recent studies reported that mutations involving Thyroid Transcriptor Factors (TTF) such as TTF-1, TTF-2, PAX-8 play an important role in altered foetal thyroid development. Deficiency of transcriptor factor (Pit-1, Prop-1, LHX-3) both in mother and in the foetus represents another rare cause of foetal hypothyroidism. At birth clinical picture may be not always so obvious and typical signs appear only after several weeks but a delayed diagnosis could have severe consequences consisting of delayed physical and mental development. Even if substitutive therapy is promptly started some learning difficulties might still arise suggesting that intrauterine adequate levels of thyroid hormones are absolutely necessary for a normal neurological development. Placental transfer of maternal antithyroid antibodies inhibiting fetal thyroid function can cause transient hypothyroidism at birth. If the mother with thyroid autoimmune disease is also hypothyroid during pregnancy and she doesn't receive substitutive therapy, a worse neurological outcome may be expected for her foetus. Foetal and/or neonatal hyperthyroidism is a rare condition and its incidence has been estimated around 1:4000-40000, according to various authors. The most common causes are maternal thyroid autoimmune disorders, such as Graves' disease and Hashimoto's thyroiditis. Rarer non autoimmune causes

Radiation of the thyroid during examination of patients with thyroid diseases using radioactive iodine

Energy Technology Data Exchange (ETDEWEB)

Zvonova, I.A.; Likhtarev, A.A.; Nikolaeva, A.A.

1984-02-01

Basing on 131I uptake functions in the thyroid of 109 patients irradiation doses of this organ were evaluated for persons with normal iodine metabolism and in the following diseases: hypothyrosis, moderate thyrotoxicosis, nodular toxic and nontoxic goiter, vegetative neurosis. Maximum tolerant doses of 123I, 125I, 131I and 132I are recommended for diagnostic examination of thyroid function and scanning of this organ.

Radionuclides in thyroid cancer

International Nuclear Information System (INIS)

Mahadev, V.

1980-01-01

The three main areas of application of radionuclides in thyroid disease will be reviewed. Firstly thyroid radionuclide imaging in thyroid swellings, in relationship to lumps in the neck and ectopic thyroid tissue such as retrosternal goitre, and lingual goitre will be described. Future developments in the field including tomographic scanning, using the coded aperture method, and fluorescent scans and ultrasound are reviewed. The second area of application is the assessment and evaluation of thyroid function and the therapy of Grave's Disease and Plummer's Disease using radioiodine. The importance of careful collection of the line of treatment, results of treatment locally and the follow-up of patients after radioiodine therapy will be described. The third area of application is in the diagnosis and therapy of thyroid cancer. Investigation of thyroid swelling, and the diagnosis of functioning metastases are reported. The therapeutic iodine scan as the sole evidence of functioning metastatic involvement is recorded. Histological thyroid cancer appears to be increasingly encountered in clinical practice and the plan of management in relation to choice of cases for therapeutic scanning is discussed with case reports. Lastly the role of whole body scanning in relationship to biochemical markers is compared. In the changing field of nuclear medicine radionuclide applications in thyroid disease have remained pre-eminent and this is an attempt to reassess its role in the light of newer developments and local experience in the Institute of Radiotherapy, Oncology and Nuclear Medicine. (author)

Thyroid surgery for Graves' disease and Graves' ophthalmopathy.

Science.gov (United States)

Liu, Zi Wei; Masterson, Liam; Fish, Brian; Jani, Piyush; Chatterjee, Krishna

2015-11-25

Graves' disease is an autoimmune disease caused by the production of auto-antibodies against the thyroid-stimulating hormone receptor, which stimulates follicular cell production of thyroid hormone. It is the commonest cause of hyperthyroidism and may cause considerable morbidity with increased risk of cardiovascular and respiratory adverse events. Five per cent of people with Graves' disease develop moderate to severe Graves' ophthalmopathy. Thyroid surgery for Graves' disease commonly falls into one of three categories: 1) total thyroidectomy, which aims to achieve complete macroscopic removal of thyroid tissue; 2) bilateral subtotal thyroidectomy, in which bilateral thyroid remnants are left; and 3) unilateral total and contralateral subtotal thyroidectomy, or the Dunhill procedure. Recent American Thyroid Association guidelines on treatment of Graves' hyperthyroidism emphasised the role of surgery as one of the first-line treatments. Total thyroidectomy removes target tissue for the thyroid-stimulating hormone receptor antibody. It controls hyperthyroidism at the cost of lifelong thyroxine replacement. Subtotal thyroidectomy leaves a thyroid remnant and may be less likely to lead to complications, however a higher rate of recurrent hyperthyroidism is expected and revision surgery would be challenging. The choice of the thyroidectomy technique is currently largely a matter of surgeon preference, and a systematic review of the evidence base is required to determine which option offers the best outcomes for patients. To assess the optimal surgical technique for Graves' disease and Graves' ophthalmopathy. We searched the Cochrane Library, MEDLINE and PubMed, EMBASE, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). The date of the last search was June 2015 for all databases. We did not apply any language restrictions. Only randomised controlled trials (RCTs) involving participants with a diagnosis

The onset of systemic lupus erythematosus and thyroid dysfunction following graves’ disease - a case report and literature review

Directory of Open Access Journals (Sweden)

Zhanga Yuanyuan

2016-01-01

Full Text Available Introduction. Graves’ disease is a multifactorial autoimmune thyroid disease, with the presence of typical circulating autoantibodies that can activate the thyroid hormone receptors, resulting in hyperthyroidism, goiter, and ophthalmopathy. Systemic lupus erythematosus is a multi-systemic autoimmune disease that involves almost all the organs of the human body and is characterized by autoantibodies formation. Several studies have reported that autoimmune thyroid and rheumatic disorders can present an unusual relationship. Case Outline. We report a case of a middle-aged woman who presented with systemic lupus erythematosus one year after being diagnosed with Graves’ disease. Prednisone and cyclophosphamide were administered to control the development of systemic lupus erythematosus. Furthermore, a percutaneous thyroid biopsy was performed for further confirmation of Graves’ disease. Methimazole instead of propylthiouracil was added into the therapeutic scheme. A month later, the patient’s clinical manifestation and laboratory tests got significant improvement, except that new thyr o id dysfunction appeared opposite to the original one. The administration of anti-thyroid drug was discontinued. With a period of decreased administration of prednisone, the patient’s thyroid function gradually got back to normal levels without any levothyroxine replacement. Conclusion. In conclusion, the clinical use of prednisone and antithyroid drugs may result in instability of the hypothalamus-pituitary-thyroid axis, and thyroid function should be carefully monitored in such patients.

The diagnostic value of Th1/Th2 cell cytokine and thyroid autoantibody on autoimmune thyroid diseases

International Nuclear Information System (INIS)

Feng Xuemin; Qin Mingxiu; Zhao Yan

2008-01-01

To study the diagnostic value of Th1/Th2 cell cytokine and thyroid autoantibody in autoimmune thyroid diseases (AITD), 28 patients with Graves' disease (GD), 15 patients with hyperthyroidism and thyroiditis (GDIII), 13 patients with Hashimoto's hyperthyroidism (HTL), 21 patients with Hashimoto's thyroiditis(HT)and 20 healthy subjects were enrolled in this study. The serum concentrations of Th1 cytokine (IFN-γ) and Th2 cytokine (IL-4) were determined by ELISA. The serum levels of thyrotropin receptor antibodies (TRAb), thyroglobulin antibodies (TGAb) and thyroid peroxidase antibodies (TPOAb) were measured by RIA. The relationship between the serum levels of IFN-γ, IL-4 and TRAb, TGAb and TPOAb were analyzed. The results showed that IFN-γ levels from higher to lower in different groups were in the order of HT, HTL, GDIII, GD and the IL-4 were GD, GDIII, HTL, HT, respectively. There was significant difference in the IFN-γ (P<0.05) and IL-4 levels (P<0.01) between GDIII and HTL groups. There was no significant difference in TGAb and TPOAb between GDIII and HTL groups. In HT group, IFN-γ levels was positively correlated with TGAb and TPOAb (r=0.67,0.54,P<0.01). In GD group, IL-4 was positively correlated with TRAb (r =0.71,P<0.01). The imbalance of Th1/Th2 cell cytokine reflects pathologic change and abnormality of immune function in AITD patients. The detection of Th1/Th2 cell cytokine combined with thyroid autoantibody may be regarded as an indicator in the diagnosis of autoimmune thyroid diseases. (authors)

Enhancing radiotherapeutic efficiency in thyroid diseases

International Nuclear Information System (INIS)

Afanas'eva, N.I.; Filatov, A.A.

1989-01-01

Scientifically substantiated figures of material costs spent on the main types of radiotherapy of thyroid diseases were calculated. Cost calculation was based on the principle of the use of means in the nonindustrial field of economy. The cost of each investigation was calculated as full expenses (main funds and current costs) allocated for a particular type of investigation in any arbitrary period of time, divided into the number of investigations performed over this period. Standardization of investigations taking account of the elaborated tactical schemes makes it possible to decrease notably (almost by 20%) material cost on the investigation of thyroid patients

Spectrum of thyroid diseases in the surgical department of a tertiary ...

African Journals Online (AJOL)

Abstract. Background: Diseases of the thyroid gland are common endocrine disorders encountered globally and the incidence varies from one geographical region to another. The aim of this study is to determine the demographic, clinical and histopathological pattern of thyroid diseases as seen in University of Port Harcourt ...

Color Doppler measurement of blood flow in the inferior thyroid artery in patients with autoimmune thyroid diseases

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Caruso, Giuseppe; Attard, Marco; Caronia, Aurelio; Lagalla, Roberto

2000-10-01

Purpose: The aim of the study is to find out whether the measurement of peak systolic velocity in the inferior thyroid artery (ITA) is a valuable parameter to differentiate autoimmune thyroid diseases (hyper-, normo- or hypofunctional) and to evaluate the efficacy of medical treatment. Material and methods: The ITA of 31 patients (eight with Graves' disease, 23 with subclinical hypothyroidism) was examined with color Doppler and pulsed Doppler. The final diagnosis was obtained by citology and by hormonal and antibodies assays. The patients were monitorized by ultrasound for a period of 8 months. Results: In all the patients with Graves' disease the peak systolic velocity was always over 150 cm/s, while in other autoimmune thyroiditis the peak systolic velocity was within the normal range, and never exceeding 65 cm/s. In the first group, the measurement taken in the ITA showed also the efficacy of the pharmacological treatment earlier and more reliably than the color Doppler pattern obtained in the parenchyma. Conclusions: The color Doppler measurement of the ITA seems to be a promising technique with low-cost and easy approach. In our experience, the color Doppler of the ITA could have a clinical role in the differential diagnosis of diffuse thyroid diseases and in the follow-up of the Graves' disease during medical treatment.

Color Doppler measurement of blood flow in the inferior thyroid artery in patients with autoimmune thyroid diseases

International Nuclear Information System (INIS)

Caruso, Giuseppe; Attard, Marco; Caronia, Aurelio; Lagalla, Roberto

2000-01-01

Purpose: The aim of the study is to find out whether the measurement of peak systolic velocity in the inferior thyroid artery (ITA) is a valuable parameter to differentiate autoimmune thyroid diseases (hyper-, normo- or hypofunctional) and to evaluate the efficacy of medical treatment. Material and methods: The ITA of 31 patients (eight with Graves' disease, 23 with subclinical hypothyroidism) was examined with color Doppler and pulsed Doppler. The final diagnosis was obtained by citology and by hormonal and antibodies assays. The patients were monitorized by ultrasound for a period of 8 months. Results: In all the patients with Graves' disease the peak systolic velocity was always over 150 cm/s, while in other autoimmune thyroiditis the peak systolic velocity was within the normal range, and never exceeding 65 cm/s. In the first group, the measurement taken in the ITA showed also the efficacy of the pharmacological treatment earlier and more reliably than the color Doppler pattern obtained in the parenchyma. Conclusions: The color Doppler measurement of the ITA seems to be a promising technique with low-cost and easy approach. In our experience, the color Doppler of the ITA could have a clinical role in the differential diagnosis of diffuse thyroid diseases and in the follow-up of the Graves' disease during medical treatment

Absence of cross-reactivity to myeloperoxidase of anti-thyroid microsomal antibodies in patients with autoimmune thyroid diseases

NARCIS (Netherlands)

Freire, BA; Paula, ID; Paula, F; Kallenberg, GGM; Limburg, PC; Queluz, TT

Background: Thyroperoxidase is the major antigen of the thyroid microsomal antibodies (TMA) detected in autoimmune thyroid diseases. Its amino acid sequence has 44% homology with myeloperoxidase (MPO), an enzyme present in the primary granules of neutrophils and one of the major antineutrophil

Pregnancy outcomes are not altered by variation in thyroid function within the normal range in women free of thyroid disease.

Science.gov (United States)

Veltri, Flora; Kleynen, Pierre; Grabczan, Lidia; Salajan, Alexandra; Rozenberg, Serge; Pepersack, Thierry; Poppe, Kris

2018-02-01

In the recently revised guidelines on the management of thyroid dysfunction during pregnancy, treatment with thyroid hormone (LT4) is not recommended in women without thyroid autoimmunity (TAI) and TSH levels in the range 2.5-4.0 mIU/L, and in a recent study in that particular group of pregnant women, more complications were observed when a treatment with LT4 was given. The objective of the study was therefore to investigate whether variation in thyroid function within the normal (non-pregnant) range in women free of thyroid disease was associated with altered pregnancy outcomes? Cross-sectional data analysis of 1321 pregnant women nested within an ongoing prospective collection of pregnant women's data in a single centre in Brussels, Belgium. Thyroid peroxidase antibodies (TPO-abs), thyroid-stimulating hormone (TSH), free T4 (FT4) and ferritin levels were measured and baseline characteristics were recorded. Women taking LT4, with TAI and thyroid function outside the normal non-pregnant range were excluded. Pregnancy outcomes and baseline characteristics were correlated with all TSH and FT4 levels within the normal range and compared between two groups (TSH cut-off 500 mL) was inversely associated with serum FT4 levels (OR: 0.35; CI 95%: 0.13-0.96); P  = 0.040. Also 10% of women free of thyroid disease had serum TSH levels ≥2.5 mIU/L. Variation in thyroid function during the first trimester within the normal (non-pregnant) range in women free of thyroid disease was not associated with altered pregnancy outcomes. These results add evidence to the recommendation against LT4 treatment in pregnant women with high normal TSH levels and without TPO antibodies. © 2018 European Society of Endocrinology.

[Serum cortisol level variations in thyroid diseases].

Science.gov (United States)

Seck-Gassama; Ndoye, O; Mbodj, M; Akala, A; Cisse, F; Niang, M; Ndoye, R

2000-01-01

This work studies the thyroid disorders impact on adrenals glands by measuring total cortisol. Radioimmunoassays of thyroid hormones and cortisol were performed in 108 subjects, aged 20-52 years, with thyroid diseases. Our results show low cortisol values (80.35 nmol/L) in 4.77% of hyperthyroids, high values in 3.57% of hyperthyroids (1348.18 nmol/L) and 12.5% of hypothyroids (969.05 nmol/L). In hyperthyroidism, thyroid hormone stimulates the secretion of 11 ceto metabolites biologically inactive, unable to slow pituitary activity, inducing an increased production of endogene cortisol. Excessive catabolism can lead to the exhausting of overstimulated adrenal glands, and therefore to a decreased cortisol. In hypothyroidism, high cortisol results of increase cortisol half life and decrease of metabolic clearance. Control mechanisms often allow normal cortisol values. These alterations in functional activity of adrenal glands, seen in nearly 10% of these subjects, sometimes command a specific attitude in diagnosis and therapy.

Imaging of the thyroid in benign and malignant disease.

Science.gov (United States)

Intenzo, Charles M; Dam, Hung Q; Manzone, Timothy A; Kim, Sung M

2012-01-01

The thyroid gland was one of the first organs imaged in nuclear medicine, beginning in the 1940s. Thyroid scintigraphy is based on a specific phase or prelude to thyroid hormone synthesis, namely trapping of iodide or iodide analogues (ie, Tc99m pertechnetate), and in the case of radioactive iodine, eventual incorporation into thyroid hormone synthesis within the thyroid follicle. Moreover, thyroid scintigraphy is a reflection of the functional state of the gland, as well as the physiological state of any structure (ie, nodule) within the gland. Scintigraphy, therefore, provides information that anatomical imaging (ie, ultrasound, computed tomography [CT], magnetic resonance imaging) lacks. Thyroid scintigraphy plays an essential role in the management of patients with benign or malignant thyroid disease. In the former, the structure or architecture of the gland is best demonstrated by anatomical or cross-sectional imaging, such as ultrasound, CT, or even magnetic resonance imaging. The role of scintigraphy, however, is to display the functional state of the thyroid gland or that of a clinically palpable nodule within the gland. Such information is most useful in (1) patients with thyrotoxicosis, and (2) those patients whose thyroid nodules would not require tissue sampling if their nodules are hyperfunctioning. In neoplastic thyroid disease, thyroid scintigraphy is often standard of care for postthyroidectomy remnant evaluation and in subsequent thyroid cancer surveillance. Planar radioiodine imaging, in the form of the whole-body scan (WBS) and posttherapy scan (PTS), is a fundamental tool in differentiated thyroid cancer management. Continued controversy remains over the utility of WBS in a variety of patient risk groups and clinical scenarios. Proponents on both sides of the arguments compare WBS with PTS, thyroglobulin, and other imaging modalities with differing results. The paucity of large, randomized, prospective studies results in dependence on consensus

[Guidelines for the diagnosis and management of thyroid disease and their utility].

Science.gov (United States)

Hashimoto, Koshi; Mori, Masatomo

2012-11-01

Thyroid dysfunction is a common disorder in daily clinical practice, however due to unspecific and diverse symptoms of the disease, it is sometimes hard to make a definite diagnosis. Japan thyroid association (JTA) published 'Guideline for the diagnosis of thyroid disease, 2010' and it is open to the public on the JTA website(http : //www.japanthyroid.jp/doctor/ guideline/japanese.html). English version of the guideline is also available. JTA also published 'Guideline for the management of subclinical hypothyroidism 2008' and 'Guideline for the diagnosis of thyroid storm, version 2'. The latter in English version has been published in Thyroid(http : //www.ncbi.nlm.nih.gov/pubmed/22494618). The utility of these guidelines is discussed.

Thyroid remnant ablation success and disease outcome in stage III or IV differentiated thyroid carcinoma: recombinant human thyrotropin versus thyroid hormone withdrawal.

Science.gov (United States)

Vallejo Casas, Juan A; Mena Bares, Luisa M; Gálvez Moreno, Maria A; Moreno Ortega, Estefanía; Marlowe, Robert J; Maza Muret, Francisco R; Albalá González, María D

2016-06-01

Most publications to date compare outcomes after post-surgical thyroid remnant ablation stimulated by recombinant human thyrotropin (rhTSH) versus thyroid hormone withholding/withdrawal (THW) in low-recurrence risk differentiated thyroid carcinoma (DTC) patients. We sought to perform this comparison in high-risk patients. We retrospectively analyzed ~9-year single-center experience in 70 consecutive adults with initial UICC (Union for International Cancer Control) stage III/IV, M0 DTC undergoing rhTSH-aided (N.=54) or THW-aided (N.=16) high-activity ablation. Endpoints included ablation success and DTC outcome. Assessed ≥1 year post-ablation, ablation success comprised a) no visible scintigraphic thyroid bed uptake or pathological extra-thyroidal uptake; b) undetectable stimulated serum thyroglobulin (Tg) without interfering autoantibodies; c) both criteria. DTC outcome, determined at the latest visit, comprised either 1) "no evidence of disease" (NED): undetectable Tg, negative Tg autoantibodies, negative most recent whole-body scan, no suspicious findings clinically, on neck ultrasonography, or on other imaging; 2) persistent disease: failure to attain NED; or 3) recurrence: loss of NED. After the first ablative activity, ablation success by scintigraphic plus biochemical criteria was 64.8% in rhTSH patients, 56.3% in THW patients (P=NS). After 3.5-year versus 6.2-year median follow-up (P<0.05), DTC outcomes were NED, 85.2%, persistent disease, 13.0%, recurrence, 1.9%, in the rhTSH group and NED, 87.5%, persistent or recurrent disease, 6.3% each, in the THW group (P=NS). In patients with initial stage III/IV, M0 DTC, rhTSH-aided and THW-assisted ablation were associated with comparable remnant eradication or DTC cure rates.

Interrelation specific autoimmune pathologies of a thyroid gland with inorganic autoimmune rheumatic diseases

Directory of Open Access Journals (Sweden)

O V Paramonova

2012-03-01

Full Text Available The problem of a pathology of a thyroid gland at rheumatic diseases, in particular at rheumatoid arthritis, remains actual and to this day. The work purpose was studying antitelogenesis to thyroid hormones at patients with mixt autoimmune pathology. In whey of blood of patients with RA and autothyroid pathology are found out antibodies (AB to Т3 and Т4, their concentration correlates with activity of pathological process. It is shown, that level AB to Т3 and Т4 authentically differs from the maintenance of the given antibodies in whey of blood of healthy faces. Level of antibodies to thyroid hormones can be considered as the criterion predicting development of pathology of a thyroid gland at patients with RA.

"PREVALENCE OF AUTOANTIBODIES TO THYROID PEROXIDASE AND AUTOIMMUNE THYROID DISEASE IN TYPE I DIABETES MELLITUS"

Directory of Open Access Journals (Sweden)

H. Moayeri A. Rabbani

2004-09-01

Full Text Available Type I diabetes mellitus (DM is frequently associated with autoimmune thyroid disease (ATD. Association of ATD and type I DM has been described with varying frequencies but there is still debate about the situation in the Iranian population. We investigated the prevalence of anti thyroid peroxidase (anti-TPO antibodies and ATD in children and adolescents with type I DM. A total of 145 patients with type I DM were participated in this study. They were screened for anti-TPO antibodies and TSH levels. Signs and symptoms of hypothyroidism and hyperthyroidism and the presence of goiter were sought. A group of 50 healthy unrelated girls and boys aged 11-16 years served as controls. Anti-TPO antibodies were found in 34 (23.4% diabetic patients and 1 subject (2% in the control group (P<0.001. Frequency of anti TPO antibodies was significantly higher in girls than boys (P<0.05. We failed to show any significant correlation between thyroid autoimmunity and duration of DM. We found that younger patients at diagnosis are more likely to be anti-TPO negative (P<0.001. Out of 145 diabetic patients, 32 (22% had visible goiter. Subclinical hypothyroidism, hypothyroidism and thyrotoxicosis occurred in 1, 9 and 1 patients, respectively. Visible goiter was found in 2 subjects (4% of the control group, but all of them were euthyroid. In conclusion, the evaluation of thyroid autoimmunity in type I diabetic patients may improve the diagnosis of thyroid disease in early stages. Yearly examination of anti-TPO antibodies allows identifying diabetic patients with thyroid autoimmunity.

Role of serum thyroglobulin levels in the assessment of thyroid disease (abstract)

International Nuclear Information System (INIS)

Abbas, H.G.; Khan, M.S.

1998-01-01

Thyroglobulin (Tg), a glycoprotein, is the principal iodoprotein of the thyroid gland and is the major component of the thyroid mass. As Tg is specific to thyroid gland and thyroid related-cells, its measurement in the circulation is potentially useful to study the pathogenesis, establish the diagnosis and follow the course of thyroid disorders. Serum Tg is a suitable marker for the differentiated thyroid carcinoma after total thyroid ablation by surgery and /sup 131/I treatment. Radioimmunoassay (RIA) and immunoradiometric (IRMA) methodologies are important to measure hormones for diagnosis of various diseases. In addition to /sup 131/I uptake, /sup 131/I whole body scintigraphy and estimation of T3, T4 and TSH levels, serum Tg levels in euthyroids (n=42), hyper thyroids (n=55) and treated cases (thyroidectomy and /sup 131/I ablation) of carcinoma (CA) thyroid were 9.7 - +9.96, 109.9 - +160.3 and 2.2 - + 4.2 respectively. Serum Tg levels were significantly higher (P < 0.005) in hyper thyroids and significantly lower (P < 0.025) in treated CA thyroids when compared with those of euthyroids. In treated patients (surgery and /sup 131/I ablation) serum Tg assay is an excellent method to assess the treatment and recurrence of disease. (author)

Immune thrombocytopenia and autoimmune thyroid disease: a controversial overlap.

Science.gov (United States)

Marta, Guilherme Nader; de Campos, Fernando Peixoto Ferraz

2015-01-01

Immune thrombocytopenia (ITP) is an entity characterized by a platelet count of less than 100 × 10(9)/L in the absence of other causes of thrombocytopenia, such as viral infections, rheumatic diseases, or drugs. Grave's disease is also an autoimmune condition in which thrombocytopenia is often observed. Moreover, in the literature, many reports show a marked interference of the thyroid dysfunction (mainly hyperthyroidism) in the control of thrombocytopenia. Although this issue still remains debatable, the authors report the case of a young woman with a previous diagnosis of ITP with a brilliant initial response to corticotherapy. Some years after this diagnosis, the patient presented thyrotoxicosis due to Grave's disease and the thrombocytopenia relapsed, but this time there was no response to the glucocorticoids. Only after the radioiodine I-131 thyroid ablation the control of thrombocytopenia was achieved. The authors call attention to this overlap and for testing thyroid function in every patient with an unexpected negative response to corticotherapy.

Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison's disease with primary hypothyroidism.

Science.gov (United States)

Sahoo, Jaya Prakash; Selviambigapathy, Jayakumar; Kamalanathan, Sadishkumar; Nagarajan, K; Vivekanandan, Muthupillai

2016-01-01

Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT) in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab) titer in Addison's disease with primary hypothyroidism. This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L) and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical) was defined as high thyroid stimulating hormone (TSH) with/without low free thyroxine (fT4). TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations.

First reported case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland.

Science.gov (United States)

Chen, Louis C; Green, Jennifer B

2011-06-01

Unilateral Graves' disease is a rare disease variant that can occur in a bilobar thyroid gland. We report the first documented case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland and review the pertinent literature. A 48-year-old man presented in June 2010 with thyrotoxicosis. I-131 radioisotope uptake was elevated at 33.4%, and scintigraphy revealed that uptake of the radioisotope was uniformly increased in the left lobe of the thyroid gland. Ultrasonography of the thyroid gland revealed a non-nodular, enlarged, and heterogeneous left lobe; Doppler investigation of the lobe showed hypervascularity classically seen in Graves' disease. The right lobe of the thyroid, on the other hand, appeared homogeneous and hypovascular on ultrasonography. Thyroid-stimulating immunoglobulin was significantly elevated at 191% (reference range disease was the most likely diagnosis. As has occasionally been described in the literature, unilateral involvement of the thyroid gland is a rare presentation of Graves' disease. Pre-existing functional or structural differences (either congenital or acquired) between the two lobes may contribute to this rare presentation. To our knowledge, this is the first reported case of unilateral Graves' disease presenting in the left lobe of a bilobar thyroid gland. Although the pathophysiology of unilateral Graves's disease has not been clearly elucidated, clinicians should be aware that Graves' disease can present unilaterally in either lobe of the thyroid gland.

Role of Nuclear Medicine in the Diagnosis of Benign Thyroid Diseases.

Science.gov (United States)

Garberoglio, Sara; Testori, Ornella

2016-01-01

A deep understanding of thyroid pathophysiology is the basis for diagnosing and treating benign thyroid diseases with radioactive materials, known as radiopharmaceuticals, which are introduced into the body by injection or orally. After the radiotracer administration, the patient becomes the emitting source, and several devices have been studied to detect and capture these emissions (gamma or beta-negative) and transform them into photons, parametric images, numbers and molecular information. Thyroid scintigraphy is the only technique that allows the assessment of thyroid regional function and, therefore, the detection of areas of autonomously functioning thyroid nodules. Scintigraphy visualizes the distribution of active thyroid tissue and displays the differential accumulation of radionuclides in the investigated cells, thus providing a functional map. Moreover, this technique is a fundamental tool in the clinical and surgical management of thyroid diseases, including: single thyroid nodules with a suppressed thyroid-stimulating hormone level, for which fine-needle aspiration biopsy (FNAB) is used to identify hot nodules; multinodular goiters, especially larger ones, to identify cold or indeterminate areas requiring FNAB and hot areas that do not need cytologic evaluation, and to evaluate mediastinal extension; the diagnosis of ectopic thyroid tissue; subclinical hyperthyroidism to identify occult hyperfunctioning tissue; follicular lesions to identify a functioning cellular adenoma that could be benign, although such nodules are mostly cold on scintigraphy; to distinguish low-uptake from high-uptake thyrotoxicosis, and to determine eligibility for radioiodine therapy. © 2016 S. Karger AG, Basel.

High prevalence of thyroid disease and role of salivary gland scintigraphy in patients with xerostomia

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Jung, Ji Hoon; Lee, Chang Hee; Son, Seung Hyun; Jeong, Ju Hye; Jeong, Shin Young; Lee, Sang Woo; Lee, Jae Tae; Ahn, Byeong Cheol [Dept. of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, Daegu (Korea, Republic of)

2017-06-15

Although Sjös syndrome (SS) is the most common disease causing xerostomia, autoimmune thyroid diseases can also affect the salivary glands. The aim of our study was to estimate the prevalence of thyroid diseases (TD) in subjects with symptoms of xerostomia and evaluate the efficacy of salivary gland scintigraphy (SGS) in the detection of TD in patients with SS and without SS. We retrospectively reviewed the SGS findings of 173 subjects (men:women, 29:144) with symptoms of xerostomia. Ejection fractions (EF) in the parotid and submandibular glands were calculated. Thyroid disease was diagnosed on the basis of the results of the visual assessment of tracer uptake in the thyroid gland on SGS images as well as serological thyroid function tests. Based on the American-European Criteria, 94 patients were diagnosed with SS. Hashimoto's thyroiditis was diagnosed in 63 patients, subacute thyroiditis in 23, subclinical hypothyroidism in five, and Graves' disease in one. There were significant differences in the EF values of the parotid and submandibular glands between patients with TD and those with undetermined diagnoses. More than half of patients with xerostomia exhibited TD. Thyroid assessment by SGS is feasible, and SGS appears to be useful for the patients with xerostomia caused by TD. SGS may be the first imaging modality capable of evaluating both salivary gland function and thyroid gland status in patients with xerostomia. This strategy would make the requirement for additional workup for thyroid disease.

High prevalence of thyroid disease and role of salivary gland scintigraphy in patients with xerostomia

International Nuclear Information System (INIS)

Jung, Ji Hoon; Lee, Chang Hee; Son, Seung Hyun; Jeong, Ju Hye; Jeong, Shin Young; Lee, Sang Woo; Lee, Jae Tae; Ahn, Byeong Cheol

2017-01-01

Although Sjös syndrome (SS) is the most common disease causing xerostomia, autoimmune thyroid diseases can also affect the salivary glands. The aim of our study was to estimate the prevalence of thyroid diseases (TD) in subjects with symptoms of xerostomia and evaluate the efficacy of salivary gland scintigraphy (SGS) in the detection of TD in patients with SS and without SS. We retrospectively reviewed the SGS findings of 173 subjects (men:women, 29:144) with symptoms of xerostomia. Ejection fractions (EF) in the parotid and submandibular glands were calculated. Thyroid disease was diagnosed on the basis of the results of the visual assessment of tracer uptake in the thyroid gland on SGS images as well as serological thyroid function tests. Based on the American-European Criteria, 94 patients were diagnosed with SS. Hashimoto's thyroiditis was diagnosed in 63 patients, subacute thyroiditis in 23, subclinical hypothyroidism in five, and Graves' disease in one. There were significant differences in the EF values of the parotid and submandibular glands between patients with TD and those with undetermined diagnoses. More than half of patients with xerostomia exhibited TD. Thyroid assessment by SGS is feasible, and SGS appears to be useful for the patients with xerostomia caused by TD. SGS may be the first imaging modality capable of evaluating both salivary gland function and thyroid gland status in patients with xerostomia. This strategy would make the requirement for additional workup for thyroid disease

Clinic-cytologic study of conjunctivochalasis and its relation to thyroid autoimmune diseases: prospective cohort study.

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de Almeida, Sandra Flavia Fiorentini; de Sousa, Luciene B; Vieira, Luis A; Chiamollera, Maria I; Barros, Jeison de N

2006-08-01

To determine the prevalence of conjunctivochalasis in patients with immune thyroid diseases, to determine whether there is any association between the 2 diseases, and to determine cytologic study of conjunctivochalasis through the cytology impression test. A clinical prospective cohort study carried out by the External Diseases Department in the Ophthalmology Sector and the Thyroid Department in the Endocrinology Sector at Federal University of Sao Paulo (UNIFESP). The patients included were divided into 2 groups following these inclusion criteria: a control group of 25 patients without thyroid diseases, confirmed after clinical and laboratory examinations (thyroid hormones), or any other ocular diseases. The study group consisted of 31 patients with thyroid diseases, the diagnosis of which was confirmed by the Endocrinology Sector. The thyroidopathies included were autoimmune diseases but excluded nonautoimmune diseases. A protocol endorsed by the UNIFESP was followed, using clinical and ophthalmological history, biomicroscopy, and impression cytology. Fifty-two percent of patients without thyroid diseases and 88% of patients with thyroid diseases presented with conjunctivochalasis. The risk ratio was 1.705 (Pr > chi(2) = 0.0038), indicating that there is an association between them. For the impression cytology in inferior bulbar conjunctiva, there was an association between the result of the impression cytology and conjunctivochalasis (Pearson chi(2) = 10.1190 Pr = 0.006). The prevalence of conjunctivochalasis in patients with autoimmune thyroid diseases was 88%. Patients with autoimmune thyroidopathy presented higher percentages of conjunctivochalasis than the control group, confirming the association between them. The cytologic study showed the highest prevalence of abnormal surface features in eyes with conjunctivochalasis.

Cancer incidence and thyroid disease among Estonian Chernobyl clean-up workers

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Auvinen, A; Salomaa, S [eds.; Radiation and Nuclear Safety Authority, Helsinki (Finland); Rahu, M; Veidebaum, T; Tekkel, M [eds.; Inst. of Experimental and Clinical Medicine, Tallinn (Estonia); Hakulinen, T [ed.; Finnish Cancer Registry, Helsinki (Finland); Boice, Jr, J D [ed.; Int. Epidemiology Inst., MD (United States)

1998-09-01

The report describes the development and summarizes the results of the project Cancer incidence and thyroid disease among Estonian Chernobyl clean-up workers. One of the goals of the report is to give research protocols and questionnaires for researchers involved in other studies. Eight previously published articles are also included summarizing the results. The development of the collaboration work of the project is described in the introduction of the report. Epidemiological methods are described in an article complemented by the protocol and English version of the questionnaire administered to all cleanup workers, as well as the data collection form of the thyroid study. The results from biological biodosimetry using both glycophorin A and FISH methods have shown that the radiation doses received by the Chernobyl cleanup workers were relatively low. Thyroid nodularity was not associated with any radiation exposure characteristic in the thyroid screening study. Estonian Chernobyl cleanup workers were followed up for cancer incidence through the Estonian Cancer Registry. No cases of leukemia or thyroid cancer were observed by the end of 1993. It is too early to observe possible effect on other types of cancer. However, mortality from suicides was increased compared with general population. Further follow-up and the extension to other Baltic countries in the future will undoubtedly strengthen the study. There are also plans for future projects covering areas from psychosocial factors to radiation biology

Fetal microchimeric cells in autoimmune thyroid diseases: harmful, beneficial or innocent for the thyroid gland?

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Lepez, Trees; Vandewoestyne, Mado; Deforce, Dieter

2013-01-01

Autoimmune thyroid diseases (AITD) show a female predominance, with an increased incidence in the years following parturition. Fetal microchimerism has been suggested to play a role in the pathogenesis of AITD. However, only the presence of fetal microchimeric cells in blood and in the thyroid gland of these patients has been proven, but not an actual active role in AITD. Is fetal microchimerism harmful for the thyroid gland by initiating a Graft versus Host reaction (GvHR) or being the target of a Host versus Graft reaction (HvGR)? Is fetal microchimerism beneficial for the thyroid gland by being a part of tissue repair or are fetal cells just innocent bystanders in the process of autoimmunity? This review explores every hypothesis concerning the role of fetal microchimerism in AITD.

2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer

Science.gov (United States)

Alexander, Erik K.; Bible, Keith C.; Doherty, Gerard M.; Mandel, Susan J.; Nikiforov, Yuri E.; Pacini, Furio; Randolph, Gregory W.; Sawka, Anna M.; Schlumberger, Martin; Schuff, Kathryn G.; Sherman, Steven I.; Sosa, Julie Ann; Steward, David L.; Tuttle, R. Michael; Wartofsky, Leonard

2016-01-01

, and thyrotropin suppression therapy using levothyroxine. Recommendations related to long-term management of differentiated thyroid cancer include those related to surveillance for recurrent disease using imaging and serum thyroglobulin, thyroid hormone therapy, management of recurrent and metastatic disease, consideration for clinical trials and targeted therapy, as well as directions for future research. Conclusions: We have developed evidence-based recommendations to inform clinical decision-making in the management of thyroid nodules and differentiated thyroid cancer. They represent, in our opinion, contemporary optimal care for patients with these disorders. PMID:26462967

Clinical significance of determination of serum TRAb levels in patients with thyroid diseases

International Nuclear Information System (INIS)

Wu Lijian; Tang Bing; Yang Chunying; Lin Jun

2005-01-01

Objective: To investigate the clinical Significance of determination of serum thyroid stimulating hormone receptor antibody (TRAb) levels in patients with thyroid diseases, especially in patients with Graves' disease. Methods: Serum TRAb levels were determined with radio-receptor assay (RRA) in 302 patients with various thyroid diseases and 52 controls. Results: In patients with Graves' disease before treatment (n=62) the positive rate of TRAb was 86.3%. In patients with Graves' diseases improved after treatment (n=60), the positive rate was 74.5%; in those clinically cured (n=68) the positive rate was 32.1%. In 58 patients with Graves' disease who relapsed after apparently cure, the positive rate of TRAb rose to 90.3 %. However, there were no positive TRAb cases in 23 patients with simple goiter and 31 patients with benign thyroid adenomas. Also, there were no positive TRAb cases in the controls. Conclusion: TRAb levels correspond well with the severity of Graves' disease. (authors)

Radioiodine therapy of autonomously functioning thyroid nodules and of Graves' disease

International Nuclear Information System (INIS)

Guhlmann, C.A.; Rendl, J.; Boerner, W.

1995-01-01

We studied the effects of radioiodine therapy (RIT) for autonomously functioning thyroid nodules (AFTNs) and Graves' disease on thyroid function and size up to one year after RIT. In 230 patients with AFTNs, a dose of 300 Gy was effective in about 90% of the cases 6 months after RIT. Out of 65 patients suffering from Graves' disease, 5 patients (8%) had persisting hyperthyroidism 6 months after RIT with a dose of 150 Gy. This group consisted exclusively of patients with manifest hyperthyroidism at the time of RIT. As determined by ultrasonography 6 months after RIT, a reduction of thyroid size by about 40% and 60% was observed in patients with AFTNs and Graves' disease, respectively. (orig.) [de

Apoptotic study in Graves disease treated with thyroid arterial embolization

International Nuclear Information System (INIS)

Zhao Wei; Gao Bulang; Yi Genfa

2009-01-01

The objective of this study was to investigate apoptosis in the thyroid of Graves disease (GD) induced by thyroid arterial embolization. Forty one patients with clinically and laboratorily ascertained GD were treated with thyroid arterial embolization and followed up for 3-54 months following embolization. Prior to embolization and at 1, 3, 6, 12 and 36 months following embolization, thyroid autoimmune antibodies were tested respectively, including thyroid stimulating antibody (TSAb), thyroglobulin antibody (TGAb) and thyroid microsomal antibody (TMAb). Thyroid biopsy was performed under the guidance of computed tomography for immunohistochemistry examination using semi-quantity analysis. The positive staining of Fas and FasL was mostly in the cytoplasma and cell membrane, the positive expression of Bax was mainly in the cytoplasma, and no positive expression of P53 was detected in the thyroid cells before embolization. After arterial embolziation, the positive cell number and staining degree of these genes were both greater than before embolization. The treatment method of thyroid arterial embolization can effectively enhance the positive expression of pro-apoptotic genes of Fas, FasL, Bax, Bcl-2 and P53 in GD thyroid, thus promoting apoptosis of GD thyroid and helping restore the thyroid size and function to normal conditions. (author)

Anti-thyroid drugs in pediatric Graves′ disease

Directory of Open Access Journals (Sweden)

Mathew John

2015-01-01

Full Text Available Graves′ disease is the most common cause of hyperthyroidism in children. Most children and adolescents are treated with anti-thyroid drugs as the initial modality. Studies have used Methimazole, Carbimazole and Propylthiouracil (PTU either as titration regimes or as block and replacement regimes. The various studies of anti-thyroid drug (ATD treatment of Graves′ disease in pediatric patients differ in terms of the regimes, remission rate, duration of therapy for adequate remission, follow up and adverse effects of ATD. Various studies show that lower thyroid hormone levels, prolonged duration of treatment, lower levels of TSH receptor antibodies, smaller goiter and increased age of child predicted higher chance of remission after ATD. A variable number of patients experience minor and major adverse effects limiting initial and long term treatment with ATD. The adverse effects of various ATD seem to more in children compared to that of adults. In view of liver injury including hepatocellular failure need of liver transplantation associated with PTU, the use has been restricted in children. The rate of persistent remission with ATD following discontinuation is about 30%. Radioactive iodine therapy is gaining more acceptance in older children with Graves′s disease in view of the limitations of ATD. For individual patients, risk-benefit ratio of ATD should be weighed against benefits of radioactive iodine therapy and patient preferences.

Thyroid diseases and Ramadan

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Syed A Raza; Osama Ishtiaq; A G Unnikrishnan; A K Azad Khan; Jamal Ahmad; Mohammed A Ganie; Kishwar Azad; Manash Baruah; Md Faruque Pathan

2012-01-01

In the month of Ramadan, patients with thyroid diseases, most of the time, do not need treatment adjustments and can fast safely without any health hazards. Patients with hypothyroidism taking thyroxine can take their tablets on an empty stomach at bedtime instead of half an hour before Sehr. Patients with hyperthyroidism, on methimazole/carbimazole can continue their dose in once or twice daily regimes, while those on propylthiouracil need to be switched. Hyperthyroid patients with severe sy...

The role of thyroid scanning in hyperthyroidism

International Nuclear Information System (INIS)

Fogelman, I.; Cooke, S.G.; Maisey, M.N.

1986-01-01

Radionuclide thyroid imaging was performed in 872 consecutive patients with hyperthyroidism. Of these, 84% were found to have diffuse toxic hyperplasia (Graves' disease), while 12% had autonomously functioning nodules (Plummer's disease), 3% had Graves' disease developing in a multinodular gland, and in the remaining 1%, either a clear diagnosis could not be established or the hyperthyroidism was due to thyroiditis or the Jod-Basedow phenomenon. It was found that a thyroid scan seldom provides additional diagnostic information in patients with Graves' disease when a diffuse goitre is present. However, if patients are to be treated with radioiodine ( 131 I), thyroid imaging with tracer quantitation can replace a 24-h 131 I uptake measurement, this having the advantages that the patients are required to attend only once, and that the gland size can be measured. In addition, visual confirmation of tracer uptake by the thyroid is obtained and patients with thyroiditis will not receive inappropriate therapy. When single or multiple thyroid nodules are palpated, a thyroid scan is crucial in establishing an accurate diagnosis, as it is not otherwise possible to differentiate between Plummer's disease and Graves' disease developing in a multinodular gland. Indeed, in 20 of our 63 patients (32%) with single autonomously functioning nodules, the initial clinical assessment had been incorrect. (orig.)

Comparison of Na{sup +}/I{sup -} symporter expression rate in malignant and benign thyroid diseases: immunohistochemical study

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Kang, Do Young; Jeong, Young Jin; Lee, Kyung Eun; Park, Heon Soo; Yoo, Young Hyun; Roh, Mee Sook [Donga University College of Medicine, Busan (Korea, Republic of)

2006-02-15

Previous studies have not showed consistent results for the level of expression of sodium/iodide symporter (NIS) in thyroid diseases, especially malignant tumor. We undertook this study to evaluate the distribution of NIS expression in malignant thyroid diseases and compare with that in benign thyoid disease. Total patients were 119 cases (Men 15, 48{+-}13 yrs). Total number of samples were 205 pieces. In malignant thyroid disease, there were 153 samples: 90 in papillary carcinoma, 4 in follicular carcinoma, 2 in medullary carcinoma and 57 in metastatic lymph node. In benign thyroid disease, there were 52 samples: 36 in goiter/cyst, 11 in thyroiditis and 5 in follicular adenoma. Using immunohistochemical methods, we probed 205 samples with monoclonal anti-NIS Ab. Grading of staining was scored as 0 (negative or absent), 1 (weakly positive), 2 (moderately positive) or 3 (strongly positive). Expression rate (ER) of NIS positivity in individual disease entity was expressed as percentage of total number divided by number in 2 plus 3 grade. ERs of malignant thyroid diseases were 63% in papillary carcinoma, 81% in metastatic lymph node, 71% in follicular carcinoma and 100% in medullary carcinoma. ERs of benign thyroid disease were 53% in goiter/cyst, 64% in thyroiditis and 40% in follicular adenoma. ER of benign thyroid deceases was higher than benign thyroid diseases (71% vs 54%). Grading of NIS expression in papillary carcinoma or goiter/cyst was heterogeneously distributed in considerable cases. Normal tissue also showed heterogeneous distribution or NIS expression, which was not correlated with that of primary lesion. In papillary thyroid carcinoma, distribution of NIS expression was heterogeneous and increased, and not different compared with that of benign thyroid disease.

Thyroid Autoimmunity and Behçet’s Disease: Is There a Significant Association?

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Filiz Cebeci

2013-01-01

Full Text Available Background. Behcet’s disease (BD could be regarded as an autoimmune disease in many aspects. Autoimmune thyroid disease (ATD is frequently accompanied by other various autoimmune diseases. Nevertheless, there is not still enough data showing the association between BD and ATD. In addition, no controlled study is present in the PubMed, which evaluates thyroidal autoimmunity using antithyroid peroxidase antibody in a large series of patients with BD. Methods. We aimed to investigate the frequency of ATD in patients with BD. The study included 124 patients with BD and 99 age- and sex-matched healthy volunteers. Results. Autoimmune thyroiditis was noted in 21 cases (16.9% with BD. In the control group, 22 cases (22.22% were diagnosed as autoimmune thyroiditis. There was no difference between the groups in respect to thyroid autoantibodies (. There were no statistically significant differences between baseline TSH levels of the BD patients and of the controls (. Statistically, the mean serum free T4 levels of the patients with BD were higher than those of the controls (. Conclusions. No association could be found between BD and ATD. Therefore, it is not of significance to investigate thyroid autoimmunity in BD.

Thyroid Storm Triggered by Strangulation in a Patient with Undiagnosed Graves’ Disease

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Jorge I. Conte

2018-01-01

Full Text Available Thyroid storm is the life-threatening end-organ manifestation of severe thyrotoxicosis. If left untreated, thyroid storm may cause acute heart failure, multiorgan dysfunction, and death. A high degree of suspicion is necessary to make the diagnosis and start antithyroid medications to decrease mortality. Thyroid storm is generally seen in patients with Graves’ disease but should also be suspected in patients with fever, tachycardia, altered mental status, and risk factors including local trauma to the neck, such as strangulation. Based on our review, we report the first case of thyroid storm after strangulation as the presentation of previously undiagnosed Graves’ disease.

A study on thyroid disorder of Sjoegren's disease in atomic bomb survivors in Hiroshima

International Nuclear Information System (INIS)

Noma, Koji; Sasaki, Hideo; Ito, Chikako; Hasegawa, Kazuyo.

1984-01-01

Thyroid disorders were seen in eight of 25 atomic bomb survivors with Sjoegren's disease -- simple goiter in 2, chronic thyroiditis in 4, and primary hypothyroidism probably arising from chronic thyroiditis in 2. Thyroid disorders associated with Sjoegren's disease seemed to occur frequently in survivors exposed near the explosion. One of the two survivors with primary hypothyroidism had been exposed to atomic bomb 1.7 km from the explosion. As for the other clinical laboratory findings, there was no significant difference between the group with thyroid disorders and the group without them. (Namekawa, K.)

Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison's disease with primary hypothyroidism

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Sahoo, Jaya Prakash; Selviambigapathy, Jayakumar; Kamalanathan, Sadishkumar; Nagarajan, K.; Vivekanandan, Muthupillai

2016-01-01

Background: Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT) in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab) titer in Addison's disease with primary hypothyroidism. Materials and Methods: This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L) and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical) was defined as high thyroid stimulating hormone (TSH) with/without low free thyroxine (fT4). TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Results: Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. Conclusions: The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations. PMID:27042409

An Observation of Ultrasonographic Findings in Thyroid Disease

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Lee, Jun Bae; Chung, Chun Phil; Kim, Dong Won; Kim, Byung Soo [Busan National University College of Medicine, Busan (Korea, Republic of)

1983-09-15

The authors analyzed ultrasonographically the total 45 cases of thyroid disease verified by historical diagnosis, functional diagnosis, and morphological diagnosis at the Department of Radiology, Busan National University Hospital from June to September 1982. The results obtained were as follows: 1. In the sex distribution female was 38 cases (84.4%), and male 7 cases (15.6%). The second, third, and fourth decades of age (78.0%) were most prevalent. 2. Among the total 45 cases thyroid adenoma was 24 cases (53.3%), nodular hyperplasia cases (17.7%), thyroid carcinoma 7 cases (15.6%), diffuse hyperplsia 3 cases (6.7%), Hashimoto's thyroiditis 1 cases (2.2%), subacute thyroiditis 1 cases (2.2%), tuberculous thyroiditis 1 case (2.2%) in orders. 3. On ultrasonogram, total 24 cases of thyroid adenoma showed a single nodule in 24 cases (100.0%), smooth outer margin in 23 cases (95.8%), capsular echo in 23 cases (95.8%), pure cystic nodule in 4 cases (16.7%), and increased echogenicity in 17 cases (85.0%) among the 20 cases exclude that pure cystic nodules. 4. Total 7 cases of thyroid carcinoma showed no capsular echo in 4 cases (57.1%), irregular outer margin in 4 case (57.1%), no pure cystic nodule in all cases, and enlargement of metastatic lymphnode in 4 cases (57.1%). 5. Total 8 cases of nodular hyperplasia showed enlargement of thyroid gland and multiple nodule in 8 cases (100.0%), and increased echogenicity in 7 cases (87.5%). 6. Total 3 cases of diffuse hyperplasia showed enlargement of thyroid gland and increased echogenicity in 3 cases (100.0%). 7. Total 3 cases of thyroiditis showed decreased echogenicity in 3 cases (100.0%) and enlargement of thyroid gland in 2 cases (66.7%). 8. The cold area visualized on radionuclide scan could be differentiated from a solid mass and cystic one by ultrasonogram.

Development of criteria for evaluating clinical response in thyroid eye disease (CRI-TED) using a modified Delphi technique

Science.gov (United States)

Douglas, Raymond S.; Tsirbas, Angelo; Gordon, Mark; Lee, Diana; Khadavi, Nicole; Garneau, Helene Chokron; Goldberg, Robert A.; Cahill, Kenneth; Dolman, Peter J.; Elner, Victor; Feldon, Steve; Lucarelli, Mark; Uddin, Jimmy; Kazim, Michael; Smith, Terry J.; Khanna, Dinesh

2014-01-01

To identify components of a provisional clinical response index for thyroid eye disease (CRI-TED) using a modified Delphi technique. The International Thyroid Eye Disease Society (ITEDS) conducted a structured, 3-round Delphi exercise establishing consensus for a core set of measures for clinical trials in TED. The steering committee discussed the results in a face-to-face meeting (nominal group technique) and evaluated each criterion with respect to its feasibility, reliability, redundancy, and validity. Redundant measures were consolidated or excluded. Criteria were parsed into 11 domains for the Delphi surveys. Eighty four respondents participated in the Delphi-1 survey, providing 220 unique items. Ninety- two members (100% of the respondents from Delphi 1 plus eight new participants) responded in Delphi-2 and rated the same 220 items. Sixty-four members (76% of participants) rated 153 criteria in Delphi-3 (67 criteria were excluded due to redundancy). Criteria with a mean greater than 6 (1 least appropriate to 9 most appropriate) were further evaluated by the nominal group technique and provisional core measures were chosen. Using a Delphi exercise, we developed provisional core measures for assessing disease activity and severity in clinical trials of therapies for TED. These measures will be iteratively refined for use in multicenter clinical trials. PMID:19752424

The role of diffusion weighted MR imaging for differentiation between Graves' disease and Hashimoto thyroiditis.

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Ozturk, T; Bozgeyik, Z; Ozturk, F; Burakgazi, G; Akyol, M; Coskun, S; Ozkan, Y; Ogur, E

2015-08-01

The aim of this study was to evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DWMRI) for differentation between Graves' disease and Hashimoto's thyroiditis. Fifty patients (27 Graves diseases and 23 Hashimoto thyroiditis) and twenty healthy volunteers were examined using T1, T2 and DWMRI. The patients were diagnosed on the basis of physical findings and the results of thyroid function tests and serological tests. Circular ROIs were positioned on the bilateral thyroid lobes and isthmus. All measurements were repeated three different b values including 100, 600 and 1000 s/mm2 in all cases. ADC (Apparent diffusion coefficient) maps were calculated automatically with the MR system. Mean ADC values were 2.93 × 10-3, 1.97 × 10-3 and 1.62 × 10-3 mm2/s in the healthy volunteers; 3.47 × 10-3, 2.25 × 10-3 and 1.64 × 10-3 mm2/s in Graves' disease; 2.53 × 10-3, 1.76 × 10-3, 1.28 × 10-3 mm2/s in Hashimoto thyroiditis for b100, b600 and b1000, respectively. The ADC values of the Graves diseases were higher than healty volunteers and Hashimoto thyroiditis. ADC values were statistically significant for differentation between Hashimoto thyroiditis and Graves' disease all b values (p Hashimoto thyroiditis and Graves' disease.

Differential diagnosis of thyroid diseases with 131I and 201TlCl scintigraphy

International Nuclear Information System (INIS)

Kumano, Machiko; Ishida, Osamu

1979-01-01

Scintigraphic study with 131 I and 201 TlCl was performed on the differential diagnosis of various kinds of thyroid disease. When thyroid nodules are cold by scintigraphy with 131 I and hot with 201 TlCl, the lesions were proved to be solid tumor, that is, mostly follicular adenoma and carcinoma, and also most probably chronic thyroiditis. Accumulation of 201 TlCl, however, is not observed in cystic lesions, and is very high with high frequency in metastatic lesion of the lymph nodes as well as the thyroid cancer, especially in well differentiated follicular carcinoma. Therefore 201 TlCl was very useful to confirm the metastatic tumors from the thyroid cancer. These features in accumulation of 131 I and 201 TlCl in thyroid disease suggest the imaging technique with 201 TlCl combined with 131 I seem to provide more pathological information on the thyroid and metastatic lesions. (author)

Thyroid nodular disease: their usefulness of diagnostic methods

International Nuclear Information System (INIS)

Mendez Ayala, Irene Maria; Sanchez Luthard, Maria de los Angeles; Martins Schmitz; Gomez, Silvia

2009-01-01

The thyroid nodular disease is defined by the presence of nodules of thyroid of solid, liquid or mixed consistency, they are or non concrete. Solitary nodule thyroid, diffuse and multinodular goiter forms can be presented in. The thyroid nodule is a frequent clinical problem, the clinical prevalence in adult population is of 4%. Objective: to make a bibliographical revision to near the utility of the different methods available for the thyroid nodular pathology diagnosis and determining which of them turns out more specific to differentiate benignancy from malignancy in the found nodules. Materials and Methods: the bibliographical search was made in the data base Medline (Pubmed), in scientific magazines of the region and text books. Criteria of inclusion: bibliographical references pertaining to medical magazines and free full text with an antiquity nongreater to 8 years were included. Conclusion: the presence of thyroid nodules constitutes a reason for frequent consultation, the main diagnostic method at the moment is the fine needle aspiration cytology, due to its simple accomplishment, low cost, not requiring the hospitalization of the patient, and being fundamental in the decision making of the doctor. This diagnostic method is, in addition, the one that with greater certainty allows to differentiate benign from malignant nodules. (authors) [es

Identification of chosen apoptotic (TIAR and TIA-1) markers expression in thyroid tissues from adolescents with immune and non-immune thyroid diseases

International Nuclear Information System (INIS)

Bossowski, A.; Czarnocka, B.; Lyczkowska, A.; Bardadin, K.; Czerwinska, J.; Moniuszko, A.; Dadan, J.; Bossowska, A.

2010-01-01

The aim of this study was to estimate sodium iodide symporter (NIS) and thyroid peroxidase (TPO) expression in thyrocytes from patients with GD and no-toxic multi nodular goitre (NTMG) in relationship with apoptotic (TIAR and TIA-1) markers. The investigation was performed on thyroid cells isolated from post operation thyroid tissues from 15 patients aged 12-21 years old with GD and 15 cases aged 13-21 years old with NTMG. Detection of NIS and TPO was performed by immunohistochemistry. Analysis of apoptotic markers in thyroid tissues was performed using antibodies to TIAR and TIA-1 by Western Blot and immunohistochemistry. Identification of pro apoptotic TIAR and TIA-1 molecules in the thyroid tissues revealed a higher expression of both proteins in patients with Graves' disease (+++; +, respectively) in comparison to patients with NTNG (+; 0). In addition, TIAR expression was detected in three bands [p50, p42, p38 (kDa)] and TIA-1 in two bands [p22, p17 (kDa)]. using Western Blot test in patients with thyroid autoimmune diseases. In patients with NTNG expression of both apoptotic proteins was lower and identified in single bands: 42 (kDa) for TIAR and 17 (kDa) for TIA-1. The analysis of expression of NIS and TPO in thyroid follicular cells was higher in patients with Graves' disease in compared to their detection in patients with NTMG. In addition, degree of thyroid antigen expression positive correlated with amount of pro apoptotic markers (TIAR, p<0.001; TIA-1, p<0.025 for NIS; TIAR, p<0.012 for TPO). We conclude that elevated expression of NIS and TPO in Graves' disease is associated with higher stimulation and activation of apoptosis in thyroid follicular cells during autoimmune process. (authors)

Development of a Short Version of the Thyroid-Related Patient-Reported Outcome ThyPRO

DEFF Research Database (Denmark)

Watt, Torquil; Bjorner, Jakob Bue; Groenvold, Mogens

2015-01-01

BACKGROUND: Thyroid diseases affect quality of life (QoL). The Thyroid-Related Patient-Reported Outcome (ThyPRO) is an international comprehensive well-validated patient-reported outcome, measuring thyroid-related QoL. The current version is rather long-85 items. The purpose of the present study...... was to develop an abbreviated version of the ThyPRO, with conserved good measurement properties. METHODS: A cross-sectional (N = 907) and a longitudinal sample (N = 435) of thyroid patients were analyzed. A graded item response theory (IRT) model was fitted to the cross-sectional data. Short-form scales.......89-0.98), and the mean scale levels were similar. CONCLUSIONS: A 39-item version of the ThyPRO, with good measurement properties, was developed and is recommended for clinical use....

[Thyroid echogeneity as a useful tool for the differential diagnosis of hyperthyroidism in the course of Graves disease and Hashimoto thyroiditis].

Science.gov (United States)

Niedziela, M; Warzywoda, M; Korman, E

2000-01-01

Hashimoto's thyroiditis (HT) and Graves' disease (GD) constitute a spectrum of autoimmune thyroid diseases (AITD). They share an autoimmune pathogenesis, with a cellular and a humoral response to the thyroid gland. As a consequence, dysfunction of the gland itself may develop, characterized by hyperfunction in the case of GD and hypofunction in the case of HT, however at the onset of HT the hyperthyroidism might be observed as a result of a rapid destruction of thyrocytes. An abnormal thyroid echographic pattern characterized by a diffuse low echogeneity has been described in both AITD. This hypoechogeneity is due to three components: increase of intrathyroidal flow, functional changes in thyroid follicles with increased cellularity and decrease of the colloid content, resulting in the reduction of the cell/colloid interface, variable degree of lymphocytic infiltration. The first two components may be reversible during medical treatment and seem to be characteristic for GD, whereas lymphocytic infiltration may rather represent mostly HT. Here we present a 17-year-old girl with typical clinical signs of hyperthyroidism [firm goiter (II degrees), tachycardia, palpitations, nervousness, excessive sweating and tremor]. Laboratory tests were the following: fT3 - 6.59 pg/ml(increasing), fT4 - 1.99 ng/dl(increasing), TSH - 0.02 micro IU/ml(decreasing); anti-Tg-Ab - 840 IU/ml(increasing), anti-TPO-Ab - 190 IU/ml(increasing) (4 months later antithyroid antibodies were 2200 and 70, respectively). Ultrasound examination showed hypoechogeneity of the whole gland and enhanced vascular flow based on power Doppler analysis. Thyroid scan visualized the generally increased uptake of technetium. The girl was put on beta-blocker (propranolol) and later an antithyroid drug (thiamazole) was added. A course of disease was unstable, therefore the fine-needle aspiration biopsy was performed and showed the presence of single groups of normal thyrocytes and scanty colloid with no features

Concomitant Graves' disease and Hashimoto's thyroiditis, presenting as primary hypothyroidism.

LENUS (Irish Health Repository)

Cronin, C C

2012-02-03

Hypothyroidism in patients with Graves\\' disease is usually the result of ablative treatment. We describe a 58 year old man with Graves\\' ophthalmopathy and pre-tibial myxoedema, who presented with spontaneous primary hypothyroidism. Circulating TSH receptor antibody activity was increased, while thyroid microsomal antibody was detectable in titres greater than one in one hundred thousand. It is likely that the TSH receptor antibody of Graves\\' disease was ineffective in stimulating hyperthyroidism because of concomitant thyroid destruction due to Hashimoto\\'s disease. Alternatively, primary hypothyroidism could have resulted from the effects of a circulating TSH receptor blocking antibody.

Development of criteria for evaluating clinical response in thyroid eye disease using a modified Delphi technique

DEFF Research Database (Denmark)

Douglas, Raymond S; Tsirbas, Angelo; Gordon, Mark

2009-01-01

OBJECTIVE: To identify components of a provisional clinical response index for thyroid eye disease using a modified Delphi technique. METHODS: The International Thyroid Eye Disease Society conducted a structured, 3-round Delphi exercise establishing consensus for a core set of measures for clinical...... parsed into 11 domains for the Delphi surveys. Eighty-four respondents participated in the Delphi 1 survey, providing 220 unique items. Ninety-two members (100% of the respondents from Delphi 1 plus 8 new participants) responded in Delphi 2 and rated the same 220 items. Sixty-four members (76......% of participants) rated 153 criteria in Delphi 3 (67 criteria were excluded because of redundancy). Criteria with a mean greater than 6 (1 = least appropriate to 9 = most appropriate) were further evaluated by the nominal group technique and provisional core measures were chosen. CONCLUSIONS: Using a Delphi...

Breaking Tolerance to Thyroid Antigens: Changing Concepts in Thyroid Autoimmunity

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Rapoport, Basil

2014-01-01

Thyroid autoimmunity involves loss of tolerance to thyroid proteins in genetically susceptible individuals in association with environmental factors. In central tolerance, intrathymic autoantigen presentation deletes immature T cells with high affinity for autoantigen-derived peptides. Regulatory T cells provide an alternative mechanism to silence autoimmune T cells in the periphery. The TSH receptor (TSHR), thyroid peroxidase (TPO), and thyroglobulin (Tg) have unusual properties (“immunogenicity”) that contribute to breaking tolerance, including size, abundance, membrane association, glycosylation, and polymorphisms. Insight into loss of tolerance to thyroid proteins comes from spontaneous and induced animal models: 1) intrathymic expression controls self-tolerance to the TSHR, not TPO or Tg; 2) regulatory T cells are not involved in TSHR self-tolerance and instead control the balance between Graves' disease and thyroiditis; 3) breaking TSHR tolerance involves contributions from major histocompatibility complex molecules (humans and induced mouse models), TSHR polymorphism(s) (humans), and alternative splicing (mice); 4) loss of tolerance to Tg before TPO indicates that greater Tg immunogenicity vs TPO dominates central tolerance expectations; 5) tolerance is induced by thyroid autoantigen administration before autoimmunity is established; 6) interferon-α therapy for hepatitis C infection enhances thyroid autoimmunity in patients with intact immunity; Graves' disease developing after T-cell depletion reflects reconstitution autoimmunity; and 7) most environmental factors (including excess iodine) “reveal,” but do not induce, thyroid autoimmunity. Micro-organisms likely exert their effects via bystander stimulation. Finally, no single mechanism explains the loss of tolerance to thyroid proteins. The goal of inducing self-tolerance to prevent autoimmune thyroid disease will require accurate prediction of at-risk individuals together with an antigen

Leptomeningeal metastases from anaplastic thyroid carcinoma

International Nuclear Information System (INIS)

Solomon, B.; Rischin, D.; Lyons, B.; Peters, L.J.

2000-01-01

Anaplastic thyroid carcinoma is an extremely aggressive neoplasm that accounts for 1-3% of all thyroid cancers. ' Most patients have metastatic disease at presentation and die in a short period of time, often with uncontrolled local disease. We report a case of anaplastic thyroid cancer characterised by good response to initial treatment both locally and in distant metastases, and the subsequent development of refractory metastatic disease in an unusual site, the leptomeninges

Side effects and risks of radioiodine treatment of benign thyroid diseases

International Nuclear Information System (INIS)

Becker, W.; Hohenberger, W.; Wolf, F.; Erlangen-Nuernberg Univ., Erlangen

1990-01-01

Radioiodine treatment is considered to be the treatment of choice in benign thyroid diseases because of its very low side effects. Real and hypothetic risks and side effects have to be differentiated. Both may occur early and late after the treatment. Radioiodinethyroiditis in small volumes at high doses is very rare. Exacerbation of a thyroid storm (0.34%) as well as local compressions accompanied with reactive edema of the thyroid are early real side effects of radioiodine treatment. Late real side effects are failure of treatment (7-30% of thyrotoxicosis) and induction of hypothyroidism (4-20% of functional autonomy and increasing frequency in Graves' diseases with time). Late hypothetic risks are somatic (1-9/10000 bis 1-9/100000) or genetic (1-9/100000). An early risk might be the misdiagnosis of an additional thyroid carcinoma. (orig.) [de

Screening for thyroid cancer according to French recommendations with thyroid ultrasound in newly diagnosed Graves' disease without palpable nodule is not useful.

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Nys, Pierre; Cordray, Jean-Pierre; Sarafian, Véronique; Lefort-Mossé, Ève; Merceron, Robert-Édouard

2015-02-01

The aim of the study was to evaluate systematic thyroid ultrasonography (US) relevance in newly diagnosed Graves' disease among patients presenting without palpable nodules. We consecutively recruited 208 cases of Graves' disease without palpable nodule. All patients were screened for thyroid antibodies and underwent a thyroid US. Ultrasonically guided biopsy was proposed for the assessment of all nodules upper or equal to 10mm in diameter. Two third of patients had an abnormal thyroid at palpation requiring an US. One third of patients had a normal thyroid at palpation and US was consequently unwarranted. Among all patients, US detected non-palpable nodules in 26% of cases. We found no smears suspected to be cancerous. In newly diagnosed Graves' disease, the US relevance is only questionable in patients without abnormal thyroid at palpation. Ultrasonography detected non-palpable nodules and none was suspected to be cancerous. These data suggest that US is not useful in patients without abnormal thyroid at palpation. Nevertheless, the recent Thyroid Imaging-Reporting And Data System classification (TI-RADS) might change our conclusions. The TI-RADS classification indeed improves the selection of nodules lower than 10mm in diameter requiring a biopsy. Nodules lower than 10mm in diameter were not biopsied in the present study. The other US data presented herein (echogenicity, vascularisation) provide no further relevance for systematic US in newly diagnosed patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Temporal relationship between onset of Graves' ophthalmopathy and onset of thyroidal Graves' disease

NARCIS (Netherlands)

Wiersinga, W. M.; Smit, T.; van der Gaag, R.; Koornneef, L.

1988-01-01

The temporal relationship between the onset of Graves' ophthalmopathy and the onset of thyroidal Graves' disease was evaluated in 125 consecutive patients with Graves' ophthalmopathy. Thyroidal Graves' disease--past or present--was clinically evident in 99 patients (79%): hyperthyroidism in 3 cases.

Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

International Nuclear Information System (INIS)

Takamatsu, J.; Hosoya, T.; Naito, N.

1988-01-01

Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients

Thyroid γ ray measurement after iodine-131 therapy for Graves' disease

International Nuclear Information System (INIS)

Liu Jianfeng; Guo Qingling; Ye Genyao; Li Xin; Wang Anyu; Wang Ying; Zhu Hui; He Ling; Yuan Chao

2004-01-01

Objective: To study the thyroid 131 I uptake within 24 hours following 131 I therapy for Graves' disease. Methods: Eighteen hyperthyroidism patients were divided into two groups according to thyroid weight and radiotherapy dosage. Low-dose group and high-dose group received the mean dose 162.8 MBq (4.4 mCi) and 255.3 MBq (6.9 mCi), respectively. The γ ray dose rates from thyroids were measured in all patients at 1, 2, 4, 8,12 and 24 h after 131 I therapy. Results: γ ray dose rates were elevated rapidly at 1 hour and continued at high level between 2-12 h and slowly fell in 24 h after 131 I therapy. γ Rat curve of low-dose group was lower than that of high-dose group. Conclusion: There was a rapid absorption and concentration period in 1 h and slow metabolism and release period after 12 h in thyroid following radioiodine therapy of Graves' disease. The thyroids of hyperthyroidism patients displayed different γ ray curves. (author)

Selenium status and over-expression of interleukin-15 in celiac disease and autoimmune thyroid diseases

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Anna Velia Stazi

2010-12-01

Full Text Available In celiac disease (CD, for its multifactorial nature, the target organs are not limited to the gut, but include thyroid, liver, skin and reproductive and nervous systems. Between the extraintestinal symptoms associated with CD, autoimmune thyroid diseases (AITDs are more evident, underlining as CD-related autoimmune alterations can be modulated not only by gluten but also by various concurrent endogenous (genetic affinity, over-expression of cytokines and exogenous (environment, nutritional deficiency factors. In their pathogenesis a central role for over-expression of interleukin-15 (IL-15 is shown, by inhibiting apoptosis, leading to the perpetuation of inflammation and tissue destruction. Thyroid is particularly sensitive to selenium deficiency because selenoproteins are significant in biosynthesis and activity of thyroid hormones; besides, some selenoproteins as glutathione peroxidase are involved in inhibiting apoptosis. Thus, selenium malabsorption in CD can be thought as a key factor directly leading to thyroid and intestinal damage. Considering the complexity of this interaction and on the basis of available evidence, the aim of this review is to assess as preventive and therapeutic target the role of IL-15 and selenium in the pathogeneses of both CD and AITD.

Strategy for the diagnosis of thyroid disorders in the developing countries

International Nuclear Information System (INIS)

Poshyachinda, M.

1992-01-01

Thyroid disorders may manifest as abnormalities of anatomy of function of the gland. Most of them can be diagnosed after a careful clinical history and physical examination. Nevertheless, laboratory evaluation is important for an accurate diagnosis before embarking on treatment. There is also a small but a significant fraction of thyroid diseases that can be diagnosed only on the basis of laboratory findings. Often a diagnosis of thyroid disease may need more than a single test. Hence, it is essential to select appropriate tests for thyroid patients by their reliability, precision and overall cost. Many thyroid function tests are nuclear techniques and this trend is not likely to change in near future. Radionuclides that are commonly used in the evaluation of thyroid disorders include iodine-131 ( 131 I), iodine-123 ( 123 I), iodine-125 ( 125 I) and technetium-99m ( 99 TC m -TcO4)

Thyroid Function Within the Normal Range and Risk of Coronary Heart Disease

DEFF Research Database (Denmark)

Åsvold, Bjørn O; Vatten, Lars J; Bjøro, Trine

2015-01-01

documented, but conflicting evidence suggests that thyrotropin levels in the upper part of the reference range may be associated with an increased risk of coronary heart disease (CHD). OBJECTIVE: To assess the association between differences in thyroid function within the reference range and CHD risk. DESIGN...... known thyroid or cardiovascular disease at baseline. EXPOSURES: Thyroid function as expressed by serum thyrotropin levels at baseline. MAIN OUTCOMES AND MEASURES: Hazard ratios (HRs) of CHD mortality and CHD events according to thyrotropin levels after adjustment for age, sex, and smoking status....... This finding suggests that differences in thyroid function within the population reference range do not influence the risk of CHD. Increased CHD risk does not appear to be a reason for lowering the upper thyrotropin reference limit....

Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison′ s disease with primary hypothyroidism

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Jaya Prakash Sahoo

2016-01-01

Full Text Available Background: Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab titer in Addison's disease with primary hypothyroidism. Materials and Methods: This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical was defined as high thyroid stimulating hormone (TSH with/without low free thyroxine (fT4. TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Results: Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. Conclusions: The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations.

Thyroid dysfunction in children receiving neck irradiation for Hodgkin's disease

International Nuclear Information System (INIS)

Atahan, I.L.; Yildiz, F.; Oezyar, E.; Uzal, D.

1998-01-01

Thyroid function was studied in 46 long-term survivors of pediatric Hodgkin's disease with a median follow-up time of 10.5 years. The mean age of the patients at the time of treatment was 8 years. Treatment consisted of radiotherapy alone in seven patients and combined radiation and chemotherapy in 39 patients. The radiotherapy dose to the thyroid gland was less than 2000 cGy in one, 2000-5000 cGy in 15, 2500-3000 cGy in 17, and greater than 3000 cGy in 13 patients. Evaluation consisted of clinical examination and thyroid function tests of total and free triiodothyronine, thyroxin, arid thyroid stimulating hormone levels. Twenty-one of 46 patients (45.6%) showed thyroid function abnormalities, however only nine of them had diffuse or nodular hyperplasia on physical examination. Risk factors of age, chemotherapy schema, total radiation dose, and dose per fraction did not significantly influence the incidence of thyroid dysfunction. (author)

Hashimoto thyroiditis: a century later.

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Ahmed, Rania; Al-Shaikh, Safa; Akhtar, Mohammed

2012-05-01

More than a century has passed since the first description of Hashimoto thyroiditis (HT) as a clinicopathologic entity. HT is an autoimmune disease in which a breakdown of immune tolerance is caused by interplay of a variety of immunologic, genetic, and environmental factors. Thyrocyte injury resulting from environmental factors results in expression of new or hidden epitopes that leads to proliferation of autoreactive T and B cells. Infiltration of thyroid by these cells results in HT. In addition to the usual type of HT, several variants such as the fibrous type and Riedal thyroiditis are also recognized. The most recently recognized variant is immunoglobulin G4(+) HT, which may occur as isolated thyroid limited disease or as part of a generalized Ig4-related sclerosing disease. The relationship between HT and Riedel thyroiditis remains unclear; however, recent evidence seems to suggest that it may also be part of the spectrum of Ig4-related sclerosing disease. HT is frequently associated with papillary thyroid carcinoma and may indeed be a risk factor for developing this type of cancer. The relationship between thyroid lymphoma and HT on the other hand appears well established.

Regulation mechanisms of pituitary-thyroid axis in normal subjects and patients with Graves' disease

International Nuclear Information System (INIS)

Takagi, Shinko; Yamauchi, Kazuyuki; Mori, Yuichi

1986-01-01

The regulatory mechanism of the pituitary-thyroid axis in normal subjects and patients with Graves' disease was investigated using a highly sensitive TSH assay based on the immunoradiometric assay. All of the normal subjects had detectable TSH values within the range 0.35 to 6.0 μU/ml. No negative correlations between TSH and free thyroid hormones existed in normal subjects. Patients with thyroid carcinoma who seemed to have normal pituitary-thyroid function showed a rapid increase of TSH after total thyroidectomy. On the other hand, while untreated patients with Graves' disease all had undetectable TSH values, these patients took 1 to 3.5 months longer to normalize their TSH values than to normalize free thyroid hormones on antithyroid drug therapy. During the recovery phase by the treatment with decrease of antithyroid drug or supplement of T 4 from iatrogenic hypothyroid state after treatment for Graves' disease and thyroid carcinoma, normalization of TSH levels was delayed than that of free thyroid hormones. Patients with Graves' disease in remission showed an extremely positive correlation between basal and peak TSH levels in TRH test, and a negative correlation between basal TSH and FT 4 . In conclusion, an individual patient may have a different set point concerning the regulatory mechanism of the pituitary-thyroid axis, and the persistence of the hyperthyroid state would seem to have caused some reversible dysfunction of the pituitary gland. (author)

Role of Diffusion-Weighted Magnetic Resonance (MR) Imaging in Differentiation Between Graves' Disease and Painless Thyroiditis.

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Abdel Razek, Ahmed Abdel Khalek; Abd Allah, Sieza Samir; El-Said, Amr Abd El-Hamid

2017-01-01

To assess the role of diffusion-weighted MR imaging in differentiation between Graves' disease and painless thyroiditis. A prospective study was conducted among 37 consecutive patients with untreated thyrotoxicosis (25 female and 12 male; mean age of 44 years) and 15 ageand sex-matched controls. Diffusion-weighted MR imaging of the thyroid gland was performed in patients and controls. The apparent diffusion coefficient (ADC) value of the thyroid gland was calculated and correlated with Tc-99m uptake and thyroid function tests of the patients. There was a significant difference in the ADC value of the thyroid gland between patients and the control group ( P =0.001). The mean ADC value of the thyroid gland in Graves' disease was 2.03±0.28×10 -3 mm 2 /sec, and in patients with painless thyroiditis 1.46±0.22×10 -3 mm 2 /sec, respectively. There was a significant difference in the ADC values between Graves' disease and painless thyroiditis ( P =0.001). When the ADC value of 1.45×10 -3 mm 2 /sec was used as a threshold value for differentiating Graves' disease from painless thyroiditis, the best result was obtained with area under the curve of 0.934, accuracy of 83.8%, sensitivity of 95.8%, and specificity of 61.5%. The mean ADC value of the thyroid gland in patients positively correlated with serum TRAb and Tc-99m uptake ( r =0.57, P =0.001 and r =0.74, P =0.001, respectively). We concluded that ADC values of the thyroid gland can be used to differentiate Graves' disease from painless thyroiditis in patients with untreated thyrotoxicosis.

The Prevalence of Thyroid Disease in the Children and Teenagers in Iodine-Deficient Region

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A V Kiyaev

2007-06-01

Full Text Available To indicate iodine intake and the prevalence of thyroid disease in the iodine-deficient area we perform complex investigation of 2332 children and teenagers in 23 settlements of Sverdlovsk region. Studying population consisted of1153 7—8 years old children (599 girls and 554 boys and 1179 14—15 years old teenagers (637 girls and 542 boys. Study protocol includes thyroid ultrasound for all children and urinary iodine excretion for younger group and, serum TSH, AT-TG and AT-TPO in older group. The incidence of diffuse goiter was 22.8% and median of urinary iodine excretion was 53 μg/l. We found that Sverdlovsk region is a mild iodine-deficient area. The incidence of significant thyroid diseases is relatively low (thyroid cancer, functional autonomy and overt hypothyroidism — in 0.04%, nodular goiter — 0.26%, autoimmune thyroiditis with subclinical hypothyroidism — 0.6%. There is no significant difference in the prevalence of thyroid disease among children and teenagers. We found that thyroid ultrasound is not a reasonable screening strategy for thyroid cancer and nodular goiter in pediatric population of the iodine-deficient region. We consider that the most reasonable screening strategy is the palpation technique.

Thyroid Hormone Receptor Mutations in Cancer and Resistance to Thyroid Hormone: Perspective and Prognosis

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Meghan D. Rosen

2011-01-01

Full Text Available Thyroid hormone, operating through its receptors, plays crucial roles in the control of normal human physiology and development; deviations from the norm can give rise to disease. Clinical endocrinologists often must confront and correct the consequences of inappropriately high or low thyroid hormone synthesis. Although more rare, disruptions in thyroid hormone endocrinology due to aberrations in the receptor also have severe medical consequences. This review will focus on the afflictions that are caused by, or are closely associated with, mutated thyroid hormone receptors. These include Resistance to Thyroid Hormone Syndrome, erythroleukemia, hepatocellular carcinoma, renal clear cell carcinoma, and thyroid cancer. We will describe current views on the molecular bases of these diseases, and what distinguishes the neoplastic from the non-neoplastic. We will also touch on studies that implicate alterations in receptor expression, and thyroid hormone levels, in certain oncogenic processes.

Frequency of subclinical thyroid dysfunction and risk factors for cardiovascular disease among women at a workplace.

Science.gov (United States)

Diaz-Olmos, Rodrigo; Nogueira, Antônio-Carlos; Penalva, Daniele Queirós Fucciolo; Lotufo, Paulo Andrade; Benseñor, Isabela Martins

2010-01-01

Subclinical thyroid dysfunction is very common in clinical practice and there is some evidence that it may be associated with cardiovascular disease. The aim here was to evaluate the frequencies of subclinical thyroid disease and risk factors for cardiovascular disease among women at a workplace, and to evaluate the association between subclinical thyroid disease and cardiovascular risk factors among them. Cross-sectional study on 314 women aged 40 years or over who were working at Universidade de São Paulo (USP). All the women answered a questionnaire on sociodemographic characteristics and risk factors for cardiovascular disease and the Rose angina questionnaire. Anthropometric variables were measured and blood samples were analyzed for blood glucose, total cholesterol and fractions, high-sensitivity C-reactive protein, thyroid-stimulating hormone (TSH), free thyroxine (free-T4) and anti-thyroperoxidase antibodies (anti-TPO). The frequencies of subclinical hypothyroidism and hyperthyroidism were, respectively, 7.3% and 5.1%. Women with subclinical thyroid disease presented higher levels of anti-TPO than did women with normal thyroid function (P = 0.01). There were no differences in sociodemographic factors and cardiovascular risk factors according to thyroid function status, except for greater sedentarism among the women with subclinical hypothyroidism. Restricting the comparison to women with subclinical hypothyroidism (TSH > 10 mIU/l) did not change the results. In this sample of women, there was no association between poor profile of cardiovascular risk factors and presence of subclinical thyroid disease that would justify screening at the workplace.

Ocorrência de doenças autoimunes tireoidianas em pacientes com doenças reumáticas Autoimmune thyroid disease in patients with rheumatic diseases

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Teresa Cristina Martins Vicente Robazzi

2012-06-01

Full Text Available Anormalidades na função tireoidiana e presença de autoanticorpos da tireoide têm sido frequentemente descritas em pacientes com doenças reumatológicas autoimunes, como síndrome de Sjögren, artrite reumatoide, lúpus eritematoso sistêmico e esclerodermia. São limitados os dados sobre prevalência e características clínicas de tireoidite autoimune em outras doenças reumatológicas, tais como febre reumática e lúpus eritematoso sistêmico juvenil. Os autores revisaram as associações de doenças autoimunes endócrinas e reumáticas, avaliando as diversas faixas etárias e condições clínicas. O levantamento bibliográfico foi realizado por meio de busca por artigos científicos indexados em bancos de dados de ciências da saúde em geral, como Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS, Medline/PubMed e Scientific Eletronic Library Online (SciELO. Utilizaram-se os seguintes descritores: "rheumatic autoimmune diseases and autoimmune thyroid diseases", "thyroid disorders and rheumatic diseases", "thyroiditis and rheumatic diseases", "autoimmune diseases and thyroid", e "pediatric rheumatic diseases and autoimmune thyroid diseases". Este estudo mostrou que, apesar de resultados contraditórios na literatura, há maior prevalência da associação entre doenças autoimunes da tireoide e doenças reumáticas, destacando-se a possibilidade de mecanismos patogênicos comuns entre as doenças.Thyroid function abnormalities and thyroid autoantibodies have been frequently described in patients with rheumatologic autoimmune diseases, such as Sjögren's syndrome, rheumatoid arthritis, systemic lupus erythematosus and scleroderma. Limited data are available regarding the prevalence and clinical characteristics of autoimmune thyroiditis in other rheumatologic disorders, such as rheumatic fever and juvenile systemic lupus erythematosus. The authors review the association of endocrine autoimmune and rheumatic

Prediction of progression to overt hypothyroidism or hyperthyroidism in female relatives of patients with autoimmune thyroid disease using the Thyroid Events Amsterdam (THEA) score

NARCIS (Netherlands)

Strieder, Thea G. A.; Tijssen, Jan G. P.; Wenzel, Björn E.; Endert, Erik; Wiersinga, Wilmar M.

2008-01-01

BACKGROUND: Genetic and environmental factors are involved in the pathogenesis of autoimmune thyroid disease (AITD). Family members of patients with AITD are at increased risk for AITD, but not all will develop overt hypothyroidism or hyperthyroidism. Our goal was to develop a simple predictive

Graves' disease: an analysis of thyroid hormone levels and hyperthyroid signs and symptoms.

Science.gov (United States)

Trzepacz, P T; Klein, I; Roberts, M; Greenhouse, J; Levey, G S

1989-11-01

Assessment of disease severity for patients with hyperthyroidism involves clinical evaluation and laboratory testing. To determine if there is a correlation between symptoms and thyroid function test results, we prospectively studied hyperthyroid patients using a standardized symptom rating scale and serum thyroid function parameters. We examined 25 patients with untreated, newly diagnosed Graves' disease using the Hyperthyroid Symptom Scale (HSS) and serum levels of thyroxine (T4), triiodothyronine (T3) relative insulin area (RIA), and estimates of free thyroxine index (FTI). In addition, we compared thyroid hormone levels with standard measures of depression and anxiety in these patients. When regression analyses controlling for age were performed, none of these symptom ratings were associated with FTI or T3 RIA. The HSS was correlated with goiter size and anxiety ratings and was inversely correlated with age. The present study suggests that there is no relationship between the clinical assessment of disease severity and serum levels of thyroid hormone in untreated Graves' disease.

Changes in haemostasis and thrombosis associated with thyroid disease: Presentation of 2 cases.

Science.gov (United States)

Rodilla Fiz, A M; Garví López, M; Gómez Garrido, M; Girón la Casa, M

2016-01-01

There is a relationship between thyroid diseases and primary and secondary changes in haemostasis. The most frequent association between them are hypocoagulability states with clinical hypothyroidism and vascular thrombophilia (hypercoagulability and/or hypofibrinolysis) with hyperparathyroidism. However, there are recent studies that have detected changes in haemostasis -primary and secondary- associated with thyroid diseases with normal hormone levels, suggesting other pathogenic mechanisms not yet known. The cases are presented of 2 patients with thyroid disease that required surgery: one multinodular goitre and one papillary carcinoma of the thyroid, both with normal hormone levels. They were shown to have haemostasis disorders during the preoperative work up. These showed a Factor VII deficiency and a Factor XI deficiency along with a thrombotic disease of unknown origin, respectively. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Thyroid Tests

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... too low Hashimoto’s disease , of the most common cause of hypothyroidism thyroid nodules and thyroid cancer Your doctor will ... of hyperthyroidism—and Hashimoto’s disease —the most common cause of hypothyroidism. Thyroid antibodies are made when your immune system ...

Graves disease and papillary thyroid cancer: An association that can be missed

International Nuclear Information System (INIS)

Al-Omari, Ahmad A.; Haddad, Fares H.; Malkawi, Omar M.; Khushman, Haytham M.

2005-01-01

Thyroid nodules are frequently found in association with Graves' disease. Papillary carcinoma can arise from these nodules. We report a 65-year-old gentleman who presented with classical features of Graves disease. Technetium 99 scintigraphy revealed diffuse goiter with a cold nodule over the isthmus. Papillary thyroid cancer was suggested by the enlarging thyroid gland, and by the presence of cold nodule, and was proven by fine needle aspiration biopsy of this nodule. The diagnosis was confirmed by histopathology of thyroid specimen after total thyroidectomy, which also showed local invasion; metastatic work up revealed pulmonary and liver metastasis. Despite treatment by total thyroidectomy, twice radioactive iodine I131 ablation and levothyroxine replacement in a thyroid stimulating hormone suppressive dose, he still harbors metastases with elevated thyroglobulin level. This case should raise the index of suspicion of the treating physician to consider similar association, and to prompt early diagnosis and surgical treatment to prevent dreadful consequences that might adversely affect the outcome. (author)

THE CLINICAL PRESENTATION OF AUTOIMMUNE THYROID DISEASE IN MEN IS ASSOCIATED WITH IL12B GENOTYPE

DEFF Research Database (Denmark)

Walsh, John P; Berry, Jemma; Liu, Shu

2011-01-01

hypothesized that IL12B genotype may influence the clinical presentation of autoimmune thyroid disease. Objective.  We tested for differences in IL12B genotype between Graves' disease and Hashimoto's disease. Patients.  We studied a discovery cohort of 203 Australian women and 37 men with autoimmune thyroid......' disease (P=0.005) and Hashimoto's disease (P=0.029). Conclusion.  In men with autoimmune thyroid disease, a common variant located upstream of the IL12B coding region may influence whether patients present with Graves' disease or Hashimoto's disease....

Clinical characteristics of children and adolescents with thyroid ...

African Journals Online (AJOL)

Background: Thyroid disorders constitute a large proportion of endocrine diseases in children and adolescents. Diseases of the thyroid have profound effect on metabolism, cognition, growth and development in children. The pattern of thyroid disorders in children in our region is still under reported. Objectives: To describe ...

Role of Diffusion-Weighted Magnetic Resonance (MR) Imaging in Differentiation Between Graves’ Disease and Painless Thyroiditis

Science.gov (United States)

Abdel Razek, Ahmed Abdel Khalek; El-Said, Amr Abd El-hamid

2017-01-01

Summary Background To assess the role of diffusion-weighted MR imaging in differentiation between Graves’ disease and painless thyroiditis. Material/Methods A prospective study was conducted among 37 consecutive patients with untreated thyrotoxicosis (25 female and 12 male; mean age of 44 years) and 15 ageand sex-matched controls. Diffusion-weighted MR imaging of the thyroid gland was performed in patients and controls. The apparent diffusion coefficient (ADC) value of the thyroid gland was calculated and correlated with Tc-99m uptake and thyroid function tests of the patients. Results There was a significant difference in the ADC value of the thyroid gland between patients and the control group (P=0.001). The mean ADC value of the thyroid gland in Graves’ disease was 2.03±0.28×10–3 mm2/sec, and in patients with painless thyroiditis 1.46±0.22×10–3 mm2/sec, respectively. There was a significant difference in the ADC values between Graves’ disease and painless thyroiditis (P=0.001). When the ADC value of 1.45×10–3 mm2/sec was used as a threshold value for differentiating Graves’ disease from painless thyroiditis, the best result was obtained with area under the curve of 0.934, accuracy of 83.8%, sensitivity of 95.8%, and specificity of 61.5%. The mean ADC value of the thyroid gland in patients positively correlated with serum TRAb and Tc-99m uptake (r=0.57, P=0.001 and r=0.74, P=0.001, respectively). Conclusions We concluded that ADC values of the thyroid gland can be used to differentiate Graves’ disease from painless thyroiditis in patients with untreated thyrotoxicosis. PMID:29662585

Guideline for radioiodine therapy for benign thyroid diseases (version 3)

International Nuclear Information System (INIS)

Dietlein, M.; Schicha, H.; Dressler, J.; Gruenwald, F.; Leisner, B.; Moser, E.; Reiners, C.; Schneider, P.; Schober, O.

2004-01-01

The version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves' disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves' disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient's preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients' preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3 rd version. (orig.) [de

The effectiveness of iodine prophylaxis and frequency of thyroid enlargement (thyroid goiter) and clinical diagnosis of thyroid diseases in inhabitants of Szczecin's region after Chernobyl accident

International Nuclear Information System (INIS)

Syrenicz, A.; Gozdzik, J.; Pynka, S.

1991-01-01

The study, supported by program MZ-17, was carried on 4567 inhabitants of the area of Szczecin (2350 females and 2217 males). The population was chosen randomly, according to a simple drawing scheme. All subjects were clinically examined using standardised questionnaires. In 3468 persons (including 1807 girls and women, 1661 boys and men) apart form clinical examination, the assessment of thyrotropin, thyroxine and triiodothyronine in serum and frequency of anti thyroglobulin antibodies and antithyroid membrane and antithyroid membrane antibodies were evaluated. The data indicate that 94% of children in Szczecin's region received the prophylactic dose of iodine, mostly between the 1st and 5th of May 1986. Only 17% of the adults received iodine. The most common preparation was Lugol solution given in a single dose. Among all persons who received iodine, only in 5% of subjects the side effects were noted (mostly in children), including symptoms of gastrointestinal tract (vomiting, abdomen pain) and occasionally intra thyroid side effects (thyroid pains). In examined population the high frequency of thyroid enlargement, mainly in women (up to 43-44% at the age group 30-50 years) was found. The frequency of thyroid enlargement, mainly in women (up to 43-44% at the age group 30-50 years) was found. The frequency of clinical diagnosis of thyroid disease was higher in woman than in man (most of the diffuse goiter, rarely the nodular goiter). The frequency of thyroid enlargement and clinical diagnosis of thyroid disease was not dependent on prophylactic iodine intake. The iodine prophylaxis did not influence on thyroid hormones and TSH serum levels and in frequency of antithyroid antibodies. (author). 1 ref, 6 tabs

Management of Graves' disease during pregnancy: the key role of fetal thyroid gland monitoring.

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Luton, Dominique; Le Gac, Isabelle; Vuillard, Edith; Castanet, Mireille; Guibourdenche, Jean; Noel, Michèle; Toubert, Marie-Elisabeth; Léger, Juliane; Boissinot, Christine; Schlageter, Marie-Hélène; Garel, Catherine; Tébeka, Brigitte; Oury, Jean-François; Czernichow, Paul; Polak, Michel

2005-11-01

Fetuses from mothers with Graves' disease may experience hypothyroidism or hyperthyroidism due to transplacental transfer of antithyroid drugs (ATD) or anti-TSH receptor antibodies, respectively. Little is known about the fetal consequences. Early diagnosis is essential to successful management. We investigated a new approach to the fetal diagnosis of thyroid dysfunction and validated the usefulness of fetal thyroid ultrasonograms. Seventy-two mothers with past or present Graves' disease and their fetuses were monitored monthly from 22 wk gestation. Fetal thyroid size and Doppler signals, and fetal bone maturation were determined on ultrasonograms, and thyroid function was evaluated at birth. Thyroid function and ATD dosage were monitored in the mothers. The 31 fetuses whose mothers were anti-TSH receptor antibody negative and took no ATDs during late pregnancy had normal test results. Of the 41 other fetuses, 30 had normal test results at 32 wk, 29 were euthyroid at birth, and one had moderate hypothyroidism on cord blood tests. In the remaining 11 fetuses, goiter was visualized by ultrasonography at 32 wk, and fetal thyroid dysfunction was diagnosed and treated; there was one death, in a late referral, and 10 good outcomes with normal or slightly altered thyroid function at birth. The sensitivity and specificity of fetal thyroid ultrasound at 32 wk for the diagnosis of clinically relevant fetal thyroid dysfunction were 92 and 100%, respectively. In pregnant women with past or current Graves' disease, ultrasonography of the fetal thyroid gland by an experienced ultrasonographer is an excellent diagnostic tool. This tool in conjunction with close teamwork among internists, endocrinologists, obstetricians, echographists, and pediatricians can ensure normal fetal thyroid function.

Diffusion-weighed MR of the thyroid gland in Graves' disease: assessment of disease activity and prediction of outcome.

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Abdel Razek, Ahmed Abdel Khalek; Sadek, Ahmed Galal; Gaballa, Gada

2010-06-01

To assess the activity and clinical course of Graves' disease with diffusion-weighted magnetic resonance (MR) imaging. Fifty-one patients with Graves' disease and 25 volunteers underwent diffusion MR imaging of the thyroid gland using a single shot echo-planar imaging with b-factor of 0, 300 and 600 second/mm(2). The apparent diffusion coefficient (ADC) values of the thyroid gland were calculated. Patients with active Graves' disease included untreated patients at initial diagnosis (n = 12), patients under antithyroid drugs (n = 11), and patients in relapse after withdrawal of therapy (n = 13). Patients with inactive disease had a remission of hyperthyroidism (n = 15). The mean ADC values of thyroid gland with active Graves' disease was 0.65 +/- 0.03 x 10(-3) mm(2)/second in patients at initial diagnosis, 0.81 +/- 0.02 x 10(-3) mm(2)/second in patients undergoing antithyroid drug and 0.72 +/- 0.07 x 10(-3) mm(2)/second in patients with relapse of hyperthyroidism. The mean ADC of patients with remission was 0.94 +/- 0.03 x 10(-3) mm(2)/second and for normal volunteer was 1.06 +/- 0.08 x 10(-3) mm(2)/second. There was significant difference in the ADC value of patients with active disease and remission (P = .001). The cutoff ADC value used for differentiating patients with active disease from patients with remission was 0.82 x 10(-3) mm(2)/second. The mean ADC value of thyroid gland had positive correlation with thyroid-stimulating hormone (r = 0.87, P = .001) and negative correlation with serum T4 (r = -0.82, P = .001) and serum T3 (r = -0.71, P = .001). The ADC value of the thyroid gland is a promising non invasive parameter for diagnosis of different clinical stages of Graves' disease. Hence it can be used to assess the activity and predict the outcome of patients during and after medical treatment. Crown Copyright (c) 2010. Published by Elsevier Inc. All rights reserved.

Technetium-99m thyroid scan; does it have a diagnostic aid in sub-clinical auto-immune thyroid disease in systemic lupus erythematosus patients?

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Amin, A; Alkemary, A; Abdo, M; Salama, M

2016-02-01

Technetium-99m (Tc-99m) thyroid scintigraphy is a well known diagnostic tool that shows the entire gland in a single image. We aimed to evaluate its additive diagnostic value in subclinical autoimmune thyroid disease (S-AITD) in systemic lupus erythematosus (SLE) patients. We investigated 100 systemic lupus erythematosus (SLE) patients without overt thyroid involvement (eight men and 92 women; mean age 40±6.5 years) and 50 age and sex matched controls. All were subjected to thyroid evaluation using anti-thyroglobulin (anti-TG) and anti-thyroid peroxidase (anti-TPO) antibodies; hormones (FT3; FT4 and TSH) and Tc-99m thyroid scintigraphy. 14/100 (14%) and none (0%) were positive for S-AITD in SLE and control groups, respectively (P = 0.0001). They were classified by thyroid scintigraphy and hormonal profile into 2/14 Hashimoto; 10/14 atrophic thyroiditis and 2/14 Graves' disease. Anti-TPO was elevated in 12 SLE cases, while anti-TG was elevated in only 2/14 (P = 0.0001). Thyroid scintigraphy showed statistically significant associations with FT4, TSH and anti-TPO. Tc-99m thyroid scintigraphy may have an additional diagnostic role in S-AITD among SLE patients, with an impact on patient management. This potential needs to be further evaluated in a larger series on a multicenter basis. © The Author(s) 2015.

Frequency of subclinical thyroid dysfunction and risk factors for cardiovascular disease among women at a workplace

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Rodrigo Diaz-Olmos

Full Text Available CONTEXT AND OBJECTIVE: Subclinical thyroid dysfunction is very common in clinical practice and there is some evidence that it may be associated with cardiovascular disease. The aim here was to evaluate the frequencies of subclinical thyroid disease and risk factors for cardiovascular disease among women at a workplace, and to evaluate the association between subclinical thyroid disease and cardiovascular risk factors among them. DESIGN AND SETTING: Cross-sectional study on 314 women aged 40 years or over who were working at Universidade de São Paulo (USP. METHODS: All the women answered a questionnaire on sociodemographic characteristics and risk factors for cardiovascular disease and the Rose angina questionnaire. Anthropometric variables were measured and blood samples were analyzed for blood glucose, total cholesterol and fractions, high-sensitivity C-reactive protein, thyroid-stimulating hormone (TSH, free thyroxine (free-T4 and anti-thyroperoxidase antibodies (anti-TPO. RESULTS: The frequencies of subclinical hypothyroidism and hyperthyroidism were, respectively, 7.3% and 5.1%. Women with subclinical thyroid disease presented higher levels of anti-TPO than did women with normal thyroid function (P = 0.01. There were no differences in sociodemographic factors and cardiovascular risk factors according to thyroid function status, except for greater sedentarism among the women with subclinical hypothyroidism. Restricting the comparison to women with subclinical hypothyroidism (TSH > 10 mIU/l did not change the results. CONCLUSION: In this sample of women, there was no association between poor profile of cardiovascular risk factors and presence of subclinical thyroid disease that would justify screening at the workplace.

Technetium-99m high resolution tomographic imaging in the thyroid gland diseases

Energy Technology Data Exchange (ETDEWEB)

Reitblat, A; Ben-Horin, C [Barzilai Nedical Center, Ashkelon (Israel)

1996-12-01

In the experiments with the thyroid phantom and first studies of patients with hyperthyroidism it was proved that in combining SPECT imaging technique and high resolution ability of pinhole collimator (commonly used for conventional scintigraphy of the thyroid) it is possible to obtain quantitative information concerning the structure and unhomogenities of the thyroid tissue , not available tom the planar imaging. The following applications of the the method are expected: 1) Estimation of the thyroid dimensions and volume for the accurate dosimetry of the following Iodine-131 - therapy. 2) Determination of the location of the thyroid in the neck , occurrences of the retrotracheal, retrolaryngeal and retrostemal extension of the goiter. 3) Estimation of the structure and unhomogenities of the thyroid gland . 4) Locations and dimensions of cold nodules in the thyroid tissue . Some of these applications are illustrated in our studies of the patients with different thyroid gland diseases (authors).

Contemporary Management of Recurrent Nodal Disease in Differentiated Thyroid Carcinoma

Science.gov (United States)

Na’ara, Shorook; Amit, Moran; Fridman, Eran; Gil, Ziv

2016-01-01

Differentiated thyroid carcinoma (DTC) comprises over 90% of thyroid tumors and includes papillary and follicular carcinomas. Patients with DTC have an excellent prognosis, with a 10-year survival rate of over 90%. However, the risk of recurrent tumor ranges between 5% and 30% within 10 years of the initial diagnosis. Cervical lymph node disease accounts for the majority of recurrences and in most cases is detected during follow-up by ultrasound or elevated levels of serum thyroglobulin. Recurrent disease is accompanied by increased morbidity. The mainstay of treatment of nodal recurrence is surgical management. We provide an overview of the literature addressing surgical management of recurrent or persistent lymph node disease in patients with DTC. PMID:26886954

F-18-FDG PET of the thyroid in Graves' disease

International Nuclear Information System (INIS)

Boerner, A.R.; Voth, E.; Schicha, H.; Wienhard, K.; Wagner, R.

1998-01-01

This study evaluates F-18-FDG PET of the thyroid in Graves' disease. Methods: Thirty patients were investigated the day before radioiodine therapy, 15 patients 3-10 days after radioiodine therapy. Twenty patients with cancer of the head or neck and normal thyroid function served as controls. Results: F-18-FDG uptake was higher in Graves' disease patients than in controls. Negative correlations of F-18-FDG uptake with half-life of radioiodine and absorbed radiation dose due to radioiodine therapy were found along with a positive correlation to autoantibody levels. Conclusion: Thus F-18-FDG PET is likely to give information on the biological activity of Graves' disease as well as on early radiation effects. (orig.) [de

Thyroid function, Alzheimer's disease and postoperative cognitive dysfunction: a tale of dangerous liaisons?

Science.gov (United States)

Mafrica, Federica; Fodale, Vincenzo

2008-05-01

Hypothyroidism and hyperthyroidism are commonly present conditions in adults, leading to neurological symptoms, affecting the central and peripheral nervous system, and to neurocognitive impairment. Several studies investigated a possible association between Alzheimer's disease (AD) and thyroid dysfunctions. Increasing evidence supports an extensive interrelationship between thyroid hormones and the cholinergic system, which is selectively and early affected in AD. Moreover, thyroid hormones negatively regulate expression of the amyloid-beta protein precursor (AbetaPP), which plays a key role in the development of AD. A condition, the so called euthyroid sick syndrome (ESS), characterized by reduced serum T_{3} and T_{4} concentrations without increased serum thyroid stimulation hormone secretion, occurs within hours after major surgery. After surgery, elderly patients often exhibit a transient, reversible state of cognitive alterations. Delirium occurs in 10-26% of general medical patients over 65, and it is associated with a significant increase in morbidity and mortality. Modifications in thyroid hormone functioning may take place as a consequence of psycho-physical stress caused by surgery, and probably as a consequence of reduced conversion of T4 into T3 by the liver engaged in metabolizing anesthetic drugs. Therefore, modifications of thyroid hormones post-surgery, might play a role in the pathogenesis of postoperative cognitive dysfunction.

Riedel's thyroiditis and multifocal fibrosclerosis are part of the IgG4-related systemic disease spectrum.

Science.gov (United States)

Dahlgren, Mollie; Khosroshahi, Arezou; Nielsen, G Petur; Deshpande, Vikram; Stone, John H

2010-09-01

Riedel's thyroiditis is a chronic fibrosing disorder of unknown etiology often associated with "multifocal fibrosclerosis." IgG4-related systemic disease is characterized by IgG4+ plasma cell infiltration and fibrosis throughout many organs. We hypothesized that Riedel's thyroiditis is part of the IgG4-related systemic disease spectrum. We searched our institution's pathology database using the terms "Riedel's," "struma," "thyroid," and "fibrosis," and identified 3 cases of Riedel's thyroiditis. Riedel's thyroiditis was diagnosed if there was a fibroinflammatory process involving all or a portion of the thyroid gland, with evidence of extension of the process into surrounding tissues. Immunohistochemical stains for IgG4 and IgG were performed. The histopathologic and immunohistochemical features of each involved organ were evaluated. The clinical features of one patient with multiple organ system disease were described. All 3 thyroidectomy samples stained positively for IgG4-bearing plasma cells. One patient had extensive extrathyroidal involvement diagnostic of IgG4-related systemic disease, including cholangitis, pseudotumors of both the lung and lacrimal gland, and a lymph node contiguous to the thyroid that stained intensely for IgG4+ plasma cells. The histologic features of all organs involved were consistent with IgG4-related systemic disease. Patient 3 had 10 IgG4+ plasma cells per high-power field initially, but rebiopsy 2 years later demonstrated no IgG4+ plasma cells. That patient's second biopsy, characterized by fibrosis and minimal residual inflammation, further solidifies the link between IgG4-bearing plasma cells in tissue and the histologic evolution to Riedel's thyroiditis. Riedel's thyroiditis is part of the IgG4-related systemic disease spectrum. In many cases, multifocal fibrosclerosis and IgG4-related systemic disease are probably the same entity.

Thyroid diseases and Ramadan

Directory of Open Access Journals (Sweden)

Syed A Raza

2012-01-01

Full Text Available In the month of Ramadan, patients with thyroid diseases, most of the time, do not need treatment adjustments and can fast safely without any health hazards. Patients with hypothyroidism taking thyroxine can take their tablets on an empty stomach at bedtime instead of half an hour before Sehr. Patients with hyperthyroidism, on methimazole/carbimazole can continue their dose in once or twice daily regimes, while those on propylthiouracil need to be switched. Hyperthyroid patients with severe symptoms should start treatment immediately and can avoid fast for few days after a consultation with their religious scholar.

Thyroid diseases and Ramadan

Science.gov (United States)

Raza, Syed A.; Ishtiaq, Osama; Unnikrishnan, A. G.; Khan, A. K. Azad; Ahmad, Jamal; Ganie, Mohammed A.; Azad, Kishwar; Baruah, Manash; Pathan, Md Faruque

2012-01-01

In the month of Ramadan, patients with thyroid diseases, most of the time, do not need treatment adjustments and can fast safely without any health hazards. Patients with hypothyroidism taking thyroxine can take their tablets on an empty stomach at bedtime instead of half an hour before Sehr. Patients with hyperthyroidism, on methimazole/carbimazole can continue their dose in once or twice daily regimes, while those on propylthiouracil need to be switched. Hyperthyroid patients with severe symptoms should start treatment immediately and can avoid fast for few days after a consultation with their religious scholar. PMID:22837909

Proteins oxidation and autoantibodies' reactivity against hydrogen peroxide and malondialdehyde -oxidized thyroid antigens in patients' plasmas with Graves' disease and Hashimoto Thyroiditis.

Science.gov (United States)

Mseddi, Malek; Ben Mansour, Riadh; Gargouri, Bochra; Mnif, Fatma; El Ghawi, Samir; Hammami, Boutheina; Ghorbel, Abdelmonem; Abid, Mohamed; Lassoued, Saloua

2017-06-25

The aim of this study was to evaluate proteins oxidation in plasmas of two autoimmune thyroid diseases (AITD): Graves' disease (GD) and Hashimoto Thyroiditis (HT), and to determine whether oxidative modification of thyroid antigens (T.Ag) enhanced the reactivity of autoantibodies in plasmas of AITD patients compared with the reactivity towards native T.Ag. Carbonyl and thiol groups and MDA-protein adducts were assessed spectrophotometric methods in plasmas of 74 AITD patients and 65 healthy controls. The reactivities immunoglobulin (Ig)G autoantibodies towards malondialdéhyde (MDA)-modified T.Ag, hydrogen peroxide (H 2 O 2 )-modified T.Ag, native T.Ag and native derm were checked by enzyme-linked immunosorbent assay (ELISA). Evaluation of oxidized proteins exhibited high levels of MDA bound to proteins and carbonyl groups, as well as reduced thiol level in plasmas of AITD patients by comparison to healthy controls (p thyroid stimulating hormone level in HT patients in the other (r = 0.65, p < 0.001). The data suggest that high production of H 2 O 2 probably occurred during hormone synthesis could contribute to protein oxidation in AITD and to create neoepitopes responsible for autoantibody reactivity's to H 2 O 2 -oxidized T.Ag enhancement. These results provide support to the involvement of oxidative stress in AITD development and/or exacerbation. Copyright © 2017 Elsevier B.V. All rights reserved.

[Lymph node and distant metastases of thyroid gland cancer. Metastases in the thyroid glands].

Science.gov (United States)

Schmid, K W

2015-11-01

The different biological features of the various major entities of thyroid cancer, e.g. papillary, follicular, poorly differentiated, anaplastic and medullary, depend to a large extent on their different metastatic spread. Papillary thyroid cancer (PTC) has a propensity for cervical lymphatic spread that occurs in 20-50 % of patients whereas distant metastasis occurs in thyroid cancer (FTC) has a marked propensity for vascular but not lymphatic invasion and 10-20 % of FTC develop distant metastases. At the time of diagnosis approximately one third of medullary thyroid cancer (MTC) cases show lymph node metastases, in 10-15 % distant metastases and 25 % develop metastases during the course of the disease. Poorly differentiated (PDTC) and anaplastic thyroid cancer (ATC) spread via both lymphatic and vascular invasion. Thus distant metastases are relatively uncommon in DTC and when they occur, long-term stable disease is the typical clinical course. The major sites of distant metastases are the lungs and bone. Metastases to the brain, breasts, liver, kidneys, muscle and skin are relatively rare or even rare. The thyroid gland itself can be a site of metastases from a variety of other tumors. In autopsy series of patients with disseminated cancer disease, metastases to the thyroid gland were found in up to 10 % of cases. Metastases from other primary tumors to the thyroid gland have been reported in 1.4-3 % of patients who have surgery for suspected cancer of the thyroid gland. The most common primary cancers that metastasize to the thyroid gland are renal cell (48.1 %), colorectal (10.4 %), lung (8.3 %) and breast cancer (7.8 %) and surprisingly often sarcomas (4.0 %).

Prevalence and clinical features of celiac disease in patients with autoimmune thyroiditis: cross-sectional study

Directory of Open Access Journals (Sweden)

Aline Ventura

Full Text Available CONTEXT AND OBJECTIVE: Celiac disease is an autoimmune disorder with an average prevalence of 1% in Europe and the United States. Because of strong European ancestry in southern Brazil, this study aimed to evaluate the seroprevalence of celiac disease among autoimmune thyroiditis patients.DESIGN AND SETTING: Cross-sectional study in a public university hospital.METHODS: This cross-sectional prevalence study included autoimmune thyroiditis patients who were tested for anti-endomysial and anti-transglutaminase antibodies between August 2010 and July 2011.RESULTS: Fifty-three patients with autoimmune thyroiditis were included; 92.5% were women, with mean age of 49.0 ± 13.5 years. Five patients (9.3% were serologically positive for celiac disease: three of them (5.6% were reactive for anti-endomysial antibodies and two (3.7% for anti-transglutaminase. None of them exhibited anemia and one presented diarrhea. Endoscopy was performed on two patients: one with normal histology and the other with lymphocytic infiltrate and villous atrophy.CONCLUSION: The prevalence of celiac disease among patients with autoimmune thyroid disease was 9.3%; one patient complained of diarrhea and none presented anemia. Among at-risk populations, like autoimmune thyroiditis patients, the presence of diarrhea or anemia should not be used as a criterion for indicating celiac disease investigation. This must be done for all autoimmune thyroiditis patients because of its high prevalence.

Role of ultrasound in the assessment of nodular thyroid disease

International Nuclear Information System (INIS)

Bastin, S.; Bolland, M. J.; Croxson, M. S.

2009-01-01

Full text: The role for ultrasound (US) in the assessment of nodular thyroid disease has increased in recent years. This expanded role has been highlighted in recent consensus guidelines on the management of nodular thyroid disease. In this review, we address the potential roles for US in assessing thyroid nodules and review these recent guidelines. In particular, we review the evidence that US characteristics of thyroid nodules can predict the risk of malignancy. A predominantly solid nodule, hypoechogenicity, microcalcification, macrocalcification, ill-defined margins, intranodular vascularity, and taller-than-wide shape have all been associated with increased risk of malignancy, but no single US characteristic is sufficiently sensitive or specific to exclude or diagnose malignancy by itself. However, the use of combinations of US characteristics to stratify nodules into high and low risk for malignancy appears a promising strategy. Unselected nodules without any suspicious US features have a low risk of malignancy (<2%), whereas malignancy rates are much higher in nodules with at least two suspicious features. Recent guidelines endorse this approach of using combinations of US features to guide nodule selection for fine needle aspiration.

Clinical significance of computed tomography in the measurement of thyroid volume after operation for Basedow's disease

International Nuclear Information System (INIS)

Kasuga, Yoshio; Miyakawa, Makoto; Sugenoya, Akira

1986-01-01

The postoperative volume of the thyroid glands was measured using computed tomography (CT) in 16 patients with Basedow's disease. In the group which had normal postoperative thyroid function and did not need to receive T 4 , CT showed increase of thyroid volume. In three of the four patients who needed to receive it, CT showed decreased thyroid volume, as compared with that immediately after operation. CT has proved to serve as a tool for measuring postoperative thyroid volume for Basedow's disease in relation to postoperative prognosis. (Namekawa, K.)

Quantitative thyroid scintigraphy for the differentiation of Graves' disease and hyperthyroid autoimmune thyroiditis

International Nuclear Information System (INIS)

Sahlmann, C.O.; Siefker, U.; Lehmann, K.; Harms, E.; Conrad, M.; Meller, J.

2004-01-01

The purpose of this study is the evaluation of the TCTUs in the differentiation between AIT and GD in patients with hyperthyroidism. Methods: We determined the TCTUs in 59 patients with untreated hyperthyroid GD and in 51 patients with AIT who had subclinical or manifest hyperthyroidism without medication. Patients with GD were characterized by the presence of hyperthyroidism, decreased echogenicity of the thyroid, elevation of TSH-receptor autoantibodies (TRAb). AIT was defined by a decreased echogenicity of the thyroid, absence of elevated TSH-receptor autoantibodies (TRAb), autoantibodies against the thyroid peroxidase (anti-TPO) and spontaneous remission or development of subclinical hypothyroidism within 3 months. Results: Thyroid volumes of patients with AIT were significantly lower than those of patients with GD (p 99m TcO 4 - offered rapid and reliable differentiation between hyperthyroid GD and AIT. (orig.)

Objective evaluation of improvement in optic neuropathy following radiation therapy for thyroid eye disease

International Nuclear Information System (INIS)

Rush, Stephen; Winterkorn, Jacqueline; Zak, Rochelle

2000-01-01

Purpose: While the literature supports the use of radiation therapy for thyroid eye disease, it does not sufficiently describe in detail the results of radiation therapy for optic neuropathy associated with thyroid eye disease. The objective of this study is to quantify the changes in parameters of optic neuropathy after orbital irradiation for thyroid eye disease. Methods and Materials: Twelve consecutive patients with optic neuropathy from thyroid eye disease were followed by a single neuro-ophthalmology practice and treated by one radiation oncologist with radiation therapy from 1991 through 1995. All cases were prospectively followed for visual acuity, color vision, mean deviation, and/or foveal sensitivity and afferent pupillary defect. All patients received 2000 cGy in 10 fractions with megavoltage irradiation to the orbits. Results: Ten of 12 patients were evaluated for follow-up (one moved out of this country and one had a stroke, which confounded interpretation of examination results). An analysis was performed retrospectively while treatment and evaluation remained uniform. Five men and five women formed the basis of this study with a median age of 60 years (35-76 years). Nineteen eyes were evaluated for thyroid optic neuropathy. Improvement in optic nerve function occurred in eight of ten patients. Improvement was seen either during radiotherapy or within 2 weeks of completion. No long-term adverse effects were noted. Conclusion: This study objectively demonstrates improvement in optic neuropathy from radiation therapy for thyroid eye disease

IL-1β a potential factor for discriminating between thyroid carcinoma and atrophic thyroiditis.

Science.gov (United States)

Kammoun-Krichen, Maha; Bougacha-Elleuch, Noura; Mnif, Mouna; Bougacha, Fadia; Charffedine, Ilhem; Rebuffat, Sandra; Rebai, Ahmed; Glasson, Emilie; Abid, Mohamed; Ayadi, Fatma; Péraldi-Roux, Sylvie; Ayadi, Hammadi

2012-01-01

Interactions between cytokines and others soluble factors (hormones, antibodies...) can play an important role in the development of thyroid pathogenesis. The purpose of the present study was to examine the possible correlation between serum cytokine concentrations, thyroid hormones (FT4 and TSH) and auto-antibodies (Tg and TPO), and their usefulness in discriminating between different thyroid conditions. In this study, we investigated serum from 115 patients affected with a variety of thyroid conditions (44 Graves' disease, 17 Hashimoto's thyroiditis, 11 atrophic thyroiditis, 28 thyroid nodular goitre and 15 papillary thyroid cancer), and 30 controls. Levels of 17 cytokines in serum samples were measured simultaneously using a multiplexed human cytokine assay. Thyroid hormones and auto-antibodies were measured using ELISA. Our study showed that IL-1β serum concentrations allow the discrimination between atrophic thyroiditis and papillary thyroid cancer groups (p = 0.027).

Role of major histocompatibility complex class II in the development of autoimmune type 1 diabetes and thyroiditis in rats

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Yokoi, N; Hidaka, S; Tanabe, S; Ohya, M; Ishima, M; Takagi, Y; Masui, N; Seino, S

2012-01-01

Although the MHC class II ‘u' haplotype is strongly associated with type 1 diabetes (T1D) in rats, the role of MHC class II in the development of tissue-specific autoimmune diseases including T1D and autoimmune thyroiditis remains unclear. To clarify this, we produced a congenic strain carrying MHC class II ‘a' and ‘u' haplotypes on the Komeda diabetes-prone (KDP) genetic background. The u/u homozygous animals developed T1D similar to the original KDP rat; a/u heterozygous animals did develop T1D but with delayed onset and low frequency. In contrast, none of the a/a homozygous animals developed T1D; about half of the animals with a/u heterozygous or a/a homozygous genotypes showed autoimmune thyroiditis. To investigate the role of genetic background in the development of thyroiditis, we also produced a congenic strain carrying Cblb mutation of the KDP rat on the PVG.R23 genetic background (MHC class II ‘a' haplotype). The congenic rats with homozygous Cblb mutation showed autoimmune thyroiditis without T1D and slight to severe alopecia, a clinical symptom of hypothyroidism such as Hashimoto's thyroiditis. These data indicate that MHC class II is involved in the tissue-specific development of autoimmune diseases, including T1D and thyroiditis. PMID:21918539

Targeting the thyroid gland with thyroid-stimulating hormone (TSH)-nanoliposomes.

Science.gov (United States)

Paolino, Donatella; Cosco, Donato; Gaspari, Marco; Celano, Marilena; Wolfram, Joy; Voce, Pasquale; Puxeddu, Efisio; Filetti, Sebastiano; Celia, Christian; Ferrari, Mauro; Russo, Diego; Fresta, Massimo

2014-08-01

Various tissue-specific antibodies have been attached to nanoparticles to obtain targeted delivery. In particular, nanodelivery systems with selectivity for breast, prostate and cancer tissue have been developed. Here, we have developed a nanodelivery system that targets the thyroid gland. Nanoliposomes have been conjugated to the thyroid-stimulating hormone (TSH), which binds to the TSH receptor (TSHr) on the surface of thyrocytes. The results indicate that the intracellular uptake of TSH-nanoliposomes is increased in cells expressing the TSHr. The accumulation of targeted nanoliposomes in the thyroid gland following intravenous injection was 3.5-fold higher in comparison to untargeted nanoliposomes. Furthermore, TSH-nanoliposomes encapsulated with gemcitabine showed improved anticancer efficacy in vitro and in a tumor model of follicular thyroid carcinoma. This drug delivery system could be used for the treatment of a broad spectrum of thyroid diseases to reduce side effects and improve therapeutic efficacy. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Marine-Lenhart syndrome with papillary thyroid carcinoma

Directory of Open Access Journals (Sweden)

Hulusi Atmaca

2015-01-01

Full Text Available Graves′ disease with accompanying functioning nodules is known as Marine-Lenhart syndrome. Autonomously functioning thyroid nodules (AFTNs also within Graves′ thyroid tissue are almost always bening in nature. A 45-year-old man developed hyperthyroidism due to the coexistence of Graves′ disease and AFTN. Total thyroidectomy was performed. The hyperfunctioning nodule with centrally hypoactive foci detected by technetium-99m thyroid scanning was histologically diagnosed as papillary thyroid carcinoma that was 2.5 cm in diameter. We report the presence of papillary thyroid carcinoma within AFTN in patients with Marine-Lenhart syndrome, which has not been reported so far.

Marine-Lenhart syndrome with papillary thyroid carcinoma.

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Atmaca, Hulusi; Çolak, Ramis; Yazici, Zihni Acar; Kefeli, Mehmet; Tosun, Fevziye Canbaz

2015-04-01

Graves' disease with accompanying functioning nodules is known as Marine-Lenhart syndrome. Autonomously functioning thyroid nodules (AFTNs) also within Graves' thyroid tissue are almost always bening in nature. A 45-year-old man developed hyperthyroidism due to the coexistence of Graves' disease and AFTN. Total thyroidectomy was performed. The hyperfunctioning nodule with centrally hypoactive foci detected by technetium-99m thyroid scanning was histologically diagnosed as papillary thyroid carcinoma that was 2.5 cm in diameter. We report the presence of papillary thyroid carcinoma within AFTN in patients with Marine-Lenhart syndrome, which has not been reported so far.

Impact of lymphocytic thyroiditis on incidence of pathological incidental thyroid carcinoma.

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Farrell, Eric; Heffron, Cynthia; Murphy, Matthew; O'Leary, Gerard; Sheahan, Patrick

2017-01-01

The purpose of this study was to investigate the impact of lymphocytic thyroiditis on incidence of incidental thyroid cancers. We conducted a retrospective review of 713 consecutive patients who underwent thyroidectomies. Incidental thyroid cancer was defined as an unexpected cancer discovered on pathological examination outside the index nodule undergoing preoperative cytology. We excluded 65 cases because of preoperative diagnosis of thyroid cancer, and 68 because of nonincidental cancer within the index nodule. Among the remaining 580 cases, there were 43 cases (7.4%) of incidental thyroid cancers. Incidental thyroid cancers were significantly associated with moderate/severe lymphocytic thyroiditis (relative risk = 2.5; p = .03). Sixteen of 56 patients with moderate/severe lymphocytic thyroiditis had Graves' disease, none of whom had incidental thyroid cancer. The risk of incidental thyroid cancer associated with moderate/severe lymphocytic thyroiditis was significantly higher in non-Graves' than patients with Graves' disease (p = .05). The risk of incidental thyroid cancer is significantly increased in patients with moderate/severe lymphocytic thyroiditis. Moderate/severe lymphocytic thyroiditis associated with Graves' disease seems to have a lower risk of incidental thyroid cancer. © 2016 Wiley Periodicals, Inc. Head Neck 39: 122-127, 2017. © 2016 Wiley Periodicals, Inc.

{sup 99m}Tc-sestamibi thyroid uptake in euthyroid individuals and in patients with autoimmune thyroid disease

Energy Technology Data Exchange (ETDEWEB)

Santos, Allan O. [Campinas State University, Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Campinas (Brazil); Avenida Independencia, Piracicaba, Sao Paulo (Brazil); Zantut-Wittmann, D.E.; Tambascia, M.A. [Campinas State University, Division of Endocrinology, Department of Internal Medicine, School of Medical Sciences, Campinas (Brazil); Nogueira, R.O.; Etchebehere, E.C.S.C.; Lima, M.C.L.; Camargo, E.E.; Ramos, C.D. [Campinas State University, Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Campinas (Brazil)

2005-06-01

We investigated the biokinetics of {sup 99m}Tc-sestamibi in the thyroid of euthyroid volunteers (EVs) and in patients with autoimmune thyroid diseases and determined the best time interval between {sup 99m}Tc-sestamibi injection and calculation of uptake. Forty EVs, 30 patients with Graves' disease (GD), 15 patients with atrophic Hashimoto's thyroiditis (AHT) and 15 patients with hypertrophic Hashimoto's thyroiditis (HHT) underwent {sup 99m}Tc-sestamibi thyroid scintigraphy. Dynamic images were acquired for 20 min, and static images were obtained 20 min, 60 min and 120 min post injection. Five-, 20-, 60- and 120-min uptake, time to maximal uptake (T{sub max}) and T{sub 1/2} of tracer clearance were calculated. Thyroid hormones and antibodies were measured. {sup 99m}Tc-pertechnetate uptake was investigated in GD patients. T{sub max} was approximately 5 min in all four groups. The mean T{sub 1/2} value for EVs was similar to the GD value and lower than the HHT and AHT values. The mean ({+-}SD) 5-min uptake was 0.13% ({+-}0.05%) for EVs. The 5-min uptake in GD was higher than that in EVs(P<0.001) and correlated with free thyroxine (r=0.54) and with {sup 99m}Tc-pertechnetate uptake (r=0.68). Uptake in HHT was higher than that in AHT (P=0.0003) and EVs (P=0.002). Uptake in AHT was lower than uptake in EVs (P=0.0001). Five minutes is the optimal time interval between {sup 99m}Tc-sestamibi injection and calculation of thyroid uptake. Five-minute uptake differentiates euthyroid individuals from GD patients. There is a high correlation between {sup 99m}Tc-sestamibi and {sup 99m}Tc-pertechnetate uptake in GD. The reduced {sup 99m}Tc-sestamibi uptake in AHT patients is probably due to glandular destruction and fibrosis. Inflammatory infiltrate and high mitochondrial density in thyrocytes possibly explain the increased uptake in GD and HHT. (orig.)

Regulatory B and T cell responses in patients with autoimmune thyroid disease and healthy controls

DEFF Research Database (Denmark)

Kristensen, Birte; Hegedüs, Laszlo

2016-01-01

). HT is primarily a T-cell mediated disease, and whether B cells play a pathogenic role in the pathogenesis is still unclear. Both GD and HT are characterized by infiltration of the thyroid gland by self-reactive T cells and B cells. In the first paper of this thesis, the role of regulatory B cells...... (Bregs) and regulatory T cells (Tregs) were investigated in the context of GD and HT. First, we studied the role of the thyroid self-antigen, thyroglobulin (TG) in healthy donors. The self-antigen TG, but not the foreign recall antigen tetanus toxoid (TT), was able to induce interleukin 10 (IL-10......Autoimmune diseases occur due to faulty self-tolerance. Graves' disease (GD) and Hashimoto's thyroiditis (HT) are classic examples of organ-specific autoimmune diseases. GD is an auto-antibody-mediated disease where autoantibodies are produced against the thyroid stimulating hormone receptor (TSHR...

Milk production and distribution in low-dose counties for the Hanford Thyroid Disease Study

International Nuclear Information System (INIS)

Schimmel, J.G.

1992-06-01

This report identifies sources of milk consumed by residents of Ferry, Okanogan, and Stevens Counties. This information will be used by the Hanford thyroid Disease Study to determine whether thyroid disease has been increased among people exposed to past iodine--131 emissions from Hanford Site Facilities

Clinical study of color Doppler sonography in Graves' disease blood flow changes after thyroid arteries embolization

International Nuclear Information System (INIS)

Zhuang Wenquan; Li Weiduo; Yang Jianyong; Chen Wei; Huang Yonghui; Guo Wenbo; Li Jiaping

2003-01-01

Objective: To study the color doppler image characteristics of thyroid arteries pre- and post-interventional procedure and to assess the clinical efficacy in Gnaves' disease. Methods: 11 from 31 patients diagnosed as Graves' disease undertaken thyroid arteries embolization, were analyzed. Color Doppler sonography was applied to monitor the pre-and post- procedure thyroid size and diameters of thyroid arteries. Power Doppler was used to detect the Vmax, Vmin, RI and blood flow. Results: After thyroid arteries embolization, the size and vascularity of thyroids were reduced. The thyroid arteries showed shrinkage and stoppage blood flow at the embolized site. The changes of RI, blood parameters of Vmax, Vmin and diameters of the thyroid arteries pre- and post-procedure turned out to be statistically significant for clinical restriction. Conclusion: The color Doppler sonography plays an important role for preoperative diagnosis and predicting the prognosis

Breast cancer metastases to the thyroid gland - an uncommon sentinel for diffuse metastatic disease: a case report and review of the literature.

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Plonczak, Agata M; DiMarco, Aimee N; Dina, Roberto; Gujral, Dorothy M; Palazzo, Fausto F

2017-09-22

Metastases to the thyroid are rare. The most common primary cancer to metastasize to the thyroid is renal cell carcinoma, followed by malignancies of the gastrointestinal tract, lungs, and skin, with breast cancer metastases to the thyroid being rare. Overall, the outcomes in malignancies that have metastasized to the thyroid are poor. There are no prospective studies addressing the role of surgery in metastatic disease of the thyroid. Isolated thyroidectomy has been proposed as a local disease control option to palliate and prevent the potential morbidity of tumor extension related to the airway. Here, we present a case of a patient with breast cancer metastases to the thyroid gland and discuss the role of thyroidectomy in the context of the current literature. A 62-year-old Afro-Caribbean woman was diagnosed as having bilateral breast carcinoma in 2004, for which she underwent bilateral mastectomy. The pathology revealed multifocal disease on the right, T2N0(0/20)M0 grade 1 and 2 invasive ductal carcinoma, and on the left side, T3N1(2/18)M0 grade 1 invasive ductal carcinoma. Surgery was followed by adjuvant chemotherapy and regional radiotherapy. The disease was under control on hormonal therapy until 2016, when she developed cervical lymphadenopathy. The fine-needle aspiration cytology of the thyroid was reported as papillary thyroid cancer; and the fine-needle biopsy of the left lateral nodal disease was more suggestive of breast malignancy. She underwent a total thyroidectomy and a clearance of the central compartment lymph nodes and a biopsy of the lateral nodal disease. The histopathological analysis was consistent with metastatic breast cancer in the thyroid and lymph nodes with no evidence of a primary thyroid malignancy. A past history of a malignancy elsewhere should raise the index of suspicion of metastatic disease in patients presenting with thyroid lumps with or without cervical lymphadenopathy. Detection of metastases to the thyroid generally

Projected reduction in healthcare costs in Belgium after optimization of iodine intake: impact on costs related to thyroid nodular disease.

Science.gov (United States)

Vandevijvere, Stefanie; Annemans, Lieven; Van Oyen, Herman; Tafforeau, Jean; Moreno-Reyes, Rodrigo

2010-11-01

nodular thyroid disease. There are likely added benefits relating to more optimal thyroid hormone influenced brain development that are more difficult to estimate but may be even more important.

Cutoff value of thyroid uptake of (99m)Tc-pertechnetate to discriminate between Graves' disease and painless thyroiditis: a single center retrospective study.

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Uchida, Toyoyoshi; Suzuki, Ruriko; Kasai, Takatoshi; Onose, Hiroyuki; Komiya, Koji; Goto, Hiromasa; Takeno, Kageumi; Ishii, Shinya; Sato, Junko; Honda, Akira; Kawano, Yui; Himuro, Miwa; Yamada, Emiko; Yamada, Tetsu; Watada, Hirotaka

2016-01-01

Thyroid uptake of (99m)Tc-pertechnetate is a useful way to determine the cause of thyrotoxicosis. In daily clinical practice, (99m)Tc-pertechnetate uptake is used to discriminate between Graves' disease and painless thyroiditis when clinical information is not enough to make the distinction. However, since the optimal cutoff value of (99m)Tc-pertechnetate uptake has not yet been elucidated, our aim was to determine this value. We recruited patients with thyrotoxicosis in whom (99m)Tc-pertechnetate uptake was measured in clinical settings between 2009 and 2013. Three experienced endocrinologists (who were blinded to the value of (99m)Tc-pertechnetate uptake and initial treatment) diagnosed the cause of thyrotoxicosis based on thyrotropin, free triiodothyronine, free thyroxine, and thyrotropin receptor antibody levels, and by ultrasound findings and using images of thyroid uptake of (99m)Tc-pertechnetate without the actual values. Ninety-four patients diagnosed as having Graves' disease or painless thyroiditis were finally included. According to the diagnosis, the optimal cutoff value of (99m)Tc-pertechnetate uptake was determined by receiver operating characteristics analysis. A cutoff value of 1.0% provided optimal sensitivity and specificity of 96.6% and 97.1%, respectively. Then, its validity was confirmed in 78 patients with confirmed Graves' disease or painless thyroiditis diagnosed at another institute. Applying this cutoff value to the patients with thyrotoxicosis revealed positive and negative predictive values for Graves' disease of 100% and 88.9%, respectively. In conclusion, a cutoff value for (99m)Tc-pertechnetate uptake of 1.0% was useful to discriminate between Graves' disease and painless thyroiditis.

Thyroid Diseases among Patients from Hadhramout Province, Yemen

African Journals Online (AJOL)

Objective: To determine the histopathological pattern of thyroid diseases among patients in Hadhramout Province, Yemen. Materials and Methods: A descriptive retrospective study was conducted at Ibn Sina Central Teaching Hospital, in Mukalla city, Hadhramout, Yemen between January 2007 and December 2012.

Thyroid hormones states and brain development interactions.

Science.gov (United States)

Ahmed, Osama M; El-Gareib, A W; El-Bakry, A M; Abd El-Tawab, S M; Ahmed, R G

2008-04-01

The action of thyroid hormones (THs) in the brain is strictly regulated, since these hormones play a crucial role in the development and physiological functioning of the central nervous system (CNS). Disorders of the thyroid gland are among the most common endocrine maladies. Therefore, the objective of this study was to identify in broad terms the interactions between thyroid hormone states or actions and brain development. THs regulate the neuronal cytoarchitecture, neuronal growth and synaptogenesis, and their receptors are widely distributed in the CNS. Any deficiency or increase of them (hypo- or hyperthyroidism) during these periods may result in an irreversible impairment, morphological and cytoarchitecture abnormalities, disorganization, maldevelopment and physical retardation. This includes abnormal neuronal proliferation, migration, decreased dendritic densities and dendritic arborizations. This drastic effect may be responsible for the loss of neurons vital functions and may lead, in turn, to the biochemical dysfunctions. This could explain the physiological and behavioral changes observed in the animals or human during thyroid dysfunction. It can be hypothesized that the sensitive to the thyroid hormones is not only remarked in the neonatal period but also prior to birth, and THs change during the development may lead to the brain damage if not corrected shortly after the birth. Thus, the hypothesis that neurodevelopmental abnormalities might be related to the thyroid hormones is plausible. Taken together, the alterations of neurotransmitters and disturbance in the GABA, adenosine and pro/antioxidant systems in CNS due to the thyroid dysfunction may retard the neurogenesis and CNS growth and the reverse is true. In general, THs disorder during early life may lead to distortions rather than synchronized shifts in the relative development of several central transmitter systems that leads to a multitude of irreversible morphological and biochemical