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Sample records for transient congenital hypothyroidism

  1. Congenital Hypothyroidism

    Science.gov (United States)

    ... Disease Featured Resource Find an Endocrinologist Search Congenital Hypothyroidism March 2012 Download PDFs English Espanol Editors Rosalind S. ... Resources MedlinePlus (NIH) Mayo Clinic What is congenital hypothyroidism? Newborn babies who are unable to make enough ...

  2. High prevalence of DUOX2 mutations in Japanese patients with permanent congenital hypothyroidism or transient hypothyroidism.

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    Matsuo, Kumihiro; Tanahashi, Yusuke; Mukai, Tokuo; Suzuki, Shigeru; Tajima, Toshihiro; Azuma, Hiroshi; Fujieda, Kenji

    2016-07-01

    Dual oxidase 2 (DUOX2) mutations are a cause of dyshormonogenesis (DH) and have been identified in patients with permanent congenital hypothyroidism (PH) and with transient hypothyroidism (TH). We aimed to elucidate the prevalence and phenotypical variations of DUOX2 mutations. Forty-eight Japanese DH patients were enroled and analysed for sequence variants of DUOX2, DUOXA2, and TPO using polymerase chain reaction-amplified direct sequencing. Fourteen sequence variants of DUOX2, including 10 novel variants, were identified in 11 patients. DUOX2 variants were more prevalent (11/48, 22.9%) than TPO (3/48, 6.3%) (p=0.020). The prevalence of DUOX2 variants in TH was slightly, but not significantly, higher than in PH. Furthermore, one patient had digenic heterozygous sequence variants of both DUOX2 and TPO. Our results suggest that DUOX2 mutations might be the most common cause of both PH and TH, and that phenotypes of these mutations might be milder than those of other causes.

  3. [Transient congenital hypothyroidism due to biallelic defects of DUOX2 gene. Two clinical cases].

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    Enacán, Rosa E; Masnata, María E; Belforte, Fiorella; Papendieck, Patricia; Olcese, María C; Siffo, Sofía; Gruñeiro-Papendieck, Laura; Targovnik, Héctor; Rivolta, Carina M; Chiesa, Ana E

    2017-06-01

    Congenital hypothyroidism affects 1:2000-3000 newborns detected by neonatal screening programs. Dual oxidases, DUOX1 and 2, generate hydrogen peroxide needed for the thyroid hormone synthesis. Hipotiroidismo congénito transitorio por defectos bialélicos del gen DUOX2. Dos casos clínicos Transient congenital hypothyroidism due to biallelic defects of DUOX2 gene. Two clinical cases Mutations in the DUOX2 gene have been described in transient and permanent congenital hypothyroidism. Two brothers with congenital hypothyroidism detected by neonatal screening with eutopic gland and elevated thyroglobulin are described. They were treated with levothyroxine until it could be suspended in both during childhood, assuming the picture as transient. Organification disorder was confirmed. Both patients were compounds heterozygous for a mutation in exon 9 of the paternal allele (c.1057_1058delTT, p.F353PfsX36 or p.F353fsX388) and in exon 11 of the maternal allele (c.1271T > G, p.Y425X) of DUOX2 gene. Our finding confirms that the magnitude of the defect of DUOX2 is not related to the number of inactivated alleles, suggesting compensatory mechanisms in the peroxide supply. Sociedad Argentina de Pediatría.

  4. [Congenital hypothyroidism].

    Science.gov (United States)

    Castilla Peón, María Fernanda

    Congenital hypothyroidism (CH) is a cause of preventable mental retardation; therefore, timely diagnosis and treatment by the primary care physician is very important. CH screening must be performed between the second and fifth days of life with capillary blood done with a heel prick and must be confirmed by measurement of thyroid hormones in venous blood. The most common cause of CH is thyroid dysgenesis, which may be identified by a thyroid scan carried out before initiating treatment. Treatment should be with levothyroxine (10-15μg/kg/day) and should not be delayed or suspended during the first 3 years of life due to the deleterious effect on neurodevelopment in case of low thyroid hormones during this time. Preterm or sick infants or those with Down syndrome require special consideration. This article provides diagnostic and therapeutic algorithms for CH. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  5. Genetics Home Reference: congenital hypothyroidism

    Science.gov (United States)

    ... Facebook Twitter Home Health Conditions Congenital hypothyroidism Congenital hypothyroidism Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Congenital hypothyroidism is a partial or complete loss of function ...

  6. Mutations of dual oxidase 2 (DUOX2) gene among patients with permanent and transient congenital hypothyroidism

    International Nuclear Information System (INIS)

    Rostampour, N.; Tajaddini, M.H.; Hashemipour, M

    2012-01-01

    Objective: The prevalence of congenital hypothyroidism (CH) is high in Isfahan, Iran. In addition, it has different etiologies compared with other countries. The rate of parental consanguinity is also high in the city. Moreover, DUOX2 gene is effective in transient CH and permanent CH due to dyshormonogenesis. Therefore, the aim of this research was to investigate the mutations of DUOX2 gene in patients with transient CH and permanent CH due to dyshormonogenesis. Methodology: In this descriptive, prospective study, patients diagnosed with transient and permanent CH due to dyshormonogenesis during CH screening program were selected. Venous blood samples were obtained to determine the 3 mutations (Q36H, R376W, and D506N) of DUOX2 gene using polymerase chain reaction (PCR) method by specific primers and complementary methods such as restriction fragment length polymorphism (RFLP) and single-strand conformation polymorphism (SSCP). Results: In this study, 25 patients with transient CH and 33 subjects with permanent CH due to dyshormonogenesis were studied. In addition, 30 children were studied as the control group. We did not find any mutations of the 3 mentioned mutations of DUOX2 gene. Conclusion: Considering the findings of the current study, further studies with other methods are required to evaluate other gene mutations such as pendrin, sodium-iodide symporter (NIS) and thyroglobulin. (author)

  7. The Prevalence of Transient and Permanent Congenital Hypothyroidism in Infants of Kurdistan Province, Iran (2006-2014

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    Zaher khazaei

    2017-02-01

    Full Text Available Background: Congenital hypothyroidism (CH is the most common endocrine diseases and one of the major causes of preventable mental retardation. This study was conducted to investigate the prevalence of transient and permanent congenital hypothyroidism in Kurdistan province, Iran.Materials and Methods: In this cross-sectional study, all registered congenital hypothyroidism neonate of health centers of cities covered by Kurdistan University of Medical Sciences during 2006 to 2014 entered to study. Demographic and laboratory information of CH neonates was collected and entered into the Stata-12 and was analyzed using student t-test and Chi-square statistic and P- value less than 0.05 was considered.Results: Overall incidence rate during 2006 to 2014 for province was 1.8, 2.3, 3.2, 4.3, 3.3, 4.0, 3.6, 4.6 and 2.7, respectively per 1000 neonates in this period. The number of diagnosed patients was 855 cases including 519 (60.7% boys and 336 (39.3% girls who 516 (60.4% cases were from urban areas. Of the total patients, 202 (22.6% were permanent. There was no significant difference between gender, location, type of childbirth, and season of birth with transient and permanent types of disease (P˃0.05; while, there was a significant statistical relationship between consanguineous marriages and congenital hypothyroidism (P

  8. Predictors of transient congenital hypothyroidism in children with eutopic thyroid gland

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    Il Soon Park

    2017-06-01

    Full Text Available PurposeCongenital hypothyroidism (CH is the most common cause of preventable mental retardation. Recently, the detection of CH cases with eutopic thyroid gland has increased due to neonatal screening programs. In this study, we aimed to identify and evaluate predictive factors that could distinguish between permanent and transient CH in patients with eutopic thyroid gland.MethodsWe retrospectively reviewed 100 children diagnosed with CH and with eutopic thyroid gland. All subjects were treated with levothyroxine and underwent re-evaluation after 3 years of age.ResultsOf the 100 CH patients, 35 (35.0% were diagnosed with permanent CH (PCH and 65 (65.0% were diagnosed with transient CH (TCH. The initial thyroid stimulating hormone levels were significantly lower in the TCH subjects than in PCH subjects. In addition, the mean doses of levothyroxine (µg/kg/day at the 1st, 2nd, and 3rd year of treatment were significantly lower in subjects with TCH than in PCH subjects with eutopic thyroid gland. Based on the receiver operating characteristic (ROC curve, the optimal cutoff dose of levothyroxine at 3 years of 2.76 µg/kg/day could predict TCH, and was associated with 87.3% sensitivity and 67.6% specificity, with an area under the ROC curve of 0.769.ConclusionThe levothyroxine dose requirement during treatment period has a predictive role in differentiating TCH from PCH in CH patients with eutopic thyroid gland.

  9. Thyroid function in mothers who gave birth to neonates with transient congenital hypothyroidism

    International Nuclear Information System (INIS)

    Karam, G.A.; Hakimi, H.; Rezaeian, M.; Gafarzadeh, A.; Rashidinejad, H.; Khaksari, M.

    2009-01-01

    Objective: To determine the thyroid status of mother's of newborns with primary congenital hypothyroidism. Methodology: Thyroid function tests were carried out on 80 mothers of hypothyroid newborns and 80 mothers of non-hypothyroid newborns as control. Results: The mean difference of the tests revealed that mothers of congenitally hypothyroid infants had a lower triiodothyronine resin uptake (T3RU) concentrations compared with the control population. The higher value of free thyroxin index (FTI) in case group showed a tendency to significance. The proportional frequency distribution showed; T3RU and triiodothyronine (T3) had a significant difference, and FTI showed a tendency to significance. There were no significant differences between; thyroid-stimulating hormone (TSH), thyroxine (T4) and anti-thyroid peroxidase antibodies (anti-TPO) in two groups. Conclusions: These results indicated that at least some cases of primary congenital hypothyroidism were attributable to the maternal thyroid disease. Therefore, we recommend that each pregnant woman should be assessed for thyroid function in region with a high prevalence of thyroid disease. (author)

  10. Etiological evaluation of primary congenital hypothyroidism cases.

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    Bezen, Diğdem; Dilek, Emine; Torun, Neşe; Tütüncüler, Filiz

    2017-06-01

    Primary congenital hypothyroidism is frequently seen endocrine disorder and one of the preventable cause of mental retardation. Aim of study was to evaluate the frequency of permanent/transient hypothyrodism, and to detect underlying reason to identfy any marker which carries potential to discriminate permanent/transient form. Forty eight cases older than 3 years of age, diagnosed as primary congenital hypothyroidism and started thyroxin therapy in newborn-period, and followed up between January 2007-June 2013 were included in the study. Thyroid hormon levels were evaluated and thyroid ultrasonography was performed in cases who are at the end of their 3 years of age, after 6 weeks of thyroxine free period. Thyroid sintigraphy was performed if serum thyroid-stimulating hormone was high (≥ 5 mIU/mL) and perchlorate discharge test was performed if uptake was normal or increased on sintigraphy. Cases with thyroid-stimulating hormone levels ≥ 5 mIU/mL were defined as permanent primary congenital hypothyroidism group and as transient primary congenital hypothyroidism group with normal thyroid hormones during 6 months. The mean age was 3.8±0.7 years. Mean diagnosis age was 16.6±6.5 days and 14 cases (29.2%) were diagnosed by screening program of Ministry of Health. There were 23 cases (14F, 9M) in permanent primary congenital hypothyroidism group and 12 (52.2%) of them were dysgenesis (8 hypoplasia, 4 ectopia), and 11 (47.8%) dyshormonogenesis. In transient primary congenital hypothyroidism group, there were 25 cases (17M, 8F). The mean thyroid-stimulating hormone levels at diagnosis were similar in two groups. The mean thyroxin dose in permanent primary congenital hypothyroidism group was significantly higher than transient group at the time of thyroxin cessation (2.1±0.7, 1.5±0.5 mg/kg/d, respectively, p=0.004). Thyroxin dose ≥1.6 mcg/kg/d was 72% sensitive and 69.6% specific for predicting permenant primary congenital hypothyroidism. Transient primary

  11. Prevalence of Congenital Hypothyroidism and Transient Increased Levels of TSH in Yazd Province

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    H Shojaeifar

    2008-10-01

    Full Text Available Introduction: Congenital hypothyroidism is one of the most preventable causes of mental retardation. Worldwide, incidences vary from 1:3000 to 1:4000 and mean incidence in Iran is estimated to be 1:1000. Neonatal screening and early treatment within first 2 weeks of neonatal period can prevent neurocognitive deficits. We aimed to study the incidence of CH and increased levels of TSH in Yazd province and collect data describing the disease status and designing first and second levels of preventive interventions. Methods: This descriptive analytic study was performed by census cross sectional method on 13022 neonates in Yazd province in 2006-2007(March 2006- March 2007 including 6495 females and 6527 males. Sampling was done (within the first 3-5 days of life by lancet sticking of neonatal heel. After transfer of 3 blood drops over filter papers, the TSH level was measured. If the TSH level was equal or higher than 5 mu/l, additional confirmation tests were done. Neonates were diagnosed according to serum confirmation test (TSH10 mu/l or T4<6.5g/dl and underwent treatment according to national guidelines. Data was analyzed by SPSS software. Results: Total number of patients was 45, including 25 males (55.5% and 20 females (44.5%. Prevalence in males, females and overall was consecutively, 1:261, 1:325 and 1:289, but this difference was not statistically significant. Prevalence in urban and rural areas was 1:315 and 1:216, but the difference was statistically not significant. The prevalence during spring, summer, autumn& winter was 1:95, 1:250, 1:1934 and 1:369, respectively, that was statistically significant. Mean age at sampling was 7.2 days, mean TSH level 2.3 mu/l and mean age of mothers was 25.8 years. Conclusions: Incidence of CH and transient increased levels of TSH in Yazd province is significantly higher than national and worldwide levels that necessitate the constancy and reinforcement of neonatal screening program. On the other

  12. Congenital hypothyroidism in neonates

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    Aneela Anjum

    2014-01-01

    Full Text Available Context: Congenital hypothyroidism (CH is one of the most common preventable causes of mental retardation in children and it occurs in approximately 1:2,000-1:4,000 newborns. Aims and Objectives: The aim of this study is to determine the frequency of CH in neonates. Settings and Design: This cross-sectional study was conducted in neonatal units of the Department of Pediatrics Unit-I, King Edward Medical University/Mayo Hospital, Lahore and Lady Willington Hospital Lahore in 6 months (January-June 2011. Materials and Methods: Sample was collected by non-probability purposive sampling. After consent, 550 newborn were registered for the study. Demographic data and relevant history was recorded. After aseptic measures, 2-3 ml venous blood analyzed for thyroid-stimulating hormone (TSH level by immunoradiometric assay. Treatment was started according to the individual merit as per protocol. Statistical Analysis Used: Data was analyzed by SPSS 17 and Chi-square test was applied to find out the association of CH with different variables. Results: The study population consisted of 550 newborns. Among 550 newborns, 4 (0.8% newborns had elevated TSH level. CH had statistically significant association with mother′s hypothyroidism (P value 0.000 and mother′s drug intake during the pregnancy period (P value 0.013. Conclusion: CH is 0.8% in neonates. It has statistically significant association with mother′s hypothyroidism and mother′s drug intake during pregnancy.

  13. Inactivating mutations in the gene for thyroid oxidase 2 (THOX2) and congenital hypothyroidism

    NARCIS (Netherlands)

    Moreno, José C.; Bikker, Hennie; Kempers, Marlies J. E.; van Trotsenburg, A. S. Paul; Baas, Frank; de Vijlder, Jan J. M.; Vulsma, Thomas; Ris-Stalpers, C.

    2002-01-01

    Background Several genetic defects are associated with permanent congenital hypothyroidism. Immunologic, environmental, and iatrogenic (but not genetic) factors are known to induce transient congenital hypothyroidism, which spontaneously resolves within the first months of life. We hypothesized that

  14. Congenital hypothyroidism: insights into pathogenesis and treatment

    OpenAIRE

    Cherella, Christine E.; Wassner, Ari J.

    2017-01-01

    Congenital hypothyroidism occurs in approximately 1 in 2000 newborns and can have devastating neurodevelopmental consequences if not detected and treated promptly. While newborn screening has virtually eradicated intellectual disability due to severe congenital hypothyroidism in the developed world, more stringent screening strategies have resulted in increased detection of mild congenital hypothyroidism. Recent studies provide conflicting evidence about the potential neurodevelopmental risks...

  15. Genetics of Primary Congenital Hypothyroidism

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    Zwaveling-Soonawala, Nitash; van Trotsenburg, Paul

    2018-01-01

    Congenital hypothyroidism (CH) is one of the most common preventable forms of mental retardation and since the implementation of neonatal screening programs in the mid-1970s, early detection and treatment have proven to be very successful in preventing brain damage. CH may be of thyroidal (=

  16. Congenital hypothyroidism presenting with postpartum bradycardia

    International Nuclear Information System (INIS)

    Kara, S.; Tayman, C.; Tonbul, A.; Tatli, M.; Andiran, N.; Turkay, S.

    2013-01-01

    Congenital hypothyroidism is a clinical condition characterized by lack of thyroid hormone because of thyroid gland developmental and thyroid hormone biosynthesis disorders. The most common cause of permanent hypothyroidism is congenital factors. Prompt diagnosis is critical. However, overt signs of hypothyroidism are rarely present at birth, and 95% of affected babies are asymptomatic. Hypoxemia, apnea, acidosis, increased intracranial pressure, vagal stimulus and central nerve system abnormalities represent the most common causes of bradycardia in the neonate. Bradycardia associated with congenital hypothyroidism is very rare. In this paper, a case of severe congenital hypothyroidism, induced by maternal blocker antibodies, who presented with bradycardia, is reported. (author)

  17. Sonographic evaluation of children with congenital hypothyroidism

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    Anelise de Almeida Sedassari

    2015-08-01

    Full Text Available AbstractObjective:To establish benchmarks and study some sonographic characteristics of the thyroid gland in a group of euthyroid children aged up to 5 years as compared with age-matched children with congenital hypothyroidism.Materials and Methods:Thirty-six children (17 female and 19 male aged between 2 months and 5 years were divided into two groups – 23 euthyroid children and 13 children with congenital hypothyroidism – and were called to undergo ultrasonography.Results:In the group of euthyroid children (n = 23, mean total volume of the thyroid gland was 1.12 mL (minimum, 0.39 mL; maximum, 2.72 mL; a homogeneous gland was found in 17 children (73.91% and 6 children (26.08% had a heterogeneous gland. In the group of children with congenital hypothyroidism (n = 13, mean total volume of the thyroid gland was 2.73 mL (minimum, 0.20 mL; maximum, 11.00 mL. As regards thyroid location, 3 patients (23.07% had ectopic thyroid, and 10 (69.23% had topic thyroid, and out of the latter, 5 had a homogeneous gland (50% and 5, a heterogeneous gland (50%. In the group with congenital hypothyroidism, 6 (46.15% children had etiological diagnosis of dyshormoniogenesis, 3 (23.07%, of ectopic thyroid, and 4 (30.76%, of thyroid hypoplasia.Conclusion:Thyroid ultrasonography is a noninvasive imaging method, widely available, easy to perform and for these reasons could, and should, be performed at any time, including at birth, with no preparation or treatment discontinuation, to aid in the early etiological definition of congenital hypothyroidism.

  18. Transient hypothyroidism following radioiodine therapy for thyrotoxicosis

    International Nuclear Information System (INIS)

    Connell, J.M.C.; McCruden, D.C.; Alexander, W.D.; Hilditch, T.E.

    1983-01-01

    A prospective study of thyroid function including serial tracer radioisotope uptake measurements in 55 patients treated with 131 I therapy is described. Five patients had an episode of transient hypothyroidism within eight months of treatment: in three of these patients this was due to impaired organification of iodide, with normal iodide trapping by the thyroid (as measured by a twenty minute 123 I uptake) being preserved. In contrast, in all patients who developed permanent hypothyroidism, iodide trapping was markedly diminished and did not recover. It is suggested that hypothyroidism due to organification failure following 131 I therapy is potentially short-lived; where hypothyroidism is associated with gross impairment of iodide trapping, recovery is unlikely. Early iodine uptake measurements may be of value in selecting those patients whose hypothyroidism is transient and who do not require permanent thyroid hormone replacement. (author)

  19. Hypothyroidism

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    ... to meet your body's needs. This condition is hypothyroidism. Hypothyroidism is more common in women, people with other ... cause. Other causes include thyroid nodules, thyroiditis, congenital hypothyroidism, surgical removal of part or all of the ...

  20. Recent Advances in Central Congenital Hypothyroidism

    OpenAIRE

    Schoenmakers, Nadia Adham; Alatzoglou, Kyriaki S; Chatterjee, Vengalil Krishna; Dattani, Mehul T

    2015-01-01

    Central Congenital Hypothyroidism (CCH) may occur in isolation, or more frequently in combination with additional pituitary hormone deficits with or without associated extrapituitary abnormalities. Although uncommon, it may be more prevalent than previously thought, affecting up to 1:16000 neonates in the Netherlands. Since TSH is not elevated, CCH will evade diagnosis in primary, TSH-based, CH screening programs and delayed detection may result in neurodevelopmental delay due to untreated ne...

  1. Recent advances in central congenital hypothyroidism

    OpenAIRE

    Schoenmakers, Nadia; Alatzoglou, Kyriaki S; Chatterjee, V Krishna; Dattani, Mehul T

    2015-01-01

    Central congenital hypothyroidism (CCH) may occur in isolation, or more frequently in combination with additional pituitary hormone deficits with or without associated extrapituitary abnormalities. Although uncommon, it may be more prevalent than previously thought, affecting up to 1:16?000 neonates in the Netherlands. Since TSH is not elevated, CCH will evade diagnosis in primary, TSH-based, CH screening programs and delayed detection may result in neurodevelopmental delay due to untreated n...

  2. Congenital Hypothyroidism and Goitre in Childhood

    OpenAIRE

    Davis, Albert J.; Curtis, Joseph

    1990-01-01

    The problems of congenital hypothyroidism and goitre are relatively common in childhood. The investigation and treatment of these disorders requires a knowledge of their various causes, appropriate investigation, and referral for specialist consultation as necessary, as well as involvement of the family physician in the monitoring of effectiveness of and compliance with treatment. Many of these disorders have life-long implications for the individual affected.

  3. Unusual occurrence of congenital hypothyroidism in a set of same ...

    African Journals Online (AJOL)

    Congenital hypothyroidism is the most common endocrinological disorder in children. Genetic and intrauterine factors have been implicated in its aetiology. The aim of this study was to describe an unusual occurrence of congenital hypothyroidism in a set of same sex triplets and challenges associated with the diagnosis.

  4. Screening for congenital hypothyroidism in Lebanon

    International Nuclear Information System (INIS)

    El Ezzi, Asmahan; Hachem, Hoda

    1999-01-01

    Full text.National programs of neonatal screening were introduced in most countries and have proved their effectiveness against different types of retardation in children. Congenital hypothyroidism is one of the most common causes of physical and mental retardation in children. Programs of screening have shown that the incidence of this disorder is ethnic-background: it is low in Africans: 1-32000 whereas it is 1-3500 and 1-5000 in Hispanic and European newborns respectively. No previous mass screening programs were done in Lebanon. For this purpose, this program was introduced in collaboration with the IAEA. Cord blood is spotted into circles on filter paper just after delivery. These samples are air-dried at room temperature and kept at 4 degree C. They are then collected from hospitals to be screened. In the laboratory, all samples are assayed for IRMA TSH first. Those showing high or borderline TSH level (20mU/L) are then assayed for RIA TT4. Only those showing straight forward high TSH and low TT4 are considered as congenital hypothyroidism cases. For IRMA and RIA, the technique of coated beads is used. We started the program by using reagents from NETRIA, but actually, we start preparing most of our reagents with the exception pf the tracer. A total of 7500 babies have been up now. One case was detected as possible case of congenital hypothyroidism: straight forward high TSH and borderline TT4: this case is now under treatment by endocrinologist and is supposed to have a problem at the pituitary level

  5. Recent advances in central congenital hypothyroidism

    Science.gov (United States)

    Schoenmakers, Nadia; Alatzoglou, Kyriaki S; Chatterjee, V Krishna; Dattani, Mehul T

    2015-01-01

    Central congenital hypothyroidism (CCH) may occur in isolation, or more frequently in combination with additional pituitary hormone deficits with or without associated extrapituitary abnormalities. Although uncommon, it may be more prevalent than previously thought, affecting up to 1:16 000 neonates in the Netherlands. Since TSH is not elevated, CCH will evade diagnosis in primary, TSH-based, CH screening programs and delayed detection may result in neurodevelopmental delay due to untreated neonatal hypothyroidism. Alternatively, coexisting growth hormones or ACTH deficiency may pose additional risks, such as life threatening hypoglycaemia. Genetic ascertainment is possible in a minority of cases and reveals mutations in genes controlling the TSH biosynthetic pathway (TSHB, TRHR, IGSF1) in isolated TSH deficiency, or early (HESX1, LHX3, LHX4, SOX3, OTX2) or late (PROP1, POU1F1) pituitary transcription factors in combined hormone deficits. Since TSH cannot be used as an indicator of euthyroidism, adequacy of treatment can be difficult to monitor due to a paucity of alternative biomarkers. This review will summarize the normal physiology of pituitary development and the hypothalamic–pituitary–thyroid axis, then describe known genetic causes of isolated central hypothyroidism and combined pituitary hormone deficits associated with TSH deficiency. Difficulties in diagnosis and management of these conditions will then be discussed. PMID:26416826

  6. Newborn screening for congenital hypothyroidism in Henan province, China.

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    Zhao, De-Hua; Shen, Yong; Gong, Jiao-Mei; Meng, Yun; Su, Li; Zhang, Xia

    2016-01-15

    Congenital hypothyroidism is the most common congenital endocrine disorder. The study aimed to determine the congenital hypothyroidism incidence by newborn screening programs in Henan Province, China. The screening programs for congenital hypothyroidism are based on the measurement of TSH in dried blood spots. The TSH concentration was measured in the dry blood spot specimen using a DELFIA fluoroimmunoassay. The TSH cutoff concentration was 8mU/l. The total coverage and the incidence of congenital hypothyroidism were 24.85% (5,142,148/20,694,441) and 0.37‰ (1992/5,142,148), respectively. The coverage and the incidence of CH were only 0.58% (4526/784,580) and 0.22‰ (1/4526) in 1997, respectively. However, the coverage and the incidence of CH were increased to 74.67% (1,203,278/1,611,582) and 0.32‰ (389/1,203,278). There were no significant differences in the number of congenital hypothyroidism between males and females (P>0.05). The number of congenital hypothyroidism was increased year after year. The newborn screening program for CH is successful and quite effective. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Transient hypothyroidism after 131I treatment of Graves disease

    International Nuclear Information System (INIS)

    Liu Jianfeng; Fang Yi; Zhang Xiuli; Ye Genyao; Xing Jialiu; Zhang Youren

    2003-01-01

    Objective: To evaluate the results of the transient hypothyroidism after 131 I treatment of Graves disease. Methods: A total of 32 transient hypothyroidism patients treated with 131 I for Graves disease were studied and followed up. Results: Transient hypothyroidism occurred within 2-6 months after 131 I treatment and 19 patients were symptomatic. At diagnosis of transient hypothyroidism, T 3 and T 4 levels were decreased had normal, TSH levels were increased, normal or low. Follow-up examination found that 20 patients were normal and 12 patients had relapse of hyperthyroidism. Conclusions: Therapy of Graves disease with low doses of 131 I causes a high incidence of transient hypothyroidism. After recovery of transient hypothyroidism, some patients have relapse of hyperthyroidism

  8. Newborn screening for congenital hypothyroidism in a public sector hospital

    International Nuclear Information System (INIS)

    Ghafoor, F.; Mohsin, S.N.; Mukhtar, S.; Hussain, W.

    2013-01-01

    Background: Congenital hypothyroidism if left untreated results in growth failure, irreversible mental retardation, and cretinism. National neonatal screening programs are therefore, launched to diagnose congenital hypothyroidism and manage it timely. Objectives: To screen new borns for congenital hypothyroidism in two public sector hospitals of Lahore. Study type, settings and duration:Cross sectional descriptive study conducted at departments of Gynae/Obs and Pediatric Shaikh Zayed Hospital and Jinnah Hospital, Lahore from February 2010 to November 2011. Subjects and Methods: Awareness brochures for congenital hypothyroidism were developed and attached with the antenatal card of each pregnant case attending antenatal clinic at Gynae/Obs OPD. Newborns who had stayed in hospital for more than 24 hour, and whose parents consented for heal prick were tested for blood spot thyroid-stimulating hormone. Results were reported within four days and thyroid-stimulating hormone >= 20mIU/L was taken as high value. Parents of those neonates who had high value were contacted to give a fresh sample for confirmation. Confirmed results were provided within next 4-5 days to the parents and treating pediatrician for appropriate treatment. Results: A total of 1357 samples were screened using blood spot thyroid-stimulating hormone and out of these 1330 were normal ( =20mIU/L). These 27 neonates were further tested using confirmatory tests For serum thyroid-stimulating hormone, T3 and T4. After confirmatory tests only one case had congenital hypothyroidism who was referred for treatment. Three cases were suspected to have subclinical hypothyroidism and these were retested after six months which, picked another case of confirmed subclinical hypothyroidism who was referred for treatment. The incidence of congenital hypothyroidism was 2 out of 1357 cases. Conclusion: The screening could pick 2 cases of hypothyroidism from a total of 1357 cases which is high when compared to global rates

  9. Congenital hypothyroidism: etiology and growth-development outcome.

    Science.gov (United States)

    Dalili, Setila; Rezvani, Seyed Mahmood; Dalili, Hossein; Mohtasham Amiri, Zahra; Mohammadi, Hamid; Abrisham Kesh, Sahar; Novin, Mohammad Hassan; Medghalchi, Abdolreza; Gholamnezhad, Hajar

    2014-01-01

    One of the most preventable causes of mental and growth retardation is congenital hypothyroidism (CH). This study tries to investigate growth and mental outcome of patients with CH. Since November 2006 and November 2007 in Guilan province, north of Iran, all neonates who were diagnosed with CH, evaluated for etiology of CH by laboratory follow up, thyroid sonography or scan. Growth and development of patients with CH were compared with healthy children in same age, geographical area, social and economical classes in four years old. Demographic characteristics including height, weight, and head circumference at birth, follow up time (four years old) and IQ (Good enough test) were recorded in questionnaires. Among 28904 screened neonates, 37 patients with CH were diagnosed. Incidence of CH was 1:781 in live births, 20 (54%) in female neonates and 17 (46%) in male neonates. The incidences of permanent and transient hypothyroidism were 43.2% (16 cases) and 56. 8% (21 cases) respectively. The incidence of permanent and transient hypothyroidism were 16 (43.2%) and 21 (56, 8%), respectively. In permanent CH, 11 cases (%.68.2) had dyshormonogenesis and 5 cases (%.31.2) had thyroid dysgenesis. Significant statistical difference was only in family history of thyroid disease (34, 3% Positive family history in CH vs. 13.2% in control group, P-value 0.03). All other demographic characteristics and IQ had no statistical difference. Patients with CH diagnosed through neonatal screening and treated had normal growth as general population that indicates effective screening program and treatment in this area (3.2%).

  10. Increased Prevalence of Renal and Urinary Tract Anomalies in Children with Congenital Hypothyroidism

    Science.gov (United States)

    Kumar, Juhi; Gordillo, Roberto; Kaskel, Frederick J.; Druschel, Charlotte M.; Woroniecki, Robert P.

    2013-01-01

    Objective We investigated the prevalence of congenital renal and urologic anomalies in children with congenital hypothyroidism to determine whether further renal and urologic investigations would be of benefit. Study design Prevalence of congenital hypothyroidism was obtained from the New York State Congenital Malformation Registry. The occurrence of urinary tract anomalies were calculated for children with congenital hypothyroidism and compared to children without congenital hypothyroidism. In addition we obtained congenital hypothyroidism data from New York State newborn screening, and the cases were matched to Congenital Malformation Registry. Results Analysis of Congenital Malformation Registry data showed 980 children with congenital hypothyroidism and 3 661 585 children without congenital hypothyroidism born in New York State (1992-2005). Children with congenital hypothyroidism have a significantly increased risk of congenital renal and urological anomalies with the odds ratio (OR) of 13.2 (10.6-16.5). The other significantly increased defects in congenital hypothyroidism were cardiac, gastrointestinal, and skeletal. Analysis of matched data confirmed an increase of congenital renal and urologic anomalies with OR of 4.8 (3.7-6.3). Conclusions Children with congenital hypothyroidism have an increased prevalence of congenital renal and urologic anomalies. We suggest that these children should be evaluated for the presence of congenital renal and urologic anomalies with renal ultrasonography, and that further studies of common genes involved in thyroid and kidney development are warranted. PMID:18823909

  11. Primary congenital hypothyroidism complicated by persistent severe ...

    African Journals Online (AJOL)

    2013-12-24

    Dec 24, 2013 ... hypothyroidism, there is a general paucity of studies on anaemia in infants ... a physiological adaptation to the decreased tissue ..... patients with Sheehan's syndrome: response to replacement of glucocorticoids and thyroxine ...

  12. Timing variability in children with early-treated congenital hypothyroidism

    NARCIS (Netherlands)

    Kooistra, L.; Snijders, T.A.B.; Schellekens, J.M.H.; Kalverboer, A.F.; Geuze, R.H.

    This study reports on central and peripheral determinants of timing variability in self-paced tapping by children with early-treated congenital hypothyroidism (CH). A theoretical model of the timing of repetitive movements developed by Wing and Kristofferson was applied to estimate the central

  13. Guidelines for Mass Screening of Congenital Hypothyroidism (2014 revision)

    Science.gov (United States)

    Nagasaki, Keisuke; Minamitani, Kanshi; Anzo, Makoto; Adachi, Masanori; Ishii, Tomohiro; Onigata, Kazumichi; Kusuda, Satoshi; Harada, Shohei; Horikawa, Reiko; Minagawa, Masanori; Mizuno, Haruo; Yamakami, Yuji; Fukushi, Masaru; Tajima, Toshihiro

    2015-01-01

    Purpose of developing the guidelines: Mass screening for congenital hypothyroidism started in 1979 in Japan, and the prognosis for intelligence has been improved by early diagnosis and treatment. The incidence was about 1/4000 of the birth population, but it has increased due to diagnosis of subclinical congenital hypothyroidism. The disease requires continuous treatment, and specialized medical facilities should make a differential diagnosis and treat subjects who are positive in mass screening to avoid unnecessary treatment. The Guidelines for Mass Screening of Congenital Hypothyroidism (1998 version) were developed by the Mass Screening Committee of the Japanese Society for Pediatric Endocrinology in 1998. Subsequently, new findings on prognosis and problems in the adult phase have emerged. Based on these new findings, the 1998 guidelines were revised in the current document (hereinafter referred to as the Guidelines). Target disease/conditions: Primary congenital hypothyroidism. Users of the Guidelines: Physician specialists in pediatric endocrinology, pediatric specialists, physicians referring patients to pediatric practitioners, general physicians, laboratory technicians in charge of mass screening, and patients. PMID:26594093

  14. Sustained attention problems in children with early treated congenital hypothyroidism

    NARCIS (Netherlands)

    Kooistra, L.; Van der Meere, J.J.; Vulsma, T.; Kalverboer, A.F.

    Sustained attention was studied in 48 children with early treated congenital hypothyroidism and 35 healthy controls, using a computer-paced and a self-paced continuous performance task. The performance of the patients, particularly those in the low T4 group (38 patients with T4 levels 50 nmol/l at

  15. Natal teeth in an infant with congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    C Venkatesh

    2011-01-01

    Full Text Available Teeth erupting at birth are referred to as natal teeth. It is a common and benign finding in the neonatal period. However, they may be associated with genetic syndromes like Ellis Van Creveld syndrome and Hallermann-Streiff syndrome. We report here a case of natal teeth in an infant with congenital hypothyroidism.

  16. The Italian National Register of infants with congenital hypothyroidism: twenty years of surveillance and study of congenital hypothyroidism

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    Olivieri Antonella

    2009-02-01

    Full Text Available Abstract All the Italian Centres in charge of screening, diagnosis, and follow-up of infants with congenital hypothyroidism participate in the Italian National Registry of affected infants, which performs the nationwide surveillance of the disease. It was established in 1987 as a program of the Health Ministry and is coordinated by the Istituto Superiore di Sanità. The early diagnosis performed by the nationwide newborn screening programme, the prompt treatment and the appropriate clinical management of the patients carried out by the Follow-up Centres, and the surveillance of the disease performed by the National Register of infants with congenital hypothyroidism are the components of an integrated approach to the disease which has been successfully established in our country. The aim of the Register is to monitor efficiency and effectiveness of neonatal screening, to provide disease surveillance and to allow identification of possible aetiological risk factors for the disease. During the past twenty years the active and continuous collaboration between the Register and the Italian Screening and Follow up Centres for Congenital Hypothyroidism allowed to perform a standardization of screening procedures and considerable improvements in the time at starting treatment and in the dose of therapy. Furthermore, the large amount and the high quality of information collected in the Register provided a unique opportunity for research into the disease. This because data collected in the Register are highly representative as referred to the entire Italian population with congenital hypothyroidism. The results derived from the epidemiological studies performed in these years, by using the Register database, contributed to deepen the knowledge of congenital hypothyroidism, to start identifying the most important risk factors for the disease, and to orient molecular studies aimed at identifying new genes involved in the aetiology of this condition.

  17. Orofacial manifestations of congenital hypothyroidism: Clinicoradiological case report

    Directory of Open Access Journals (Sweden)

    Gundareddy N Suma

    2014-01-01

    Full Text Available Thyroid disorders have a widespread effect on the ossification of cartilage, growth of teeth, facial contour, and overall body proportions. Both growth hormones and thyroid hormones show permissive action on growth stimulation. Deregulation in thyroid homeostasis can result in various orofacial and skeletal abnormalities. This report describes a case of congenital hypothyroidism in a 20-year-old female patient, presenting with a short stature, hypotonia, alopecia, euryprosopic face with puffiness, multiple retained deciduous teeth, delayed fusion of the intracranial sutures, and epiphysis and diaphysis of the long bones. Based on various biochemical and radiographic investigations, diagnosis of congenital hypothyroidism was established. Craniometry and hand-wrist radiographic evaluation of the growth pattern further aided in strengthening the diagnosis.

  18. Congenital hypothyroidism and concurrent renal insufficiency in a kitten

    Directory of Open Access Journals (Sweden)

    Chee Kin Lim

    2014-11-01

    Full Text Available A 3-month-old male domestic short-hair kitten was presented with chronic constipation and disproportionate dwarfism. Radiographs of the long bones and spine revealed delayed epiphyseal ossification and epiphyseal dysgenesis. Diagnosis of congenital primary hypothyroidism was confirmed by low serum total thyroxine and high thyroid stimulating hormone concentrations. Appropriate supplementation of levothyroxine was instituted. The kitten subsequently developed mild renal azotaemia and renal proteinuria, possibly as a consequence of treatment or an unmasked congenital renal developmental abnormality. Early recognition, diagnosis and treatment are vital as alleviation of clinical signs may depend on the cat’s age at the time of diagnosis.

  19. Congenital hypothyroidism and concurrent renal insufficiency in a kitten.

    Science.gov (United States)

    Lim, Chee Kin; Rosa, Chantal T; de Witt, Yolanda; Schoeman, Johan P

    2014-11-14

    A 3-month-old male domestic short-hair kitten was presented with chronic constipation and disproportionate dwarfism. Radiographs of the long bones and spine revealed delayed epiphyseal ossification and epiphyseal dysgenesis. Diagnosis of congenital primary hypothyroidism was confirmed by low serum total thyroxine and high thyroid stimulating hormone concentrations. Appropriate supplementation of levothyroxine was instituted. The kitten subsequently developed mild renal azotaemia and renal proteinuria, possibly as a consequence of treatment or an unmasked congenital renal developmental abnormality. Early recognition, diagnosis and treatment are vital as alleviation of clinical signs may depend on the cat's age at the time of diagnosis.

  20. Screening of newborns for congenital hypothyroidism. Guidance for developing programmes

    International Nuclear Information System (INIS)

    2005-12-01

    Congenital hypothyroidism is a condition that, if left untreated, can cause lifelong human suffering as a result of severe mental retardation and deficiency of growth. With the involvement of the IAEA, screening programmes to detect congenital hypothyroidism in newborn infants have been introduced successfully in a large number of countries. The cornerstone of these programmes is accurate and reliable screening methods involving isotope techniques and simple medical treatment. The suffering - and heavy social and economic burden - caused by congenital hypothyroidism prompted many countries to institute a formalized screening programme directed at newborns, just as a vaccination programme has become an integral part of child health care. In many other countries however, this type of formalized service has not yet been established. For these countries, the implementation of a neonatal screening programme will bring about a considerable improvement in child health care. It is hoped that the guidance in this publication will be especially useful to the signatories of the United Nations Convention on the Rights of the Child. Several factors that prevail in a country - the climate, political environment, economic development, level of health care and the transportation system - have an influence on the overall operational systems, design and implementation of a screening programme. As such, the design of such a programme will differ greatly from country to country. Nevertheless, neonatal screening programmes have many elements in common. This book draws on the IAEA's experience in this area over more than a decade, and on the results of a regional technical cooperation programme on neonatal screening for congenital hypothyroidism in East Asia (IAEA Project RAS6032). This publication provides guidance aimed specifically at implementing and sustaining programmes for the screening of newborn infants

  1. Congenital hypothyroidism and concurrent renal insufficiency in a kitten

    OpenAIRE

    Chee Kin Lim; Chantal T. Rosa; Yolanda de Witt; Johan P. Schoeman

    2014-01-01

    A 3-month-old male domestic short-hair kitten was presented with chronic constipation and disproportionate dwarfism. Radiographs of the long bones and spine revealed delayed epiphyseal ossification and epiphyseal dysgenesis. Diagnosis of congenital primary hypothyroidism was confirmed by low serum total thyroxine and high thyroid stimulating hormone concentrations. Appropriate supplementation of levothyroxine was instituted. The kitten subsequently developed mild renal azotaemia and renal pro...

  2. A case of kwashiorkor in a child with congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    Helena Aneke Tangkilisan

    2001-12-01

    Full Text Available A 12-year-old Indonesian girl with the body weight of 9.8 kg and length 78 cm was admitted to the Department of Child Health, Manado General Hospital with kwashiorkor and congenital hypothyroidism. The main complaint was edema starting 3 weeks before admission. Physical examination showed body weight for age (BW/A 14.3%, body weight for body length (BW/BL 66.0% and body length for age (BL/A 49.1%. On admission she looked severely ill, apathetic, with hypothermia and hypotonia. Almost all signs and symptoms of kwashiorkor and congenital hypothyroidism were found accompanied bronchopneumonia and dermatologic problems. Laboratory findings showed severe anemia, leukocytosis, hypoproteinemia, hyponatremia, hypokalemia, elevated thyroid stimulating hormone and low level of Thyroxine-4. Bone age equaled to a newborn baby bone age. There was no thyroid tissue on thyroid ultrasound examination. The patient was treated for severe protein energy malnutrition and ThyraxR. Problems of kwashiorkor could been solved well but not with the congenital hypothyroidism. She was discharged from hospital after 2 months treatment and till now at 14th year of age with her developmental milestones equals to that of 8 month old baby.

  3. Transient Hypothyroidism During Lactation Arrests Myelination in the Anterior Commissure of Rats. A Magnetic Resonance Image and Electron Microscope Study.

    Science.gov (United States)

    Lucia, Federico S; Pacheco-Torres, Jesús; González-Granero, Susana; Canals, Santiago; Obregón, María-Jesús; García-Verdugo, José M; Berbel, Pere

    2018-01-01

    Thyroid hormone deficiency at early postnatal ages affects the cytoarchitecture and function of neocortical and telencephalic limbic areas, leading to impaired associative memory and in a wide spectrum of neurological and mental diseases. Neocortical areas project interhemispheric axons mostly through the corpus callosum and to a lesser extent through the anterior commissure (AC), while limbic areas mostly project through the AC and hippocampal commissures. Functional magnetic resonance data from children with late diagnosed congenital hypothyroidism and abnormal verbal memory processing, suggest altered ipsilateral and contralateral telencephalic connections. Gestational hypothyroidism affects AC development but the possible effect of transient and chronic postnatal hypothyroidism, as occurs in late diagnosed neonates with congenital hypothyroidism and in children growing up in iodine deficient areas, still remains unknown. We studied AC development using in vivo magnetic resonance imaging and electron microscopy in hypothyroid and control male rats. Four groups of methimazole (MMI) treated rats were studied. One group was MMI-treated from postnatal day (P) 0 to P21; some of these rats were also treated with L-thyroxine (T4) from P15 to P21, as a model for early transient hypothyroidism. Other rats were MMI-treated from P0 to P150 and from embryonic day (E) 10 to P170, as a chronic hypothyroidism group. The results were compared with age paired control rats. The normalized T2 signal using magnetic resonance image was higher in MMI-treated rats and correlated with the number and percentage of myelinated axons. Using electron microscopy, we observed decreased myelinated axon number and density in transient and chronic hypothyroid rats at P150, unmyelinated axon number increased slightly in chronic hypothyroid rats. In MMI-treated rats, the myelinated axon g-ratio and conduction velocity was similar to control rats, but with a decrease in conduction delays. These

  4. Transient Hypothyroidism During Lactation Arrests Myelination in the Anterior Commissure of Rats. A Magnetic Resonance Image and Electron Microscope Study

    Directory of Open Access Journals (Sweden)

    Federico S. Lucia

    2018-04-01

    Full Text Available Thyroid hormone deficiency at early postnatal ages affects the cytoarchitecture and function of neocortical and telencephalic limbic areas, leading to impaired associative memory and in a wide spectrum of neurological and mental diseases. Neocortical areas project interhemispheric axons mostly through the corpus callosum and to a lesser extent through the anterior commissure (AC, while limbic areas mostly project through the AC and hippocampal commissures. Functional magnetic resonance data from children with late diagnosed congenital hypothyroidism and abnormal verbal memory processing, suggest altered ipsilateral and contralateral telencephalic connections. Gestational hypothyroidism affects AC development but the possible effect of transient and chronic postnatal hypothyroidism, as occurs in late diagnosed neonates with congenital hypothyroidism and in children growing up in iodine deficient areas, still remains unknown. We studied AC development using in vivo magnetic resonance imaging and electron microscopy in hypothyroid and control male rats. Four groups of methimazole (MMI treated rats were studied. One group was MMI-treated from postnatal day (P 0 to P21; some of these rats were also treated with L-thyroxine (T4 from P15 to P21, as a model for early transient hypothyroidism. Other rats were MMI-treated from P0 to P150 and from embryonic day (E 10 to P170, as a chronic hypothyroidism group. The results were compared with age paired control rats. The normalized T2 signal using magnetic resonance image was higher in MMI-treated rats and correlated with the number and percentage of myelinated axons. Using electron microscopy, we observed decreased myelinated axon number and density in transient and chronic hypothyroid rats at P150, unmyelinated axon number increased slightly in chronic hypothyroid rats. In MMI-treated rats, the myelinated axon g-ratio and conduction velocity was similar to control rats, but with a decrease in conduction

  5. THYROID FUNCTION Quitting smoking-transient risk of autoimmune hypothyroidism

    NARCIS (Netherlands)

    Wiersinga, Wilmar M.

    2012-01-01

    Smoking is a risk factor for Graves disease. However, Carle et al. have demonstrated that individuals have a transient increased risk of developing overt autoimmune hypothyroidism in the first 2 years after quitting smoking. The mechanisms involved in these two opposing effects of smoking on the

  6. Technetium 99m pertechnetate scans in congenital hypothyroidism

    International Nuclear Information System (INIS)

    Bauman, R.A.; Bode, H.H.; Hayek, A.; Crawford, J.D.

    1976-01-01

    Goiters are rarely palpable in infants with congenital hypothyroidism except in the case of maternal ingestion of iodide. The presence or absence of glandular tissue is, however, important for genetic and prognostic counseling and for acceleration of diagnosis in other affected siblings. The detection of thyroid tissue by /sup 99m/Tc pertechnetate scans in a significant number of our patients heretofore considered athyreotic establishes that physical findings and traditional laboratory data are not adequate to determine whether or not thyroid tissue is present

  7. Congenital Hypothyroidism in Yazd: Is It Really Prevalent?

    Directory of Open Access Journals (Sweden)

    Narjes Hazar

    2018-04-01

    Full Text Available Congenital hypothyroidism (CH is the most frequent type of endocrine disorders which presents at birth. It plays a major role in developing the most common preventable type of mental retardation around the world. In this study, we aimed to investigate CH incidence and its predictive factors among newborns in Yazd province. This cohort study was conducted in 38 health centers of 10 cities in Yazd province which is located in the center of Iran, from March 2008 to February 2015. All neonates, as the audiences of this program, were evaluated using heel prick or Guthrie test according to the national protocol of CH screening. During 7 years of screening for CH from March 2008 to February 2015, 143190 neonates were screened. Among them, 434 neonates were diagnosed as affected cases by CH, and the 7-year incidence of this disease was 303/ 100,000 live births. First, cousin consanguinity, hospitalization, male sex and low birth weight had a significant relationship with congenital hypothyroidism. Logistic regression analysis revealed that aforementioned variables in addition to delivery type (cesarean section were significant predictor of CH. CH is more prevalent in Yazd compared to the other provinces in Iran. It is recommended that the effects of probable risk factors are evaluated through additional longitudinal studies and effective preventive strategies are designed according to the results.

  8. Transient hypothyroidism in the newborn: to treat or not to treat

    Science.gov (United States)

    Kanike, Neelakanta; Davis, Ajuah

    2017-01-01

    Transient congenital hypothyroidism (CH) refers to a temporary deficiency of thyroid hormone identified after birth, with low thyroxine (T4) and elevated thyrotropin (TSH), which later recovers to improved thyroxine production, typically in first few months of infancy. Approximately 17% to 40% of children diagnosed with CH by newborn screening (NBS) programs were later determined to have transient hypothyroidism. Causes of transient CH are prematurity, iodine deficiency, maternal thyrotropin receptor blocking antibodies, maternal intake of anti-thyroid drugs, maternal or neonatal iodine exposure, loss of function mutations and hepatic hemangiomas. The classic clinical symptoms and signs of CH are usually absent immediately after birth in vast majority of infants due to temporary protection from maternal thyroxine. NBS has been largely successful in preventing intellectual disability by early detection of CH by performing thyroid function tests in infants with abnormal screening results. In this review we present the evidence for decision making regarding treatment vs. withholding treatment in infants with transient CH and present a rational approach to identifying transient CH based on American Academy of Pediatrics (AAP) recommendation. PMID:29184815

  9. The final report on neonatal screening of congenital hypothyroidism

    International Nuclear Information System (INIS)

    Hamadeh, N.; Eddin Ali, N.; Al Sheikh, F; Ghouri, I.

    2003-01-01

    Virtually all developed countries now have neonatal screening programs for hypothyroidism where capillary blood specimens collected on filter paper soon after birth. These specimens are analysed for TSH or T4. The ideal screening procedure would be measurement of both TSH and FT4, however measurement of FT4 on filter paper specimen is not yet feasible. The Atomic Energy Commission of Syria with the aid of the International Atomic Energy Agency and the collaboration of the ministries of Higher Education, Health and Defense adopted a screening program for congenital hypothyroidism in Syria. in this program blood specimen were collected on filter paper on the 4th of birth and then the specimen are analysed for TT4 and TSH using RIA and TRMA techniques respectively. Between 1995 and the present time six centres, for sample's collection, were opened. A well equipped laboratory for the analysis was established with highly trained staff. During this period of time (six years) 41341 babies were screened with 19 cases diagnosed after determination of the local normal values for both TSH and TT4. (author)

  10. Prolonged Ileus in an Infant Presenting with Primary Congenital Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Caroline Chua

    2015-01-01

    Full Text Available Congenital hypothyroidism (CH is the most common endocrine disorder affecting the newborn. Universal newborn screening (NBS has virtually eliminated the static encephalopathy and devastating neurodevelopmental syndrome known as cretinism. This report describes the presentation of an infant referred by the primary pediatrician to our hospital at 12 days of age for confirmatory testing after the NBS was consistent with CH. The infant had hypoglycemia secondary to lethargy and poor feeding and required transfer to the neonatal intensive care unit for worsening abdominal distension despite normalization of serum thyroid function tests following hormone replacement. In particular, the recalcitrant ileus and secondary bowel obstruction resulted in an additional diagnostic workup and lengthened hospital day. Our report highlights the acute gastrointestinal consequences of hypothyroidism despite evidence of effective treatment. We believe that the preclinical detection and immediate therapy for CH have lessened the prevalence of this presentation in general practice, and hence practitioners are less likely to be familiar with its natural history and management.

  11. Neonatal screening and a new cause of congenital central hypothyroidism

    Directory of Open Access Journals (Sweden)

    Toshihiro Tajima

    2014-09-01

    Full Text Available Congenital central hypothyroidism (C-CH is a rare disease in which thyroid hormone deficiency is caused by insufficient thyrotropin (TSH stimulation of a normally-located thyroid gland. Most patients with C-CH have low free thyroxine levels and inappropriately low or normal TSH levels, although a few have slightly elevated TSH levels. Autosomal recessive TSH deficiency and thyrotropin-releasing hormone receptor-inactivating mutations are known to be genetic causes of C-CH presenting in the absence of other syndromes. Recently, deficiency of the immunoglobulin superfamily member 1 (IGSF1 has also been demonstrated to cause C-CH. IGSF1 is a plasma membrane glycoprotein highly expressed in the pituitary. Its physiological role in humans remains unknown. IGSF1 deficiency causes TSH deficiency, leading to hypothyroidism. In addition, approximately 60% of patients also suffer a prolactin deficiency. Moreover, macroorchidism and delayed puberty are characteristic features. Thus, although the precise pathophysiology of IGSF1 deficiency is not established, IGSF1 is considered to be a new factor controlling growth and puberty in children.

  12. Language Profile in Congenital Hypothyroid Children Receiving Replacement Therapy.

    Science.gov (United States)

    Soliman, Hend; Abdel Hady, Aisha Fawzy; Abdel Hamid, Asmaa; Mahmoud, Heba

    2016-01-01

    The aim of this work was to evaluate receptive and expressive language skills in children with congenital hypothyroidism receiving early hormonal replacement treatment before the age of 3 months and to identify any subtle areas of weaknesses in their language development to check the necessity for future language intervention. The study was conducted on 30 hypothyroid children receiving hormonal replacement. They were subdivided into group I (5-8 years 11 months; 12 cases) and group II (9-12 years 11 months; 18 cases). All patients were subjected to a protocol of assessment applied in the Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU) and evaluation of language skills by the REAL scale. The younger group reached average Arabic language scores, while the older group showed moderate language delay. Early replacement therapy supports language development in young children. However, longitudinal and follow-up studies are required to identify difficulties presenting at older ages that may affect children in the academic settings. © 2016 S. Karger AG, Basel.

  13. Congenital Hypothyroidism: Increased Incidence in Yazd Province, Iran

    Directory of Open Access Journals (Sweden)

    M. Noori-Shadkam

    2012-07-01

    Full Text Available Introduction: Congenital hypothyroidism (CH is one of the most common preventable causes of mental retardation. Its worldwide incidence is estimated to be one in 2500-5500 births. Assessment of thyroid gland in neonates is critical. The aims of this study were to demonstrate the incidence of CH in neonates born in Yazd province, Iran in 1389 (2010 and compare the results with other reported studies and investigate biochemical characteristics of affected infants. Materials & Methods: This is an analytical descriptive cross-sectional study. The study was conducted on all infants (13022 births born in 1389 (March 2010-March 2011. Thyroid stimulating hormone (TSH was measured using ELISA technique. Results: Forty five infants suffered from congenital hypothyroidism with an overall incidence of one in 289 live births. Twenty five of the diagnosed infants were males (incidence 1:261 and twenty were females (incidence 1:325. The incidence of CH in boys was more than girls (P-value = 0.295. The highest incidence of CH was observed in spring followed by summer and the lowest incidence was in autumn followed by winter (P-value=0.000. Conclusion: The CH incidence was 10.3 to 13.8 times more than other countries. The highest CH incidence was in spring followed by summer and the lowest incidence was in autumn followed by winter. It is important that a larger size of cases need to be screened and more information on the aetiology of the affected infants to be obtained

  14. Cognitive Outcomes for Congenital Hypothyroid and Healthy Children: A Comparative Study

    OpenAIRE

    Mahtab ORDOOEI; Hadi MOTTAGHIPISHEH; Razieh FALLAH*; Azar RABIEE

    2014-01-01

    How to Cite This Article: Ordooei M, MottaghiPisheh H, Fallah R, Rabiee A. Cognitive Outcomes for Congenital Hypothyroid andHealthy Children: A Comparative Study. Iran J Child Neurol. 2014 Autumn;8(4): 28-32.AbstractObjectiveEarly diagnosis and treatment of congenital hypothyroidism (CH) and the prevention of developmental retardation is the main goal of public health national screening programs. This study compares the cognitive ability of children with CH diagnosed by neonatal screening wit...

  15. A baby with congenital hypothyroidism born to a hypothyroid mother who expressed undiagnosed thyroid stimulation blocking antibody

    Directory of Open Access Journals (Sweden)

    Mock Ryeon Kim

    2016-09-01

    Full Text Available In adults, hypothyroidism caused by thyroid stimulation blocking antibody (TSB Ab is rare, and confirmed cases are even fewer, as TSB Ab levels are rarely assayed. However, this may create problems in babies, as the transplacental passage of maternal TSB Ab can cause a rare type of hypothyroidism in the infant. Prompt levothyroxine replacement for the baby starting immediately after birth is important. We describe a congenital hypothyroid baby born to a hypothyroid mother who was not aware of the cause of her hypothyroid condition, which turned out to be associated with the expression of TSB Ab. This cause was confirmed in both the infant and mother using a series of thyroid function tests and measurements of autoantibody levels, including TSB Ab. During periodic follow-up, the TSB Ab and thyroid stimulating hormone receptor antibody titers became negative in the baby at 8 months of age, but remained positive in the mother. Evaluation of hypothyroidism and its cause in mothers during pregnancy is important for both maternal and child health.

  16. Visuospatial, visuoperceptual, and visuoconstructive abilities in congenital hypothyroidism.

    Science.gov (United States)

    Simic, Nevena; Khan, Sarah; Rovet, Joanne

    2013-11-01

    Individuals with congenital hypothyroidism (CH), even those diagnosed and treated early, experience selective cognitive deficits, the most striking of which involves the visuocognitive domain. However, the range and nature of their visuocognitive disturbances is not fully understood. We assessed a range of higher-order visuocognitive abilities in 19 children and adolescents with CH and 19 age- and sex-matched typically developing peers (TD) using a battery of neuropsychological tests and a novel self-report measure of sense of direction. CH scored lower than TD on direct tests of visuocognitive function (judging line orientation, parts-to-whole localization, copying three-dimensional block towers, discriminating designs, and matching unfamiliar faces in ¾ profile-view) as well as on self-reported problems in spatial ability. Visuocognitive problems were not global as CH and TD did not differ at copying two-dimensional block designs, mentally rotating and matching abstract shapes, or at matching unfamiliar front-view faces, design features, or designs that engaged either figure-ground segregation, visual constancy, or closure. Early and concurrent thyroid stimulating hormone (TSH) levels were associated with visuocognitive ability, although attention and working memory were not. Individuals with CH exhibit selective visuocognitive weaknesses, some of which are related to early and concurrent TSH levels.

  17. Intellectual development in preschool children with early treated congenital hypothyroidism.

    Science.gov (United States)

    Seo, Min Kyoung; Yoon, Jong Seo; So, Chul Hwan; Lee, Hae Sang; Hwang, Jin Soon

    2017-06-01

    Delayed treatment of congenital hypothyroidism (CH) is a common cause of mental retardation. The aim of the present study was to evaluate intellectual outcomes in preschool children with treated CH. We retrospectively reviewed the clinical records of 43 children (age range: 13 to 60 days of life; 22 girls and 21 boys) diagnosed with CH. Children aged 5 to 7 years were examined using the Korean Wechsler Intelligence Scale for Children or the Korean Wechsler Preschool and Primary Scale of Intelligence. The patients started treatment between 13 and 60 days of age. The mean intelligence quotient (IQ) of patients tested at age 5 to 7 years was 103.14±11.68 (IQ range: 76-126). None had intellectual disability (defined as an IQ scale IQ (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ) scores between the 2 groups. FSIQ, PIQ, and VIQ scores were not significantly correlated with initial dose of L-T4, initial fT4, age at treatment in multivariate analysis. IQ scores of subjects with early treated CH diagnosed through a neonatal screening test were within normal range, regardless of etiology, thyroid function, initial dose of levothyroxine, and age at start of treatment.

  18. Scintigraphic evaluation of primary congenital hypothyroidism: results of the Greek screening program

    Energy Technology Data Exchange (ETDEWEB)

    Panoutsopoulos, G.; Ilias, I.; Batsakis, C.; Christakopoulou, I. [Dept. of Nuclear Medicine, ' ' Sotiria' ' Hospital, Athens (Greece); Mengreli, C. [Inst. of Child Health, Athens (Greece)

    2001-04-01

    The Greek screening program for primary congenital hypothyroidism was initiated in 1979. By early 2000, thyrotropin measurements had been performed in 1,976,719 newborns, using dried blood spots obtained by heel prick. Among these children, 584 were diagnosed with congenital hypothyroidism (incidence: 1/3,384 births) and were given L-thyroxine (L-T{sub 4}) replacement therapy. In order to further evaluate and classify the children as having either an aplastic (AT) or an ectopic thyroid gland (ET) or as showing thyroidal dyshormonogenesis (DN, with a nomotopic gland), scintigraphic studies were performed at the age of 2-3 years. In 413 children of this age group (including 24 subsequently diagnosed as having had transient hypothyroidism, in whom L-T{sub 4} therapy was not resumed), thyroid hormones were measured and scintigraphic studies were done after withdrawal of L-T{sub 4} replacement treatment for 3 weeks. Given the long duration of the study, we used various scintigraphic modalities. In 96 children (group A), scintigraphy was performed using technetium-99m pertechnetate ({sup 99m}TcO{sub 4}{sup -}; 18.5 MBq given i.v.) and a rectilinear scanner. Seventy-three children (group B) were studied with {sup 99m}TcO{sub 4}{sup -} (18.5 MBq given i.v.) and a gamma camera equipped with a pinhole collimator. In these groups, atropine was administered 30 min prior to the study (0.02 mg/kg i.v. or i.m.) in order to reduce the secretion of saliva from the salivary glands. Finally, in the remaining 220 children (group C) iodine-123 sodium iodide ({sup 123}I-Na) (0.74-1.85 MBq i.v.) and the same gamma camera were used. Between-group comparisons of scintigraphic findings were done with the chi square test. In 191 children from group C, thyroglobulin (Tg) was measured and in 49 children ultrasound (US) was performed (categorising the gland as AT or ET/DN). Comparison of these modalities was done with the kappa statistic. In group A, 61.5% of children had AT, 26.0% had ET and

  19. Transient Hypothyroidism after Radioiodine for Graves' Disease: Challenges in Interpreting Thyroid Function Tests.

    Science.gov (United States)

    Sheehan, Michael T; Doi, Suhail A R

    2016-03-01

    Graves' disease is the most common cause of hyperthyroidism and is often managed with radioactive iodine (RAI) therapy. With current dosing schemes, the vast majority of patients develop permanent post-RAI hypothyroidism and are placed on life-long levothyroxine therapy. This hypothyroidism typically occurs within the first 3 to 6 months after RAI therapy is administered. Indeed, patients are typically told to expect life-long thyroid hormone replacement therapy to be required within this timeframe and many providers expect this post-RAI hypothyroidism to be complete and permanent. There is, however, a small subset of patients in whom a transient post-RAI hypothyroidism develops which, initially, presents exactly as the typical permanent hypothyroidism. In some cases the transient hypothyroidism leads to a period of euthyroidism of variable duration eventually progressing to permanent hypothyroidism. In others, persistent hyperthyroidism requires a second dose of RAI. Failure to appreciate and recognize the possibility of transient post-RAI hypothyroidism can delay optimal and appropriate treatment of the patient. We herein describe five cases of transient post-RAI hypothyroidism which highlight this unusual sequence of events. Increased awareness of this possible outcome after RAI for Graves' disease will help in the timely management of patients. © 2016 Marshfield Clinic.

  20. Transient Hypothyroidism after Radioiodine for Graves’ Disease: Challenges in Interpreting Thyroid Function Tests

    Science.gov (United States)

    Sheehan, Michael T.; Doi, Suhail A.R.

    2016-01-01

    Graves’ disease is the most common cause of hyperthyroidism and is often managed with radioactive iodine (RAI) therapy. With current dosing schemes, the vast majority of patients develop permanent post-RAI hypothyroidism and are placed on life-long levothyroxine therapy. This hypothyroidism typically occurs within the first 3 to 6 months after RAI therapy is administered. Indeed, patients are typically told to expect life-long thyroid hormone replacement therapy to be required within this timeframe and many providers expect this post-RAI hypothyroidism to be complete and permanent. There is, however, a small subset of patients in whom a transient post-RAI hypothyroidism develops which, initially, presents exactly as the typical permanent hypothyroidism. In some cases the transient hypothyroidism leads to a period of euthyroidism of variable duration eventually progressing to permanent hypothyroidism. In others, persistent hyperthyroidism requires a second dose of RAI. Failure to appreciate and recognize the possibility of transient post-RAI hypothyroidism can delay optimal and appropriate treatment of the patient. We herein describe five cases of transient post-RAI hypothyroidism which highlight this unusual sequence of events. Increased awareness of this possible outcome after RAI for Graves’ disease will help in the timely management of patients. PMID:26864507

  1. Intellectual development in preschool children with early treated congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    Min Kyoung Seo

    2017-06-01

    Full Text Available PurposeDelayed treatment of congenital hypothyroidism (CH is a common cause of mental retardation. The aim of the present study was to evaluate intellectual outcomes in preschool children with treated CH.MethodsWe retrospectively reviewed the clinical records of 43 children (age range: 13 to 60 days of life; 22 girls and 21 boys diagnosed with CH. Children aged 5 to 7 years were examined using the Korean Wechsler Intelligence Scale for Children or the Korean Wechsler Preschool and Primary Scale of Intelligence.ResultsThe patients started treatment between 13 and 60 days of age. The mean intelligence quotient (IQ of patients tested at age 5 to 7 years was 103.14±11.68 (IQ range: 76–126. None had intellectual disability (defined as an IQ <70. Twenty-one subjects were treated with a low dose (6.0–9.9 µg/kg/day and 22 with a high dose of levothyroxine (10.0–16.0 µg/kg/day. There was no significant difference in the mean full-scale IQ (FSIQ, verbal IQ (VIQ, and performance IQ (PIQ scores between the 2 groups. FSIQ, PIQ, and VIQ scores were not significantly correlated with initial dose of L-T4, initial fT4, age at treatment in multivariate analysis.ConclusionIQ scores of subjects with early treated CH diagnosed through a neonatal screening test were within normal range, regardless of etiology, thyroid function, initial dose of levothyroxine, and age at start of treatment.

  2. Hypothyroidism

    Science.gov (United States)

    ... weight gain, cold intolerance, constipation, impaired fertility, and depression. • Women are much more likely than men to develop hypothyroidism. • Women with hypothyroidism should discuss ...

  3. Detecting congenital hypothyroidism with newborn screening: the relevance of thyroid-stimulating hormone cutoff values.

    Science.gov (United States)

    Silvestrin, Stela Maris; Leone, Claudio; Leone, Cléa Rodrigues

    To assess the prevalence of congenital hypothyroidism and the ability of various neonatal thyroid-stimulating hormone (TSHneo) cutoff values to detect this disease. This cohort study was based on the retrospective collection of information available from the Reference Service for Newborn Screening database for all live births from January 1, 2010, to December 31, 2012, assessed using the Newborn Screening Program of a Brazilian state, Brazil. The infants were divided into two groups: I - Control: infants with normal newborn screening tests and II - Study: infants with congenital hypothyroidism. Analysis included comparing the TSHneo levels from both groups. A receiver operating characteristic (ROC) curve was constructed to assess the TSHneo cutoff values. Using a TSHneo cutoff value of 5.0μIU/mL, 50 out of 111,705 screened infants had diagnosis of congenital hypothyroidism (prevalence 1:2234 live births). The ROC curve showed that TSHneo value of 5.03μIU/mL had 100% sensitivity and the greatest associated specificity (93.7%). The area under the curve was 0.9898 (pvalue of 5.0μIU/mL adopted by the Newborn Screening Program of a Brazilian state was the most appropriate for detecting congenital hypothyroidism and most likely explains the high prevalence that was found. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  4. Subcorneal Pustular Dermatosis In A Child With Congenital Hypothyroidism : Association Or Co - Incidental

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    Kanthraj G R

    1998-01-01

    Full Text Available Subcorneal pustular dermatosis (SCPD is a chronic benign relapsing, pustular eruption with distinctive histology1 affecting usually the females in the age group of 40 yrs. Recently, its association with hyperthyroidism has been reported2. We describe a child with congenital hypothyroidism and SCPD.

  5. Evaluation of Cognitive and Motor Development in Toddlers With Congenital Hypothyroidism Diagnosed by Neonatal Screening

    NARCIS (Netherlands)

    van der Sluijs Veer, L.; Kempers, M.J.E.; Wiedijk, B.M.; Last, B.F.; Grootenhuis, M.A.; Vulsma, T.

    2012-01-01

    OBJECTIVE: The Dutch neonatal congenital hypothyroidism (CH) screening procedure and treatment modality has been adapted several times since its national institution in 1981. These changes enabled us to investigate whether earlier treatment has resulted in improved cognitive and motor outcomes. The

  6. Evaluation of cognitive and motor development in toddlers with congenital hypothyroidism diagnosed by neonatal screening

    NARCIS (Netherlands)

    van der Sluijs Veer, L.; Kempers, M.J.; Wiedijk, B.M.; Last, B.F.; Grootenhuis, M.A.; Vulsma, T.

    2012-01-01

    OBJECTIVE: The Dutch neonatal congenital hypothyroidism (CH) screening procedure and treatment modality has been adapted several times since its national institution in 1981. These changes enabled us to investigate whether earlier treatment has resulted in improved cognitive and motor outcomes. The

  7. Evaluation of Cognitive and Motor Development in Toddlers With Congenital Hypothyroidism Diagnosed by Neonatal Screening

    NARCIS (Netherlands)

    van der Sluijs Veer, Liesbeth; Kempers, Marlies J. E.; Wiedijk, Brenda M.; Last, Bob F.; Grootenhuis, Martha A.; Vulsma, Tom

    2012-01-01

    Objective: The Dutch neonatal congenital hypothyroidism (CH) screening procedure and treatment modality has been adapted several times since its national institution in 1981. These changes enabled us to investigate whether earlier treatment has resulted in improved cognitive and motor outcomes. The

  8. Intellectual and motor development of young adults with congenital hypothyroidism diagnosed by neonatal screening.

    NARCIS (Netherlands)

    Kempers, M.J.E.; van der Sluijs-Veer, L.; Nijhuis-Van der Sanden, M.W.G.; Kooistra, L.; Wiedijk, B.M.; Faber, I.R.; Last, B.F.; Vijlder, J.J. de; Grootenhuis, M.A.; Vulsma, T.

    2006-01-01

    CONTEXT: Long-term follow-up data on cognitive and motor functioning in adult patients with congenital hypothyroidism, diagnosed by neonatal screening, are scarce. Hence, it is still unclear whether the frequently reported cognitive and motor deficits observed during childhood persist in adulthood.

  9. Intellectual and motor development of young adults with congenital hypothyroidism diagnosed by neonatal screening

    NARCIS (Netherlands)

    Kempers, M. J. E.; van der Sluijs Veer, L.; Nijhuis-van der Sanden, M. W. G.; Kooistra, L.; Wiedijk, B. M.; Faber, I.; Last, B. F.; de Vijlder, J. J. M.; Grootenhuis, M. A.; Vulsma, T.

    2006-01-01

    Long-term follow-up data on cognitive and motor functioning in adult patients with congenital hypothyroidism, diagnosed by neonatal screening, are scarce. Hence, it is still unclear whether the frequently reported cognitive and motor deficits observed during childhood persist in adulthood. The

  10. Frequency of Congenital Cardiac Malformations in the Neonates with Congenital Hypothyroidism

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    yazdan ghandi

    2018-05-01

    Full Text Available Background: Congenital hypothyroidism (CH is a prevalent disorder, which is associated with several other congenital anomalies, especially cardiac diseases. The present study aimed to determine the prevalence of congenital heart disease (CHD in the neonates with CH.Methods: This cross-sectional study was conducted on two groups of 79 subjects to compare the type and frequency of congenital cardiac anomalies between the neonates with the confirmed diagnosis of CH (TSH≥10 mlU/ml and healthy infants. The study was performed in Kowsar Clinic affiliated to Arak University of Medical Sciences, Iran. Level of thyroid-stimulating hormone (TSH was measured within days 3-7 of birth using the samples collected from the soles of the neonates. In addition, all the subjects were evaluated for the presence of CHD using echocardiography before day 30 of life.Results: In total, 79 neonates were enrolled in the study. The case group consisted of 34 females (43.04% and 45 males (53.96%, and the control group consisted of 43 females (54.43% and 36 males (45.57%. The groups were matched in terms of age and gender. Cardiac involvement was only detected in the case group (CH infants with the prevalence of 22.7%. Among the non-cyanotic malformations observed in the case group, one infant had ventricular septal defect (1.3%, eight infants had atrial septal defect (10.1%, three infants had patent ductus arteriosus (3.8%, three neonates had endocardial cushion defect (3.8%, two neonates had pulmonary stenosis (2.5%, and one infant had dilated cardiomyopathy (1.3%. Moreover, six neonates were diagnosed with Down syndrome. All the infants with endocardial cushion defect (n=3 had Down syndrome, and no significant association was observed between TSH and thyroxine (T4 in the presence of CHD.Conclusion: According to the results, the high prevalence of cardiac malformations in the neonates with CH necessitated cardiac examinations using echocardiography.

  11. Congenital hypothyroidism screening in term neonates using umbilical cord blood TSH values

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    Ravi Bhatia

    2018-01-01

    Full Text Available Congenital hypothyroidism remains one of the most common preventable causes of mental retardation among children. Screening for congenital hypothyroidism remains one of the most cost-effective tools to prevent mental retardation in the population. Umbilical cord blood thyroid-stimulating hormone (TSH levels remain an attractive and a practical step for screening for congenital hypothyroidism. The aims of this study were as follows: (1 to find normative values of cord blood TSH for the study group and (2 to use cord blood TSH levels as a marker for screening of congenital hypothyroidism. Cord blood of 1824 neonates who were of term gestation, weighed >2.5 kg at birth, whose mothers were off thyroid medication were a part of the study group. Umbilical cord blood was collected at the time of delivery and TSH was estimated. All babies who had a cord blood TSH value of >20 mIU/L were called bay on day 7 of life for a full thyroid profile. Cord blood samples of 1824 neonates were tested for TSH. Male–female ratio was 979:845 = 1.15:1. The birth weights ranged between 2.5 and 4.5 kg with an average birth weight of 2.811 kg. Mean (standard deviation TSH value was 7.725 (8.99. TSH values ranged between 1.2 and 100 mIU/ml. TSH values corresponding to the 3rd, 10th, 25th, 50th, 90th, 95th, and 97th percentile were 2.32, 4.05, 5.67, 7.5, 12, 20.63, and 30.88, respectively. Out of the 88 babies recalled for repeat testing, 80 babies only turned up; eventually one turned out to be hypothyroid on repeat testing. The incidence of congenital hypothyroidism in our study was 1 in 1824. To conclude, we can safely use a cutoff of cord blood TSH value of >20 mIU/L for the purpose of screening for congenital hypothyroidism. For logistic angles, a higher cutoff of >30 mIU/L can be used. Large population-based studies are required to establish normative values for cord blood TSH in our country.

  12. Trisomy 21 causes persistent congenital hypothyroidism presumably of thyroidal origin

    NARCIS (Netherlands)

    van Trotsenburg, A. S. Paul; Kempers, Marlies J. E.; Endert, Erik; Tijssen, Jan G. P.; de Vijlder, Jan J. M.; Vulsma, Thomas

    2006-01-01

    OBJECTIVE AND DESIGN: Lowered neonatal plasma thyroxine (T(4)) and mildly elevated thyrotropin concentrations together with developmental benefits from neonatally started T(4) treatment in a randomized clinical trial demonstrated Down syndrome (DS) neonates to be mildly hypothyroid, at least during

  13. Hypothyroidism

    Science.gov (United States)

    Myxedema coma, the most severe form of hypothyroidism, is rare. It occurs when thyroid hormone levels get very ... or certain medicines in people with untreated hypothyroidism. Myxedema coma is a medical emergency that must be treated ...

  14. Subclinical hypothyroidism: A common finding in adult patients with cyanotic congenital heart disease.

    Science.gov (United States)

    Bak, Peter; Hjortshøj, Cristel S; Gaede, Peter; Idorn, Lars; Søndergaard, Lars; Jensen, Annette S

    2018-03-01

    Cyanotic congenital heart disease is a systemic disease, with effects on multiple organ systems. A high prevalence of subclinical hypothyroidism (SCH) has been reported in a small cohort of cyanotic congenital heart disease patients. Subclinical hypothyroidism has been associated with various adverse cardiovascular effects, as well as an increased risk of progression to overt hypothyroidism. The aim of this study was to examine the prevalence of SCH in cyanotic congenital heart disease patients, consider possible etiologies, and evaluate thyroid function over time. First, 90 clinically stable cyanotic congenital heart disease patients were examined with blood samples (thyroid-stimulating hormone, C-reactive protein, hemoglobin, hematocrit, and N-terminal pro-brain-natriuretic peptide) in a cross-sectional descriptive study. Second, a longitudinal follow-up study of 43 patients originating from the first study part, was carried out. These patients had thyroid function parameters (thyroid-stimulating hormone, thyroid hormones, and thyroid peroxidase antibodies) evaluated biannually. Elevated thyroid-stimulating hormone was present in 24% of the 90 screened patients. During follow-up (6.5 ± 1.0 years), SCH (defined as ≥2 consecutive elevated thyroid-stimulating hormone values) was present in 26%. Three patients progressed to overt hypothyroidism. Patients with SCH were younger (34 ± 12 vs 42 ± 16 years; P = .01) and had a lower oxygen saturation (80 ± 5 vs 84 ± 6%; P = .03). Subclinical hypothyroidism is a very common finding in cyanotic congenital heart disease. This is not associated with increased levels of C-reactive protein, heart failure, or autoimmunity but appears to be associated with cyanosis and age. Since the clinical impact of SCH is uncertain, further studies are needed to determine this. Regular thyroid evaluation is recommended in cyanotic congenital heart disease patients since SCH can develop to overt hypothyroidism. © 2017

  15. The congenital hypothyroidism: the incidence and clinical features of different forms

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    T.V. Sorokman

    2017-04-01

    Full Text Available Background. Congenital hypothyroidism (CH as the most common hereditary thyroid pathology is a serious social, economic and psychological burden for a family, where the sick child was born, as well as for the society. The purpose of our study was to evaluate the disease incidence and to detect the clinical features of various forms of congenital hypothyroidism in children. Materials and methods. Twenty two medical records of patients with CH (14 girls, 8 boys aged 1 month to 6 years (experimental group and 20 healthy children of the correspondent age were analyzed, and the further assessment of their physical and neuropsychological development was conducted. All children underwent the ultrasound examination of the neck region, indirect laryngoscopy; thyroid-stimulating hormone (TSH, thyroglobulin antibodies, free thyroxine (fT4, thyroglobulin tests were also performed. Clinical signs of CH in the neonatal period were estimated according to the Apgar scores. Statistical analysis was performed with the aid of the Statistica 6.0 program. Results. The thyroid dystopia was diagnosed in 59.1 % of cases, in particular: in the hyoid area (5, the root of the tongue (2, submandibular area (2, jugular fossa (1, unspecified (2. The median of TSH in the first stage of screening in children of the main group was 38 mU/l (24.2–122.4 mU/l, in the comparison group — 2.03 mU/l (1.7–2.6 mU/l. The fT4 level ranged from 0.49 to 14.7 pmol/l, on average — 2.37 pmol/l. The number of clinical signs was not dependent on the age neither on the form of hypothyroidism at the moment of diagnosis. With age, children’s development increasingly lags behind those of correspondent age contributing to further development of fine motor delay. In 40.9 % of patients with CH, the relatives suffered from thyroid disease. Conclusions. The thyroid dystopia is the most common among various forms of congenital hypothyroidism (59.1 %. The reliable differences in TSH and fT4 levels

  16. The effect of life-long thyroxine treatment and physical activity on bone mineral density in young adult women with congenital hypothyroidism

    NARCIS (Netherlands)

    Kempers, M. J. E.; Vulsma, T.; Wiedijk, B. M.; de Vijlder, J. J. M.; van Eck-Smit, B. L. F.; Verberne, H. J.

    2006-01-01

    OBJECTIVE: Normalization of plasma thyrotropin in T4-supplemented patients with thyroidal congenital hypothyroidism (CH) requires elevated plasma FT4-concentrations compared to patients with acquired thyroidal hypothyroidism. We investigated bone mineral density (BMD) in patients with CH. PATIENTS

  17. Determination of congenital hypothyroidism in neonatal by immunoradiometric assays of thyrotropin

    International Nuclear Information System (INIS)

    Contreras P, E.

    1998-01-01

    The congenital hypothyroidism is the endocrine illness more frequent of the childhood, it is the one that produce the devastating effects on the growth and the development. It represent one of the few causes of mental delay that it could be prevented if it is diagnosed and treaty on time. The infants affected with congenital hypothyroidism, could be detected for the apparent presence of some physical abnormalities, which comes the first days of the birth. Unfortunately, in the moment in which the classical manifestations are made present, it is very probable that cerebral damage already exists, for what the affected children should be tried before the three months of life administering them thyroid hormones. In Mexico the incidence of the congenital hypothyroidism is of one for each 1612 births for that is very important in the area of Public Health diagnose in early form and with certainty the congenital hypothyroidism. The TSH hormone or thyrotropin is formed in the hypophysis and intervenes in the synthesis of the thyroid hormones (T3, T4) when the concentration of these is adapted, the formation of TSH is inhibited, for that upon lacking the thyroid hormones the concentration of TSH in the blood is high. For these reasons the shot metabolic state of a newborn could be determined, quantifying the TSH in blood obtained by heel stab of the neonatal, or in coming blood from the umbilical cord, after 48 hours of being born. However because the TSH is similar to other hormones and is in extremely low concentrations, it is made necessary appeal analytic techniques of very sensitive and specific laboratory like the Immunoradiometric assays (Irma) in order to could determine the levels of this hormone in the blood. (Author)

  18. Effect of Prolonged Discontinuation of L-Thyroxine Replacement in a Child with Congenital Hypothyroidism

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    Rita Ann Kubicky

    2012-01-01

    Full Text Available When diagnosed through neonatal screening and treated promptly and adequately, infants with congenital hypothyroidism (CH experience normal physical growth and neurological development. Here we present a 3-year-old boy diagnosed with CH as a newborn, who was subsequently left untreated and experienced significant growth failure and developmental delay. This case emphasizes the importance of a consistent adherence to treatment in preventing such complications, especially in infancy and early childhood.

  19. Follow-Up Study of Behavioral Development and Parenting Stress Profiles in Children with Congenital Hypothyroidism

    OpenAIRE

    Mei-Chyn Chao; Pinchen Yang; Hsiu-Yi Hsu; Yuh-Jyh Jong

    2009-01-01

    Recent longitudinal experiences have emphasized that the follow-up of children with treated congenital hypothyroidism (CHT) should not be limited to the cognitive domain. This study attempted to evaluate the emotional–behavioral profiles in children with CHT together with maternal parenting stress profiles. Data for child and family characteristics were collected from 47 families with a 3–12-year-old CHT child diagnosed and treated since the newborn period. Cognitive assessments were performe...

  20. Changes in the sialylation and sulfation of secreted thyrotropin in congenital hypothyroidism

    International Nuclear Information System (INIS)

    Gyves, P.W.; Gesundheit, N.; Thotakura, N.R.; Stannard, B.S.; DeCherney, G.S.; Weintraub, B.D.

    1990-01-01

    The authors have examined the oligosaccharide structure of secreted thyrotropin (TSH) in perinatal and mature rats with congenital primary hypothyroidism. Rat pituitaries from euthyroid control animals and those rendered hypothyroid by methimazole treatment were incubated with [ 3 H]glucosamine in vitro. Secreted TSH was purified, and oligosaccharides were enzymatically released and characterized by anion-exchange HPLC. In perinatal hypothyroid animals compared with control animals, oligosaccharides from TSH α and β subunits contained more species with three or more negative charges. Moreover, perinatal hypothyroid animals demonstrated a dramatic increase in the ratio of sialylated to sulfated species within oligosaccharides of the same negative charge. In mature hypothyroid 9-week-old animals compared with control animals, changes were less pronounced, suggesting that endocrine regulation of oligosaccharide structure is dependent upon the maturational state of the animal. Together, these data provide direct evidence and characterization of specific changes in the structure of a secreted pituitary glycoprotein hormone occurring as a result of in vivo endocrine alterations during early development. Moreover, they provide a potential structural basis to explain the delayed clearance of both TSH and the gonadotropins with end-organ deficiency, which may have important implications for the in vivo biological activities of these hormones

  1. INTELLECTUAL AND ACADEMIC PERFORMANCE OF CHILDREN WITH CONGENITAL HYPOTHYROIDISM IN RELATION TO TIME OF DIAGNOSIS

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    Madhava Vijaya Kumar

    2016-12-01

    Full Text Available BACKGROUND Context- Congenital hypothyroidism is an important cause of preventable mental retardation in children. Since, neonatal screening is not done routinely in India, many cases are diagnosed late. Earlier, the diagnosis and initiation of treatment, better will be the outcome. The aim of the study is to assess the effect of time of onset of treatment in intellectual and scholastic performances in children with congenital hypothyroidism. MATERIALS AND METHODS Children were classified into 3 groups. Group 1 were diagnosed and treatment initiated within one month of birth. Group 2, between 1 and 6 months and group 3 after 6 months. General intelligence and IQ were assessed by Malin’s intelligence scale for Indian children. Scholastic performance were evaluated by academic evaluation scale for slow learners and ADHD were diagnosed by DSM-IV criteria. Settings and Design- The study was done in the Paediatric Endocrinology Clinic of Institute of Maternal and Child Health, Department of Paediatrics, Government Medical College, Kozhikode. Study population included children of age group 6-9 years with congenital hypothyroidism. Statistical Methods Used- Statistical analysis was done with SPSS software version 16. The statistical analysis was done by ANOVA test. RESULTS IQ and intellectual outcomes were better in group 1 where treatment was initiated within one month. Similarly, poor academic abilities and increased incidence of ADHD were noted in children in whom diagnosis was made late. CONCLUSION Later the diagnosis more will be the intellectual and scholastic backwardness in children underscoring the importance of universal newborn screening.

  2. European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

    Science.gov (United States)

    Léger, Juliane; Olivieri, Antonella; Donaldson, Malcolm; Torresani, Toni; Krude, Heiko; van Vliet, Guy; Polak, Michel

    2014-01-01

    Objective: The aim was to formulate practice guidelines for the diagnosis and management of congenital hypothyroidism (CH). Evidence: A systematic literature search was conducted to identify key articles relating to the screening, diagnosis, and management of CH. The evidence-based guidelines were developed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. Consensus Process: Thirty-two participants drawn from the European Society for Paediatric Endocrinology and five other major scientific societies in the field of pediatric endocrinology were allocated to working groups with assigned topics and specific questions. Each group searched the literature, evaluated the evidence, and developed a draft document. These papers were debated and finalized by each group before presentation to the full assembly for further discussion and agreement. Recommendations: The recommendations include: worldwide neonatal screening, approaches to assess the cause (including genotyping) and the severity of the disorder, the immediate initiation of appropriate L-T4 supplementation and frequent monitoring to ensure dose adjustments to keep thyroid hormone levels in the target ranges, a trial of treatment in patients suspected of transient CH, regular assessments of developmental and neurosensory functions, consulting health professionals as appropriate, and education about CH. The harmonization of diagnosis, management, and routine health surveillance would not only optimize patient outcomes, but should also facilitate epidemiological studies of the disorder. Individuals with CH require monitoring throughout their lives, particularly during early childhood and pregnancy. PMID:24446653

  3. Neurodevelopmental Outcome of Children with Congenital Hypothyroidism Diagnosed in a National Screening Program in Turkey.

    Science.gov (United States)

    Baysal, Bahar Toklu; Baysal, Bora; Genel, Ferah; Erdur, Baris; Ozbek, Erhan; Demir, Korcan; Ozkan, Behzat

    2017-05-15

    To study the factors affecting a neurodevelopmental status of children with congenital hypothyroidism, diagnosed on national screening program. The study was performed in the Pediatric Endocrinology Department of Dr. Behcet Uz Children's Hospital between May 2012 and May 2013. Children with congenital hypothyroidism, aged between 24 and 36 months, diagnosed by national screening program were included in the study group. Healthy subjects at the same age group consisted of the control group. For the neurodevelopmental evaluation, Bayley Scale of Infant Development- II (BSID-II) was used. Factors possibly effective on neurodevelopment were evaluated. 42 patients and 40 healthy children (mean (SD) age, 29.4 (3.7) and 29.2 (3.5), respectively were included in the study. The mean MDI score [92.6 (7.07) vs 97.1 (9.69), P=0.14)] and the mean PDI score [97.8 (15.68) vs 99.1 (10.57), P=0.66)] in the study group and control group were not significantly different. Among the patient, 4.6% and 4.7% children were moderately retarded as per the MDI scores and PPI scores, respectively. The sex, socioeconomic status, birth weight, screening levels of TSH, severity of the congenital hypothyroidism, initiation time and the dosage of thyroid hormone replacement, length of the normalization period of TSH, and adherence to treatment were not found to affect the MDI and PDI scores of the patients. Some children with congenital hypothyrodism may have mild to moderate neurodevelopmental retardation, despite the early diagnosis and treatment, and thus need to be under regular follow-up for neurodevelopmental status.

  4. The early development of transient and permanent hypothyroidism following radioiodine therapy for hyperthyroid Graves' disease

    International Nuclear Information System (INIS)

    Peden, N.R.; Hart, J.R.

    1984-01-01

    The outcome in 110 patients first treated with radioiodine (mean dose 6.56 mCi) for hyperthyroid Graves' disease in 1980 was reviewed. In 23 percent of the patients the disease had not been controlled by the initial dose after 3 months, and 17 percent were given one or two more doses. Within 2 years 65 percent of the patients required replacement thyroxine therapy. Although about half of the patients were biochemically hypothyroid 3 months after the last dose of iodine 131, this condition was transient in a third of them; five of these patients even became hyperthyroid again. Patients with transient, as opposed to permanent, hypothyroidism at 3 months tended to be clinically euthyroid but to have residual palpable thyroid tissue and only a modest reduction in the serum thyroxine level. It is therefore recommended that patients not overtly hypothyroid 3 months after treatment with 131 I be observed still longer before thyroxine replacement therapy is instituted

  5. Screening for congenital hypothyroidism (CH) among Filipino newborn infants. Philippine Newborn Screening Study Group.

    Science.gov (United States)

    Fagela-Domingo, C; Padilla, C D; Cutiongco, E M

    1999-01-01

    From June 1996 to June 1998 a total of 62.841 newborn infants were screened for congenital hypothyroidism with thyroid stimulating hormone assay as a primary test. The method used was an immunofluorescent assay using the DELFIA TSH Kit on dried blood specimens collected by heelprick on filter paper. All infants with TSH values greater than 20 microU/ml were retested. If the results remained abnormally high, confirmatory testing was done by radioimmunoassay. All infants who were confirmed to be hypothyroid were referred to pediatric endocrinologists for initial management. The overall weighted incidence of congenital hypothyroidism obtained in this study was 0.000277 (95% CI; 0.000122 - 0.000432) or 1:3,610 which may be higher than that reported by most screening programs worldwide. The recall rate was 0.16%. The higher recall rate may be explained by early testing in a number of cases and by the possibility of iodine deficiency in some of the mothers. On the basis of the results of this study, we would recommend (1) screening on a greater number of infants to verify the incidence of CH and (2) establishing normal TSH values at different hours of life to improve our recall rate.

  6. Cord blood thyrotropin screening for congenital hypothyroidism. Three years' experience on the Island of Saint Lucia.

    Science.gov (United States)

    Sajous, C; Goto, M; Fitzgerald, M; Anderson, C L; Craft, W; Hurley, R M; Zeller, W P

    1991-01-01

    Cord blood thyrotropin (TSH) screening for congenital primary hypothyroidism has been in effect on the island of St. Lucia for the past three years. Umbilical cord blood samples are obtained on Guthrie filter paper and then transported 3,000 miles to Loyola University of Chicago and delivered to the Illinois State Metabolic Screening Laboratory. There TSH is measured by radioimmunoassay (RIA). After three years, 1,789 newborns have been screened, and the mean value is 6.23 +/- 0.13 microIU per ml. This mean value is less than previously reported by us in 1986 (10.23 +/- 0.29 microIU per ml).13 It is concluded that this screening service continues to be possible far removed from the population under observation. No case of primary hypothyroidism has been detected. Our decreased mean TSH value is due to the new method currently used by the Illinois State Metabolic Screening Laboratory. Congenital hypothyroidism will not be missed provided internal controls are established and rigidly observed.

  7. Abnormal expression of ephrin-A5 affects brain development of congenital hypothyroidism rats.

    Science.gov (United States)

    Suo, Guihai; Shen, Feifei; Sun, Baolan; Song, Honghua; Xu, Meiyu; Wu, Youjia

    2018-05-14

    EphA5 and its ligand ephrin-A5 interaction can trigger synaptogenesis during early hippocampus development. We have previously reported that abnormal EphA5 expression can result in synaptogenesis disorder in congenital hypothyroidism (CH) rats. To better understand its precise molecular mechanism, we further analyzed the characteristics of ephrin-A5 expression in the hippocampus of CH rats. Our study revealed that ephrin-A5 expression was downregulated by thyroid hormone deficiency in the developing hippocampus and hippocampal neurons in rats. Thyroxine treatment for hypothyroid hippocampus and triiodothyronine treatment for hypothyroid hippocampal neurons significantly improved ephrin-A5 expression but could not restore its expression to control levels. Hypothyroid hippocampal neurons in-vitro showed synaptogenesis disorder characterized by a reduction in the number and length of neurites. Furthermore, the synaptogenesis-associated molecular expressions of NMDAR-1 (NR1), PSD95 and CaMKII were all downregulated correspondingly. These results suggest that ephrin-A5 expression may be decreased in CH, and abnormal activation of ephrin-A5/EphA5 signaling affects synaptogenesis during brain development. Such findings provide an important basis for exploring the pathogenesis of CH genetically.

  8. Congenital hypothyroidism due to ectopic sublingual thyroid gland in Prader-Willi Syndrome: a case report.

    Science.gov (United States)

    Bocchini, Sarah; Fintini, Danilo; Grugni, Graziano; Boiani, Arianna; Convertino, Alessio; Crinò, Antonino

    2017-09-22

    Thyroid gland disorders are variably associated with Prader-Willi syndrome (PWS). Many of the clinical features in newborns with PWS are similar to those found in congenital hypothyroidism (CH). We report a case of a girl with CH and PWS. At the age of 9 months CH caused by an ectopic sublingual thyroid was diagnosed, and hormone replacement therapy was started. In spite of this treatment a decrease in growth velocity, weight excess and delayed development were observed. At the age of 9 years PWS was suspected on the basis of phenotype and genetic tests confirmed a maternal uniparental disomy of chromosome 15. This is the second reported case of hypothyroidism due to an ectopic sublingual thyroid gland in PWS suggesting that, although rare, an association between CH and PWS may exist. In our case diagnosis of PWS was delayed because mental retardation, hypotonia, obesity and short stature were initially attributed to hypothyroidism. In this context PWS should be considered in obese children with CH who do not improve adequately with l-thyroxine therapy. Also, thyroid function in all PWS children should be assessed regularly in order to avoid delayed diagnosis of hypothyroidism.

  9. Neonatal Screening for Congenital Hypothyroidism in an University Hospital in Tehran, Iran

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    Najafian

    2016-05-01

    Full Text Available Background The national program of neonatal screening was performed in 2005 in Iran. According to the studies, the outbreak of congenital hypothyroidism (CH was one in every 670 live births in 2011. The prevalence of the disease in the world is 1 in 3000. The mean prevalence of this disease in Iran is estimated to be 1 in 1,000, which indicates a high prevalence of the disease in Iran. Objectives This study was conducted to investigate the prevalence of congenital hypothyroidism among neonates in the Najmiyeh hospital in Tehran, Iran. Patients and Methods This cross-sectional study was conducted from 2011 to 2014. Most heel blood samples were taken between three and seven days of birth. Thyroid stimulating hormone (TSH was tested using the enzyme-linked immunosorbent assay method. Neonates with abnormal screening results (TSH > 10 mIU/L, Free T4 < 1.6 mg/dL were re-examined. Data were analyzed using the SPSS software. Results A total of 11427 infants were screened. Of 399 re-called subjects (re-call rate = 3%, 57 cases were detected with CH, a CH prevalence of 1:200 (the female:male ratio of 1:1.5. Conclusions The prevalence of CH in our center is high. These results emphasize the importance of the congenital screening program.

  10. The Study of Congenital Hypothyroidism Prevalence Using Screening in Azarshahr, East Azerbaijan Province, Iran, 2011

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    Ali Nayerpour

    2015-08-01

    Full Text Available Background and objectives : Congenital hypothyroidism (CH is one of the most prevalent causes of mental retardation which is preventable provided that earlier diagnosis and treatment are performed. The aim of this study was to investigate the prevalence of congenital hypothyroidism among newborns in Azarshahr during 2011. Material and Methods : This cross-sectional study was conducted on 1775 newborns in Azarshahr applying census method. In this regard, four drops of blood samples were taken preferably from each 3-5 day-old newborn’s heel using auto-lancet and then transferred to Whatman® 903 filter papers. Samples were checked to measure TSH level using ELISA method. Results : Program covering percentage was 95.9%. The disease prevalence was 1.12 per 1000 live births or one case per 887 live births. According to the results, 52.4% of the newborns were male. Samples in 84.6% of newborns were taken within 3rd-5th days of life and in 14.8%, within 6th-21st days of life. The TSH level in 97.5% of screened newborns was lower than 5 mu/L and in 1.6% of the samples was within the range of 5-9.9 mu/L. Recall rate was 1.7% and among them, two patients with hypothyroidism were found. The average age of treatment onset in patients was 20.5 days. Conclusion : Because of high prevalence of hypothyroidism in Azarshahr in comparison with other areas of Iran and the world, it is necessary to continue screening program.

  11. Congenital hypothyroidism - Polish recommendations for therapy, treatment monitoring, and screening tests in special categories of neonates with increased risk of hypothyroidism.

    Science.gov (United States)

    Kucharska, Anna Małgorzata; Beń-Skowronek, Iwona; Walczak, Mieczysław; Ołtarzewski, Mariusz; Szalecki, Mieczysław; Jackowska, Teresa; Lewiński, Andrzej; Bossowski, Artur

    2016-01-01

    Proper treatment of congenital hypothyroidism warrants normal intellectual and physical development. This paper introduces the principles of treatment of congenital hypothyroidism, the recommended levothyroxine dosage, and the aims of therapy with its justification. The principles of treatment, specialist care of the patient, and methods used to evaluate therapeutic effects are described. Based on these data, recommendations concerning treatment and its monitoring in patients with congenital hypothyroidism are formulated. The paper also highlights the importance of educating the patients and/or their caretakers as one of the basic components of an effective therapy. The interpretation of screening tests in preterm neonates is provided as well. In the current screening program in preterm children TSH was determined between days three and five of life and then after three weeks. During this time TSH values are frequently low because of the immaturity of the hypothalamic-pituitary axis. Due to the increased risk of primary and secondary hypothyroidism in preterm and low birth weight babies the determination of TSH and fT4 between days three and five of life is recommended, irrespective of the screening test. (Endokrynol Pol 2016; 67 (5): 536-547).

  12. Clinicopathological features of transient myeloproliferative syndrome and congenital leukaemia

    International Nuclear Information System (INIS)

    Sajid, N.; Ahmed, N.; Mahmood, S.

    2010-01-01

    The objectives of the study were to determine the spectrum of the clinical and pathological findings, the management and prognosis of patients of transient myeloproliferative syndrome (TMS) and congenital leukaemia. Study Design: Case series. Place and Duration of Study: The study was conducted over a period of 8 years, from January 2000 to December 2007, at the Children's Hospital and the Institute of Child Health, Lahore. Methodology: Suspected patients presenting with fever, pallor, bruises and hepatosplenomegaly and diagnosed as either transient myeloproliferative disorder or congenital leukaemia were studied. The complete blood count, reticulocyte count, leukocyte alkaline phosphatase score, liver function tests, karyotyping studies and bone marrow aspiration biopsy were performed in all of those patients. Management and out come was noted. Results were described as frequency percentages. Results: Out of 10,000 patients presenting during this period, 24 patients were diagnosed as either of transient myeloproliferative syndrome or congenital leukaemia. Fifteen of these were diagnosed as patients of TMS and 9 as patients of congenital leukaemia. Down syndrome (DS) was diagnosed in 75% of these patients. TMS patients were put on supportive treatment and recovered spontaneously. One DS patient with congenital leukaemia went into spontaneous remission and 2 of DS patients with congenital leukaemia responded to chemotherapy while rest of them either died or lost to follow-up. Conclusion: TMS and congenital leukaemia were not very uncommon in the studied population. Majority had Down syndrome. It is important to differentiate their clinical and pathological presentations for proper management. TMS may resolve with supportive treatment while congenital leukaemia is a fatal condition requiring chemotherapy. (author)

  13. Confirmatory study for the congenital hypothyroidism diagnostic in newborns with suspicious neonatal sieve

    International Nuclear Information System (INIS)

    Murillo V, D.; Badillo A, V.; Villasana R, A. P.

    2009-10-01

    The congenital hypothyroidism is an endocrine illness knows from the X V century. It is caused by the anatomical or functional absence of the thyroid gland, what causes a deficiency in the thyroid hormones production. These hormones are indispensable for an appropriate physical and mental development from the first moments of the life. This illness is the more frequent cause of avoidable mental retardation in the child. In Mexico, is considered that 1 of each 2,537 newborns present congenital hypothyroidism, this frequency is extraordinarily high in relation to other countries. For the opportune confirmation of this illness is carried out by means of the radio immuno analysis that is a competitive type technique which is based on the antigen-antibody reaction. To the present antigen in the sample problem, is go to add a constant and known quantity of labelled antigen (hot antigen). The labelled antigens are formed substituting some of the normal atoms of the antigen for the corresponding radioactive isotope I 125 in the molecule. The two types of antigens, cold and hot will compete, in equality of conditions, to unite with the available antibody. The concentrations of labelled antigen and antibody not change, the only variable of the system is the non labelled antigen (cold antigen) concentration. As much as more it is the quantity of cold antigen in the sample problem, it is displaced at the hot antigen and therefore they are fixed to the antibody smaller quantities of labelled antigen. Therefore, the formation of radioactive complexes (Ag-Ac) it varies in function of the non labelled antigen concentration: to major non labelled antigen concentration, major formation of non labelled antigen-antibody complexes, and minor formation of radioactive complexes and vice versa. 29 cases were analyzed with suspicion of congenital hypothyroidism therefore the T4 neonatal and TSH neonatal were quantified by the radio immuno analysis technique giving the confirmation of a

  14. Use of Tc-99 m thyroid scans in borderline congenital hypothyroidism.

    Science.gov (United States)

    Oren, Asaf; Wang, Michael Ke; Brnjac, Lori; Mahmud, Farid H; Palmert, Mark R

    2016-03-01

    Mild or borderline congenital hypothyroidism [often referred to as mild neonatal hyperthyrotropinemia (MNH)] is characterized by an abnormal newborn screen (NBS), followed by mildly elevated TSH and normal FT4 on confirmatory testing. This condition is increasingly observed, but data regarding optimal management are limited. Examine the use of routine technetium thyroid scanning (TS) in the management of MNH. Retrospective study of infants with MNH between 2000 and 2011. We assessed the clinical course of infants with MNH according to TS results; as a comparator, infants with classic congenital hypothyroidism (CH) were analysed in parallel. We identified 69 infants (52% boys) with MNH and 164 (34% boys) with classic CH. TS results were divided into four subgroups: no uptake in 7% of MNH vs 24% of classic CH (P MNH, neither NBS-TSH, confirmatory TSH and FT4, mean LT-4 treatment doses and number of dose escalations, nor post-treatment FT4 and TSH differed among the four subgroups. In contrast, clinical features in infants with classic CH differed among the subgroups. Among MNH infants who reached 3 years of age, trial-off treatment was successful in 6 of 11 (55%) with no apparent difference in success rates among TS subgroups. The information provided by TS during evaluation of MNH does not predict clinical course; obtaining these scans in infants with MNH may not be an effective use of healthcare resources. © 2015 John Wiley & Sons Ltd.

  15. Dynamics of the plasma concentrations of TSH, FT4 and T3 following thyroxine supplementation in congenital hypothyroidism

    NARCIS (Netherlands)

    Bakker, Bert; Kempers, Marlies J. E.; de Vijlder, Jan J. M.; van Tijn, David A.; Wiedijk, Brenda M.; van Bruggen, Michael; Vulsma, Thomas

    2002-01-01

    OBJECTIVE The dynamics of the plasma concentrations of various diagnostic determinants of thyroid function were analysed in children with congenital hypothyroidism (CH) after the start of T4 supplementation. The description of the biochemical dynamics of TSH and free T4 (FT4) during the first period

  16. Concentration of plasma thyroglobulin and urinary excretion of iodinated material in the diagnosis of thyroid disorders in congenital hypothyroidism

    NARCIS (Netherlands)

    Gons, M. H.; Kok, J. H.; Tegelaers, W. H.; de Vijlder, J. J.

    1983-01-01

    In this paper we describe methods for the early aetiological diagnosis of congenital hypothyroidism, using beside the classical T4, T3 and TSH plasma concentrations, four additional parameters in plasma and urine. The first one is thyroglobulin (Tg). In normal children of more than one year of age

  17. Quality of life, developmental milestones, and self-esteem of young adults with congenital hypothyroidism diagnosed by neonatal screening

    NARCIS (Netherlands)

    van der Sluijs Veer, L.; Kempers, M. J. E.; Last, B. F.; Vulsma, T.; Grootenhuis, M. A.

    2008-01-01

    CONTEXT: With advances in the treatment of congenital hypothyroidism (CH), the neuropsychological functioning of CH patients is considerably improved. Although much is written about cognitive and motor development, little is known about emotional and social consequences for patients growing up with

  18. Quality of life, developmental milestones, and self-esteem of young adults with congenital hypothyroidism diagnosed by neonatal screening

    NARCIS (Netherlands)

    van der Sluijs Veer, L.; Kempers, M.J.; Last, B.F.; Vulsma, T.; Grootenhuis, M.A.

    2008-01-01

    Context: With advances in the treatment of congenital hypothyroidism (CH), the neuropsychological functioning of CH patients is considerably improved. Although much is written about cognitive and motor development, little is known about emotional and social consequences for patients growing up with

  19. Quality of life, developmental milestones, and self-esteem of young adults with congenital hypothyroidism diagnosed by neonatal screening.

    NARCIS (Netherlands)

    Sluijs-Veer, L. van der; Kempers, M.J.E.; Last, B.F.; Vulsma, T.; Grootenhuis, M.A.

    2008-01-01

    CONTEXT: With advances in the treatment of congenital hypothyroidism (CH), the neuropsychological functioning of CH patients is considerably improved. Although much is written about cognitive and motor development, little is known about emotional and social consequences for patients growing up with

  20. [Combined l-thyroxine and l-triiodothyronine replacement therapy in congenital hypothyroidism].

    Science.gov (United States)

    Péter, Ferenc; Muzsnai, Agota

    2013-05-12

    L-thyroxine replacement therapy is the treatment of choice for hypothyroidism. Recently, several studies suggested to complete it with l-triiodothyronine in acquired hypothyroidism. To study the role of combined l-thyroxine and l-triiodothyronine therapy in special cases with congenital hypothyroidism. Data of 16 patients (age: 11.9 ± 6.3 years; mean ± SD) are presented who had high serum free thyroxine values or even above the upper limit of reference range (21.16 ± 2.5 pmol/l) together with nonsuppressed TSH levels (15.7 ± 5.7 mIU/l), and therefore received l-triiodothyronine in completion (0.18 ± 0.09 μg/kg) once a day. The combined replacement therapy resulted in a rapid improvement of the hormone parameters (TSH: 4.2 ± 3.15 mIU/l; free thyroxine: 16.55 ± 2.4 and free triiodothyronine: 7.4 ± 1.8 pmol/l). The efficiency of this combined therapy proved to be more evident (TSH: 4.33 ± 3.2 mIU/l; free thyroxine: 16.85 ± 3.1 and free triiodothyronine: 6.4 ± 0.85 pmol/l) in 10 patients treated for a longer period of time (duration of treatment: 2.9 ± 2.0 years). The dose of thyroxine substitution decreased from 2.6 ± 0.9 to 2.18 ± 0.6 μg/kg/day), the ratio of these hormones was between 5:1 and 19:1 and the quotient of free fractions was normalized (3.8 ± 0.4→2.6 ± 0.3) during the replacement therapy. According to the observation of the authors a serious disturbance of feed-back mechanism may develop in some (>5%) children with congenital hypothyroidism (increased TSH release despite elevated free thyroxine level) after normal function of the feed-back system for years. Hormone parameters of these patients improve, then become normal on combined therapy supporting the rationale for this treatment method.

  1. A neonatal screening of congenital hypothyroidism covered 266 401 cases in Tianjin area

    International Nuclear Information System (INIS)

    Fang Peihua; Lv Mei; Huang Guangyu; Yuan Chengyun; Xu Jing; Yang Qingyan; Wang Xiuying; Ma Xiancheng; Liu Geli; Chen Kunming; Zhang Moling

    2003-01-01

    Objective: To observe the incidence, the curative rate and the long term prognosis of congenital hypothyroidism (CH) newborns detected by screening program in Tianjin area initiated at the beginning of 1982. Methods: Primarily, the T 4 and thyroid-stimulating hormone (TSH) radioimmunoassay (RIA) of dried blood sample on filter paper developed in our laboratory were used. The TSH RIA was replaced by a time-resolved fluorescence immunoassay (Tr-FIA) in 1998. The primary T 4 RIA was replaced by a commercial kit for T 4 RIA in 1999. SPECT imaging on thyroid was performed after intravenous administration of 99 Tc m O 4 - 11.1-18.5 MBq. Results: A total of 266 401 neonates was screened for CH in our laboratory in Tianjin area. 36 cases of permanent CH were confirmed in the program. The incidence of CH was 0.014%; 22 cases of CH here were kept in treatment . Of the 22 cases, 19 cases were recalled in 2000, 18 of them (94.7%) showed currently with normal growth and development in the check-up. Imaging on thyroid ( 99 Tc m ): among 19 patients with CH, 1 case was found with normal gland, 1 with a hypogenetic thyroid, 3 cases with enlarged thyroid, 7 with ectopic gland, and the remaining 7 cases didn't show any image of thyroid. The bone age of 20 CH children was evaluated with the X ray radiography. In 6 cases of them, the bone age was normal, and 7 cases had progressed from development delay to normal. So far, retarded bone age of the remaining 7 CH patients didn't show any renewing yet. The bone age renewal was found in 3 younger children of them, but for the other 3 cases (9-12 years old) of CH patients with thyroid gland absence, the renewal of bone age was slower. Intelligence quotient (IQ) in 16 cases was measured. The scores of IQ in 13 cases of them (81.3%) were 80-119, 2 cases 72-77, 1 case 60. IQs of 6/16 cases of CH patients with thyroid absence were lower. May be it related to that, their hypothyroidism during fetal life was severer. Conclusions: Neonatal

  2. Incidence and Interrelated Factors in Patients With Congenital Hypothyroidism as Detected by Newborn Screening in Guangxi, China

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    Xin Fan MD

    2015-01-01

    Full Text Available Background. A newborn screening program (NSP for congenital hypothyroidism (CH was carried out in Guangxi in order to understand the incidence of CH and the factors interrelated to major types of CH in this region of China. Methods. During 2009 to 2013, data from 930 612 newborns attending NSP in Guangxi were collected. Patients were classified with either permanent CH (PCH or transient CH (TCH after 2 years of progressive study. Results. A total of 1210 patients were confirmed with CH with an incidence of 1/769, including 68 PCH and 126 TCH cases with incidences of 1/6673 and 1/3385, respectively. The frequency of thyroid stimulating hormone values greater than 5 mIU/L was 7.2%, which, based on WHO guidelines, suggests that the population was mildly iodine deficient. Conclusions. The incidence of CH was high in Guangxi. Approximately two thirds of CH patients were TCH, which may be due to a deficiency in iodine within the population.

  3. [Contributions of the measurement of TSH, T4 and thyroglobulin, of 99m Tc scintigraphy and of cervical ultrasonography to the early diagnosis of congenital hypothyroidism].

    Science.gov (United States)

    Delisle, M J; Gibold, C; Deltour, G; Pennaforte, F

    1988-01-01

    Over 10 years, extending from 1978, 200,000 newborns of the Champagne-Ardennes Region have been tested within the screening program for congenital hypothyroidism. Congenital hypothyroidism was diagnosed in 96 infants (28 boys, 68 girls): 73 thyroid dysgenesis (50 ectopic glands and 23 undetectable thyroid tissue) and 23 thyroid dyshormonogenesis (14 permanent and 9 transient defects). Our local frequency was 1/2,600, significantly higher than the French and European frequencies. There was a marked shortening of the age at diagnosis during the 10 year period (mean age: 45 days between 1978 and 1980, 18 days in 1987). The TSH measurement was found to be the most sensitive tool for the diagnosis. Scintigraphy and more recently ultrasonography were performed in order to characterize the anatomical variety. For the last year, the following protocol was used: high frequency ultrasonography at first, then 123I or 99 m Tc scintigraphy (using parallel colimator and digital acquisition) depending on whether the thyroid gland was seen on ultrasound or not. Treatment of thyroid dyshormonogenesis was withdrawn after 5 years for reassessment.

  4. Current status of the congenital hypothyroidism neonatal screening program in Adana Province, Turkey.

    Science.gov (United States)

    Kor, Yılmaz; Kor, Deniz

    2018-05-11

    Congenital hypothyroidism (CH) is a common cause of mental retardation; it has a worldwide incidence ranging from 1:3000 to 1:4500 live births. Predictably, an increase in the reported incidence of primary CH occurs when the cut-off levels of thyroid-stimulating hormone are lowered. We aimed to evaluate the results of a congenital hypothyroidism screening program and current status in this study. Analysis results of 1300 infants who were referred to the endocrinology polyclinic because of suspected CH within the scope of the Ministry of Health National Neonatal Screening Program were retrospectively evaluated. The diagnosis of CH and initiation of treatment were both done in 223 (18.5%) and 10 (0.8%) infants as a result of the initial evaluation and follow-up, respectively. The mean capillary and venous thyroid-stimulating hormone (TSH) levels of 223 patients were 40.78 (5.5-100) μIU/mL and 67.26 (10.7-100) μIU/mL, respectively. These patients' mean heel prick time was 8.65 (0-30, median: 7) days. The mean age of the 223 infants whose treatment was initiated as a result of the initial evaluation was 19.87 (4-51, median: 20) days, and the mean age of the infants whose treatment was started at follow-up was 43.71 (29-65) days. The duration between heel prick time and venous TSH time was 11.10 (2-28, median: 11) days and was longer than planned (3-5 days). Although the duration for the diagnosis and initiation of CH treatment were markedly reduced with the implementation of the screening program in Turkey compared to those before the implementation of the screening program, we have not yet achieved the ideal time (≤14 days).

  5. Repeatability of heart rate variability in congenital hypothyroidism as analysed by detrended fluctuation analysis

    International Nuclear Information System (INIS)

    Echeverría, J C; Solís, L I; Pérez, J E; Gaitán, M J; Mandujano, M; Sánchez, M C; González-Camarena, R; Rivera, I R

    2009-01-01

    The analysis of heart rate fluctuations, or heart rate variability (HRV), may be applied to explore children's neurodevelopment. However, previous studies have reported poor reliability (repeatability) of HRV measures in children at rest and during light exercise. Whether the reliability can be improved by controlling variables such as physical activity, breathing rate and tidal volume, or by selecting non-conventional techniques for analysing the data remains as an open question. We evaluated the short-term repeatability of RR-interval data from medicated children with congenital hypothyroidism (CH). The α 1 exponents, obtained by detrended fluctuation analysis (DFA), from the data of 21 children collected at two different sessions were compared. Elapsed days between sessions were 59 ± 33, and data were obtained during 10 min, trying to restrict the children's activity while being seated. We found statistical agreement between the means of α 1 exponents for each session (p = 0.94) and no bias with a low-coefficient variation (9.1%); an intraclass correlation coefficient ri = 0.48 ([0.14 0.72], 95% confidence interval) was also estimated. These findings, which were compared with results obtained by conventional time and frequency techniques, indicate the existence of agreement between the α 1 exponents obtained at each session, thereby providing support concerning the repeatability of HRV data as analysed by DFA in children with congenital hypothyroidism. Of particular interest was also the agreement found by using the central frequency of the high-frequency band and the parameter pNN20, both showing better or similar ri than α 1 (0.77 [0.57 0.89] and 0.51 [0.17 0.74], respectively), yet considerably better repeatability than other conventional time and frequency parameters

  6. Transient hypothyroidism in iodine-131 treated thyrotoxicosis - a review of cases from 1970-1984 at JRRMMC

    International Nuclear Information System (INIS)

    Reyes, E.B.; de la Cruz, C.; Gonzales, V.L.

    1988-01-01

    This review was conducted to determine the minimum dose of radioactive iodine necessary to show signs and symptoms of thyrotoxicosis among Filipinos, to determine the incidence of hypothyroidism secondary to radioactive treatment and to determine if some cases of hypothyroidism following radioactive iodine treatment are only transient and replacement therapy could be withheld or not. A total of 212 patients who had I-131 therapy was evaluated (177 female and 35 male). Of this number 19 or 8.9% developed hypothyroidism. After three years, 14 or 74% of the hypothyroids were noted. Easy fatigability ranked first of the patients complaints, followed by dry skin, sleepiness, numbness of extremities, and joint pains. Results of this study indicate that there is a definite, although low incidence of hypothyroidism following I-131 therapy (8.9%). (ELC). 6 refs.; 6 tabs

  7. The etiologies and incidences of congenital hypothyroidism before and after neonatal TSH screening program implementation: a study in southern Thailand.

    Science.gov (United States)

    Jaruratanasirikul, Somchit; Piriyaphan, Jutarat; Saengkaew, Tansit; Janjindamai, Waricha; Sriplung, Hutcha

    2018-05-11

    Congenital hypothyroidism (CH) is one of the common causes of intellectual disability which can be prevented by early detection of an elevated thyroid stimulating hormone (TSH) level in the newborn and by treatment with thyroxine. In Thailand, neonatal TSH screening was implemented nationwide in 2005. The objective of the study was to determine the etiologies and the estimated incidences of CH in southern Thailand before and after the implementation of a neonatal TSH screening program in 2005. The medical records of pediatric patients who were diagnosed with primary CH at Songklanagarind Hospital during 1995-2013 were retrospectively reviewed. The study was divided into two time periods: study period 1 (SP1) (1995-2004) and study period 2 (SP2) (2005-2013), the time before and after TSH program implementation. The most common form of CH during SP1 was overt permanent CH (66%), mostly caused by athyreosis or ectopic thyroid. In SP2, the most common form of CH was mild permanent CH (39%) (mostly due to dyshormonogenesis), followed by overt CH (32%) and transient CH (29%). The overall annual estimated incidence of CH per 10,000 live births in Songkhla Province was 1.69 (1:5021) in SP1, increasing to 4.77 (1:2238) in SP2; in all 14 provinces in southern Thailand, the estimated incidence was 1.24 (1:8094) in SP1 and 2.33 (1:4274) in SP2. Neonatal TSH screening has a significant impact on the increased detection of the mild form of permanent and transient CH cases, which may be important for the prevention of brain damage from less severe CH although this remains to be documented.

  8. [Papillary thyroid carcinoma in a child with congenital dyshormonogenetic hypothyroidism. Case report].

    Science.gov (United States)

    Orellana, María José; Fulle, Angelo; Carrillo, Diego; Escobar, Lucía; Ebensperger, Alicia; Martínez, Raúl; Rumié Carmi, Hana

    Papillary thyroid carcinoma (PTC) is a rare childhood disease. The development of PTC in dyshormonogenetic congenital hypothyroidism (CH) is infrequent, with very few case reports in literature. To report a case of PTC in a boy with dyshormonogenetic CH without goitre and exposed to ionising radiation. To evaluate relationships between these factors and development of PTC. We present a boy with dyshormonogenetic CH since birth. Early hormonal substitution was initiated, with subsequent normal levels of thyrotropin and thyroid hormones. He has also congenital cardiomyopathy, exposed to interventional treatment with 10 heart catheterisations, and approximately 26 chest X-rays at paediatric doses. A thyroid nodule was found in thyroid echography at the age of 6 years old. Fine needle aspiration biopsy confirmed high probability of thyroid carcinoma (Bethesda 5). The pre-surgical thorax and cerebral scan showed no evidence of metastasis. The patient underwent total thyroidectomy. Pathological examination revealed a 0.5cm papillary thyroid micro-carcinoma in the right lobe, with no evidence of dissemination. Genetic mutations and radiation exposure may play an important role in the development of PTC. There may be common pathways between dyshormonogenetic CH and thyroid carcinoma that need further investigation. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Overview of diagnosis, management and outcome of congenital hypothyroidism: A call for a national screening programme in Sudan

    OpenAIRE

    Babiker, Amir M. I.; Jurayyan, Nasir A. Al; Mohamed, Sarar H.; Abdullah, Mohamed A.

    2012-01-01

    Congenital hypothyroidism (CH) is the commonest preventable cause of mental retardation in children worldwide. It continued to be a major health problem amongst Sudanese children. The lack of a screening programme in Sudan may be the major factor of missing the diagnosis in newborns with such a condition that can present very subtle clinically, yet with poor neurodevelopmental consequences. The outcome is very good when the condition is noticed early (in the first 2 - 3 weeks of life). Howeve...

  10. Congenital hypothyroidism - An usual suspect at an unusual age: A case series

    Directory of Open Access Journals (Sweden)

    Suja P Sukumar

    2013-01-01

    Full Text Available Menorrhagia is the most common menstrual irregularity in hypothyroid women. However, it is an uncommon presentation of congenital hypothyroidism (CH. In the era of newborn screening across the world, when CH is extremely rare, we came across four cases of CH due to delayed diagnosis, presenting in adulthood with severe menorrhagia. Aims: To signify the atypical presentation of CH in late adulthood due to delayed diagnosis and its sequelae; and to increase the awareness about this treatable condition. Settings and Design: This is a cross-sectional analysis of consecutive patients with CH presenting after 18 years between 2010 and 2012 from the CH registry of Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER, India. Subjects and Methods: Four patients of CH presenting late (>18 years with atypical presentations out of total 16 cases of CH within a period of 3 years were analyzed for clinical, hormonal, and imaging findings. Results: Between the years 2010 and 2012, 16 cases of CH were registered at our center out of which four cases presented in late adolescence and adulthood with menorrhagia. Age range of these patients was 18-30 years. All four patients were females presenting with anemia secondary to menorrhagia and upon evaluation were found to have CH. All of them showed improvement after starting treatment and are currently doing well with regular menstrual cycles. Conclusions: Our study demonstrates the importance of thyroid evaluation in a patient presenting with menorrhagia along with short stature. There is need for awareness among clinicians regarding the clinical features of CH and nationwide screening for CH in our country.

  11. MOTOR AND COGNITIVE-DEVELOPMENT IN CHILDREN WITH CONGENITAL HYPOTHYROIDISM - A LONG-TERM EVALUATION OF THE EFFECTS OF NEONATAL TREATMENT

    NARCIS (Netherlands)

    KOOISTRA, L; LAANE, C; VULSMA, T; SCHELLEKENS, JMH; VANDERMEERE, JJ; KALVERBOER, AF

    Although neonatal thyroid screening programs have been of value in preventing cerebral damage, ii is still controversial whether patients with congenital hypothyroidism achieve normal motor and cognitive skills. We studied the motor and cognitive skills of 72 children with early-treated congenital

  12. Children with Congenital Hypothyroidism Have Similar Neuroradiological Abnormal Findings as Healthy Ones

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    Marianna Rachmiel

    2013-01-01

    Full Text Available Objective. To assess the neuroradiological findings of children with congenital hypothyroidism (CHT compared to healthy controls (HC. Patients and Methods. Thirty children with CHT, mean age 12.5 ± 1.6 years, 14 (44.8% males, were compared with 38 HC mean age 11.7 ± 1.7 years, 16 (45.7% males. Clinical data were collected from medical charts and questionnaires seeking information on family history, birth and perinatal period events, medications, and overall health history. Neurocognitive function was assessed for global intelligence, visual and verbal memory, and executive functioning using standardized tests. Neuroimaging was performed using 1.5 T magnetic resonance imaging and assessed by two pediatric radiologists. Results. Children with CHT had a similar proportion of incidental findings as did the children in the HC group, at 43.3% and 39.5%, respectively, . Abnormalities of the sellar region were reported in 13.3% of CHT group and 7.9% of HC group, . Other incidental findings included cerebellar ectopia, choroidal fissure and pineal cysts, and multiple increased signal intensity foci. Neuroradiological findings were not associated with clinical and neurocognitive abnormalities. Conclusion. Neuroimaging of children with CHT demonstrated a similar incidence of structural abnormalities as in the healthy population. There is no association between those findings and neurocognitive function.

  13. Hippocampal Functioning and Verbal Associative Memory in Adolescents with Congenital Hypothyroidism

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    Sarah Marie Wheeler

    2015-10-01

    Full Text Available Thyroid hormone (TH is essential for normal development of the hippocampus, which is critical for memory and particularly for learning and recalling associations between visual and verbal stimuli. Adolescents with congenital hypothyroidism (CH, who lack TH in late gestation and early life, demonstrate weak verbal recall abilities, reduced hippocampal volumes, and abnormal hippocampal functioning for visually associated material. However, it is not known if their hippocampus functions abnormally when remembering verbal associations. Our objective was to assess hippocampal functioning in CH using functional magnetic resonance imaging (fMRI. Fourteen adolescents with CH and 14 typically developing controls (TDC were studied. Participants studied pairs of words and then, during fMRI acquisition, made two types of recognition decisions: in one they judged whether the pairs were the same as when seen originally and in the other, whether individual words were seen before regardless of pairing. Hippocampal activation was greater for pairs than items in both groups, but this difference was only significant in TDC. When we directly compared the groups, the right anterior hippocampus was the primary region in which the TDC and CH groups differed for this pair memory effect. Results signify that adolescents with CH show abnormal hippocampal functioning during verbal memory processing.

  14. Parenting styles and coping strategies among patients with early detected and treated congenital hypothyroidism.

    Science.gov (United States)

    Pardo Campos, María L; Musso, Mariel; Keselman, Ana; Gruñeiro, Laura; Bergadá, Ignacio; Chiesa, Ana

    2018-04-01

    Congenital hypothyroidism (CH), as any chronic disease, has an impact on the parent-child relationship and on the child's resources to cope with conflicting situations. To describe parenting styles according to the perception of children with CH and their coping strategies. Children aged 9-10 years who had CH detected by newborn screening and had received adequate treatment and a group without CH (control group). The Argentine Coping Questionnaire, the Argentine Scale for the Perception of Parent Relations, and the comprehension subtest of the Wechsler Intelligence Scale for Children III (WISC III) were used. Results were compared using a multivariate analysis of variance (MANOVA). Sixty children with CH were included; they perceived that their mothers exercised a strict control and that their fathers showed more acceptance. They sought more support and became paralyzed more often in conflicting situations than the 60 children without CH. These findings may be associated with a higher level of dependence. They should be taken into consideration in CH care. Sociedad Argentina de Pediatría.

  15. Central congenital hypothyroidism due to gestational hyperthyroidism: detection where prevention failed.

    Science.gov (United States)

    Kempers, Marlies J E; van Tijn, David A; van Trotsenburg, A S Paul; de Vijlder, Jan J M; Wiedijk, Brenda M; Vulsma, Thomas

    2003-12-01

    Much worldwide attention is given to the adverse effects of maternal Graves' disease on the fetal and neonatal thyroid and its function. However, reports concerning the adverse effects of maternal Graves' disease on the pituitary function, illustrated by the development of central congenital hypothyroidism (CCH) in the offspring of these mothers, are scarce. We studied thyroid hormone determinants of 18 children with CCH born to mothers with Graves' disease. Nine mothers were diagnosed after pregnancy, the majority after their children were detected with CCH by neonatal screening. Four mothers were diagnosed during pregnancy and treated with antithyroid drugs since diagnosis. Another four mothers were diagnosed before pregnancy, but they used antithyroid drugs irregularly; free T(4) concentrations less than 1.7 ng/dl (hyperthyroid fetal environment impaired maturation of the fetal hypothalamic-pituitary-thyroid system. The frequent occurrence of this type of CCH (estimated incidence 1:35000) warrants early detection and treatment to minimize the risk of cerebral damage. A T(4)-based screening program appears useful in detecting this type of CCH. However, the preferential and presumably best strategy to prevent CCH caused by maternal Graves' disease is preserving euthyroidism throughout pregnancy.

  16. Follow-Up Study of Behavioral Development and Parenting Stress Profiles in Children with Congenital Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Mei-Chyn Chao

    2009-11-01

    Full Text Available Recent longitudinal experiences have emphasized that the follow-up of children with treated congenital hypothyroidism (CHT should not be limited to the cognitive domain. This study attempted to evaluate the emotional–behavioral profiles in children with CHT together with maternal parenting stress profiles. Data for child and family characteristics were collected from 47 families with a 3–12-year-old CHT child diagnosed and treated since the newborn period. Cognitive assessments were performed. The main caregiver completed the following questionnaires: (1 Strengths and Difficulties Questionnaire, which rated behavioral symptoms in children; (2 Parenting Stress Index, which determined the quality and magnitude of parenting stress experienced by the caregiver; and (3 Symptom Checklist-90-R, which evaluated the psychopathological symptoms of the caregiver. In addition, 31 unaffected siblings were recruited as a comparative control group. The results revealed that children with treated CHT had normal intelligence quotients (mean, 93.6 ± 16.2 at the time of the study. However, CHT children had more problems in emotional–behavioral domains than sibling controls (p = 0.01. Overall, 29.8% (14/47 of the CHT children had emotional–behavioral problems above the clinical cutoff. In addition, 13% of the caregivers of CHT children had parenting stress above the clinical cutoff. Therefore, professional intervention is warranted in these subgroups of CHT children and parents.

  17. High incidence of congenital hypothyroidism in one region of the republic of macedonia.

    Science.gov (United States)

    Anastasovska, V; Koviloska, R; Kocova, M

    2014-06-01

    Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation in children. Diagnosis is difficult at birth without neonatal screening. Neonatal thyroid screening was established in Prilep, Republic of Macedonia as an integral part of the nationwide screening program. To estimate the prevalence of CH in this region, neonatal thyroid screening was performed on 9757 newborns, during the period 2002-2011. The DELFIA method was applied to measure the thyroid-stimulating hormone (TSH) concentration in dried blood spot samples on standard filter paper taken 48 hours after birth by heel-stick. The TSH cut-off level was 10 mU/L. The neonatal thyroid screening coverage was 93.4%. Eight newborns with CH were detected, with an incidence of 1:1220 live births, significantly higher compared to the nationwide results 1:2602. The TSH level was not significantly dependent on the gender of the newborn. There was a statistically significant difference between the TSH level and the timing of newborn screening sampling (p One point ninety-two percent of newborns with TSH levels above 5 mU/L indicated an iodine sufficiency in Prilep. The incidence of CH in Prilep, which is higher when compared with that reported in surrounding countries, might be a consequence of the higher percentage of the Romany population in this region. Further analysis of this population in other regions is warranted.

  18. Thyroid abnormalities among first-degree relatives of children with congenital hypothyroidism: an ultrasound survey.

    Science.gov (United States)

    Adibi, Atoosa; Haghighi, Mahshid; Hosseini, Seyed Reza; Hashemipour, Mahin; Amini, Massoud; Hovsepian, Silva

    2008-01-01

    Congenital hypothyroidism (CH) is caused by thyroid dysgenesis and dyshormonogenesis. Evidence suggests the presence of genetic factors in both types of pathogenesis. We investigated whether an increased incidence of thyroid abnormalities could be shown by ultrasonography among first-degree relatives of children with CH. In this case-control study the presence of both developmental and non-developmental thyroid abnormalities was studied among first-degree relatives of CH patients and healthy children. Assessments included neck ultrasonography and thyroid function tests. The data obtained from parents, siblings and children were compared in the case and control groups. In the case group, 92 patients, 172 parents and 57 siblings, and in the control group, 82 healthy children, 160 parents and 39 siblings were studied. Thyroid developmental abnormalities were more prevalent among parents (3.5 vs. 0%, p = 0.03) and siblings (10.5 vs. 0, p = 0.01) of CH patients than the control group. Non-developmental abnormalities were not significantly different between the case and control groups (17 vs. 13%, p = 0.3). Thyroid developmental abnormalities were more prevalent among parents and siblings of CH patients than the control group, confirming the familial component of this entity. Copyright 2008 S. Karger AG, Basel.

  19. Follow-up study of behavioral development and parenting stress profiles in children with congenital hypothyroidism.

    Science.gov (United States)

    Chao, Mei-Chyn; Yang, Pinchen; Hsu, Hsiu-Yi; Jong, Yuh-Jyh

    2009-11-01

    Recent longitudinal experiences have emphasized that the follow-up of children with treated congenital hypothyroidism (CHT) should not be limited to the cognitive domain. This study attempted to evaluate the emotional-behavioral profiles in children with CHT together with maternal parenting stress profiles. Data for child and family characteristics were collected from 47 families with a 3-12-year-old CHT child diagnosed and treated since the newborn period. Cognitive assessments were performed. The main caregiver completed the following questionnaires: (1) Strengths and Difficulties Questionnaire, which rated behavioral symptoms in children; (2) Parenting Stress Index, which determined the quality and magnitude of parenting stress experienced by the caregiver; and (3) Symptom Checklist-90-R, which evaluated the psychopathological symptoms of the caregiver. In addition, 31 unaffected siblings were recruited as a comparative control group. The results revealed that children with treated CHT had normal intelligence quotients (mean, 93.6 +/- 16.2) at the time of the study. However, CHT children had more problems in emotional-behavioral domains than sibling controls (p = 0.01). Overall, 29.8% (14/47) of the CHT children had emotional-behavioral problems above the clinical cutoff. In addition, 13% of the caregivers of CHT children had parenting stress above the clinical cutoff. Therefore, professional intervention is warranted in these subgroups of CHT children and parents.

  20. Subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Bak, Peter; Hjortshøj, Cristel S; Gaede, Peter

    2018-01-01

    OBJECTIVE: Cyanotic congenital heart disease is a systemic disease, with effects on multiple organ systems. A high prevalence of subclinical hypothyroidism (SCH) has been reported in a small cohort of cyanotic congenital heart disease patients. Subclinical hypothyroidism has been associated...... with various adverse cardiovascular effects, as well as an increased risk of progression to overt hypothyroidism. The aim of this study was to examine the prevalence of SCH in cyanotic congenital heart disease patients, consider possible etiologies, and evaluate thyroid function over time. METHODS: First, 90...... follow-up (6.5 ± 1.0 years), SCH (defined as ≥2 consecutive elevated thyroid-stimulating hormone values) was present in 26%. Three patients progressed to overt hypothyroidism. Patients with SCH were younger (34 ± 12 vs 42 ± 16 years; P = .01) and had a lower oxygen saturation (80 ± 5 vs 84 ± 6%; P = .03...

  1. Early determination of the congenital hypothyroidism by means of the cuantification of STH and T4 by radioimmunoassay method

    International Nuclear Information System (INIS)

    De Penados, R.C.

    1986-11-01

    It was investigated the advantages and disadvantages and conditions of working for the diagnosis of the congenital hypothyroidism by RIA, and its future implementation. It was determined concentration of neonatal STH and neonatal T4 in whole blood of 517 new borns, obtained by capilar punction and recollected in filter paper. 261 samples were found with levels of T4 between normal limits and STH between 0 and 12.5 u U/ml correspond to a normal thyroid function. 29 samples with normal T4 and STH above 30 u U/ml, correspond to a possible primary hypothyroidism. 171 samples with normal T4 and STH between 12.5 and 30 u U/ml were found. (Author)

  2. Study of the incidence and etiology of congenital hypothyroidism in an endemic goiter area after treatment with iodine enriched salt

    International Nuclear Information System (INIS)

    Liu Shizhen

    1992-01-01

    A screening program for congenital hypothyroidism (CH) was performed in a severe endemic goiter area, Chengde district including 7 counties, after treatment with Iodine enriched salt, and Beijing city as a control area. From May 1985 to Sep. 1991, 26570 newborns in Beijing city and 16227 in Chengde were screened. The incidence of primary hypothyroidism in Beijing city was 1/8800 and that in Chengde 1/8100. Of all the 5 Ch detected, 3 from Beijing city and 2 from Chengde, were thyroid dysgenesis. Not a single case of endemic goiter cretinism (including both myxedematous and neurological cretinism) was found in our study. We conclude that Iodine deficiency is the only cause of endemic cretinism and this problem can be solved by Iodine enriched salt treatment

  3. Outcome of Congenitally Hypothyroid Screening Program in Isfahan: Iran From Prevention to Treatment

    Directory of Open Access Journals (Sweden)

    Mahin Hashemipour

    2010-01-01

    Full Text Available Objectives: Early and proper treatment is crucial to prevent neuropsychologic deficits in congenital hypothyroidism (CH. Considering the high prevalence of CH in Isfahan, the aim of this study was to evaluate the outcome of treatment in CH patients.Methods: In this study CH neonates diagnosed during screening program in Isfahan from May 2002 to September 2009 were studied. Frequent visits were performed to CH patients to monitor and follow their treatments. Quality of treatment was assessed by evaluating mean age of treatment initiation and mean TSH and T4 levels before and after treatment and during the first and second years according to their normal reference ranges.Results: Of 225,224 screened neonates, 536 were diagnosed as CH patients. The prevalence of CH was 1/420 live births. Mean age at starting treatment was 22.9  13.2 days. In 93.7% of patients, treatment was begun before the 45th day of life. In the first measurement after initiating the treatment, T4 and TSH were not in their acceptable range in 3.9% and 9.8% of CH patients, respec-tively. Mean T4 and TSH reached to normal range during the treatment period. T4 reached the normal range earlier than TSH.Conclusions: The mean age of treatment initiation was in acceptable range but the findings suggest that both early and high-dose treatments are crucial for optimal treatment, especially in patients with severe CH. Further studies are needed to determine the outcome of treatment specially regarding to different etiologies of CH.

  4. Evaluation of TSH Levels in the Program of Congenital Hypothyroidism Newborn Screening in a Pilot Study of Preterm Newborns in Bogotá, Colombia

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    Gustavo Adolfo Giraldo

    2015-07-01

    Full Text Available Introduction: Preterm infants (<37 weeks of gestation have low levels of thyroid hormones due to multiple factors. Objective: To evaluate levels of thyroid-stimulation hormone (TSH in the program congenital hypothyroidism (CH newborn screening in a sample of preterm infants in the city of Bogotá, Colombia. Methods: The Secretaría de Salud Distrital screening protocol for CH (blood sample is collected from the umbilical cord in all the newborns remeasured the serum TSH and heel TSH when preterm infants completed 37 weeks of gestation. Results: A total of 59 preterm neonates were rescreened, of which 2 neonates had elevated levels of TSH and 1 neonate had transient hypothyroxinemia. The Kolmogorov-Smirnov 2-sample/bilateral statistical test was used to compare the neonatal TSH levels of preterm and full-term newborns, which do not follow the same distribution. Conclusion: In our pilot study, 2 of the rescreened infants presented high levels of TSH and 1 had transient hyperthyrotropinemia, suggesting the need for rescreening of preterm infants. Additionally, a larger study should be performed to determine the screening cutoff values for preterm newborns.

  5. Optimization and field trial of nuclear medicine procedure for the detection of congenital hypothyroidism in a developing country

    International Nuclear Information System (INIS)

    Arnaldo Foradori, C.

    1987-08-01

    The optimization of the method for screening of neonatal hypothyroidism was done on the basis of local preparation of the necessary reagents like anti T4 rabbit antibody, radioactive tracer and goat antirabbit second antibody with the elimination of commercially available reagents kits. The blood sampling was performed using absorbing paper and T4 concentration was checked. The selection of T4 RIA was due to the robustness of the method and its easy reproducibility in comparison with TSH-RIA. In a group of 2000 newborns in Chile, three cases with neonatal hypothyroidism were found. One of them died within 72 hours because of multiple congenital defects while the two others with high TSH and low T4 are under current L-thyroxine treatment. The results obtained show the frequence of 3 cases of neonatal hypothyroidism out of 2000 newborns. This result is similar to results published in other Latin American countries, but higher than in Europe and USA. 14 refs, figs and tabs

  6. Communicative and psycholinguistic abilities in children with phenylketonuria and congenital hypothyroidism

    Science.gov (United States)

    GEJÃO, Mariana Germano; FERREIRA, Amanda Tragueta; SILVA, Greyce Kelly; ANASTÁCIO-PESSAN, Fernanda da Luz; LAMÔNICA, Dionísia Aparecida Cusin

    2009-01-01

    ABSTRACT The Neonatal Screening for Inborn Errors of Metabolism of the Association of Parents and Friends of Special Needs Individuals (APAE) - Bauru, Brazil, was implanted and accredited by the Brazilian Ministry of Health in 1998. It covers about 286 cities of the Bauru region and 420 collection spots. Their activities include screening, diagnosis, treatment and assistance to congenital hypothyroidism (CH) and phenylketonuria (PKU), among others. In 2005, a partnership was established with the Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, University of São Paulo, Bauru, seeking to characterize and to follow, by means of research studies, the development of the communicative abilities of children with CH and PKU. Objective: The aim of this study was to describe communicative and psycholinguistic abilities in children with CH and PKU. Materials and Methods: Sixty-eight children (25 children aged 1 to 120 months with PKU and 43 children aged 1 to 60 months with CH) participated in the study. The handbooks were analyzed and different instruments were applied (Observation of Communication Behavior, Early Language Milestone Scale, Peabody Picture Vocabulary Test, Gesell & Amatruda's Behavioral Development Scale, Portage Operation Inventory, Language Development Evaluation Scale, Denver Developmental Screening Test, ABFW Child Language Test-phonology and Illinois Test of Psycholinguistic Abilities), according to the children's age group and developmental level. Results: It was observed that the children with PKU and CH at risk for alterations in their developmental abilities (motor, cognitive, linguistic, adaptive and personal-social), mainly in the first years of life. Alterations in the psycholinguistic abilities were also found, mainly after the preschool age. Attention deficits, language and cognitive alterations were more often observed in children with CH, while attention deficits with hyperactivity and alterations in the

  7. Communicative and psycholinguistic abilities in children with phenylketonuria and congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    Mariana Germano Gejão

    2009-01-01

    Full Text Available The Neonatal Screening for Inborn Errors of Metabolism of the Association of Parents and Friends of Special Needs Individuals (APAE - Bauru, Brazil, was implanted and accredited by the Brazilian Ministry of Health in 1998. It covers about 286 cities of the Bauru region and 420 collection spots. Their activities include screening, diagnosis, treatment and assistance to congenital hypothyroidism (CH and phenylketonuria (PKU, among others. In 2005, a partnership was established with the Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, University of São Paulo, Bauru, seeking to characterize and to follow, by means of research studies, the development of the communicative abilities of children with CH and PKU. OBJECTIVE: The aim of this study was to describe communicative and psycholinguistic abilities in children with CH and PKU. MATERIALS AND METHODS: Sixty-eight children (25 children aged 1 to 120 months with PKU and 43 children aged 1 to 60 months with CH participated in the study. The handbooks were analyzed and different instruments were applied (Observation of Communication Behavior, Early Language Milestone Scale, Peabody Picture Vocabulary Test, Gesell & Amatruda's Behavioral Development Scale, Portage Operation Inventory, Language Development Evaluation Scale, Denver Developmental Screening Test, ABFW Child Language Test-phonology and Illinois Test of Psycholinguistic Abilities, according to the children's age group and developmental level. RESULTS: It was observed that the children with PKU and CH at risk for alterations in their developmental abilities (motor, cognitive, linguistic, adaptive and personal-social, mainly in the first years of life. Alterations in the psycholinguistic abilities were also found, mainly after the preschool age. Attention deficits, language and cognitive alterations were more often observed in children with CH, while attention deficits with hyperactivity and alterations in the

  8. Interest of nuclear medicine in the diagnosis of congenital and childhood hypothyroidism; Apports de la medecine nucleaire au diagnostic des hypothyroidies congenitales et de l'enfant

    Energy Technology Data Exchange (ETDEWEB)

    Clerc, J. [Hopital Necker, Medecine Nucleaire, 75 - Paris (France)

    2002-08-01

    The paediatric thyroid scan (PTS) remains a cornerstone test in guiding the etiological diagnosis of congenital hypothyroidism (CH). In hypothyroid babies, thyroxine therapy must be started immediately. A reliable PTS can be obtained in the following days even under T4 therapy. {sup 123}I is the isotope of choice since it provides quantitated images and a clinically relevant grading of dys-hormonal-genetic disorders. The dosimetry of {sup 123}I is lower than usually considered because iodine uptake is absent or low in most cases of CH and because the energy deposited within the colloid has no expected radiobiological detriment. PTS is a highly contributive, sensitive and reproducible test in identifying thyroid dysgenesis the most frequent etiology (70%) of permanent CH. Since agenesis requires a very careful T4 therapy monitoring, PTS is also of therapeutic interest. PTS can distinguish 3 types of dys-hormonal-genetic disorders (10%). In type 1, low uptake indicates a defective R-TSH or a NIS defect when {sup 123}I gastric uptake is absent. Type 2 - high uptake, goiter and positive perchlorate discharge test (PDT) - refers to organification defects (TPO, THOX1,2, Pendrin). Type 3 (goiter, high uptake, negative PDT) includes coupling defects, thyroglobulin abnormalities and dehalogenase deficiency. Main transient aetiologies (20%) of CH are iodine overload and blocking anti hR-TSH antibodies, while thyroiditis and dietary iodine overload are more frequent thereafter The molecular understanding of the defects involved in CH rapidly develops. However, precocious diagnosis, appropriate T4 therapy and sorting out the etiology are the most relevant parameters which determine the final clinical prognosis. (author)

  9. A New PAX8 Mutation Causing Congenital Hypothyroidism in Three Generations of a Family Is Associated with Abnormalities in the Urogenital Tract

    NARCIS (Netherlands)

    Carvalho, Ana; Hermanns, Pia; Rodrigues, Ana-Luísa; Sousa, Isabel; Anselmo, João; Bikker, Hennie; Cabral, Rita; Pereira-Duarte, Carlos; Mota-Vieira, Luísa; Pohlenz, Joachim

    2013-01-01

    Background: Although thyroid dysgenesis is the most common cause of congenital hypothyroidism (CH), its molecular basis remains largely elusive. Indeed, in only a minority of cases with thyroid dysgenesis (2%-3%) was it possible to identify an underlying genetic defect. The objective of this study

  10. Congenital hypothyroidism. The role of nuclear medicine in diagnosis: a case of lingual thyroid

    International Nuclear Information System (INIS)

    Maggs, J.; Cotter, A.; Bartholomeusz, D.; Chatterton, B.

    2005-01-01

    Hypothyroidism present from birth is a devastating condition and causes cretinism, which results in delayed development and mental retardation unless treated very early. All neonates in Australia are screened by a blood test when about two days old to exclude hypothyroidism (and several other biochemical conditions). A non-invasive nuclear scan may be able to recognise the cause of neonatal hypothyroidism: 1. Thyroid dysgenesis, (anatomical anomalies) including aplasia or hypoplasia of the thyroid gland; and ectopy of the thyroid, often with hypoplasia, in which there is insufficient tissue to match the demands of the infant or growing child. The abnormal anatomy is seen on thyroid scanning. 2. Dyshormonogencsis, (organification defects) a serious error in thyroid hormone synthesis. In general, thyroid trapping of pertechnctate or iodine will be increased, and demonstrated on the radionuclide study. 3. Hypopituitarism (secondary hypothyroidism) due to pituitary aplasia or midline brain developmental defects. There may also be hypothalamic dysfunction (tertiary hypothyroidism). An anatomically normal thyroid will show reduced uptake. Lingual thyroid is a rare developmental anomaly caused by failure of migration of the thyroid gland to its normal position in the neck. The incidence is relatively rare and sex incidence is four or five to one in favour of females. If untreated, there are sequelae of hypothyroidism, or growth of the mass in base of the tongue to the mass of a normal thyroid gland, which may cause respiratory compression. Thyroid malignancies may also be more frequent. This poster reports a case of lingual thyroid in a 19-day-old baby girl with biochemically diagnosed hypothyroidism. T4 = 9 (N > 12), TSH = 80, (N < 5). Scanning with a pinhole collimator 20min after IV injection of 40 MBq of Pertechnetate showed the only uptake to be in the base of the tongue, a lingual thyroid. Uptake was estimated at 2%, (N not available in infants)

  11. [Evaluation of physical development of children with congenital hypothyroidism detected in the screening test--personal observations].

    Science.gov (United States)

    Kik, Eugenia; Noczyńska, Anna

    2011-01-01

    Congenital hypothyroidism (CH) is the most prevalent endocrinopathy resulting from thyroid hormones deficiency or lack of thyroid hormones (TH). Aim of the study is to evaluate the physical development of children with congenital hypothyroidism detected in screening tests, determine the effect of TSH level, thyroid hormones and perinatal, parental and environmental factors on the physical development of children. the study involved 79 children (47 girls, 32 boys) aged 3-18 years (mean age 7.3±3.5) with CH diagnosed in screening tests. Children's development was analysed in correlation with TSH value in the screening test, time of commencement of therapy with LT4, the initial dose of the LT4, mean TSH level in the first year of life, mean value of TSH and LT4 in the 2-year follow-up period, social origin, place of residence (village, city), parents': anthropometric parameters (BMI, height), age, level of education of the parents, which pregnancy it was, time of pregnancy. In children: body mass and length at birth, score on Apgar scale, additional chronic disease. Too low body mass was usually observed in the 2-4 month of life - 11.1%, while in the following months, the number of children with body mass below the 3 centile became lower. In children diagnosed with too low body mass 97 centile occurred more often in the group of children with CH in the age range of 11 months - 6.9 years than in the control group, whereas ≥7 years obesity did not occur. The number of children with insufficient body length increased in the age groups: 11-18 months - 7.4%; 1.6-3.9 years - 7.9 % and 4-6.9 years - 9.1%. Children ≥7 years with height 97 centile in three age groups did not go beyond 4%. The biggest number of children >97 centile was noted in the age group 1.6-3.9 years (7.9%). Mean height SDS in all age groups was within the norm (±1 SDS for healthy population). 1. Physical development of children in infancy was in normal range. 2. Mean SDS of body mass in children was

  12. [Evaluation of mental development of children with congenital hypothyroidism detected in screening test--personal observations].

    Science.gov (United States)

    Kik, Eugenia; Noczyńska, Anna

    2010-01-01

    Thyroid hormones are crucial for a proper development of the central nervous system (CNS), skeleton and tooth buds. They are important from the early stages of fetal development. The aim of the study was to evaluate the mental development of children with congenital hypothyroidism detected in screening and to determine the effect of TSH, level of thyroid hormones during observation, perinatal factors as well as parental and environmental factors on the children's IQ. 44 children (28 girls and 16 boys) aged 3.5-18 years (mean age 7.3+/- 3.5) were enrolled in the study. The subjects' mental development was analyzed. General intelligence quotient was measured on verbal and non-verbal scale and chosen parameters of mental development were measured. The evaluation of mental development was performed in two age groups: group A - 20 patients in the age range 3.5-5.9 years (mean age 5.3+/-0.8) tested using the Columbus method, and group B - 24 patients in the age range 6-18 years (mean age 10.3+/-2.2) tested on the Wechsler Scale. The intelligence quotient (IQ) in both groups was within the average IQ range on Wechsler scale. Mean IQ values on verbal and non-verbal scale were comparable and within the average IQ range on Wechsler scale. The level of intelligence in group A correlated, on the brink of statistical significance (IS), with the education level of the parents (r=0.32; p=0.0934), while in the group B - IS correlated with birth weight (r=0.62; p=0.00247), it correlated on the brink of statistical significance with the education level of parents (r=0.4; p=0.0532) and mother's age (r=0.41; p=0.0514). The level of intelligence on verbal scale in group B, statistically significant, positively correlated with the body mass at birth (r=0.62; p=0.00147) and negatively with the mean value of TSH in 2-year follow-up period (r=-0.47; p=0.0381). The level of general intelligence and on verbal and non-verbal scale did not correlate with the time of commencement of therapy

  13. Congenital Hypothyroidism Caused by a PAX8 Gene Mutation Manifested as Sodium/Iodide Symporter Gene Defect

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    Wakako Jo

    2010-01-01

    Full Text Available Loss-of-function mutations of the PAX8 gene are considered to mainly cause congenital hypothyroidism (CH due to thyroid hypoplasia. However, some patients with PAX8 mutation have demonstrated a normal-sized thyroid gland. Here we report a CH patient caused by a PAX8 mutation, which manifested as iodide transport defect (ITD. Hypothyroidism was detected by neonatal screening and L-thyroxine replacement was started immediately. Although 123I scintigraphy at 5 years of age showed that the thyroid gland was in the normal position and of small size, his iodide trapping was low. The ratio of the saliva/plasma radioactive iodide was low. He did not have goiter; however laboratory findings suggested that he had partial ITD. Gene analyses showed that the sodium/iodide symporter (NIS gene was normal; instead, a mutation in the PAX8 gene causing R31H substitution was identified. The present report demonstrates that individuals with defective PAX8 can have partial ITD, and thus genetic analysis is useful for differential diagnosis.

  14. Neonatal screening: 9% of children with filter paper thyroid‐stimulating hormone levels between 5 and 10 μIU/mL have congenital hypothyroidism

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    Flávia C. Christensen‐Adad

    2017-11-01

    Conclusion: The study showed that 9.13% of the children with f‐TSH between 5 and 10 μIU/mL developed hypothyroidism and that in approximately one‐quarter of them, the diagnosis was confirmed only after the third month of life. Based on these findings, the authors suggest the use of a 5 μIU/mL cutoff for f‐TSH and long‐term follow‐up of infants whose serum TSH has not normalized to rule out congenital hypothyroidism.

  15. Increasing doses effect of L-T4 and L-T3 in the hypothalamus - hypophysis - thyroid in patients carrier of congenital and acquired hypothyroidism

    International Nuclear Information System (INIS)

    Cavaliere, H.

    1987-01-01

    The pituitary and peripheral response to L-T4 and L-T3 therapy were studied in 12 patients with congenital goitrous hypothyroidism, in 10 patients with an ectopic thyroid and onset of hypothyroidism at 3-8 years of age, and in 6 patients with adult-onset hypothyroidism, after they had had their chronic thyroid hormone replacement therapy discontinued for 30 days. They were first treated with increasing L-T4 (0.1, 0.2, and 0.4 mg daily) followed by L-T3 (0.05 and 0.2 mg daily) after stopping thyroid medication for another month. Ten normal subjects were treated identically. Since all patients received similar doses of thyroid hormones (μg/Kg of body weight) and had similar serum levels of T4 and T3 on each dose of L-T4 or L-T3, this paper concludes that congenitally hypothyroid patients have persistent pituitary resistance, but no peripheral resistance, to thyroid hormone. (author)

  16. Determination of congenital hypothyroidism in neonatal by immunoradiometric assays of thyrotropin; Determinacion de hipotiroidismo congenito en neonatos por analisis inmunoradiometrico de tirotrofina

    Energy Technology Data Exchange (ETDEWEB)

    Contreras P, E

    1998-06-01

    The congenital hypothyroidism is the endocrine illness more frequent of the childhood, it is the one that produce the devastating effects on the growth and the development. It represent one of the few causes of mental delay that it could be prevented if it is diagnosed and treaty on time. The infants affected with congenital hypothyroidism, could be detected for the apparent presence of some physical abnormalities, which comes the first days of the birth. Unfortunately, in the moment in which the classical manifestations are made present, it is very probable that cerebral damage already exists, for what the affected children should be tried before the three months of life administering them thyroid hormones. In Mexico the incidence of the congenital hypothyroidism is of one for each 1612 births for that is very important in the area of Public Health diagnose in early form and with certainty the congenital hypothyroidism. The TSH hormone or thyrotropin is formed in the hypophysis and intervenes in the synthesis of the thyroid hormones (T3, T4) when the concentration of these is adapted, the formation of TSH is inhibited, for that upon lacking the thyroid hormones the concentration of TSH in the blood is high. For these reasons the shot metabolic state of a newborn could be determined, quantifying the TSH in blood obtained by heel stab of the neonatal, or in coming blood from the umbilical cord, after 48 hours of being born. However because the TSH is similar to other hormones and is in extremely low concentrations, it is made necessary appeal analytic techniques of very sensitive and specific laboratory like the Immunoradiometric assays (Irma) in order to could determine the levels of this hormone in the blood. (Author).

  17. Impact of congenital calcitonin deficiency due to dysgenetic hypothyroidism on bone mineral density

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    Daripa M.

    2004-01-01

    Full Text Available The objective of the present study was to determine the effect of chronic calcitonin deficiency on bone mass development. The results of 11 patients with thyroid dysgenesis (TD were compared to those of 17 normal individuals (C and of 9 patients with other forms of hypothyroidism (OH: 4 with hypothyroidism due to inborn errors of thyroid hormone synthesis and 5 with Hashimoto's thyroiditis. The subjects received an intravenous calcium stimulus and blood was collected for the determination of ionized calcium (Ca2+, calcitonin, and intact parathyroid hormone. Bone mineral density (BMD was determined by dual-energy X-ray absorptiometry. After calcium administration the levels of Ca2+ in the two groups of hypothyroidism were significantly higher than in the normal control group (10 min after starting calcium infusion: C = 1.29 ± 0.08 vs TD = 1.34 ± 0.03 vs OH = 1.34 ± 0.02 mmol/l; P < 0.05, and only the TD group showed no calcitonin response (5 min after starting calcium infusion: C = 27.9 ± 5.8 vs TD = 6.6 ± 0.3 vs OH = 43.0 ± 13.4 ng/l. BMD values did not differ significantly between groups (L2-L4: C = 1.116 ± 0.02 vs TD = 1.109 ± 0.03 vs OH = 1.050 ± 0.04 g/cm². These results indicate that early deficiency of calcitonin secretion has no detrimental effect on bone mass development. Furthermore, the increased calcitonin secretion observed in patients with inborn errors of thyroid hormone biosynthesis does not confer any advantage in terms of BMD.

  18. A Novel Missense Mutation in SLC5A5 Gene in a Sudanese Family with Congenital Hypothyroidism.

    Science.gov (United States)

    Watanabe, Yui; Ebrhim, Reham Shareef; Abdullah, Mohamed A; Weiss, Roy E

    2018-05-15

    Thyroid hormone synthesis requires the presence of iodide. The sodium iodide symporter (NIS) is a glycoprotein which mediates the active uptake of iodide from the blood stream into the thyroid grand. NIS defects due to SLC5A5 gene mutations are known to cause congenital hypothyroidism (CH). The proposita is a 28-year-old female whose origin is the North Sudan where neonatal screening for CH is not available. She presented with severe constipation and a goiter at the age of 40 days. Laboratory testing confirmed CH and she was started on levothyroxine (L-T4). Presumably due to the delayed treatment the patient developed mental retardation. Her younger sister presented with a goiter, tongue protrusion and umbilical hernia and the youngest brother was also diagnosed with CH based on the TSH >100 µIU/mL at the age of 22 days and 8 days, respectively. Two siblings were treated with L-T4 and had normal development. Their consanguineous parents had no history of thyroid disorders. We performed whole exome sequencing (WES) on the proposita. WES identified a novel homozygous missense mutation in the SLC5A5 gene: c.1042T>G, p.Tyr348Asp, which was subsequently confirmed by Sanger sequencing. All affected children were homozygous for the same mutation and their unaffected mother was heterozygous. The NIS protein is composed of 13 transmembrane segments (TMS), an extracellular amino-terminus and an intracellular carboxyl terminus. The mutation is located in the TMS IX which has the most β-OH group-containing amino acids (serine and threonine) which is implicated in Na+ binding and translocation. In conclusion, a novel homozygous missense mutation in the SLC5A5 gene was identified in the Sudanese family with CH. The mutation is located in the TMS IX of the NIS protein which is essential for NIS function. Low iodine intake in Sudan is considered to affect severity of hypothyroidism in the patients.

  19. Cerebral blood flow abnormalities induced by transient hypothyroidism after thyroidectomy. Analysis by Tc-99m-HMPAO and SPM96

    International Nuclear Information System (INIS)

    Nagamachi, Shigeki; Jinnouchi, Seishi; Nishii, Ryuichi; Ishida, Yasushi; Fujita, Seigo; Futami, Shigemi; Kodama, Takao; Tamura, Shozo; Kawai, Keiichi

    2004-01-01

    The current study is an investigation of alterations in regional cerebral blood flow (rCBF) distribution in patients with transient hypothyroidism after thyroidectomy. In addition, the effects of thyroxine treatment on rCBF changes were studied. Noninvasive rCBF measurements using 99m Tc-HMPAO SPECT were performed on 24 post-thyroidectomy patients who were in a hypothyroidic state. The measurements were conducted before 131 I therapy and after thyroid hormone (thyroxine) replacement. We used adjusted rCBF images (normalization of global CBF for each subject to 50 ml/100 g/min with proportional scaling) to compare these data with age-matched normal control groups (n=15) using statistical parametric mapping (SPM) 96. We also compared the absolute rCBF value of hypothyroidic patients with those of normal control groups. In addition, the association between rCBF alteration and the severity of depression was also analyzed. Finally, the effect of thyroid hormone replacement on rCBF was investigated individually using the Jack-knife test, in which patient data were compared with those from healthy volunteers. According to the result of this test, all cases were categorized into three subgroups, namely, improved, unchanged group and normal. To prove the reversibility of rCBF alteration after thyroid hormone replacement, a group comparison test between the normal controls and the improved group was done before and after thyroid hormone replacement. Similarly a group comparison test between the unchanged group and normal controls was also performed. In the hypothyroidic condition, there was a significant decrease in the posterior part of the bilateral parietal lobes and in part of the bilateral occipital lobes, including the cuneus. These decreased rCBF areas extended to the bilateral prefrontal cortices as deterioration became more profound. On individual analysis, 16 of 24 patients (66.7%) demonstrated rCBF reduction, while 8 patient did not show significant rCBF change

  20. Central congenital hypothyroidism due to gestational hyperthyroidism: Detection where prevention failed

    NARCIS (Netherlands)

    Kempers, Marlies J. E.; van Tijn, David A.; van Trotsenburg, A. S. Paul; de Vijlder, Jan J. M.; Wiedijk, Brenda M.; Vulsma, Thomas

    2003-01-01

    Much worldwide attention is given to the adverse effects of maternal Graves' disease on the fetal and neonatal thyroid and its function. However, reports concerning the adverse effects of maternal Graves' disease on the pituitary function, illustrated by the development of central congenital

  1. Influence of timing and dose of thyroid hormone replacement on mental, psychomotor, and behavioral development in children with congenital hypothyroidism.

    Science.gov (United States)

    Bongers-Schokking, Jacoba J; de Muinck Keizer-Schrama, Sabine M P F

    2005-12-01

    To evaluate the influence of initial and postinitial treatment factors on cognitive, psychomotor, and psychological outcome in schoolchildren with congenital hypothyroidism (CH). We studied 45 patients (19 with severe CH and 26 with mild CH) and 37 control children by correlating initial and postinitial treatment factors (free thyroxine and thyroid-stimulating hormone [TSH] concentrations, and the percentage of overtreatment and undertreatment periods) with the results of neuropsychological tests and behavior (as reported on the Teacher Report Form [TRF]). The global IQ of the children with CH was comparable to that of the controls; visuomotor and verbal scores were lower, and total TRF scores were higher. Ethnic group, previous development, and overtreatment predicted IQ and verbal scores, with higher scores seen for the overtreated patients than for the control children and those patients who had not been overtreated. As initial treatment was less satisfactory, total TRF scores were higher. Our study suggests that initial and postinitial suboptimal treatment of CH leads to abnormalities in IQ and specific fields. Overtreatment may advance cognitive development in 5-1/2- to 7-year-olds. Suboptimal initial treatment may lead to behavioral problems. We recommend that TSH concentrations be maintained within the normal range in patients with CH.

  2. The Missense Alteration A5T of the Thyroid Peroxidase Gene is Pathogenic and Associated with Mild Congenital Hypothyroidism.

    Science.gov (United States)

    Cangül, Hakan; Demir, Korcan; Babayiğit, H Ömür; Abacı, Ayhan; Böber, Ece

    2015-09-01

    Congenital hypothyroidism (CH) occurs with a prevalence of approximately 1:4000 live births. Defects of thyroid hormone synthesis account for 15-20% of these cases. Thyroid peroxidase (TPO) gene is the most common cause for dyshormonogenesis. So far, more than 60 mutations in the TPO gene have been described, resulting in a variable decrease in TPO bioactivity. We present an 8-day-old male with mild CH who was identified to have a G to A transition in the fifth codon of the TPO gene (c.13G>A; p.Ala5Thr). The unaffected family members were heterozygous carriers of the mutation, whereas 400 healthy individuals of the same ethnic background did not have the mutation. Mutation analysis of 11 known causative CH genes and 4 of our own strong candidate genes with next-generation sequencing revealed no mutations in the patient nor in any other family members. The results of in silico functional analyses indicated partial loss-of-function (LOF) in the resulting enzyme molecule due to mutation. The patient's clinical finding s were consistent with the effect of this partial LOF of the mutation. In conclusion, we strongly believe that A5T alteration in the TPO gene is actually pathogenic and suggest that it should be classified as a mutation.

  3. c-Fos downregulation positively regulates EphA5 expression in a congenital hypothyroidism rat model.

    Science.gov (United States)

    Song, Honghua; Zheng, Yuqin; Cai, Fuying; Ma, Yanyan; Yang, Jingyue; Wu, Youjia

    2018-04-01

    The EphA5 receptor is well established as an axon guidance molecule during neural system development and plays an important role in dendritic spine formation and synaptogenesis. Our previous study has showed that EphA5 is decreased in the developing brain of congenital hypothyroidism (CH) and the EphA5 promoter methylation modification participates in its decrease. c-Fos, a well-kown transcription factor, has been considered in association with brain development. Bioinformatics analysis showed that the EphA5 promoter region contained five putative c-fos binding sites. The chromatin immunoprecipitation (ChIP) assays were used to assess the direct binding of c-fos to the EphA5 promoter. Furthermore, dual-luciferase assays showed that these three c-fos protein binding sites were positive regulatory elements for EphA5 expression in PC12 cells. Moreover, We verified c-fos positively regulation for EphA5 expression in CH model. Q-PCR and Western blot showed that c-fos overexpression could upregulate EphA5 expression in hippocampal neurons of rats with CH. Our results suggest that c-fos positively regulates EphA5 expression in CH rat model.

  4. A novel deletion in the thyrotropin Beta-subunit gene identified by array comparative genomic hybridization analysis causes central congenital hypothyroidism in a boy originating from Turkey.

    Science.gov (United States)

    Hermanns, Pia; Couch, Robert; Leonard, Norma; Klotz, Cherise; Pohlenz, Joachim

    2014-01-01

    Isolated central congenital hypothyroidism (ICCH) is rare but important. Most ICCH patients are diagnosed later, which results in severe growth failure and intellectual disability. We describe a boy with ICCH due to a large homozygous TSHβ gene deletion. A 51-day-old male Turkish infant, whose parents were first cousins, was admitted for evaluation of prolonged jaundice. His clinical appearance was compatible with hypothyroidism. Venous thyrotropin (TSH) was undetectably low, with a subsequent low free T4 and a low free T3, suggestive of central hypothyroidism. Using different PCR protocols, we could not amplify both coding exons of the boy's TSHβ gene, which suggested a deletion. An array comparative genomic hybridization (aCGH) using specific probes around the TSHβ gene locus showed him to be homozygous for a 6-kb deletion spanning all exons and parts of the 5' untranslated region of the gene. Infants who are clinically suspected of having hypothyroidism should be evaluated thoroughly, even if their TSH-based screening result is normal. In cases with ICCH and undetectably low TSH serum concentrations, a TSHβ gene deletion should be considered; aCGH should be performed when gene deletions are suspected. In such cases, PCR-based sequencing techniques give negative results.

  5. Pediatric Hypothyroidism: Diagnosis and Treatment.

    Science.gov (United States)

    Wassner, Ari J

    2017-08-01

    Thyroid hormone has important physiologic functions in nearly every organ system. The critical role of thyroid hormone in growth and in physical and neurologic development lends particular importance to the prompt diagnosis and appropriate treatment of hypothyroidism in infants and children. Congenital hypothyroidism is common and has potentially devastating neurologic consequences. While the approach to diagnosis and treatment of severe congenital hypothyroidism is well established, data continue to emerge about the genetic causes, clinical significance, and prognosis of the milder forms of congenital hypothyroidism that are increasingly being diagnosed by newborn screening. Similarly, the diagnosis and treatment of severe acquired hypothyroidism is straightforward and clearly of clinical benefit, but uncertainty remains about the optimal management of mild subclinical hypothyroidism. This review summarizes current knowledge of the causes, clinical manifestations, diagnosis, treatment, and prognosis of hypothyroidism in infants and children, with a focus on recent developments and areas of uncertainty in this field.

  6. The incidence of congenital hypothyroidism and its determinants from 2012 to 2014 in Shadegan, Iran: a case-control study

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    Ehsan Keshavarzian

    2016-05-01

    Full Text Available OBJECTIVES: Congenital hypothyroidism (CH is one of the major causes of preventable mental retardation in infants. The aim of this study was to determine the incidence of CH in Shadegan, Khuzestan Province, Iran from 2012 to 2014 and to identify the risk factors associated with CH. METHODS: A total of 203 cases were confirmed from 2012 to 2014 in Shadegan, with 66, 86, and 51 patients reported in 2012, 2013, and 2014, respectively. A total of 3,900, 3,991, and 4,050 live births occurred in 2012, 2013, and 2014, respectively. The controls (n=657 were selected using a random number table, and a case-control study was carried out to determine the risk factors for neonatal CH, including demographic, environmental, and medical factors. RESULTS: The incidence of CH was 17.0 per 1,000 live births in 2012, 21.5 per 1,000 live births in 2013, and 12.6 per 1,000 live births in 2014. This study showed that the likelihood of CH in children born to parents with a history of consanguineous marriage was 2.41 times greater than in children born to parents with no such history (odds ratio, 2.41; 95% confidence interval [CI], 1.65 to 3.53. This study also found that CH was 3.4 times more likely (95% CI, 2.29 to 5.20 in infants born in urban settings than in infants born in rural areas. CONCLUSIONS: The incidence of CH in Shadegan from 2012 to 2014 was approximately 17 times greater than the expected incidence in Iran. CH was associated with a history of consanguineous marriage and urbanization.

  7. Neurodevelopmental and body composition outcomes in children with congenital hypothyroidism treated with high-dose initial replacement and close monitoring.

    Science.gov (United States)

    Albert, Benjamin B; Heather, Natasha; Derraik, José G B; Cutfield, Wayne S; Wouldes, Trecia; Tregurtha, Sheryl; Mathai, Sarah; Webster, Dianne; Jefferies, Craig; Gunn, Alistair J; Hofman, Paul L

    2013-09-01

    Despite newborn screening and early levothyroxine replacement, there are continued reports of mild neurocognitive impairment in children with congenital hypothyroidism (CHT). In Auckland, New Zealand, cases are identified by a neonatal screening program with rapid institution of high-dose levothyroxine replacement (10-15 μg/kg·d), producing prompt normalization of thyroid function. Subsequently, frequent monitoring and dose alterations are performed for 2 years. We aimed to assess whether the Auckland treatment strategy prevents impairment of intellectual and motor development. This study encompassed all children with CHT born in 1993-2006 in Auckland and their siblings. Neurocognitive assessments included the following: 1) intelligence quotient via Weschler Preschool and Primary Scale of Intelligence III or Weschler Intelligence Scale for Children IV; 2) Movement Assessment Battery for Children; and 3) Beery Developmental Test of Visual-Motor Integration. Body composition was assessed by dual-energy x-ray absorptiometry. Forty-four CHT cases and 53 sibling controls aged 9.6 ± 3.9 years were studied. Overall intelligence quotient was similar among CHT cases and controls (95.2 vs 98.6; P = .20), and there were also no differences in motor function. Severity of CHT did not influence outcome, but greater time to normalize free T4 was associated with worse motor balance. There were no differences in anthropometry or body composition between groups. These findings suggest that a strategy of rapidly identifying and treating infants with CHT using high-dose levothyroxine replacement is associated with normal intellectual and motor development. The subtle negative impact on motor function associated with time to normalize free T4 levels is consistent with benefit from rapid initial correction.

  8. Delayed diagnosis of congenital hypothyroidism in an adolescent results in avoidable complications: a case report

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    Indra Ihsan

    2017-04-01

    Full Text Available Delayed diagnosis of congenital hyporhyroidism (CH remains a serious problem. A retrospective analysis of 1,000 CH cases in Turkey found a mean age of 49 months at the time of clinical diagnosis. Only 3.1% of cases were diagnosed during the neonatal period and 55.4% were diagnosed after 2 years of age.1 In Cipto Mangunkusumo Hospital, Jakarta, 53% cases were diagnosed at 1-5 years, 3.3% at 6-12 years, and 6.7% after 12 years of age, while the remainder were diagnosed at < 1 year of age.2 The majority of affected children exhibit signs and symptoms that are highly non-specific, as most infants with CH are asymptomatic at birth, and only 5% of cases can be diagnosed based on clinical examination during the first day of life.3 The other factors that contribute to delayed diagnosis are uneducated parents, who do not notice or dismiss the importance of mild/moderate deviations in physical and mental growth, as well as constipation, feeding difficulties, or other vague, non-specific symptoms in infancy. Parents are often unaware of the importance of early diagnosis and commencement of therapy for CH.4

  9. Myopathy in acute hypothyroidism

    OpenAIRE

    Ma, JTC; Yu, YL; Kung, AWC

    1987-01-01

    Hypothyroid myopathy has so far been reported in long standing cases of hypothyroidism. We describe two adult patients with myopathy associated with acute transient hypothyroidism. Both presented with severe muscle aches and cramps, stiffness and spasms. Muscle enzymes were markedly elevated and electromyography in one patient showed myopathic features. Histological changes were absent in muscle biopsy, probably because of the short duration of metabolic disturbance. The myopathy subsided pro...

  10. Myopathy in acute hypothyroidism.

    OpenAIRE

    Kung, A. W.; Ma, J. T.; Yu, Y. L.; Wang, C. C.; Woo, E. K.; Lam, K. S.; Huang, C. Y.; Yeung, R. T.

    1987-01-01

    Hypothyroid myopathy has so far been reported in long standing cases of hypothyroidism. We describe two adult patients with myopathy associated with acute transient hypothyroidism. Both presented with severe muscle aches and cramps, stiffness and spasms. Muscle enzymes were markedly elevated and electromyography in one patient showed myopathic features. Histological changes were absent in muscle biopsy, probably because of the short duration of metabolic disturbance. The myopathy subsided pro...

  11. Transient gestational and neonatal hypothyroidism-induced specific changes in androgen receptor expression in skeletal and cardiac muscles of adult rat.

    Science.gov (United States)

    Annapoorna, K; Anbalagan, J; Neelamohan, R; Vengatesh, G; Stanley, J; Amudha, G; Aruldhas, M M

    2013-03-01

    The present study aims to identify the association between androgen status and metabolic activity in skeletal and cardiac muscles of adult rats with transient gestational/neonatal-onset hypothyroidism. Pregnant and lactating rats were made hypothyroid by exposing to 0.05% methimazole in drinking water; gestational exposure was from embryonic day 9-14 (group II) or 21 (group III), lactational exposure was from postnatal day 1-14 (group IV) or 29 (group V). Serum was collected for hormone assay. Androgen receptor status, Glu-4 expression, and enzyme activities were assessed in the skeletal and cardiac muscles. Serum testosterone and estradiol levels decreased in adult rats of groups II and III, whereas testosterone remained normal but estradiol increased in group IV and V, when compared to coeval control. Androgen receptor ligand binding activity increased in both muscle phenotypes with a consistent increase in the expression level of its mRNA and protein expressions except in the forelimb of adult rats with transient hypothyroidism (group II-V). Glut-4 expression remained normal in skeletal and cardiac muscle of experimental rats. Specific activity of hexokinase and lactate dehydrogenase increased in both muscle phenotypes whereas, creatine kinase activity increased in skeletal muscles alone. It is concluded that transient gestational/lactational exposure to methimazole results in hypothyroidism during prepuberal life whereas it increases AR status and glycolytic activity in skeletal and cardiac muscles even at adulthood. Thus, the present study suggests that euthyroid status during prenatal and early postnatal life is essential to have optimal AR status and metabolic activity at adulthood. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Sustained attention in school-age children with congenital hypothyroidism: Influence of episodes of overtreatment in the first three years of life.

    Science.gov (United States)

    García Morales, L; Rodríguez Arnao, M D; Rodríguez Sánchez, A; Dulín Íñiguez, E; Álvarez González, M A

    2017-11-20

    Children with congenital hypothyroidism (CH) are at risk of developing mild cognitive impairment despite normal overall intellectual performance. These deficits may be caused by disease-related and treatment-related factors. This study explores the impact of abnormal thyroid function during the first 3 years of life on attention performance at school age. We included 49 children diagnosed with CH and receiving treatment for the condition: 14 boys (mean age 9.5±2.8 years) and 35 girls (9.6±2.6 years). The number of episodes of normal, under-, and overtreatment were estimated based on TSH levels during their first 3 years of life (at 12, 18, 24, 30, and 36 months). Children were assessed using a computerised version of a Sustained attention test. General linear models were calculated with the attention index as the dependent variable and sex, aetiology, and number of episodes of normal, under-, and overtreatment as independent variables. Higher numbers of episodes of overtreatment (low TSH level) were associated with poorer attention performance at school age (P=.005, r=-0.45). Children with CH should be monitored closely during the first 3 years of life in order to prevent not only hypothyroidism but also any adverse effects of overtreatment that may affect attentional function at school age. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Trends in Scottish newborn screening programme for congenital hypothyroidism 1980-2014: strategies for reducing age at notification after initial and repeat sampling.

    Science.gov (United States)

    Mansour, Chourouk; Ouarezki, Yasmine; Jones, Jeremy; Fitch, Moira; Smith, Sarah; Mason, Avril; Donaldson, Malcolm

    2017-10-01

    To determine ages at first capillary sampling and notification and age at notification after second sampling in Scottish newborns referred with elevated thyroid-stimulating hormone (TSH). Referrals between 1980 and 2014 inclusive were grouped into seven 5-year blocks and analysed according to agreed standards. Of 2 116 132 newborn infants screened, 919 were referred with capillary TSH elevation ≥8 mU/L of whom 624 had definite (606) or probable (18) congenital hypothyroidism. Median age at first sampling fell from 7 to 5 days between 1980 and 2014 (standard 4-7 days), with 22, 8 and 3 infants sampled >7 days during 2000-2004, 2005-2009 and 2010-2014. Median age at notification was consistently ≤14 days, range falling during 2000-2004, 2005-2009 and 2010-2014 from 6 to 78, 7-52 and 7-32 days with 12 (14.6%), 6 (5.6%) and 5 (4.3%) infants notified >14 days. However 18/123 (14.6%) of infants undergoing second sampling from 2000 onwards breached the ≤26-day standard for notification. By 2010-2014, the 91 infants with confirmed congenital hypothyroidism had shown favourable median age at first sample (5 days) with start of treatment (10.5 days) approaching age at notification. Most standards for newborn thyroid screening are being met by the Scottish programme, but there is a need to reduce age range at notification, particularly following second sampling. Strategies to improve screening performance include carrying out initial capillary sampling as close to 96 hours as possible; introducing 6-day laboratory reporting and use of electronic transmission for communicating repeat requests. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Epidemiología del hipotiroidismo congénito en México Epidemiology of congenital hypothyroidism in Mexico

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    Marcela Vela-Amieva

    2004-04-01

    Full Text Available OBJETIVO: Describir las características epidemiológicas del hipotiroidismo congénito en recién nacidos en unidades médicas de la Secretaría de Salud de México. MATERIAL Y MÉTODOS: Estudio transversal en el cual se cuantificó tirotropina en 1 379 717 muestras de sangre de recién nacidos (de cordón umbilical o de talón, recolectadas en papel filtro, de enero de 2001 a diciembre de 2002, en unidades médicas de la Secretaría de Salud. Las muestras con tirotropina >15 µUI/ml para sangre de cordón, y > 10 µUI/ml para talón, se consideraron sospechosas, y se notificaron para realizar el perfil tiroideo y gammagrafía. Cuando los resultados fueron positivos, el caso se registró como hipotiroidismo congénito confirmado, y se anotaron los datos clínicos y demográficos en formatos específicos. Se utilizó estadística descriptiva estándar. RESULTADOS: Se encontró una prevalencia de 4.12 x 10 000 recién nacidos, con predominancia del sexo femenino (66.84%. Se observaron variaciones estatales en la prevalencia, máxima en Quintana Roo (8.13 x 10 000 recién nacidos y mínima en Sinaloa (0.62 X 10 000. Se encontraron 57.46% tiroides ectópicas, 35.91% agenesias tiroideas y 6.63% defectos de la función de las hormonas tiroideas. Los principales datos clínicos fueron hernia umbilical (43.73% e ictericia (41.58%. A 151 (17.12% sospechosos no se les realizó estudio confirmatorio debido a datos incompletos o falsos en la ficha de identificación, fallecimiento del recién nacido, renuencia de los padres y cambio de domicilio. CONCLUSIONES: El hipotiroidismo se presentó en 1:2 426 recién nacidos, con predominio femenino (2:1, siendo la ectopia tiroidea su forma más común, y la hernia umbilical y la ictericia sus datos clínicos prominentes.OBJECTIVE: To describe the epidemiological characteristics of congenital hypothyroidism (CH in newborns (NB detected by the Ministry of Health of Mexico (SSA. MATERIAL AND METHODS: A cross

  15. Hypothyroidism in children

    Directory of Open Access Journals (Sweden)

    Renata Karwowska

    2017-12-01

    Full Text Available Thyroid hormones are crucial for normal development of a child from early foetal life. They have an impact on the development of the central nervous system, both prenatally and up to the age of 3 years, and regulate growth and most metabolic processes. Their importance has led to the introduction of screening for congenital hypothyroidism, which has been conducted in Poland for over 40 years. The diagnosis of congenital hypothyroidism necessitates immediate levothyroxine implementation and strict treatment monitoring. Thanks to iodine prophylaxis, children in Poland do not require additional iodine administration. An isolated increase in thyroid-stimulating hormone concentration without clinical signs of hypothyroidism and with negative antithyroid antibodies does not require treatment, but only monitoring of thyroidstimulating hormone levels. Children with positive antithyroid antibodies, genetic syndromes that predispose to hypothyroidism and history of thyroid irradiation require more frequent controls. The recommendations for suspected hypothyroidism presented in this article are based on the European Thyroid Association guidelines from 2014 on the management of subclinical hypothyroidism in children and pregnant women.

  16. Subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Bak, Peter; Hjortshøj, Cristel S; Gaede, Peter

    2018-01-01

    follow-up (6.5 ± 1.0 years), SCH (defined as ≥2 consecutive elevated thyroid-stimulating hormone values) was present in 26%. Three patients progressed to overt hypothyroidism. Patients with SCH were younger (34 ± 12 vs 42 ± 16 years; P = .01) and had a lower oxygen saturation (80 ± 5 vs 84 ± 6%; P = .03...... clinically stable cyanotic congenital heart disease patients were examined with blood samples (thyroid-stimulating hormone, C-reactive protein, hemoglobin, hematocrit, and N-terminal pro-brain-natriuretic peptide) in a cross-sectional descriptive study. Second, a longitudinal follow-up study of 43 patients...... originating from the first study part, was carried out. These patients had thyroid function parameters (thyroid-stimulating hormone, thyroid hormones, and thyroid peroxidase antibodies) evaluated biannually. RESULTS: Elevated thyroid-stimulating hormone was present in 24% of the 90 screened patients. During...

  17. Atención sostenida en niños en edad escolar con hipotiroidismo congénito Sustained attention in school aged children with congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    Ana Olivares Torres

    2004-08-01

    Full Text Available Los programas de diagnóstico precoz de hipotiroidismo congénito han demostrado la eficaz prevención del retraso mental. El problema científico actual consiste en la identificación de trastornos cognitivos sutiles que persisten a pesar del tratamiento precoz. Resulta favorable contar con procedimientos diagnósticos específicos diseñados para esto. Diferentes métodos indirectos sugieren que aunque se tengan cocientes de inteligencia dentro de rangos normales, el proceso de mantener la atención durante un intervalo de tiempo prolongado en estos niños se encuentra ligeramente comprometido. Este estudio tiene el objetivo de validar la eficiencia de una batería computadorizada SESH 1.O (sistema para evaluación y seguimiento de pacientes hipotiroideos para la detección de trastornos en niños con hipotiroidismo congénito (HC. Se estudiaron 3 grupos de niños: trastornos del aprendizaje (TA, hipotiroidismo congénito (HC y controles sanos (CS. Los resultados muestran que los valores de los niños del grupo HC se mantienen en un nivel intermedio entre los CS y los TA, lo que se interpreta como la existencia de un déficit subclínico en la atención sostenida. La capacidad discriminatoria del software empleado permite su incorporación inmediata a la práctica clínica del programa nacional de diagnóstico precoz de HC como un medio complementario de alta utilidad.The programs of early diagnosis of congenital hypothyroidism have proved the efficient prevention of mental retardation. The current scientific problem is the identification of subtle cognitive disorders persisting in spite of early treatment. It is convenient to have specific diagnostic procedures designed to this end. Different indirect methods suggest that even with intelligence quotients within the normal ranges, the process of maintaining attention during a prolonged time in these children is mildly compromised. This study is aimed at validating the efficiency of a SESH 1

  18. Evaluation and Management of the Child with Hypothyroidism.

    Science.gov (United States)

    Leung, Alexander K C; Leung, Alexander A C

    2018-05-08

    Thyroid hormones are critical for early neurocognitive development as well as growth and development throughout childhood. Prompt recognition and treatment of hypothyroidism is therefore of utmost importance to optimize physical and neurodevelopmental outcomes. To review in depth the evaluation, diagnosis, and treatment of hypothyroidism in children. A PubMed search was completed in Clinical Queries using the key term "hypothyroidism". Patents were searched using the key term "hypothyroidism" from www.freepatentsonline.com. Hypothyroidism may be present at birth (congenital hypothyroidism) or develop later in life (acquired hypothyroidism). Thyroid dysgenesis and dyshormonogenesis account for approximately 85% and 15% of permanent cases of congenital primary hypothyroidism, respectively. More than 95% of infants with congenital hypothyroidism have few, if any, clinical manifestations of hypothyroidism. Newborn screening programs allow early detection of congenital hypothyroidism. In developed countries, Hashimoto thyroiditis is the most common cause of goiter and acquired hypothyroidism in children and adolescents. Globally, iodine deficiency associated with goiter is the most common cause of hypothyroidism. Central hypothyroidism is uncommon and may be associated with other congenital syndromes and deficiencies of other pituitary hormones. Familiarity of the clinical features would allow prompt diagnosis and institution of treatment. Recent patents related to the management of childhood hypothyroidism are discussed. To optimize neurocognitive outcome in infants with congenital hypothyroidism, treatment with levothyroxine should be started as soon as possible, preferably within the first two weeks of life. Children with acquired hypothyroidism should also be treated early to ensure normal growth and development as well as cognitive outcome. The target is to keep serum TSH hypothyroidism. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  19. Health- related quality of life and self-worth in 10-year old children with congenital hypothyroidism diagnosed by neonatal screening

    Directory of Open Access Journals (Sweden)

    van der Sluijs Veer Liesbeth

    2012-10-01

    Full Text Available Abstract Background Much is written about cognitive and motor development; less is known about social and emotional consequences of growing up with congenital hypothyroidism (CH. The objectives of the study were: (1 to compare health related quality of life (HRQoL and self-worth of 10 year old patients with CH with the general population; (2 to explore associations of disease factors, IQ and motor skills with the outcomes. Methods Children with CH and their parents completed several questionnaires. Patients were classified to ‘severe CH, n = 41’ or ‘moderate/mild CH, n = 41’ based on pre-treatment FT4 concentration. Differences between CH and the general population were tested by analysis of covariance and one sample t-tests (mean scale scores HRQoL and self-worth, chi-square tests and binomial tests (% at risk of impaired HRQoL and self-worth. Linear regression analyses corrected for gender were conducted to explore associations of the outcomes with disease factors, IQ and motor skills. Results Patients with CH reported lower mean HRQoL on motor, cognitive and social functioning, and on autonomy and positive emotions (p  Conclusions Negative consequences in terms of HRQoL and self-worth are prevalent in children with CH, independent of disease factors, IQ and motor skills. Physicians should to be attentive to these consequences and provide attention and supportive care.

  20. Effect of Atomoxetine on the Cognitive Functions in Treatment of Attention Deficit Hyperactivity Disorder in Children with Congenital Hypothyroidism: A Pilot Study.

    Science.gov (United States)

    Yang, Rongwang; Gao, Weijia; Li, Rong; Zhao, Zhengyan

    2015-04-19

    With early initiation of thyroxine supplementation, children with congenital hypothyroidism (CH) retain some subtle deficits, such as attention and inhibitory control problems. This study assessed the effects of atomoxetine on cognitive functions in treatment of attention deficit hyperactivity disorder (ADHD) symptoms in children with CH. In a 6-month, open-labeled pilot study, 12 children were recruited and received atomoxetine. The measures of efficacy were scores on the Swanson, Nolan and Pelham Teacher and Parent Rating Scale, version IV (SNAP-IV) and Clinical Global Impression-Severity scale (CGI-S). The cognitive functions were evaluated with the Wechsler Intelligence Scale for Chinese Children, Digit Span, Wisconsin Card Sorting Test, and Stroop test. A statistically significant difference was found between the mean CGI-S and SNAP-IV scores before and after treatment (p Atomoxetine appears to be useful in improving ADHD symptoms, as well as cognitive functions, in children with CH. Larger, randomized, double-blinded, clinical trials are required to replicate these results. © The Author 2015. Published by Oxford University Press on behalf of CINP.

  1. Hypothyroidism coordinately and transiently affects myelin protein gene expression in most rat brain regions during postnatal development.

    Science.gov (United States)

    Ibarrola, N; Rodríguez-Peña, A

    1997-03-28

    To assess the role of thyroid hormone on myelin gene expression, we have studied the effect of hypothyroidism on the mRNA steady state levels for the major myelin protein genes: myelin basic protein (MBP), proteolipid protein (PLP), myelin-associated glycoprotein (MAG) and 2':3'-cyclic nucleotide 3'-phosphodiesterase (CNP) in different rat brain regions, during the first postnatal month. We found that hypothyroidism reduces the levels of every myelin protein transcript, with striking differences between the different brain regions. Thus, in the more caudal regions, the effect of hypothyroidism was extremely modest, being only evident at the earlier stages of myelination. In contrast, in the striatum and the cerebral cortex the important decrease in the myelin protein transcripts is maintained beyond the first postnatal month. Therefore, thyroid hormone modulates in a synchronous fashion the expression of the myelin genes and the length of its effect depends on the brain region. On the other hand, hyperthyroidism leads to an increase of the major myelin protein transcripts above control values. Finally, lack of thyroid hormone does not change the expression of the oligodendrocyte progenitor-specific gene, the platelet derived growth factor receptor alpha.

  2. Subclinical Hypothyroid

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Kalantar Hormozi

    2011-04-01

    Full Text Available Background: subclnical hypothyroid (SCH, defined by a normal total or free T4 level and a midly Elevated TSH, is common in adults. Subclinical hypothyroid is a risk factor for developing hypothyroidism complication . the goal of screening is to identify and treatment patients with sublinical hypothyroid before they develop these complication. Methods: The sample size of this study was the articles indexed in pubmed,ovid, tripdatabase, new spring link black coehrane, Elsevirer, Embase and contained the terms subclinical hypothyroid, Anti-tpo, Thyrotropin, levothyroxine trapy. Results: 831 articles were found that 75 articles were investigated for this issue. The results are discussed under. The subtile such as subclinical hypothyroid, screening for subclinical hypothyroid, Indication of treatment of Subclinical hypothyroid. Conclusion: In this summary, we tried to review the current literature about definition, Indection of screening and treatment of subclinical hypothyroid and reach a comprehensive guidline for practical significance of this subject in routines practice.

  3. Hypothyroidism (image)

    Science.gov (United States)

    Hypothyroidism is a decreased activity of the thyroid gland which may affect all body functions. The rate ... and physical sluggishness. The most severe form of hypothyroidism is myxedema, which is a medical emergency.

  4. Thyroid scintigraphy and perchlorate test after recombinant human TSH: a new tool for the differential diagnosis of congenital hypothyroidism during infancy

    Energy Technology Data Exchange (ETDEWEB)

    Fugazzola, Laura; Vannucchi, Guia; Mannavola, Deborah; Beck-Peccoz, Paolo [University of Milan and Fondazione Policlinico IRCCS, Department of Medical Sciences, Milan (Italy); Persani, Luca [University of Milan and Istituto Auxologico Italiano, Department of Medical Sciences, Via Zucchi, Cusano, Milan (Italy); Carletto, Marco; Longari, Virgilio [Fondazione Policlinico IRCCS, Department of Nuclear Medicine, Milan (Italy); Vigone, Maria C.; Cortinovis, Francesca; Weber, Giovanna [Universita Vita-Salute S. Raffaele, Centro di Endocrinologia dell' Infanzia e dell' Adolescenza, Milan (Italy); Beccaria, Luciano [A. Manzoni Hospital, Paediatric Unit, Lecco (Italy)

    2007-09-15

    Prompt initiation of l-thyroxine therapy in neonates with congenital hypothyroidism (CH) often prevents the performance of functional studies. Aetiological diagnosis is thus postponed until after infancy, when the required investigations are performed after l-thyroxine withdrawal. The aim of this study was to verify the efficacy and safety of new protocols for rhTSH (Thyrogen) testing during l-thyroxine replacement in the differential diagnosis of CH. Ten CH patients (15-144 months old) were studied. Seven had neonatal evidence of gland in situ at the ultrasound examination performed at enrolment and received two rhTSH injections (4 {mu}g/kg daily, i.m.) with {sup 123}I scintigraphy and perchlorate test on day 3. Three patients with an ultrasound diagnosis of thyroid dysgenesis received three rhTSH injections with {sup 123}I scintigraphy on days 3 and 4. TSH and thyroglobulin (Tg) determinations were performed on days 1, 3 and 4, and neck ultrasound on day 1. rhTSH stimulation caused Tg levels to increase in eight cases. Blunted Tg responses were seen in two patients with ectopia and hypoplasia. Interestingly, in two cases the association of different developmental defects was demonstrated. Perchlorate test revealed a total iodide organification defect in two patients, including one with a neonatal diagnosis of Pendred's syndrome, who were subsequently found to harbour TPO mutations. rhTSH did not cause notable side-effects. These new rhTSH protocols always resulted in accurate disease characterisation, allowing specific management and targeted genetic analyses. Thus, rhTSH represents a valid and safe alternative to l-thyroxine withdrawal in the differential diagnosis of CH in paediatric patients. (orig.)

  5. Thyroid scintigraphy and perchlorate test after recombinant human TSH: a new tool for the differential diagnosis of congenital hypothyroidism during infancy

    International Nuclear Information System (INIS)

    Fugazzola, Laura; Vannucchi, Guia; Mannavola, Deborah; Beck-Peccoz, Paolo; Persani, Luca; Carletto, Marco; Longari, Virgilio; Vigone, Maria C.; Cortinovis, Francesca; Weber, Giovanna; Beccaria, Luciano

    2007-01-01

    Prompt initiation of l-thyroxine therapy in neonates with congenital hypothyroidism (CH) often prevents the performance of functional studies. Aetiological diagnosis is thus postponed until after infancy, when the required investigations are performed after l-thyroxine withdrawal. The aim of this study was to verify the efficacy and safety of new protocols for rhTSH (Thyrogen) testing during l-thyroxine replacement in the differential diagnosis of CH. Ten CH patients (15-144 months old) were studied. Seven had neonatal evidence of gland in situ at the ultrasound examination performed at enrolment and received two rhTSH injections (4 μg/kg daily, i.m.) with 123 I scintigraphy and perchlorate test on day 3. Three patients with an ultrasound diagnosis of thyroid dysgenesis received three rhTSH injections with 123 I scintigraphy on days 3 and 4. TSH and thyroglobulin (Tg) determinations were performed on days 1, 3 and 4, and neck ultrasound on day 1. rhTSH stimulation caused Tg levels to increase in eight cases. Blunted Tg responses were seen in two patients with ectopia and hypoplasia. Interestingly, in two cases the association of different developmental defects was demonstrated. Perchlorate test revealed a total iodide organification defect in two patients, including one with a neonatal diagnosis of Pendred's syndrome, who were subsequently found to harbour TPO mutations. rhTSH did not cause notable side-effects. These new rhTSH protocols always resulted in accurate disease characterisation, allowing specific management and targeted genetic analyses. Thus, rhTSH represents a valid and safe alternative to l-thyroxine withdrawal in the differential diagnosis of CH in paediatric patients. (orig.)

  6. Congenital hypothyroidism: influence of disease severity and L-thyroxine treatment on intellectual, motor, and school-associated outcomes in young adults.

    Science.gov (United States)

    Oerbeck, Beate; Sundet, Kjetil; Kase, Bengt F; Heyerdahl, Sonja

    2003-10-01

    To describe intellectual, motor, and school-associated outcome in young adults with early treated congenital hypothyroidism (CH) and to study the association between long-term outcome and CH variables acting at different points in time during early development (CH severity and early L-thyroxine treatment levels [0-6 years]). Neuropsychological tests were administered to all 49 subjects with CH identified during the first 3 years of the Norwegian neonatal screening program (1979-1981) at a mean age of 20 years and to 41 sibling control subjects (mean age: 21 years). The CH group attained significantly lower scores than control subjects on intellectual, motor, and school-associated tests (total IQ: 102.4 [standard deviation: 13] vs 111.4 [standard deviation: 13]). Twelve (24%) of the 49 CH subjects had not completed senior high school, in contrast to 6% of the control subjects. CH severity (pretreatment serum thyroxine [T4]) correlated primarily with motor tests, whereas early L-thyroxine treatment levels were related to verbal IQ and school-associated tests. In multiple regression analysis, initial L-thyroxine dose (beta = 0.32) and mean serum T4 level during the second year (beta = 0.48) predicted Verbal IQ, whereas mean serum T4 level during the second year (beta = 0.44) predicted Arithmetic. Long-term outcome revealed enduring cognitive and motor deficits in young adults with CH relative to control subjects. Verbal functions and Arithmetic were associated with L-thyroxine treatment variables, suggesting that more optimal treatment might be possible. Motor outcome was associated with CH severity, indicating a prenatal effect.

  7. Health- related quality of life and self-worth in 10-year old children with congenital hypothyroidism diagnosed by neonatal screening.

    Science.gov (United States)

    van der Sluijs Veer, Liesbeth; Kempers, Marlies Je; Maurice-Stam, Heleen; Last, Bob F; Vulsma, Tom; Grootenhuis, Martha A

    2012-10-03

    Much is written about cognitive and motor development; less is known about social and emotional consequences of growing up with congenital hypothyroidism (CH).The objectives of the study were: (1) to compare health related quality of life (HRQoL) and self-worth of 10 year old patients with CH with the general population; (2) to explore associations of disease factors, IQ and motor skills with the outcomes. Children with CH and their parents completed several questionnaires. Patients were classified to 'severe CH, n = 41' or 'moderate/mild CH, n = 41' based on pre-treatment FT4 concentration.Differences between CH and the general population were tested by analysis of covariance and one sample t-tests (mean scale scores HRQoL and self-worth), chi-square tests and binomial tests (% at risk of impaired HRQoL and self-worth). Linear regression analyses corrected for gender were conducted to explore associations of the outcomes with disease factors, IQ and motor skills. Patients with CH reported lower mean HRQoL on motor, cognitive and social functioning, and on autonomy and positive emotions (p < 0.0001). Patients were also more often at risk for impaired HRQoL and self-worth. No differences were found between the severity groups. Lower IQ was only significant associated with worse cognitive HRQoL. Initial FT4 plasma, age at onset of therapy, initial T4 dose and motor skills were not significantly associated with HRQoL and self-worth. Negative consequences in terms of HRQoL and self-worth are prevalent in children with CH, independent of disease factors, IQ and motor skills. Physicians should to be attentive to these consequences and provide attention and supportive care.

  8. Confirmatory study for the congenital hypothyroidism diagnostic in newborns with suspicious neonatal sieve;Estudio confirmatorio para el diagnostico de hipotiroidismo congenito en recien nacidos con tamiz neonatal sospechoso

    Energy Technology Data Exchange (ETDEWEB)

    Murillo V, D.; Badillo A, V.; Villasana R, A. P., E-mail: black_dany87@hotmail.co [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Laboratorio de Radioinmunoanalisis, Calle Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas (Mexico)

    2009-10-15

    The congenital hypothyroidism is an endocrine illness knows from the X V century. It is caused by the anatomical or functional absence of the thyroid gland, what causes a deficiency in the thyroid hormones production. These hormones are indispensable for an appropriate physical and mental development from the first moments of the life. This illness is the more frequent cause of avoidable mental retardation in the child. In Mexico, is considered that 1 of each 2,537 newborns present congenital hypothyroidism, this frequency is extraordinarily high in relation to other countries. For the opportune confirmation of this illness is carried out by means of the radio immuno analysis that is a competitive type technique which is based on the antigen-antibody reaction. To the present antigen in the sample problem, is go to add a constant and known quantity of labelled antigen (hot antigen). The labelled antigens are formed substituting some of the normal atoms of the antigen for the corresponding radioactive isotope I{sup 125} in the molecule. The two types of antigens, cold and hot will compete, in equality of conditions, to unite with the available antibody. The concentrations of labelled antigen and antibody not change, the only variable of the system is the non labelled antigen (cold antigen) concentration. As much as more it is the quantity of cold antigen in the sample problem, it is displaced at the hot antigen and therefore they are fixed to the antibody smaller quantities of labelled antigen. Therefore, the formation of radioactive complexes (Ag-Ac) it varies in function of the non labelled antigen concentration: to major non labelled antigen concentration, major formation of non labelled antigen-antibody complexes, and minor formation of radioactive complexes and vice versa. 29 cases were analyzed with suspicion of congenital hypothyroidism therefore the T4 neonatal and TSH neonatal were quantified by the radio immuno analysis technique giving the confirmation of

  9. Central hypothyroidism - a neglected thyroid disorder.

    Science.gov (United States)

    Beck-Peccoz, Paolo; Rodari, Giulia; Giavoli, Claudia; Lania, Andrea

    2017-10-01

    Central hypothyroidism is a rare and heterogeneous disorder that is characterized by a defect in thyroid hormone secretion in an otherwise normal thyroid gland due to insufficient stimulation by TSH. The disease results from the abnormal function of the pituitary gland, the hypothalamus, or both. Moreover, central hypothyroidism can be isolated or combined with other pituitary hormone deficiencies, which are mostly acquired and are rarely congenital. The clinical manifestations of central hypothyroidism are usually milder than those observed in primary hypothyroidism. Obtaining a positive diagnosis for central hypothyroidism can be difficult from both a clinical and a biochemical perspective. The diagnosis of central hypothyroidism is based on low circulating levels of free T 4 in the presence of low to normal TSH concentrations. The correct diagnosis of both acquired (also termed sporadic) and congenital (also termed genetic) central hypothyroidism can be hindered by methodological interference in free T 4 or TSH measurements; routine utilization of total T 4 or T 3 measurements; concurrent systemic illness that is characterized by low levels of free T 4 and normal TSH concentrations; the use of the sole TSH-reflex strategy, which is the measurement of the sole level of TSH, without free T 4 , if levels of TSH are in the normal range; and the diagnosis of congenital hypothyroidism based on TSH analysis without the concomitant measurement of serum levels of T 4 . In this Review, we discuss current knowledge of the causes of central hypothyroidism, emphasizing possible pitfalls in the diagnosis and treatment of this disorder.

  10. Maternal hypothyroidism: An overview of current experimental models.

    Science.gov (United States)

    Ghanbari, Mahboubeh; Ghasemi, Asghar

    2017-10-15

    Maternal hypothyroidism (MH) is the most common cause of transient congenital hypothyroidism. Different animal models are used for assessing developmental effects of MH in offspring. The severity and status of hypothyroidism in animal models must be a reflection of the actual conditions in humans. To obtain comparable results with different clinical conditions, which lead to MH in humans, several factors have been suggested for researchers to consider before designing the experimental models. Regarding development of fetal body systems during pregnancy, interference at different times provides different results and the appropriate time for induction of hypothyroidism should be selected based on accurate time of development of the system under assessment. Other factors that should be taken into consideration include, physiological and biochemical differences between humans and other species, thyroid hormone-independent effects of anti-thyroid drugs, circadian rhythms in TSH secretion, sex differences, physical and psychological stress. This review addresses essential guidelines for selecting and managing the optimal animal model for MH as well as discussing the pros and cons of currently used models. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. The different requirement of L-T4 therapy in congenital athyreosis compared with adult-acquired hypothyroidism suggests a persisting thyroid hormone resistance at the hypothalamic-pituitary level.

    Science.gov (United States)

    Bagattini, Brunella; Cosmo, Caterina Di; Montanelli, Lucia; Piaggi, Paolo; Ciampi, Mariella; Agretti, Patrizia; Marco, Giuseppina De; Vitti, Paolo; Tonacchera, Massimo

    2014-11-01

    Levothyroxine (l-T4) is commonly employed to correct hormone deficiency in children with congenital hypothyroidism (CH) and in adult patients with iatrogenic hypothyroidism. To compare the daily weight-based dosage of the replacement therapy with l-T4 in athyreotic adult patients affected by CH and adult patients with thyroid nodular or cancer diseases treated by total thyroidectomy. A total of 36 adult patients (27 females and nine males) aged 18-29 years were studied; 13 patients (age: 21.5±2.1, group CH) had athyreotic CH treated with l-T4 since the first days of life. The remaining 23 patients (age: 24±2.7, group AH) had hypothyroidism after total thyroidectomy (14 patients previously affected by nodular disease and nine by thyroid carcinoma with clinical and biochemical remission). Patient weight, serum free thyroid hormones, TSH, thyroglobulin (Tg), anti-Tg, and anti-thyroperoxidase antibodies were measured. Required l-T4 dosage was evaluated. At the time of the observations, all patients presented free thyroid hormones within the normal range and TSH between 0.8 and 2 μIU/ml. Patients had undetectable Tg and anti-thyroid antibodies. The daily weight-based dosage of the replacement therapy with l-T4 to reach euthyroidism in patients of group CH was significantly higher than that in those of group AH (2.16±0.36 vs 1.73±0.24 μg/kg, Phypothyroidism, patients of group CH required a daily l-T4 dose/kg higher than group AH patients, despite higher levels of TSH. The different requirement of replacement therapy between adult patients with congenital and those with surgical athyroidism could be explained by a lack of thyroid hormones since fetal life in CH, which could determine a different set point of the hypothalamus-pituitary-thyroid axis. © 2014 European Society of Endocrinology.

  12. Transient tachypnea of the newborn and congenital pneumonia: a comparative study.

    Science.gov (United States)

    Costa, Sandra; Rocha, Gustavo; Leitão, Andreia; Guimarães, Hercília

    2012-07-01

    Identify perinatal risk factors for transient tachypnea and pneumonia in neonates, and compare the outcome of these clinical conditions during the Neonatal Intensive Care Unit (NICU) stay. Retrospective review of newborns admitted to a level III NICU, comparing patients with transient tachypnea, pneumonia and a control group of healthy neonates. We included 202 patients with transient tachypnea, 29 with pneumonia and 498 controls. Perinatal infectious risk factors were more frequent in patients with pneumonia than in transient tachypnea (p ventilatory support more frequently and for a longer period. Comparing with controls, Apgar score at one and five minutes was higher in controls than in patients with pneumonia (p0.032 and p newborns with transient tachypnea and pneumonia are indistinguishable at presentation but clinical evolution is significantly different. The presence of perinatal infectious risk supports the diagnosis of pneumonia. Low Apgar score at one and five minutes was associated with both diseases, suggesting that etiologic factors may already be present at birth.

  13. Hypothyroidism Among Military Infants Born in Countries of Varied Iodine Nutrition Status

    Science.gov (United States)

    2010-02-01

    while permanent congenital hypothyroidism causes include thyroid dysgenesis, dys- hormonogenesis, and central hypothyroidism and is relatively rare, with... causes have found a gender influence only among permanent cases of congenital hypothyroidism [15,20]. Given our use of ICD-9-CM codes to define cases...Naval Health Research Center Hypothyroidism among Military Infants Born in Countries of Varied Iodine Nutrition Status . M. M. Cranston

  14. Mineralización ósea en niños y adolescentes con hipotiroidismo congénito Bone mineralization in children and adolescents presenting with a congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    Kesia Granela Cortiñas

    2011-08-01

    Full Text Available Introducción: en el hipotiroidismo congénito la mineralización ósea puede afectarse por la enfermedad o por los efectos del tratamiento con hormonas tiroideas. Objetivo: determinar en pacientes con hipotiroidismo congénito la mineralización ósea. Métodos: se realizó estudio descriptivo transversal pareado, en niños cubanos con hipotiroidismo congénito (n=67 y un grupo control (n=67. Se analizó la mineralización ósea por densitometría, y se tuvo en cuenta la edad, el sexo, la maduración ósea y sexual, el diagnóstico hormonal y el tratamiento. Se aplicaron intervalos de confianza (95 %, análisis de varianza y correlación con significación. Resultados: la densidad, el contenido mineral óseo y el z-score en niños cubanos con hipotiroidismo congénito, y el grupo control no fue diferente significativamente (p=0,466; 0,155; 0,416 respectivamente. Estimaciones de asociación de mineralización ósea por edad mostró diferencia significativa en la densidad mineral ósea y contenido mineral óseo (p=0,000 para ambos grupos, y el z-score solo para los enfermos. La mineralización ósea fue significativa en la dosis promedio con levotiroxina en la segunda y tercera fase ósea, y en el tiempo de tratamiento. En el hipotiroidismo congénito permanente hubo correlación con el diagnóstico hormonal y el tiempo de tratamiento (p=0,000. Conclusiones: la mineralización ósea es homogénea en ambos grupos. La densidad y el contenido mineral óseo en niños cubanos con hipotiroidismo congénito y el grupo control se asocian con la edad, y son independientes del sexo. El z-score en pacientes con hipotiroidismo congénito sufre variación con la edad, y es independiente al sexo en ambos grupos. La densidad y el contenido mineral óseo varían en niños con hipotiroidismo congénito.Introduction: in the case of the congenital hypothyroidism the bone mineralization may be affected by disease or by the effects of the thyroid hormones treatment

  15. Hypothyroidism (primary)

    DEFF Research Database (Denmark)

    Nygaard, Birte

    2014-01-01

    INTRODUCTION: Hypothyroidism is six times more common in women, affecting up to 40 in 10,000 each year (compared with 6/10,000 men). METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for clinical (overt......) hypothyroidism? What are the effects of treatments for subclinical hypothyroidism? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We...

  16. Importância do fonoaudiólogo no acompanhamento de indivíduos com hipotireoidismo congênito Speech and language pathologist importance in the attendance of individuals with congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    Mariana Germano Gejão

    2008-01-01

    Full Text Available TEMA: o hipotireoidismo congênito é uma alteração metabólica que traz conseqüência graves para indivíduos não tratados e mesmo as crianças que realizam o tratamento podem apresentar distúrbios do desenvolvimento. O Programa Nacional de Triagem Neonatal, instituído pelo Ministério da Saúde, prevê o acompanhamento longitudinal de indivíduos com equipe multidisciplinar. Entretanto, a Fonoaudiologia não é incluída nesta equipe. Deste modo, considerando a ocorrência de distúrbios da comunicação nestes indivíduos, realizou-se levantamento bibliográfico nas bases de dados Lilacs, MedLine e PubMed, no período de 1987 a 2007, referente às alterações em habilidades do desenvolvimento decorrentes do hipotireoidismo congênito. OBJETIVO: verificar, na literatura científica, presença de alterações do desenvolvimento em indivíduos com hipotireoidismo congênito e refletir sobre a importância da atuação fonoaudiológica, em conjunto com equipe multidisciplinar especializada, no acompanhamento dos mesmos. CONCLUSÃO: a literatura relata alterações nas habilidades do desenvolvimento (motoras, cognitivas, lingüísticas e de autocuidados e destaca que crianças com hipotireoidismo congênito são de risco para alterações no desenvolvimento lingüístico e, portanto, necessitam do acompanhamento longitudinal do desenvolvimento comunicativo. Torna-se evidente a importância da atuação do fonoaudiólogo nos Programas de Triagem Neonatal credenciados pelo Ministério da Saúde. Ressalta-se ainda a necessidade de investigações referentes às outras alterações metabólicas contempladas nestes programas, nas quais o fonoaudiólogo pode atuar de modo a prevenir, habilitar e reabilitar os distúrbios da comunicação, contribuindo para o trabalho em equipe, promovendo saúde nesta população.BACKGROUND: congenital hypothyroidism is a metabolic disturbance that causes severe consequence for non-treated individuals and even

  17. Central hypothyroidism

    Directory of Open Access Journals (Sweden)

    Vishal Gupta

    2011-01-01

    Full Text Available Central hypothyroidism is defined as hypothyroidism due to insufficient stimulation by thyroid stimulating hormone (TSH of an otherwise normal thyroid gland. It has an estimated prevalence of approximately 1 in 80,000 to 1 in 120,000. It can be secondary hypothyroidism (pituitary or tertiary hypothyroidism (hypothalamus in origin. In children, it is usually caused by craniopharyngiomas or previous cranial irradiation for brain tumors or hematological malignancies. In adults, it is usually due to pituitary macroadenomas, pituitary surgeries or post-irradiation. Fatigue and peripheral edema are the most specific clinical features. Diagnosis is established by the presence of normal to low-normal TSH on the background of low-normal thyroid hormones, confirmed by the thyrotropin releasing hormone stimulation test. Therapy includes use of levothyroxine titrated to improvement in symptomology and keeping free T4 in the upper limit of normal reference range.

  18. Neonatal hypothyroidism

    Science.gov (United States)

    ... the first month or so usually have normal intelligence. Untreated mild hypothyroidism can lead to severe intellectual ... 2018, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM ...

  19. Synthetic prevention and treatment for hypothyroidism after radioiodine therapy hyperthyroidism

    International Nuclear Information System (INIS)

    Li Shiyun

    2004-01-01

    Hypothyroidism is main complication after 131 I therapy for hyperthyroidism in Graves' disease. The hypothyroidism restricts its popular application that 131 I treatment for Graves' disease. In clinic practice, different factors of every patient, involved case selection, sensitivity estimation, unite using medicine before 131 I therapy are analysed, and synthetic measures for posttreatment examination, transient hypothyroidism and permanent hypothyroidism after 131 I therapy are discussed

  20. Transient mega-esophagus in a neonate with congenital diaphragmatic hernia

    International Nuclear Information System (INIS)

    Makhoul, I.R.; Smolkin, T.; Sujov, P.; Shoshany, G.; Epelman, M.

    2001-01-01

    Esophageal dilatation (ED) in neonates is rare. In the present case, ED was detected in a chest radiograph following repair of congenital diaphragmatic hernia (CDH) in a term neonate. A roentgenographic swallow study on the seventh day of life demonstrated ED and a sub-diaphragmatic stomach. The infant thrived adequately on enteral feeding. A swallow study on the twentieth day of life showed a normal-width esophagus with gastroesophageal reflux and small hiatus hernia. The longstanding herniated stomach in the fetus apparently caused kinking, edema, and obstruction of the gastroesophageal junction. This led to a significant ED and concealment of gastroesophageal reflux. We aim to arouse awareness about the occurrence of ED with CDH, and about its benign course under conservative management. (orig.)

  1. Transient mega-esophagus in a neonate with congenital diaphragmatic hernia

    Energy Technology Data Exchange (ETDEWEB)

    Makhoul, I.R.; Smolkin, T.; Sujov, P. [Dept. of Neonatology, Rambam Medical Center and Rappaport Faculty of Medicine, Technion, Haifa (Israel); Shoshany, G. [Dept. of Pediatric Surgery, Rambam Medical Center and Rappaport Faculty of Medicine, Technion, Bat-Galim, Haifa (Israel); Epelman, M. [Dept. of Radiology, Rambam Medical Center and Rappaport Faculty of Medicine, Technion, Bat-Galim, Haifa (Israel)

    2001-05-01

    Esophageal dilatation (ED) in neonates is rare. In the present case, ED was detected in a chest radiograph following repair of congenital diaphragmatic hernia (CDH) in a term neonate. A roentgenographic swallow study on the seventh day of life demonstrated ED and a sub-diaphragmatic stomach. The infant thrived adequately on enteral feeding. A swallow study on the twentieth day of life showed a normal-width esophagus with gastroesophageal reflux and small hiatus hernia. The longstanding herniated stomach in the fetus apparently caused kinking, edema, and obstruction of the gastroesophageal junction. This led to a significant ED and concealment of gastroesophageal reflux. We aim to arouse awareness about the occurrence of ED with CDH, and about its benign course under conservative management. (orig.)

  2. Epidemiology of subtypes of hypothyroidism in Denmark

    DEFF Research Database (Denmark)

    Carlé, Allan; Laurberg, Peter; Pedersen, Inge B.

    2006-01-01

    in the cohort; the incidence rate was 32.8 per 100 000 person-years (standardised to the Danish population). Nosological types of hypothyroidism were: spontaneous (presumably autoimmune) 84.4%, post-partum 4.71%, amiodarone-associated 4.0%. subacute thyroiditis 1.8%. previous radiation or surgery 1.......8%. congenital 1.6% and lithium-associated 1.6%. Crude incidence rates were 29.0 around Aalborg and 40.6 in an area of Copenhagen. The higher incidence rate of hypothyroidism in the area with higher iodine intake was caused solely by more cases of spontaneous (presumably autoimmune) hypothyroidism, whereas...

  3. NEUROPHYSIOLOGICAL CONSEQUENCES IN HIPPOCAMPUS AS A FUNCTION OF DEVELOPMENTAL HYPOTHYROIDISM.

    Science.gov (United States)

    Thyroid hormones are essential for maturation and function of the mammalian central nervous system. Severe congenital hypothyroidism results in irreversible structural damage and mental retardation in children. Although a variety of environmental contaminants have been demonstrat...

  4. Neonatal hypothyroidism detection with locally produced reactives

    International Nuclear Information System (INIS)

    Balter, H.; Robles, A.; Nappa, A.

    1993-01-01

    The Congenital hypothyroidism is the endocrinopathy of frequency lives in the childhood together with the Diabetes Mellitus. It has estimated in other countries that approximately a boy for each 4500 has probability of being born with this pathology.It is detected by radioinmuno essay RIA.In 1990 it forms to multidisciplinary group for the hypothyroidism congenital studies, integrate for the Nuclear Investigations Center of (CIN), Nuclear Medicine Center (CMN), the Neonatology Department of the Medicine College and the Cathedra of Radioquimica of the Chemistry College with the aim for implement the programme [es

  5. Hypothyroidism associated with parathyroid disorders.

    Science.gov (United States)

    Mantovani, Giovanna; Elli, Francesca Marta; Corbetta, Sabrina

    2017-03-01

    Hypothyroidism may occur in association with congenital parathyroid disorders determining parathyroid hormone insufficiency, which is characterized by hypocalcemia and concomitant inappropriately low secretion of parathormone (PTH). The association is often due to loss of function of genes common to thyroid and parathyroid glands embryonic development. Hypothyroidism associated with hypoparathyroidism is generally mild and not associated with goiter; moreover, it is usually part of a multisystemic involvement not restricted to endocrine function as occurs in patients with 22q11 microdeletion/DiGeorge syndrome, the most frequent disorders. Hypothyroidism and hypoparathyroidism may also follow endocrine glands' damages due to autoimmunity or chronic iron overload in thalassemic disorders, both genetically determined conditions. Finally, besides PTH deficiency, hypocalcemia can be due to PTH resistance in pseudohypoparathyroidism; when hormone resistance is generalized, patients can suffer from hypothyroidism due to TSH resistance. In evaluating patients with hypothyroidism and hypocalcemia, physical examination and clinical history are essential to drive the diagnostic process, while routine genetic screening is not recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Smoking cessation is followed by a sharp but transient rise in the incidence of overt autoimmune hypothyroidism – A population‐based, case–control study

    DEFF Research Database (Denmark)

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

    2012-01-01

    habits were verified by measuring urinary cotinine (a nicotine metabolite). Incident hypothyroidism was very common in people who had recently stopped smoking: OR vs never smokers (95%‐CI); quit smoking 10 years, 0·76 (0·38–1·51). Results were consistent in both sexes and irrespective of age. Within two...

  7. Inherited hypothyroidism.

    Science.gov (United States)

    Jackson, I M

    1976-03-01

    Familial hypothyroidism results from both thyroidal and extrathyroidal dysfunction. Specific intrathyroidal abnormalities in thyroid hormone synthesis causing goitrous hypothyroidism are iodide trap defect, organification defect, "coupling" defect, iodoprotein defect, and dehalogenase defect. The diagnostic studies for each are outlined utilizing radioiodine(131I) studies. Other causes of cretinism include failure of the thyroid gland to respond to TSH and lack of pituitary TSH (or hypothalamic TRH). The syndrome of peripheral resistance to thyroid hormone is discussed. The diagnosis of inherited hypothyrodism rests on an adequate family history and measurement of both T4 and TSH levels which can be determined in cord blood or peripheral blood from the infant. The importance of early treatment of hypothyroidism in the neonatal period to prevent brain damage is emphasized. The rec:nt discovery of the importance of reverse T3 (RT3) in fetal thyroid metabolism is described, and the possibility of amniocentesis as an aid in prenatal diagnosis is considered. The place of intrauterine administration of thyroid hormone to the fetus at risk from hypothyroidism is uncertain at this time and requires carefully controlled studies and long-term follow-up.

  8. Manifestações fonoaudiológicas relatadas por pais de crianças com hipotireoidismo congênito Speech-language pathology manifestations reported by parents of children with congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    Ligia Oliva Ferreira

    2011-09-01

    Full Text Available OBJETIVO: Identificar manifestações fonoaudiológicas apresentadas por crianças com hipotireoidismo congênito e investigar a associação de tais manifestações com a época do diagnóstico e o início do tratamento. MÉTODOS: Responsáveis por 15 crianças diagnosticadas com hipotireoidismo congênito e atendidas pelo Serviço de Referência em Triagem Neonatal dos estados de Rondônia e Acre responderam a um questionário no qual deveriam relatar principalmente queixas fonoaudiológicas. A idade das crianças variou de 2 a 7 anos, 67% de meninos e 33% de meninas. A média de idade da época do diagnóstico foi de 1 mês e 3 dias e o tratamento iniciou-se, em média, com 1 mês e 6 dias. A dosagem do medicamento variou entre 5 mg/dia e 100 mg/dia. RESULTADOS: As queixas relatadas foram: atraso para início da linguagem oral, trocas na fala, fala ininteligível, comportamento agitado e comportamento nervoso. Alguns responsáveis não referiram queixas. Verificou-se que a maioria dos sujeitos apresentou problemas na fala (80% e a menor parte (7,7%, alteração auditiva. Para aqueles que referiram queixa, a média da época do diagnóstico e do início do tratamento foi mais tardia quando comparado àqueles que não as relataram. CONCLUSÃO: Foram relatadas manifestações fonoaudiológicas, principalmente relacionadas à fala. Além disso, houve associação entre a presença de queixa e problema de fala com a época do diagnóstico e o início do tratamento. Sugere-se a inserção do fonoaudiólogo no acompanhamento das crianças com hipotireoidismo congênito.PURPOSE: To identify speech-language pathology manifestations presented by children with congenital hypothyroidism, and to investigate the association of such manifestations with the time of diagnosis and beginning of treatment. METHODS: Caregivers of 15 children diagnosed with congenital hypothyroidism who attended the Reference Service on Neonatal Screening of the states of Rond

  9. Phenylketonuria, congenital hypothyroidism and haemoglobinopathies: public health issues for a Brazilian newborn screening program Fenilcetonúria, hipotireoidismo congênito e hemoglobinopatias: questões de saúde pública para um programa de triagem neonatal brasileiro

    Directory of Open Access Journals (Sweden)

    Judy Botler

    2012-09-01

    Full Text Available In this study, the frequency of detected congenital hypothyroidism, phenylketonuria and haemoglobinopathies in the State of Rio de Janeiro's (Brazil Newborn Screening Program (NBSP was analyzed between the years of 2005 and 2007. There were two Newborn Screening Reference Centers (named NSRC A and B with programmatic differences. In 2007, overall detection coverage reached 80.7%. The increase in the incidence of congenital hypothyroidism (1:1,030 in 2007 was attributed to the reduction of neonatal TSH value limits over time. The incidence discrepancy of phenylketonuria between NSRC A (1:28,427 and B (1:16,522 might be partially explained by the small number of cases. The incidence of sickle cell disease and its traits were uniformly high (1:1,288 and 1:21, respectively. This was coherent with the ethnic composition of the population. The differences in laboratory methods and critical values, in addition to other programmatic issues, may explain the variances in the results and limited analysis of the role of biological and environmental determinants in the occurrence of these diseases.Neste estudo, foi analisada a frequência de detecção do hipotireoidismo congênito, fenilcetonúria e hemoglobinopatias no Programa de Triagem Neonatal do Estado do Rio de Janeiro, Brasil, entre 2005 e 2007. Havia dois Serviços de Referência em Triagem Neonatal (designados SRTN A e B com diferenças programáticas. Em 2007, a cobertura alcançou 80,7%. O aumento na incidência do hipotireoidismo congênito (1:1.030 em 2007 foi atribuído à redução no valor de corte do TSH ao longo do tempo. As incidências discrepantes da fenilcetonúria entre os modelos (SRTN A - 1:28.427; SR-TN B - 1:16.522 podem ser parcialmente explicadas pelo pequeno número de casos. A incidência da doença falciforme e do traço falcêmico foi uniformemente elevada (1:1.288 e 1:21, respectivamente, sendo coerente com a composição étnica da população. As diferenças nos m

  10. Prepregnancy hypothyroidism versus gestational hypothyroidism: A comparative study

    Directory of Open Access Journals (Sweden)

    Prashant Ulhas Kaduskar

    2017-01-01

    Full Text Available Introduction: Hypothyroidism managed inadequately in pregnancy may have grave outcomes for both mother and baby. Understanding pregnancy outcomes in our country with low awareness about thyroid diseases is important. Objectives: The objectives of the study were to evaluate demographic features and biochemical parameters in patients with prepregnancy hypothyroidism versus patients diagnosed to have primary hypothyroidism during pregnancy and to assess pregnancy outcomes. Study Design: Prospective design Materials and Methods: The study was conducted in a tertiary care center in Bengaluru for 2 years. The patients were divided into two groups - Group I: Prepregnancy hypothyroidism and Group II: Hypothyroid during pregnancy. They were further staged according to ESI guidelines as subclinical or overt hypothyroidism. Statistical Analysis: Chi-square and Mann–Whitney test. Results: A total of 452 pregnant women with hypothyroidism were analyzed. The data of 371 delivered pregnancies were available. Group I and II had 196 (43.36% and 256 (56.64% patients, respectively. Age at presentation (years was 27.09 ± 4.19 in Group I versus 25.74 ± 4.29 in Group II (P = 0.003; gestational age (weeks was 9.04 ± 5.41 in Group I versus 13.81 ± 9.12 in Group II (P = 0.000. There was one case of congenital hypothyroidism in baby in each group. Mean birth weight was 2.90 ± 0.39 kg in Group I versus 2.88 ± 0.36 kg in Group II; P = 0.608. There were four abortions in Group I versus ten in Group II (P = 0.231, 104 cesarean sections in Group I compared to 133 in Group II; (P = 0.382. There was no difference in number of cesarean sections, abortions and low birth weight babies between overt and subclinical hypothyroidism subgroups. Conclusions: Group I patients presented earlier for testing suggesting awareness was good in this group. There was no difference in pregnancy outcome between the two groups. Overt versus subclinical status did not have any different

  11. Congenital goiter due to maternal ingestion of iodide

    International Nuclear Information System (INIS)

    Iancu, T.; Boyanower, Y.; Laurian, N.

    1974-01-01

    A newborn infant with large bilateral cervical masses developed respiratory difficulties three days after birth. A congenital goiter was suspected and a biopsy was performed. Later information pointed to the ingestion of large amounts of inorganic iodine, during the pregnancy, by the asthmatic mother. Further investigation proved the goiter to be due to transient depression of peroxidase activity by the exogenous iodine. Within several days after birth, the infant's thyroid regained its full activity, the goiter disappeared, and the few signs of hypothyroidism subsided. (U.S.)

  12. Central Diabetes Insipidus, Central Hypothyroidism, Renal Tubular ...

    African Journals Online (AJOL)

    readmitted to the hospital because of jaundice and failure to thrive, for which he was investigated and diagnosed to have central congenital hypothyroidism. Shortly thereafter, he was admitted to our institute with a history of vomiting, decreased oral intake, polyuria, and dehydration having lasted 5 days. He was investigated ...

  13. NEOCORTICAL HYPERTROPHY FOLLOWING DEVELOPMENTAL HYPOTHYROIDISM IN RATS

    Science.gov (United States)

    Thyroid hormones (TH) are essential to the normal development of the brain. Although severe congenital hypothyroidism has long been associated with mental retardation and motor defects, it has only recently been established that even subtle decreases in maternal TH alter fetal br...

  14. Comparação entre duas estratégias para a detecção precoce do hipotiroidismo congênito Comparison between two strategies for the precocious detection of congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    L.S. Ward

    1998-06-01

    Full Text Available OBJETIVO: Comparar em recém-nascidos (RN duas estratégias diferentes para o rastreamento do hipotiroidismo congênito (HC, a dosagem primária de TSH no sangue colhido do cordão umbilical (método 1 e a dosagem primária de T4 no sangue colhido por punção de calcanhar no 2º dia de internação (método 2. MÉTODOS: Os autores compararam as duas estratégias em 10.000 RN. Dosaram o TSH por método imunofluorimétrico sensível em papel de filtro e o T4 por radioimunoensaio em papel de filtro. A coleta de sangue do calcanhar foi realizada no 2º dia de vida RESULTADOS: Os dois programas diagnosticaram todos os casos de HC nos RN (4 casos, 1/2.500 RN. O índice de rechamada por coleta inadequada foi nulo no método 1 e de 8,5% (850 RN no método 2. O índice de reconvocação para confirmação de resultados foi de 0,06% (6 RN no método 1 e de 2,25% (225 RN no método 2; quando este método incluía também a dosagem suplementar de TSH, o índice baixou para 1,63% (163 RN. CONCLUSÃO: Os dados dos autores evidenciam a superioridade técnica da coleta de sangue a partir do cordão umbilical em relação à punção de calcanhar, assim como da dosagem primária de TSH em relação à de T4, uma vez que apresentam índices muito menores de reconvocação.OBJECTIVE: Compare two different strategies in newborn screening for congenital hypothyroidism, primary TSH in the umbilical cord blood (method 1 and primary T4 in blood collected from the heel in the 2nd day of life (method 2. METHODS: We compared both strategies in 10,000 newborns, measuring TSH by a sensitive immunofluorimetric assay and T4 by a radioimmunoassay. RESULTS: Both strategies detected all cases of hypothyroidism (4 cases, 1/2,500 newborns. The recalling index owing to insufficient amount of blood to perform the assays was zero in method 1 and 8.5% (850 newborns in method 2. The recalling index for confirmation of the results was 0.06% (6 newborns in method 1 and 2.25% (225

  15. Hypothyroidism and the Heart

    Science.gov (United States)

    Udovcic, Maja; Pena, Raul Herrera; Patham, Bhargavi; Tabatabai, Laila; Kansara, Abhishek

    2017-01-01

    Hypothyroidism is a commonly encountered clinical condition with variable prevalence. It has profound effects on cardiac function that can impact cardiac contractility, vascular resistance, blood pressure, and heart rhythm. With this review, we aim to describe the effects of hypothyroidism and subclinical hypothyroidism on the heart. Additionally, we attempt to briefly describe how hypothyroid treatment affects cardiovascular parameters. PMID:28740582

  16. Hypothyroidism in clinical practice

    Directory of Open Access Journals (Sweden)

    Faiza Qari

    2014-01-01

    Full Text Available Background: Hypothyroidism is the most common endocrine disease that was seen in the clinical practice especially for family physicians. Methods: This review article covered the important practical clinical issues for managing overt hypothyroidism, subclinical hypothyroidism and hypothyroidism during pregnancy. Conclusions: The clinical issues were addressed by clinical scenario followed by questions and stressed on the important clinical points.

  17. Hypothyroidism and the Heart.

    Science.gov (United States)

    Udovcic, Maja; Pena, Raul Herrera; Patham, Bhargavi; Tabatabai, Laila; Kansara, Abhishek

    2017-01-01

    Hypothyroidism is a commonly encountered clinical condition with variable prevalence. It has profound effects on cardiac function that can impact cardiac contractility, vascular resistance, blood pressure, and heart rhythm. With this review, we aim to describe the effects of hypothyroidism and subclinical hypothyroidism on the heart. Additionally, we attempt to briefly describe how hypothyroid treatment affects cardiovascular parameters.

  18. The incidence of congenital hypotyroidism is increasing

    DEFF Research Database (Denmark)

    Leunbach, Tina Lund; Christensen, Pia Sønderby; Kristensen, Kurt

    2017-01-01

    The prognosis of primary congenital hypothyroidism, which has potentially devastating effects on neurodevelopment, has been almost eradicated after the implementation of the neonatal screening programme. Although early facilitation with substitution of levothyroxine is preventative, caution shoul...

  19. Dyslipidemia in subclinical hypothyroidism

    OpenAIRE

    Čaparević Zorica; Bojković Gradimir; Stojanović Dragoš Lj.; Ilić Vesna

    2003-01-01

    Introduction Subclinical hypothyroidism is defined as an increased serum TSH and normal serum FT4 concentration. In subclinical hypothyroidism, thyroid peroxidase and thyroglobulin antibodies are frequently present. Subclinical hypothyroidism may have endogenous or exogenous causes. The prevalence of subclinical hypothyroidism is rather high. The number of patients progressing to overt hypothyroidism may be higher. These patients may be asymptomatic, or have only mild symptoms or a single sym...

  20. Hypothyroidism in Filipino neonates

    International Nuclear Information System (INIS)

    Guevarra, R.; Torres, J.F.; Estrada, F.A.; San Luis, T.O.L.

    1988-01-01

    Thyroid hormone determination (T4, T3, rT3, TSH) in cord blood of 3,897 newborns was carried out in Metro Manila (non-endemic) and central, Northern and Southern Luzon (endemic for goiter). The objective is to detect congenital hypothyroidism and establish its incidence in new born Filipinos. This was done by radioimmunoassay, using commercial kits from Abbott Laboratories. The results obtained as mean values for non-endemic regions are: T4: 10.96 +- 2.25 ug/dl; T3: 60-64 +- 13.82 ng/dl; rT3: 250.4 +- 64.9 ng/dl; and TSH 5.89 +- 2.58 uU/ml, n=200. Mean values in endemic regions (n = 205) are T4: 9.46 +- 2.18 ug/dl; T3: 67.8 +- 12.05 ng/dl; rT3: 184.3 +- 32.7 ng/dl and TSH: 6.65 +- 3.13 uU/ml. From the above data, nomograms were drawn where the values obtained from each case were plotted. From non-endemic regions 28 positive cases were recalled and in the endemic regions 16 positive cases were also recalled for re-examination but most of them turned out to be false positive. As of now, four positive cases were found in Metro Manila, i.e. 4/2, 441 births and five in endemic regions out of 1,456 births so the incidence of neonatal hypothyroidism is 9/3,897 births. This is 9 times higher than most reports abroad which is about 1/4000 births. (Auth.). 36 refs; 10 tabs; 10 figs

  1. Experimental models of developmental hypothyroidism.

    Science.gov (United States)

    Argumedo, G S; Sanz, C R; Olguín, H J

    2012-02-01

    Hypothyroidism is a systemic disease resulting from either thyroid gland's anatomical and functional absence or lack of hypophyseal stimulation, both of which can lead to deficiency in thyroid hormone (TH) production. TH is essential for human and animal development, growth, and function of multiple organs. Children with deficient TH can develop alterations in central nervous system (CNS), striated muscle, bone tissue, liver, bone marrow, and cardiorespiratory system. Among the clinical outlook are signs like breathing difficulty, cardiac insufficiency, dysphagia, and repeated bronchial aspiration, constipation, muscle weakness, cognitive alterations, cochlear dysfunction, reduced height, defects in temperature regulation, anaemia, jaundice, susceptibility to infection, and others. Experimental and clinical studies have shown that TH is very essential for normal brain development. Other research work based on mice pointed out that a reduced level of TH in pregnant mother leads to congenital hypothyroidism in animal models and it is associated with mental retardation, deep neurologic deficiency that impacts on cognitive, learning, and memory functions. The principal experimental model studies that have focused on hypothyroidism are reviewed in this study. This is important on considering the fact that almost all animal species require thyroid hormones for their metabolism. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Neonatal screening for hypothyroidism in Southern Thailand

    International Nuclear Information System (INIS)

    Sukthomya, V.

    1985-08-01

    Thyroid stimulating hormone (TSH) determination by a radioimmunoassay on dried blood spots was selected as the screening method for congenital hypothyroidism in Southern Thailand. Blood from the infant's heel was obtained in 7814 newborns on the fifth day of life. Infants with TSH values greater than 25 mU/L were recalled for a more careful clinical examination and to have their T4 (thyroxine) and TSH re-estimated. Fifty-four infants with TSH values between 25 and 50 mU/L were found to be normal at re-evaluation. These are still being followed longitudinally for full confirmation. Two with values above 50 mU/L, although clinically euthyroid, were found to be hypothyroid by T3, T4, thyroid scintigraphy and bone age on roentgenography. Replacement therapy has been started. We have shown that a screening program for neonatal hypothyroidism can be done, and is probably worthwhile and perhaps even cost-effective

  3. Medicines for Hypothyroidism

    Science.gov (United States)

    ... T4 made by your body. What is the treatment for hypothyroidism? People who have hypothyroidism must take a pill ... Questions to ask your doctor • Do I have hypothyroidism? • What treatment do I need for it? • What are the ...

  4. Does Breast Feeding Protect the Hypothyroid Infant Diagnosed by Newborn Screening?

    Science.gov (United States)

    Rovet, Joanne F.

    Because breast milk contains small quantities of thyroid hormones not found in commercial formula preparations, it was hypothesized that breast feeding may provide some protective benefit to the hypothyroid infant before medical treatment is begun. Of 108 children with congenital hypothyroidism, breast-fed children had higher thyroid hormone…

  5. Juvenile-onset hypothyroidism in a dog

    International Nuclear Information System (INIS)

    Greco, D.S.; Peterson, M.E.; Cho, D.Y.; Markovits, J.E.

    1985-01-01

    Juvenile-onset hypothyroidism was diagnosed in an adult mixed-breed dog examined because of quadraparesis. Unusual clinical signs attributable to juvenile-onset or congenital hypothyroidism included disproportionate dwarfism; enlarged, protruding tongue; mental dullness; and retention of a 'puppy' coat, which was soft and fluffy, without guard hairs. Radiography of the vertebral column and long bones revealed multiple areas of delayed epiphyseal closure and epiphyseal dysgenesis. Myelography demonstrated several intervertebral disk protrusions in the cervical and lumbar regions. Hypothyroidism was confirmed on the basis of a low basal serum thyroxine concentration that failed to increase after the administration of thyroid stimulating hormone. Other laboratory abnormalities included nonregenerative, normocytic, normochromic anemia; mild hypercalcemia; and an impaired growth hormone (GH) secretory response after xylazine administration. At necropsy, the thyroid gland was small and weighed only 0.2g. Microscopic examination of the thyroid gland revealed a loss of glandular tissue, which was replaced by adipose tissue along its periphery. Gross or microscopic abnormalities were not noted in the pituitary gland, and immunohistochemical staining of the pituitary gland revealed a normal number of GH-containing acidophils. This suggests that primary hypothyroidism may result in an impaired secretion of growth hormone, and that pituitary dwarfism or GH deficiency may be difficult to differentiate from hypothyroid dwarfism on the basis of provocative GH testing alone

  6. Kocher-Debré-Sémélaigne syndrome and congenital nystagmus

    OpenAIRE

    Radhakrishnan, K.; Walia, B. N. S.; Venkateswarlu, K.; Mann, S. B. S.

    1982-01-01

    A 11-year-old boy with hypothyroidism developed generalized muscle hypertrophy and proximal muscular weakness. Electromyographic findings were suggestive of myopathy. He had had congenital nystagmus (CN) since early infancy. Although the association of childhood hypothyroidism and CN has been documented before, the triad of hypothyroidism, hypertrophic myopathy and CN exhibited by the patient is believed to be unique.

  7. Thyroid peroxidase and thyroglobulin auto-antibodies in patients with newly diagnosed overt hypothyroidism

    DEFF Research Database (Denmark)

    Carle, A.; Laurberg, P.; Knudsen, N.

    2006-01-01

    Objectives: Thyroid autoimmunity is a major cause for hypothyroidism. We describe thyroid auto-antibodies in patients with various nosological subtypes of hypothyroidism identified in a population study. Design: Population-based follow-up study identifying all new cases of hypothyroidism in an open...... cohort. Methods: We established a monitoring system, and identified all new cases with primary overt hypothyroidism (n = 685) in a 4 year period in a well-defined population cohort (2,027,208 person-years of observation). Patients were sub-classified into: spontaneous hypothyroidism, presumably...... of autoimmune origin ( n 578); non-spontaneous hypothyroidism ( associated with medication, delivery, neck-irradiation or subacute thyroiditis, n 97); and congenital hypothyroidism ( n 10). A total of 186 adult patients (61% of those invited) underwent thyroid ultrasonography and measurements of antibodies...

  8. Transient thyrotoxicosis during nivolumab treatment

    NARCIS (Netherlands)

    van Kooten, M. J.; van den Berg, G.; Glaudemans, A. W. J. M.; Hiltermann, T. J. N.; Groen, H. J. M.; Rutgers, A.; Links, T. P.

    Two patients presented with transient thyrotoxicosis within 2-4 weeks after starting treatment with nivolumab. This thyrotoxicosis turned into hypothyroidism within 6-8 weeks. Temporary treatment with a beta blocker may be sufficient.

  9. Central Hypothyroidism in Miniature Schnauzers

    NARCIS (Netherlands)

    Voorbij, Annemarie M W Y; Leegwater, Peter A J; Buijtels, Jenny J C W M; Daminet, Sylvie; Kooistra, Hans S

    2016-01-01

    BACKGROUND: Primary hypothyroidism is a common endocrinopathy in dogs. In contrast, central hypothyroidism is rare in this species. OBJECTIVES: The objective of this article is to describe the occurrence and clinical presentation of central hypothyroidism in Miniature Schnauzers. Additionally, the

  10. Primary and secondary hypothyroidism (image)

    Science.gov (United States)

    Hypothyroidism is a decreased activity of the thyroid gland which may affect all body functions. The rate ... and physical sluggishness. The most severe form of hypothyroidism is myxedema, a medical emergency. Hypothyroidism can be ...

  11. MENSTRUAL IRREGULARITIES IN HYPOTHYROIDISM

    OpenAIRE

    Kalyani

    2015-01-01

    AIM OF THE STUDY: To study the effect of hypothyroidism, on the menstrual cycle of women in the reproductive age group. MATERIAL & METHODS: A total number of 50 cases of hypothyroidism patients recruited over a period of one year from the department of Nuclear Medicine K.G.H Visakhapatnam. All these subjects were evaluated clinically and the data recorded as per the proforma. RESULTS: In my study out of 50 hypothyroid women, 22% had normal menstrual cycle &...

  12. Hypothyroidism and myxedema coma.

    Science.gov (United States)

    Finora, Kevin; Greco, Deborah

    2007-01-01

    Hypothyroidism is a common endocrinopathy in dogs but is rare in cats. Lymphocytic thyroiditis and idiopathic thyroid atrophy are common causes of this condition. Specific thyroid function tests, in conjunction with clinical signs and physical examination findings, are used to help confirm a diagnosis of hypothyroidism. This disease can be managed with synthetic hormone supplementation and has an excellent prognosis. Myxedema coma is a rare and potentially fatal manifestation of severe hypothyroidism that can be successfully treated using intravenous levothyroxine.

  13. Congenital hypothyroidism in two siblings | Oduwole | Nigerian ...

    African Journals Online (AJOL)

    Nigerian Quarterly Journal of Hospital Medicine. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 10, No 2 (2000) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. DOWNLOAD FULL TEXT Open Access ...

  14. Transient spontaneous remission in congenital MLL-AF10 rearranged acute myeloid leukemia presenting with cardiorespiratory failure and meconium ileus.

    Science.gov (United States)

    Gyárfás, Tobias; Wintgens, Juergen; Biskup, Wolfgang; Oschlies, Ilske; Klapper, Wolfram; Siebert, Reiner; Bens, Susanne; Haferlach, Claudia; Meisel, Roland; Kuhlen, Michaela; Borkhardt, Arndt

    2016-12-01

    Neonatal leukemia is a rare disease with an estimated prevalence of about one to five in a million neonates. The majority being acute myeloid leukemia (AML), neonatal leukemia can present with a variety of symptoms including hyperleucocytosis, cytopenia, hepatosplenomegaly, and skin infiltrates. Chromosomal rearrangements including mixed lineage leukemia (MLL) translocations are common in neonatal AML. A female neonate born at 34 weeks gestation presented with cardiorespiratory failure, hepatosplenomegaly, pancytopenia, and coagulopathy. She required intensive care treatment including mechanical ventilation, high-dose catecholamine therapy, and multiple transfusions. Small intestinal biopsy obtained during laparotomy for meconium ileus revealed an infiltrate by an undifferentiated monoblastic, MLL-rearranged leukemia. No other manifestations of leukemia could be detected. After spontaneous clinical remission, lasting 5 months without any specific treatment, the patient presented with leukemia cutis and full-blown monoblastic leukemia. MLL-AF10-rearranged AML could be re-diagnosed and successfully treated with chemotherapy and hematopoietic stem cell transplantation. Our patient exhibited a unique manifestation of neonatal MLL-AF10 rearranged AML with cardiorespiratory failure and intestinal infiltration. It highlights the importance of leukemia in the differential diagnosis of neonatal distress, congenital hematological abnormalities, and skin lesions.

  15. Prenatal diagnosis and treatment perspective of fetal hypothyroidism with goiter

    International Nuclear Information System (INIS)

    Gulraze, A.; Kurdi, W.; Tulbah, M.; Niaz, F.A.

    2013-01-01

    We describe two cases of fetal goiter in women with no history of thyroid disease. Diagnosis of fetal goiter during antenatal care was made by ultrasound and MRI. Congenital hypothyroidism was confirmed by fetal blood sampling that was treated with weekly intra-amniotic injections of L-thyroxin. One fetus was initially treated with four weekly intra-amniotic injections of 200 mu gms of L-thyroxin, later increased to 400 mu gms. The other fetus was treated with only three weekly intraamniotic injections of 400 mu gms of L-thyroxin. Therapeutic response was monitored by repeated ultrasound and MRI along with fetal blood sampling. At birth, none of the babies had goiter and were put on oral thyroxin. Post-natal studies were suggestive of congenital hypothyroidism due to dyshormogenesis. No abnormality was detected at follow-up. These cases highlight the role of intra-amniotic thyroxine in management of fetal hypothyroidism with goiter. (author)

  16. Palpebral redundancy from hypothyroidism.

    Science.gov (United States)

    Wortsman, J; Wavak, P

    1980-01-01

    A patient is described with disabling palpebral edema. Primary hypothyroidism had been previously diagnosed and treated. Testing of thyroid function revealed persistence of the hypothyroidism. Treatment with L-thyroxine produced normalization of the biochemical parameters and resolution of palpebral edema. The search for hypothyrodism in patients with palpebral redundancy is emphasized.

  17. Hypothyroidism in Women.

    Science.gov (United States)

    Dunn, Donna; Turner, Carla

    2016-01-01

    Hypothyroidism, a disease in which the thyroid gland does not make enough thyroid hormone, is the second most common endocrine disorder among women. Symptoms of hypothyroidism include fatigue, weight gain, alteration in cognition, infertility, and menstrual abnormalities. The most common cause of hypothyroidism in the United States is Hashimoto's thyroiditis. The American Thyroid Association recommends an initial screening for thyroid disease at age 35years and every 5years thereafter. Thyroid-stimulating hormone is highly sensitive to thyroid dysfunction and is used to evaluate thyroid disorders. Monotherapy with levothyroxine is the standard for treating hypothyroidism. Diagnosing hypothyroidism requires appropriate diagnostic tests to facilitate prompt diagnosis and treatment. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  18. Hypothyroidism: etiology, diagnosis, and management.

    Science.gov (United States)

    Almandoz, Jaime P; Gharib, Hossein

    2012-03-01

    Hypothyroidism is the result of inadequate production of thyroid hormone or inadequate action of thyroid hormone in target tissues. Primary hypothyroidism is the principal manifestation of hypothyroidism, but other causes include central deficiency of thyrotropin-releasing hormone or thyroid-stimulating hormone (TSH), or consumptive hypothyroidism from excessive inactivation of thyroid hormone. Subclinical hypothyroidism is present when there is elevated TSH but a normal free thyroxine level. Treatment involves oral administration of exogenous synthetic thyroid hormone. This review presents an update on the etiology and types of hypothyroidism, including subclinical disease; drugs and thyroid function; and diagnosis and treatment of hypothyroidism. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Clinical research and long-term follow-up of early hypothyroidism after 131I treatment for hyperthyroidism

    International Nuclear Information System (INIS)

    Liu Jianfeng; Zhang Youren; Xing Jialiu; Ye Genyao

    2004-01-01

    Objective: To evaluate the clinical research and long-term follow-up results of early hypothyroidism after 131 I treatment for hyperthyroidism. Methods: One hundred and forty-five patients with hyperthyroidism who developed hypothyroidism within 12 months after 131 I therapy were evaluated by clinical symptoms and plasma T 3 , T 4 , thyroid-stimulating hormone (TSH). One year after treatment, 121 of 145 patients were divided into two groups according to the occurrence of hypothyroidism. Results: 1) Group 1: transient hypothyroidism (n=33), 64%(21/33) of the patients developed euthyroidism and 36%(12/33) patients had recurrent hyperthyroidism within 1 year after being diagnosed with hypothyroidism after 131 I treatment. The long-term follow-up showed 2 patients were with euthyroidism and 2 patients who were previously with hyperthyroidism developed permanent hypothyroidism after 3 months ∼6 years. Three patients who were previously with hyperthyroidism developed euthyroidism after 3 months ∼5 years. Group 2: permanent hypothyroidism (n=88), 82.95% (73/88) patients of group 2 were treated with low-dose 131 I, 86.36% (76/88) cases of this group were found with clinical hypothyroidism. Conclusions: 72.73% (88/121) patients of early hypothyroidism after 131 I therapy developed permanent hypothyroidism. The incidence of permanent hypothyroidism in the patients treated with low-dose 131 I was higher. Recovery of transient hypothyroidism after 131 I therapy did not predict future thyroid function. (authors)

  20. Rhabdomyolysis case based on hypothyroidism

    OpenAIRE

    Bilal Katipoglu; Ihsan Ates; Fatih Acehan; Ayşenur Meteris; Nisbet Yılmaz

    2016-01-01

    Summary Hypothyroidism is a wide clinical spectrum disorder and only a few cases in literature show this. Rhabdomyolysis and acute renal impairment can be seen concurrently in a hypothyroid state. We report a case of severe hypothyroidism with poor drug compliance leading to rhabdomyolysis and acute kidney injury. Learning points: Hypothyroidism is a rare cause of acute kidney injury. In this case report, we studied a rare occurrence of acute renal impairment due to hypothyroidism with poor d...

  1. Hypothyroidism simulating as polymyositis.

    Science.gov (United States)

    Aslam, Hina; Sayeed, Mohammad Ahsan; Qadeer, Rashid; Afsar, Salahuddin

    2015-05-01

    Polymyositis-like syndrome in hypothyroidism is a rare condition characterised by proximal muscle weakness and elevated muscle enzymes. Patients with this condition can initially be misdiagnosed as having polymyositis due to similar characteristics of both diseases; however a response to thyroxine is the main differentiating feature. This report highlights the case of a 30-year-old male who had severe myalgia and proximal muscle weakness. In addition to raised creatinine phosphokinase (CPK) levels, his biochemical profile showed hypothyroidism. Initially thought to be suffering from polymyositis, improvement in both clinical and biochemical profile with thyroxine led to the diagnosis of polymyositis-like syndrome associated with hypothyroidism.

  2. Thyroid function testing in neonates born to women with hypothyroidism.

    Science.gov (United States)

    McGovern, Matthew; Reyani, Zahra; O'Connor, Pamela; White, Martin; Miletin, Jan

    2016-12-01

    Our aim was to assess the utility of serum thyroxine and thyroid stimulating hormone performed at 10-14 days of life in diagnosing congenital hypothyroidism (CH) in babies born to mothers with hypothyroidism. This was a retrospective study of all babies born in a tertiary referral centre for neonatology over a 12-month period. Infants who had thyroid function testing (TFT) checked at 10-14 days of life because of maternal hypothyroidism during the period of study were included. The results of the newborn bloodspot and day 10-14 TFT were recorded along with whether or not patients were subsequently treated. Of the 319 patients included in the study, only two patients were found to have CH and in both cases the newborn blood spot had been abnormal. No extra cases of CH were detected from the thyroid test at 10-14 days and this practice should be discontinued due to the robust nature of existing newborn screening programmes. What is Known: • Congenital hypothyroidism(CH) is the commonest preventable cause of childhood intellectual impairment. • Family history of hypothyroidism has been implicated as a risk factor for CH. • CH has formed part of newborn screening since the 1970s. What is New: • There is no research recommending thyroid function testing at 10-14 days of life to detect CH in neonates born to mothers with hypothyroidism. • Thyroid function testing at 10-14 days of life does not improve diagnostic yield for CH in babies born to mothers with hypothyroidism. • Newborn blood spot remains the mainstay for accurate and timely diagnosis of CH.

  3. The heart and hypothyroidism

    African Journals Online (AJOL)

    1983-04-09

    Apr 9, 1983 ... influenced by the thyroid disorder and vice versa. We recenrly ... hypothyroidism is a rare cause of heart failure other causes of heart failure must be excluded ... signs of cardiac tamponade and echocardiographic features of a.

  4. Macular amyloidosis and hypothyroidism

    Directory of Open Access Journals (Sweden)

    Chopra Adarsh

    1999-01-01

    Full Text Available A 53 year old woman presented with extensive pruritic hyperpigmented macules in interscapular area and extremities of four years duration.She was an established case of hypothyroidism on treatment for last four years.

  5. Association of Van Wyk Grumbach and Debre Semelaigne Syndromes with Severe Hypothyroidism.

    Science.gov (United States)

    Oden Akman, Alkim; Tayfun, Meltem; Demirel, Fatma; Ucakturk, Seyit Ahmed; Gungor, Ali

    2015-12-01

    Van Wyk Grumbach syndrome (VWGS) and Kocher-Debre Semelaigne syndrome (KDSS) are rare forms of pseudo-precocious puberty and myopathy in patients with longstanding untreated hypothyroidism. We present the case of an adolescent girl who developed pseudo-precocious puberty and myopathy caused by long-term untreated hypothyroidism. A 17-year-old female patient was referred to our outpatient clinic due to menstrual irregularities. She had muscle pain and multiple cystic ovaries in addition to clinical signs of severe congenital hypothyroidism. High levels of creatinine and creatinine kinase and accompanying muscle hypertrophy were present. After the initiation of L-thyroxine therapy, the symptoms were alleviated in a short time. Congenital and acquired hypothyroidism should be considered in the differential diagnosis of pseudo-precocious puberty and myopathy that presents with muscle pain, muscle hypertrophy, and elevated creatinine kinase levels. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  6. Skeletal manifestations of juvenile hypothyroidism and the impact of treatment on skeletal system

    Directory of Open Access Journals (Sweden)

    Manish Gutch

    2013-01-01

    Full Text Available Thyroid hormone mediates growth and development of the skeleton through its direct effects and through its permissive effects on growth hormone. The effect of hypothyroidism on bone is well described in congenital hypothyroidism, but the impact of thyroid hormone deficiency on a growing skeleton, as it happens with juvenile hypothyroidism, is less defined. In addition, the extent to which the skeletal defects of juvenile hypothyroidism revert on the replacement of thyroid hormone is not known. A study was undertaken in 29 juvenile autoimmune hypothyroid patients to study the skeletal manifestations of juvenile hypothyroidism and the impact of treatment of hypothyroidism on the skeletal system of juvenile patients. Hypothyroidism has a profound impact on the skeletal system and delayed bone age, dwarfism, and thickened bands at the metaphyseal ends being the most common findings. Post treatment, skeletal findings like delayed bone age and dwarfism improved significantly, but there were no significant changes in enlargement of sella, presence of wormian bones, epihyseal dysgenesis, vertebral changes and thickened band at the metaphyseal ends. With the treatment of hypothyroidism, there is an exuberant advancement of bone age, the catch up of bone age being approximately double of the chronological age advancement.

  7. Skeletal manifestations of juvenile hypothyroidism and the impact of treatment on skeletal system.

    Science.gov (United States)

    Gutch, Manish; Philip, Rajeev; Philip, Renjit; Toms, Ajit; Saran, Sanjay; Gupta, K K

    2013-10-01

    Thyroid hormone mediates growth and development of the skeleton through its direct effects and through its permissive effects on growth hormone. The effect of hypothyroidism on bone is well described in congenital hypothyroidism, but the impact of thyroid hormone deficiency on a growing skeleton, as it happens with juvenile hypothyroidism, is less defined. In addition, the extent to which the skeletal defects of juvenile hypothyroidism revert on the replacement of thyroid hormone is not known. A study was undertaken in 29 juvenile autoimmune hypothyroid patients to study the skeletal manifestations of juvenile hypothyroidism and the impact of treatment of hypothyroidism on the skeletal system of juvenile patients. Hypothyroidism has a profound impact on the skeletal system and delayed bone age, dwarfism, and thickened bands at the metaphyseal ends being the most common findings. Post treatment, skeletal findings like delayed bone age and dwarfism improved significantly, but there were no significant changes in enlargement of sella, presence of wormian bones, epihyseal dysgenesis, vertebral changes and thickened band at the metaphyseal ends. With the treatment of hypothyroidism, there is an exuberant advancement of bone age, the catch up of bone age being approximately double of the chronological age advancement.

  8. Renal Function in Hypothyroidism

    International Nuclear Information System (INIS)

    Khalid, S.; Khalid, M; Elfaki, M.; Hassan, N.; Suliman, S.M.

    2007-01-01

    Background Hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatremia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective Renal function is profoundly influenced by thyroid status; the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and Patients In 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate (GFR) using modified in diet renal disease (MDRD) formula. Result In hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR Increased. The hypothyroid patients showed elevated serum creatinine levels (> 1.1mg/dl) compared to control group (p value .000). In patients mean estimated GFR decreased, compared to mean estimated GFR increased in the control group (p value= .002).

  9. Renal Function in Hypothyroidism

    International Nuclear Information System (INIS)

    Khalid, A. S; Ahmed, M.I; Elfaki, H.M; Hassan, N.; Suliman, S. M.

    2006-12-01

    Background hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatraemia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective renal function is profoundly influenced by thyroid status, the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and patients in 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate(GFR) using modified in diet renal disease (MDRD) formula. Result in hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR increased. The hypothyroid patients showed elevated serum creatinine levels(>1.1 mg/d1) compared to control group (p value= 000). In patients mean estimated GFR increased in the control group (p value=.002).Conclusion thus the kidney, in addition to the brain, heart and muscle, is an important target of the action of thyroid hormones.(Author)

  10. Vegan diets and hypothyroidism.

    Science.gov (United States)

    Tonstad, Serena; Nathan, Edward; Oda, Keiji; Fraser, Gary

    2013-11-20

    Diets eliminating animal products have rarely been associated with hypothyroidism but may protect against autoimmune disease. Thus, we investigated whether risk of hypothyroidism was associated with vegetarian compared to omnivorous dietary patterns. The Adventist Health Study-2 was conducted among church members in North America who provided data in a self-administered questionnaire. Hypothyroidism was queried at baseline in 2002 and at follow-up to 2008. Diet was examined as a determinant of prevalent (n = 4237 of 65,981 [6.4%]) and incident cases (1184 of 41,212 [2.9%]) in multivariate logistic regression models, controlled for demographics and salt use. In the prevalence study, in addition to demographic characterstics, overweight and obesity increased the odds (OR 1.32, 95% CI: 1.22-1.42 and 1.78, 95% CI: 1.64-1.93, respectively). Vegan versus omnivorous diets tended to be associated with reduced risk (OR 0.89, 95% CI: 0.78-1.01, not statistically significant) while a lacto-ovo diet was associated with increased risk (OR 1.09, 95% CI: 1.01-1.18). In the incidence study, female gender, white ethnicity, higher education and BMI were predictors of hypothyroidism. Following a vegan diet tended to be protective (OR 0.78, 95% CI: 0.59-1.03, not statistically significant). In conclusion, a vegan diet tended to be associated with lower, not higher, risk of hypothyroid disease.

  11. Lipid profile in hypothyroidism

    International Nuclear Information System (INIS)

    Ramalho, A.; Medeiros, F.; Campos, C.; Medeiros, N.; Kuklinsky-Sobral, J.; Araujo, E.

    1995-01-01

    The elevated levels of cholesterol (T-C), more specifically, the increase of carried cholesterol by low density protein (LDL-C), is the principal responsible to atheroma's plaque. This elevated levels had been associated with chronic renal disease, bile pathway obstruction and hypothyroidism; this pathology is an important and frequent cause of reversible hyperlipidaemia by hormonal treatment. In 50 hypothyroidism cases diagnosed by radioimmunoassay method, principally primary form, have been met elevated levels of TC (68%), triglyceride (14%), LDL-C (78%), HDL-C (66%) and coronary heart disease (CHD) risk, LDL-C/HDL-C (82%). These percentages showed that the low concentration of thyroid hormones conduct to high concentration of LDL-C, which represents the risk factor to CHD, despite the increase of HDL-C. Thereby, the hypothyroidism must be always searched in hyperlipemic patients without apparent cause. (author). 17 refs., 3 tabs

  12. A link between hypothyroidism, obesity and male reproduction.

    Science.gov (United States)

    Aiceles, Veronica; da Fonte Ramos, Cristiane

    2016-01-01

    Hypothyroidism is a condition in which the serum levels of thyroid hormones are below that necessary to carry out physiological functions in the body. Hypothyroidism is related to obesity as an increase in body weight gain is seen in hypothyroid patients. Moreover, an inverse correlation between free thyroxine values and body mass index has been reported. Leptin, a polypeptide hormone produced by adipocytes, was originally thought to be an antiobesity hormone due its anorexic effects on hypothalamic appetite regulation. However, nowadays it is known that leptin conveys information about the nutritional status to the brain being considered a crucial endocrine factor for regulating several physiological processes including reproduction. Since the identification of thyroid hormone and leptin receptors on the testes, these hormones are being recognized as having important roles in male reproductive functions. A clear link exists among thyroid hormones, leptin and reproduction. Both hormones can negatively affect spermatogenesis and consequently may cause male infertility. The World Health Organization (WHO) estimates the overall prevalence of primary infertility ranging from 8 to 15%. The fact that 30% of couples' inability to conceive is related to a male factor and that the longer hypothyroidism persisted, the greater the damage to the testes, strongly suggest that more studies attempting to clarify both hormones actions directly in the testes need to be conducted specially in cases of congenital hypothyroidism. Therefore, the goal of this review is to highlight the relationship of such hormones in the reproductive system.

  13. Hypothyroidism masquerading as polymyositis

    OpenAIRE

    Cabili, Shaltiel; Kaplinsky, Naomi; Pines, Amos; Frankl, Otto

    1982-01-01

    A group of patients is described who presented with proximal muscle weakness and elevated muscle enzymes. They were initially believed to have polymyositis and one of them was even treated as such over a long period of time. The patients were subsequently found to have hypothyroidism and responded well to thyroid hormone replacement.

  14. Vegan Diets and Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Serena Tonstad

    2013-11-01

    Full Text Available Diets eliminating animal products have rarely been associated with hypothyroidism but may protect against autoimmune disease. Thus, we investigated whether risk of hypothyroidism was associated with vegetarian compared to omnivorous dietary patterns. The Adventist Health Study-2 was conducted among church members in North America who provided data in a self-administered questionnaire. Hypothyroidism was queried at baseline in 2002 and at follow-up to 2008. Diet was examined as a determinant of prevalent (n = 4237 of 65,981 [6.4%] and incident cases (1184 of 41,212 [2.9%] in multivariate logistic regression models, controlled for demographics and salt use. In the prevalence study, in addition to demographic characterstics, overweight and obesity increased the odds (OR 1.32, 95% CI: 1.22–1.42 and 1.78, 95% CI: 1.64–1.93, respectively. Vegan versus omnivorous diets tended to be associated with reduced risk (OR 0.89, 95% CI: 0.78–1.01, not statistically significant while a lacto-ovo diet was associated with increased risk (OR 1.09, 95% CI: 1.01–1.18. In the incidence study, female gender, white ethnicity, higher education and BMI were predictors of hypothyroidism. Following a vegan diet tended to be protective (OR 0.78, 95% CI: 0.59–1.03, not statistically significant. In conclusion, a vegan diet tended to be associated with lower, not higher, risk of hypothyroid disease.

  15. Hypothyroidism following 131I therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    Kubo, Atsushi; Kondo, Makoto; Kinoshita, Fumio; Maekawa, Akira; Okamoto, Jiro.

    1977-01-01

    Of 890 patients who received 131 I therapy for hyperthyroidism, the results of therapy were examined on 584 who could be followed up. Of these 502 (86%), were sured including 3 patients who had been completely healed after recurrence, 9 patients are still under medical treatment, and 10 died. The incidence of hypothyroidism following 131 I therapy was 1.6% after 1 year, 2.3% after 2 years, 4.7% after 5 years, 15.0% after 10-12 years, 22.1% after 13-15 years and 27.5% after 16-20 years. The incidence increased constantly with the passage of time. Factors influencing the response to treatment have been investigated. As a consequence, the number of rads delivered to the thyroid gland, the gland size, and previous surgery correlated with the incidence of hypothyroidism. The number of doses of 131 I, uptake and half-life of 131 I in the thyroid, previous antithyroid medication, time between the onset of hyperthyroid symptoms and 131 I therapy, and the age or sex of the patients appeared unrelated. The times taken to become euthyroid following a single dose of 131 I were 5.6 months with 2000-4000 rads, 4.4 months with 4001-7000 rads, 4.2 months with 7001-10000 rads and 3.5 months with more than 10001 rads. The time was prolonged with decrease of rads delivered to the thyroid gland. It was found that the patients who passed through a transient hypothyroid phase in the period of three to four months after administration of 131 I had a high incidence of late permanent hypothyroidism. (Evans, J.)

  16. [Pregnancy (conception) in hyper- or hypothyroidism].

    Science.gov (United States)

    Corssmit, E P; Wiersinga, W M; Boer, K; Prummel, M F

    2001-04-14

    Pregnancy is accompanied by changes in thyroid function. Due to the increased synthesis of thyroid binding globulin and the thyroid-stimulating effect of human chorionic gonadotrophin (hCG), serum concentrations of thyroid hormones will increase in the first trimester of pregnancy (total T4, T3). Free T4 levels decrease during the latter half of pregnancy. Hyperthyroidism during pregnancy is usually due to Graves' disease. Definitive therapy may be considered for cases prior to pregnancy, although a medical management as would be given during pregnancy is an equally good option. The medical management of hyperthyroidism consists of a monotherapy with thyreostatics in which the recommended dose needs to be adjusted on the basis of free T4 in the high-normal and thyroid stimulating hormone (TSH) in the low-normal area so as to minimise the risk of foetal hypothyroidism. The transplacental passage of maternal TSH receptor stimulating antibodies may cause foetal hyperthyroidism. Another cause of maternal hyperthyroidism during pregnancy is 'gestational transient thyrotoxicosis', which is associated with high hCG levels during the first trimester of pregnancy. It is nearly always accompanied by hyperemesis gravidarum. Hypothyroidism in pregnancy has negative consequences for the foetus. If the hypothyroidism is apparent prior to pregnancy, it should be corrected before conception (target TSH value of 1 mU/l). If discovered during pregnancy, treatment with levothyroxine should be started as soon as possible. In the case of a pre-existing hypothyroidism a 25-50% increase in the levothyroxine dosage is often needed during the first trimester of pregnancy. This is possibly due to an increased requirement. An adequate serum concentration of T4 is necessary for foetal brain development.

  17. Hypothyroidism: Can It Cause Peripheral Neuropathy?

    Science.gov (United States)

    Hypothyroidism: Can it cause peripheral neuropathy? Can hypothyroidism cause peripheral neuropathy and, if so, how is it treated? Answers from Todd B. Nippoldt, M.D. Hypothyroidism — a condition in which your ...

  18. [Genetic aspects in congenital hypothyrodism].

    Science.gov (United States)

    Perone, Denise; Teixeira, Silvânia S; Clara, Sueli A; Santos, Daniela C dos; Nogueira, Célia R

    2004-02-01

    Congenital hypothyroidism (CH) affects between 1:3,000 and 1:4,000 newborns. Many genes are essential for normal development of the hypothalamus-pituitary-thyroid axis and hormone production, and are associated with CH. About 85% of primary hypothyroidism is called thyroid digenesis and evidence suggests that mutations in transcription factors (TTF2, TTF1, and PAX-8) and TSH receptor gene could be responsible for the disease. Genetic defects of hormone synthesis could be caused by mutations in the following genes: NIS (natrium-iodide symporter), pendrine, thyreoglobulin (TG), peroxidase (TPO). Recently, mutations in the THOX-2 gene have also been related to organification defects. Central hypothyroidism affects about 1:20,000 newborns and has been associated with mutations in pituitary transcriptional factors (POUIF1, PROP1, LHX3, and HESX1). The syndrome of resistance to thyroid hormone is rare, implies a hypothyroidism state for some tissues and is frequently associated with dominant autosomal mutations in the beta-receptor (TRss).

  19. Respiratory manifestations of hypothyroidism

    DEFF Research Database (Denmark)

    Sorensen, Jesper Roed; Winther, Kristian Hillert; Bonnema, Steen Joop

    2016-01-01

    BACKGROUND: Hypothyroidism has been associated with increased pulmonary morbidity and overall mortality. We conducted a systematic review to identify the prevalence and underlying mechanisms of respiratory problems among patients with thyroid insufficiency. METHODS: PubMed and EMBASE databases were...... searched for relevant literature from January 1950 through January 2015 with study eligibility criteria: English-language publications; Adult subclinical or overt hypothyroid patients; Intervention, observational or retrospective studies; and respiratory manifestations. We followed the PRISMA statement...... and used the Cochrane's risk of bias tool. RESULTS: A total of 1699 papers were screened by two independent authors for relevant titles. Of 109 relevant abstracts, 28 papers underwent full text analyses, of which 22 were included in the review. We identified possible mechanisms explaining respiratory...

  20. Subclinical hypothyroidism: Should we treat?

    Science.gov (United States)

    Redford, Christopher; Vaidya, Bijay

    2017-06-01

    Subclinical hypothyroidism (also known as compensated hypothyroidism or mild hypothyroidism) is a condition associated with a raised serum concentration of thyroid stimulating hormone (TSH) but a normal serum free thyroxine (FT4). It is common, affecting about 10% of women above the age of 55 years. Autoimmunity is the commonest cause of subclinical hypothyroidism. About 2.5% of patients with subclinical hypothyroidism progress to clinically overt hypothyroidism each year; the rate of progression is higher in patients with thyroid autoantibodies and higher thyroid stimulating hormone levels. However, thyroid function normalises spontaneously in up to 40% cases. Only a small minority of patients with subclinical hypothyroidism have symptoms, and the evidence to support that levothyroxine ameliorate the symptoms in these patients is weak. Subclinical hypothyroidism in younger patients (treatment can prevent these risks, although a large observational study of the UK general practice research database has shown that levothyroxine may reduce the risk of coronary heart disease in younger patients (hypothyroidism should be made after careful consideration of the patient's age, the presence of symptoms, the presence of thyroid antibodies and other risk factors such as cardiovascular disease.

  1. Implementation of a national detection plan of neonatal hypothyroidism. First year of experience from population sample

    International Nuclear Information System (INIS)

    Aznarez, A.; Balter, H.; Giambruno, G.

    1992-01-01

    The experience of the first year of development from a detection program of congenital hypothyroidism is presented. The radioimmunoassay of TSH from heel capillary blood, obtained before the discharge of new-born baby in two obstetrics assistance centers of Medicine Faculty is also studied. (C.G.C.)

  2. Influence of neonatal hypothyroidism on hepatic gene expression and lipid metabolism in adulthood

    DEFF Research Database (Denmark)

    Santana-Farré, Ruymán; Mirecki-Garrido, Mercedes; Bocos, Carlos

    2012-01-01

    Thyroid hormones are required for normal growth and development in mammals. Congenital-neonatal hypothyroidism (CH) has a profound impact on physiology, but its specific influence in liver is less understood. Here, we studied how CH influences the liver gene expression program in adulthood. Pregn...

  3. Molecular analysis of congenital goitres with hypothyroidism caused by defective thyroglobulin synthesis. Identification of a novel c.7006C>T [p.R2317X] mutation and expression of minigenes containing nonsense mutations in exon 7.

    Science.gov (United States)

    Machiavelli, Gloria A; Caputo, Mariela; Rivolta, Carina M; Olcese, María C; Gruñeiro-Papendieck, Laura; Chiesa, Ana; González-Sarmiento, Rogelio; Targovnik, Héctor M

    2010-01-01

    Thyroglobulin (TG) deficiency is an autosomal-recessive disorder that results in thyroid dyshormonogenesis. A number of distinct mutations have been identified as causing human hypothyroid goitre. The purpose of this study was to identify and characterize new mutations in the TG gene in an attempt to increase the understanding of the genetic mechanism responsible for this disorder. A total of six patients from four nonconsanguineous families with marked impairment of TG synthesis were studied. Single-strand conformation polymorphism (SSCP) analysis, sequencing of DNA, genotyping, expression of chimeric minigenes and bioinformatic analysis were performed. Four different inactivating TG mutations were identified: one novel mutation (c.7006C>T [p.R2317X]) and three previously reported (c.886C>T [p.R277X], c.6701C>A [p.A2215D] and c.6725G>A [p.R2223H]). Consequently, one patient carried a compound heterozygous for p.R2223H/p.R2317X mutations; two brothers showed a homozygous p.A2215D substitution and the remaining three patients, from two families with typical phenotype, had a single p.R277X mutated allele. We also showed functional evidences that premature stop codons inserted at different positions in exon 7, which disrupt exonic splicing enhancer (ESE) sequences, do not interfere with exon definition and processing. In this study, we have identified a novel nonsense mutation p.R2317X in the acetylcholinesterase homology domain of TG. We have also observed that nonsense mutations do not interfere with the pre-mRNA splicing of exon 7. The results are in accordance with previous observations confirming the genetic heterogeneity of TG defects.

  4. Hipotireoidismo congênito: perfil clínico dos recém-nascidos identificados pelo Programa de Triagem Neonatal de Minas Gerais Congenital hypothyroidism: the clinical profile of affected newborns identified by the Newborn Screening Program of the State of Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Isabela L. Pezzuti

    2009-02-01

    Full Text Available OBJETIVO: Avaliar o perfil clínico de recém-nascidos com hipotireoidismo congênito identificados pelo Programa Estadual de Triagem Neonatal de Minas Gerais entre 2000 e 2006. MÉTODOS: A frequência das manifestações clínicas de hipotireoidismo congênito foi analisada em relação aos níveis de hormônio estimulante da tireoide T4L (determinados por quimioluminescência, valores de referência de 0,3 a 5,0 µUI/mL e 0,8 a 1,8 ng/dL, respectivamente e idades ao diagnóstico e tratamento. Estudou-se 443 crianças, sendo 55,8% do sexo feminino e 95% delas com menos 60 dias de vida. RESULTADOS: Os sinais clínicos mais prevalentes foram: hérnia umbilical (51%, fontanela anterior ampla (50,3% e fontanela posterior aberta (47,2%. Hipotonia, macroglossia e sucção débil foram os sinais mais associados com a gravidade bioquímica da doença. Em 32,1% das crianças houve atraso na idade óssea ao diagnóstico. As medianas de TSH e T4L séricos foram 120 µUI/mL e 0,62 ng/dL, respectivamente. A mediana da idade de início de tratamento foi de 28 dias. CONCLUSÃO: Existem sinais clínicos precoces que sugerem o diagnóstico de hipotireoidismo congênito. Portanto, diante de uma criança com esses sinais, devem ser avaliados TSH e T4L séricos para confirmar ou excluir a doença, independentemente do resultado do teste de triagem. A idade de início de tratamento ainda foi elevada, mas o programa vem adotando estratégias para redução da mesma.OBJECTIVE: To evaluate the clinical profile of newborns with congenital hypothyroidism identified by the Newborn Screening Program of the State of Minas Gerais, Brazil, between 2000 and 2006. METHODS: Analysis of factors involved in this profile, including: TSH and FT4 levels (determined by chemiluminescence, with limits of normality set at 0.3-5.0 µUI/mL and 0.8-1.8 ng/dL, respectively, age at diagnosis and age at treatment. The study sample consisted of 443 children, 55.8% were female and 95% were seen

  5. Fine motor skills and expressive language: a study with children with congenital hypotyreoidism.

    Science.gov (United States)

    Frezzato, Renata Camargo; Santos, Denise Castilho Cabrera; Goto, Maura Mikie Fukujima; Ouro, Michelle Prado Cabral do; Santos, Carolina Taddeo Mendes Dos; Dutra, Vivian; Lima, Maria Cecília Marconi Pinheiro

    2017-03-09

    To screen the global development of children with and without congenital hypothyroidism and to investigate the association between fine motor skills and expressive language development in both groups. This is a prospective study of a cohort of children diagnosed with Congenital Hypothyroidism and monitored in a reference service for congenital hypothyroidism of a public hospital and of children without this disorder. The screening was performed using the Bayley Scales of Infant Development III in the cognitive, gross and fine motor skills, and receptive and expressive language domains. The children's performance was expressed in three categories: competent, and non-competent. We screened 117 children with average age of 21 months diagnosed with Congenital Hypothyroidism at birth, with the Thyroid Stimulating Hormone (TSH) level normalized during screening, and 51 children without the condition. The children with Congenital Hypothyroidism presented lower performance in gross and fine motor skills upon comparison between the two groups, and no differences were found in the cognitive and receptive and expressive language domains. The association between fine motor skills and language persisted in the group with Hypothyroidism, demonstrating that the interrelationship of skills is present in all individuals, although this group is two times more likely to present expressive language impairment when fine motor skills are already compromised. In the development process, both skills - motor and expressive language - might be associated and/or dependent on each other in the sample assessed.

  6. Electromyographic Findings in Overt Hypothyroidism and Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Emel Oğuz Akarsu

    2013-12-01

    Full Text Available OBJECTIVE: Hypothyroidism may cause neurologic signs and symptoms as its effects neuromuscular system like many other systems. Subclinical hypothyroidism is the most common thyroid dysfuntion, it may cause neuromuscular signs and symptoms. In this retrospective study, it is aimed to compare neuromuscular symptoms and electromyographic (EMG manifestations between hypothyroid patients and control group with normal thyroid function and without a disease causing polyneuropathy. METHODS: 31 overt hypothyroidic, 139 subclinic hypothyroidic patients and 50 individuals with normal thyroid function, without a disease causing polyneuropathy, as control group whom made EMG for another reason were included to the study. Neuromuscular symptoms, neurological examination and electrophysiological findings was obtained from the patient records. RESULTS: In our study, we observed frequent neuromuscular complaints such as fatigue, morning stiffness, cramp, general pain and paresthesia in favor of both for overt and subclinic hypothyroidism. Carpal Tunnel Syndrom(CTS, was statistically higher in overt hypothyroidism group than control group. CTS was also observed higher in subclinic hypothyroidism group when compared with control group but it didn't reach to statistical significance. We did not detect polyneuropathy in any group. Motor nerve velocity and compound muscle action potential amplitudes were found to be statistically significant difference between hypothyroid ve control group. CONCLUSION: Since motor fibres' and neuromuscular area's being affected in hypothyroidism, which we interpret to happen due to basal metabolism's slowing down, can show a significant recovery after thyroid replacement therapy. We consider that, in further studies, comparison of electrophysiological findings after treatment with the findings of pre -treatment is necessary

  7. Hypertrichosis due to primary hypothyroidism.

    OpenAIRE

    Stern, S R; Kelnar, C J

    1985-01-01

    A 10 year old girl with hypertrichosis associated with primary hypothyroidism that resolved after 6 months' replacement treatment with thyroxine is reported. It is important to consider the diagnosis of hypothyroidism in children with abnormal hairiness or distribution of body hair.

  8. Overview of Hypothyroidism in Pregnancy.

    Science.gov (United States)

    Kroopnick, Jeffrey M; Kim, Caroline S

    2016-11-01

    Overt hypothyroidism in pregnancy, defined as an elevated serum thyroid-stimulating hormone (TSH) and reduced serum free thyroxine or a TSH >10 mIU/L, is known to have adverse effects on pregnancy. Subclinical hypothyroidism is typically defined as an elevated TSH and normal FT4 levels. There remains much controversy on the benefit of starting levothyroxine for mothers diagnosed with subclinical hypothyroidism. Recent studies are redefining the normal range for TSH in pregnancy, and the data on whether treatment of subclinical hypothyroidism improves outcomes for the mother and fetus are unclear. One confounding variable is the presence of thyroid peroxidase antibodies, as it may be a surrogate marker for other autoimmune disorders detrimental to pregnancy. If levothyroxine treatment is initiated, the dosing and monitoring strategy is different from nonpregnant individuals. Randomized clinical trials are underway that may better elucidate whether treatment of subclinical hypothyroidism is warranted. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Diural TSH variations in hypothyroidism.

    Science.gov (United States)

    Weeke, J; Laurberg, P

    1976-07-01

    There is a circadian variation in serum TSH in euthyroid subjects. A similar diurnal variation has been demonstrated in patients with hypothyroidism. In the present study the 24-hour pattern of serum TSH was investigated in eight patients with hypothyroidism of varying severity and in five hypothyroid patients treated with thyroxine (T4). There was a circadian variation in serum TSH in patients with hypothyroidism of moderate degree, and in patients treated for severe hypothyrodism with thyroxine. The pattern was similar to that found in normal subjects, i.e., low TSH levels in the daytime and higher levels at night. In severely hypothyroid patients, no diurnal variation in serum TSH was observed. A practical consequence is that blood samples for TSH measurements in patients with moderately elevated TSH levels are best taken after 1100 h, when the low day levels are reached.

  10. Subclinical hypothyroidism in childhood.

    LENUS (Irish Health Repository)

    O'Grady, M J

    2012-02-01

    Subclinical hypothyroidism (SH) is defined as an elevated thyroid stimulating hormone (TSH) in association with a normal total or free thyroxine (T4) or triiodothyronine (T3). It is frequently encountered in both neonatology and general paediatric practice; however, its clinical significance is widely debated. Currently there is no broad consensus on the investigation and treatment of these patients; specifically who to treat and what cut-off level of TSH should be used. This paper reviews the available evidence regarding investigation, treatments and outcomes reported for childhood SH.

  11. Congenital Leukemia in Down's syndrome

    International Nuclear Information System (INIS)

    Iqbal, W.; Khan, F.; Muzaffar, M.; Khan, U. A.; Rehman, M. U.; Khan, M. A.; Bari, A.

    2006-01-01

    Congenital Leukemia is a condition and often associated with fatal outcome/sup 1/. Most of the neonatal cases reported have acute non-lymphoblastic leukemia, in contrast to the predominance of acute lymphoblastic leukemia found in later childhood. congenital leukemia is occasionally associated with number of congenital anomalies and with chromosomal disorders such as Down's syndrome. Subtle cytogenetic abnormalities may occur more commonly in the affected infants and their parents, when studied with newer cytogenetic techniques/sup 2/. Inherent unstable hematopoieses resulting from chromosomal aberration in children with Downs's syndrome can present with transient myeloproliferative disorder, mimicking leukemia which undergoes spontaneous recovery/sup 3/. Only few cases of congenital leukemia with Downs syndrome, presented as congenital leukemia. (author)

  12. Very early onset of autoimmune thyroiditis in a toddler with severe hypothyroidism presentation: a case report.

    Science.gov (United States)

    Marzuillo, Pierluigi; Grandone, Anna; Perrotta, Silverio; Ruggiero, Laura; Capristo, Carlo; Luongo, Caterina; Miraglia Del Giudice, Emanuele; Perrone, Laura

    2016-06-18

    In infants under 3 years of age acquired primary hypothyroidism caused by autoimmune thyroiditis is very rare. Hypothyroidism can manifest with different signs and symptoms and has a wide range of presentations from subclinical hypothyroidism to overt form. We describe a child with acquired autoimmune thyroiditis during a very early period of life and with a severe hypothyroidism presentation. A 22-month-old white male patient with normal neonatal screening presented with a six-month history of asthenia and cutaneous pallor. At general clinical and biochemical exams he showed weight gain, statural growth deceleration, poor movements, sleepy expression, instability while walking, myxoedema, bradycardia, open anterior fontanelle, changes in the face habitus, macrocytic anaemia, ascites, and high CPK, creatinine and cholesterol levels. Acquired autoimmune thyroiditis was the final diagnosis. The thyroxine replacement therapy normalized all the clinical and biochemical abnormalities but at the age of 30 months his mental age showed a delay of 6 months. Our case could give useful learning points: i) although the screening for congenital hypothyroidism is routinely performed, a severe hypothyroidism (for example due to autoimmune thyroiditis) can anyway occur early in life and the clinicians should consider this possibility; ii) hypothyroidism can have a misleading and multi-face clinical presentation; iii) anemia, rhabdomyolysis and high creatinine levels should always include the hypothyroidism in the differential diagnosis; iv) thyroxine replacement therapy is able to revert all the clinical manifestations related to the hypothyroidism; v) evaluating the patient's previous pictures could play an important role in resolving a diagnostic conundrum.

  13. INCIDENCE OF OVARIAN CYST IN HYPOTHYROIDISM: AN INSTITUTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Ramesan C

    2016-09-01

    Full Text Available BACKGROUND Primary hypothyroidism is the decrease in production and secretion of thyroid hormones by the thyroid gland. This is characterised by slackening of metabolism and leading to multiple system impairment. The important aetiological factors for primary hypothyroidism are congenital, iodine deficiency, autoimmune thyroiditis and iatrogenic.[1] Ovarian cysts are a common cause for gynaecological surgeries. The aetiology[2] of ovarian cysts can vary greatly including benign or malignant tumours, endometriosis and inflammation, etc. However, some cysts are direct result of endocrine disorders and do not require surgery. Hypothyroidism may cause reproductive and endocrinological disorders as well. The aetiopathogenesis is complex. In 1960 Van Wyk and Grumbach first described the relation between ovarian cyst and hypothyroidism. They proposed that there was a hormonal overlap in the pituitary feedback mechanism. It is due to the fact that TSH, GH, FSH and LH are all glycoproteins with a common alpha chain and may thus cross react. High TSH could produce FSH and LH like activity leading to luteinised ovarian cyst. The TRH may also act on pituitary cells to stimulate gonadotropin release and hence FSH and LH. Other postulated mechanisms are increased ovarian sensitivity to gonadotropins, altered metabolism of oestrogen, hypothalamopituitary dysfunction and altered prolactin metabolism. AIMS To study the percentage of ovarian cyst among the diagnosed cases of primary hypothyroidism and then to find out the association between hypothyroidism and ovarian cyst. To study the relation between level of TSH and size of ovarian cyst. To study the percentage of ovarian cyst among patients with TSH 100 mIU/L separately. SETTINGS Study Design: Descriptive: Cross-sectional study. Duration: One year. Period: March 2013 to February 2014. Sample Size: 100. Study Area: Government Medical College, Calicut. INCLUSION CRITERIA Female patients of age more than 12

  14. Correlation of Hypothyroidism and Obesity

    Directory of Open Access Journals (Sweden)

    Т.Y. Yuzvenko

    2016-11-01

    Full Text Available Obesity and hypothyroidism are common diseases, and consequently clinicians should be particularly alert for the possible thyroid dysfunction in obese patients. The relationship between thyroid function and obesity is likely to be bidirectional, with hypothyroidism affecting weight, but obesity also influencing thyroid function. Both serum thyroid-stimulating hormone and fT3 are typically increased in obese individuals, likely mediated by leptin. Following LT4 treatment for overt hypothyroidism, weight loss appears due to water weight rather than fat. Selected thyroid analogs might be a means to improve weight loss by increasing energy expenditure in obese patients during lasting hypocaloric diet.

  15. Neonatal screening for treatable congenital disorders

    International Nuclear Information System (INIS)

    Charoensiriwatana, W.; Janejai, N.; Boonwanich, W.; Krasao, P.; Waiyasilp, S.

    2001-01-01

    Congenital hypothyroidism is a treatable disease if detected at the early stage of life. It is one of the most frequent cause of mental retardation in children. In 85 % of cases, congenital hypothyroidism is a consequence of thyroid disgenesis, in which the gland is either absent, located ectopically and/or severely reduced in size. Early detection and treatment with thyroid hormone supplement can significantly reduce mental damage. In 1996, Thailand initiated a neonatal screening programme for congenital hypothyroidism (CHT) and phenylketonuria (PKU), with the objective of bringing a better quality of life to people throughout the country, but especially in the remote areas. The programme involves implementing routine screening nationwide. The plan of action was designed with the goal of having public health service units throughout the country provide neonatal screening by year 2002 for the 1.2 million babies born per annum in Thailand. The government supported the programme by allocating a five-year budget of approximately US$15 million. The programme received additional assistance through technical support and human resource development from the International Atomic Energy Agency (IAEA) and the US Centers for Disease Control. This assistance promoted self-sustainability and strengthened the programme's technical base. The programme is on track. It is expected that by year 2002 all new born babies in Thailand will be screened for CHT and PKU

  16. Newborn screening for classic galactosemia and primary congenital ...

    African Journals Online (AJOL)

    Objectives. The main objective of this work was to establish the incidence of classic galactosaemia and primary congenital hypothyroidism in newborns in the Nkangala district of Mpumalanga. In the process a cost-effective protocol for neonatal screening of both diseases was developed. Study design and setting.

  17. Primary goitrous hypothyroidism in a young adult domestic longhair cat: diagnosis and treatment monitoring

    Directory of Open Access Journals (Sweden)

    Mark E Peterson

    2015-11-01

    Full Text Available Case summary Primary goitrous hypothyroidism was diagnosed in a 12-month-old cat examined because of small stature, mental dullness, severe lethargy, generalized weakness and gait abnormalities. Radiographs of the long bones and spine revealed delayed epiphyseal ossification and epiphyseal dysgenesis. Diagnosis of primary hypothyroidism was confirmed by low serum concentrations of total and free thyroxine (T4 with high thyroid-stimulating hormone (TSH concentrations. Thyroid scintigraphy revealed severe enlargement of both thyroid lobes, as evidenced by a seven-fold increase in calculated thyroid volume above the reference interval. In addition, this bilateral goiter had an extremely high radionuclide uptake, about 10-fold higher than the normal feline thyroid gland. Treatment with twice-daily levothyroxine (L-T4, administered on an empty stomach, resulted in increased alertness, playfulness, strength and improvement in gait, as well as an increase in body length and weight. L-T4 replacement also led to normalization of serum thyroid hormone and TSH concentrations, and complete resolution of goiter. Relevance and novel information Spontaneous hypothyroidism is rarely reported in cats, with congenital hypothyroidism in kittens diagnosed most frequently. Despite the fact that this cat was a young adult, it likely had a form of congenital hypothyroidism caused by dyshormonogenesis (defect in thyroid hormone synthesis that led to compensatory development of goiter. In hypothyroid cats, treatment with L-T4 is best given twice daily on an empty stomach to ensure adequate absorption. Normalization of serum TSH and shrinkage of goiter, as well as improvement in clinical signs, is the goal of treatment for cats with goitrous hypothyroidism.

  18. Hypothyroidism in metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Kota

    2012-01-01

    Full Text Available Aim: Metabolic syndrome (MetS and hypothyroidism are well established forerunners of atherogenic cardiovascular disease. Considerable overlap occurs in the pathogenic mechanisms of atherosclerotic cardiovascular disease by metabolic syndrome and hypothyroidism. Insulin resistance has been studied as the basic pathogenic mechanism in metabolic syndrome. [1] This cross sectional study intended to assess thyroid function in patients with metabolic syndrome and to investigate the association between hypothyroidism and metabolic syndrome. Materials and Methods: One hundred patients with metabolic syndrome who fulfilled the National Cholesterol Education Program- Adult Treatment Panel (NCEP-ATP III criteria [ 3 out of 5 criteria positive namely blood pressure ≥ 130/85 mm hg or on antihypertensive medications, fasting plasma glucose > 100 mg/dl or on anti-diabetic medications, fasting triglycerides > 150 mg/dl, high density lipoprotein cholesterol (HDL-C 102 cms in men and 88 cms in women] were included in the study group. [2] Fifty patients who had no features of metabolic syndrome (0 out of 5 criteria for metabolic syndrome were included in the control group. Patients with liver disorders, renal disorders, congestive cardiac failure, pregnant women, patients on oral contraceptive pills, statins and other medications that alter thyroid functions and lipid levels and those who are under treatment for any thyroid related disorder were excluded from the study. Acutely ill patients were excluded taking into account sick euthyroid syndrome. Patients were subjected to anthropometry, evaluation of vital parameters, lipid and thyroid profile along with other routine laboratory parameters. Students t-test, Chi square test and linear regression, multiple logistic regression models were used for statistical analysis. P value < 0.05 was considered significant. Results: Of the 100 patients in study group, 55 were females (55% and 45 were males (45%. Of the 50

  19. The role of scintigraphy and ultrasound in the imaging of neonatal hypothyroidism: 5-year retrospective review of single-centre experience

    International Nuclear Information System (INIS)

    De Silva, Ami; Jong, Ian; McLean, Glenda; Nandurkar, Dee; Bergman, Philip; Brown, Justin; Rodda, Christina

    2014-01-01

    Congenital hypothyroidism (CH), as indicated by an elevation of capillary thyroid-stimulating hormone (TSH) at newborn screening, is a preventable cause of mental retardation with varying aetiology; it can be transient or permanent. Radionuclide assessment is currently the gold standard for imaging CH. This study aimed to (i) review the different scintigraphic patterns and correlate them with TSH levels/patient outcomes, (ii) assess the role of sonography in neonates with apparent agenesis as indicated by scintigraphy and (iii) develop a diagnostic investigative algorithm. The technetium thyroid scans of 83 consecutive patients (49 females, average age 32 days) with CH scanned between 2005 and 2009 were retrospectively reviewed. Two nuclear medicine physicians blinded to the clinical details interpreted the scans in consensus. Scintigram appearances were categorised into five groups. Patients scintigraphically diagnosed with thyroid agenesis were evaluated with ultrasound. TSH values and scintigraphic and sonographic findings were correlated with patients' final diagnosis. Based on scintigraphy, 14, 13 and 19 patients out of 83 were assessed as having normal thyroid sites with normal, increased and decreased uptake, respectively. Twenty-two of 83 patients had no uptake, and 15 of 83 patients had ectopic uptake. Higher median TSH levels were seen in no-uptake and ectopic uptake subgroups. Eighteen of 22 patients with no uptake were evaluated with ultrasound. Three of the 18 patients had a normal thyroid gland, and three of 18 patients had a hypoplastic thyroid. Scintigram findings in patients with congenital hypothyroidism fall into five major categories, which have therapeutic implications (lifelong thyroxine in agenesis versus trial of stopping thyroxine in other subgroups). Sonographic demonstration of thyroid tissue in patients scintigraphically diagnosed with thyroid agenesis has major management implications.

  20. A Clinical Study on Hypothyroidism

    International Nuclear Information System (INIS)

    Park, Keun Jo; Park, Sun Yang; Park, Jung Sik; Lee, Myung Chul; Koh, Chang Soon; Lee, Mun Ho

    1976-01-01

    A clinical study was made on 263 patients of hypothyroidism among the 5,970 patients of Various thyroid diseases diagnosed and treated at the Radioisotope Clinic and Laboratory, Seoul National University Hospital from May, 1960 to Aug, 1975. The results obtained with this study are as follows: 1) The etiological classification of hypothyroidism revealed 244 cases (93%) of primary hypothyroidism and 19 cases (7%) of secondary hypothyroidism. 2) The most frequent cause of the thyroprivic primary hypothyroidism was post radioiodine therapy with 109 cases (41.4%). 3) There were 37 cases (14%) of male and 226 cases (86%) of female, showing a ratio of 1 : 6. 4) The majority of patients were between the ages of 30 and 60 with the peak incidence (87 cases, 33%) in their fourth decades of lives. 5) The major symptoms and signs were weakness (97%), edema of face and extremities (92%); Decreased Achilles tendon reflex (87%), cold intolerance (82%), gain in weight (76%), constipation (58%) and cold skin (51%). 6) The cumulative incidence of hypothyroidism in patient treated with 131 I (3-8 mci) was 7.2% at first year, 33.3% at tenth year and the 50% at fourteenth year and the annual increment was 2.9%. 7) The incidence of hypothyroidism related to the numbers of 131 I therapy was not linear. 8) The diagnostic compatibilities of the various tests to hypothyroidism were TSH (100%), T 4 (93.8%), 24-hour-RNIU (91.5%), ATR (86.7%), T 3 RU (66.1%) and BMR (64.9%).

  1. Primary hypothyroidism masquerading pituitary macroadenoma

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2014-03-01

    Full Text Available Diffuse and reactive pituitary gland enlargement secondary to primary hypothyroidism is an uncommon occurrence and that can masquerade many pituitary disorders. In present article, we report a case of 19 year female severe hypothyroidism presenting with diffuse enlargement of pituitary gland and hyperprolactinemia and review the clinical importance of this entity. Knowledge of this entity is very important to avoid unnecessary surgery and irreversible complications in this sub-group of patients.

  2. Primary hypothyroidism masquerading pituitary macroadenoma

    OpenAIRE

    Agrawal Amit; Reddy Amareesh P.; Malleswara Rao G.; Reddy V. Umamaheswara

    2014-01-01

    Diffuse and reactive pituitary gland enlargement secondary to primary hypothyroidism is an uncommon occurrence and that can masquerade many pituitary disorders. In present article, we report a case of 19 year female severe hypothyroidism presenting with diffuse enlargement of pituitary gland and hyperprolactinemia and review the clinical importance of this entity. Knowledge of this entity is very important to avoid unnecessary surgery and irreversible complications in this sub-group of patients.

  3. A Clinical Study on Hypothyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Park, Keun Jo; Park, Sun Yang; Park, Jung Sik; Lee, Myung Chul; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1976-03-15

    A clinical study was made on 263 patients of hypothyroidism among the 5,970 patients of Various thyroid diseases diagnosed and treated at the Radioisotope Clinic and Laboratory, Seoul National University Hospital from May, 1960 to Aug, 1975. The results obtained with this study are as follows: 1) The etiological classification of hypothyroidism revealed 244 cases (93%) of primary hypothyroidism and 19 cases (7%) of secondary hypothyroidism. 2) The most frequent cause of the thyroprivic primary hypothyroidism was post radioiodine therapy with 109 cases (41.4%). 3) There were 37 cases (14%) of male and 226 cases (86%) of female, showing a ratio of 1 : 6. 4) The majority of patients were between the ages of 30 and 60 with the peak incidence (87 cases, 33%) in their fourth decades of lives. 5) The major symptoms and signs were weakness (97%), edema of face and extremities (92%); Decreased Achilles tendon reflex (87%), cold intolerance (82%), gain in weight (76%), constipation (58%) and cold skin (51%). 6) The cumulative incidence of hypothyroidism in patient treated with {sup 131}I (3-8 mci) was 7.2% at first year, 33.3% at tenth year and the 50% at fourteenth year and the annual increment was 2.9%. 7) The incidence of hypothyroidism related to the numbers of {sup 131}I therapy was not linear. 8) The diagnostic compatibilities of the various tests to hypothyroidism were TSH (100%), T{sub 4} (93.8%), 24-hour-RNIU (91.5%), ATR (86.7%), T{sub 3}RU (66.1%) and BMR (64.9%).

  4. Infants of hypothyroid mothers- are postnatal Thyroid Function Tests necessary? A Retrospective Study in a Regional Hospital

    LENUS (Irish Health Repository)

    Hawke, A

    2017-02-01

    Congenital hypothyroidism is a preventable cause of intellectual disability. The aim of this study was to establish whether adding an additional thyroid function check between days of life 10-14 in infants born to mothers with known hypothyroidism identified any additional cases of congenital hypothyroidism requiring treatment that were not detected by the national newborn bloodspot screening programme. Babies who had Thyroid Function Tests (TFTs) measured at 10-14 days of age were identified using the Paediatric Ward attenders log from the years 2012-2014. Data were collected on patients’ TFTs and their mothers’ Anti-Thyroid Peroxidase (Anti-TPO) antibody levels. Of the 121 patients included, none were found to have a significantly raised TSH requiring treatment. 40 infants had repeat TFTs performed. None of the 121 infants had a significantly raised TSH, which required treatment with thyroxine. Congenital hypothyroidism is already being screened for as part of the National Newborn Screening Programme. The findings of our study have led us to recommend stopping current practice of routinely checking TFTs on day 10-14 of life in infants of hypothyroid mothers.

  5. Cardiac function in acute hypothyroidism

    International Nuclear Information System (INIS)

    Donaghue, K.; Hales, I.; Allwright, S.; Cooper, R.; Edwards, A.; Grant, S.; Morrow, A.; Wilmshurst, E.; Royal North Shore Hospital, Sydney

    1985-01-01

    It has been established that chronic hypothyroidism may affect cardiac function by several mechanisms. It is not known how long the patient has to be hypothyroid for cardiac involvement to develop. This study was undertaken to assess the effect of a short period of hypothyroidism (10 days) on cardiac function. Nine patients who had had total tyroidectomy, had received ablative radioiodine for thyroid cancer and were euthyroid on replacement therapy were studied while both euthyroid and hypothyroid. Cardiac assessment was performed by X-ray, ECG, echocardiography and gated blood-pool scans. After 10 days of hypothyroidisms, the left-ventricular ejection fraction failed to rise after exercise in 4 of the 9 patients studied, which was significant (P<0.002). No significant changes in cardiac size or function at rest were detected. This functional abnormality in the absence of any demonstrable change in cardiac size and the absence of pericardial effussion with normal basal function suggest that short periods of hypothyroidism may reduce cardiac reserve, mostly because of alterations in metabolic function. (orig.)

  6. Novel compound heterozygous Thyroglobulin mutations c.745+1G>A/c.7036+2T>A associated with congenital goiter and hypothyroidism in a Vietnamese family. Identification of a new cryptic 5' splice site in the exon 6.

    Science.gov (United States)

    Citterio, Cintia E; Morales, Cecilia M; Bouhours-Nouet, Natacha; Machiavelli, Gloria A; Bueno, Elena; Gatelais, Frédérique; Coutant, Regis; González-Sarmiento, Rogelio; Rivolta, Carina M; Targovnik, Héctor M

    2015-03-15

    Several patients were identified with dyshormonogenesis caused by mutations in the thyroglobulin (TG) gene. These defects are inherited in an autosomal recessive manner and affected individuals are either homozygous or compound heterozygous for the mutations. The aim of the present study was to identify new TG mutations in a patient of Vietnamese origin affected by congenital hypothyroidism, goiter and low levels of serum TG. DNA sequencing identified the presence of compound heterozygous mutations in the TG gene: the maternal mutation consists of a novel c.745+1G>A (g.IVS6 + 1G>A), whereas the hypothetical paternal mutation consists of a novel c.7036+2T>A (g.IVS40 + 2T>A). The father was not available for segregation analysis. Ex-vivo splicing assays and subsequent RT-PCR analyses were performed on mRNA isolated from the eukaryotic-cells transfected with normal and mutant expression vectors. Minigene analysis of the c.745+1G>A mutant showed that the exon 6 is skipped during pre-mRNA splicing or partially included by use of a cryptic 5' splice site located to 55 nucleotides upstream of the authentic exon 6/intron 6 junction site. The functional analysis of c.7036+2T>A mutation showed a complete skipping of exon 40. The theoretical consequences of splice site mutations, predicted with the bioinformatics tool NNSplice, Fsplice, SPL, SPLM and MaxEntScan programs were investigated and evaluated in relation with the experimental evidence. These analyses predicted that both mutant alleles would result in the abolition of the authentic splice donor sites. The c.745+1G>A mutation originates two putative truncated proteins of 200 and 1142 amino acids, whereas c.7036+2T>A mutation results in a putative truncated protein of 2277 amino acids. In conclusion, we show that the c.745+1G>A mutation promotes the activation of a new cryptic donor splice site in the exon 6 of the TG gene. The functional consequences of these mutations could be structural changes in the protein

  7. Congenital tuberculosis

    African Journals Online (AJOL)

    Prof Ezechukwu

    2012-06-20

    Jun 20, 2012 ... Key words: Congenital tuberculo- sis, case report, miliary tuberculosis. Introduction. Congenital tuberculosis defines tuberculosis in infants of .... tary TB and otitis media, resulting in seizures, deafness, and death. It is therefore not surprising that the index case who presented at twelve weeks of age, had ...

  8. Congenital Abnormalities

    Science.gov (United States)

    ... tube defects. However, there is also a genetic influence to this type of congenital anomaly. Unknown Causes The vast majority of congenital abnormalities have no known cause. This is particularly troubling for parents who plan to have more children, because there is no way to predict if ...

  9. Aortic stenosis with abnormal eccentric left ventricular remodeling secondary to hypothyroidism in a Bourdeaux Mastiff

    Directory of Open Access Journals (Sweden)

    Guilherme Augusto Minozzo

    Full Text Available ABSTRACT: This paper describes a case of congenital aortic stenosis with eccentric left ventricular hypertrophy associated with hypothyroidism in a 1-year-old Bourdeaux Mastiff dog. The dog had ascites, apathy, alopecic and erythematous skin lesions in different parts of the body. A two-dimensional echocardiogram revealed aortic valve stenosis, with poststenotic dilation in the ascending aorta. The same exam showed eccentric hypertrophy and dilation of the left ventricle during systole and diastole. Aortic stenosis usually results in concentric left ventricular hypertrophy instead of eccentric hypertrophy; and therefore, this finding was very unusual. Hypothyroidism, which is uncommon in young dogs, may be incriminated as the cause of ventricular dilation, making this report even more interesting. Because hypothyroidism would only result in dilatation, the eccentric hypertrophy was attributed to pressure overload caused by aortic stenosis. Thus, cardiac alterations of this case represent a paradoxical association of both diseases.

  10. Therapy of Primary Hypothyroidism with α-Lipoic Acid Review of Studies Results

    Directory of Open Access Journals (Sweden)

    A.V. Savustyanenko

    2016-05-01

    Full Text Available Primary hypothyroidism occurs in the general population with an incidence of 0.5–1 %, and includes congenital and acquired (due to autoimmune thyroiditis, after surgical removal of the thyroid gland or treatment with radioactive iodine forms. The basic treatment of primary hypothyroidism is replacement therapy with L-thyroxine. Combined administration of L-thyroxine and α-lipoic acid resulted in more marked decrease of oxidative stress, hyperlipidemia, hyperactivity of the immune system, endothelial dysfunction and neurological disorders, observed in patients with primary hypothyroidism, as compared to monotherapy with L-thyroxine. α-lipoic acid use was effective in adults and children, in case of parenteral and/or oral administration.

  11. CARDIOVASCULAR DISORDERS WITH HYPOTHYROIDISM AND ADIPOKINES

    Directory of Open Access Journals (Sweden)

    S. Ye. Myasoyedova

    2015-01-01

    Full Text Available The article describes the mechanisms of development of cardiovascular disorders and dyslipidemia with hypothyroidism. Reference data are presented that are devoted to the study of adipokines content with hypothyroidism and their effect on echocardiographic indicators.

  12. Thyroidectomy for Graves' disease: is hypothyroidism inevitable?

    OpenAIRE

    Davenport, M.; Talbot, C. H.

    1989-01-01

    The outcome of 234 patients with Graves' disease treated by subtotal thyroidectomy over a 12-year period is analysed with specific reference to hypothyroidism. Of definite hypothyroid cases, 98% occurred within 2 years. Failure to develop hypothyroidism was statistically related to large remnant size and a large goitre preoperatively. Histological review showed that any degree of lymphocytic infiltration was associated with the development of hypothyroidism (50% vs 22%). Late onset hypothyroi...

  13. Does Hypothyroidism Affect Gastrointestinal Motility?

    Directory of Open Access Journals (Sweden)

    Olga Yaylali

    2009-01-01

    Full Text Available Background. Gastrointestinal motility and serum thyroid hormone levels are closely related. Our aim was to analyze whether there is a disorder in esophagogastric motor functions as a result of hypothyroidism. Materials and Methods. The study group included 30 females (mean age ± SE 45.17 ± 2.07 years with primary hypothyroidism and 10 healthy females (mean age ± SE 39.40 ± 3.95 years. All cases underwent esophagogastric endoscopy and scintigraphy. For esophageal scintigraphy, dynamic imaging of esophagus motility protocol, and for gastric emptying scintigraphy, anterior static gastric images were acquired. Results. The mean esophageal transit time (52.56 ± 4.07 sec for patients; 24.30 ± 5.88 sec for controls; P=.02 and gastric emptying time (49.06 ± 4.29 min for the hypothyroid group; 30.4 ± 4.74 min for the control group; P=.01 were markedly increased in cases of hypothyroidism. Conclusion. Hypothyroidism prominently reduces esophageal and gastric motor activity and can cause gastrointestinal dysfunction.

  14. A Japanese Family with Central Hypothyroidism Caused by a Novel IGSF1 Mutation.

    Science.gov (United States)

    Nishigaki, Satsuki; Hamazaki, Takashi; Fujita, Keinosuke; Morikawa, Shuntaro; Tajima, Toshihiro; Shintaku, Haruo

    2016-12-01

    Hemizygous mutations in the immunoglobulin superfamily member 1 (IGSF1) gene have been demonstrated to cause congenital central hypothyroidism in males. This study reports a family with a novel mutation in the IGSF1 gene located on the long arm of the X chromosome. A two-month-old boy was diagnosed with central hypothyroidism because of prolonged jaundice. A thyrotropin-releasing hormone (TRH) stimulation test indicated dysfunction in both the hypothalamus and the pituitary gland, and prompted the IGSF1 gene to be analyzed. The patient had a novel nonsense variant, c.2713C>T (p.Q905X), in exon 14 of the IGSF1 gene. Studies of the family revealed that the patient's sister and mother were heterozygous carriers of the IGSF1 mutation. The patient's maternal uncle carried the same mutation as the proband but had no overt symptoms. The mother and uncle started levothyroxine supplementation because of subclinical hypothyroidism. A novel mutation (c.2713C>T, p.Q905X) of the IGSF1 gene was identified that causes congenital central hypothyroidism in a Japanese family. The findings further expand the clinical heterogeneity of this entity.

  15. Congenital rubella

    Science.gov (United States)

    ... that usually closes shortly after birth remains open ( patent ductus arteriosus ) Narrowing of the large artery that ... prior to pregnancy can prevent congenital rubella. Pregnant women who have not had the vaccine should avoid ...

  16. Canine hypothyroidism. A diagnostic challenge?

    International Nuclear Information System (INIS)

    Boretti, Felicitos; Reusch, C.E.

    2010-01-01

    Hypothyroidism is one of the most common endocrinopathies in dogs. Clinical symptoms and hematological and biochemical parameters lead to a first suspicion. To confirm diagnosis can be challenging, however. Determination of total serum T4 concentration is accepted as the primary screening test for the disease, and low serum T4 concentrations are intuitively suggestive of hypothyroidism. However it is well known that low T4 concentrations are frequently encountered in euthyroid dogs with various nonthyroidal diseases and in dogs receiving certain pharmacologic agents. Since assessment of endogenous TSH (canine TSH) using current canine TSH assays shows normal values in a high percentage of hypothyroid dogs (up to 40%), its diagnostic value is only limited. The TSH-stimulation test can still be recognized as the gold standard for the diagnosis of hypothyroidism in dogs. Determination of circulating T4 concentration before and 6 hours after the administration of exogenous TSH (recombinant human TSH, Thyrogen registered ) provides an assessment of the functional reserve capacity of the thyroid gland with minimal change in post-TSH T4 concentration, compared with the basal concentration, expected in dogs with hypothyroidism. Also this test can be influenced by nonthyroidal illness and by medications known to affect thyroid function. This suppressing influence seems to be less pronounced using a higher dose of TSH. Therefore, to improve the discriminatory power of the TSH stimulation test to differentiate between euthyroid-sick and primary hypothyroidism, the higher dose should be used in cases in which testing cannot be delayed. More recently, ultrasonography and scintigraphy have been used for the diagnosis of primary hypothyroidism. Using ultrasonography, a sensitivity of 98% was reported if size and echogenicity of the gland were combined. However, specificity was as low as 77%. and care must be taken when measuring the gland because of a relatively high

  17. Etiology of congenital hypothyroidism in Isfahan: Does it different?

    Directory of Open Access Journals (Sweden)

    Mahin Hashemipour

    2014-01-01

    Conclusion: Seven years of our experiences in CH screening program indicated that the etiology of CH in Isfahan, with a higher rate of CH, with a predominance of thyroid dyshormonogenesis is different from most of the studies world-wide and similar to other reports from Iran. The findings of the current study provide us baseline information for determination of CH pathogenesis in this region.

  18. Hypothyroidism and obesity: Cause or Effect

    International Nuclear Information System (INIS)

    Verma, A.; Jayaraman, M.; Kumar, Hari K.V.S.; Modi, Kirtikumar D.

    2008-01-01

    Objective was to establish relationship between obesity and hypothyroidism and to analyze the frequency of primary hypothyroidism in obese patients and frequency of obesity in primary hypothyroidism patients. We conducted this retrospective, observational study in Department of Endocrinology and Obesity Clinic, Medwin Hospital, Hyderabad, India in March 2008. In the last 18 months (between September 2006 to February 2008), data on 625 consecutive primary hypothyroidism patients (Group I) and 450 patients from obesity clinic (Group II) were analyzed. Frequency difference between the 2 groups was assessed by Chi-square test. In Group I, 278/625 (44%) had body mass index (BMI) >25 kg/m2. Obesity was higher (46% versus 34%) in overt hypothyroidism than in subclinical hypothyroidism (p=0.21). More patients were overweight in overt hypothyroidism group than in subclinical hypothyroidism group (p=0.02). In obesity patients, overt hypothyroidism was present in 33% and subclinical hypothyroidism in 11% patients. Overall thyroid dysfunction was found more in obese individuals with varying degree of significance. Detailed studies are required to assess the cause and effect relation between obesity and hypothyroidism. (author)

  19. Hypothyroidism and obesity: An intriguing link

    Directory of Open Access Journals (Sweden)

    Debmalya Sanyal

    2016-01-01

    Full Text Available According to common perception, hypothyroidism is held responsible for obesity. However, linking them causally is controversial. Overt hypothyroidism is associated with modest weight gain, but there is a lack of clarity regarding subclinical hypothyroidism. Novel view indicates that changes in thyroid-stimulating hormone (TSH could well be secondary to obesity. The increasing prevalence of obesity further confounds definition of normal TSH range in population studies. Thyroid autoantibody status may help in establishing the diagnosis of subclinical hypothyroidism in obesity. High leptin levels may play a role in the hyperthyrotropinemia of obesity and also increase susceptibility to thyroid autoimmunity and subsequent hypothyroidism. There is at most a modest effect of L-T4 treatment in overt hypothyroidism in inducing weight loss; benefit in subclinical hypothyroidism is not established with no data supporting thyroid hormone use in euthyroid obese patients.

  20. 3,5-Diiodo-L-thyronine activates brown adipose tissue thermogenesis in hypothyroid rats.

    Directory of Open Access Journals (Sweden)

    Assunta Lombardi

    Full Text Available 3,5-Diiodo-l-thyronine (T2, a thyroid hormone derivative, is capable of increasing energy expenditure, as well as preventing high fat diet-induced overweight and related metabolic dysfunction. Most studies to date on T2 have been carried out on liver and skeletal muscle. Considering the role of brown adipose tissue (BAT in energy and metabolic homeostasis, we explored whether T2 could activate BAT thermogenesis. Using euthyroid, hypothyroid, and T2-treated hypothyroid rats (all maintained at thermoneutrality in morphological and functional studies, we found that hypothyroidism suppresses the maximal oxidative capacity of BAT and thermogenesis, as revealed by reduced mitochondrial content and respiration, enlarged cells and lipid droplets, and increased number of unilocular cells within the tissue. In vivo administration of T2 to hypothyroid rats activated BAT thermogenesis and increased the sympathetic innervation and vascularization of tissue. Likewise, T2 increased BAT oxidative capacity in vitro when added to BAT homogenates from hypothyroid rats. In vivo administration of T2 to hypothyroid rats enhanced mitochondrial respiration. Moreover, UCP1 seems to be a molecular determinant underlying the effect of T2 on mitochondrial thermogenesis. In fact, inhibition of mitochondrial respiration by GDP and its reactivation by fatty acids were greater in mitochondria from T2-treated hypothyroid rats than untreated hypothyroid rats. In vivo administration of T2 led to an increase in PGC-1α protein levels in nuclei (transient and mitochondria (longer lasting, suggesting a coordinate effect of T2 in these organelles that ultimately promotes net activation of mitochondrial biogenesis and BAT thermogenesis. The effect of T2 on PGC-1α is similar to that elicited by triiodothyronine. As a whole, the data reported here indicate T2 is a thyroid hormone derivative able to activate BAT thermogenesis.

  1. Depression and anxiety in hypothyroidism.

    Science.gov (United States)

    Demet, M M; Ozmen, B; Deveci, A; Boyvada, S; Adiguzel, H; Aydemir, O

    2003-09-01

    The aim of the study was to determine the prevalence and severity of depression and anxiety in patients with hypothyroidism and to compare this with euthyroid patients. Thirty patients with hypothyroidism and 30 euthyroid controls attending the Endocrinology outpatient department of Celal Bayar University, Medical Faculty were included in the study. The hormonal screening was done by immunoassay and haemagglutination methods. Then, for psychiatric assessment, Hospital Anxiety and Depression Scale (HAD), Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A) were used. There was no difference between the two groups in terms of demographic features. Total scores obtained from the scales used in the study did not differ significantly (p > 0.05). The frequency of items of both HAM-D and HAM-A did not show any differences in the two groups. By Wilks' Lambda discriminant analysis, depressive mood (HAM-D#1) was found to be the discriminating feature between the hypothyroid group and the euthyroid group. Therefore, depression and anxiety were not outstanding features in hypothyrodism. However, depression was more significant in the hypothyroid than euthyroid group.

  2. Hypothyroidism in adults. Levothyroxine if warranted by clinical and laboratory findings, not for simple TSH elevation.

    Science.gov (United States)

    2015-10-01

    Hypothyroidism is a common disorder due to inadequate thyroid hormone secretion. When a patient has signs and symptoms suggestive of hypothyroidism, how is it determined whether thyroid hormone replacement therapy will have a favourable harm-benefit balance? How should treatment be managed? To answer these questions, we conducted a review of the literature using the standard Prescrire methodology. The symptoms of hypothyroidism are due to slow metabolism (constipation, fatigue, sensitivity to cold, weight gain, etc.) and to polysaccharide accumulation in certain tissues, leading to hoarseness, eyelid swelling, etc. A blood TSH concentration of less than 4 or 5 mlU/L rules out peripheral hypothyroidism. TSH levels increase with age. Between 30% and 60% of high TSH levels are not confirmed on a second blood test. In overt hypothyroidism, the TSH level is high and the free T4 (thyroxine) level is low. Most of these patients are symptomatic. So-called subclinical hypothyroidism, which is rarely symptomatic, is characterised by high blood TSH levels and normal free T4 levels. The natural history of hypothyroidism depends on its cause. In chronic autoimmune thyroiditis, the most common form seen in rich countries, hypothyroidism generally worsens over time. However, other situations can lead to transient hypothyroidism that may last several weeks or months. Subclinical hypothyroidism, as the name implies, is usually asymptomatic. The risk of progression to overt hypothyroidism is about 3% to 4% per year overall but increases with the initial TSH level. Treatment guidelines are mainly based on physiological and pharmacological considerations and generally recommend levothyroxine therapy. The adverse effects of levothyroxine are signs of thyrotoxicosis in case of overdose (tachycardia, tremor, sweating, etc.). Even a slight overdose carries a risk of osteoporotic fractures and atrial fibrillation, especially in the elderly. In young adults, levothyroxine is usually started

  3. Developmental delay and failure to thrive in a 7-month-old baby boy with spontaneous transient Graves' thyrotoxicosis: a case report.

    Science.gov (United States)

    Yatsuga, Shuichi; Saikusa, Tomoko; Sasaki, Takako; Ushijima, Kikumi; Kitamura, Miyuki; Nishioka, Junko; Koga, Yasutoshi

    2016-08-10

    Thyroid dysfunction can induce developmental delay and failure to thrive in infancy. Congenital hypothyroidism is one of the common causes of these symptoms in infancy. By contrast, hyperthyroidism is a rare cause of these symptoms in infancy. A 7-month-old Japanese baby boy was examined for developmental delay and failure to thrive. Blood tests were performed, which showed low levels of thyroid-stimulating hormone (hyperthyroidism, most likely Graves' disease. His free thyroxine level decreased in the first month after our examination. No increased vascularity of his thyroid gland was noted. The technetium uptake of his thyroid gland in scintigraphy was relatively increased compared to the intake of his salivary gland. We elected to observe rather than treat with anti-thyroid medications. We have to rule out spontaneous transient Graves' thyrotoxicosis when babies have symptoms of developmental delay and fail to thrive.

  4. Hypothyroidism: The Thyroid and You | NIH Medlineplus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Hypothyroidism The Thyroid and You: Coping with a Common ... is made by the pituitary gland. What is hypothyroidism? Hypothyroidism is a condition in which the thyroid ...

  5. Hypothyroidism:Symptoms,Diagnosis and Treatment | NIH Medlineplus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Hypothyroidism Hypothyroidism: Symptoms, Diagnosis & Treatment Past Issues / Spring 2012 Table ... of its symptoms are seen in other diseases, hypothyroidism usually cannot be diagnosed based on symptoms alone. ...

  6. Incidence of Subclinical Hypothyroidism and Hypothyroidism in Early Pregnancy.

    Science.gov (United States)

    Akram, Frida Hosseini; Johansson, Bengt; Möllerström, Gunnar; Landgren, Britt-Marie; Stavreus-Evers, Anneli; Skjöldebrand-Sparre, Lottie

    2017-11-01

    Untreated and subclinical hypothyroidism (SCH) has been associated with adverse pregnancy complications such as increased risk of miscarriage, hypertension, preeclampsia, and preterm delivery. However, in Sweden, screening for thyroid dysfunction during pregnancy is only recommended for women with a high risk of thyroid disease. Therefore, the aim of this study was to determine the incidence of clinical and SCH in women in the first trimester of pregnancy. In this prospective study, 1298 pregnant women were divided into three groups: one unselected general screening group (n = 611), one low-risk group comprising women without risk factors for thyroid disorder (n = 511), and one high-risk group comprising women with an inheritance or suspicion of thyroid disease or undergoing treatment for thyroid disease (n = 88). Serum was obtained up to gestational week 13, and thyrotropin (TSH) was analyzed. The incidences of thyroid dysfunction in the three screening groups were 9.8% in the general screening group, 9.6% in the low-risk group, and 10.2%, p = 0.948, in the high-risk group. In the women with known hypothyroidism on levothyroxine treatment, 50.6% had serum TSH levels above 2.0 mIU/L. High-risk screening is not useful in predicting which women are at risk of thyroid disease in early pregnancy since ∼10% of women with SCH or hypothyroidism could not be diagnosed in this way.

  7. Neonatal goiter with congenital thyroid dysfunction in two infants diagnosed by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kondoh, Mutsuko [Department of Radiology, St. Marianna University, Seibu Hospital, Kanagawa (Japan); Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa-ken 216-8511 (Japan); Miyazaki, Osamu; Imanishi, Yoshimasa; Hayakawa, Minako [Department of Radiology, St. Marianna University, Seibu Hospital, Kanagawa (Japan); Aikyou, Miho; Doi, Hiromi [Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa (Japan)

    2004-07-01

    It is essential to diagnose thyroid dysfunction at an early stage because congenital hypothyroidism (CH) represents one of the most common preventable causes of delayed physical and psychological development, including mental retardation. US evaluates the shape of the thyroid gland. CT and scintigraphic examinations demonstrate iodine metabolism of the thyroid, but there is associated radiation exposure. We encountered two cases of congenital goiter, in which MRI was very helpful in confirming thyroid dysfunction and was very useful in making an accurate diagnosis. (orig.)

  8. Neonatal goiter with congenital thyroid dysfunction in two infants diagnosed by MRI

    International Nuclear Information System (INIS)

    Kondoh, Mutsuko; Miyazaki, Osamu; Imanishi, Yoshimasa; Hayakawa, Minako; Aikyou, Miho; Doi, Hiromi

    2004-01-01

    It is essential to diagnose thyroid dysfunction at an early stage because congenital hypothyroidism (CH) represents one of the most common preventable causes of delayed physical and psychological development, including mental retardation. US evaluates the shape of the thyroid gland. CT and scintigraphic examinations demonstrate iodine metabolism of the thyroid, but there is associated radiation exposure. We encountered two cases of congenital goiter, in which MRI was very helpful in confirming thyroid dysfunction and was very useful in making an accurate diagnosis. (orig.)

  9. Congenital amusias.

    Science.gov (United States)

    Tillmann, B; Albouy, P; Caclin, A

    2015-01-01

    In contrast to the sophisticated music processing reported in the general population, individuals with congenital amusia show deficits in music perception and production. Congenital amusia occurs without brain damage, sensory or cognitive deficits, and has been suggested as a lifelong deficit with genetic origin. Even though recognized for a long time, this disorder has been systematically studied only relatively recently for its behavioral and neural correlates. The currently most investigated hypothesis about the underlying deficits concerns the pitch dimension, notably with impaired pitch discrimination and memory. Anatomic and functional investigations of pitch processing revealed that the amusic brain presents abnormalities in the auditory and inferior frontal cortices, associated with decreased connectivity between these structures. The deficit also impairs processing of pitch in speech material and processing of the time dimension in music for some of the amusic individuals, but does not seem to affect spatial processing. Some studies suggest at least partial dissociation in the disorder between perception and production. Recent studies revealed spared implicit pitch perception in congenital amusia, supporting the power of implicit cognition in the music domain. Current challenges consist in defining different subtypes of congenital amusia as well as developing rehabilitation programs for this "musical handicap." © 2015 Elsevier B.V. All rights reserved.

  10. Conversion of autoimmune hypothyroidism to hyperthyroidism

    OpenAIRE

    Furqan, Saira; Haque, Naeem-ul; Islam, Najmul

    2014-01-01

    Background Graves’ disease and Hashimoto’s thyroiditis are the two autoimmune spectrum of thyroid disease. Cases of conversion from hyperthyroidism to hypothyroidism have been reported but conversion from hypothyroidism to hyperthyroidism is very rare. Although such cases have been reported rarely in the past we are now seeing such conversions from hypothyroidism to hyperthyroidism more frequently in clinical practice. Case presentation We are reporting three cases of middle aged Asian female...

  11. [Treatment of primary hypothyroidism in adult patients].

    Science.gov (United States)

    Salmela, Pasi; Metso, Saara; Moilanen, Leena; Niskanen, Leo; Nuutila, Pirjo; Schalin-Jäntti, Camilla

    2016-01-01

    The diagnosis of hypothyroidism is based on the findings of an increased serum TSH (above the reference range) and decreased serum free T4 (below the reference range) concentration. Treatment of subclinical hypothyroidism is indicated if serum THS is above 10 mU/l. For less severe forms of subclinical hypothyroidism, the treatment should be individually tailored. The treatment of choice is synthetic human levothyroxine. The goals for treatment are amelioration of symptoms and normalization of TSH and free T4 concentrations.

  12. Hypothyroidism - new aspects of an old disease

    OpenAIRE

    Kostoglou-Athanassiou, I; Ntalles, K

    2010-01-01

    Hypothyroidism is divided in primary, caused by failure of thyroid function and secondary (central) due to the failure of adequate thyroid-stimulating hormone (TSH) secretion from the pituitary gland or thyrotrophin-releasing hormone (TRH) from the hypothalamus. Secondary hypothyroidism can be differentiated in pituitary and hypothalamic by the use of TRH test. In some cases, failure of hormone action in peripheral tissues can be recognized. Primary hypothyroidism may be clinical, where free ...

  13. The Treatment of Hypothyroidism in Pregnancy

    OpenAIRE

    Miulescu Rucsandra Dănciulescu; Mihai Andrada Doina

    2017-01-01

    Hypothyroidism is a pathologic condition generated by the thyroid hormone deficiency. The American Thyroid Association advises for the screening of hypothyroidism beginning at 35 years and thereafter every 5 years in people at high risk for this condition: females older than 60 years, pregnant women, patients with other autoimmune disease or patients with a history of neck irradiation. In pregnant women, hypothyroidism can been associated with adverse effect for both mother and child. The „Gu...

  14. Subclinical hypothyroidism: Controversies to consensus

    Directory of Open Access Journals (Sweden)

    Syed Abbas Raza

    2013-01-01

    Full Text Available Diagnoses of subclinicaal hypothyroidism (SCH is biochemically made, when serum thyroid stimulating hormone (TSH levels is elevated while free thyroid hormone levels are within normal reference range. SCH is diagnosed after excluding all other causes of elevated TSH levels. Symptoms of SCH may vary from being asymptomatic to having mild nonspecific symptoms. The risk of progression to overt hypothyroidism is related to number of factors including initial serum TSH concentration, presence of auto antibodies, family history and presence goiter. Various screening recommendations for thyroid function assessment are in practice. There are still controversies surrounding SCH and associated risk of various cardiovascular diseases (CVDs, pregnancy outcomes, neuropsychiatric issues, metabolic syndrome, and dyslipidemia. Consensus will require more large randomized clinical studies involving various age groups and medical condition, especially in developing countries. All these efforts will definitely improve our understanding of disease and ultimately patient outcomes.

  15. Clinical presentation of primary hypothyroidism

    International Nuclear Information System (INIS)

    Ahmed, B.; Hussain, T.; Memon, A. R.; Solangi, G. A.

    2001-01-01

    Objective: To determine the clinical preparation of primary hypothyroidism at the time of diagnosis. Design: It was an observational and prospective study. Place and Duration of Study: Civil Hospital, Karachi from 1st January 1997 to 31st December 1997. Subjects and Methods: Forty-eight consecutive cases of primary hypothyroidism were included. A detailed history with special emphasis on symptoms and signs was conducted and the findings observed were noted in previously made proforma. Results: Primary hypothyroidism was found to be 5 times more common in female patients, with male to female ratio 1:5, majority of cases (33.33%) were between 41 to 50 years of age. The common symptoms at the time of presentation were tiredness (95.8%), weakness (91.6%), weight gain (85.4%), hoarseness of voice (83.3%), cold intolerance (77.0%) and constipation (75.0%) in patients. Physical signs observed were delayed relaxation of ankle jerk (93.7%), periorbital edema (83.3%), thick tongue (62.5%), goiter (50.0%), dry and coarse skin (47.9%) in patients. Serum, TSH, T4 and T3 were performed in all cases through immunoradiometric technique. Serum TSH was markedly elevated, with normal to reduced T4 and T3 levels in all cases. Conclusion: Primary hypothyroidism was found more common in female than male of the age group 41-50 years. Weakness, tiredness, hoarseness of voice and constipation were the common symptoms noted. The diagnosis is almost certain on clinical grounds if the patient happens to have delayed relaxation of ankle jerks and periorbital puffiness. (author)

  16. Psychiatric and cognitive manifestations of hypothyroidism

    Science.gov (United States)

    Samuels, Mary H

    2014-01-01

    Purpose of review Overt hypothyroidism has major effects on neuropsychiatric function, but patients with mild hypothyroidism may attribute unrelated neuropsychiatric symptoms to their thyroid condition. This review will summarize data on neuropsychiatric effects of hypothyroidism, and provide guidelines regarding the relationship between hypothyroidism and neuropsychiatric issues, and treatment indications. Recent findings Clinical investigations and functional imaging studies confirm that overt hypothyroidism is associated with affective and cognitive decrements, largely reversible with treatment. In contrast, subclinical hypothyroidism is not associated with major neuropsychiatric deficits, although studies utilizing sensitive measures show small deficits in memory and executive function. Neuropsychiatric complaints are more common when patients are aware of their thyroid disease, regardless of their thyroid function at the time of testing. Summary Neuropsychiatric dysfunction is common in overt hypothyroidism, and will improve (although perhaps not completely resolve) with therapy. On the other hand, deficits related to thyroid dysfunction are usually mild in subclinical hypothyroidism, and realistic expectations need to be set regarding symptom reversibility with treatment. Patients with mild hypothyroidism and significant distress related to neuropsychiatric symptoms most likely have independent diagnoses that should be evaluated separately. PMID:25122491

  17. Recurrent thyrotoxicosis after I-131 induced hypothyroidism

    International Nuclear Information System (INIS)

    Liu, L.; Borowski, G.D.; Shtasel, P.; Rose, L.I.

    1984-01-01

    The first clinically and biochemically documented case of recurrent thyrotoxicosis after I-131 induced hypothyroidism in a patient with Graves' disease is reported. Two months after the administration of 9.2 mCi of I-131, the subject developed hypothyroidism. One month later, the patient became euthyroid. Then, nine months following ablation, the patient again developed thyrotoxicosis. A second dose of I-131 of 12.5 mCi was required to finally produce permanent hypothyroidism. This case illustrates the recurrence of hypothyroidism after what had seemed to have been adequate I-131 radiation

  18. Hemostasis in Hypothyroidism and Autoimmune Thyroid Disorders.

    Science.gov (United States)

    Ordookhani, Arash; Burman, Kenneth D

    2017-04-01

    There are contradictory results on the effect of hypothyroidism on the changes in hemostasis. Inadequate population-based studies limited their clinical implications, mainly on the risk of venous thromboembolism (VTE). This paper reviews the studies on laboratory and population-based findings regarding hemostatic changes and risk of VTE in hypothyroidism and autoimmune thyroid disorders. A comprehensive literature search was conducted employing MEDLINE database. The following words were used for the search: Hypothyroidism; thyroiditis, autoimmune; blood coagulation factors; blood coagulation tests; hemostasis, blood coagulation disorders; thyroid hormones; myxedema; venous thromboembolism; fibrinolysis, receptors thyroid hormone. The papers that were related to hypothyroidism and autoimmune thyroid disorder and hemostasis are used in this review. Overt hypothyroidism is more associated with a hypocoagulable state. Decreased platelet count, aggregation and agglutination, von Willebrand factor antigen and activity, several coagulation factors such as factor VIII, IX, XI, VII, and plasminogen activator-1 are detected in overt hypothyrodism. Increased fibrinogen has been detected in subclinical hypothyroidism and autoimmune thyroid disease rendering a tendency towards a hypercoagulability state. Increased factor VII and its activity, and plasminogen activator inhibitor-1 are among several findings contributing to a prothrombotic state in subclinical hypothyroidism. Overt hypothyroidism is associated with a hypocoagulable state and subclinical hypothyroidism and autoimmune thyroid disorders may induce a prothrombotic state. However, there are contradictory findings for the abovementioned thyroid disorders. Prospective studies on the risk of VTE in various levels of hypofunctioning of the thyroid and autoimmune thyroid disorders are warranted.

  19. Reversible hypothyroidism and Whipple's disease

    Directory of Open Access Journals (Sweden)

    Tran Huy A

    2006-05-01

    Full Text Available Abstract Background The major cause of primary hypothyroidism is autoimmune mediated with progressive and permanent destruction of the thyroid gland resulting in life-long replacement therapy. Treatable and reversible hypothyroidism is unusual and here forth is such a case due to infection of the thyroid gland with Tropheryma whippleii, Whipple disease. Case presentation A 45 year-old female presented with symptoms and signs consistent with primary hypothyroidism, which was also confirmed biochemically. Her response to thyroxine replacement therapy was poor however, requiring a significantly elevated amount. Further investigation revealed the presence of Whipple's disease involving the gastrointestinal trace and possibly the thyroid gland. Her thyroxine requirement decreased drastically following appropriate antimicrobial therapy for Whipple's disease to the extent that it was ceased. Thyrotropin releasing hormone testing in the steady state suggested there was diminished thyroid reserve due to Whipple's disease. Conclusion This is the first ante-mortem case report studying the possible involvement of the thyroid gland by Whipple's disease. Despite the normalization of her thyroid function test biochemically after antibiotic therapy, there is diminished thyroid reserve thus requiring close and regular monitoring.

  20. Congenital Hydrocephalus.

    Science.gov (United States)

    Estey, Chelsie M

    2016-03-01

    There are several types of hydrocephalus, which are characterized based on the location of the cerebrospinal fluid (CSF) accumulation. Physical features of animals with congenital hydrocephalus may include a dome-shaped skull, persistent fontanelle, and bilateral ventrolateral strabismus. Medical therapy involves decreasing the production of CSF. The most common surgical treatment is placement of a ventriculoperitoneal shunt. Postoperative complications may include infection, blockage, drainage abnormalities, and mechanical failure. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Congenital diplopodia

    International Nuclear Information System (INIS)

    Brower, Jason S.; Wootton-Gorges, Sandra L.; Costouros, John G.; Boakes, Jennette; Greenspan, Adam

    2003-01-01

    Diplopodia, or duplicated foot, is a rare congenital anomaly. It differs from polydactyly in that supernumerary metatarsal and tarsal bones are present as well as extra digits. Only a few cases of this anomaly have been reported in the literature to date. We present a newborn male without intrauterine teratogen exposure who was born with a duplicate foot of the left lower extremity and imperforate anus. (orig.)

  2. Congenital toxoplasmosis.

    Science.gov (United States)

    Kieffer, François; Wallon, Martine

    2013-01-01

    Congenital toxoplasmosis results from the transplacental transmission of the parasite Toxoplasma gondii after a maternal infection acquired in pregnancy. Prevalence of congenital infection ranges from 0.1 to 0.3 per 1000 live births. The maternal-fetal transmission rate increases with gestational age at maternal seroconversion, from less than 15% at 13 weeks of gestation to over 70% at 36 weeks. Conversely, the later the maternal infection, the lower the risk of symptomatic congenital infection (infections acquired during the third trimester are most often asymptomatic at birth). Prenatal diagnosis is currently performed by PCR analysis in amniotic fluid. Antenatal management and treatment vary considerably among countries. In some European countries, maternal infections are detected through serological screening allowing a prompt treatment with spiramycin, which is expected to reduce the risk of vertical transmission. If PCR analysis in amniotic fluid is positive or if maternal infection was acquired in the third trimester of pregnancy, a combination with pyrimethamine and sulphonamide is given until delivery. Benefits of antenatal treatments remain controversial. Infected newborns are prescribed pyrimethamine and sulphonamide for 12 months. Despite antenatal and postnatal treatment, chorioretinitis can occur at any age (prevalence>20% at 10 years of age): long-term ophthalmological follow-up remains necessary. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Congenital leptin deficiency and thyroid function

    Directory of Open Access Journals (Sweden)

    Paz-Filho Gilberto

    2009-11-01

    Full Text Available Abstract Thyroid function is closely related to leptin's secretion by the adipose tissue. In states of leptin-deficiency, the circadian rhythm of TSH is altered, leading to central hypothyroidism in animal models. In humans, central hypothyroidism has also been described in rare cases of congenital leptin deficiency. However, the thyroid phenotype in these cases is heterogeneous, with the occurrence of central hypothyroidism in a minority of cases. Here we describe thyroid function in four leptin-deficient humans (2 males aged 5 and 27, and 2 females aged 35 and 40, before and during leptin replacement with recombinant human methionyl leptin (r-metHuLeptin. The child was evaluated for four years, and the adults, for eight years. In addition, the adults were submitted to a brief withdrawal of leptin during six weeks in the sixth year. Our results show that, regardless of leptin replacement, our leptin-deficient patients have normal thyroid function. In spite of having an important role in regulating the hypothalamic-pituitary-thyroidal axis, leptin is not required for normal thyroid function. Trial Registration ClinicalTrials.gov Identifiers: NCT00659828 and NCT00657605

  4. Post-external radiotherapy hypothyroidism: 15 cases

    International Nuclear Information System (INIS)

    Kaffel, N.; Mnif, M.; Abid, M.; Daoud, J.

    2001-01-01

    Post-external radiotherapy hypothyroidism: 15 cases. Hypothyroidism frequency is estimated to be between 10 and 45% after radiotherapy alone, and 40 to 67% after radiotherapy associated with thyroidectomy. This hypothyroidism is infra-clinical in 60% of the cases. Our study concerned 15 cases of hypothyroidism after external radiotherapy delivered between and 1991 and 1999. An irradiation of the cervical, cerebral and thorax regions was indicated for different types of cancers. Larynx carcinoma epidermoid was the most frequent cancer (seven cases); the radiation treatment used cobalt 60 with conventional fractionation, i.e., 2 Gy per treatment, five treatments a week. In nine cases, the hypothyroidism was discovered during a systematic examination; it was clinically evident in the six remaining cases. Hypothyroidism appeared after an irradiation dose average of 50 Gy (extremes 30-65 Gy). The average duration of the irradiation was about 7 weeks and the hypothyroidism appeared in a mean 22 months. In all cases, the substituting treatment was initiated with a favorable progression. Faced with the risk of hypothyroidism, it is necessary to check patients who have undergone external irradiation of the neck. (authors)

  5. Hypothyroidism in the elderly: diagnosis and management

    Science.gov (United States)

    Bensenor, Isabela M; Olmos, Rodrigo D; Lotufo, Paulo A

    2012-01-01

    Thyroid disorders are highly prevalent, occurring most frequently in aging women. Thyroid-associated symptoms are very similar to symptoms of the aging process; thus, improved methods for diagnosing overt and subclinical hypothyroidism in elderly people are crucial. Thyrotropin measurement is considered to be the main test for detecting hypothyroidism. Combined evaluations of thyroid stimulating hormone (TSH) and free-thyroxine can detect overt hypothyroidism (high TSH with low free-thyroxine levels) and subclinical hypothyroidism (high TSH with normal free-thyroxine levels). It is difficult to confirm the diagnosis of thyroid diseases based only on symptoms, but presence of symptoms could be an indicator of who should be evaluated for thyroid function. The most important reasons to treat overt hypothyroidism are to relieve symptoms and avoid progression to myxedema. Overt hypothyroidism is classically treated using L-thyroxine; elderly patients require a low initial dose that is increased every 4 to 6 weeks until normalization of TSH levels. After stabilization, TSH levels are monitored yearly. There is no doubt about the indication for treatment of overt hypothyroidism, but indications for treatment of subclinical disease are controversial. Although treatment of subclinical hypothyroidism may result in lipid profile improvement, there is no evidence that this improvement is associated with decreased cardiovascular or all-cause mortality in elderly patients. In patients with a high risk of progression from subclinical to overt disease, close monitoring of thyroid function could be the best option. PMID:22573936

  6. Rhabdomyolysis in a Patient with Severe Hypothyroidism

    OpenAIRE

    Salehi, Nooshin; Agoston, Endre; Munir, Iqbal; Thompson, Gary J.

    2017-01-01

    Patient: Female, 52 Final Diagnosis: Hypothyroidism induced rhabdomyolysis Symptoms: Bilateral leg pain ? fatigue Medication: Levothyroxine ? Calcitriol ? Calcium Gluconate Clinical Procedure: ? Specialty: Endocrinology and Metabolic Objective: Unusual clinical course Background: Muscular symptoms, including stiffness, myalgia, cramps, and fatigue, are present in the majority of the patients with symptomatic hypothyroidism, but rhabdomyolysis, the rapid breakdown of skeletal muscle, is a rare...

  7. Hypothyroidism in late-onset Pompe disease

    Directory of Open Access Journals (Sweden)

    Joseph Schneider

    2016-09-01

    Conclusions: Hypothyroidism was found at a higher prevalence in patients with late-onset Pompe disease compared to the general adult population at UMMC. Studies in larger populations of patients with Pompe disease would be needed to confirm an association of Pompe disease and hypothyroidism. Challenges include finding an adequate sample size, due the rarity of Pompe disease.

  8. Rhabdomyolysis in a Patient with Severe Hypothyroidism

    Science.gov (United States)

    Salehi, Nooshin; Agoston, Endre; Munir, Iqbal; Thompson, Gary J.

    2017-01-01

    Patient: Female, 52 Final Diagnosis: Hypothyroidism induced rhabdomyolysis Symptoms: Bilateral leg pain • fatigue Medication: Levothyroxine • Calcitriol • Calcium Gluconate Clinical Procedure: — Specialty: Endocrinology and Metabolic Objective: Unusual clinical course Background: Muscular symptoms, including stiffness, myalgia, cramps, and fatigue, are present in the majority of the patients with symptomatic hypothyroidism, but rhabdomyolysis, the rapid breakdown of skeletal muscle, is a rare manifestation. In most patients with hypothyroidism who develop rhabdomyolysis, precipitating factors, such as strenuous exercise or use of lipid-lowering drugs, can be identified. Case Report: We report a case of a 52-year-old Hispanic woman with a history of hypothyroidism, hypertension, and type 2 diabetes mellitus who presented with fatigue, severe generalized weakness, bilateral leg pain, and recurrent falls. She reported poor medication compliance for the preceding month. Initial laboratory testing showed elevated thyroid stimulating hormone (TSH) and creatine kinase (CK) levels, indicating uncontrolled hypothyroidism with associated rhabdomyolysis. Supportive treatment with intravenous fluids and intravenous levothyroxine were initiated and resulted in dramatic clinical improvement. Conclusions: We report a case of rhabdomyolysis, which is a rare but potentially serious complication of hypothyroidism. Screening for hypothyroidism in patients with elevated muscle enzymes should be considered, since an early diagnosis and prompt treatment of hypothyroidism is essential to prevent rhabdomyolysis and its consequences. PMID:28827517

  9. SUBCLINICAL HYPOTHYROIDISM CURRENT CONCEPTS & M ANAGEMENT STRATEGEIES

    OpenAIRE

    Radha Krishnan; Soumini; Adithya

    2015-01-01

    Subclinical hypothyroidism is a biochemical diagnosis characterized by raised thyroid stimulating hormone ( TSH ) and normal free T3 & T4 , without clinical features of hypothyroidism . Clinical significance of SCH remains uncertain and controversial . Symptoms of SCH may vary from being asymptomatic to having mild nonspecific symptoms . There are still controversies surrounding SCH and associated risk of ...

  10. Prognostic Role of Hypothyroidism in Heart Failure

    Science.gov (United States)

    Ning, Ning; Gao, Dengfeng; Triggiani, Vincenzo; Iacoviello, Massimo; Mitchell, Judith E.; Ma, Rui; Zhang, Yan; Kou, Huijuan

    2015-01-01

    Abstract Hypothyroidism is a risk factor of heart failure (HF) in the general population. However, the relationship between hypothyroidism and clinical outcomes in patients with established HF is still inconclusive. We conducted a systematic review and meta-analysis to clarify the association of hypothyroidism and all-cause mortality as well as cardiac death and/or hospitalization in patients with HF. We searched MEDLINE via PubMed, EMBASE, and Scopus databases for studies of hypothyroidism and clinical outcomes in patients with HF published up to the end of January 2015. Random-effects models were used to estimate summary relative risk (RR) statistics. We included 13 articles that reported RR estimates and 95% confidence intervals (95% CIs) for hypothyroidism with outcomes in patients with HF. For the association of hypothyroidism with all-cause mortality and with cardiac death and/or hospitalization, the pooled RR was 1.44 (95% CI: 1.29–1.61) and 1.37 (95% CI: 1.22–1.55), respectively. However, the association disappeared on adjustment for B-type natriuretic protein level (RR 1.17, 95% CI: 0.90–1.52) and in studies of patients with mean age hypothyroidism associated with increased all-cause mortality as well as cardiac death and/or hospitalization in patients with HF. Further diagnostic and therapeutic procedures for hypothyroidism may be needed for patients with HF. PMID:26222845

  11. Radioimmunoassay of luteinizing hormone in hypothyroidism

    International Nuclear Information System (INIS)

    Sobieszczyk, S.

    1975-01-01

    Radioimmunoassay of luteinizing hormone was performed in 18 women with primary hypothyroidism and 15 women with secondary hypothyroidism. The results of determinations were compared with LH values found in healthy women at reproductive age and after menopause. It was observed that in primary hypothyroidism the level of LH is normal, in young women it was from 6 to 25 m IU/ml, while in the postmenopausal period it increased to 70 to 200 m IU/ml. In secondary hypothyroidism due to pituitary hypofunction the LH level is undetectable or lies in the range of lowest values observed in healthy subjects, not exceeding 8 m IU/ml. Determinations of serum LH may be useful for differential diagnosis of primary and secondary hypothyroidism. (author)

  12. Verbal episodic memory in young hypothyroid patients

    Directory of Open Access Journals (Sweden)

    Vatsal Priyadarshi Pandey

    2017-01-01

    Full Text Available Context: Hypothyroidism affects cognitive functions especially memory. However, most of the previous studies have generally evaluated older hypothyroid patients and sample size of these studies varied in terms of age range. Aims: To see whether hypothyroidism affects memory in young patients. Settings and Design: The sample consisted of 11 hypothyroid patients with an age of 18–49 and 8 healthy controls matched on age and education. Subjects and Methods: Verbal episodic memory was assessed using Hindi adaptation of Rey-Auditory Verbal Learning Test. Statistical Analysis Used: An independent t-test was used to see the difference between mean performance of the patient group and healthy control on memory measures. Results: Results indicated nonsignificant difference between verbal episodic memory of patient group and healthy controls. Conclusions: On the basis of these findings, it was concluded that hypothyroidism may not affect younger patients in terms of episodic verbal memory the same way as it does in the older patients.

  13. Excess mortality in patients diagnosed with hypothyroidism

    DEFF Research Database (Denmark)

    Thvilum, Marianne; Brandt, Frans; Pedersen, Dorthe Almind

    2013-01-01

    Background: Although hypothyroidism is associated with increased morbidity, an association with increased mortality is still debated. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism influences mortality. Methods: In an observational cohort study from...... January 1, 1978 until December 31, 2008 using record-linkage data from nationwide Danish health registers, 3587 singletons and 682 twins diagnosed with hypothyroidism were identified. Hypothyroid individuals were matched 1:4 with nonhypothyroid controls with respect to age and gender and followed over...... a mean period of 5.6 years (range 0-30 years). The hazard ratio (HR) for mortality was calculated using Cox regression analyses. Comorbidity was evaluated using the Charlson score (CS). Results: In singletons with hypothyroidism, the mortality risk was increased (HR 1.52; 95% confidence interval [CI]: 1...

  14. Frequency of other endocrine disorders in hypothyroidism

    Directory of Open Access Journals (Sweden)

    Bjekić-Macut Jelica

    2012-01-01

    Full Text Available Hypothyroidism is a condition of reduced production, distribution, or absence of action of thyroid hormones. Clinical diagnosis of hypothyroidism is not easily established due to the nonspecific clinical manifestations. Determination of serum TSH is the first-line test for the diagnosis of hypothyroidism. The aim of the study was to determine the presence of other endocrine disorders in patients with subclinical (TSH levels between 5 and 10 mIU/l, or clinical (TSH above 10 mIU/l hypothyrodism. We analyzed 50 patients (35 with clinical hypothyroidism and 15 with subclinical form. In all patients anthropometric data (age, sex, weight, height, body mass index, blood pressure and heart rate, and clinical signs of hypothyroidism (skin changes, menstrual disorders were determined. Blood was drawn in fasting state for measurement of FT4, sTSH, glucose, lipids, ionized calcium, PTH, cortisol, ACTH, prolactin, gonadotropins, estradiol in women of reproductive age, and testosterone in men. Skin lesions were rarely present. Oligomenorrhea was more frequent in subclinical hypothyroidism, and menopause in clinical hypothyroidism. Blood pressure was normal in all subjects. Patients with clinical hypothyroidism compared to those with subclinical form had higher TSH values (19.5 ± 5.7 vs. 5.9 ± 0.3 mIU/l, and higher doses of L-thyroxine (81.2 ± 4.6 vs. 21.4 ± 3.5 μg/day. Disturbance of glycemic control was present in 18% of patients. Total cholesterol and LDL were insignificantly higher in patients with hypothyroidism than in subclinical form of the disease. FT4, calcium, PTH, cortisol, ACTH, gonadotropins, estradiol and testosterone did not differ between groups. The proatherogenic relation of estradiol with triglycerides was established in women with clinical form of hypothyroidism.

  15. Hypothyroidism and Mortality among Dialysis Patients

    Science.gov (United States)

    Rhee, Connie M.; Alexander, Erik K.; Bhan, Ishir

    2013-01-01

    Summary Background and objectives Hypothyroidism is highly prevalent among ESRD patients, but its clinical significance and the benefits of thyroid hormone replacement in this context remain unclear. Design, setting, participants, & measurements This study examined the association between hypothyroidism and all-cause mortality among 2715 adult dialysis patients with baseline thyrotropin levels measured between April of 2005 and April of 2011. Mortality was ascertained from Social Security Death Master Index and local registration systems. The association between hypothyroidism (thyrotropin greater than assay upper limit normal) and mortality was estimated using Cox proportional hazards models. To reduce the risk of observing reverse-causal associations, models included a 30-day lag between thyrotropin measurement and at-risk time. Results Among 350 (12.9%) hypothyroid and 2365 (87.1%) euthyroid (assay within referent range) patients, 917 deaths were observed during 5352 patient-years of at-risk time. Hypothyroidism was associated with higher mortality. Compared with thyrotropin in the low-normal range (0.4–2.9 mIU/L), subclinical hypothyroidism (thyrotropin >upper limit normal and ≤10.0 mIU/L) was associated with higher mortality; high-normal thyrotropin (≥3.0 mIU/L and ≤upper limit normal) and overt hypothyroidism (thyrotropin >10.0 mIU/L) were associated with numerically greater risk, but estimates were not statistically significant. Compared with spontaneously euthyroid controls, patients who were euthyroid while on exogenous thyroid replacement were not at higher mortality risk, whereas patients who were hypothyroid were at higher mortality risk. Sensitivity analyses indicated that effects on cardiovascular risk factors may mediate the observed association between hypothyroidism and death. Conclusions These data suggest that hypothyroidism is associated with higher mortality in dialysis patients, which may be ameliorated by thyroid hormone replacement

  16. Subclinical hypothyroidism in obese children

    Directory of Open Access Journals (Sweden)

    Aleksandra Januszek-Trzciąkowska

    2013-08-01

    Full Text Available Subclinical hypothyroidism (SH is defined as an elevated thyroid stimulating hormone (TSH associated with normal levels of free thyroxine. In obese persons prevalence of SH is significantly higher than in general population. SH is of particular interest in children with respect to the crucial role of thyroid hormones in the development of central nervous system and linear growth. Currently there is no general consensus on the treatment of SH with L-tyroxine. It is suggested that this hormonal state is rather a consequence that the cause of the overweight status.

  17. [Subclinical hypothyroidism in obese children].

    Science.gov (United States)

    Januszek-Trzciąkowska, Aleksandra; Małecka-Tendera, Ewa

    2013-08-05

    Subclinical hypothyroidism (SH) is defined as an elevated thyroid stimulating hormone (TSH) associated with normal levels of free thyroxine. In obese persons prevalence of SH is significantly higher than in general population. SH is of particular interest in children with respect to the crucial role of thyroid hormones in the development of central nervous system and linear growth. Currently there is no general consensus on the treatment of SH with L-tyroxine. It is suggested that this hormonal state is rather a consequence that the cause of the overweight status.

  18. The secondary hypothyroidism after radioiodine therapy and the replacement treatment

    International Nuclear Information System (INIS)

    Xu Ying; Xu Xiaohui

    2004-01-01

    The secondary hypothyroidism is the most important intercurrent disease after radioiodine therapy. The early hypothyroidism and the late hypothyroidism are incompletely different in pathogenesis. It needs researching further. there has not yet been an affirmable answer to choose the distillates from animal hypothyroid extract or complex preparation of levo-thyroxine in replacement treatment. (authors)

  19. The heart and hypothyroidism | Bennett | South African Medical ...

    African Journals Online (AJOL)

    The association of hypothyroidism with heart disease is reviewed. The. relative rarity of cardiac failure due to hypothyroidism is stressed, and structural abnormalities of the heart due to hypothyroidism are discussed. The clinical management of hypothyroid patients with heart disease is described.

  20. Congenital syphilis

    International Nuclear Information System (INIS)

    Lee, Sang Wook; Kim, Kyung Soo; Hur, Don

    1983-01-01

    In recent years, marked increase in incidence of congenital syphilis has occurred throughout the world due to changes in social norms and development of penicillin-resistant strains. Early diagnosis plays an important role in congenital syphilis as the clinical manifestations may simulate many other conditions in the paediatric age group. The authors analyzed 52 cases of congenital syphilis admitted to the department of paediatrics, Chosun University Hospital, clinically and radiologically. Among them, 18 cases were born in this hospital and 34 cases were admitted from OPD, during the period of 8 years from January, 1975 to December, 1982. The results obtained were as follows; 1. In 28 of 34 cases (82%), the first clinical manifestations were below the age of 3 months. 2. Among the 52 cases, a male predominance was observed with a male to female ratio of 2 : 1. 3. The serologic test (VDRL) of the 52 studied cases showed reactive response in 49 cases (94%), and that of syphilitic mothers except 6 cases, reactive in all studied cases. 4. The major manifestations of the 52 cases were bone tenderness (12%) and swelling of the joints (7%) in skeletal system, hepatosplenomegaly (79%) and skin lesions (73%) in extraskeletal one. 5. The radiological skeletal changes were detected in 45 of 52 cases (87%), and the commonest findings were detected in 45 of 52 cases (87%), and the commonest findings were metaphysitis (83%) and periostitis (81%). The most characteristic type of metaphysitis were transverse trophic line (74%) and zone of rarefaction (65%). 6. The commonest bones to be affected were growing metaphyses of the long bones, particulary about the wrist and the knee. The order of frequency were radius (80%), uina (80%), tibia (77%), femur (69%) and humerus (40%)

  1. Ocular changes in primary hypothyroidism.

    Science.gov (United States)

    Ozturk, Banu T; Kerimoglu, Hurkan; Dikbas, Oguz; Pekel, Hamiyet; Gonen, Mustafa S

    2009-12-29

    To determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy. Thirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT), anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus) and cup to disc ratio (C/D), mean retinal thickness and mean retinal nerve fiber layer (RNFL) thickness measurements with optical coherence tomography (OCT) in addition to ophthalmological examination preceeding the replacement therapy and at the 1(st), 3(rd )and 6(th )months of treatment. The mean age of the patients included in the study were 40.58 +/- 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP) revealed no significant change. The mean CCT was 538.05 +/- 3.85 mu initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 +/- 0.03 and the mean retinal thickness was 255.83 +/- 19.49 mu initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered. Neither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.

  2. [Hypothyroidism in patients with heart disease].

    Science.gov (United States)

    Jiskra, Jan

    Hypothyroidism is frequently found in patients with heart disease. It is a risk factor for atherosclerosis and ischemic heart disease and has a direct negative effect on both the left and right ventricular functions (hypothyroidism-induced cardiomyopathy). The confirmed manifest hypothyroidism is always a reason for replacement therapy with levothyroxine; regarding patients with heart disease, we always begin treatment with a small dose and increase it gradually. The treatment of subclinical hypothyroidism in patients with heart disease is disputable and its benefits probably depend on age. At a higher age, the therapy-related risks often outweigh its benefits, so we make do with the target levels of the thyroid stimulating hormone being within the upper band of the normal range, or even slightly above it, rather than overdosing the patient. To summarize in a simplified way, the treatment of subclinical hypothyroidism in patients with heart disease is the most effective in younger individuals, mainly those aged below 65, while at a higher age > 80 years the risk usually outweighs the benefit.Key words: cardiovascular risk - hypothyroidism - ischemic heart disease - left ventricular dysfunction - right ventricular dysfunction - subclinical hypothyroidism - thyroid peroxidase antibodies.

  3. Rhabdomyolysis in a Patient with Severe Hypothyroidism.

    Science.gov (United States)

    Salehi, Nooshin; Agoston, Endre; Munir, Iqbal; Thompson, Gary J

    2017-08-22

    BACKGROUND Muscular symptoms, including stiffness, myalgia, cramps, and fatigue, are present in the majority of the patients with symptomatic hypothyroidism, but rhabdomyolysis, the rapid breakdown of skeletal muscle, is a rare manifestation. In most patients with hypothyroidism who develop rhabdomyolysis, precipitating factors, such as strenuous exercise or use of lipid-lowering drugs, can be identified. CASE REPORT We report a case of a 52-year-old Hispanic woman with a history of hypothyroidism, hypertension, and type 2 diabetes mellitus who presented with fatigue, severe generalized weakness, bilateral leg pain, and recurrent falls. She reported poor medication compliance for the preceding month. Initial laboratory testing showed elevated thyroid stimulating hormone (TSH) and creatine kinase (CK) levels, indicating uncontrolled hypothyroidism with associated rhabdomyolysis. Supportive treatment with intravenous fluids and intravenous levothyroxine were initiated and resulted in dramatic clinical improvement. CONCLUSIONS We report a case of rhabdomyolysis, which is a rare but potentially serious complication of hypothyroidism. Screening for hypothyroidism in patients with elevated muscle enzymes should be considered, since an early diagnosis and prompt treatment of hypothyroidism is essential to prevent rhabdomyolysis and its consequences.

  4. Hypothyroidism after radiotherapy to the neck

    International Nuclear Information System (INIS)

    Yoden, Eisaku; Soejima, Toshinori; Maruta, Tsutomu; Demizu, Yusuke; Nishimura, Hideki; Ejima, Yasuo; Sasaki, Ryohei; Yamada, Kazunari; Sugimura, Kazuro

    2004-01-01

    The purpose of this study was to investigate the incidence and possible predictors of hypothyroidism after radiotherapy to the neck, focusing on radiation dose-volume factors. Thyroid function was measured in 169 patients treated with radiation ports including the thyroid, between 1989 and 2000. Hypothyroidism was determined with an endpoint of elevated serum thyroid stimulating hormone (TSH) levels >10.0 μU/ml. In 60 patients, radiation dose-volume factors were calculated; e.g., total volume of the thyroid, mean radiation dose to the thyroid, and %-volume of the thyroid which received radiation doses of no less than 10-70 Gy (V 10 -V 70 ). The evaluated risk factors for hypothyroidism included these dose-volume factors, sex, age, primary disease, combined chemotherapy, and follow-up period. Hypothyroidism was detected in 33 (19.5%) of the 169 patients. None of them had clinical symptoms of hypothyroidism. V 10 , V 20 , and V 30 seemed to be possible predictors of hypothyroidism and had a significant impact on the peak level of serum TSH. Radiation dose-volume factors of the thyroid seemed to correlate with the incidence of hypothyroidism, and V 10 , V 20 , and V 30 had a significant impact on the peak level of serum TSH. (author)

  5. Conversion of autoimmune hypothyroidism to hyperthyroidism.

    Science.gov (United States)

    Furqan, Saira; Haque, Naeem-ul; Islam, Najmul

    2014-08-03

    Graves' disease and Hashimoto's thyroiditis are the two autoimmune spectrum of thyroid disease. Cases of conversion from hyperthyroidism to hypothyroidism have been reported but conversion from hypothyroidism to hyperthyroidism is very rare. Although such cases have been reported rarely in the past we are now seeing such conversions from hypothyroidism to hyperthyroidism more frequently in clinical practice. We are reporting three cases of middle aged Asian females who presented with classical symptoms of hypothyroidism and the investigations showed elevated thyroid stimulating hormone with positive thyroid antibodies. Diagnosis of autoimmune hypothyroidism was made and thyroxine replacement therapy was initiated. Patients became asymptomatic with normalization of thyroid stimulating hormone level. After few years they developed symptoms of hyperthyroidism with suppressed thyroid stimulating hormone level. Over replacement of thyroxine was considered and the dose of thyroxine was decreased, but they remain symptomatic. After gradual decrease in the dose of thyroxine it was stopped finally. Even after few months of stopping thyroxine, the symptoms of hyperthyroidism did not improve and the biochemical and imaging modalities confirmed that the patients have developed hyperthyroidism. Anti-thyroid treatment was then started and the patients became symptom free. High index of suspicion should be there for possible conversion of hypothyroidism to hyperthyroidism if a patient with primary hypothyroidism develops persistent symptoms of hyperthyroidism. Otherwise it can be missed easily considering it as an over replacement with thyroid hormone.

  6. Effects of transient hypo- and hyper-thyroidism on growth ...

    African Journals Online (AJOL)

    In order to investigate the effects of transient hypo- and hyperthyroidism on growth performance, organ weights and serum thyroid hormones of broilers, 120 one-day-old broiler chicks were randomly divided into four dietary treatments for six weeks. The dietary treatments included: 1) control, 2) hypothyroid (hypo; ...

  7. [Cardiac myopathy due to overt hypothyroidism].

    Science.gov (United States)

    Harbeck, B; Berndt, M J; Lehnert, H

    2014-03-01

    A 51-year-old man presented with progressive tiredness, proximal muscle weakness, hair loss and weight gain for months. The patient showed mild pretibial myxedema and dry skin. Laboratory findings revealed strongly elevated cardiac enzymes as well as marked hypothyroidism. The electrocardiogram, echocardiography, abdominal sonography and chest X-ray were unremarkable. Thyroid ultrasound demonstrated features of Hashimoto thyroiditis. The findings supported the diagnosis of an overt hypothyroidism with myxedema and rhabdomyolysis. After starting levothyroxine and volume substitution laboratory parameters and clinical condition slowly normalized. Severe overt hypothyroidism may rarely present primarily as myopathy with myositis and cardiac involvement. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Hypothyroidism after radiotherapy for early glottic cancer

    International Nuclear Information System (INIS)

    Katayama, Motoyuki; Nishimura, Tetsuo; Nozue, Masashi; Kawai, Hiroaki; Takai, Michikatsu; Kaneko, Masao; Nishi, Shigeo

    1993-01-01

    Reported is the case of a 46-year-old male with hypothyroidism after radiotherapy for early glottic cancer, T1N0M0, Stage I. Six months after 60 Co irradiation 66 Gy with the radiation field size of 5 x 5 cm was given, the clinical signs of acute hypothyroidism was presented. Retrospective CT examinations proved that over 80% of the total dose was irradiated to about 10% of whole thyroid volume. Since laboratory examinations revealed high serum level of thyrogobrin antibody, we postulated immunological mechanism was associated with the onset of hypothyroidism. (author)

  9. Gender differences in symptoms of hypothyroidism

    DEFF Research Database (Denmark)

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

    2015-01-01

    of questionnaires. The gender-specific distribution of 13 hypothyroidism-associated symptoms and a simple combined score (0-13) was explored in conditional uni- and multivariate models taking into account a broad spectrum of possible confounders. Diagnostic odds ratios (DORs) were calculated as measures......OBJECTIVES: We examined the gender-specific symptom prevalences in hypothyroidism and in healthy controls and explored the extent to which symptoms indicative of thyroid status may be different in women and men. DESIGN AND METHODS: Patients newly diagnosed with overt autoimmune hypothyroidism (n...

  10. Spontaneous Bacterial Peritonitis in Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Dalip Gupta

    2013-11-01

    Full Text Available Hypothyroidism is an uncommon cause of ascites. Here we describe a case of a 75 year-old female patient with spontaneous bacterial peritonitis and subclinical hypothyroidism that resolved with thyroid replacement and antibiotic therapy respectively. Ascitic fluid analysis revealed a gram-positive bacterium on gram staining. A review of the literature revealed just one other reported case of myxoedema ascites with concomitant spontaneous bacterial peritonitis and no case has till been reported of spontaneous bacterial peritonitis in subclinical hypothyroidism.

  11. Neonatal hypothyroidism and its related factors in infants born inYazd Province during the years 2013 to 2014

    Directory of Open Access Journals (Sweden)

    Hossein Shojaeefar

    2017-03-01

    Full Text Available Introduction:Congenital hypothyroidism (CH is the leading cause of preventable Mental retardation. Neonatal screening in the first days of life with early diagnosis prevents the decrease in IQ. The aim of this study is to determine the prevalence of CH and associated factors to helps policymakers and managers of health system. Methods:This cross-sectional study was done on 51938 neonate in Yazd province during 2014-2015 by census. A blood sample from the heel is tested for TSH by Elisa method in Reference Laboratory.TSH less than 5 and 4 mmol is classified healthy neonate For aged 3-7 days and others respectively. Other TSH results were Suspicious for CH and followed. Age, sex, nationality, date of birth, birth weight, type of delivery, age of mother and Consanguineous of parents collected by questionnaire.For mean, standard deviation, frequency and percentage and Chi-square test were used Epi Info software. The significance level of p-value was considered less than 0.05 . Results:From 51938 neonates, 51% were male and 95.9% Iranian. 93.5% neonates live in urban area and 26.1% parents are contagious.The prevalence of birth weight < 2500 gr was 6.7%. 58.4% of mothers is 20-29 years old. Cesarean section include 45.7% deliveries. prevalence of CH is 3.4 per 1000 live birth in Yazd that it had significant associated with birth weight, type of delivery & city of residence. CH was not associated With the season of birth, maternal age, nationality and sex Conclusion:Due to high prevalence of CH , health system manager and researcher Should pay more attention To determine the causes of disease. It is essential that diagnosis of transient and permanent type of CH was differentiated.Quality review and possible revision of the screening program in the implementation process is recommended.

  12. Congenital amusia.

    Science.gov (United States)

    Williamson, Victoria J; Stewart, Lauren

    2013-01-01

    For most people, music, like language, is acquired effortlessly in early life. But a few percent of the population have lifelong difficulties in the perception and production of music. In this chapter we discuss psycho-acoustic and behavioral studies that have attempted to delineate the nature of the auditory perceptual deficits in this group and consider whether these difficulties extend outside the musical domain. Finally, we review structural imaging studies in this group which point to subtle anomalies in temporal and frontal areas. We suggest that amusia can be considered a disorder of neural development, which has relatively specific consequences at the behavioral level. Studies of congenital amusia provide a unique window on the neurocognitive architecture of music processing. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Hypothyroidism

    Science.gov (United States)

    ... you may notice that you feel colder, you tire more easily, your skin is getting drier, you’ ... to the thyroid. Keeping thyroid hormone production in balance requires the right amount of iodine. Taking in ...

  14. Hypothyroidism

    Science.gov (United States)

    ... the front of your neck, below your Adam’s apple. The thyroid makes hormones that control how your ... Travel Occupational Health First Aid and Injury Prevention Crisis Situations Pets and Animals myhealthfinder Food and Nutrition ...

  15. [Management of hypothyroidism and hyperthyroidism].

    Science.gov (United States)

    Jiskra, Jan

    2015-10-01

    Functional thyropathies present significant health risks for patients. Advanced functional thyropathies are always treated while indications for therapy of subclinical thyropathies are individual and often controversial. It is widely agreed that these disorders should be diagnosed and individuals should be followed. The drug of choice in substitution therapy of hypothyroidism is levothyroxine, in the treatment of hyperthyroidism it is methimazole. Administration of propylthiouracil should be limited to the first trimester of pregnancy, because its serious hepatotoxicity has been described. Hyperthyroidism based on thyroid nodules and immunogenic hyperthyroidism not reaching long-term remission, need to be treated radically: by surgery or radioiodine treatment. When radiation protection requirements are met, radioiodine can also be administered on an outpatient basis. Exceptionally, small doses of methimazole can be administered over an extended period of time in individual cases.

  16. Thyroid function in neonatal hypothyroidism.

    Science.gov (United States)

    Dussault, J H; Letarte, J; Guyda, H; Laberge, C

    1976-10-01

    Various aspects of the thyroid function have been measured in 28 cases of neonatal hypothyroidism detected by means of the Quebec Screening Program for Metabolic Diseases. In all instances the T4 value in the blood of filter paper spot was below 2 SD of the mean of the day, averaging 0.39 +/- 0.04 ng/40 mul (mean +/- SEM) of eluted blood. The T4 value of a second similar sample averaged 0.22 +/- 0.04 ng/mul of eluted blood; this value was significantly lower than the first one. The serum T4 concentration was decreased in all the infants, whereas three of them had a normal serum TSH concentration. At least three groups of patients could be identified: (1) patients with primary thyroid failure, (2) those with secondary or tertiary hypothyrodism, and (3) those with abnormal synthesis of thyroid hormone.

  17. Hypothyroidism: Does It Cause Joint Pain?

    Science.gov (United States)

    ... help, adequate thyroid hormone replacement is the primary treatment and often helps dramatically. When to see your doctor Keep in mind that people with the most common form of hypothyroidism have an increased risk of developing other autoimmune ...

  18. The debate on treating subclinical hypothyroidism

    Science.gov (United States)

    Tng, Eng Loon

    2016-01-01

    Subclinical hypothyroidism (SCH) represents a mild or compensated form of primary hypothyroidism. The diagnosis of SCH is controversial, as its symptoms are non-specific and its biochemical diagnosis is arbitrary. The treatment of SCH was examined among non-pregnant adults, pregnant adults and children. In non-pregnant adults, treatment of SCH may prevent its progression to overt hypothyroidism, reduce the occurrence of coronary heart disease, and improve neuropsychiatric and musculoskeletal symptoms associated with hypothyroidism. These benefits are counteracted by cardiovascular, neuropsychiatric and musculoskeletal side effects. SCH is associated with adverse maternal and fetal outcomes that may improve with treatment. Treating SCH in children is safe and may improve growth. Importantly, the evidence in this field is largely from retrospective and prospective studies with design limitations, which precludes a conclusive recommendation for the treatment of SCH. PMID:27779276

  19. Subclinical hypothyroidism after vascular complicated pregnancy

    NARCIS (Netherlands)

    Zanden, M. van der; Hop-de Groot, R.J.; Sweep, F.C.; Ross, H.A.; Heijer, M. den; Spaanderman, M.E.A.

    2013-01-01

    OBJECTIVE: Women with a history of vascular complicated pregnancy are at risk for developing remote cardiovascular disease. It is associated with underlying cardiovascular risk factors both jeopardizing trophoblast and vascular function. Subclinical hypothyroidism may relate to both conditions.

  20. Acute compartment syndrome caused by uncontrolled hypothyroidism.

    Science.gov (United States)

    Modi, Anar; Amin, Hari; Salzman, Matthew; Morgan, Farah

    2017-06-01

    Acute compartment syndrome is increased tissue pressure exceeding perfusion pressure in a closed compartment resulting in nerve and muscle ischemia. Common precipitating causes are crush injuries, burns, substance abuse, osseous or vascular limb trauma. This is a case of 42year old female with history of hypothyroidism who presented to emergency room with acute onset of severe pain and swelling in right lower extremity. Physical examination was concerning for acute compartment syndrome of right leg which was confirmed by demonstration of elevated compartmental pressures. No precipitating causes were readily identified. Further laboratory testing revealed uncontrolled hypothyroidism. Management included emergent fasciotomy and initiating thyroid hormone replacement. This case represents a rare association between acute compartment syndrome and uncontrolled hypothyroidism. We also discuss the pathogenesis of compartment syndrome in hypothyroid patients and emphasize the importance of evaluating for less common causes, particularly in setting of non-traumatic compartment syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. The debate on treating subclinical hypothyroidism.

    Science.gov (United States)

    Tng, Eng Loon

    2016-10-01

    Subclinical hypothyroidism (SCH) represents a mild or compensated form of primary hypothyroidism. The diagnosis of SCH is controversial, as its symptoms are non-specific and its biochemical diagnosis is arbitrary. The treatment of SCH was examined among non-pregnant adults, pregnant adults and children. In non-pregnant adults, treatment of SCH may prevent its progression to overt hypothyroidism, reduce the occurrence of coronary heart disease, and improve neuropsychiatric and musculoskeletal symptoms associated with hypothyroidism. These benefits are counteracted by cardiovascular, neuropsychiatric and musculoskeletal side effects. SCH is associated with adverse maternal and fetal outcomes that may improve with treatment. Treating SCH in children is safe and may improve growth. Importantly, the evidence in this field is largely from retrospective and prospective studies with design limitations, which precludes a conclusive recommendation for the treatment of SCH. Copyright: © Singapore Medical Association.

  2. Antithyroid drug-induced fetal goitrous hypothyroidism

    DEFF Research Database (Denmark)

    Bliddal, Sofie; Rasmussen, Ase Krogh; Sundberg, Karin

    2011-01-01

    Maternal overtreatment with antithyroid drugs can induce fetal goitrous hypothyroidism. This condition can have a critical effect on pregnancy outcome, as well as on fetal growth and neurological development. The purpose of this Review is to clarify if and how fetal goitrous hypothyroidism can...... be prevented, and how to react when prevention has failed. Understanding the importance of pregnancy-related changes in maternal thyroid status when treating a pregnant woman is crucial to preventing fetal goitrous hypothyroidism. Maternal levels of free T(4) are the most consistent indication of maternal...... and fetal thyroid status. In patients with fetal goitrous hypothyroidism, intra-amniotic levothyroxine injections improve fetal outcome. The best way to avoid maternal overtreatment with antithyroid drugs is to monitor closely the maternal thyroid status, especially estimates of free T(4) levels....

  3. Subclinical Hypothyroidism: A Prospective Observational Study from Southern India.

    Science.gov (United States)

    Sridhar, Mathrubootham; Mahadevan, Shriraam; Vishwanathan, Latha; Subbarayan, Anbezhil

    2018-03-15

    To assess the natural history and progression of subclinical hypothyroidism and to study factors which help predict evolution of subclinical hypothyroidism into overt hypothyroidism. Longitudinal study in 40 children (2-16 yrs) presenting with subclinical hypothyroidism in a tertiary care unit in Chennai, India. Patients showing evidence of overt hypothyroidism or thyroid stimulating hormone ≥15 mIU/mL during follow-up were started on thyroxine. Others were followed up with 3-monthly thyroid function tests up to one year. At the end of our study period 3 (7.5%) were overtly hypothyroid, 16 (40%) remained as subclinical hypothyroid, and 21 (52.5%) became euthyroid. Evidence of auto- immunity at baseline was a significant (Phypothyroidism. Subclinical hypothyroidism in children, with thyroid stimulating hormone upto 15 mIU/L and irrespective of thyroid autoimmunity, needs only periodic clinical and biochemical follow up. Thyroid autoimmunity may point to an increased probability of progression to overt hypothyroidism.

  4. Ocular changes in primary hypothyroidism

    Directory of Open Access Journals (Sweden)

    Pekel Hamiyet

    2009-12-01

    Full Text Available Abstract Background To determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy. Findings Thirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT, anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus and cup to disc ratio (C/D, mean retinal thickness and mean retinal nerve fiber layer (RNFL thickness measurements with optical coherence tomography (OCT in addition to ophthalmological examination preceeding the replacement therapy and at the 1st, 3rd and 6th months of treatment. The mean age of the patients included in the study were 40.58 ± 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP revealed no significant change. The mean CCT was 538.05 ± 3.85 μ initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 ± 0.03 and the mean retinal thickness was 255.83 ± 19.49 μ initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered. Conclusions Neither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.

  5. Hypothyroidism in late-onset Pompe disease.

    Science.gov (United States)

    Schneider, Joseph; Burmeister, Lynn A; Rudser, Kyle; Whitley, Chester B; Jarnes Utz, Jeanine

    2016-09-01

    In Pompe disease, a deficiency of acid α-glucosidase enzyme activity leads to pathologic accumulation of glycogen in tissues. Phenotype heterogeneity in Pompe includes an infantile form and late-onset forms (juvenile- and adult-onset forms). Symptoms common to all phenotypes include progressive muscle weakness and worsening respiratory function. Patients with late-onset forms of Pompe disease commonly complain of chronic fatigue and generalized muscle weakness prior to being diagnosed with Pompe disease, and this may lead to consideration of hypothyroidism in the differential diagnosis. This study aimed to evaluate the prevalence of hypothyroidism in the adult-onset form of Pompe disease. Electronic chart review was performed at the Advanced Therapies Clinic at the University of Minnesota Medical Center (UMMC) to identify patients with late-onset Pompe disease. The identified charts were reviewed for a co-diagnosis of hypothyroidism. A query was made to the clinical data repository at UMMC searching diagnosis ICD9 code 244.9 (hypothyroidism not otherwise specified) and/or presence of levothyroxine from 2011 to 2014 in patients 18 years of age and older. The clinical data repository found a prevalence of hypothyroidism of 3.15% (56,072 of 1,782,720 patients) in the adult patient population at UMMC. Ten adult patients with Pompe disease were identified, five with the diagnosis of hypothyroidism (50%, 95% CI: 23.7, 76.3, p Hypothyroidism was found at a higher prevalence in patients with late-onset Pompe disease compared to the general adult population at UMMC. Studies in larger populations of patients with Pompe disease would be needed to confirm an association of Pompe disease and hypothyroidism. Challenges include finding an adequate sample size, due the rarity of Pompe disease.

  6. High androgen levels protect against hypothyroidism.

    Science.gov (United States)

    Schmidt, Johanna; Dahlgren, Eva; Bryman, Inger; Berntorp, Kerstin; Trimpou, Penelope; Wilhelmsen, Lars; Landin-Wilhelmsen, Kerstin

    2017-01-01

    Hypothyroidism is a common disorder, appearing mainly in women although less frequently found in women with polycystic ovary syndrome (PCOS). The objective was to test the hypothesis that hyperandrogenism might protect against hypothyroidism. The data from three prospective follow-up studies (up to 21 years) and one register study were compared: women with PCOS (Rotterdam criteria), n = 25, women with Turner syndrome, n = 217, a random population sample of women, n = 315, and men, n = 95 (the WHO MONICA study). Findings were to be verified or rejected in all females, n = 553 716, from the same region. The proportion of hypothyroidism was calculated and thyroid peroxidase antibodies (TPO) in serum were measured. Hypothyroidism at >50 years of age was found in 8% of women with PCOS, 4% in men (PCOS vs. men; ns), 43% of women with Turner syndrome, irrespective of karyotype (p Hypothyroidism increased with age in all groups except PCOS women and men. In the register study, hypothyroidism was less common in women with PCOS >25 years (5.5%) than in women without PCOS (6.8%) from the same region (p Hypothyroidism was less frequently seen in women with PCOS and in men compared with women in the general population and among women with Turner syndrome. This was not explained by altered autoimmunity or the Y-chromosome. Androgens seem to protect against hypothyroidism. © 2016 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology.

  7. Hemostasis in Hypothyroidism and Autoimmune Thyroid Disorders

    OpenAIRE

    Ordookhani, Arash; Burman, Kenneth D.

    2017-01-01

    Context There are contradictory results on the effect of hypothyroidism on the changes in hemostasis. Inadequate population-based studies limited their clinical implications, mainly on the risk of venous thromboembolism (VTE). This paper reviews the studies on laboratory and population-based findings regarding hemostatic changes and risk of VTE in hypothyroidism and autoimmune thyroid disorders. Evidence Acquisition A comprehensive literature search was conducted employing MEDLINE database. T...

  8. Massive pericardial effusion associated with hypothyroidism.

    Science.gov (United States)

    Ionescu, Simona Daniela; Tănase, Daniela Maria; Ouatu, Anca; Ambăruş, V; Dosa, Anca; Arsenescu-Georgescu, Cătălina

    2014-01-01

    The diagnosis of hypothyroidism is difficult because hypothyroidism in adults and especially the elderly, classic, has an insidious onset with a range of nonspecific symptoms which may delay diagnosis for months or even years. Old age seems to represent trigger factor for autoimmune diseases, including hypothyroidism. Clinical features in hypothyroidism, such as weight gain, fatigue, cold intolerance, constipation, dry skin, edema and muscle weakness, and decreased osteo-tendinous reflexes are usually subtle and can be overlooked. Thyroid dysfunction may be associated with a negative impact on the cardiovascular system. Pericardial, pleural and peritoneal effusions are common findings in hypothyroidism. This case report represents a typical primary hypothyroidism (autoimmune) and shows the clinical features of this disease. Basically we talked about a severe myxedema with the involvement of internal organs in an elderly woman and the euthyroidism restoration, under thyroid replacement therapy, was correlated with the clinical improvement and cardiovascular and neurological status, with radiographic remission and regression to extinction of pericardial effusion at repeated echocardiographic evaluations.

  9. Hypothyroidism and Hyponatremia: Rather Coincidence Than Causality.

    Science.gov (United States)

    Wolf, Peter; Beiglböck, Hannes; Smaijs, Sabina; Wrba, Thomas; Rasoul-Rockenschaub, Susanne; Marculescu, Rodrig; Gessl, Alois; Luger, Anton; Winhofer, Yvonne; Krebs, Michael

    2017-05-01

    Hypothyroidism is referred to be a rare but possible cause of hyponatremia. However, there is only poor evidence supporting this association. Since hyponatremia and hypothyroidism are both common conditions themselves, co-occurrence does not have to be causal. To address a potential relationship, a retrospective analysis of data from the Division of Endocrinology of the Medical University of Vienna from April 2004 to February 2016 was performed. A total of 8053 hypothyroid patients (48 ± 18 years of age; 71% female) with thyrotropin >4.0 μIU/mL and available blood tests for free thyroxine and sodium (Na + ) within maximal ± seven days were included and screened for hyponatremia. Patients' records were searched for concomitant disease and medication when Na + concentration was causes of hyponatremia in 442/448 (98.88%) patients (i.e., side effects of medication, concomitant underlying disease, or other endocrine disorders). This distribution did not differ between patients suffering from clinical or subclinical hypothyroidism. No case of clinically relevant hyponatremia (Na + hypothyroidism. There was a very weak but statistically significant trend toward a positive association between thyroid function and serum Na + levels (Na + /thyrotropin: R = 0.022, p = 0.046; Na + /free thyroxine: R = -0.047, p hypothyroid patients with moderate to severe hyponatremia often have other potential explanations for their low serum Na + concentrations in routine care.

  10. Production rates and turnover of triiodothyronine in rat-developing cerebral cortex and cerebellum. Responses to hypothyroidism

    International Nuclear Information System (INIS)

    Silva, J.E.; Matthews, P.S.

    1984-01-01

    Local 5'-deiodination of serum thyroxine (T4) is the main source of triiodothyronine (T3) for the brain. Since we noted in previous studies that the cerebral cortex of neonatal rats tolerated marked reductions in serum T4 without biochemical hypothyroidism, we examined the in vivo T4 and T3 metabolism in that tissue and in the cerebellum of euthyroid and hypothyroid 2-wk-old rats. We also assessed the contribution of enhanced tissue T4 to T3 conversion and decreased T3 removal from the tissues to the T3 homeostasis in hypothyroid brain. Congenital and neonatal hypothyroidism was induced by adding methimazole to the drinking water. Serum, cerebral cortex (Cx), cerebellum (Cm), liver (L) and kidney (R) concentrations of 125I-T4, 125I-T3(T4), and 131I-T3 were measured at various times after injecting 125I-T4 and 131I-T3. The rate of T3 removal from the tissues was measured after injecting an excess of anti-T3-antibody to rats previously injected with tracer T3. In hypothyroidism, the fractional removal rates and clearances were reduced in all tissues, in cortex and cerebellum by 70%, and in liver and kidney ranging from 30 to 50%. While greater than 80% of the 125I-T3(T4) in the brain tissues of euthyroid rats was locally produced, in hypothyroid cerebral cortex and cerebellum the integrated concentrations of 125I-T3(T4) were 2.7- and 1.5-fold greater than in euthyroid rats

  11. Towards the pre-clinical diagnosis of hypothyroidism caused by iodotyrosine deiodinase (DEHAL1) defects.

    Science.gov (United States)

    Iglesias, Ainhoa; García-Nimo, Laura; Cocho de Juan, José A; Moreno, José C

    2014-03-01

    DEHAL1 (also named IYD) is the thyroidal enzyme that deiodinates mono- and diiodotyrosines (MIT, DIT) and recycles iodine, a scarce element in the environment, for the efficient synthesis of thyroid hormone. Failure of this enzyme leads to the iodotyrosine deiodinase deficiency (ITDD), characterized by hypothyroidism, compressive goiter and variable mental retardation, whose diagnostic hallmark is the elevation of iodotyrosines in serum and urine. However, the specific diagnosis of this type of hypothyroidism is not routinely performed, due to technical and practical difficulties in iodotyrosine determinations. A handful of mutations in the DEHAL1 gene have been identified as the molecular basis for the ITDD. Patients harboring DEHAL1 defects so far described all belong to consanguineous families, and psychomotor deficits were present in some affected individuals. This is probably due to the lack of biochemical expression of the disease at the beginning of life, which causes ITDD being undetected in screening programs for congenital hypothyroidism, as currently performed. This worrying feature calls for efforts to improve pre-clinical detection of iodotyrosine deiodinase deficiency during the neonatal time. Such a challenge poses questions of patho-physiological (natural history of the disease, environmental factors influencing its expression) epidemiological (prevalence of ITDD) and technical nature (development of optimal methodology for safe detection of pre-clinical ITDD), which will be addressed in this review. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus: a case report

    Directory of Open Access Journals (Sweden)

    Kunii Yasuto

    2011-09-01

    Full Text Available Abstract Introduction Non-convulsive status epilepticus is a form of epileptic seizure that occurs without convulsions. Recent reviews suggest that the diagnosis of non-convulsive status epilepticus remains difficult. Here, we report the case of a patient with thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus. Case presentation Our patient was a 68-year-old Japanese woman. The results of endocrine testing after her first episode of non-convulsive status epilepticus suggested latent subclinical hypothyroidism: she had elevated thyroid-stimulating hormone with normal levels of free tri-iodothyronine and free thyroxine. On examination, a diagnosis of thyroid disorder was not supported by other test results and our patient remained untreated. A follow-up examination revealed that her thyroid-stimulating hormone levels had spontaneously normalized. When she consulted another doctor for confusion, the transient increase in thyroid-stimulating hormone levels following non-convulsive status epilepticus was mistaken for subclinical hypothyroidism, and unfortunately treated with levothyroxine. Our patient then experienced levothyroxine-induced non-convulsive status epilepticus. Conclusions In this report, we suggested possible mechanisms for latent hypothyroid-like hormone abnormality following epileptic seizures and the possibility of provoking epileptic seizures by administering levothyroxine for misdiagnosed subclinical hypothyroidism.

  13. Subclinical hypothyroidism in children with Down syndrome: To treat ...

    African Journals Online (AJOL)

    Mohamed El Kholy

    2014-12-01

    Dec 1, 2014 ... In children with subclinical hypothyroidism, The American. Thyroid Association ... reflects mild hypothyroidism that could harm brain growth and development in the ... results in a normal cognitive development [9]. In conclusion ...

  14. Congenital platelet function defects

    Science.gov (United States)

    ... pool disorder; Glanzmann's thrombasthenia; Bernard-Soulier syndrome; Platelet function defects - congenital ... Congenital platelet function defects are bleeding disorders that cause reduced platelet function. Most of the time, people with these disorders have ...

  15. Congenital Heart Information Network

    Science.gov (United States)

    ... heart defects. Important Notice The Congenital Heart Information Network website is temporarily out of service. Please join ... and Uwe Baemayr for The Congenital Heart Information Network Exempt organization under Section 501(c)3. Copyright © ...

  16. Congenital heart disease

    Science.gov (United States)

    Congenital heart disease (CHD) is a problem with the heart's structure and function that is present at birth. ... Fraser CD, Kane LC. Congenital heart disease. In: Townsend CM Jr, ... Sabiston Textbook of Surgery: The Biological Basis of Modern ...

  17. Cardiogenic Pulmonary Edema in a Dog Following Initiation of Therapy for Concurrent Hypoadrenocorticism and Hypothyroidism.

    Science.gov (United States)

    Paik, Jooyae; Kang, Ji-Houn; Chang, Dongwoo; Yang, Mhan-Pyo

    A 5 yr old intact female cocker spaniel dog weighing 7.8 kg was referred with anorexia, vomiting, and depression. At referral, the dog was diagnosed initially with typical hypoadrenocorticism, and 2 d later, concurrent primary hypothyroidism was detected. Hormonal replacement therapies, including fludrocortisone, prednisolone, and levothyroxine, were initiated, but a few days later the dog became abruptly tachypneic, and thoracic radiographs indicated the development of pulmonary edema. Echocardiography showed that there were abnormalities indicating impaired left ventricular function, although the heart valves were normal. Following treatment with pimobendan and furosemide, the pulmonary edema resolved. The dog had no recurrence of the clinical signs after 10 mo of follow-up, despite being off all cardiac medications; consequently, the cardiac failure was transient or reversible in this dog. The case report describes the stepwise diagnosis and successful treatment of cardiogenic pulmonary edema after initiation of hormonal replacement therapy for concurrent hypoadrenocorticism and hypothyroidism in a dog.

  18. Update on the treatment of hypothyroidism.

    Science.gov (United States)

    Jonklaas, Jacqueline

    2016-01-01

    Differentiated thyroid cancer is a malignancy that is rapidly increasing in frequency. As thyroidectomy plays a central role in the treatment of thyroid cancer, it is incumbent on physicians treating this patient group to be well versed in the intricacies of treating hypothyroidism. Treatment of hypothyroidism may be refined by careful attention to dose selection, monitoring of therapy and achievement of thyrotropin goals that are specific to the individual patient's overall clinical situation. These goals are common not only to patients with a sole diagnosis of hypothyroidism, as discussed in the recent American Thyroid Association Guidelines, but also to patients with hypothyroidism in the setting of thyroid cancer. Several recent studies have illuminated our understanding of the benefits and risks of thyrotropin suppression therapy in patients with differentiated thyroid cancer. Multiple studies of combination therapy with levothyroxine and liothyronine for treating hypothyroidism have not led to a clear conclusion about its benefits over levothyroxine monotherapy. Animal studies have advanced our understanding of the altered serum and tissue milieu that characterizes levothyroxine monotherapy. Crossing the bridge from this translational research into clinical research using sustained release triiodothyronine preparations may ultimately enhance the health of our patients. Continued refinement of our understanding of thyroid status and our ability to flawlessly implement thyroid hormone replacement is an active area of research.

  19. Congenital Intrahepatic Portosystemic Shunts

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woong Hee; Kim, Young Tong; Jou, Sung Shick; Shin, Hyeong Cheol [Soonchunhyang University, Asan (Korea, Republic of)

    2008-12-15

    Intrahepatic portosystemic shunts are an anomalous connection between the portal vein and hepatic vein/IVC, which may be either congenital or acquired secondary to liver cirrhosis or portal hypertension. Cases of congenital intrahepatic shunts are usually encountered in children and may spontaneously resolve. We report 5 cases of congenital intrahepatic portosystemic shunts in neonates and an adult

  20. Hypothyroid symptoms and the likelihood of overt thyroid failure

    DEFF Research Database (Denmark)

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

    2014-01-01

    in hypothyroidism. Hypothyroid patients suffered mostly from tiredness (81%), dry skin (63%), and shortness of breath (51%). Highest DORs (95% CI) were reported for tiredness (5.94 (3.70-9.60)), hair loss (4.58 (2.80-7.51)), and dry skin (4.09 (2.73-6.16)). A hypothyroidism-component-score was defined as the number...

  1. [Changes in muscle tissue in hypothyroidism].

    Science.gov (United States)

    Jiskra, J

    2001-09-01

    This article offers a synopsis of detailed analysis of the functional and structural changes in muscle tissue in manifest and subclinical hypothyroidism. There is a brief overview of the division between mypathy and myositis, with emphasis on endocrinological and metabolic disorders. The necessity of endocrinological examination in each case of myopathy the etiology of which is indefinite is stressed, and this especially before the instigation of non-specific immunosuppressive treatment (e.g., corticosteroids) as this treatment has the risk of undesirable side-effects. In conclusion, it emphasises the negative influence of the nexus of hypothyroidism and the administering of a hypolipidemic in tandem on muscle tissue, as in rare cases this can lead to the disintegration of muscle tissue, i.e., rhabdomyolysis. The administering of hypolipidemic drugs to patients with hypothyroidism is indicated only in those cases where persists hyperlipoproteinemia after the normalisation of the thyroid function by substitutional treatment.

  2. Adolescent with Rhabdomyolysis due to Undiagnosed Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Raquel Farias Moeller

    2011-01-01

    Full Text Available Exercise-induced rhabdomyolysis has been described in military recruits, trained athletes and daily runners. Statin use, quail ingestion, infection by Epstein-Barr virus (EBV, and hypothyroidism, though rare, are risk factors for the development of rhabdomyolysis. We describe the case of a 15-year-old female who presented with myalgias, weakness, and pigmenturia following marching band practice. Laboratory tests confirmed an elevated creatine kinase (CK level as well as a profound hypothyroid state. Muscle biopsy revealed severe muscle necrosis and myositis. Treatment with levothyroxine resulted in obtaining an euthyroid state and regain of muscle strength as well as decrease in CK levels. Although rare, hypothyroidism should be considered as a potential cause of rhabdomyolysis in pediatric patients undergoing a myopathy workup.

  3. Primary Hypothyroidism With Markedly High Prolactin

    Directory of Open Access Journals (Sweden)

    MOHD SALEEM ANSARI

    2016-04-01

    Full Text Available Secondary Pituitary enlargement due to primary hypothyroidism is not a common manifestation. The loss of thyroxin feedback inhibition in primary hypothyroidism causes overproduction of thyroid-releasing hormone (TRH, which results in secondary pituitary enlargement.TRH has a weak stimulatory effect on lactotroph cells of pituitary, so mild to moderate rise in prolactin (PRL level is expected. We report a 67 years old female who presented with a large pituitary mass and very high level of TSH with a significant rise in PRL level. In this case the diagnosis of seller mass was challenging, it was difficult to distinguish between pituitary prolactinoma and primary hypothyroidism with secondary pituitary hyperplasia. The thyroid hormone replacement proved that hyperprolactinemia was due to hyperplasia of the pituitary gland.Hence, the correct diagnosis and thyroid hormone therapy can prevent unnecessary treatment with dopamine agonist.

  4. SUBCLINICAL HYPOTHYROIDISM CURRENT CONCEPTS & M ANAGEMENT STRATEGEIES

    Directory of Open Access Journals (Sweden)

    Radha Krishnan

    2015-05-01

    Full Text Available Subclinical hypothyroidism is a biochemical diagnosis characterized by raised thyroid stimulating hormone ( TSH and normal free T3 & T4 , without clinical features of hypothyroidism . Clinical significance of SCH remains uncertain and controversial . Symptoms of SCH may vary from being asymptomatic to having mild nonspecific symptoms . There are still controversies surrounding SCH and associated risk of various cardiovascular diseases ( CVDs , pregnancy outcomes , neuropsychiatric issues , metabolic syndrome , and dyslipidemia . This review will summarize the current data related to the effects of SCH on cardiovascular risk , SCH in pregnancy , in dyslipedemia and clinical guidelines on management of this condition . The evidence has been updated by a Pub med search on the risks and treatment of subclinical hypothyroidism of most recent articles published until March 2015

  5. The interrelation between hypothyroidism and glaucoma

    DEFF Research Database (Denmark)

    Thvilum, Marianne; Hjelm Brandt Kristensen, Frans; Brix, Thomas Heiberg

    2017-01-01

    Data on the association between hypothyroidism and glaucoma are conflicting. We sought to shed light on this by conducting a critical review and meta-analyses. The meta-analyses were conducted in adherence with the widely accepted MOOSE guidelines. Using the Medical Subject Heading (MeSH) terms......: hypothyroidism, myxoedema and glaucoma or intraocular pressure, case-control studies, cohort studies and cross-sectional studies were identified (PubMed) and reviewed. Using meta-analysis, the relative risk (RR) of coexistence of glaucoma and hypothyroidism was calculated. Based on the literature search......, thirteen studies fulfilled the inclusion criteria and could be categorized into two groups based on the exposure. The designs of the studies varied considerably, and there was heterogeneity related to lack of power, weak phenotype classifications and length of follow-up. Eight studies had glaucoma (5757...

  6. Pulmonary functions in patients with subclinical hypothyroidism.

    Science.gov (United States)

    Cakmak, Gulfidan; Saler, Tayyibe; Saglam, Zuhal Aydan; Yenigun, Mustafa; Ataoglu, Esra; Demir, Tuncalp; Temiz, Levent Umit

    2011-10-01

    To determine whether alterations in pulmonary function takes place in subclinical hypothyroidism by examining the diffusion lung capacity and muscle strength of such patients. This is a descriptive study conducted in 2009 at Haseki Training and Research Hospital, Istanbul, Turkey. Hundred and twenty-six patients with subclinical hypothyroidism and 58 age and sex matched individuals were recruited. Simple spirometry tests were performed, and pulmonary diffusion capacity (DLco) and muscle strength were measured. ScH patients showed a significant reduciton of the following pulmonary function tests (% predicted value) as compared with control subjects: FVC, FEV1, FEV1%, FEF25-75, FEF25-75%, DLco, DLco/VA, Pimax, Pimax% and Pemax%. These data indicate that pulmonary functions are effected in subclinical hypothyrodism. Therefore patients with or who are at high risk of having subclinical hypothyroidism, should be subjected to evaluation of pulmonary functions with simple spirometry.

  7. Hypothyroidism: challenges when treating older adults.

    Science.gov (United States)

    Pearson, Tamera

    2013-01-01

    Hypothyroidism frequently affects older adults' general sense of health, their cognitive abilities, and quality of life. Management decisions regarding when to start treatment and at what dosage to begin medication are influenced by both laboratory values and patient symptoms. Although specific guidelines regarding management of hypothyroidism in older adults do not exist, general recommendations include initiating hormone replacement with levothyroxine (Levoxyl(®), Synthroid(®), and others) at 12.5 mcg to 25 mcg and titrating the dose slowly based on response at 6-week intervals. Multiple medications and certain foods can interact with levothyroxine; therefore, the best dosage time is when a person is fasting or 4 hours postprandial. Using a consistent brand-name drug for hormone replacement with levothyroxine is important due to variations in the active ingredient in generic formulations. Providers need to be aware of the prevalence of hypothyroidism and management issues when caring for older adults. Copyright 2013, SLACK Incorporated.

  8. Radionuclide Esophageal Transit Scintigraphy in Primary Hypothyroidism.

    Science.gov (United States)

    Khan, Shoukat H; P, Madhu Vijay; Rather, Tanveer A; Laway, Bashir A

    2017-01-30

    Esophageal dysmotility is associated with gastrointestinal dysmotility in various systemic and neuroregulatory disorders. Hypothyroidism has been reported to be associated with impaired motor function in esophagus due to accumulation of glycosaminoglycan hyaluronic acid in its soft tissues, leading to changes in various contraction and relaxation parameters of esophagus, particularly in the lower esophageal sphincter. In this study we evaluated esophageal transit times in patients of primary hypothyroidism using the technique of radionuclide esophageal transit scintigraphy. Thirty-one patients of primary hypothyroidism and 15 euthyroid healthy controls were evaluated for esophageal transit time using 15-20 MBq of Technetium-99m sulfur colloid diluted in 10-15 mL of drinking water. Time activity curve was generated for each study and esophageal transit time was calculated as time taken for clearance of 90% radioactive bolus from the region of interest encompassing the esophagus. Esophageal transit time of more than 10 seconds was considered as prolonged. Patients of primary hypothyroidism had a significantly increased mean esophageal transit time of 19.35 ± 20.02 seconds in comparison to the mean time of 8.25 ± 1.71 seconds in healthy controls ( P < 0.05). Esophageal transit time improved and in some patients even normalized after treatment with thyroxine. A positive correlation ( r = 0.39, P < 0.05) albeit weak existed between the serum thyroid stimulating hormone and the observed esophageal transit time. A significant number of patients with primary hypothyroidism may have subclinical esophageal dysmotility with prolonged esophageal transit time which can be reversible by thyroxine treatment. Prolonged esophageal transit time in primary hypothyroidism may correlate with serum thyroid stimulating hormone levels.

  9. Hypophysiary hyperplasia secondary to primary hypothyroidism

    International Nuclear Information System (INIS)

    Garcia, Jorge; Polania, Diana Ligia; Builes, Carlos Alfonso

    2005-01-01

    This is a 43 years old woman, complaining of galactorhea, headache and hyperprolactinaemia. A large macro adenoma of the pituitary with extensive suprasellar extension and displacement of the optic chiasm was detected on MRI and primary hypothyroidism was found. After treatment with levothyroxine for four months, her TSH and prolactin levels returned to normal, her symptoms improved and a marked shrinkage of the selar lesion was observed. The visual fields returned to normal. This is a case of pituitary hyperplasia due to primary hypothyroidism

  10. Serum lipids in hypothyroidism: Our experience

    OpenAIRE

    Prakash, Archana; Lal, Ashok Kumar

    2006-01-01

    In order to determine whether the screening of lipid profile is justified in patients with hypothyroidism we estimated serum lipids in cases having different levels of serum TSH. 60 patients of hypothyroidism in the age group of 20 to 60 yrs were studied for thyroid profile over a period of one year. On the basis of serum TSH level the cases were divided into three groups: In the first group TSH concentration was 8.8±2.99 μlU/ml, 95% confidence interval (Cl) 8.8±1.07, whereas serum total chol...

  11. Transient analyzer

    International Nuclear Information System (INIS)

    Muir, M.D.

    1975-01-01

    The design and design philosophy of a high performance, extremely versatile transient analyzer is described. This sub-system was designed to be controlled through the data acquisition computer system which allows hands off operation. Thus it may be placed on the experiment side of the high voltage safety break between the experimental device and the control room. This analyzer provides control features which are extremely useful for data acquisition from PPPL diagnostics. These include dynamic sample rate changing, which may be intermixed with multiple post trigger operations with variable length blocks using normal, peak to peak or integrate modes. Included in the discussion are general remarks on the advantages of adding intelligence to transient analyzers, a detailed description of the characteristics of the PPPL transient analyzer, a description of the hardware, firmware, control language and operation of the PPPL transient analyzer, and general remarks on future trends in this type of instrumentation both at PPPL and in general

  12. Treatment for primary hypothyroidism: current approaches and future possibilities

    Science.gov (United States)

    Chakera, Ali J; Pearce, Simon HS; Vaidya, Bijay

    2012-01-01

    Primary hypothyroidism is the most common endocrine disease. Although the diagnosis and treatment of hypothyroidism is often considered simple, there are large numbers of people with this condition who are suboptimally treated. Even in those people with hypothyroidism who are biochemically euthyroid on levothyroxine replacement there is a significant proportion who report poorer quality of life. This review explores the historical and current treatment options for hypothyroidism, reasons for and potential solutions to suboptimal treatment, and future possibilities in the treatment of hypothyroidism. PMID:22291465

  13. Asymptomatic myotonia congenita unmasked by severe hypothyroidism.

    Science.gov (United States)

    Passeri, Elena; Sansone, Valeria A; Verdelli, Chiara; Mendola, Marco; Corbetta, Sabrina

    2014-04-01

    Myotonia congenita is an inherited muscle disorder sustained by mutations in the skeletal muscle chloride channel gene CLCN1. Symptoms vary from mild to severe and generalized myotonia and worsen with cold, stressful events and hormonal fluctuations. Here we report the case of a young woman who sought medical attention because of subacute onset of diffuse and severe limb myotonia. CLCN1 gene sequencing showed a heterozygous transversion (T550M), two polymorphisms and one silent mutation. Thyroid function screening revealed severe hypothyroidism. She was placed on l-thyroxine replacement therapy which dramatically improved myotonia. We conclude that hypothyroidism unmasked a genetically determined, clinically asymptomatic chloride channelopathy. Diagnostic work-up in patients with clinically isolated myotonia should not be limited to genetic screening of non-dystrophic or dystrophic myotonias. Considering the high prevalence of hypothyroidism in females, systematic thyroid function screening by looking for additional hypothyroid symptoms and serum TSH levels measurement is mandatory in these patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Recurrent Pericardial Effusion Associated with Hypothyroidism in ...

    African Journals Online (AJOL)

    Background: The complex of Down Syndromehypothyroidism-pericardial effusion is largely unreported in sub-Sahara. Objective: To present and highlight an unusual manifestation of hypothyroidism. Methods: A 16-year-old girl with confirmed Down Syndrome presented with complaints of generalised body swelling of eight ...

  15. Effects of Hypothyroidism and Exogenous Thyroxine on ...

    African Journals Online (AJOL)

    Summary: Thyroxine (T4) is important in gut development and maturation, and its use in treating hypothyroidism is becoming more popular. This study was conducted to evaluate the effect of thyroidectomy and thyroxine replacement on some gastrointestinal organs. Ten out of 20 thyroidectomised rats received 100pg/kgbw ...

  16. Severe hypothyroidism masquerading as renal impairment

    DEFF Research Database (Denmark)

    Bistrup, C; Jensen, Dorte Møller; Kvetny, J

    1996-01-01

    A case of severe hypothyroidism in a 51-year old male is presented. The patient was especially complaining of weakness, stiffness and moderate pain in the proximal muscle groups together with rhinorrhea and nasal stenosis. Because of severely elevated S-creatine-kinase combined with reduced...

  17. Hypothyroidism and depression: Are cytokines the link?

    Directory of Open Access Journals (Sweden)

    Parimal S Tayde

    2017-01-01

    Full Text Available Context: Primary hypothyroidism has been thought of as an inflammatory condition characterized by raised levels of cytokines such as C-reactive protein (CRP, interleukin-6 (IL-6, and tumor necrosis factor-alpha (TNF-α. Depression is also well known to occur in hypothyroidism. Depression is also characterized by elevated inflammatory cytokines. We planned to study whether cytokines play an important part in linking these two conditions. Objectives: (1 To know the prevalence of depression in overt hypothyroidism due to autoimmune thyroid disease. (2 To correlate the levels of inflammatory markers with the occurrence of depression. (3 To study the effect of levothyroxine on inflammatory markers and depression. Materials and Methods: In this longitudinal, case–controlled study, 33 patients with autoimmune hypothyroidism (thyroid-stimulating hormone >10 uIU/ml were included with 33 age-, sex-, and body max index-matched healthy controls. Individuals were tested for Serum TNF-α, IL-6, high-sensitivity-CRP (hs-CRP. They were assessed for depression using Montgomery Asberg Depression Rating Scale (MADRS and World Health Organization Quality of Life (QOL Scale. Patients received L Thyroxine titrated to achieve euthyroidism and were reassessed for inflammatory markers and cognitive dysfunction. Results: Nineteen patients (57% had mild to moderate depression (MADRS >11. After 6 months of treatment, eight patients (42% had remission of depression with significant improvement in QOL scores (P < 0.05. TNF-α, IL-6, and hs-CRP were significantly elevated in patients compared with controls and reduced with therapy but did not reach baseline as controls. The change in inflammatory markers correlated with improvement in QOL scores in social and environmental domains (P < 0.01. Conclusions: Primary autoimmune hypothyroidism is an inflammatory state characterized by elevated cytokines which decline with LT4 therapy. It is associated with depression and poor

  18. Thermogenic Effect of Glucose in Hypothyroid Subjects

    Directory of Open Access Journals (Sweden)

    Agnieszka Kozacz

    2014-01-01

    Full Text Available The importance of thyroid hormone, catecholamines, and insulin in modification of the thermogenic effect of glucose (TEG was examined in 34 healthy and 32 hypothyroid subjects. We calculated the energy expenditure at rest and during oral glucose tolerance test. Blood samples for determinations of glucose, plasma insulin, adrenaline (A, and noradrenaline (NA were collected. It was found that TEG was lower in hypothyroid than in control group (19.68±3.90 versus 55.40±7.32 kJ, resp., P<0.0004. Mean values of glucose and insulin areas under the curve were higher in women with hypothyroidism than in control group (286.79±23.65 versus 188.41±15.84 mmol/L·min, P<0.003 and 7563.27±863.65 versus 4987.72±583.88 mU/L·min, P<0.03 resp.. Maximal levels of catecholamines after glucose ingestion were higher in hypothyroid patients than in control subjects (Amax—0.69±0.08 versus 0.30±0.07 nmol/L, P<0.0001, and NAmax—6.42±0.86 versus 2.54±0.30 nmol/L, P<0.0002. It can be concluded that in hypothyroidism TEG and glucose tolerance are decreased while the adrenergic response to glucose administration is enhanced. Presumably, these changes are related to decreased insulin sensitivity and responsiveness to catecholamine action.

  19. Hypothyroidism and Glaucoma in The United States

    Science.gov (United States)

    Kakigi, Caitlin; Kasuga, Toshimitsu; Wang, Sophia Y.; Singh, Kuldev; Hiratsuka, Yoshimune; Murakami, Akira; Lin, Shan C.

    2015-01-01

    Purpose To investigate the association between hypothyroidism and glaucomatous disease. Methods This cross-sectional study included all subjects above the age of 40 years from two nationwide surveys: the 2008 National Health Interview Survey (NHIS) as well as the 2007 and 2008 National Health and Nutrition Examination Survey (NHANES). The presence or absence of glaucoma, thyroid disease and other demographic and health-related information including comorbidities was ascertained via interview. Blood samples were collected from NHANES subjects and analyzed for thyrotropin (TSH). Results A total of 13,599 and 3,839 NHIS and NHANES participants respectively were analyzed to assess for a possible relationship between self-reported glaucoma, and self-reported hypothyroidism as well as self-reported thyroid disease. The unadjusted odds ratio (OR) for NHIS showed a significant association between self-reported glaucoma and self-reported hypothyroidism (OR 1.46, 95% confidence interval [CI] 1.07-1.99). Multivariate logistic regression analysis adjusted for age, gender, race, comorbidities, and health-related behavior, however, showed no association between self-reported glaucoma and hypothyroidism or thyroid disease in both surveys (OR 1.60, 95%CI 0.87-2.95 for NHIS; OR 1.05, 95%CI 0.59-1.88 for NHANES). Conclusion A previously reported association between hypothyroidism and glaucomatous disease was not confirmed in two large U.S. health survey populations. While such an association was noted in the univariate analysis for the NHIS survey, such a relationship was not found in the multivariate analysis after adjustment for potential confounding variables. PMID:26230664

  20. Asymmetric Dimethyl Arginine in Hypothyroid Patients

    International Nuclear Information System (INIS)

    Abdel-Messeih, P.L.

    2012-01-01

    Thyroid diseases may lead to endothelial dysfunction, however, the mechanism underlying the endothelial dysfunction in thyroid disease is still not clear. Asymmetric dimethyl arginine (ADMA), a novel inhibitor of endothelial nitric oxide synthetase (eNOS), was reported to inhibit nitric oxide (NO) synthesis from L-arginine. The present study was carried out to investigate ADMA levels together with effects of dislipidemia in sub-clinical and overt hypothyroid females. There were significant increase in the levels of total cholesterol, low density lipoprotein-cholesterol (LDL-c), high density lipoprotein-cholesterol (HDL-c), thyroid stimulating hormone (TSH) and ADMA in hypothyroid females as compared to controls while the levels of NO and free T 4 were significantly decreased than controls. Sub-clinical hypothyroid females had significant high TSH, LDL-c and non-significantly high ADMA levels and total cholesterol as compared to controls while they had significant decrease in NO, HDL-c and non-significant decrease in free T 4 as compared to controls. There were significant negative correlations between NO and both ADMA (r 2 = 0.84) and free T 4 (r 2 = 0.95) in overt hypothyroid group while significant positive correlation (r 2 = 0.85) was detected between TSH and HDL-c in the same group. These results are highly suggestive that the decrease of nitric oxide secondary to accumulation of ADMA represent an important pathogenic factor together with dyslipidemia in endothelial dysfunction and increased cardiovascular risk especially in hypothyroid females

  1. Asymmetric Dimethyl Arginine in Hypothyroid Patients

    Energy Technology Data Exchange (ETDEWEB)

    Abdel-Messeih, P. L. [Health Radiation Research Department, National Centre for Radiation Research and Technology, Cairo (Egypt)

    2012-07-01

    Thyroid diseases may lead to endothelial dysfunction, however, the mechanism underlying the endothelial dysfunction in thyroid disease is still not clear. Asymmetric dimethyl arginine (ADMA), a novel inhibitor of endothelial nitric oxide synthetase (eNOS), was reported to inhibit nitric oxide (NO) synthesis from L-arginine. The present study was carried out to investigate ADMA levels together with effects of dislipidemia in sub-clinical and overt hypothyroid females. There were significant increase in the levels of total cholesterol, low density lipoprotein-cholesterol (LDL-c), high density lipoprotein-cholesterol (HDL-c), thyroid stimulating hormone (TSH) and ADMA in hypothyroid females as compared to controls while the levels of NO and free T{sub 4} were significantly decreased than controls. Sub-clinical hypothyroid females had significant high TSH, LDL-c and non-significantly high ADMA levels and total cholesterol as compared to controls while they had significant decrease in NO, HDL-c and non-significant decrease in free T{sub 4} as compared to controls. There were significant negative correlations between NO and both ADMA (r{sup 2} = 0.84) and free T{sub 4} (r{sup 2} = 0.95) in overt hypothyroid group while significant positive correlation (r{sup 2} = 0.85) was detected between TSH and HDL-c in the same group. These results are highly suggestive that the decrease of nitric oxide secondary to accumulation of ADMA represent an important pathogenic factor together with dyslipidemia in endothelial dysfunction and increased cardiovascular risk especially in hypothyroid females.

  2. Congenital orbital teratoma

    OpenAIRE

    Aiyub, Shereen; Chan, Weng Onn; Szetu, John; Sullivan, Laurence J; Pater, John; Cooper, Peter; Selva, Dinesh

    2013-01-01

    We present a case of mature congenital orbital teratoma managed with lid-sparing exenteration and dermis fat graft. This is a case report on the management of congenital orbital teratoma. A full-term baby was born in Fiji with prolapsed right globe which was surrounded by a nonpulsatile, cystic mass. Clinical and imaging features were consistent with congenital orbital teratoma. Due to limited surgical expertise, the patient was transferred to Adelaide, Australia for further management. The p...

  3. The issue of neuropsychiatric disorders in patients with hypothyroidism

    Directory of Open Access Journals (Sweden)

    Kutashov V.A.

    2016-09-01

    Full Text Available The aim of the study was assessment of thyroid function in patients with psychiatric and psychological assistance; to study the structure of AR in patients with hypothyroidism, to reveal alexithymical identifying of personality characteristics of patients with hypothyroidism and AP Materials and Methods. 406 patients with AR at the age of 51.3±4.7 years. To verify the useofTSH hypothyroidism rate and to assess depressive disorder — Hamilton Scale and the Montgomery— Asberg; with clinical and psychopathological study: 1 the scale of self-BH alarm Spielberger (Y. L. Hanin, 2 questionnaire G. Shmisheka 3 Toronto alexithymia scale. Results. Hypothyroidism is set at 116 (28.6% of 406 patients suffering from RA. Among the 374 patients with depressive disorders hypothyroidism was observed in 116: subclinical — in 76 patients (65.5%, symptomatic — in 40 (34.5%. The first group consisted of 258 patients with the presence of depressive disorders and without hypothyroidism; second — 116 patients with the presence of depression and hypothyroidism. TSH in patients suffering AR, without thyroid dysfunction was 5.2 times lower than in patients with the presence of hypothyroidism. Among AP comorbid with hypothyroidism, are predominant depressive with a predominance of mild and moderate forms. Dominating are anxious-depressive, dysphoric, adynamic, sad, depressive disorders. Conclusion. In patients with AR and hypothyroidism predominant types of personality accentuation are dysthymic, anxious, demonstrative and meticulous.

  4. Cytomegalovirus Congenital Cataract

    Directory of Open Access Journals (Sweden)

    Ridha Wahyutomo

    2011-06-01

    Full Text Available Cytomegalovirus congenital infection is an infection caused by the the subfamily â Herpesviridae, during pregnancy. The incidence of infections among newborn infants is 1 %. One of the effects of congenitally acquired infection is the congenital cataract. A 6-year-old child complained to have a blurred vision diagnosed with cytomegalovirus congenital cataract. The diagnosis was confirmed by a positive serology testing for Ig M and Ig G CMV. The laboratory test using Giemsa staining to find inclusion bodies and a faster PCR could not be carried out (Sains Medika, 3(1:84-88.

  5. Mitochondrial disorders in congenital myopathies

    Directory of Open Access Journals (Sweden)

    D. A. Kharlamov

    2014-01-01

    Full Text Available The literature review gives data on the role of mitochondrial disorders in the pathogenesis of congenital myopathies: congenital muscular dystrophies and congenital structural myopathies. It describes changes in congenital muscular dystrophies with type VI collagen, in myodystrophy with giant mitochondria, in congenital central core myopathies, myotubular myopathy, etc. Clinical and experimental findings are presented. Approaches to therapy for energy disorders in congenital myopathies are depicted.

  6. Increased psychiatric morbidity before and after the diagnosis of hypothyroidism

    DEFF Research Database (Denmark)

    Thvilum, Marianne; Brandt, Frans; Pedersen, Dorthe Almind

    2014-01-01

    Background: Thyroid hormones are necessary for fetal brain development, while hypothyroidism in adults has been associated with mood symptoms and reduced quality of life. Nevertheless, our knowledge regarding the association and temporal relation between hypothyroidism and mental disorders...... is ambiguous. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism is associated with psychiatric morbidity. Methods: Observational cohort study. Based on record-linkage between different Danish health registers, 2822 hypothyroid singletons each matched with 4 non......-hypothyroid controls were identified and followed over a mean period of 6 years (range 1-13). Additionally, we included 385 same sex twin pairs discordant for hypothyroidism. Diagnoses of psychiatric disorders as well as treatment with antidepressants, antipsychotics and anxiolytics were recorded. Logistic and cox...

  7. Prevalence of hypothyroidism in term pregnancies in North India

    Directory of Open Access Journals (Sweden)

    Bharti Kalra

    2018-01-01

    Full Text Available Background: Hypothyroidism is common in pregnancy. No study has determined the prevalence of hypothyroidism in term pregnancies in India. Aim: This study aims to determine the prevalence and correlates of hypothyroidism in women who delivered at a center in Karnal, Haryana, North India. Results: Indoor records of all women who had delivered at this centre from April 2016 to March 2017 were reviewed. The prevalence of hypothyroidism was 12.3%, of which 15.5% were diagnosed during pregnancy. The dose requirement of L-thyroxine ranged from 25 to 200 μg (mean 76.38 +- 43.02. With this, 80% were able to achieve trimester-specific thyroid-stimulating hormone targets. Hypothyroidism did not correlate with any medical or obstetric complications. Conclusion: Hypothyroidism is common in term pregnancies. If treated adequately, healthy fetomaternal outcomes can be achieved.

  8. Congenital heat disease

    International Nuclear Information System (INIS)

    Higgins, C.B.; Silverman, N.H.; Kersting-Somerhoff, B.A.

    1990-01-01

    The book covers the tomographic anatomy of the normal and congenitally malformed heart and tomographic imaging of the normal heat. It then compares echocardiographic evaluation and the use of MR imaging in the diagnosis and evaluation of individual congenital cardiac malformations

  9. Hemodynamic changes after levothyroxine treatment in subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Faber, J; Petersen, L; Wiinberg, N

    2002-01-01

    by LT(4) (p treatment in SH results in changes in hemodynamic parameters of potentially beneficial character. SH and overt hypothyroidism should......In hypothyroidism, lack of thyroid hormones results in reduced cardiac function (cardiac output [CO]), and an increase of systemic vascular resistance (SVR). We speculated whether hemodynamic regulation in subjects with subclinical hypothyroidism (SH) (defined as mildly elevated thyrotropin [TSH......) and T(3) estimates) LT(4) treatment resulted in 6% reduction in supine MAP (p treatment (p

  10. Polymyositis-like syndrome caused by hypothyroidism, presenting as camptocormia.

    Science.gov (United States)

    Kim, Ji Min; Song, Eun Joo; Seo, Jae Seok; Nam, Eon Jeong; Kang, Young Mo

    2009-01-01

    Polymyositis-like syndrome characterized by proximal muscle weakness and elevation of muscle enzymes may be a presenting manifestation of hypothyroidism. Camptocormia, which can be caused by myopathy of the paraspinal muscles, is an involuntary truncal flexion of the thoracolumbar spine while standing or walking. Among various neuromuscular disorders, hypothyroidism has not been reported in the literature as a cause of camptocormia. This is the first report of polymyositis-like syndrome with camptocormia caused by hypothyroidism.

  11. Veganism as a cause of iodine deficient hypothyroidism.

    Science.gov (United States)

    Yeliosof, Olga; Silverman, Lawrence A

    2018-01-26

    Iodine deficiency is the most common cause of acquired hypothyroidism worldwide. Although uncommon in the Western world, the incidence of iodine deficiency may be rising due to the increased use of restrictive diets. We present a 23-month-old boy diagnosed with iodine deficiency hypothyroidism, induced by a vegan diet. This case highlights the risk for iodine deficiency in children on a vegan diet after discontinuation of breast/formula feeding that could lead to acquired hypothyroidism.

  12. Global epidemiology of hyperthyroidism and hypothyroidism.

    Science.gov (United States)

    Taylor, Peter N; Albrecht, Diana; Scholz, Anna; Gutierrez-Buey, Gala; Lazarus, John H; Dayan, Colin M; Okosieme, Onyebuchi E

    2018-05-01

    Thyroid hormones are essential for growth, neuronal development, reproduction and regulation of energy metabolism. Hypothyroidism and hyperthyroidism are common conditions with potentially devastating health consequences that affect all populations worldwide. Iodine nutrition is a key determinant of thyroid disease risk; however, other factors, such as ageing, smoking status, genetic susceptibility, ethnicity, endocrine disruptors and the advent of novel therapeutics, including immune checkpoint inhibitors, also influence thyroid disease epidemiology. In the developed world, the prevalence of undiagnosed thyroid disease is likely falling owing to widespread thyroid function testing and relatively low thresholds for treatment initiation. However, continued vigilance against iodine deficiency remains essential in developed countries, particularly in Europe. In this report, we review the global incidence and prevalence of hyperthyroidism and hypothyroidism, highlighting geographical differences and the effect of environmental factors, such as iodine supplementation, on these data. We also highlight the pressing need for detailed epidemiological surveys of thyroid dysfunction and iodine status in developing countries.

  13. Therapy of endemic goiter and hypothyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Luft, D.

    1983-09-12

    Successful treatment of endemic goitre depends on the correct diagnosis and the comprehension of the pathophysiologic changes as well. Several criteria, e.g. anamnestic data, general clinical condition, local symptoms and signs, certainty of diagnosis, contraindications, rates of success, and side effects, determine the particular form of therapy (suppression with thyroid hormones, surgical resection, radio-iodine). The decision criteria are discussed. Prophylaxis of recurrent goitre with either thyroid hormones or iodine salts is necessary after successful treatment. Some endemic goitres behave like either hyper- or hypothyroidism. Treatment with thyroid hormones of patients with latent hyperthyroidism is senseless and dangerous, whereas other methods of treatment may be applied. An unequivocal indication for treatment exists in patients with latent hypothyroidism accompanied by goitre, but not in all patients without goitre. Hormonal replacement therapy of manifest hypothydroidism is simple, but long term success is not achieved in all patients.

  14. Therapy of endemic goiter and hypothyroidism

    International Nuclear Information System (INIS)

    Luft, D.

    1983-01-01

    Successful treatment of endemic goitre depends on the correct diagnosis and the comprehension of the pathophysiologic changes as well. Several criteria, e.g. anamnestic data, general clinical condition, local symptoms and signs, certainty of diagnosis, contraindications, rates of success, and side effects, determine the particular form of therapy (suppression with thyroid hormones, surgical resection, radio-iodine). The decision criteria are discussed. Prophylaxis of recurrent goitre with either thyroid hormones or iodine salts is necessary after successful treatment. Some endemic goitres behave like either hyper- or hypothyroidism. Treatment with thyroid hormones of patients with latent hyperthyroidism is senseless and dangerous, whereas other methods of treatment may be applied. An unequivocal indication for treatment exists in patients with laent hypothyroidism accompanied by goitre, but not in all patients without goitre. Hormonal replacement therapy of manifest hypothydroidism is simple, but long term success is not achieved in all patients. (orig.) [de

  15. Serum lipids in hypothyroidism: Our experience.

    Science.gov (United States)

    Prakash, Archana; Lal, Ashok Kumar

    2006-09-01

    In order to determine whether the screening of lipid profile is justified in patients with hypothyroidism we estimated serum lipids in cases having different levels of serum TSH. 60 patients of hypothyroidism in the age group of 20 to 60 yrs were studied for thyroid profile over a period of one year. On the basis of serum TSH level the cases were divided into three groups: In the first group TSH concentration was 8.8±2.99 μlU/ml, 95% confidence interval (Cl) 8.8±1.07, whereas serum total cholesterol and LDL-chol levels were 196±37.22 and 126±29.17 mg/dl respectively. The statistical analysis of these two groups showed a significant correlation between raised TSH levels and serum total cholesterol and LDL-chol (Phypothyrodism is associated with changes in lipid profile.

  16. Junctional ectopic tachycardia following repair of congenital heart ...

    African Journals Online (AJOL)

    Background: Postoperative junctional ectopic tachycardia (JET) is a rare and transient phenomenon occurring after repair of congenital heart defects. Report on this arrhythmia in the subregion is rare. We set out to determine the incidence of this arrhythmia and review the treatment and outcomes of treatment in our centre.

  17. Prenatal intraventricular hemorrhage in a term infant with congenital ...

    African Journals Online (AJOL)

    Intraventricular hemorrhage (IVH) occurs rarely in term infant, since subependymal area is a transient structure in fetal life. IVH in term infant indicates generally that it happened prenatally. Congenital cytomegalovirus (CMV) infection is frequent, occurring in 1% of live births. It is a severe infection leading to developmental ...

  18. Key aspects congenital infection

    Directory of Open Access Journals (Sweden)

    Yu. V. Lobzin

    2014-01-01

    Full Text Available The key questions to solve the problem of congenital infection in the Russian Federation are: using in national practice over world accepted terminology adapted to the recommendations of the World Health Organization; representation of the modern concepts of an infectious process in the classification of congenital infections; scientific development and introducing in clinical practice the «standard case definitions», applied to different congenital infections; optimization of protocols and clinical guidelines for diagnosis, treatment and prevention of congenital infections; improvement a knowledge in the infectious disease for all  pecialists involved in the risk assessment of congenital infections, manage pregnancy and children. Based on our experience and analysis of publications, the authors suggest possible solutions.

  19. Radionuclide Esophageal Transit Scintigraphy in Primary Hypothyroidism

    OpenAIRE

    Khan, Shoukat H; Madhu, Vijay P; Rather, Tanveer A; Laway, Bashir A

    2017-01-01

    Background/Aims Esophageal dysmotility is associated with gastrointestinal dysmotility in various systemic and neuroregulatory disorders. Hypothyroidism has been reported to be associated with impaired motor function in esophagus due to accumulation of glycosaminoglycan hyaluronic acid in its soft tissues, leading to changes in various contraction and relaxation parameters of esophagus, particularly in the lower esophageal sphincter. In this study we evaluated esophageal transit times in pati...

  20. Adolescent with Rhabdomyolysis due to Undiagnosed Hypothyroidism

    OpenAIRE

    Farias Moeller, Raquel; Zecavati, Nassim; Sherafat-Kazemzadeh, Rosa; Aleinikoff, Shoshana; Rennert, Wolfgang

    2011-01-01

    Exercise-induced rhabdomyolysis has been described in military recruits, trained athletes and daily runners. Statin use, quail ingestion, infection by Epstein-Barr virus (EBV), and hypothyroidism, though rare, are risk factors for the development of rhabdomyolysis. We describe the case of a 15-year-old female who presented with myalgias, weakness, and pigmenturia following marching band practice. Laboratory tests confirmed an elevated creatine kinase (CK) level as well as a profound hypothyro...

  1. Respiratory Manifestations of Hypothyroidism: A Systematic Review.

    Science.gov (United States)

    Sorensen, Jesper Roed; Winther, Kristian Hillert; Bonnema, Steen Joop; Godballe, Christian; Hegedüs, Laszlo

    2016-11-01

    Hypothyroidism has been associated with increased pulmonary morbidity and overall mortality. A systematic review was conducted to identify the prevalence and underlying mechanisms of respiratory problems among patients with thyroid insufficiency. PubMed and EMBASE databases were searched for relevant literature from January 1950 through January 2015 with the following study eligibility criteria: English-language publications; adult subclinical or overt hypothyroid patients; intervention, observational, or retrospective studies; and respiratory manifestations. The Preferred Reporting Items for Systematic reviews and Meta-Analyses statement was followed, and Cochrane's risk of bias tool was used. A total of 1699 papers were screened by two independent authors for relevant titles. Of 109 relevant abstracts, 28 papers underwent full-text analyses, of which 22 were included in the review. Possible mechanisms explaining respiratory problems at multiple physiological levels were identified, such as the ventilator control system, diaphragmatic muscle function, pulmonary gas exchange, goiter caused upper airway obstruction, decreased capacity for energy transduction, and reduced glycolytic activity. Obstructive sleep apnea syndrome was found among 30% of newly diagnosed patients with overt hypothyroidism, and demonstrated reversibility following treatment. The evidence for or against a direct effect on pulmonary function was ambiguous. However, each of the above-mentioned areas was only dealt with in a limited number of studies. Therefore, it is not possible to draw any strong conclusions on any of these themes. Moreover, most studies were hampered by considerable risk of bias due for example to small numbers of patients, lack of control groups, randomization and blinding, and differences in body mass index, sex, and age between subjects and controls. Mechanistic data linking hypothyroidism and respiratory function are at best limited. This area of research is therefore

  2. Acute mania after thyroxin supplementation in hypothyroid state

    Directory of Open Access Journals (Sweden)

    Rohit Verma

    2013-01-01

    Full Text Available The current literature variedly ascribes depressive and manic symptoms to hypo- and hyperthyroid state, respectively, reporting mania in hypothyroidism as an unusual entity. More unusual is precipitation of manic state in hypothyroid subjects after thyroxine supplementation for which studies report otherwise treating manic symptoms in hypothyroid state with thyroxine. We report a case of a patient whose acute mania appears to have been precipitated by thyroxine supplementation in hypothyroidism state. This case underscores the importance of thyroid screening in patients with mood and psychotic disorders, as well as the potency of thyroxine in producing manic symptoms.

  3. Both hypothyroidism and hyperthyroidism increase atrial fibrillation inducibility in rats.

    Science.gov (United States)

    Zhang, Youhua; Dedkov, Eduard I; Teplitsky, Diana; Weltman, Nathan Y; Pol, Christine J; Rajagopalan, Viswanathan; Lee, Bianca; Gerdes, A Martin

    2013-10-01

    Evidence indicates that cardiac hypothyroidism may contribute to heart failure progression. It is also known that heart failure is associated with an increased risk of atrial fibrillation (AF). Although it is established that hyperthyroidism increases AF incidence, the effect of hypothyroidism on AF is unclear. This study investigated the effects of different thyroid hormone levels, ranging from hypothyroidism to hyperthyroidism on AF inducibility in thyroidectomized rats. Thyroidectomized rats with serum-confirmed hypothyroidism 1 month after surgery were randomized into hypothyroid (N=9), euthyroid (N=9), and hyperthyroid (N=9) groups. Rats received placebo, 3.3-mg l-thyroxine (T4), or 20-mg T4 pellets (60-day release form) for 2 months, respectively. At the end of treatment, hypothyroid, euthyroid, and hyperthyroid status was confirmed. Hypothyroid animals showed cardiac atrophy and reduced cardiac systolic and diastolic functions, whereas hyperthyroid rats exhibited cardiac hypertrophy and increased cardiac function. Hypothyroidism and hyperthyroidism produced opposite electrophysiological changes in heart rates and atrial effective refractory period, but both significantly increased AF susceptibility. AF incidence was 78% in hypothyroid, 67% in hyperthyroid, and the duration of induced AF was also longer, compared with 11% in the euthyroid group (all Phyperthyroidism lead to increased AF vulnerability in a rat thyroidectomy model. Our results stress that normal thyroid hormone levels are required to maintain normal cardiac electrophysiology and to prevent cardiac arrhythmias and AF.

  4. Frequency of hypothyroidism in patients of beta-thalassaemia

    International Nuclear Information System (INIS)

    Malik, S.A.; Syed, S.; Ahmed, N.

    2010-01-01

    To determine the frequency of hypothyroidism in patients suffering from homozygous-thalassaemia. This descriptive study included 70 diagnosed thalassaemia major patients aged 5-14 years. Demographic data as well as history of blood transfusion and chelation therapy was collected. Random blood samples were drawn and thyroid profile (serum thyroxine [T4], triiodothyronine [T3] and thyroid stimulating hormone concentrations [TSH]) was done by enzyme-linked immunosorbent assay (ELISA). Primary hypothyroidism was defined by a TSH level >4 macro IU/ml. Results were analysed by descriptive statistical methods. Primary hypothyroidism was seen in 18 (25.7%) patients. Of these, 17 had normal T4 levels with elevated TSH levels consistent with a diagnosis of compensated primary hypothyroidism whereas only one patient showed a decreased T4 level with elevated TSH (uncompensated primary hypothyroidism). Mean age of hypothyroid patients was 9.2 +- 2.6 years. Frequency of hypothyroidism was associated with increased serum ferritin levels. Primary hypothyroidism occurs in a significant proportion of thalassaemia major patients in the absence of obvious clinical signs of hypothyroidism. Regular follow-up for early detection and timely treatment of such complications could improve the quality of life of these patients (JPMA 60:17; 2010). (author)

  5. Both Hypothyroidism and Hyperthyroidism Increase Atrial Fibrillation Inducibility in Rats

    Science.gov (United States)

    Zhang, Youhua; Dedkov, Eduard I.; Teplitsky, Diana; Weltman, Nathan Y.; Pol, Christine J.; Rajagopalan, Viswanathan; Lee, Bianca; Gerdes, A. Martin

    2014-01-01

    Background Evidence indicates that cardiac hypothyroidism may contribute to heart failure (HF) progression. It is also known that HF is associated with an increased risk of atrial fibrillation (AF). While it is established that hyperthyroidism increases AF incidence, the effect of hypothyroidism on AF is unclear. This study investigated the effects of different thyroid hormone levels, ranging from hypothyroidism to hyperthyroidism on AF inducibility in thyroidectomized rats. Methods and Results Thyroidectomized rats with serum confirmed hypothyroidism 1 month after surgery were randomized into hypothyroid (n=9), euthyroid (n=9) and hyperthyroid (n=9) groups. Rats received placebo, 3.3mg L-thyroxine (T4), or 20 mg T4 pellets (60 day release form) for 2 months, respectively. At the end of treatment, hypothyroid, euthyroid and hyperthyroid status was confirmed. Hypothyroid animals showed cardiac atrophy and reduced cardiac systolic and diastolic function, while hyperthyroid rats exhibited cardiac hypertrophy and increased cardiac function. Hypothyroidism and hyperthyroidism produced opposite electrophysiological changes in heart rates and atrial effective refractory period, but both significantly increased AF susceptibility. AF incidence was 78% in hypothyroid, 67% in hyperthyroid, and the duration of induced AF was also longer, compared with 11% in the euthyroid group (all phyperthyroidism lead to increased AF vulnerability in a rat thyroidectomy model. Our results stress that normal thyroid hormone levels are required to maintain normal cardiac electrophysiology and prevent cardiac arrhythmias and AF. PMID:24036190

  6. Hypothyroidism and hyperthyroidism in the elderly.

    Science.gov (United States)

    Mintzer, M J

    1992-04-01

    Thyroid disease in the elderly can be easily overlooked. Symptoms too often are explained away as normal processes of aging. Development of unstable illness, especially cardiac disease, is a frequent mode of presentation. One symptom or one clinical feature of thyroid disease in the elderly may be overwhelming in its presentation, as in apathetic hyperthyroidism, thyroid myopathy, depression and dementia. Physical examination of the thyroid gland can be helpful but in a high percentage of older patients the gland is normal to palpation. The treatment of hypothyroidism is straightforward. Only myxedema coma requires large doses of levothyroxine parenterally; all other forms of hypothyroidism are treated with oral levothyroxine. The dose is started very low and increased gradually over months. The euthyroid state is achieved gradually and safely. Hyperthyroidism can be treated by several modalities. In the unstable elderly patient, antithyroid medication can quickly produce a euthyroid state. When the patient is stable, further decisions can be made regarding definitive therapy. Radioactive iodine therapy is well-tolerated and effective. On occasion, a second course of therapy is needed to suppress hyperthyroidism. Close follow-up of all patients ever having received this therapy is needed to identify the development of hypothyroidism. Surgical thyroid ablation may be necessary in patients who fail to respond to radioactive iodine therapy. Abnormalities associated with unresolved thyromegaly, dysphagia, or tracheal compression may require surgical intervention. If suspicion exists that the gland is cancerous, surgical intervention is warranted.

  7. An extremely high dietary iodide supply forestalls severe hypothyroidism in Na+/I- symporter (NIS) knockout mice.

    Science.gov (United States)

    Ferrandino, Giuseppe; Kaspari, Rachel R; Reyna-Neyra, Andrea; Boutagy, Nabil E; Sinusas, Albert J; Carrasco, Nancy

    2017-07-13

    The sodium/iodide symporter (NIS) mediates active iodide (I - ) accumulation in the thyroid, the first step in thyroid hormone (TH) biosynthesis. Mutations in the SLC5A5 gene encoding NIS that result in a non-functional protein lead to congenital hypothyroidism due to I - transport defect (ITD). ITD is a rare autosomal disorder that, if not treated promptly in infancy, can cause mental retardation, as the TH decrease results in improper development of the nervous system. However, in some patients, hypothyroidism has been ameliorated by unusually large amounts of dietary I - . Here we report the first NIS knockout (KO) mouse model, obtained by targeting exons 6 and 7 of the Slc5a5 gene. In NIS KO mice, in the thyroid, stomach, and salivary gland, NIS is absent, and hence there is no active accumulation of the NIS substrate pertechnetate ( 99m TcO 4 - ). NIS KO mice showed undetectable serum T 4 and very low serum T 3 levels when fed a diet supplying the minimum I - requirement for rodents. These hypothyroid mice displayed oxidative stress in the thyroid, but not in the brown adipose tissue or liver. Feeding the mice a high-I - diet partially rescued TH biosynthesis, demonstrating that, at high I - concentrations, I - enters the thyroid through routes other than NIS.

  8. Prevalence of Hypothyroidism in Nonalcoholic Fatty Liver disease

    Science.gov (United States)

    Pagadala, Mangesh R.; Zein, Claudia O.; Dasarathy, Srinivasan; Yerian, Lisa; Lopez, Rocio; McCullough, Arthur J.

    2014-01-01

    Background A possible association between nonalcoholic fatty liver disease (NAFLD) and hypothyroidism has been suggested. Possible explanations for this association are the recognized links between hypothyroidism and various elements of the metabolic syndrome which is often present in NAFLD. To further explore this association, we determined the prevalence of hypothyroidism in a cohort of patients with NAFLD and analyzed the potential factors associated with hypothyroidism in this patient population. Methods Two hundred and forty six patients with biopsy proven NAFLD attending hepatology clinics at the Cleveland Clinic between October 2006 to June 2009 and 430 age, gender, race and BMI matched control subjects seen in the general internal medicine clinic were included. Patients with a clinical diagnosis of hypothyroidism who were on thyroid replacement therapy were considered to be hypothyroid. Results Hypothyroidism was more frequent among patients with NAFLD (21%vs 9.5%.; Phypothyroidism were 2.1 (95% CI: 1.1, 3.9,P=0.02)) and 3.8 (95% CI:2,6.9, Phypothyroidism. NAFLD subjects who reported mild alcohol consumption were less likely to have hypothyroidism compared to those who reported complete abstinence (OR 0.37, P=0.008). Conclusions A higher prevalence of hypothyroidism was demonstrated in patients with NAFLD compared to controls. Patients with hypothyroidism were more likely to have NASH. Among subjects with NALFD, female gender, increased BMI and history of abstinence from alcohol were associated with hypothyroidism. Further studies are needed in order to confirm and better characterized these findings as well as the described associations and their pathogenesis. PMID:22183820

  9. Congenital symmastia revisited

    DEFF Research Database (Denmark)

    Sillesen, Nanna H; Hölmich, Lisbeth R; Siersen, Hans Erik

    2012-01-01

    Symmastia is defined as medial confluence of the breast. The term 'symmastia' is modified from Greek (syn meaning 'together', and mastos meaning 'breast') and was first presented by Spence et al. in 1983. Two forms of symmastia exist: an iatrogenic and a congenital version. Congenital symmastia...... is a rare condition in which web-like soft tissue traverses the sternum to connect the breasts medially. The literature on congenital symmastia is limited, few cases have been published, and knowledge about ideal treatment is still insufficient....

  10. Pleiotropic Effects of Thyroid Hormones: Learning from Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Martha Franco

    2011-01-01

    Full Text Available Hypothyroidism induces several metabolic changes that allow understanding some physiopathological mechanisms. Under experimental hypothyroid conditions in rats, heart and kidney are protected against oxidative damage induced by ischemia reperfusion. An increased resistance to opening of the permeability transition pore seems to be at the basis of such protection. Moreover, glomerular filtration rate of hypothyroid kidney is low as a result of adenosine receptors-induced renal vasoconstriction. The vascular tone of aorta is also regulated by adenosine in hypothyroid conditions. In other context, thyroid hormones regulate lipoprotein metabolism. High plasma level of LDL cholesterol is a common feature in hypothyroidism, due to a low expression of the hepatic LDL receptor. In contrast, HDL-cholesterol plasma levels are variable in hypothyroidism; several proteins involved in HDL metabolism and structure are expressed at lower levels in experimental hypothyroidism. Based on the positive influence of thyroid hormones on lipoprotein metabolism, thyromimetic drugs are promising for the treatment of dyslipidemias. In summary, hypothyroid status has been useful to understand molecular mechanisms involved in ischemia reperfusion, regulation of vascular function and intravascular metabolism of lipoproteins.

  11. Subclinical hypothyroidism and hyperthyroidism. I. Prevalence and clinical relevance

    NARCIS (Netherlands)

    Wiersinga, W. M.

    1995-01-01

    Subclinical hypothyroidism has a prevalence of approx. 6% in the general population; it is more common in females and in the elderly. The incidence of progression to overt hypothyroidism is 5-15% per year; women with positive thyroid antibodies are especially at risk. The biological significance

  12. [Should subclinical hypothyroidism in older persons be treated?

    NARCIS (Netherlands)

    Elzen, W.P. den; Smit, J.W.A.; Mooijaart, S.P.; Gussekloo, J.

    2012-01-01

    Subclinical hypothyroidism is a common finding in older persons. Clinical guidelines are inconsistent in providing recommendations for the treatment of subclinical hypothyroidism, especially in older persons. To date, there is no high-quality evidence from randomized controlled trials about the

  13. Subclinical hypothyroidism ups the risk of vascular complications in ...

    African Journals Online (AJOL)

    Subclinical hypothyroidism ups the risk of vascular complications in type 2 diabetes. ... hypothyroidism (SCH) and vascular complications of type 2 diabetes. ... However, gender (p = 0.076), BMI (p = 0.092), and smoking (P = 0.715) were not ...

  14. Pituitary hyperplasia secondary to hypothyroidism in an adolescent

    International Nuclear Information System (INIS)

    Capiel, Carlos A. h; Bouzas, Carlos A.; Mondino, Ana

    2003-01-01

    We report a case of a 14 years old patient with growth arrest and laboratory evidence of hypothyroidism. MR revealed pituitary enlargement simulating macro adenoma. Thyroid replacement therapy resulted in regression of the pituitary size. Awareness of MR appearance of pituitary hyperplasia in children and juvenile patients with laboratory evidence of hypothyroidism might avoid misdiagnosis for pituitary tumor. (author)

  15. Effect of levothyroxine therapy on dyslipidemia in hypothyroid patients

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    hypothyroidism (both subclinical and overt hypothyroidism), its association with ... with dyslipidemia, replacement therapy with levothyroxine resulted in reversal to .... aseptically after 12 hours overnight fasting for lipid ..... Workers in the field also observed that restoration ... between SCH and metabolic syndrome (MetS) and.

  16. Sub-clinical hypothyroidism in infertile Nigerian women with ...

    African Journals Online (AJOL)

    Studies on the impact of subclinical hypothyroidism in infertility are scarce and this seeks to determine the proportion of infertile Nigerian women with hyperprolactinaemia that had subclinical hypothyroidism. Serum prolactin and thyroid stimulating hormone were determined using ELECSYS 1010 auto analyzer.

  17. Association between different degrees of hypothyroidism and serum ...

    African Journals Online (AJOL)

    The association between overt hypothyroidism (OH) and altered lipid profile is well known, however the significance of dyslipidemia in subclinical hypothyroidism (SCH) remain controversial. Therefore, this study was conducted to determine any association between lipid profile and different degrees of thyroid dysfunction.

  18. Hypertension in Hypothyroidism; a Rare Association in Childhood

    Directory of Open Access Journals (Sweden)

    Bushra Minhaji

    2017-08-01

    Full Text Available The association of hypothyroidism with hypertension is an uncommon phenomenon.   Hypertension adds to cardiovascular risk in any population and hypertension due to hypothyroidism is reversible with hormonal replacement. Although there are various case studies exists in adults but such reports are rare in children.

  19. Pituitary function and morphology in dogs with primary hypothyroidism

    NARCIS (Netherlands)

    Diaz Espineira, M.M.

    2008-01-01

    Thyroid hormones have effect on almost every organ system in the body. This explains the wide range of clinical manifestations of primary hypothyroidism in dogs. The signs and symptoms are often nonspecific and the disease onset is insidious. It may therefore take a long time before hypothyroidism

  20. High radio-isotope uptakes in patients with hypothyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Wing, J.; Kalk, W.J.; Ganda, C. (University of the Witwatersrand, Johannesburg (South Africa). Dept. of Medicine)

    1982-12-04

    Hypothyroidism is usually associated with a low radio-isotope uptake by the thyriod gland. We report 8 cases of Hashimoto's thyroiditis with clinical and biochemical hypothyroidism and with borderline high or overtly increased technetium-99m pertechnetate and/or iodine-131 uptakes.

  1. Photobiomodulation laser improves the early repair process of hypothyroid rats

    Science.gov (United States)

    Uzêda e Silva, V. D.; Rodriguez, T. T.; Xavier, F. C. A.; dos Santos, J. N.; Vasconcelos, R. M.; Ramalho, L. M. P.

    2018-04-01

    Delay in wound healing has been observed in the hypothyroidism disfunction. Laser light can modulate various biological phenomena acting on different cell types. However, there are few reports in the literature regarding the effects of laser on wound healing of hypothyroid models. This study aimed to evaluate the differences in reepithelialization process of cutaneous wounds on hypothyroid and euthyroid rats treated with laser phototherapy. Forty-eight rats were divided into two main groups: euthyroid (EU) and hypothyroid (HYPO). Hypothyroidism was induced by Thyroidectomy. Each group was divided into subgroups: control (without laser) and laser groups. Standard surgical wound was created on the dorsum of each rat. The irradiation protocols (λ660 nm, 40 mW, CW; 10 J/cm2) was carried out immediately after wounding and repeated every 24h during 3 and 7 days. After animal death, specimens were taken, routinely processed, cut, stained with hematoxylin-eosin, and underwent histological analysis. Three days after the surgery, it was possible to observe initial reepithelialization in more advanced stages in the wound area of the irradiated hypothyroid group when compared to control hypothyroid group (p<0.05). No significant difference was found in the experimental period of 7 days among the groups. It was concluded that the laser light did influence reepithelialization process on hypothyroid rats in early stages of healing process.

  2. An embryological point of view on associated congenital anomalies of children with Hirschsprung disease.

    Science.gov (United States)

    Slavikova, T; Zabojnikova, L; Babala, J; Varga, I

    2015-01-01

    The most common congenital gut motility disorder is the Hirschsprung disease (HSCR). This anomaly is characterized by absence of neural crest-derived enteric neuronal ganglia. The aim of our study was to analyze the relationship between HSCR and other congenital anomalies or malfunctions. We examined 130 patients with Hirschsprung disease from Slovakia for last 10 years. During patients examination we focused not only on morphological abnormalities, but also functional anomalies. The incidence of associated congenital anomalies in our patients with HSCR was 26.1 %. But if we add functional defects (hypothyroidism, malfunction in cellular immunity, neurological deficit) to the morphological congenital abnormalities, the rate of the patients with HSCR with additional defects achieves 50.1 %. Nine of our patients (6.9 %) had syndromic HSCR. The most frequent disorder (13.6 % of patients) was primary deficiency in cellular immunity. More than 12.3 % of patients with HSCR had genitourinary abnormalities, in 10.0 % of patients variable degree of psychomotor retardation was observed, and skeletal, muscle and limb anomalies involved 7.7 % of patients. In 7.6 % cases of patients we found congenital hypothyroidism (including 2 cases of agenesis of thyroid gland). More than 6.1 % of patients presented with an associated anomaly in gastrointestinal tract (mostly anorectal malformations). Up to 5.5 % patients had congenital anomaly of heart, 3.8 % had ophthalmic and 3.1 % had craniofacial anomalies. Down syndrome was the main diagnosis in 3.8 % patients. We discussed  the relationship between HSCR and other anomalies, which are probably caused by abnormal migration, proliferation, or differentiation, of neural crest cells during embryogenesis (Tab. 1, Fig. 2, Ref. 75).

  3. Experimentally-induced maternal hypothyroidism alters crucial enzyme activities in the frontal cortex and hippocampus of the offspring rat.

    Science.gov (United States)

    Koromilas, Christos; Tsakiris, Stylianos; Kalafatakis, Konstantinos; Zarros, Apostolos; Stolakis, Vasileios; Kimpizi, Despoina; Bimpis, Alexios; Tsagianni, Anastasia; Liapi, Charis

    2015-02-01

    approaches towards the experimental simulation of congenital and early-age-occurring hypothyroidism.

  4. Congenital orbital teratoma.

    Science.gov (United States)

    Aiyub, Shereen; Chan, Wengonn; Szetu, John; Sullivan, Laurence J; Pater, John; Cooper, Peter; Selva, Dinesh

    2013-12-01

    We present a case of mature congenital orbital teratoma managed with lid-sparing exenteration and dermis fat graft. This is a case report on the management of congenital orbital teratoma. A full-term baby was born in Fiji with prolapsed right globe which was surrounded by a nonpulsatile, cystic mass. Clinical and imaging features were consistent with congenital orbital teratoma. Due to limited surgical expertise, the patient was transferred to Adelaide, Australia for further management. The patient underwent a lid-sparing exenteration with frozen section control of the apical margin. A dermis fat graft from the groin was placed beneath the lid skin to provide volume. Histopathology revealed mature tissues from each of the three germ cell layers which confirmed the diagnosis of mature teratoma. We describe the successful use of demis fat graft in socket reconstruction following lid-sparing exenteration for congenital orbital teratoma.

  5. Congenital orbital teratoma

    Directory of Open Access Journals (Sweden)

    Shereen Aiyub

    2013-01-01

    Full Text Available We present a case of mature congenital orbital teratoma managed with lid-sparing exenteration and dermis fat graft. This is a case report on the management of congenital orbital teratoma. A full-term baby was born in Fiji with prolapsed right globe which was surrounded by a nonpulsatile, cystic mass. Clinical and imaging features were consistent with congenital orbital teratoma. Due to limited surgical expertise, the patient was transferred to Adelaide, Australia for further management. The patient underwent a lid-sparing exenteration with frozen section control of the apical margin. A dermis fat graft from the groin was placed beneath the lid skin to provide volume. Histopathology revealed mature tissues from each of the three germ cell layers which confirmed the diagnosis of mature teratoma. We describe the successful use of demis fat graft in socket reconstruction following lid-sparing exenteration for congenital orbital teratoma.

  6. Congenital Constriction Band Syndrome

    OpenAIRE

    Rajesh Gupta, Fareed Malik, Rishabh Gupta, M.A.Basit, Dara Singh

    2008-01-01

    Congenital constriction bands are anomalous bands that encircle a digit or an extremity. Congenitalconstriction band syndrome is rare condition and is mostly associated with other musculoskeletaldisorders.We report such a rare experience.

  7. Congenital anterior urethral diverticulum

    International Nuclear Information System (INIS)

    Jung, Hyun Sub; Chung, Young Sun; Suh, Chee Jang; Won, Jong Jin

    1985-01-01

    Two cases of congenital anterior urethral diverticular which have occurred in a 4 year old and one month old boy are presented. Etiology, diagnostic procedures, and its clinical results are briefly reviewed

  8. Features of Type 2 Diabetes Mellitus in Combination with Hypothyroidism

    Directory of Open Access Journals (Sweden)

    T.Yu. Yuzvenko

    2015-11-01

    Full Text Available Background. The last decades are characterized by the considerable increase in the prevalence of endocrine disorders with the change of the structure, and first of all cases of polyendocrinopathy, the special place among which is occupied by combination of diabetes mellitus (DM and thyroid diseases. Increase in the incidence of DM type 2 associated with hypothyroidism affects the clinical course of this pathology, remains topical problem of modern medical science. The objective: to study the prevalence of hypothyroidism in patients with type 2 DM and to establish clinical features of DM type 2 in combination with hypothyroidism. Materials and methods. We have examined 179 patients with DM associated with primary hypothyroidism, including 64 patients with DM type 1 and 115 patients with type 2 DM. Comparison group consisted of 62 patients with DM without hypothyroidism (27 of them — with DM type 1, 35 — with DM type 2. Thyroid function was assessed by determining the basal concentrations of thyroid stimulating hormone and free thyroxine fraction. Results. It was found that patients with DM type 2 and hypothyroidism belonged to an older age group than patients with DM type 1 and hypothyroidism. Thus, the age of patients with DM type 1 and hypothyroidism was 35.3 ± 9.5 years, and in patients with type 2 DM and hypothyroidism — 47.6 ± 11.0 years. In all groups of patients, the percentage of women was much higher than men. The significant differences were detected in terms of the amplitude of glycemic index, namely its increase in patients with DM type 1 and hypothyroidism. When DM type 2 was combined with hypothyroidism, lipid metabolism indices were higher than in DM type 2 without thyroid disease. This confirms the effect of hypothyroidism on lipid metabolism and causes increased risk of progression of cardiovascular events at the presence of two diseases. Conclusions. Among examined patients, hypothyroidism occurred 2.4 times more often

  9. A Rare Manifestation of Hypothyroid Myopathy: Hoffmann's Syndrome

    Directory of Open Access Journals (Sweden)

    Kang Won Lee

    2015-12-01

    Full Text Available Hypothyroid myopathy is observed frequently and the resolution of the clinical manifestations of myopathy following thyroid hormone replacement is well known. However, a specific subtype of hypothyroid myopathy, Hoffmann's syndrome, characterized by increased muscular mass (pseudohypertrophy, proximal muscle weakness, muscle stiffness and cramps, is rarely reported. Herein, we describe a 34-year-old male who presented with proximal muscle weakness and non-pitting edema of the lower extremities. He initially visited the neurology department where he was suspected of having polymyositis. Additional laboratory evaluation revealed profound autoimmune hypothyroidism and elevated muscle enzymes including creatine kinase. The patient was started on levothyroxine treatment and, subsequently, clinical symptoms and biochemical parameters resolved with the treatment. The present case highlights that hypothyroidism should be considered in the differential diagnosis of musculoskeletal symptoms even in the absence of overt manifestations of hypothyroidism. To our knowledge, this is the first case reported in Korea.

  10. Evaluation of olfactory function in adults with primary hypothyroidism.

    Science.gov (United States)

    Günbey, Emre; Karlı, Rıfat; Gökosmanoğlu, Feyzi; Düzgün, Berkan; Ayhan, Emre; Atmaca, Hulusi; Ünal, Recep

    2015-10-01

    Sufficient clinical data are not available on the effect of hypothyroidism on olfactory function in adults. In this study, we aimed to evaluate the olfactory function of adult patients diagnosed with primary hypothyroidism. Forty-five patients aged between 18 and 60 years who were diagnosed with clinical primary hypothyroidism and 45 healthy controls who had normal thyroid function tests were included in the study. Sniffin' Sticks olfactory test results of the 2 groups were compared. The relationships between thyroid function tests and olfactory parameters were evaluated. Odor threshold, identification, and discrimination scores of the hypothyroid group were significantly lower than those of the control group (p adults with hypothyroidism. FT3 levels were found to have a more significant relationship with olfactory parameters than TSH or FT4 levels. © 2015 ARS-AAOA, LLC.

  11. Congenital chylous ascites

    International Nuclear Information System (INIS)

    Romanska-Kita, J.; Borszewska-Kornacka, M. K.; Rudzinska, I.; Wawrzoniak, T.; Dobrzanska, A.; Czech-Kowalska, J.

    2011-01-01

    Congenital chylous ascites is a rare entity, conditioned by numerous factors and with changing dynamics of the disease. Because of the lack of therapeutic and diagnostic standards, this disease constitutes to be a medical challenge. This article presents current knowledge on pathogenesis, diagnostics and management of this disease, as well as a case of a newborn with primary congenital chylous ascites in the abdominal cavity. (authors)

  12. Multifocal Congenital Hemangiopericytoma.

    Science.gov (United States)

    Robl, Renata; Carvalho, Vânia Oliveira; Abagge, Kerstin Taniguchi; Uber, Marjorie; Lichtvan, Leniza Costa Lima; Werner, Betina; Mehrdad Nadji, Mehrdad

    2017-01-01

    Congenital hemangiopericytoma (HPC) is a rare mesenchymal tumor with less aggressive behavior and a more favorable prognosis than similar tumors in adults. Multifocal presentation is even less common than isolated HPC and hence its clinical and histologic recognition may be challenging. A newborn infant with multifocal congenital HPC causing severe deformity but with a favorable outcome after chemotherapy and surgical removal is reported. © 2016 Wiley Periodicals, Inc.

  13. Hypothyroid myopathy. A clinical and pathologaical study.

    Science.gov (United States)

    McKeran, R O; Slavin, G; Ward, P; Paul, E; Mair, W G

    1980-09-01

    Ten patients with varying degrees of hypothroid myopathy were studied clinically and by serial percutaneous needle muscle biopsies before and during treatment with L-thyroxine. The biochemical evidence of hypothyroidism was related to the severity of the myopathic and signs before treatment. The severity of myopathic symptoms before and during treatment correlated with the biochemical evidence of hypothyrodism, a type II fibre atrophy and increased central nuclear counts. Likewise, the clinical evidence of a myopathy before and during treatment was correlated with both a type II fibre atrophy and loss and increased central nuclear counts but was not related to the biochemical parameters of hypothyroidism, except the level of thyroid stimulating hormone. In the muscle, before and during treatment, of the two most severely affected patients, intracellular glycogen inclusions were seen in scattered muscle fibres. On light microscopy and on electronmicroscopy, numerous mitochondria were seen responding to L-thyroxine with accumulations of subsarcolemmal honey-combing. Vesicular abnormalities, an electron dense matrix or occasional crystalline deposits were seen in muscle mitochondria from less severely azffected patients. Severely myopathic muscle contained excessive glycogen, membrane bound glycogen and excess lipid in a mainly perinuclear distribution. Occasional myelin and membranous bodies were seen and satellite cells during the recovery phase. A group of patients with hypothyroid myopathy who are likely to have a delayed recovery of full muscle strength on L-thyroxine may be recognised by the presence of severe proximal muscle weakness and characteristic changes on histochemical and electronmicroscopic examination of muscle. The spectrum of histochemical and electronmicroscopic abnormalities of muscle revealed with increasing degree of hypothyrodism, suggests that a generally reversible acquired glycogen storage and mictochondrial disorder is an important feature

  14. Hyperprolactinemia in Children with Subclinical Hypothyroidism.

    Science.gov (United States)

    Sharma, Neera; Dutta, Deep; Sharma, Lokesh Kumar

    2017-12-15

    Prevalence of hyperprolactinemia in children with subclinical hypothyroidism (ScH) is not known. This study aimed to determine the occurrence and predictors of hyperprolactinemia in euthyroid children and in children with ScH and overt primary hypothyroidism (OPH). Serum prolactin levels were estimated in consecutive children hypothyroidism, multiple pituitary hormone deficiency, comorbid states, and drug-induced hyperprolactinemia were excluded. From the initially screened 791 children, hormonal data from 602 children who fulfilled all criteria were analyzed. Seventy-one (11.79%) of these had ScH, and 33 (5.48%) had OPH. Occurrence of hyperprolactinemia was highest in the OPH group (51.51%), followed by ScH (30.98%) and euthyroid children (4.41%) (p<0.001). Median (25 th -75 th percentiles) levels for prolactin in euthyroid, ScH, and OPH children were 13.3 (9.4-17.95), 19.15 (15.97-30.12), and 28.86 (17.05-51.9) ng/mL, respectively (p<0.001). In children, prolactin levels were comparable in males and females. An age-related increase in serum prolactin was noted in euthyroid children, which was statistically significant in post-pubertal (16-18 years) children. Area under the curve for thyroid stimulating hormone (TSH) in predicting hyperprolactinemia in children was 0.758 (95% confidence interval: 0.673-0.829; p<0.001). TSH ≥4.00 mIU/L had a sensitivity of 69.4% and specificity of 77.6% in detecting hyperprolactinemia. Hyperprolactinemia is common in children with ScH and OPH. TSH ≥4.00 mIU/L has a good sensitivity and specificity in predicting hyperprolactinemia in children. More studies are needed to establish if hyperprolactinemia should be an indication for treating ScH in children.

  15. Hypothyroidism in Patients with Psoriasis or Rosacea: A Large Population Study.

    Science.gov (United States)

    James, Sara M; Hill, Dane E; Feldman, Steven R

    2016-10-15

    Hypothyroidism is a common disease, and there may be a link between hypothyroidism and inflammatory skin disease. The purpose of this study is to assess whether hypothyroidism is more prevalent in psoriasis or rosacea patients. We utilized a large claims-based database to analyze rates of hypothyroidism in patients with psoriasis and rosacea compared to other patients with skin diseases. Participants were patients between 20-64 years of age with ICD-9 diagnosis codes for psoriasis, rosacea, and hypothyroidism. We found that rates of hypothyroidism in rosacea and psoriasis patients were similar to rates of hypothyroidism in those without rosacea or psoriasis.

  16. Neonatal hyper- and hypothyroidism alter the myoglobin gene expression program in adulthood.

    Science.gov (United States)

    Souza, K de Picoli; Nunes, M T

    2014-08-01

    Myoglobin acts as an oxygen store and a reactive oxygen species acceptor in muscles. We examined myoglobin mRNA in rat cardiac ventricle and skeletal muscles during the first 42 days of life and the impact of transient neonatal hypo- and hyperthyroidism on the myoglobin gene expression pattern. Cardiac ventricle and skeletal muscles of Wistar rats at 7-42 days of life were quickly removed, and myoglobin mRNA was determined by Northern blot analysis. Rats were treated with propylthiouracil (5-10 mg/100 g) and triiodothyronine (0.5-50 µg/100 g) for 5, 15, or 30 days after birth to induce hypo- and hyperthyroidism and euthanized either just after treatment or at 90 days. During postnatal (P) days 7-28, the ventricle myoglobin mRNA remained unchanged, but it gradually increased in skeletal muscle (12-fold). Triiodothyronine treatment, from days P0-P5, increased the skeletal muscle myoglobin mRNA 1.5- to 4.5-fold; a 2.5-fold increase was observed in ventricle muscle, but only when triiodothyronine treatment was extended to day P15. Conversely, hypothyroidism at P5 markedly decreased (60%) ventricular myoglobin mRNA. Moreover, transient hyperthyroidism in the neonatal period increased ventricle myoglobin mRNA (2-fold), and decreased heart rate (5%), fast muscle myoglobin mRNA (30%) and body weight (20%) in adulthood. Transient hypothyroidism in the neonatal period also permanently decreased fast muscle myoglobin mRNA (30%) and body weight (14%). These results indicated that changes in triiodothyronine supply in the neonatal period alter the myoglobin expression program in ventricle and skeletal muscle, leading to specific physiological repercussions and alterations in other parameters in adulthood.

  17. Neonatal hyper- and hypothyroidism alter the myoglobin gene expression program in adulthood

    International Nuclear Information System (INIS)

    Picoli Souza, K. de; Nunes, M.T.

    2014-01-01

    Myoglobin acts as an oxygen store and a reactive oxygen species acceptor in muscles. We examined myoglobin mRNA in rat cardiac ventricle and skeletal muscles during the first 42 days of life and the impact of transient neonatal hypo- and hyperthyroidism on the myoglobin gene expression pattern. Cardiac ventricle and skeletal muscles of Wistar rats at 7-42 days of life were quickly removed, and myoglobin mRNA was determined by Northern blot analysis. Rats were treated with propylthiouracil (5-10 mg/100 g) and triiodothyronine (0.5-50 µg/100 g) for 5, 15, or 30 days after birth to induce hypo- and hyperthyroidism and euthanized either just after treatment or at 90 days. During postnatal (P) days 7-28, the ventricle myoglobin mRNA remained unchanged, but it gradually increased in skeletal muscle (12-fold). Triiodothyronine treatment, from days P0-P5, increased the skeletal muscle myoglobin mRNA 1.5- to 4.5-fold; a 2.5-fold increase was observed in ventricle muscle, but only when triiodothyronine treatment was extended to day P15. Conversely, hypothyroidism at P5 markedly decreased (60%) ventricular myoglobin mRNA. Moreover, transient hyperthyroidism in the neonatal period increased ventricle myoglobin mRNA (2-fold), and decreased heart rate (5%), fast muscle myoglobin mRNA (30%) and body weight (20%) in adulthood. Transient hypothyroidism in the neonatal period also permanently decreased fast muscle myoglobin mRNA (30%) and body weight (14%). These results indicated that changes in triiodothyronine supply in the neonatal period alter the myoglobin expression program in ventricle and skeletal muscle, leading to specific physiological repercussions and alterations in other parameters in adulthood

  18. Neonatal hyper- and hypothyroidism alter the myoglobin gene expression program in adulthood

    Energy Technology Data Exchange (ETDEWEB)

    Picoli Souza, K. de [Faculdade de Ciências Biológicas e Ambientais, Universidade Federal da Grande Dourados, Dourados, MS (Brazil); Nunes, M.T. [Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, Universidade de São Paulo, São Paulo, SP (Brazil)

    2014-06-24

    Myoglobin acts as an oxygen store and a reactive oxygen species acceptor in muscles. We examined myoglobin mRNA in rat cardiac ventricle and skeletal muscles during the first 42 days of life and the impact of transient neonatal hypo- and hyperthyroidism on the myoglobin gene expression pattern. Cardiac ventricle and skeletal muscles of Wistar rats at 7-42 days of life were quickly removed, and myoglobin mRNA was determined by Northern blot analysis. Rats were treated with propylthiouracil (5-10 mg/100 g) and triiodothyronine (0.5-50 µg/100 g) for 5, 15, or 30 days after birth to induce hypo- and hyperthyroidism and euthanized either just after treatment or at 90 days. During postnatal (P) days 7-28, the ventricle myoglobin mRNA remained unchanged, but it gradually increased in skeletal muscle (12-fold). Triiodothyronine treatment, from days P0-P5, increased the skeletal muscle myoglobin mRNA 1.5- to 4.5-fold; a 2.5-fold increase was observed in ventricle muscle, but only when triiodothyronine treatment was extended to day P15. Conversely, hypothyroidism at P5 markedly decreased (60%) ventricular myoglobin mRNA. Moreover, transient hyperthyroidism in the neonatal period increased ventricle myoglobin mRNA (2-fold), and decreased heart rate (5%), fast muscle myoglobin mRNA (30%) and body weight (20%) in adulthood. Transient hypothyroidism in the neonatal period also permanently decreased fast muscle myoglobin mRNA (30%) and body weight (14%). These results indicated that changes in triiodothyronine supply in the neonatal period alter the myoglobin expression program in ventricle and skeletal muscle, leading to specific physiological repercussions and alterations in other parameters in adulthood.

  19. Neonatal hyper- and hypothyroidism alter the myoglobin gene expression program in adulthood

    Directory of Open Access Journals (Sweden)

    K. de Picoli Souza

    2014-08-01

    Full Text Available Myoglobin acts as an oxygen store and a reactive oxygen species acceptor in muscles. We examined myoglobin mRNA in rat cardiac ventricle and skeletal muscles during the first 42 days of life and the impact of transient neonatal hypo- and hyperthyroidism on the myoglobin gene expression pattern. Cardiac ventricle and skeletal muscles of Wistar rats at 7-42 days of life were quickly removed, and myoglobin mRNA was determined by Northern blot analysis. Rats were treated with propylthiouracil (5-10 mg/100 g and triiodothyronine (0.5-50 µg/100 g for 5, 15, or 30 days after birth to induce hypo- and hyperthyroidism and euthanized either just after treatment or at 90 days. During postnatal (P days 7-28, the ventricle myoglobin mRNA remained unchanged, but it gradually increased in skeletal muscle (12-fold. Triiodothyronine treatment, from days P0-P5, increased the skeletal muscle myoglobin mRNA 1.5- to 4.5-fold; a 2.5-fold increase was observed in ventricle muscle, but only when triiodothyronine treatment was extended to day P15. Conversely, hypothyroidism at P5 markedly decreased (60% ventricular myoglobin mRNA. Moreover, transient hyperthyroidism in the neonatal period increased ventricle myoglobin mRNA (2-fold, and decreased heart rate (5%, fast muscle myoglobin mRNA (30% and body weight (20% in adulthood. Transient hypothyroidism in the neonatal period also permanently decreased fast muscle myoglobin mRNA (30% and body weight (14%. These results indicated that changes in triiodothyronine supply in the neonatal period alter the myoglobin expression program in ventricle and skeletal muscle, leading to specific physiological repercussions and alterations in other parameters in adulthood.

  20. Does developmental hypothyroidism produce lasting effects ...

    Science.gov (United States)

    The subgranular zone of the dentate gyrus (DO) of the adult hippocampus generates new neurons throughout life. Thyroid hormones (TH) are essential for brain development, but impaired neurogenesis with adult hypothyroidism has also been reported. We investigated the role of milder degrees of TH disruption on adult neurogenesis following hypothyroidism induced during development, in adulthood, or both. Pregnant dams were administered the TH synthesis inhibitor, propylthiouracil (PTU, 0 or 3ppm in drinking water) from gestational day 6 and pups were weaned to control water on postnatal day (PN)2 I. On PN6O, offspring from control or PTU dams were either re-exposed to PTU (3ppm) for I month or maintained on control. Bromodeoxyuridine (BrdU 50 mg/kg, ip, twice daily) was administered to all animals on the last 5 days of the re-exposure period, and animals sacrificed 28 d later. Animals were perfused intracardially, the brains were removed, embedded in a MultiBrain (NSA) array and freeze sectioned. Every 8th section throughout the hippocampus was stained with an antibody against BrdU to mark actively dividing cells. The volume of the DO and the number of BrdUpositive cells were assessed from images captured on a Nikon microscope (200X) and Nikon Elements software. Preliminary findings indicate that developmental exposure to PTU produced a persistent reduction in the volume of the adult DO. BrdU cell counts were reduced similarly in all P11J-exposed groups. These data

  1. Effect of Combination Treatment for Hypothyroidism on Renal Function in Patients with Hypothyroidism

    Directory of Open Access Journals (Sweden)

    O.M. Didushko

    2016-02-01

    Full Text Available Objective. To improve known methods of diagnosing kidney damage in patients suffering from hypothyroidism with elements of metabolic syndrome, to study the effect of combined treatment on renal function. Materials and methods. The study included 240 patients with primary hypothyroidism (among them — 130 patients with primary hypothyroidism with components of the metabolic syndrome. All patients were divided into 2 groups: the I group included 42 patients with hypothyroidism without obesity (age 44.8 ± 5.7 years; body mass index (BMI 21.3 ± 2.6 kg/m2; group II — 45 patients with hypothyroidism and abdominal obesity (age 43.8 ± 6.1 years; BMI 33.4 ± 4.8 kg/m2. The control group included 20 healthy individuals (age 43.5 ± 5.9 years; BMI 22.0 ± 2.4 kg/m2. Kidney damage was detected in violation of glomerular filter permeability — occurrence of albuminuria and parameters of glomerular filtration rate (GFR were determined using CKD-EPI formulas. The concentration of monocyte chemoattractant protein-1 (MCP-1, leptin, insulin was determined by immunoenzyme assay. Results. During the correlation analysis, between GFR in patients of group I we have established: moderate inverse correlation between the level of GFR and thyroid stimulating hormone (TSH (r = 0.571, GFR and vascular endothelial growth factor (r = –0.616, GFR anf interleukin-6 (IL-6 (r = –0.418, total cholesterol (ChS (r = –0.311, GFR and insulin resistance index (IIR (r = –0.606 and weak inverse relationship between level of GFR and MCP-1 (r = –0.2917. In the II group of patients, a strong direct correlation between the level of GFR and IIR (r = 0.819, Caro index (r = 0.793 and a strong inverse correlation between GFR and TSH (r = –0.782, GFR and HOMA index (r = –0.875, moderate inverse correlation between the levels of GFR and ChS (r = –0.577, leptin (r = –0.476, GFR and IL-6 (r = –0.418, GFR and glucose (r = –0.436 and vascular endothelial growth factor (r

  2. Hypothyroidism causing paralytic ileus and acute kidney injury - case report

    Directory of Open Access Journals (Sweden)

    Rodrigo Chaturaka

    2011-02-01

    Full Text Available Abstract We present a patient with severe hypothyroidism complicated by paralytic ileus and acute kidney injury. A 65 year old male patient, diagnosed with hypothyroidism one year ago was transferred to our unit in a state of drowsiness and confusion. He was severely hypothyroid and had paralytic ileus and impaired renal function at the time of transfer. Hypokalaemia was present, and was likely to have contributed to the paralytic ileus and this together with dehydration was likely to have contributed to renal injury. Nonetheless, hypothyroidism is very likely to have been the principal precipitant of both these complications, and both paralytic ileus and acute kidney injury improved with thyroxine replacement. Unfortunately, the patient died unexpectedly eight days after admission to the unit. Hypothyroidism may induce de novo acute kidney injury or it may exacerbate ongoing chronic kidney disease. This rare complication is assumed to be due to the hypodynamic circulatory state created by thyroid hormone deficiency. Paralytic ileus is an even rarer fatal manifestation of hypothyroidism and is thought to be due to an autonomic neuropathy affecting the intestines that is reversible with thyroxine replacement. To our knowledge, both these complications have not been observed in a single patient so far. It is important that clinicians are aware of these rare manifestations of hypothyroidism as in most occasions, thyroxine deficiency may be missed, and treatment can reverse the complications.

  3. Heat production during contraction in skeletal muscle of hypothyroid mice

    Energy Technology Data Exchange (ETDEWEB)

    Leijendekker, W.J.; van Hardeveld, C.; Elzinga, G. (Free Univ., Amsterdam (Netherlands))

    1987-08-01

    The effect of hypothyroidism on tension-independent and -dependent heat produced during a twitch and a tetanic contraction of extensor digitorum longus (EDL) and soleus muscle of mice was examined. The amount of heat produced during a twitch and the rate of heat development during a tetanus of EDL and soleus were measured at and above optimal length. The effect of hypothyroidism on force production was <30%. Straight lines were used to fit the relation between heat production and force. Hypothyroidism significantly decreases tension-independent heat during contraction of EDL and soleus muscle. Because the tension-independent heat is considered to be related to the Ca{sup 2+} cycling, these findings suggest that ATP splitting due to the Ca{sup 2+} cycling is reduced in hypothyroid mice. This conclusion was strengthened by the observation that the oxalate-supported {sup 45}Ca{sup 2+}-uptake activity and {sup 45}Ca{sup 2+}-loading capacity of muscle homogenates from hypothyroid mice were reduced, respectively, to 51 and to 65% in soleus and to 63 and 73% in EDL muscle as compared with euthyroid mice. The tension-dependent rate of heat development during a tetanus was also decreased in soleus muscle of hypothyroid mice. This suggests a lower rate of ATP hydrolysis related to cross-bridge cycling in this muscle due to the hypothyroid state.

  4. Hypothyroidism after radiotherapy for head and neck cancer patients

    International Nuclear Information System (INIS)

    Ozawa, Hiroyuki; Saito, Hideyuki; Inagaki, Kouji; Mizutari, Kunio

    2004-01-01

    We report two cases of hypothyroidism with clinical symptoms that occurred after radiotherapy for cancer of the head and neck. The first patient underwent total laryngectomy without thyroidectomy for laryngeal cancer and partial gastrectomy for gastric cancer. Radiation of the neck was carried out postoperatively. Two years later, he developed chest pain and pericardial effusion was detected, leading to a diagnosis of myxedema due to hypothyroidism. The second patient received radiotherapy alone for laryngeal carcinoma. Two months later, a low serum sodium concentration and anemia were detected, both of which proved difficult to correct. The cause of these changes was found subsequently to be hypothyroidism. From the experience of these 2 cases, we measured thyroid function in 37 patients who had received neck radiation for head and neck cancers at our hospital over the past 10 years. In 13 of the 37 patients (35%), hypothyroidism was observed. The prevalence of hypothyroidism was higher in the 13 patients treated with both radiation and surgery, with 6 (46%) showing this condition, compared with 7 of the 24 patients (29%) who received radiation alone. The risk factor responsible for hypothyroidism was not evident from statistical analysis of these cases. We consider that thyroid function should be evaluated periodically in patients who have received neck radiotherapy, as it is often difficult to diagnose hypothyroidism from clinical symptoms. (author)

  5. Altered fructosamine and lipid fractions in subclinical hypothyroidism.

    Science.gov (United States)

    Udupa, Sridevi V; Manjrekar, Poornima A; Udupa, Vinit A; Vivian, D'Souza

    2013-01-01

    Thyroid function disorders lead to changes in the lipoprotein metabolism. To study the lipid and the glycaemic abnormalities in the subclinical hypothyroidism cases and to compare the same with the euthyroid, overt hypothyroid and the hyperthyroid subjects. Four groups, euthyroid (Group-I), hypothyroid (Group-II), subclinical hypothyroid (Group-III) and hyperthyroid (Group-IV), which consisted of 30 subjects each, of either sex, who were aged 25-55 years, underwent Fasting Plasma Glucose (FPG), fructosamine, lipid profile and total T3, T4 and TSH estimations. The subjects who were on lipid lowering or thyroid disorder drugs and known diabetics were excluded from the study. In Group-III, all the lipid fractions were comparable to those of Group-II and they were significantly deranged, as compared to those of Group-I. The fructosamine levels were significantly higher in Group-II and Group-III (phypothyrodism, the subclinical hypothyroid cases also need to be treated similarly. The fructosamine values which are largely in excess of the FPG values, indicate a higher propensity to glycation and a decreased turnover of the proteins in the hypothyroid and the subclinical hypothyroid pools. Vice versa is true of the hyperthyroid pool. Fructosamine can be included in the thyroid work up of the patients to assess the metabolic function and the subsequent response after the initiation of the therapy.

  6. The association of congenital neuroblastoma and congenital heart disease

    International Nuclear Information System (INIS)

    Bellah, R.; D'Andrea, A.; Children's Hospital, Boston, MA; Darillis, E.; Fellows, K.E.

    1989-01-01

    Several authors have reported an association between neuroblastoma and congenital heart disease; others contend that, unlike specific wellknown associations between malignancy and congenital defects (Wilm's tumor and aniridia, leukemia and Down's syndrome), no real relationship exists. We present three cases of cyanotic congenital heart disease in which subclinical neuroblastoma was found. We speculate that abnormal neural crest cell migration and development may be a common link between cardiac malformations and congenital neuroblastoma. (orig.)

  7. Congenital malaria in China.

    Directory of Open Access Journals (Sweden)

    Zhi-Yong Tao

    2014-03-01

    Full Text Available BACKGROUND: Congenital malaria, in which infants are directly infected with malaria parasites from their mother prior to or during birth, is a potentially life-threatening condition that occurs at relatively low rates in malaria-endemic regions. It is recognized as a serious problem in Plasmodium falciparum-endemic sub-Saharan Africa, where recent data suggests that it is more common than previously believed. In such regions where malaria transmission is high, neonates may be protected from disease caused by congenital malaria through the transfer of maternal antibodies against the parasite. However, in low P. vivax-endemic regions, immunity to vivax malaria is low; thus, there is the likelihood that congenital vivax malaria poses a more significant threat to newborn health. Malaria had previously been a major parasitic disease in China, and congenital malaria case reports in Chinese offer valuable information for understanding the risks posed by congenital malaria to neonatal health. As most of the literature documenting congenital malaria cases in China are written in Chinese and therefore are not easily accessible to the global malaria research community, we have undertaken an extensive review of the Chinese literature on this subject. METHODS/PRINCIPAL FINDINGS: Here, we reviewed congenital malaria cases from three major searchable Chinese journal databases, concentrating on data from 1915 through 2011. Following extensive screening, a total of 104 cases of congenital malaria were identified. These cases were distributed mainly in the eastern, central, and southern regions of China, as well as in the low-lying region of southwest China. The dominant species was P. vivax (92.50%, reflecting the malaria parasite species distribution in China. The leading clinical presentation was fever, and other clinical presentations were anaemia, jaundice, paleness, diarrhoea, vomiting, and general weakness. With the exception of two cases, all patients

  8. Neonatal hypothyroidism affects testicular glucose homeostasis through increased oxidative stress in prepubertal mice: effects on GLUT3, GLUT8 and Cx43.

    Science.gov (United States)

    Sarkar, D; Singh, S K

    2017-07-01

    Thyroid hormones (THs) play an important role in maintaining the link between metabolism and reproduction and the altered THs status is associated with induction of oxidative stress in various organs like brain, heart, liver and testis. Further, reactive oxygen species play a pivotal role in regulation of glucose homeostasis in several organs, and glucose utilization by Leydig cells is essential for testosterone biosynthesis and thus is largely dependent on glucose transporter 8 (GLUT8). Glucose uptake by Sertoli cells is mediated through glucose transporter 3 (GLUT3) under the influence of THs to meet energy requirement of developing germ cells. THs also modulate level of gap junctional protein such as connexin 43 (Cx43), a potential regulator of cell proliferation and apoptosis in the seminiferous epithelium. Although the role of transient neonatal hypothyroidism in adult testis in terms of testosterone production is well documented, the effect of THs deficiency in early developmental period and its role in testicular glucose homeostasis and oxidative stress with reference to Cx43 in immature mice remain unknown. Therefore, the present study was conducted to evaluate the effect of neonatal hypothyroidism on testicular glucose homeostasis and oxidative stress at postnatal days (PND) 21 and 28 in relation to GLUT3, GLUT8 and Cx43. Hypothyroidism induced by 6-propyl-2-thiouracil (PTU) markedly decreased testicular glucose level with considerable reduction in expression level of GLUT3 and GLUT8. Likewise, lactate dehydrogenase (LDH) activity and intratesticular concentration of lactate were also decreased in hypothyroid mice. There was also a rise in germ cell apoptosis with increased expression of caspase-3 in PTU-treated mice. Further, neonatal hypothyroidism affected germ cell proliferation with decreased expression of proliferating cell nuclear antigen (PCNA) and Cx43. In conclusion, our results suggest that neonatal hypothyroidism alters testicular glucose

  9. Congenital cytomegalovirus infection

    Directory of Open Access Journals (Sweden)

    Katarina Rednak-Paradiž

    2006-11-01

    Full Text Available Background: CMV is the most common agent that causes congenital virus infection. Only 10 % of infected children have symptomatic infection immediately after birth. Signs of central nervous system damage, neurosensory deafness and delayed psychomotor development may manifest as a result of asimptomatic congenital infection later in childhood. In the article we present basic properties of CMV; we describe clinical picture of the congenital infection and possibilities of diagnose and its treatment. We present five children with symptomatic congenital CMV infection that were hospitalized for the period 1992–2002 at the Neonatal department in the University Children’s Hospital in Ljubljana.Conclusions: Identification of infected neonates, especially those with asimptomatic congenital CMV infection, is difficult. Latest incidence of infection in Slovenia is unknown. With new investigations the efficiency of antiviral therapy was discovered but exact indications for therapy are not yet known. CMV vaccine, once available, may ultimately be the best control strategy for this important public health problem. Proper educating women in childbearing age about the risks of CMV and how to avoid disease transmission during pregnancy (hand washing, avoiding mouth-to-mouth contact with preschool children, usage of gloves especially when handling dipers or respiratory secretions are the only control strategies available.

  10. Prevalence of congenital amusia.

    Science.gov (United States)

    Peretz, Isabelle; Vuvan, Dominique T

    2017-05-01

    Congenital amusia (commonly known as tone deafness) is a lifelong musical disorder that affects 4% of the population according to a single estimate based on a single test from 1980. Here we present the first large-based measure of prevalence with a sample of 20 000 participants, which does not rely on self-referral. On the basis of three objective tests and a questionnaire, we show that (a) the prevalence of congenital amusia is only 1.5%, with slightly more females than males, unlike other developmental disorders where males often predominate; (b) self-disclosure is a reliable index of congenital amusia, which suggests that congenital amusia is hereditary, with 46% first-degree relatives similarly affected; (c) the deficit is not attenuated by musical training and (d) it emerges in relative isolation from other cognitive disorder, except for spatial orientation problems. Hence, we suggest that congenital amusia is likely to result from genetic variations that affect musical abilities specifically.

  11. Hypothyroidism as a risk factor for statin intolerance.

    Science.gov (United States)

    Robison, Craig D; Bair, Tami L; Horne, Benjamin D; McCubrey, Ray O; Lappe, Donald L; Muhlestein, Joseph B; Anderson, Jeffrey L

    2014-01-01

    Three-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) are one of the most commonly prescribed classes of medications because of their proven cardiovascular benefits. However, statin intolerance occurs in 5% to 20% of patients. Understanding the basis for statin intolerance remains a key issue in preventive medicine. To evaluate the association of statin intolerance with hypothyroidism in a large integrated health care system, including its sex-specific relationship and subsequent statin rechallenge and prescription history. The Intermountain Healthcare electronic medical record database identified patients (n = 2686; males = 1276, females = 1410) with a documentation of intolerance ("allergy") to at least 1 statin. Age and sex similar controls (n = 8103; males = 3892, females = 4211) were identified among patients prescribed statins without documented intolerance. Patients were evaluated for a history of hypothyroidism, development of hypothyroidism, and statin prescription history up to 5 years of follow-up. A total of 30.2% patients (210 males, 16.5%; 602 females, 42.7%) with statin intolerance had a history of hypothyroidism compared with 21.5% of statin-tolerant patients (475 males, 12.2%; 1266 females, 30.1%), for an odds ratio (OR) in the total population of 1.49 (95% confidence interval [CI] 1.34-1.65; P intolerance and hypothyroidism were less likely to be on a statin than their statin-intolerant counterparts without hypothyroidism (hazard ratio 0.84; 95% CI 0.75-0.94; P = .002). Hypothyroidism is more prevalent in those with statin intolerance, both in males and, especially, in females. People with hypothyroidism are less likely to have a prescription for a statin at follow-up than those without hypothyroidism. Copyright © 2014 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  12. Investigation of the choroidal thickness in patients with hypothyroidism

    Directory of Open Access Journals (Sweden)

    Fatih Ulas

    2015-01-01

    Full Text Available Purpose: The effect of hypothyroidism on the choroidal thickness (CT was investigated in patients with subclinical hypothyroidism and overt hypothyroidism, and biochemically and clinically euthyroid patients receiving levothyroxine treatment. The patients were compared with healthy subjects. Materials and Methods: One eye of 71 hypothyroid and 22 healthy subjects between 20 and 40 years of age were included in this study. CT measurements were taken at the fovea and at 2 points that were 1500 μm nasal and temporal to the fovea using spectral-domain optical coherence tomography. Independent sample t-test′s and was used for statistical analysis of the data. Results: The CT was significantly thicker in hypothyroid patients compared to healthy subjects (P values were 0.013 for subfoveal, 0.015 for temporal and 0.020 for nasal segments. The intraocular pressure (IOP and body mass index (BMI were also significantly higher in hypothyroid patients (P values were 0.021 and 0.003, respectively. There was not a statistically significant difference in the BMI and IOP measurements between healthy subjects and euthyroid patients (P > 0.05. However, there was a statistically significant difference in the subfoveal, temporal and nasal CT measurements between healthy subjects and euthyroid patients (P values were 0.006, 0.031 and 0.013, respectively. Conclusions: All subgroups of hypothyroid patients had thicker CT compared to healthy subjects. Euthyroid patients receiving levothyroxine treatment had lower IOP, BMI levels, and serum lipid levels than patients with subclinical hypothyroidism and overt hypothyroidism.

  13. Hypothyroidism Is Associated With Coronary Endothelial Dysfunction in Women

    Science.gov (United States)

    Sara, Jaskanwal D; Zhang, Ming; Gharib, Hossein; Lerman, Lilach O; Lerman, Amir

    2015-01-01

    Background Hypothyroidism is associated with an increased risk of coronary artery disease, beyond that which can be explained by its association with conventional cardiovascular risk factors. Coronary endothelial dysfunction precedes atherosclerosis, has been linked to adverse cardiovascular events, and may account for some of the increased risk in patients with hypothyroidism. The aim of this study was to determine whether there is an association between epicardial and microvascular coronary endothelial dysfunction and hypothyroidism. Methods and Results In 1388 patients (mean age 50.5 [12.3] years, 34% male) presenting with stable chest pain to Mayo Clinic, Rochester, MN for diagnostic coronary angiography, and who were found to have nonobstructive coronary artery disease (hypothyroidism, defined as a documented history of hypothyroidism or a thyroid-stimulating hormone (TSH) >10.0 mU/mL, n=188, and euthyroidism, defined as an absence of a history of hypothyroidism in the clinical record and/or 0.3hypothyroidism had a significantly lower % Δ CBF Ach (48.26 [80.66] versus 64.58 [128.30]) compared to patients with euthyroidism, while the % Δ CAD Ach did not vary significantly between groups. After adjusting for covariates, females with hypothyroidism still had a significantly lower % Δ CBF Ach (estimated difference in % Δ CBF Ach [SE]: −16.79 [8.18]). Conclusions Hypothyroidism in women is associated with microvascular endothelial dysfunction, even after adjusting for confounders, and may explain some of the increased risk of cardiovascular disease in these patients. PMID:26224049

  14. 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.

  15. Iatrogenic, sulfonamide-induced hypothyroid crisis in a Labrador Retriever.

    Science.gov (United States)

    Brenner, K; Harkin, K; Schermerhorn, T

    2009-12-01

    This case report describes a sulfonamide-induced hypothyroid crisis in a 4-year-old Labrador Retriever bitch. Empirical therapy with high-dose trimethoprim-sulfamethoxazole for 10 days produced signs of weakness, ataxia and mental depression and the clinicopathological results supported hypothyroid-induced central nervous system depression. Short-term levothyroxine sodium therapy led to complete resolution of all clinical signs and follow-up thyroid hormone assays ruled out underlying thyroid pathology. This case report is the first to highlight this potentially life-threatening manifestation of sulfonamide-induced hypothyroidism. Sulfonamide combinations are widely used antimicrobials in veterinary medicine and early recognition of this syndrome is critical.

  16. Changes of cardiac function in hyperthyroidism and hypothyroidism

    International Nuclear Information System (INIS)

    Morishita, Takeshi; Kawamura, Yasuaki; Yamazaki, Junichi; Okuzumi, Ichio; Muto, Toshinori; Wakakura, Manabu; Okamoto, Kiyoshi; Irie, Minoru; Inoue, Kazuko.

    1988-01-01

    Changes of cardiac parameters in patients with 21 hyperthyroidisms and 11 primary hypothyroidisms were studied administered by methimazole or 1-thyroxine using radionuclide method. In hyperthyroidisms, cardiac parameter (CI, EF, PEP/LVET, PEP) normalized 4 - 6 week delayed compared with hormonal level (T 3 , T 4 ) recovery period. On the other hand, in hypothyroidism PEP/LVET delayed about 2 weeks compared with hormonal level, however, other cardiac parameters were maintained within normal level, relatively. Correlation between T 3 and LVET was significant statistically (r = -0.59, p 3 and PEP was significant (r = -0.60, p < 0.01) in hypothyroidisms, respectively. (author)

  17. Hypercalcaemia in a dog with primary hypothyroidism : clinical communication

    Directory of Open Access Journals (Sweden)

    R. G. Lobetti

    2011-05-01

    Full Text Available A 7-year old female beagle was evaluated for symptomatic hypercalcaemia and primary hypothyroidism. Clinical findings were typical for hypothyroidism. Plasma parathyroid hormone was low and obvious causes for the hypercalcaemia were ruled out by means of abdominal ultrasonography, ultrasonography of the parathyroid glands, survey thoracic radiographs, and fine needle aspirate cytology of the spleen, liver, and peripheral lymph nodes. Treatment with thyroxine resulted in resolution of the hypercalcaemia after approximately 9 weeks of therapy. This is the 1st report of primary adult-onset hypothyroidism associated with symptomatic hypercalcaemia in a dog.

  18. Nitrofurantoin and congenital abnormalities

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft

    2001-01-01

    or fetuses with Down’s syndrome (patient controls), 23 (2.8%) pregnant women were treated with nitrofurantoin. The above differences between population controls and cases may be connected with recall bias, because the case-control pair analysis did not indicate a teratogenic potential of nitrofurantoin use......Objective: To study human teratogenic potential of oral nitrofurantoin treatment during pregnancy. Materials and Methods: Pair analysis of cases with congenital abnormalities and matched population controls in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital...... during the second and the third months of gestation, i.e. in the critical period for major congenital abnormalities. Conclusion: Treatment with nitrofurantoin during pregnancy does not present detectable teratogenic risk to the fetus....

  19. Congenital syphilis: literature review

    Directory of Open Access Journals (Sweden)

    Eduardo Chaida Sonda

    2013-01-01

    Full Text Available Syphilis is an infectious disease caused by Treponema pallidum and has high rates of vertical transmission, which can reach 100% depending on the maternal disease and stage of pregnancy. The diagnosis of gestational syphilis is simple and its screening is required during the prenatal period. However, this disease still has a high prevalence, affecting two million pregnant women worldwide. The procedures performed in newborns with congenital syphilis represent costs that are three-fold higher than the ones spent with a baby without this infection. The treatment is generally carried out with penicillin and must be extended to sexual partners. Inadequate or lack of treatment of congenital syphilis can result in miscarriage, premature birth, acute complications and other fetal sequelae. KEYWORDS: Congenital syphilis. Treponema pallidum. Vertical transmission.

  20. Congenital cataract screening

    Directory of Open Access Journals (Sweden)

    Zhale Rajavi

    2016-01-01

    Full Text Available Congenital cataract is a leading cause of visual deprivation which can damage the developing visual system of a child; therefore early diagnosis, management and long-term follow-up are essential. It is recommended that all neonates be screened by red reflex examination at birth and suspected cases be referred to ophthalmic centers. Early surgery (1 year is highly recommended. After surgery, amblyopia treatment and periodic follow-up examinations should be started as soon as possible to achieve a satisfactory visual outcome. Practitioners should consider the possibility of posterior capsular opacity, elevated intraocular pressure and amblyopia during follow-up, especially in eyes with microphthalmia and/or associated congenital anomalies. All strabismic children should undergo slit lamp examination prior to strabismus surgery to rule out congenital lens opacities. From a social point of view, equal and fair medical care should be provided to all children regardless of gender.

  1. Transient pseudohypoaldosteronism

    Directory of Open Access Journals (Sweden)

    Stajić Nataša

    2011-01-01

    Full Text Available Introduction. Infants with urinary tract malformations (UTM presenting with urinary tract infection (UTI are prone to develop transient type 1 pseudohypoaldosteronism (THPA1. Objective. Report on patient series with characteristics of THPA1, UTM and/or UTI and suggestions for the diagnosis and therapy. Methods. Patients underwent blood and urine electrolyte and acid-base analysis, serum aldosterosterone levels and plasma rennin activity measuring; urinalysis, urinoculture and renal ultrasound were done and medical and/or surgical therapy was instituted. Results. Hyponatraemia (120.9±5.8 mmol/L, hyperkalaemia (6.9±0.9 mmol/L, metabolic acidosis (plasma bicarbonate, 11±1.4 mmol/L, and a rise in serum creatinine levels (145±101 μmol/L were associated with inappropriately high urinary sodium (51.3±17.5 mmol/L and low potassium (14.1±5.9 mmol/L excretion. Elevated plasma aldosterone concentrations (170.4±100.5 ng/dL and the very high levels of the plasma aldosterone to potassium ratio (25.2±15.6 together with diminished urinary K/Na values (0.31±0.19 indicated tubular resistance to aldosterone. After institution of appropriate medical and/or surgical therapy, serum electrolytes, creatinine, and acid-base balance were normalized. Imaging studies showed ureteropyelic or ureterovesical junction obstruction in 3 and 2 patients, respectively, posterior urethral valves in 3, and normal UT in 1 patient. According to our knowledge, this is the first report on THPA1 in the Serbian literature. Conclusion. Male infants with hyponatraemia, hyperkalaemia and metabolic acidosis have to have their urine examined and the renal ultrasound has to be done in order to avoid both, the underdiagnosis of THPA1 and the inappropriate medication.

  2. Scintigraphic evaluation of congenital anomalies of the thyroid gland

    International Nuclear Information System (INIS)

    Paul, A. K.; Hassan, M.A.; Miah, M.S.R.

    2001-01-01

    Total 2287 patients who undergone thyroid scintigraphy in Nuclear Medicine Centre, Khulna from January 1998 to December 2000 were retrospectively studied to evaluate the congenital anomalies of the thyroid gland. Scintigraphy showed thyroid anomalies in 11 patients (0.48%). The presenting features and thyroid function tests were analyzed and a detailed study was performed. Of these 11 cases, 7 patients (63.6%) had ectopic thyroid gland and site of ectopic was found to be lingual in 4 cases, sublingual in 2 cases and pre laryngeal in 1 case, 3 patients (27.3%) with hemi agenesis of thyroid and 1 patient (9.1%) with athyreosis. Biochemically 3 cases were hypothyroid of which 2 had ectopic thyroid and 1 with athyreosis. 1 patient was hyperthyroid with hemi agenesis of thyroid and 7 were euthyroid. Females were more affected than males, the ratio being 4.5:1. (authors) 2 tabs. 12 refs

  3. Congenital maxillary double lip

    Directory of Open Access Journals (Sweden)

    Dinesh Singh Chauhan

    2012-01-01

    Full Text Available Double lip, also referred to as "macrocheilia," is a rare anomaly which affects the upper lip more commonly than the lower lip. It consists of a fold of excess or redundant hypertrophic tissue on the mucosal side of the lip. The congenital double lip is believed to be present at birth and becomes more prominent after eruption of teeth. It affects esthetics and also interferes with speech and mastication. Simple surgical excision produces good functional and cosmetic results. We report a case of a non-syndromic congenital maxillary double lip in a 21-year-old male patient.

  4. Congenital hearing impairment

    Energy Technology Data Exchange (ETDEWEB)

    Robson, Caroline D. [Children' s Hospital and Harvard Medical School, Division of Neuroradiology, Department of Radiology, Boston, MA (United States)

    2006-04-15

    Establishing the etiology of congenital hearing impairment can significantly improve treatment for certain causes of hearing loss and facilitates genetic counseling. High-resolution CT and MRI have contributed to the evaluation and management of hearing impairment. In addition, with the identification of innumerable genetic loci and genetic defects involved in hearing loss, genetic testing has emerged as an invaluable tool in the assessment of hearing impairment. Some of the common forms of congenital hearing loss are reviewed and their imaging features illustrated. (orig.)

  5. Congenital spinal malformations

    International Nuclear Information System (INIS)

    Ertl-Wagner, B.B.; Reiser, M.F.

    2001-01-01

    Congenital spinal malformations form a complex and heterogeneous group of disorders whose pathogenesis is best explained embryologically. Radiologically, it is important to formulate a diagnosis when the disorder first becomes symptomatic. However, it is also crucial to detect complications of the disorder or of the respective therapeutic interventions in the further course of the disease such as hydromyelia or re-tethering after repair of a meningomyelocele. Moreover, once a congenital spinal malformation is diagnosed, associated malformations should be sought after. A possible syndromal classification such as in OEIS- or VACTERL-syndromes should also be considered. (orig.) [de

  6. Congenital hearing impairment

    International Nuclear Information System (INIS)

    Robson, Caroline D.

    2006-01-01

    Establishing the etiology of congenital hearing impairment can significantly improve treatment for certain causes of hearing loss and facilitates genetic counseling. High-resolution CT and MRI have contributed to the evaluation and management of hearing impairment. In addition, with the identification of innumerable genetic loci and genetic defects involved in hearing loss, genetic testing has emerged as an invaluable tool in the assessment of hearing impairment. Some of the common forms of congenital hearing loss are reviewed and their imaging features illustrated. (orig.)

  7. Congenital laryngeal anomalies,

    Directory of Open Access Journals (Sweden)

    Michael J. Rutter

    2014-12-01

    Full Text Available Introduction: It is essential for clinicians to understand issues relevant to the airway management of infants and to be cognizant of the fact that infants with congenital laryngeal anomalies are at particular risk for an unstable airway. Objectives: To familiarize clinicians with issues relevant to the airway management of infants and to present a succinct description of the diagnosis and management of an array of congenital laryngeal anomalies. Methods: Revision article, in which the main aspects concerning airway management of infants will be analyzed. Conclusions: It is critical for clinicians to understand issues relevant to the airway management of infants.

  8. Congenital Heart Defects and CCHD

    Science.gov (United States)

    ... and more. Stony Point, NY 10980 Close X Home > Complications & Loss > Birth defects & other health conditions > Congenital heart defects and ... in congenital heart defects. You have a family history of congenital heart ... syndrome or VCF. After birth Your baby may be tested for CCHD as ...

  9. Neonatal Graves' Disease with Maternal Hypothyroidism.

    Science.gov (United States)

    Akangire, Gangaram; Cuna, Alain; Lachica, Charisse; Fischer, Ryan; Raman, Sripriya; Sampath, Venkatesh

    2017-07-01

    Neonatal Graves' disease presenting as conjugated hyperbilirubinemia is a diagnostic challenge because the differential includes a gamut of liver and systemic diseases. We present a unique case of neonatal Graves' disease in a premature infant with conjugated hyperbilirubinemia born to a mother with hypothyroidism during pregnancy and remote history of Graves' disease. Infant was treated with a combination of methimazole, propranolol, and potassium iodide for 4 weeks. Thyroid function improved after 8 weeks of treatment with full recovery of thyroid function, disappearance of thyroid-stimulating antibodies, and resolution of failure to thrive and conjugated hyperbilirubinemia. This case provides several clinical vignettes as it is a rare, severe, presentation of an uncommon neonatal disease, signs, symptoms, and clinical history presented a diagnostic challenge for neonatologists and endocrinologists, normal newborn screen was misleading, and yet timely treatment led to a full recovery.

  10. [Myocardial contractility and hemodynamics in hypothyroidism].

    Science.gov (United States)

    Selivonenko, V G

    1977-01-01

    The author determined the phasic structure of the systole of the left ventricle by the method of polycardiography and hemodynamics in 20 patients suffering from hypothyrodism. Blood plasma and erythrocyte electrolytes were examined at the same time. Patients with hypothyroidism displayed a phasic syndrome of hypodynamia and a marked correlation between the phase of the synchronous contraction, the period of ejection, the strength of contraction of the left ventricle and the electrolyte content. Sodium and magnesium produced the greatest influence on the phasic structure of the systole; potassium and calcium had a lesser effect. The heart stroke volume diminished; as to the cardiac index, expenditure of the energy of cardiac contractions directed to the maintenance of movement of 1 litre of the minute blood volume; the external work, and the peripheral vascular resistance displayed no significant change.

  11. The multiple genetic causes of central hypothyroidism.

    Science.gov (United States)

    Persani, Luca; Bonomi, Marco

    2017-03-01

    An insufficient stimulation by thyrotropin (TSH) of an otherwise normal thyroid gland represents the cause of Central Hypothyrodism (CeH). CeH is about 1000-folds rarer than Primary Hypothyroidism and often represents a real challenge for the clinicians, mainly because they cannot rely on adequately sensitive parameters for diagnosis or management, as it occurs with circulating TSH in PH. Therefore, CeH diagnosis can be frequently missed or delayed in patients with a previously unknown pituitary involvement. A series of genetic defects have been described to account for isolated CeH or combined pituitary hormone defects (CPHDs) with variable clinical characteristics and degrees of severity. The recently identified candidate gene IGSF1 appears frequently involved. This review provides an updated illustration of the different genetic defects accounting for CeH. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Tablets or scalpel: Pituitary hyperplasia due to primary hypothyroidism

    Directory of Open Access Journals (Sweden)

    Ahmed Imran Siddiqi, MBBS, MRCP

    2015-01-01

    Full Text Available We describe a patient with pituitary hyperplasia due to primary hypothyroidism. Pituitary hyperplasia and pituitary masses cannot be reliably differentiated on imaging alone, despite significant improvement in imaging quality in recent years.

  13. Hypothyroidism caused by 131I treatment for Graves disease

    International Nuclear Information System (INIS)

    Deng Shouzhen; Lin Xiangtong; He Wanting; Zhang Kaili; Zhang Jinming; Kuai Dayu

    1991-01-01

    The refollow-up has been carried out in hypothyroidism caused by 131 I treatment for Graves disease. The serum HS-TSH(IRMA), FT3, TSH(RIA), TT3, TT4, FT4I, MCA, TGA, Cholesterol and Triglyceride has been measured in 26 patient after 131 I treatment for 9.5 years in average. At the same time TRH stimulation test was also performed, and the clinical symptoms and signs assessed. The results showed that TSH is the most sensitive criterion for hypothyroidism, followed by Cholesterol and FT 4 I. The occurence of hypothyroidism may be related to the presence of thyroid antibody as demonstrated by the elevation of serum MCA, TGA. Therefore measurement of serum TSH, FT 4 I and Cholesterol during long term follow-up is beneficial for early diagnosis of hypothyroidism and evaluating the effect of substitution treatment

  14. Renal function improves with the treatment of hypothyroidism.

    Science.gov (United States)

    Bulur, Oktay; Dal, Kursat; Ertugrul, Derun Taner; Eser, Murat; Kaplan Efe, Fatma; Karakaya, Serdar; Şahin, Kubilay; Baser, Salih; Ata, Naim; Aybal Kutlugun, Aysun; Beyan, Esin

    2017-08-01

    It has been known that thyroid hormones may affect renal function. In this study, we aimed to investigate the effect of levothyroxine replacement on renal function in hypothyroid patients before and after treatment. We retrospectively investigated free T3 (fT3), free T4 (fT4), TSH, creatinine, and eGFR measurements during both hypothyroid and euthyroid states of hypothyroid patients. The eGFR was calculated using the simplified Modification of Diet in Renal Disease formula. fT3, fT4, and eGFR measurements increased, meanwhile creatinine and TSH levels decreased significantly after euthyroidism was achieved with levothyroxine treatment (p treatment (r: 0.288, p treatment (r: -0.272, p hypothyroidism and found out that renal function improved in most patients after euthyroidism was achieved. In some patients, above-normal creatinine levels completely returned to normal once the patients became euthyroid.

  15. Hypothyroidism and acute kidney injury: an unusual association.

    Science.gov (United States)

    Neves, Precil Diego Miranda de Menezes; Bridi, Ramaiane Aparecida; Balbi, André Luis; Ponce, Daniela

    2013-08-09

    Association between severe hypothyroidism and acute kidney injury (AKI) is rare. A 40-year-old woman presented with 15 days history of generalised muscle pain, weakness, weight gain and oedema. hypertension and hypothyroidism. dry skin, peripheral/periorbital oedema, slow thought and speaking, thyroid increased. Laboratory examinations: high levels of creatine kinase , creatinine, uric acid and lactate dehydrogenase. Free T4 was very low (hypothyroidism-induced rhabdomyolysis. Intravenous fluids were started, urinary alkalisation and increased l-thyroxine dose replacement. On the day after admission, forced diuresis with furosemide was introduced leading to a progressive improvement of symptoms. Although hypothyroidism and AKI is unusual, it should be suspected in patients presenting decrease of renal function and high creatine kinase in the absence of other causes of rhabdomyolysis.

  16. [Clinical case of acute renal failure revealing an autoimmune hypothyroidism].

    Science.gov (United States)

    Montasser, Dina Ibrahim; Hassani, Mohamed; Zajjari, Yassir; Bahadi, Abdelali; Alayoud, Ahmed; Hamzi, Amine; Hassani, Kawtar; Moujoud, Omar; Asseraji, Mohamed; Kadiri, Moncif; Aatif, Taoufik; El Kabbaj, Driss; Benyahia, Mohamed; Allam, Mustapha; Akhmouch, Ismail; Oualim, Zouhir

    2010-04-01

    Although the clinic picture is often indicative of muscle manifestations in patients with hypothyroidism, signs and symptoms of this condition are variable from simple elevation of serum muscle enzymes with myalgia, muscle weakness, cramps to rhabdomyolysis with acute renal failure which remains a rare event. Thyroid hormones affect the function of almost every body organ, and thyroid dysfunction produces a wide range of metabolic disturbances. Hypothyroidism is associated with significant effects on the kidney which the pathophysiology seems to be multifactorial, but the exact mechanisms remain poorly understood. Hypothyroidism as a cause of renal impairment is usually overlooked, leading to unnecessary diagnostic procedures. The main objective of our observation is to report a case of acute renal failure revealing an autoimmune hypothyroidism in which thyroid hormone substitution led to a significant improvement in muscular, thyroid and renal disorders. Copyright 2010 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  17. Is subclinical hypothyroidism increasing exogen obesity in children?

    Directory of Open Access Journals (Sweden)

    Ceyda Tuna Kirsaclioglu

    2015-03-01

    Conclusion:.Thyrotropin releasing hormone stimulation test may be helpful to determine subclinical hypothyroidism in exogen obese children, if basal TSH levels were elevated. [J Contemp Med 2015; 5(1.000: 1-7

  18. SEMDSA/ACE-SA Guideline for the Management of Hypothyroidism ...

    African Journals Online (AJOL)

    2014-10-19

    Oct 19, 2014 ... assumes no responsibility for personal or other injury, loss or damage that may result .... (UNICEF) and the International Council for Control of Iodine. Deficiency .... 74 years.7 The main causes of hypothyroidism in older adults.

  19. SEMDSA/ACE-SA Guideline for the Management of Hypothyroidism ...

    African Journals Online (AJOL)

    Background: Hypothyroidism is a common clinical condition confronting all healthcare practitioners yet there remains uncertainty about the optimal medication and optimum treatment targets. In addition, many patients remain symptomatic despite using recommended medications and attaining recommended treatment ...

  20. No evidence of a causal relationship between hypothyroidism and glaucoma

    DEFF Research Database (Denmark)

    Thvilum, Marianne; Brandt, Frans; Brix, Thomas Heiberg

    2018-01-01

    Background An interrelationship between hypothyroidism and glaucoma, due to a shared autoimmune background or based on deposition of mucopolysaccharides in the trabecular meshwork in the eye, has been suggested but is at present unsubstantiated. Therefore, our objective was to investigate......-hypothyroid controls according to age and sex. Prevalence of glaucoma was recorded and cases and controls were followed over a mean of 7.1 years (range 0±17). Logistic and Cox regression models were used to assess the risk of glaucoma before and after the diagnosis of hypothyroidism, respectively. Results Overall, we...... found a higher prevalence of glaucoma in subjects with hypothyroidism as compared to controls (4.6% vs. 4.3%, p glaucoma [1.09; 95% confidence interval (CI): 1.04-1.13]. Based on the Cox regression...

  1. GENOMIC ANALYSIS OF PTU-INDUCED HYPOTHYROIDISM IN RAT HIPPOCAMPUS.

    Science.gov (United States)

    Propylthiouracil (PTU) exposure results in depletion of thyroid hormone by blocking its synthesis. It often is used to study the effects of hypothyroidism in the brain, where deficits during critical periods lead to neuroanatomical, molecular and neurochemical alterations. Decre...

  2. DEVELOPMENTAL HYPOTHYROIDISM IMPAIRS HIPPOCAMPAL LEARNING AND SYNAPTIC TRANSMISSION IN VIVO.

    Science.gov (United States)

    A number of environmental chemicals have been reported to alter thyroid hormone (TH) function. It is well established that severe hypothyroidism during critical periods of brain development leads to alterations in hippocampal structure and learning deficits, yet evaluation of ...

  3. Growth hormone action in hypothyroid infant rats.

    Science.gov (United States)

    Humbert, J T; Bergad, P L; Masha, O; Stolz, A M; Kaul, S; Berry, S A

    2000-02-01

    In neonatal rats, expression of serine protease inhibitors 2.1 and 2.3 mRNA peaks on d 2 of life and declines shortly thereafter, coinciding with levels of circulating GH. To evaluate the role of GH in this increase and to test the hypothesis that GH is active in perinatal life, we studied GH action in a model of GH deficiency. Maternal/neonatal hypothyroidism with consequent GH deficiency was induced by methimazole administration to pregnant dams. The resultant hypothyroid neonates were treated at d 2 or 7 of age with GH or saline for 1 h before exsanguination. In d-7 neonates, but not at d 2, GH administration resulted in significant serine protease inhibitors 2.1 and 2.3 mRNA induction. This treatment did not result in increased production of either GH receptor or IGF-I mRNA at either age. There was a slight GH-independent increase in GH receptor and IGF-I mRNA expression by d 7. Electromobility shift assays using hepatic nuclear extracts from these neonates and the GH response element from the serine protease inhibitor 2.1 promoter showed signal transducer and activator of transcription 5 (Stat5) binding in response to GH in extracts from d-7 rats only. Immunoblots of these extracts showed twice as much Stat5 in the nuclei of d-7 treated neonates compared with d-2 treated neonates. We conclude that there is apparent insensitivity to GH treatment in d-2 neonates that remits by d 7 and that this remission correlates with increased abundance of GH receptor and Stat5.

  4. Hypothyroidism in diabetes mellitus patients in Eastern Nepal

    Directory of Open Access Journals (Sweden)

    Robin Maskey

    2015-01-01

    Full Text Available Context: The coexistence of diabetes mellitus (DM with hypothyroidism is a known clinical observation. Aims: To estimate prevalence and co-relate that of hypothyroidism in patients with DM in relation to the age and sex, the lipid profile, body mass index visiting diabetes clinic and inpatients in B. P. Koirala Institute of Health Sciences. Settings and Design: The hospital-based descriptive study. Materials and Methods: Two hundred and seventy-one known or newly detected cases of DM aged more than 15 years were selected randomly from September 2012 to September 2013 and subjected to evaluation for thyroid function - clinically and biochemically and other relevant investigations were done. Statistical Analysis Used: For descriptive statistics mean, standard deviation, percentage, proportion were calculated. For inferential statistics following test were carried out at the level of significant 0.05 where confidence interval is 95%. The statistical operations were done through Statistical Package for the Social Sciences version 10. Results: Of 271 subjects, the prevalence of hypothyroidism (clinical and subclinical in diabetics was, 4.05% (11/271 with females preponderance, of which 7 (30.4% were clinically hypothyroid and 4 (17.4% were subclinical hypothyroid. One (4.3% patient had subclinical hyperthyroidism. The mean age at diagnosis of type 2 DM was 51-60 years. 8.69% of diabetics with primary hypothyroids were having morbid obesity. High-density lipoprotein among different thyroid status were statistically significant (P = 0.042. Conclusions: Hypothyroidism is not uncommon in diabetes, and we found body mass index, mean triglyceride and cholesterol levels were more in those diabetic patients having coexisting hypothyroidism.

  5. Treatment for primary hypothyroidism: current approaches and future possibilities

    OpenAIRE

    Chakera, Ali J; Pearce, Simon HS; Vaidya, Bijay

    2011-01-01

    Ali J Chakera1, Simon HS Pearce2, Bijay Vaidya11Department of Endocrinology, Royal Devon and Exeter Hospital and Peninsula Medical School, Exeter, 2Endocrine Unit, Royal Victoria Infirmary and Newcastle University, Newcastle upon Tyne, UKAbstract: Primary hypothyroidism is the most common endocrine disease. Although the diagnosis and treatment of hypothyroidism is often considered simple, there are large numbers of people with this condition who are suboptimally treated. Even in those people ...

  6. Clinical outcomes of patients with hypothyroidism undergoing percutaneous coronary intervention

    Science.gov (United States)

    Zhang, Ming; Sara, Jaskanwal D.S.; Matsuzawa, Yasushi; Gharib, Hossein; Bell, Malcolm R.; Gulati, Rajiv; Lerman, Lilach O.

    2016-01-01

    Abstract Aims The aim of this study was to investigate the association between hypothyroidism and major adverse cardiovascular and cerebral events (MACCE) in patients undergoing percutaneous coronary intervention (PCI). Methods and results Two thousand four hundred and thirty patients who underwent PCI were included. Subjects were divided into two groups: hypothyroidism ( n = 686) defined either as a history of hypothyroidism or thyroid-stimulating hormone (TSH) ≥5.0 mU/mL, and euthyroidism ( n = 1744) defined as no history of hypothyroidism and/or 0.3 mU/mL ≤ TSH hypothyroidism were further categorized as untreated ( n = 193), or those taking thyroid replacement therapy (TRT) with adequate replacement (0.3 mU/mL ≤ TSH hypothyroidism compared with those with euthyroidism (MACCE: HR: 1.28, P = 0.0001; myocardial infarction (MI): HR: 1.25, P = 0.037; heart failure: HR: 1.46, P = 0.004; revascularization: HR: 1.26, P = 0.0008; stroke: HR: 1.62, P = 0.04). Compared with untreated patients or those with inadequate replacement, adequately treated hypothyroid patients had a lower risk of MACCE (HR: 0.69, P = 0.005; HR: 0.78, P = 0.045), cardiac death (HR: 0.43, P = 0.008), MI (HR: 0.50, P = 0.0004; HR: 0.60, P = 0.02), and heart failure (HR: 0.50, P = 0.02; HR: 0.52, P = 0.017). Conclusion Hypothyroidism is associated with a higher incidence of MACCE compared with euthyroidism in patients undergoing PCI. Maintaining adequate control on TRT is beneficial in preventing MACCE. PMID:26757789

  7. Hypothyroidism: causes, killers, and life-saving treatments.

    Science.gov (United States)

    Dubbs, Sarah B; Spangler, Ryan

    2014-05-01

    Hypothyroidism is a very common, yet often overlooked disease. It can have a myriad of signs and symptoms, and is often nonspecific. Identification requires analysis of thyroid hormones circulating in the bloodstream, and treatment is simply replacement with exogenous hormone, usually levothyroxine (Synthroid). The deadly manifestation of hypothyroidism is myxedema coma. Similarly nonspecific and underrecognized, treatment with exogenous hormone is necessary to decrease the high mortality rate. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. [Hypothyroidism in adults in a basic health area].

    Science.gov (United States)

    López-Macías, I; Hidalgo-Requena, A; Pérez-Membrive, E; González-Rodríguez, M E; Bellido-Moyano, C; Pérula-de Torres, L A

    2018-04-01

    The objective of the present study is to study the prevalence, as well as the clinical and epidemiological characteristics of hypothyroid disease in adults using the computerised clinical records. Observational, descriptive and cross-sectional study. The target population was the patients of the health centres of Lucena I and II (Córdoba). Patients 14 years or older, diagnosed with hypothyroidism, born and resident in Lucena. Two hundred and fourteen patients were recruited by random sampling, who then underwent a clinical interview using a questionnaire. The mean age of the patients was 49.71 years (SD 17.03; 95% CI 47.34-51.98), with 85.5% women. A diagnosis of sub-clinical hypothyroidism was found in 74.8%, compared to 18.7% of primary hypothyroidism, and 6.5% of secondary hypothyroidism. The 53.7% (95% CI 46.81-60.59) of patients diagnosed with hypothyroidism did not have thyroid antibodies results. However, 75.2% (95% CI 68.89-80.86) were being treated with levothyroxine. The prevalence of hypothyroidism was 5.7% (95% CI 5.46-5.96). Sub-clinical hypothyroidism is very common in Primary Care clinics. Many patients are not correctly diagnosed and many are over-medicated, suggesting a need to review the diagnosis. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Chronic brain ischemia in patients with arterial hypertension and hypothyroidism

    Directory of Open Access Journals (Sweden)

    O.Ye. Kovalenko

    2017-02-01

    Full Text Available The questions of the pathogenesis of chronic brain ischemia in patients with hypertension and hypothyroidism are studied. Examples of some results of authors’ research are listed. According to the research, patients with hypertensive dyscirculatory encephalopathy and hypothyroidism have deterioration of blood supply to the brain by reducing the reactivity of the vascular wall, decrease in the functional activity of the brain, impairement of cognitive function and increase in the anxiety and depression.

  10. Renal handling of sodium and water in the hypothyroid rat

    Science.gov (United States)

    Michael, Ulrich F.; Barenberg, Robert L.; Chavez, Rafaelita; Vaamonde, Carlos A.; Papper, Solomon

    1972-01-01

    Hypothyroid rats were examined with conventional renal clearance and micropuncture techniques to elicit the mechanism and site within the nephron responsible for the increased salt and water excretion observed in these animals. When compared with age-matched control rats, a decrease in inulin clearance of 30% (P < 0.001) and in Hippuran clearance of 32% (P < 0.005) was observed in the hypothyroid rats. Absolute excretion of sodium and water was increased 3-fold (P < 0.02) and 2-fold (P < 0.025), respectively, while fractional excretion of sodium and water was increased 4.3-fold (P < 0.02) and 2.9-fold (P < 0.05), respectively, in the hypothyroid animals. Fractional proximal reabsorption of sodium as assessed from proximal tubular fluid to plasma ratios of inulin ([TF/P]IN) was found to be decreased by 28% (P < 0.001) in the hypothyroid rats. Superficial single nephron filtration rate was reduced proportionately to the decrease in total filtration rate in the hypothyroid rats. These data indicate that the proximal tubule is one of the sites of diminished sodium and water reabsorption in the hypothyroid rat. The data also suggest that the observed decrease in glomerular filtration rate in the hypothyroid animals is not caused by a decrease in the number of functioning nephrons and that the observed increase in sodium and water excretion is not caused by a redistribution of filtrate from juxtamedullary to superficial nephrons. Although the exact mechanisms of the observed changes in proximal tubular function remain unknown, the data suggest that they are probably related to the lack of thyroid hormone. Whatever their mechanism, it appears that the enhanced sodium and water excretion observed in the hypothyroid animals must be determined by further reduction in tubular sodium reabsorption in the distal nephron. PMID:5024038

  11. Hypothyroidism incidence in and around pregnancy: a Danish nationwide study.

    Science.gov (United States)

    Andersen, S L; Carlé, A; Olsen, J; Laurberg, P

    2016-11-01

    Immunological changes in and after a pregnancy may influence the onset of autoimmune diseases. An increased incidence of hyperthyroidism has been observed both in early pregnancy and postpartum, but it remains to be studied if the incidence of hypothyroidism varies in a similar way. Population-based cohort study using Danish nationwide registers. All women who gave birth to a singleton live-born child in Denmark from 1999 to 2008 (n = 403 958) were identified, and data on hospital diagnosis of hypothyroidism and redeemed prescriptions of thyroid hormone were extracted. The overall incidence rate (IR) of hypothyroidism during 1997-2010 and the IR in three-month intervals before, during and after the woman's first pregnancy in the study period were calculated and compared with the IR of hyperthyroidism. Altogether 5220 women were identified with onset of hypothyroidism from 1997 to 2010 (overall IR 92.3/100 000/year) and 1572 women developed hypothyroidism in the period from 2 years before to 2 years after birth of the first child in the study period. The incidence of hypothyroidism decreased during the pregnancy (incidence rate ratio (IRR) vs overall IR in the rest of the study period: first trimester: 0.89 (95% CI: 0.66-1.19), second trimester: 0.71 (0.52-0.97), third trimester: 0.29 (0.19-0.45)) and increased after birth with the highest level at 4-6 months postpartum (IRR 3.62 (2.85-4.60)). These are the first population-based data on the incidence of hypothyroidism in and around pregnancy. The incidence declined during pregnancy followed by a sharp increase postpartum. Notably, hypothyroidism as opposed to hyperthyroidism showed no early pregnancy increase. © 2016 European Society of Endocrinology.

  12. Myxedema coma in a patient with subclinical hypothyroidism.

    Science.gov (United States)

    Mallipedhi, Akhila; Vali, Hamza; Okosieme, Onyebuchi

    2011-01-01

    Myxedema coma is the extreme manifestation of hypothyroidism, typically seen in patients with severe biochemical hypothyroidism. Its occurrence in association with subclinical hypothyroidism is extremely unusual. We describe a patient with subclinical hypothyroidism who developed clinical manifestations of myxedema coma. A 47-year-old woman presented to our endocrine clinic with complaints of fatigue and biochemical findings of subclinical hypothyroidism. She was started on treatment with thyroxine (T4) but remained unwell and was later admitted to hospital with hormone profile showing persisting subclinical hypothyroidism (elevated thyrotropin and normal free T4 [FT4] and free triiodothyronine [FT3]): FT4 10.7 pmol/L (reference range 10.3-24.5), FT3 2.7 pmol/L (reference range 2.67-7.03), and thyrotropin 6.09 mU/L (reference range 0.4-4.0). She subsequently developed hypothermia (temperature 33.2°C), circulatory collapse, and coma. Biochemical profile showed hyponatremia, elevated creatinine phosphokinase, metabolic acidosis, and renal failure. An echocardiogram revealed a moderate-sized pericardial effusion. We diagnosed myxedema coma and started treatment with intravenous T3. She responded dramatically with improvement in level of consciousness and normalization of metabolic parameters. We found no explanation other than hypothyroidism to account for the presentation. Adrenocorticotrophic hormone (ACTH) stimulation tests excluded adrenal insufficiency, and serum gonadotrophins were within the normal reference range. FT4 estimation by equilibrium dialysis excluded analytical interference, and molecular analysis for the thyroid hormone receptor β gene associated with thyroid hormone resistance was negative. To the best of our knowledge this is the first report of myxedema coma in a patient with subclinical hypothyroidism. The reason for normal thyroid hormone levels is unclear but may reflect deviation from a higher pre-morbid set-point. The case

  13. Severe congenital neutropenia

    DEFF Research Database (Denmark)

    Borregaard, Niels

    2014-01-01

    In this issue of Blood, Tidwell et al1 demonstrate that mutations in the start codon (protein synthesis is initiated at the codon ATG) of neutrophil elastase (ELANE) result in the production of N-terminally truncated elastase, which mislocates to the nucleus and results in severe congenital neutr...... neutropenia (SCN)....

  14. Giant Congenital Melanocytic Nevus

    DEFF Research Database (Denmark)

    Rasmussen, Bo Sonnich; Henriksen, Trine Foged; Kølle, Stig-Frederik Trojahn

    2015-01-01

    Giant congenital melanocytic nevi (GCMN) occur in 1:20,000 livebirths and are associated with increased risk of malignant transformation. The treatment of GCMN from 1981 to 2010 in a tertiary referral center was reviewed evaluating the modalities used, cosmetic results, associated complications...

  15. Congenital neck masses.

    Science.gov (United States)

    Rosa, Peter A; Hirsch, David L; Dierks, Eric J

    2008-08-01

    Congenital neck lesions reflect abnormal embryogenesis in head and neck development. A thorough knowledge of embryology and anatomy is critical in the diagnosis and treatment of these lesions. The appropriate diagnosis of these lesions is necessary to provide appropriate treatment and long-term follow up, because some of these lesions may undergo malignant transformation or be harbingers of malignant disease.

  16. Congenital cystic eyeball

    Directory of Open Access Journals (Sweden)

    Gupta V

    1990-01-01

    Full Text Available A rare case of histopathologically proved case of congenital cystic eye in a one day old girl is described. It was an unusually large cystic mass bulging forwards stretching the upperlid. There was no rudimentary eyeball in the orbit. The cystic eye′s predilection for the left eye has been pointed out for the first time in this article.

  17. Congenital extracranial meningioma

    International Nuclear Information System (INIS)

    Wong, H.F.; Ng, S.H.; Wai, Y.Y.; Wan, Y.L.; Kong, M.S.

    1995-01-01

    The authors report a case of congenital meningioma in a newborn. This tumour is extremely rare and only six cases have been reported in the literature. Those reported cases were mainly intracranial. This is the first case of a neonatal extracranial meningioma that was evaluated preoperatively by computed tomography and magnetic resonance imaging. (orig.)

  18. Congenital cystic adenomatoid malformation

    International Nuclear Information System (INIS)

    Chaudhry, A.K.; Azam, M.; Maqsood, R.; Naz, B.; Salam, A.

    2003-01-01

    This case report presents the clinical picture, diagnostic methodology and surgical treatment of a female child who presented with chronic cough and dyspnoea due to congenital malformation of lung. A discussion of diagnosis and management is presented at the end. (author)

  19. Pseudoamblyopia in Congenital Cyclotropia

    Directory of Open Access Journals (Sweden)

    Antonio Frattolillo

    2017-01-01

    Full Text Available Purpose. To study the effect of surgery on amblyopia and suppression associated with congenital cyclovertical strabismus. Methods. The fixation pattern was investigated with microperimetry before and soon after surgery in ten consecutive children operated for congenital superior oblique palsy at the S. Martino Hospital, Belluno, Italy, between September 2014 and December 2015. Changes in visual performance in terms of best-corrected visual acuity (BCVA and stereopsis between the day before and one week after surgery were also evaluated. No other amblyopia treatment has been administered during the time study. Results. Surgical correction of the excyclodeviation in congenital SO palsy determined monocular and binocular sensory consequences: monocularly, in the cyclodeviated amblyopic eye, BCVA (0.46–0.03 LogMAR; p<0.0001 and the fixation pattern improved, as demonstrated by microperimetry examination. Binocularly, stereopsis improved or emerged while suppression at the Worth four-dot test disappeared. Conclusions. In the absence of further amblyopic factors such as coexisting constant vertical and/or horizontal deviation and anisometropia, the amblyopia encountered in congenital SO palsy may resolve soon after the surgical alignment. Therefore, it may be considered and defined “pseudoamblyopia.”

  20. Identification of congenital deafblindness

    DEFF Research Database (Denmark)

    Dammeyer, Jesper Herup

    2012-01-01

    . The study evaluated the assessment procedure of 190 children and adults found to be congenitally deafblind. Among the 190 individuals 76 percent were determined using functional assessment in addition to medical examination. A case example involving a 12-year-old child is also presented to illustrate...