Endocrine Abstracts

Objective: There is currently extensive debate regarding elevated TSH (Thyroid Stimulating Hormone) concentrations and associated cardiovascular risk. This study investigated whether correlations exists between TSH concentrations within the accepted range of normality and increasing cardiovascular risk.Design: We performed a cross-sectional study of 728 asymptomatic women aged 45–60 years attending for thyroid screening over a twelve month period. P...

Resistance to thyroid hormone is a dominantly inherited condition of impaired tissue responsiveness to the action of thyroid hormone. Thyroid hormone levels are elevated with failure to suppress TSH.The presentation is highly variable. In individuals with generalized resistance to thyroid hormone (GRTH) appear to have eumetabolic state with compensatory high thyroid hormone levels. In contrast, those who appear to have hyper metabolic features but may have similar thyroid horm...

The course of Graves’ disease is associated with the inflow of lymphocytes to the thyroid gland and dysregulation of the immune system characterized by reaction to thyroid antigens (peroxidase, thyroglobulin, TSH receptors and Na+/I− symporter).The aim of this study was to estimate sodium iodine symporter (NIS) and thyroid peroxidase (TPO) expression in thyrocytes which release cytokines INF-γ and IL-4 from young pat...

The aim of our study was to evaluate the reference ranges of thyrotropin (TSH) and free thyroxin (FT4) assayed with 5 methods at the second and the third trimesters of pregnancy for women with iodine intake at the lower limit of the normal range. This study used 297 sera (42 controls without pregnancy with age <40 years, 139 women at the second trimester and 116 at the third with mean age to 27 years in both groups). The assays were for TSH (Elecsys Roche), for thyroproxid...

The effects of goitrogens on the thyroid gland have been much studied and calcium is considered as a goitrogen in some cases. Since the level of calcium is high in drinking water of some cities of Khuzestan province, the effects of high calcium intake on the function of thyroid gland is investigated in this study. For this purpose the concentration of thyroid hormones is measured in rats.The study was carried out on73 male and female rats. The animals we...

Recombinant human TSH (rhTSH) has recently been used as an adjuvant to the treatment of non-toxic multinodular goitre (MNG) by means of 131I. The aim of our study was to evaluate the efficacy of 0.2 mg rhTSH or placebo administered im on 2 consecutive days before a fixed therapeutic dose of 14 mCi of 131I. Thirteen elderly patients (71±7 years) with large non-toxic MNG (group 1) were treated with rhTSH plus 131I. While a control group of 8...

The aim of the study: To compare FNA cytological examination and histological examination results of follicular thyroid tumors (FTT) and to define clinical features of benign and malignant FTT.Materials: cases of patients with FTT, who underwent thyroid surgery in the Head Research Center for Endocrinology during the period 1998–2003, were studied retrospectively. The results of FNA and histological examination were evaluated particularly.<p cla...

Thyroid dysfunction affects a considerable number of elderly subjects. However the role of screening and treatment of thyroid disorders in geriatric population is still debated. The aim of this study was the evaluation of the prevalence of thyroid dysfunction and its impact on comorbidity and comedication.Two independent populations were evaluated: 2001 residents in 21 federated nursing homes in the province of Pavia (Northern Italy), age >60 y, and ...

Background: Thyrotoxicosis is a common disorder with a prevalence of 3% in females and 0.3% in males in iodine replete areas. The prevalence may be higher in areas of iodine deficiency. It is known to induce many cardiovascular effects. The most important complication of thyrotoxicosis is atrial fibrillation. We aimed to assess thyroid function in patients with atrial fibrillation and determine the frequency of thyrotoxicosis in this group.Methods: We st...

Aim: Evaluation of efficacy and safety of thyroid artery embolization procedure as a method of treatment of hyperthyreosis.Patient and methods: Since May 2004 to July 2005 the thyroid artery embolization procedures have been performed in 9 pts (7 women and 2 men) in mean age 62.3 (44 – 77). The reason for such a treatment were: hyperthyroid goiter with the other organs compression in 5 cases, Graves disease in 2 and thyrotoxicosis type I after amiod...

Both thyroid dysfunction and psychological morbidity are common in the general population. Association between mood disorders and overt thyroid dysfunction are well established. Hypothyroid patients are more prone to depression and anxiety is a frequently reported symptom in thyrotoxicosis. However, the relationship between thyroid hormones in the normal range and psychological well being has not been established.In this study we analysed the relationshi...

Introduction: The thyroid is a multifunctional endocrine gland which, by its hormones, affects all the organs, metabolisms and nonspecific defence of the body. The aim of this study is to establish if endogenous thyroxin (FT4) is involved in the nonspecific defence of the organism.Material and methods: 94 patients were included in the study, 47 with hyperthyroidism and 47 with hypothyroidism, 81 women, 13 men aged 7–78. FT4 was...

Graves’ ophthalmopathy is an autoimmune disorder with orbital tissue inflammation. Decompression surgery is considered when conservative treatment fails. Indications for this operation are optic neuropathy, severe inflammation with pain and proptosis.The aim of the present study is to describe the long-term results of decompression surgery in patients with thyroid-associated ophthalmopathy (TAO. This study includes retrospective analysis and clinica...

Radioactive iodine (RAI) is a common treatment for hyperthyroidism, but the dosage and cure rates vary between centres. We administer 370 MBq 131I in all cases unless a large goitre is present, and repeat the dose until hyperthyroidism is cured. Patients are considered cured if euthyroid or hypothyroid one year after the last dose of RAI.We audited the outcome of RAI treatment in our institution between January 2000 and March 2002 to 112 patie...

Aim: The aim of this paper is to summarise the seven’s years of investigations on the frequency and kind of mutations witch occurred in gene RET in patients with medullary thyroid cancer.Methods: Within 330 subjects studied, there were 235 patients with RRT and 95 their healthy relatives. DNA was isolated from peripheral blood lymphocytes. The following exons of the gene RET were amplified by the PCR method: 10, 11, 13, 14, 15 and 16 a...

2.788 inhabitant (726 men 1192 women and 870 children) were examined in mountain region of Adjara on thyroid gland pathology at the age from 1 to 75 (2003-2005 years). The investigated population was selected by ‘randomized method’. The data of ultrasonography, clinical and laboratory tests (defining T3, T4, TSH hormones, antibodies and iodine excretion in urine) were diagnostic criteria’s of thyroid gland pathology. To study risk factors of thyroid gland pathol...

Introduction: Fine Needle Aspiration Biopsy (FNA) is a method widely used in the assessment of thyroid nodules. The main aim of this 18-year retrospective study was the investigation of the diagnostic value of FNA in the approach of thyroid malignancy.Subjects and methods: patients underwent 1938 FNAs from 1987 to 2004 in the Department of Endocrinology, ‘Hippocration’ General Hospital, Thessaloniki, Greece. 178 of these patients subsequently u...

Aim: To analyse the clinical profile in patients with differentiated thyroid carcinoma.Materials & Methods: A retrospective analysis of case records of 232 patients who had under gone treatment for differentiated thyroid carcinoma from year 2000–2004 in Christian Medical College, Vellore was done and the intended data obtained using spss data.Results: A preoperative FNAC suggested thyroid neoplasm in 60%. Total thyroidecto...

Objective of the study: To determine the prevalence of thyroid tissue changes in mild iodine deficiency region.Materials and methods: The 17-th month-lasting study was carried out in Moscow colleges, factories and offices. 1520 people (1403 female, 117 male) median age – 34 years were screened by thyroid ultrasonography with liner probe 7,5 MHz.Results: Thyroid ultrasound disorders have been demonstrated to be high prevalent i...

Background: It is controversial whether symptoms of hypothyroidism and quality of life (QoL) in people with subclinical hypothyroidism (SCH) are impaired and whether treatment with L-thyroxine alleviates these. Previous studies of L-Thyroxine therapy have shown conflicting results. No previous study has simultaneously 1investigated effects of treatment on quality of life (QoL), health status, symptoms and treatment satisfaction.Methods: One hundred patie...

Introduction: Papillary Thyroid cancer (PTC) accounts for 80% or more of all thyroid malignancies and genetic alterations associated with the development and progresion of this type of carcinoma remains largely unknown. Chromosomal band 11q13 seems to be one of the most frequently amplified regions in human cancer. Allelic imbalance involving EMSY, CAPN5 and PAK1 loci in thyroid cancer, have never been investigated. The aim of our study was to investigate the existence of alle...

Aim: The aim of the study was to assess the effect of environmental and socio-economical factors on the increase in the incidence rate of thyroid cancer observed in Olsztyn and the Warmia and Mazury Region in the years 1994-2003.Material and methods: In the group of patients registered in the standardized thyroid cancer register their place of residence, education level, place of parents descent, exposure to ionizing irradiation during the Chernobyl acci...

RT-coding genes are expressed at very low levels in differentiated, non pathological tissues, while are significantly up-regulated in undifferentiated and transformed cells, suggesting a direct correlation between the level of expression of RT and the proliferative state of the cell. Either nevirapine and efavirenz, two RT inhibitors, used in the therapy of AIDS, reversibly down-regulate cell proliferation and induce differentiation in several human tumor cell lines.<p cla...

Introduction: Radioiodine (Iodine-131) is a widely used treatment for thyrotoxicosis. Fluctuation in thyroid hormone levels following radioiodine treatment is common. Hypothyroidism occurs in approximately 5.5% of patients per month in the first 6 months, with onset time hard to predict. In contrast, some patients remain hyperthyroid either due to persistent pre-radioiodine thyrotoxicosis or transient exacerbation following radioiodine. We examined whether the block & repl...

Uzbekistan is area of low dietary iodide intake (45.5% of population with iodide deficiency) and high goiter prevalence (more then 40%).Objective: The aim of this study was to investigate the prevalence of amiodarone-induce thyroid disorders among patients residence in iodine deficiency region.Patients and methods: We observed 46 patients with supraventricular or ventricular arrhythmias, aged 53±12 years. The mean duration of ...

Numerous number of studies indicate significant role of oxidative stress in the pathogenesis of thyrotoxicosis. The aim of this work was to estimate oxidative metabolism changes in myocardium and effectiveness of olygocrine in the experimental model of thyrotoxicosis.Methods: Thyrotoxicosis was induced in mature white wistar rats by daily administration of L-thyroxine (100 μg/100 g). We have conducted 3 series of experiments studying: (1) effects of...

Introduction: Thyroid disease is associated with cardiovascular disease and many cardiovascular risk factors cluster within the metabolic syndrome. It could therefore be hypothesised that thyroid function is associated with the metabolic syndrome.Aim of the study: To investigate the relationship of thyroid function -in the euthyroid range- with serum lipid concentrations and with insulin resistance.Methods: 2703 adult inhabitants o...

Introduction: Thyroid disease, both clinical and subclinical, is a common disorder. Various studies, however, differ in reported prevalences of abnormal thyroid function.Aim of the study: To investigate 1. the prevalence of abnormal thyroid function and anti-thyroidperoxidase antibodies (TPOab) in a random sample of the inhabitants of a middle-sized city in the Netherlands; 2. the relationship of the presence of TPOab with TSH concentration in the euthyr...

Low-T3 syndrome (euthyroid sick syndrome) develops in critically ill patients. Due to the catabolic state, accompanying critical illnesses, enhanced oxidative damage to macromolecules is expected to occur in subjects suffering from the low-T3 syndrome.The study aimed at evaluating the level of lipid peroxidation products in blood serum, collected from critically ill patients with the low-T3 syndrome and at estimating the ...

In terms of mechanism by which thyroid diseases lead the endothelial dysfunction, several aspects have been taking into consideration. One potential factor may be variation in plasma asymmetric dimethylarginine (ADMA) levels. ADMA, which is derived from the catabolism of proteins containing methylated arginine residues, competitively inhibits NOS. The relationship between thyroid disease and variation in plasma ADMA levels is still a potential research area. The aim of this st...

The occurrence of thyroid diseases is determined by interplay between genetic and environmental factors. The major environmental factor that determines goiter prevalence is iodine status.Thyroid nodules are present in up to 30% of the Georgian population. The causative role of iodine deficiency which is still endemic in this country has long been established.Fine-needle aspiration biopsy (FNAB) of the thyroid gland is the cost-effe...

Aim of this study was the evaluation of the accuracy of ultrasound and US-FNAB in the diagnosis of thyroid cancer in a population of subjects submitted to US-FNAB of all thyroid nodules, with no prior selection. 1803 patients (1447 females e 356 males, age range 11 – 87 years, mean 49.6±13.7, with a total of 3378 nodules) were submitted by the same physician (first author) to ultrasound evaluation and US-FNAB of all thyroid nodules. Results. The nodules were 3 to 90 ...

Parathyroid lesions are often occasionally discovered during thyroid ultrasound evaluation (incidentalomas); in other cases there is a previous diagnosis of hyperparathyroidism. In many cases it is difficult or even impossible to distinguish these lesions from those of thyroid origin, because they often share common ultrasound features. Scintiscan and cytology are also frequently inadequate. The aim of this study is to evaluate the contribute of PTH determination in the aspira...

The suppression of serum TSH is a marker for increased risk of vascular mortality or death due to other causes are unknown. Nevertheless, patients who was operated on account of differentiated carcinoma of thyroid, had to take high doses of thyroxine for a long time to achieve suppression of TSH<0.1 mU/l. Heart rate variability (HRV), a method of mathematical analysis of heart rhythm (computer analysis of 24 h Holter monitoring), was used to assess function of the autonomi...

Background: In Graves’ disease, immune cellular mechanisms and cytokine release, as well as auto-antibody production found in the serum, most likely contribute to the development of thyroid eye disease (TED). Biosynthesis of neopterin is closely associated with activation of the cellular immune system and could be a valuable marker of the severity of the disease.Objectives: To assess whether serum neopterin concentrations in patients with TED are a ...

Deficient production of thyroid hormones in maternal organism may have a drastic impact on brain development of the offsprings. Among the people originated from the regions with essential deficiency of iodine in foodstuff there is a high chance for prevalence of mental retardation and neurological cretinism with all possible complications.The present study analyses changes in emotional state (open field testing), learning ability and memory processes (ma...

Introduction: The integrated quantitative and qualitative method was used to evaluate the impact of a ten-year iodine intervention programme on school children’s health status in rural areas of Tehran.Methods: In survey, 188 students aged 6–15 years of two villages, Kiga and Ahar, were studied. These villages that are situated near the Tehran, were known for sever endemic goitre in previous studies. The clinical and biochemical measurement carr...

Thyroid Hormones have extensive effects on differentiation, development, and growth of different organs. In this study the effect of the administration of PTU on pregnant and lactating rats on isolated aorta response of their adult offsprings has been investigated. Three groups of female rats were selected. In the first group (fetal group) observation of vaginal plug after mating was considered as the first day of pregnancy, then PTU was added to their drinking water until the...

Toxic adenomas (TA) and toxic multinodular goiters (TMNG) are frequent causes of hyperthyroidism in Galicia, an endemic goiter area. In some European countries, 40–80% of toxic goiters are caused by TSH receptor (TSHr) and Gs alfa-subunit (Gsa) mutations that activate cAMP pathway.Aims: To study 1) the prevalence of TSHr and Gsa mutations in TMNG and TA from Galicia, 2) the clonality of sequenced samples, 3) the constitutive activity of the identifi...

Background and aim: Atrial fibrillation (AF) is a relatively common complication of thyrotoxicosis. The aim of this study was to estimate the association between echocardiographic variables and AF in patients with Graves’ disease.Patients and methods: Standard echocardiographic examination was performed in 166 patients with Graves’ disease (40 men and 126 women, mean age±S.D. 43.9±12.8 years) referred to the endocrinolo...

Megalin is a member of the LDL receptor family expressed by several epithelial cells where it mediates endocytosis of ligands. In the thyroid megalin is responsible for transcytosis of hormone-poor thyroglobulin (Tg) molecules. This process favors hormone release by preventing hormone-poor Tg to enter the lysosomal pathway, where hormones are cleaved from hormone-rich Tg molecules. Accordingly, megalin KO mice have a distinct thyroid phenotype with primary hypothyroidism. In r...

RAP (LDL receptor associated protein) is a 44 kDa endoplasmic reticulum (ER) resident molecular chaperone. In the thyroid RAP is required for expression of megalin, an endocytic receptor responsible for transcytosis of thyroglobulin (Tg), but it also binds to Tg itself, suggesting it may affect thyroid function in various manners. Indeed, findings in RAP KO mice indicate that disruption of the RAP gene results in impaired Tg storage into the colloid, suggesting that RAP serves...

Recently, we have reported a few cases of acute liver damage in patients with Graves’ ophthalmopathy (GO), during or following high dose intravenous (iv) glucocorticoid (GC) pulse therapy. In the present study we analyzed retrospectively liver enzymes (LE) in 294 consecutive patients with GO who underwent ivGC. LE were measured before or during ivGC, and in 91 patients also within 6 months after ivGC. An asymptomatic increase in LE (AST peak: 67–88 U/L, ALT peak: 75&...

The aim of the study was to evaluate the safety, feasibility and efficacy of HIFU (High Insensity Focused Ultrasound) for the destruction of thyroid nodules in patients who are indicated for thyroid surgery.Material and methods: 13 patients were treated by a HIFU device 2 weeks before thyroidectomy for euthyroid multinodular goiter. Ultrasound (US) examination was performed before and at 3, 8 and 15 days post treatment. Free T3, T4, TSH, thyroglobulin we...

Thyroid Eye Disease (TED) is an autoimmune inflammatory condition of the orbit occurring in the setting of thyroid disease. Prevention of the distressing physical and psychological sequelae of TED depends on accurate quantification of disease activity to allow selection of the most appropriate treatment modality. Current practice is based on the use of a Clinical Activity Score (CAS). As an alternative approach, and with the potential benefits of reproducibility and ease of us...

Much controversy persists over aggressiveness of oncocytic thyroid carcinoma (OTC) and its optimal treatment. The study purpose was to determine prognostic factors for persistent or recurrent disease (PRD) and discuss therapeutic directions.We reviewed the medical records of 81 consecutive patients with OTC among a total of 1729 (4.7%) epithelial thyroid cancers, operated from 1983 to 2003 in our center. Follow-up information was updated. Age ranged from...

Introduction: Graves disease (GD) is inherited as a complex multigenic disorder. One of the most promising genes for susceptibility to GD is cytotoxic T lymphocyte antigen-4 (CTLA4), a negative regulator of T-cell activation.Objective: The aim of this study was to determine whether A/G polymorphism in exon 1 of the CTLA-4 gen was associated with GD in spanish patients.Patients and methods: Fifty one adult GD patients and 25 unrelat...

Pregnancy causes significant physiological changes that can alter the results of thyroid function testing. The changes in circulating plasma-binding protein (TBG) concentrations interfere with FT4 estimate methods, and the hCG thyrotropic effect impacts TSH activity estimation. A TSH assay is the most sensitive test to assess thyroid status. T4 levels have been implicated as associated with fetal neurodevelopment. During pregnancy, differences in FT4 concentrations have been d...

Both humic substances (HS) and iodine may influence the thyroid gland. Tap water is a major source of iodine intake in some areas, where iodine has been shown to be bound in HS.We investigated tap water and old subjects from two areas with and without iodine bound in HS in tap water, to assess their importance for urinary iodine excretion and for the thyroid. Analysis of tap water, measurement of iodine in urine and thyrotropin (TSH), thyroid peroxidase ...

Thyroid hormone (TH) plays a major role in nervous system development. Its deficiency causes severe brain malfunction, which in the human results in cretinism. With the recent availability of new imaging techniques, as small animal PET, it is now possible to study cerebral metabolism in vivo. The aim of this work was to study the in vivo effect of TH on the brain of hypothyroid rats in terms of metabolic function, using PET scanning. For the experiment we used th...

Background: Mourits’ clinical activity score (CAS) is commonly used in assessing disease activity in patients with thyroid eye disease (TED). However measurements must be taken on more than one occasion, and specialised ophthalmic equipment is needed.Aim: To develop a symptom-based TED clinical activity score.Methods: The Mourits Clinical Activity Score (CAS) was modified to produce a CAS based only on symptoms. 15 patients we...

Background: Thyroid Eye Disease (TED) is known to affect vision and appearance. Although the signs and symptoms are well documented, little research has been done to establish patients’ experience of their symptoms.Aim: To document patients’ descriptions of TED symptoms using qualitative research methods.Methods: 15 patients were recruited from a hospital TED clinic. Patients with a range of disease severity were sampled....

Congenital hypothyroidism (CH) with a normal located thyroid gland may be transient or permanent and environmental, iatrogenic, immunologic or genetic factors can be involved. PAX-8, TSH receptor and THOX2 gene mutations have been identified in cases of CH with a gland of normal size.In this study we performed genetic analysis of PAX8, TSH receptor and THOX2 genes in 14 children with CH and a normal sized eutopic gland. Genomic DNA was extracted from lym...

Objective: 21 different activating germline mutations have been identified up to date. We describe a large euthyroid family with a new TSH-receptor(TSHR) germline mutation where the hyperthyroid index patient also carries a somatic TSHR mutation.Method: Mutation analysis of the exon 9 and 10 of the TSHR gene from the peripheral blood samples of the members of this family and toxic thyroid nodules of the index patient were performed by denaturing gradient...

Background: The ultrasound investigation in combination with fine-needle aspiration biopsy is one of the precise methods of the diagnostic of the thyroid nodular formations.Aim: To assess the possibilities of the diagnostic methods in case of the euthyroid nodular formations of the thyroid.Materials and methods: 220 patients with nodular euthyroid formations of the thyroid were investigated, from which: 189 were women and 31 –...

Objective: It is very important to determine the malignancy risk in thyroid nodules for to improve therapeutic strategies. In this study we attempted to evaluate the relationship of doppler (DUS) and B- mode ultrasonographic (BUS) features of thyroid nodules with fine needle aspiration (FNA) findings.Method: 111 patients which have been followed between March and September 2004 were evaluated with ultrasonography and ultrasound guided FNA was performed i...

Whether TTA affects GO remains to be established. Here we studied the effects of TTA in 90 patients with mild-moderate GO randomized into 3 groups of thyroid treatment: MMI (methimazole), TX [near-total thyroidectomy (NTTX)], TTA (NTTX plus 131-I). Patients were treated with ivGC and evaluated at 3 and 9 mo. GO was considered improved or worsened when at least 2 of the following criteria changed, either positively or negatively: i) proptosis and/or eyelid width by at least 2 m...

Dyslipidemia is frequently registered in the patients with hypothyroidism (HLP type 2a, 2b, 4). Its atherosclerosis acceleration role is well known.Objective: To evaluate lipids profile in newly diagnosed hypothyroidism and to assess atherosclerosis features by carotid scan morphological parametres.Matherial and methods: Study involeved 30 newly diagnosed hypothyroid females (54±10 years). After the completion of lab (includin...

Pregnant women may require treatment of hypo- or hyperthyroidism, L-thyroxine (LT4), propylthiouralcil (PTU) and methimazole (MMI) being the most frequently used drugs. Aim of this study was to verify the consequences on both the mother and the fetus of pharmacological treatment during pregnancy. We retrospectively evaluated 292 pregnancies: 63 patients under MMI treatment, 8 of whom (7 Graves’ (GD) and 1 toxic nodular goiter) still hyperthyroid in spite of treatment (H-M...

In pregnant women with thyroid diseases an increased amount of LT4 may be required for the correction of hypothyroidism or treatment of nodular goiter. Aim of this study was to assess the amount of the variations of LT4 requirement in pregnant women with thyroid diseases. To address this issue, we retrospectively evaluated a cohort of 107 women treated with LT4 divided in two groups: 42 euthyroid (E) (affected by nodular goiter (NG) treated with LT4 suppressive therapy) and 65...

Congenital morphological thyroid abnormalities can be classified as hemiagenesis or total agenesis, lingual thyroid, substernal thyroid, thyroglossal ductus remnant. Hemiagenesis with absence of one lobe or lobe and isthmus is very rare, it was found in 4 of 7000 scans in one study. The left lobe is absent four times as often as the right lobe, and women are about three times more likely than men to have this developmental defect. Usually diagnosing this condition is not very ...

Thyroid stunning means reduced radioiodine uptake in thyroid tissue or tumour following a diagnostic 131I test dose. This may compromise subsequent 131I radiotherapy. Recently, we found that 131I inhibits iodide uptake in cultured thyroid cells at non-lethal absorbed doses. Here, we have investigated whether 131I irradiation affects the TSH-stimulated transcription of the sodium/iodide symporter (NIS) gene, and whether insulin-like g...

A 38-year-old woman with chronic autoimmune thyroiditis and hypothyroidism treated with levothyroxine (125 μg/day) was referred to our outpatient clinic with a history of sudden increase of goiter, weakness, dysphagia, dyspnea and suffocating sensation. Physical examination showed an enlarged, stony thyroid gland (three times of normal), without palpable cervical lymph nodes. Biochemical evaluation showed the following abnormalities: TSH 6.0 μU/ml (0.4–4.3), fre...

Radioiodine (RAI) is widely used for the treatment of thyrotoxicosis. The efficacy and hypothyroidism rate following a single dose of RAI is variable and the optimum administered dose – sufficient to achieve remission but with an acceptable low hypothyroidism rate, is still debated.Our audit sought to compare the results of local practice with published rates of success and hypothyroidism following RAI. We also examined the relationship between trea...

At the present time, the most widely accepted tool for follow-up management of differentiated thyroid cancer (DTC) patients consists of serum thyroglobulin (Tg) measurement. It is not uncommon to measure the serum Tg level while the patient taking thyroid hormones (on-treatment Tg measurement). The purpose of the study was to evaluate the accuracy of on-treatment measurement of serum Tg in detecting remnant/recurrent or metastatic disease in high risk DTC patients. Patients an...

Objective: Differences in iodine intake could account for the variable prevalences reported for somatic TSHR and Gs alpha mutations in TTNs. However, this question has never been setteled, since no study has yet determined the TSHR mutation prevalence in TTNs in regions with and without iodine deficiency in the same population. Therefore we studied the prevalence of somatic TSHR mutations in TTNs by investigating TTNs from patients who lived in endemic and nonendemic goiter re...

Context: Euthyroid women positive for thyroid antibodies are prone to develop subclinical/overt hypothyroidism during gestation and seem to suffer from a poor outcome.Objective: Assessing if patients with autoimmune thyroid disease undergoing Assisted Reproduction Technologies (ART) are afflicted by poor pregnancy and/or delivery rate and if the outcome is conditioned by pre-ART thyroid status.Design: Prospective study since Januar...

Context. The routine measurement of serum calcitonin (CT) has been proposed for patients with nodular goiter (NG), to detect unsuspected medullary thyroid carcinoma (MTC) before surgery. Objective To assess the prevalence of hypercalcitoninemia and MTC in NG patients; to compare the ability of CT measurement and fine needle aspiration cytology (FNAC) to predict MTC; to identify age groups of NG patients who should be better candidates than others to undergo routine measurement...

We performed the analysis of correlation between gene expression profile of the papillary thyroid cancer PTC tumors and known clinical factors influencing the outcome of the disease. Gene expression profile was assessed on Human Genome U133A array (Affymetrix). We examined tumors samples obtained from 49 patients diagnosed with PTC. For further evaluation we included following factors: sex, age, tumor size, capsule invasion, multifocality, vascular invasion, lymph node and dis...

The efficacy of Levothyroxine suppressive therapy in thyroid nodules is still controversial; the aim of this study is to evaluate the effect of levothyroxine on nodule volume.Subjects and methods: Ninety three euthyroid patients (92 females, mean age =43.7 years) harboring multindular (n=53) or solitary (n=40) nodules hare been treated for at least 6 months with thyroid hormones (Levothyroxine), the nodule size is assessed by it’s maxi...

Reputedly, thyroid hormones make thinner and change the body composition. The aim of this randomized and prospective study was the assessment of the effect of levothyroxine suppressive therapy on body composition in women with benign thyroid nodule.Method: Thirty seven euthyroid and non obese women (18–60 years old) with benign thyroid nodule (fine needle cytology and calcitonin measurement) were randomized into 2 equal groups. The first group recei...

Introduction-objective: Fas-mediated thyroid cell apoptosis is differentially regulated in autoimmune thyroid disease (AITD) being up-regulated in Hashimoto’s thyroiditis (HT) and down-regulated in Graves’ disease (GD). The soluble form of Fas (sFas), lacking the transmembrane domain due to alternative splicing may inhibit apoptosis by binding to Fas ligand. In this preliminary study we examined whether sFas is also differentially expressed in patients with AITD....

The mechanism of autoimmune destruction of thyrocytes in pathogenesis of Hashimoto thyroiditis remain unclear. It has been showed that the HT patients produce antibodies to DNA, which are directed against various structures of the nucleus and probably may be involved in process of apoptosis.In order to show that the increased production of anti-DNA antibodies is intrinsic property of HT, but not of another non-autoimmune thyroid diseases, we have measure...

Objective: To investigate the potential association between serum inflammatory cytokine levels and thyroxine replacement dose in patients with Hashimoto disease.Patients and methods: The study included 40 patients (12 men) with a mean age of 56.52±6.12 years who had hypothyroidism due to Hashimoto disease. Serum Interleukin-1b (IL-1b), Tumour Necrosis Factor-alpha (TNF-alpha) and Interleukin-6 (IL-6) levels, as well as TSH, fT3 and fT<sub...

The selenoenzyme plasma glutathione peroxidase (GPx3, pGPx) is highly expressed in thyroid, kidney, placenta and bronchio-epithelial tissue. In the thyroid gland, the enzyme is thought to regulate thyroid hormone production by controlling the availability of H2O2, the cosubstrate for thyroperoxidase (TPO) and to protect the thyrocyte against H2O2-induced oxidative damage. To explain the high thyroidal expression levels, we studied GP...

Patients with non-functional FOXE1 (forkhead transcription factor) display congenital hypothyroidism, ‘spikey’ hair and other abnormalities. In the thyroid, FoxE1 controls migration of the developing gland and adult expression of thyroid specific genes. Our earlier studies demonstrated FOXE1 protein expression in keratinocytes of the epidermis and hair-follicle outer root sheath.We aimed to characterise the expression and functional activity of...

Inhibins A and B, peptides belonging to TGF-ß superfamily, have an ubiquitous antagonist action on activin signalling. In thyroid gland, TGF-ß1 and activin mainly exert an inhibitory action on growth and function. In human thyroid, beside the presence of activin β subunits and its transductional elements (ActRI/II, SMAD), there is no evidence for α subunit expression, an essential component for inhibin A/B gathering (α-ßA/α-ßB), nor for ...

Background and aim: In clinical populations, generic quality of life (QoL) questionnaires should be supplemented with disease-specific questionnaires, which may have higher sensitivity and clinical relevance. For the purpose of developing a comprehensive thyroid QoL questionnaire, we have evaluated the relative importance of various QoL aspects to thyroid patients.Methods: A list of problems (issues) related to thyroid diseases, previously identified thr...

There is no ideal treatment for the simple goiter. The treatment options in NMG is: surgery, I131, L-thyroxine or continous monitoring without therapy.From 2000–2003 we evaluated 150 patients (120 women and 30 men) having their agings between 20 and 80 years with L-T4 treatment for nontoxic multinodular goiter. Duration of therapy was 3 years. The pacients was evaluated by clinical examination, level of TSH, free-T4,...

Recently, linkage between chromosome 1q23 and rheumatoid arthritis within the Japanese population has been narrowed down to association of four single nucleotide polymorphisms (SNPs), fcrl3_3, fcrl3_4, fcrl3_5 and fcrl3_6, within FCRL3, a known regulator of B cell signalling. Of these four SNPs, fcrl3_3 was shown to disrupt FCRL3 expression on B cells, suggesting a potential etiological role. Association of fcrl3_3 was also replicated in a Japanese Graves’ disease ...

Aim: Progressive medullary (MTC) or iodine-negative papillary (PTC) or follicular (FTC) thyroid carcinomas present a challenge due to limited treatment options. The aim of this study was to evaluate the response to chemotherapy with doxorubicin.Methods: 22 patients (12 female, 10 male, mean 61 years) with PTC or FTC received chemotherapy with doxorubicin. Tumors were histologically classified as follicular in 14 (64%) patients, including 6 (27%) oncocyta...

Aim: Metastatic medullary (MTC) or iodine-negative papillary (PTC) or follicular (FTC) thyroid carcinomas present a challenge due to limited treatment options. We prospectively compared various staging procedures that may be necessary to define extent and progress of the disease.Methods: 31 patients were included (9×MTC, 8×PTC, 14×FTC). Staging procedures included CTs of chest, abdomen, and CNS, 18FGD-PET, and bone scan. Tumor s...

Background: Studies on thyroid hormones in obese adult patients are contradictory. Moreover, little is known about the effect of weight loss on thyroid functions. Thus, we aimed to investigate thyroid hormone status, and possible effect of weight loss on thyroid hormones in obese patients.Methods: We study population consisted of 39 (35 female, 4 male) euthyroid obese patients with mean age 42.76±10.52 years. Of these 19 patients were morbid obese. ...

Purpose: To evaluate the level of intellect according to tests data in the regions with iodine deficiency.Methods: In the frame the ‘Thyromobil’ project that was held during 2003-2005y in 18 regions of Russian Federation were done standartized epidemiologic research. The research included clinical examination, palpation thyroid, ultrasonic examination of thyroid, definitions of ioduria. We used Cattell test, free of cultural influence (Culture ...

The effect of growth hormone (GH) replacement on thyroid function in hypopituitary patients has only been studied in small groups of children and adults with conflicting results.We aimed to define the effect and clinical significance of adult GH replacement on thyroid status in a large cohort of 243 patients with hypopituitarism due to various causes. 84 patients were considered euthyroid before GH treatment and 159 patients had central hypothyroidism an...

Introduce: Lack of radioiodine uptake in Differentiated Thyroid Carcinoma (DTC) is a huge diagnostic and therapeutic problem. This sign is associated with worse prognosis. In patients with elevated thyroglobulin levels and with no evidence of disease on radioiodine scintigraphy, scintigraphy with somatostatin analogs can be an alternative imaging modality.The aim: Assessment of scintigraphy with the somatostatin analog 99mTc-HYNIC-TATE to visu...

Congenital hypothyroidism (CH) affects 1:2.000–3.000 newborns. In most cases, the cause is a developmental defect (dysgenesia) or an arrested migration (ectopia) of the thyroid gland. In the remaining cases TSH resistance or defects in iodide transport or thyroid hormonogenesis account for CH. The differential diagnosis is aimed to recognize permanent CH forms and to achieve an etiologic diagnosis for accurate management and genetic counselling. Appropriate investigations...

Introduction: An increase of thyroid iodine uptake (Tup) is one of the symptoms of thyrocyte stimulation by means of recombinant human thyrotropin (rhTSH). Low Tup, characteristic of iodine induced hyperthyroidism, creates serious problems, when 131I is considered, making this kind of treatment difficult, if not impossible.Material and methods: We report a case of a 74 years old patient, with hyperthyroidism, induced by amiodarone administrati...

In addition to its central role in the control of thyrocyte growth and function, the TSHR is expressed during the differentiation of mesenchymal precursors. To explore further, we have developed an in vitro model in which TSHR activation is achieved by introducing constitutively active (M453T, L629F) TSHR, using retroviral vectors.We aimed to investigate the effect of TSHR activation on body composition, via the production of TNFα and express...

Aim of the study was to evaluate whether clinical parameters and echographic patterns may be predictive of malignancy in thyroid nodules with a cytological diagnosis of follicular (FOL) and H?rthle cell (HC) neoplasia. The study included 495 patients (388 F: mean age 45±14 yr; 107 M: mean age 46±14 yr) with FOL (n=418) and CH (n=77) nodules, ‘cold’ at scintiscan and undergone to thyroidectomy. Clinical parameters considered were: sex, age, goi...

Objective: Patients with hyperthyroidism occasionally need rapid restoration to the euthyroid state. In wiew of the increased enterohepatic circulation of thyroxine (T4) and triiodothyronine (T3) in thyrotoxicosis, and metabolic effects of konjac glucomannan in gastrointestinal system, we aimed to determine the activity of glucomannan in treatment of hyperthyroidism.Methods: A prospective, randomized, placebo-controlled, one-blind study design was used w...

Adipogenesis is induced when intracellular cAMP increases and follows cell cycle arrest. During preadipocyte differentiation expression of the TSHR, which signals via cAMP and the inositol phosphate cascade, is upregulated. To investigate the role of TSHR activation in adipogenesis, we have developed an in vitro model in which constitutively active TSHR mutants (L629F, M453T) are introduced by retroviral vectors (RV).We aimed to compare the effect...

The effectiveness of thyroid remnants ablation with 131I after thyroidectomy for differentiated thyroid carcinoma (DTC) depends mainly on absorbed radiation dose, which is proportional to 131I uptake (Tup) and its effective half-life time (EHL) in the remnants.Aim: Assessment of endogenous TSH level increment effects on EHL of 131I and Tup in thyroid remnants after surgery for DTC.Material: Twenty-o...

Objectives: To analyse the outcome of 100 consecutive patients treated for thyrotoxicosis by total thyroidectomy, and compare the efficacy of this treatment modality to I131 therapy and thionamide therapy.Design: Data collected prospectively from a tertiary referral multidisciplinary thyroid clinic on 100 consecutive patients operated on for thyrotoxicosis by one thyroid surgeon. Patient demographics, reasons for selection of surgical treatmen...

Purpose: Thyrotoxic patients have an increased bone turnover and decreased Bone Mineral Density (BMD) at diagnosis. During antithyroid drug treatment (ATD) the patients improved their BMD but earlier studies have not been able to determine if BMD normalize or how long it will take.Methods: We have prospectively examined 32 females (approved by Danish Ethical Committee) with newly diagnosed Graves’ disease (antilog10, mean age (CI 95%)): 39 years (34...

Atrial fibrillation (AF) and, in general, cardiac arrhythmias are among the most frequent complications during clinical thyrotoxicosis. However to-day the most frequent conditions of hyperthyroidism are subclinical and more subtle is the relationship between this last condition and cardiac arrhythmias.In order to evaluate this topic, we considered two groups: A) patients admitted into the hospital for AF; B) patients affected by subclinical hyperthyroidi...

Aims: To evaluate the cardiovascular morbidity in patients with and without hypothyroidism admitted to a central hospital, between 1989 and 2004.Materials and methods: Data from the Hospital Coding Centre were retrospectively analysed according to International Classification of Diseases (9th version) criteria. We have studied the distribution by age, sex, causes and duration of admissions. Statistical analysis was performed with Student’s t-test, &...

Aim of the study was to establish the diagnostic value of nuclear atypia thyroid nodules with cytological diagnosis of follicular (FOL) and Hv¨rthle cell (HC) neoplasia. 1039/23.313 fine needle aspiration (FNA) performed in January 2002 June 2005 in the Department of Endocrinology, University of Pisa had cytological diagnosis of FOL e CH. FNA was performed under echo guidance, using 23 gauge needle attached to 10 mL syringe. The material was air-dryed and stained with Pap...

Housekeeping genes (HK) are commonly used as controls for the normalization of the RNA amount in quantitative RT-PCR experiments. The question whether their expression is influenced by the metabolic state of the patient and/or the tumour transformation is still unresolved and until now, HK genes have been used in quantitative studies without considering that their expression could be different in tumor with respect to normal tissue. Aim of this study was to identify HK genes e...

Mutations in the RET proto-oncogene are responsible for multiple endocrine neoplasia type II. Somatic RET mutations were described in 50% of medullary thyroid carcinoma (MTC). We describe here a novel germline mutation of the RET gene detected in an apparentely sporadic MTC.The index case was a 67 years old patient who arrived at our observation for a bilateral laterocervical linfoadenopathy. The patient was clinically evaluated for thyroid function and ...

About 10–15% of FNA cytologies are nondiagnostic, because of inadequate material or indeterminate (i.e. follicular neoplasms). Aim of this study was to analyse the practical usefulness of the analysis of BRAF mutations and RET/PTC rearrangements, known to be associated to papillary thyroid carcinoma (PTC), in FNA-material.We analysed 100 thyroid nodules with a nondiagnostic cytology: 75 follicular nodules and 25 cases with inadequate material. Fifte...

Selenoproteins play a major role in the redox-systems of the body. Gluthathionperoxidase is important for the enzymatic reduction of hydro-peroxidases in the thyroid gland. Selenium (Se) is able to capture radicals, one of which is oxygen originating from thyroxin-peroxidase (TPO) activity. It has been shown that Se supplementation is associated with a decrease of anti-TPO-titers. Women with Hashimoto’s were shown to have lowered serum Se concentrations.<p class="abst...

Background: One of the major limits of gene therapy with sodium iodide symporter (NIS), which enables cells to be subjected to radioiodine therapy, is that NIS transfected cells rapidly release the intracellular iodine.Materials and methods: We transfected two human anaplastic (FRO) and medullary (TT) thyroid cancer derived cell lines, unable to take up iodine, with human NIS cDNA. The possibility of increasing the iodine retention time by treating cells...

We previously found that two cell lines (ARO and FRO) derived from anaplastic thyroid cancer and one (TT) deriving from medullary thyroid cancer did not respond to the retinoic acid (RA) treatment. We supposed that it was related to the lack of the RA receptor RAR beta mRNA expression. It has been suggested that the promoter methylation was one possible cause of loss of RAR beta expression.We analyzed the methylation status of RAR beta promoter in ARO, F...

Thyroid physiology in early pregnancy is characterised by an increase of thyroxine binding globulin. This has been taken into account when using total T4 (TT4) if a ‘T3 uptake test (TUp)’ is used to derive the FTI. The American Thyroid Association Guidelines (1990) recommend ceasing the use of uptake tests, although in the USA they are still widely used. The aim of this study is to compare the TT4 and TUp to the FT4 in early gestation. TT4, TUp, FT4 and TSH were meas...

The presence of thyroid peroxidase antibodies (TPOAb) is a marker of autoimmune thyroid disease and, when present in early pregnancy, is predictive of postpartum thyroiditis. In the course of undertaking the Controlled Antenatal Thyroid Screening Study we have taken the opportunity to measure TPOAb in a large number of samples from 11–16 weeks gestation by 3 different assays.The assays were (1) an in-house ELISA; (2) Bayer ADVIA Centaur anti-TPO ass...

The cohort comprised 2296 patients with Graves’ disease (GD) (1920 females, 376 males) and 361 with Hashimoto’s thyroiditis (HT) (313 females, 48 males) recruited using standard diagnostic criteria for investigation of genetic susceptibility to AITD. We investigated variation in disease phenotype with age and gender, examining factors including biochemical severity, presence of goitre and presence of thyroid eye disease (TED) classified by NOSPECS score.<p class=...

Autoimmune thyroid diseases (AITD), Graves’ disease (GD) and Hashimoto’s thyroiditis (HT) cluster in families. We investigated whether having a family history (FH) of AITD altered age of diagnosis. The cohort comprised 2296 GD (1920F,376M) and 361 HT (313F,48M) recruited according to standard diagnostic criteria. We compared age at diagnosis of GD or HT in those with or without a FH of overt hyper- or hypothyroidism (ascertained using a standardised questionnaire).</...

The association of autoimmune thyroid diseases (AITD) with other autoimmune disorders is well documented. Familial prevalence of thyroid dysfunction and other autoimmune diseases was examined in our cohort of 2296 with Graves’ disease (GD) (1920 females, 376 males) and 361 with Hashimoto’s thyroiditis (HT) (313 females, 48 males), probands being recruited using standard diagnostic criteria. FH was ascertained using a standardised structured questionnaire.<p class...

Graves’ disease (GD) is an autoimmune disorder of the thyroid gland. Autoimmune diseases cluster within families and individuals, leading to the hypothesis of common autoimmunity genes being shared between diseases. This has been confirmed through studies demonstrating association of the HLA region, the CTLA-4 gene and the PTPN22 gene with many disorders including GD and rheumatoid arthritis (RA). We and others have confirmed highly significant association of the R620W SN...

On their first antenatal visit (median 10th gestational week), 977 pregnant women in one district were assayed for TSH (IRMA, non-pregnant normal range 0,15-5 mIU/l) and TPO-Ab (RIA). Abnormal values were found in 154 women (15.8%): positive TPO-Ab in 92 (9.4%), TSH<0,15 in 35 (3.6%), TSH>5 in 49 (5.0%). Of them, 128 women were examined in our endocrine clinic (median 15th week), incl. thyroid ultrasonography (7.5 MHz, Doppler), and assayed for TSH, free T4, free T3, a...

Toxic multinodular goiter is a heterogeneous disease producing hyperthyroidism frequently found in iodine-deficient areas. The aim of this study was to evaluate the gene expression profile of functioning and non-functioning thyroid nodules present in the same thyroid gland from two patients affected by autonomous multinodular goiter by using the Affymetrix technology.Total RNA was extracted from nodular and non nodular tissues, retrotranscribed, and the ...

Aim: To estimate efficiency of 200 mkg/day iodine for prevention of development of hypothyroxinemia in pregnant women with non toxic goiter and without it, who were living in region with mild iodine – deficiency.Subjects and methods: Study group consists of 32 pregnant women: 16 – with non toxic goiter (8 from them took 200 mkg of iodine), 16 - without thyroid disease (8 from them took 200 mkg of iodine).Results: Pregnant...

Thyroid associated ophthalmopathy (TAO) is a chronic autoimmune disorder characterized by an increased volume of the adipose/connective tissue in the human orbit. Fibroblasts from the connective orbital tissue are able to differentiate into mature adipocytes if grown in particular culture conditions. Aim of the present study was to determine the gene expression profile of orbital fibroblasts after adipocytic differentiation. Fibroblasts in primary culture were obtained from or...

Objectives: While evidence for an increased risk of hypertension in both overt hyperthyroidism and overt hypothyroidism is consistent, the relation between subclinical hyperthyroidism and blood pressure has not yet received sufficient attention. We aimed to investigate possible associations of decreased serum thyrotropin levels and subclinical hyperthyroidism with blood pressure, pulse pressure, and the risk of hypertension.Design: The population-based c...

The incidence of childhood thyrotoxicosis in the UK and Ireland is unknown. The commonest cause worldwide is Graves’ disease (60–90% of cases), with reported incidences varying from 0.79 (Denmark) to 6.5 (Hong Kong) per 100,000 pop./yr. Mean age at diagnosis is reported as 11.3 years with a F:M ratio of 5.5:1. Some countries have recently reported an increasing incidence.To ascertain the UK and Ireland incidence of childhood thyrotoxicosis and ...

Thyroid stimulating hormone (TSH) is the key modulator of thyroid cell function. Binding of TSH to its receptor (TSHR) results in an increase of cAMP intracellular concentration, which activates protein kinase A (PKA) to phosphorylate CREB and other substrates. Eventually, this leads to gene transcription modification associated with both proliferation and differentiation. Two major types of PKA (PKA I and II) exist in mammal cells, but their specific role in TSH signaling is ...

Vesicular thyroid tumours evolve from benign to malignant states, respectively called adenomas and carcinomas by respect to the World Health Organisation classification. Borderline cases, atypical adenomas, cannot be clearly classified. When an abnormal cytoplasmic mitochondrial proliferation occurs into the tumour cells, these tumours called oncocytomas, are more aggressive. Oncogenic mechanisms and signal pathways of these tumours are not well known and the origin of the onc...

The purpose of this study was to describe MRI signs of Hashimoto’s thyroiditis (HT) in patients from the iodine deficient region.30 euthyroid patients with HT from the iodine deficient region and 5 healthy individuals were examined by MRI in FSE T1 and T2 pulse sequences. The diagnosis was confirmed according to the standard criteria.The atrophic form of HT (2 cases) showed the reduction of thyroid volume with denominated lobu...

Background: Scintigrafically cold nodules are hypofunctioning areas in the thyroid gland. These nodules are common and as the risk of malignancy is low, surgery is only necessary in very few cases. Fine Needle Aspiration Cytology (FNAC) is the standard method for detecting malignant tumours. However, FNAC is a difficult diagnostic procedure which often gives insufficient working material.Materials and methods: A prospective study was designed to calculat...

T3 is essential for skeletal development and T3-actions in bone are mediated mainly by the nuclear receptor TRα1. We previously identified that FGFR1 is a T3-responsive gene in osteoblasts by subtraction hybridization. In mice that harbor a dominant negative mutation PV, FGFR1 mRNA expression is reduced in TRα1PV mutants that exhibit skeletal hypothyroidism and increased in TRβPV/PV mice with skeletal thyrotoxicosis. In this study, primary ...

A lot of debate has been going on over when to treat subclinical hypothyroidism. Some studies plead to lower the consensus TSH cutoff value of 10 mUI/l in order to improve general well-being and cardiovascular risk factors with early LT4 treatment. Our study aim was to assess progression of subclinical to overt hypothyroidism and to identify factors that would benefit from early treatment. A cohort of 76 patients with subclinical hypothyroidism was studied retrospectively, ove...

Undifferentiated thyroid carcinoma is a highly aggressive human cancer with poor prognosis. A strong association has been observed between undifferentiated thyroid carcinoma and TP53 mutations. Plitidepsin (AplidinTM) a novel anticancer compound from a sea tunicate, has been reported to induce apoptosis independently of TP53 status. We investigated the actions of plitidepsin in human thyroid cancer cells. initiallyexperiments using primary cultured cells from a d...

A 25-year-old teacher presented acutely unwell with palpitations, breathlessness, nausea and vomiting. 4 years previously, she was treated for Graves’ disease with carbimazole for 15 months, and had since remained euthyroid. On examination, she was tachycardic but normotensive, tachypnoeic, had tremors of out-stretched hands, retraction of eyelids, and moderate sized smooth diffuse goitre with bruit. Initial blood tests revealed hyperthyroidism together with hypercalcaemi...

Introduction: In the management of patients with differentiated thyroid carcinoma (DTC), serum thyroglobulin (Tg) levels are often well correlated with whole-body radio-iodine scanning (WBS) results. However, occasionally a mismatched result, increased Tg with negative WBS, is encountered. High doses of radio-iodine (RAI) have been suggested as a therapeutic choice with controversial results. Our aim was to evaluate the therapeutic benefit of this approach.<p class="abstex...

Thyroid hormone resistance (THR) is associated with elevated FT4 and FT3 with inappropriately high TSH levels. T3 action is mediated by two types of thyroid hormone receptor, encoded by alpha and beta genes. We evaluated the endothelial function of a THR transgenic mouse model with a targeted mutation in the thyroid hormone beta receptor gene ex vivo.Isometric tension of aortic rings of 10 mice of each genotype (TRbPV/PV, TRbPV/+</...

Both hyper- and hypothyroidism show reduced spontaneous and GHRH-stimulated GH secretion. Although impaired GHRH secretion and activity as well as reduced GH pituitary synthesis have been reported in these pathological conditions, a definitive description of the underlying pathophysiological mechanisms have not been provided yet. Ghrelin elicits a potent GH-releasing effect partially mediated by a functional somatostatin antagonism and a synergic interaction with GHRH. Moreove...

The purpose of these studies was to conduct a multi-center evaluation of the performance of the new Abbott ARCHITECT Anti-Tg and Anti-TPO assays. Both assays are two-step, chemiluminescent, microparticle-based immunoassay for the quantitative determination of either the IgG class of thyroglobulin autoantibodies (anti-Tg) or the IgG class of thyroid peroxidase autoantibodies (anti-TPO) in human serum and plasma. The ARCHITECT Anti-Tg and Anti-TPO assays are designed to have a d...

Graves’ disease (GD) and thyroid-associated ophthalmopathy (TAO) are often observed together. In purpose to elucidate the pathogenetic relationships between these two autoimmune disorders we investigated profile of different autoantibodies in patients with GD without TAO (n=38, group 1), GD with TAO (n=40, group 2), and in healthy people (n=124, control group). Autoantibodies to thyroid gland, eye muscle cell membranes (Ab-EMCM) and skin fibroblasts w...

Introduction: Lack of radioiodine uptake in Differentiated Thyroid Carcinoma is a huge diagnostic and therapeutic problem. This sign is associated with worse prognosis. DOTA-TATE preparation is a somatostatin analogue coupled with 90 Y which emites β (−) radiation. Its use in a treatment depends on excessive expression of somatostatin receptors (SSTR) in malignant tumours.The aim of the study: To present a possibility of treatment o...

Hashimoto’s thyroiditis (HT) is the most frequent thyroid disease in children, in areas of the world with sufficient iodine intake.Aim: To study the clinical features of HT in children at presentation.Material and method: We studied 99 children with HT, 76 (76.8%) girls and 23 (23.2%) boys, with mean chronological age 10.7±2.6 ys (3.2–15.6 ys). The diagnosis of HT was established from the high titers of antithyroid a...

The aim of the study was to compare efficacy and tolerability of systemic corticotherapy alone to corticotherapy combined with orbital radiotherapy in severe active Graves’ ophthalmopathy. We studied 905 patients, aged 35–73 years (mean 58.2 ±12), with clinical activity score above 4 and ATA class 3c to 6. Therapeutic outcome was assessed by change in ophthalmopathy index. For 4 weeks all subjects received corticotherapy: 869 - oral prednisone 60–100 mg dai...

We examined the effects of L-thyroxin on level of prolactin (PRL), CRP (C-reactive protein) and insulin in premenopausal women with subclinical hypothyreoidism (SH).The study included 21 women ages 41.3±3.5 years with SH (TSH>mIU/ml with normal level of T3 and T4).Laboratory evaluation included basal hormone (serum free T3, free T4, TSH, PRL, insulin, cortisol, ACTH, GH, FSH, LH, E2, thyroid antibodies and TGL), level of C...

Aims: The aim of the present study was to evaluate the relative frequency of histological categories of thyroid malignant neoplasms. Another aim was to evaluate the TNM stage differentiated thyroid carcinoma (DTC) at the time of initial presentation in Valencia Community (Spain).Methods: Histopathology and TNM stage thyroid carcinomas diagnosed of thyroid carcinoma diagnosed between 1998 and 2005 in our endocrinology service, were recorded.The sample was...

Aim: Estimation of the effectiveness of a single low dose 0.05 mg rhTSH in increasing radioiodine uptake (RAIU) before 131I therapy for multinodular toxic goiter with low initial RAIU.Patients: 24 patients (21 women, 3 men) with multinodular toxic goiter without prior antithyroid drug therapy. The initial 24 h RAIU was 21.1±8.44%; range, 6–39% and thyroid volume 64.14±22.49 ml; range, 24.8–109 ml.Meth...

The sodium iodide symporter (NIS) mediates the uptake of iodide into thyroid follicular cells. The pituitary tumor transforming gene (PTTG) is a multifunctional oncogene which stimulates expression of fibroblast growth factor-2 (FGF-2) via the PTTG binding factor (PBF). PTTG, FGF-2 and PBF are all up-regulated in thyroid cancer. PTTG and FGF-2 inhibit NIS mRNA expression and iodide uptake in rat thyroid FRTL5 cells. We have shown previously that both PTTG and PBF repres...

The long-term risk of carcinogenic and genetic damage following the treatment with 131I for differentiated thyroid cancer (DTC) is quite low. The hypothyroid status (HS), at the time of 131I administration, decreases the renal clearance of 131I and increases the whole-body, blood and bone marrow irradiation, unlike the euthyroid status (ES). Chromosome aberrations (CA) in peripheral lymphocytes reflect blood cells exposure to irradiation. This ...

Introduction: The objective of this study is to detect whether the correction of hypomagnesaemia would help to relief the symptoms of hypocalcaemia that occurs after thyroidectomy. Methods: This prospective study comprised 35 patients who had thyroidectomy between September 2001 and June 2002. Thirteen patients had total thyroidectomy (TT), thirteen had total lobectomy on one side and subtotal lobectomy on the other side (TLSL) and nine patients had hemi...

Selenium (Se) is indispensable for enzymatic activities of glutathione peroxidases (GPx) involved in antioxidative defense and deiodinase isozymes (Dio) that control thyroid hormone (TH) action. Se deficiency can impact negatively on thyroid galnd funtioning and TH metabolism and thereby perturb development and metabolism. We have generated Se-deficient mice by genetic inactivation of Selenoprotein P (SePP), the main plasma Se carrier. SePP-KO mice display decreased serum and ...

Background and methodology: There are few data on changes in thyroxine requirement in the long-term follow-up of hypothyroid patients. We carried out a retrospective analysis to evaluate the long-term changes in thyroxine dose and its relationship with age, gender, thyroxine dose at registration and aetiology of hypothyroidism.Results: We identified 5,029 patients from our hospital based thyroid register with a minimum of 4 years follow-up (88% female, 7...

The HLA class II region, in particular DRB1/DQA1/DQB1, has been consistently associated with Graves’ disease (GD) for over thirty years. Only recently has work within our own group made progress in narrowing down the etiological variant(s) present within DRB1/DQA1/DQB1, by excluding DQB1, and by mapping association at DRB1 to nine amino acid positions present within the peptide binding domain, with position β74 being the most associated. Independ...

Radioiodine-131 is commonly used for treatment of hyperthyroidism, however the effects on testis function are not known. This prompted us to study testis function in hyperthyroid men after 131I treatment. 15 hyperthyroid patients scheduled for 131I treatment underwent: testis US, hormone assessment and sperm analysis before and 45 days, 3, 6 and 10–15 months after 131I. The control group (for testis volume and semen analysis) was constitut...

Background and methodology: In the long-term surveillance of treated hypothyroid patients, annual surveillance (with thyroid function testing) is widely recommended. This is largely based on consensus, as there is limited evidence to support this practice. Currently around 20,000 patients are registered in our hospital based thyroid register and the majority are on 18 monthly follow-up. We carried out a retrospective analysis to see if there is evidence to support increased fr...

cAMP signaling systems play a critical role in regulation of thyroid cell proliferation and function. Besides the well known protein kinase A (PKA) cascade, Epac (exchange protein directly activated by cAMP) depicts a novel effector of cAMP. Epac is directly activated by cAMP and in turn stimulates kinase cascades like Akt kinase, phospholipase Cε and MAP kinases as well as the Ras-like GTPases Rap1 and Rap2. As data about the impact of Epac on cAMP signaling of thyroid c...

In assessing TAO, orbital CT scan allows measurement of extraocular muscle and optic nerve dimensions but it is useful mainly for a qualitative analysis and cannot be used in the clinical score of the disease. Aim of the present study was to seek a number which could express the expansion of the orbital tissue and be used in grading the severity of TAO. 39 TAO patients and 24 control subjects were studied. We have measured the orbital area (OA) on the central axial section of ...

Radioiodine (RAI) has been used to treat hyperthyroidism for more than 60 years. However there is no absolute clarity in the appropriate dose or method of administering RAI. We evaluated the efficacy of RAI therapy and compared our RAI doses with the guide doses suggested by Royal College of Physicians (Graves’ disease 400–550 MBq and Multinodular goitre (MNTG) >550 MBq).We audited 602 hyperthyroid patients treated with RAI between 1994&#15...

Thyroid cancer is the commonest malignancy seen in endocrine practice. Audits of clinical practice have revealed significant variations in management, and the British Thyroid Association have published guidelines (2002) to address this. The aim of our study was to assess the care-stage at which practice falls short of agreed standards. We performed retrospective case note review of 83 patients (72 female) followed in a specialist thyroid cancer clinic over 5 years. Histology d...

We are conducting an open study on the treatment of Graves’ disease (GD) and thyroid-associated ophthalmopathy (TAO) with the monoclonal antibody to CD-20, rituximab (RTX) (MabThera, Hoffman-Roche, Basel). RTX induces depletion of B cells and GD is typically a B cell dependent autoimmune disease. We present preliminary results on 7 patients with GD and TAO at different clinical stages: 3 women with newly diagnosed GD and initial TAO; 1 woman with GD and moderate-severe TA...

Permanent hypoparathyroidism is rare after total thyroidectomy. However, our experience is that often patients remain on alfacalcidol and calcium supplements long-term after thyroidectomy.A study was initiated in our centre in 2004, whereby all patients on alfacalcidol or calcium supplements post thyroidectomy underwent a gradual alfacalcidol and calcium reduction programme. Of 57 patients thus enrolled, we report on 22 who were initially on alfacalcidol...

Pretibial myxedema (PM) is a rare extrathyroidal manifestation of Graves’ disease for which there is no specific treatment. When the clinical picture is markedly evident, topical treatment with steroid ointments is practised. There has been previous experience of subcutaneous injections with steroids by using standard needles, but this procedure caused nodular degeneration of the skin. Aim of the present study was to experiment a novel modality of treatment with the injec...

Behavioural restrictions observed following Radioiodine therapy(RAI) administered for management of hyperthyroidism are becoming more stringent. Over the last two years we have administered a fixed 400 MBq RAI dose after performing a 24-hour RAI uptake test with a view to reducing post RAI restrictions e.g. for patients with a 50% uptake, restrictions applicable to 200 MBq were advised. The aim or our study was to compare the restrictions as advised by this method with what wo...

We apply the oligonucleotide microarray technology to study the expression profile of differentiated thyroid cancer (DTC) and to select transcripts which differentiate between its subclasses. We use state-of-the-art bioinformatic techniques, based on Support Vector Machines algorithms, to select not only the single ‘solitary’ markers but rather the sets of genes which are taken into account cooperatively to enhance the diagnosis accuracy. Simultaneously, we try to me...

Subclinical hypothyroidism is defined as a biochemical abnormality characterized by an elevated serum level of sTSH with normal thyroid hormones (FT4) and no clinical symptoms. The objective of this study was to asses whether patients with subclinical hypothyroidism have a risk of hypercholesterolemia. We have evaluated 37 adults (34 female and 3 male), mean age 49.20±9.65 years, with laboratory confirmed subclinical hypothyroidism, sTSH value above of 4.5 mU/L and normal...

In euthyroid women normal pregnancy is associated with a rise in free thyroxine and fall in TSH levels attributable to high levels of hCG in the first trimester. In hypothyroid women free thyroxine tends to fall and TSH rises if the dose of thyroxine is not raised, due to further pregnancy - associated changes including a rapid rise in thyroxine-binding globulin and increased renal clearance and placental metabolism of thyroid hormone. Fetal thyroid development occurs by 12 we...

Despite the common clinical opinion that thyrotoxicosis is associated with quantitative and qualitative sleep alterations, at present, an objective evaluation of sleep quality and quantity in this clinical condition has never been performed so far. Based on this foregoing, in order to perform a qualitative and quantitative description of sleep in this clinical condition, we enrolled 6 normal-weighted patients suffering from naïve overt hyperthyroidism due to Basedow Disea...

Resistance to thyroid hormones (RTH), is with the exceptions caused by mutations in the gene coding β1-subunit of the thyroid receptor (TRβ1) located on chromosome 3. More than 700 individuals with RTH belonging to about 250 families have been identified up to date. The presence of goiter, tachycardia and hyperactivity together with abnormal findings on routine thyroid testing usually lead to further investigation and, ultimately, the diagnosis ...

Exposure to ionising radiation, changing levels of iodine nutrition, and increased pathologic diagnosis of clinically unimportant thyroid neoplasm have all been proposed as explanations for a world-wide rise in the incidence of thyroid carcinoma over the past 6 decades. Yakutia is geographically an area of endemic iodine deficiency (the population is about 1 million). According to previous research in the endemic areas there are more occasions of follicular thyroid cancer, whe...

The detection of antithyroid antibodies, specifically of antithyroglobulin antibodies, in patients with differentiated thyroid carcinoma after near-total thyroidectomy, radioiodine therapy and thyroxine suppression presents difficulties in screening patients for residual disease or recurrence of the disease as it may interfere with thyroglobulin measurement. The aim of the study was to estimate the rate of decrease in antithyroid antibody levels in patients with differentiated...

Aim: To estimate further results of treatment and outcomes in patients with subacute thyroiditis observed in the period from 1993 to 2005 years.Materials and methods: 102 patients (84 women, 18 men) with confirmed De Quervain’s subacute thyroiditis (SAT) were investigated and the findings were analysed retrospectively (clinical features, ultrasonography, laboratory tests). Ultrasound device (Hewlett Packard Image Point HX) with 7.5 – 10 MHz. Se...

Cowden syndrome is an autosomal dominant disorder characterized by germline mutations in the PTEN tumour suppressor gene on 10q23.3 which mediates cell-cycle arrest and apoptosis. The diagnosis is primarily based on clinical findings including a combination of mucocutaneous lesions (trichilemmomas), macrocephaly, thyroid lesions (mainly follicular adenoma or carcinoma) and breast and endometrial cancer. The prevalence is estimated at 1/200 000. Lifetime risk for developing bre...

Background: The most common method for evaluation of a suspicious thyroid nodule is a fine needle aspiration biopsy (FNAB). Together with ultrasound examination, thyroid scanning using pertechnetate and functional thyroid testing it helps in distinguishing between benign and malignant disease.Objective: Aim of this study is to assess accuracy of FNAB in the diagnostic evaluation of thyroid nodules.Patients: We retrospectively analy...

Fine-needle aspiration biopsy (FNAB) of the thyroid gland is the most effective examination in the evaluation of thyroid nodules. To describe our experience with FNAB of the thyroid and compare the results with palpation versus ultrasonography-guided (UG) methods in an endemic goiter area in Turkey.Methods: We studied on 176 patients whom 140 were females and 36 males, submitted to FNAB of thyroid nodules at outpatient clinic of a university hospital in ...

A 31-year-old Taiwanese lady presented with palpitations, anxiety, orthopnoea, peripheral oedema, diarrhoea and a swelling in her neck. She was taking no regular medication. Her paternal uncle had been treated for thyrotoxicosis. She smoked 20 cigarettes per day. Clinical examination revealed tachycardia (pulse rate between 115 and 150 beats/min), tachypnoea (respiratory rate 30 breaths/min), hypertension (BP 161/125 mmHg) and congestive cardiac failure. The thyroid gland was ...

Medullary thyroid carcinoma (MTC) is a rare tumoral entity related to parafollicular C cells of the thyroid gland, characterized by peculiar morphological, functional and evolutional features. The aim of this study was to characterize the cases of medullary carcinoma diagnosed in a university hospital in a 5 years interval (January 1999–December 2003) and to evaluate the diagnostic methods. In this time interval, from a total of 171 thyroid malignancy, 12 (7%) were medull...

Background and aims: The type 1 DM patients who are GAD antibody positive have more risk of autoimmune thyroid disease than who are negative. In patients with autoimmune thyroid disease there is a significantly increased risk of anti-pancreatic autoimmune response as shown by increased GAD antibody positivity compared to normal population. However, the linkage between IA2 and thyroid autoimmunity is evaluated in one studied. Our aim is to evaluate the frequency of presence of ...

A 42-year-old lady, previously fit and well, presented to the Accident and Emergency department following a cardiac arrest. She had received four D.C. shocks by the ambulance crew prior to cardioversion to sinus rhythm from ventricular fibrillation. She was admitted to ITU and during this admission developed a grandmal seizure. Physical examination was unremarkable and CT scan of her head was normal. Blood tests including full blood count and biochemistry were all normal excep...

Background: Clinical manifestations of hyperthyroidism resemble those of hyperadrenergic state. Previous studies of linear analysis of heart rate variability (HRV) revealed cardiac autonomic dysfunctions in hyperthyroidism. In recent years, increasing attention is being directed to the nonlinear analysis of HRV to gain insight into neural modulation of heart rate dynamics. Based on the chaos and fractal theory, an attractor in phase space can characterize the dynamics of a cha...

We have collected an extensive record of more than 8000 patients with a thyroid carcinoma over the years 1946–2005. In all cases, the diagnosis was done by the histology examination carried by a pathologist. Those records were classified by their dimension and the extent of the thyroid gland. This classification is used as a basis for the treatment decision. Tumors of the bigger size needs radiotherapy with I 131 whereas the smaller tumors are subject of observation and r...

Recently it has been shown that somatostatin (SST) might be of therapeutic value in the treatment of active Graves’ophthalmopathy (GO). SST and somatostatin receptors (sst) transcripts are expressed and functional in cultured orbital fibroblasts deriving from GO patients (FGO). Octreotide, the SST analogue currently used is able to inhibit in vitro growth and activity of FGO. New analogues with wider sst-affinity are now available for in vitro experim...

Aim: To estimate further results of treatment and outcomes in patients with subacute thyroiditis observed in the period from 1993 to 2005 years.Materials and methods: 102 patients (84 women, 18 men) with confirmed De Quervain’s subacute thyroiditis (SAT) were investigated and the findings were analysed retrospectively (clinical features, ultrasonography, laboratory tests).Results: There were 102 patients in the cohort within t...

Apoptosis plays a pivotal role in the regulation of the immune mechanisms in the pathogenesis of autoimmune thyroid diseases. The aim of the study was to compare soluble Fas, FasL and Bcl-2 in Graves’ disease (GD) and Hashimoto thyroiditis (HT) in relation to the age of the studied patients. The study was carried out in 5 groups of subjects: 1/14 patients with GD in euthyreosis on methimazol (euGD) 2/20 patients with hyperthyroid GD (hrGD) 3/15 patients with HT in euthyre...

Introduction: Radioactive Iodine (RAI) is a well-established and effective treatment for hyperthyroidism. Lithium (Li) blocks the release of organic iodide and thyroid hormone from the thyroid gland without effecting thyroidal RAI uptake. Through decreasing the loss of RAI from the thyroid it has also been shown to reduce urinary RAI excretion. Its use as an adjunct to RAI in the therapy of hyperthyroidism has been postulated, but information on the subject is limited.<p c...

Simple goiter is one of the most prevalent endocrine diseases all over the word. Iran and Khuzestan province were Endemic area for goiter before Iodine supplementation in 1990. This study was performed in 2002–2003, about 13 years after consumption of Iodized salt (40 ppm), to determine prevalence of goiter and urinary Iodine excretion in 1800 school children (6–10 years old) in Ahvaz, choosed by cluster sampling. Physical examination and goiter staging according to ...

Adjara is a region in Georgia with high level at iodine deficiency.The aim of the present work was to study the subclinical dysfunctions of thyroid gland in women older than 40 years whose thyroid state hadn’t been examined before.Materials and Methods: From 1998 to 2005 693 women aged 40–78 had been examined. Primary examination was done by different specialists.All women were tested on thyreotropi...