Endocrine Abstracts

Objective: The goal of this paper is to investigate the effectiveness of antithyroidiennes, associated or not, with the thyroid hormone.Material and methods: Patients and their clinical histories were examined when each ambulatory patient was personally visited, for one year, by the author. 156 cases were examined (16 males and 140 females). The diagnoses were based on anamnesis, clinical exploration, TSH + thyroid hormone and bioquim determinations and ...

A 53 year-old woman presented with labile and difficult to control hypertension on three deferent anti hypertensive medications. Abdominal computed tomography (CT) and Ultrasonography of the thyroid gland showed 1.8 cm thyroid nodule. Fine needle aspiration biopsy of the thyroid nodule revealed papillary thyroid carcinoma. Serum TSH & FT4, calcitonin, CEA, intact PTH and calcium levels were within normal limits. A 24-h urine metanephrines showed significant elev...

Objective: Maternal thyroid hormone excess or deficiency has been associated with adverse health outcomes for both the mother and child. This study performed to study the prevalence of thyroid disorders and its effect on pregnancy outcome in pregnant women.Methods: Five hundred pregnant women in first trimester of pregnancy were enrolled in the study. Serum Thyrotropin (TSH), Free T4 (FT4), and Free T3 (FT3) we...

Purpose: To assess the utility of BRAFV600E mutation detection in preoperative thyroid cancer diagnostic.Materials and methods: We studied 46 aspirates taken by FNA from patients with thyroid gland nodes. Thyroid tissue aspirates DNA was extracted by sorbent method. BRAF gene mutation was analyzed with primers specific for wild and mutant gen type by RT-PCR.Results: All patients were divided into three groups by cytological conclus...

There were evaluated galectin-3 expression in 66 fine-needle aspiration biopsy (FNAB) specimens from patients with thyroid gland nodules by flow cytometry method. We include in our study 29 patients with papillary thyroid cancer (PTC), 31 – with follicular neoplasia, 6 – with nodular colloid goiter by cytological examination. For specimens analysis, taken by FNAB of thyroid gland nodules, were used indirect immunofluorence method /Coons/.Result...

Gelsolin is an actin-binding protein involved in dynamic changes of the actin cytoskeleton. This protein regulates the length of actin filaments by binding, severing, and capping the fast-growing filament ends and promotes actin nucleation. Gelsolin is widely expressed in normal tissues. Decreased gelsolin expression occurs in many transformed cell types and in carcinomas of the colon, bladder, breast, lung, stomach and prostate. Transcriptional silencing of tumor suppressor g...

Amiodarone, an iodine-containing antiarrhythmic drug frequently used in chronic heart failure (CHF) patients, is often the cause of primary hypothyroidism. It has not been well investigated, however, whether its use could lead to a poor prognosis in these patients by inducing and/or worsening thyroid function. The aim of this study was to evaluate the prognostic significance of hypothyroidism detection in CHF outpatients treated with amiodarone. Out of 355 patients affected by...

The primary objective of this observational study was to determine the medical practice for the management of simple goiter in France from a representative sample of general practitioners (GPs) and endocrinologists (ENDOs). As secondary objective, this study reported the incidence rate of simple goiter, toxic and non-toxic nodular goiters in France.Four hundred and sixty-nine general practitioners and 195 endocrinologists participated in the study. Eight...

Introduction: Different nutritional and environmental factors are responsible for pathogenesis of goiter but iodine deficiency is the most important factor. However, little is known about the natural course of benign thyroid nodules in euthyroid patients over time. Few studies have used ultrasonographic evaluation to address this issue, especially in iodine-deficient areas. In this study, we present the long-term follow-up of benign thyroid nodules in a moderately iodine-defic...

Introduction: Recent conducted studies show that clinical hypothyroidism (CH) has similar cardiovascular risk with subclinical hypothyroidism (SCH). Carotid intima media thickness (CIMT) that is an important marker of early atherosclerotic changes is an indicator of cardiovascular events. In our study, we evaluated CIMT in female patients, who have both CH and SCH, with similar age and demographic features.Materials and methods: We recruited 38 healthy f...

Background: Work-up of thyroid nodules remains challenging. Fine needle aspiration (FNA) has been shown to be the most cost–effective way to select patients for surgery with sensitivities of 54–69% and specificities of 60–96% for the detection of malignant lesions. Ultrasound-based Realtime Elastography (RTE) enables the determination of tissue elasticity and has shown promising results for the differentiation of thyroid nodules. A meta-analysis was performed to...

Introduction: Subclinical and clinical primary hypothyroidism potentially makes a negative influence on the patient’s quality of life. Present study examined the level of hypothyroid symptoms and signs expression as well patient’s quality of life before levothyroxine and after substitutionally-induced laboratory euthyroidism.Material and methods: Prospective case–control study consisted of 75 female patients divided into three groups based...

Introduction: Nodular thyroid disease is a common problem in clinical practice. Fine-needle aspiration (FNA) has become the principal test in the diagnosis of nodular thyroid disease. However, sometimes the information provided by this procedure is not definitive as it happens in those cases where the cytologic specimens are suspicious or indeterminate and a clear cytologic diagnosis can not be made. Based on that, we therefore undertook a study to investigate the histological...

Background: Glucocorticoids (GCs) have an important modulatory influence on immune system. GCs accomplish their effects on target tissue through binding to the glucocorticoid receptor (GR). Alterations in glucocorticoid signaling due to polymorphisms of the GR gene may have an impact on the pathophysiology of autoimmune disorders.Aims/methods: We examined the presence of BclI, N363S, A3669G and ER22/23EK GR gene variants in patients with autoimmun...

Objective: Vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor 1 (VEGFR1) are known to be related to thyroid tumorigenesis, but data are limited about their relationship with insulin like growth factor 1 (IGF1) and IGF1 receptor. The aim of this study was to clarify the role of VEGF, VEGFR-1, IGF1 and IGF1 receptor in thyroid tumorigenesis.Methods: We examined 40 patients with differentiated thyroid carcinoma (DTC) a...

Introduction: About 20% of fine needle aspiration biopsy of thyroid (FNA) with result of follicular tumour (FT) is malignant. Several factors have been suggested as indicators of malignancy.Objectives: To determine predictive factors of malignancy in FNA with result of FT.Methods: We evaluated retrospectively 140 clinical files of patients with cytology (ultrasound-guided or palpation) of FT. Presence of relationship between malign...

Objective: Papillary thyroid microcarcinoma (PTM) is a malignant thyroid tumour with potential multifocality and diameter ≤1 cm. Usually is found like incidentaloma, and the epidemiology is not clearly established. We have analysed their epidemiologic in La Palma Island at last 10 years.Patients and methods: We collected all cases of PTM diagnosed in 345 consecutive thyroid surgeries performed for whichever benign thyroid disease (thyrogloss duct c...

CA19-9 (sialyl Lewis[a] antigen) was originally described as a gastrointestinal system and pancreas specific tumour marker. Immunohistochemical studies have demonstrated that CA19-9 is expressed in both differentiated and anaplastic thyroid carcinomas. Increased serum levels of CA 19-9 were reported in few patients with anaplastic thyroid cancer; however, to the best of our knowledge, there is no previous report about serum levels of CA 19-9 in differentiated thyroid cancer. S...

Introduction: Thyroid hormones are the most important factors involved in the regulation of the basal metabolic state, as well as in the oxidative metabolism. Oxidative stress accompanying hyperthyroidism is caused by increased synthesis of reactive oxygen species (ROS) and changes in the antioxidant defence system.Aim of the study: To evaluate the pro-oxidant/antioxidant status and the effect of vitamin E supplementation in damage caused by the excessiv...

Protein kinase C (PKC) is a key enzyme which regulates proliferation, apoptosis and differentiation, representing a pharmacological target for tumor therapy. PKC is a serin/threonin kinase involved in the control of neoplastic transformation, carcinogenesis, neoplastic invasion, chemoresistance. The role of PKC depends on the tissue and on the specific isoform, among the 11 identified so far. In particular, PKC beta II inhibits cell functions, while PKC delta has a protective ...

Introduction: Type 2 amiodarone-induced thyrotoxicosis (AIT) is a form of destructive thyroiditis, commonly responsive to glucocorticoids. On the contrary, type 1 AIT is an iodine-induced hyperthyroidism, occurring in patients with underlying thyroid disease often responding to thionamides.Aim of the study: To compare the effectiveness of methimazole (MMI) or prednisone (GLU) in the treatment of AIT patients with multinodular goiter with biochemical feat...

A 63-year-old woman came to our observation. She has been affected by a nodular goiter for 20 years. She was treated with 6 months short L-thyroxine therapy cycle (75 μg/day); the therapy was interrupted on her own initiative 3 months before we saw her. Symptoms: constriction, tachycardia. US: diffusely enlarged and hypoechogenic thyroid, a 5 cm well defined solid nodule on the right lobe. FNAB: poor colloid, numerous follicular cells, some of them showing ...

A functional sodium iodide symporter (NIS) is essential for radioiodine treatment of thyroid cancer. Unfortunately, most of de-differentiated tumours as well as anaplastic thyroid cancers loss the ability to concentrate iodine. Loss of NIS expression usually depends on epigenetic modifications, suggesting the use of epigenetic drugs as promising tools for re-differentiation. Panobinostat (LBH589) is a novel deacetylase inhibitor, acting at nanomolar concentrations, currently i...

Aim: The aim of the study was to analyze the nodular goiter (NG) natural selection features in modern terms.Materials and methods: The average fertility indices per person, 211 patients with NG from the female cohort of Kharkov (eastern Ukraine) inhabitants, years of birth – 1925–1950, mean age – 58.6±0.5 years with the physiological cessation of fertility and 2105 normal healthy ones were analyzed. The dead (Pd) and...

Introduction: Thyroid nodules are common and are often found incidentally by palpation. Most of thyroid nodules are benign but 0–10% are malignant. A small proportion are due to metastatic lesions from other primary tumors. FNA is a standard diagnostic procedure to differentiate between benign and malignant nodules. But the use of additional immunochemistry markers will be important for diagnosis.Lung adenocarcinoma is one of the tumors which may me...

Aim of the study: The paper presents some clinical and laboratory parameters reflecting activity and severity of Graves ophtalmopathy (GO) and discusses the correlation between them.Subjects and methods: The study included 25 GO cases, with mean age 47.7±11.2 years and a female/male ratio of 21/4. The patients were evaluated clinically, by assessment of thyroid status (TSH, FT3, FT4, thyrotropin receptor autoantibodies (TRAb)) ...

Aim: To evaluate clinical presentation and thyroid dysfunction types in children with thyromegaly.Patients and methods: Thirty-nine children were referred to endocrinologist examination because of thyromegaly. Assessment of clinical history, physical examination, auxological data pubertal staging and complete evaluation of basal thyroid function were carried out in all children. Thyroid autoantibodies, urinary iodine excretion (UIE) and ultrasound examin...

Hypocalcemia is a classic complication after total thyroidectomy, mostly due to post-operative hypoparathyroidism. However others factors, like vitamin D deficiency, may contribute to this hypocalcemia.Objective: To determine if vitamin D preoperative status influence early postoperative serum calcium levels after total thyroidectomy.Patients and methods: Seventy-nine patients (65 women/14 men), mean age 52.8 (±12.7), were inc...

Background: Postpartum mood disturbances occur very often in otherwise healthy women, whereas thyroid function is affected during a normal pregnancy. We examined whether thyroid hormone levels in women free from thyroid dysfunction associate with the prevalence of postpartum mood disturbances.Methods: This cross-sectional study included 57 Greek women. Concentrations of thyroid hormones (free T3, free T4, TSH) and anti...

Because of the increased prevalence of thyroid disorders in Romania we realized a retrospective study in which we followed the variance of TSH, function of temperature, in different seasons. In this context, based on TSH value we appreciated the need of thyroid hormones and antithyroid drugs to maintain an euthyroid state.Material and methods: The group of study consist of 634 patients, men and women over 18-years-old with thyroid disorders: hypo, hyper,...

Background: Thyroid function, insulin resistance, serum lipid, C-reactive protein (CRP) and homocysteine are associated with an increased cardiovascular risk in patients with autoimmune thyroiditis (AIT).Objective: To evaluate the interrelations between thyroid function, insulin resistance, serum lipid concentrations, CRP and homocysteine in patients with AIT and subclinical hypothyroidism.Subjects and methods: We recorded thyroid ...

Introduction: Hypokalemic periodic paralysis associated with hyperthyroidism is a well-known acute electrolyte and acute muscle disorder. Lesser known is normokalemic periodic paralysis associated with hyperthyroidism (TNPP). Because plasma potassium is normal, and it can be misdiagnosed as some other disorder if thyroid function is not evaluated. We report a case of TNPP due to non-autoimmune thyroiditis.Case report: A 23-year-old woman was admitted to ...

Objective: The aim of this study was to assess the value of some clinical and paraclinical factors in an attempt to predict outcome following antithyroid drug therapy.Methodology: We performed a retrospective audit of 101 new patients, aged 16–85, separated into two groups: 59 patients with Graves’ disease (GD) and control group of 42 patients with other ethyologic forms of hyperthyroidism, admitted to our clinic between 2003 and 2008. Data wer...

Background and aim: Papillary thyroid carcinomas (PTCs) with a diameter <1 cm are referred to as papillary microcarcinomas (PTMCs). They are being diagnosed with increasing frequency. Within this type of tumour some clinical and histological characteristics with prognostic and therapeutic impact have been proposed. In the present study we describe the clinical and pathological presentation of PTMCs and compare them with papillary thyroid carcinomas of larger size.<p cl...

It has been reported recently that selenium (SE) administration over a 6-month period significantly improved the eye involvement in patients with mild GO.Aim: To investigate SE levels in such patients and find out if they differ from controls, finding which might explain the beneficial effect of SE in such patients.Patients: One hundred and four patients (82F) mean age 47.88±827 (S.D.) (range 32–65) with mi...

Introduction: The thyroid is a multifaced endocrine gland. By its hormones it has an effect on almost all organs of the body, metabolism and defence system too. The relationship between the thyroid hormones and the nonspecific defence system has been less studied.Aim: To study and prove whether the endogenous thyroxin (FT4) is involved in the nonspecific defence system of the organism. We followed the correlation between the FT4 and...

Various haemostatic abnormalities have been associated with thyroid dysfunction, especially with hypothyroidism. The underlying mechanisms are not well established.The aim of the study was to evaluate the primary and secondary haemostasis in patients with severe hypothyroidism, to assess the role of thyroid hormone deficiency and to determine whether increased serum TSH level despite normal free thyroid hormone concentrations could influence the coagulat...

Congenital hypothyroidism (CH) is frequently associated with congenital heart defects (CHD). Thyroid defects may have a higher prevalence in children with CHD as embryonic thyroid gland share nuclear transcription factors with heart and great vessels during organogenesis. We investigated thyroid function in 325 children (165 M/160 F, aged 0.2–15.4 years), affected by CHD. Patients with Down syndrome, recent administration of iodinated contrast agents, low T3 sy...

Introduction: The incidence of the thyroid carcinoma (TC) is relatively low, although its increase has been observed in the last 20 years.Aim: A comparative clinical and epidemiological analysis of two cohorts of patients surgically treated for the thyroid diseases in the Endocrine Surgery Department in Cracow during two five-year periods: 1982–1986 and 2000–2005.Material and methods: Two subsets of patients, who underwen...

Background: Sales of iodized table salt (household use, bulk containers) have been flat in Germany since 1996/97. Nevertheless, the amount of iodide excreted with the urine has been steadily on the rise in the German population since 1993.Aim of the study: We investigated the beverage iodine levels as possible source of the increased input of iodine into the food chain. No systematic studies on this topic have yet been carried out in Germany.<p class...

Background: Recent regional and German wide investigations have shown that the abolition of the requirement to declare iodine in foodstuffs and the greater emphasis on information about goitre prevention led to an increase in urinary iodine excretion in German schoolchildren. There was also a decrease in thyroid size and goitre prevalence in children. No up to date results in adults for the whole of Germany are available.Methods: In 2005, we examined the...

The phosphodiesterase inhibitor pentoxifylline (PTX) is known to have immunomodulatory effects in some autoimmune diseases. The aim of our study was to assess the influence of glucocorticoids monotherapy and additive treatment with PTX on peripheral blood mononuclear cells (PBMC) proliferation and apoptosis in patients with Graves’ ophthalmopathy (GO).Eighteen patients with GO and 28 healthy controls were investigated. GO patients were divided into ...

Background: Etiology of infertility and miscarriages is multifactorial. Negative impact of overt thyroid dysfunction on fertility, pregnancy and development of offspring is known. Moreover, even presence of euthyroid autoimmune thyroid diseases may increase risk of miscarriages. The prevalence of positive antibodies to thyroid peroxidase (TPOAb) ranges 9–39% in women with recurrent miscarriages and 0–37% in controls. The aim of the study was to compare serum concentr...

Introduction: Serum Ct is considered the most sensitive tool for MTC screening, but with poor specificity. Pg-test sensitivity and specificity are high, but doubtful for 30–100 pg/ml of Ct peak. FNAB is not routinely used due to its very low sensitivity and specificity. Only few studies from a small number of patients are available on the role of Ct measurement in the wash-out fluid (Ct-FNAB) for MTC diagnosis, providing conflicting results.Aim of t...

Papillary thyroid cancer (PTC) represents the majority of differentiated thyroid cancers, presenting in 29–83% of cases the activating BRAF V600E mutation. The aim of our study was to analyse the influence of BRAF V600E mutation analysis on diagnostic accuracy of fine needle aspiration biopsies (FNAB) in clinically unsuspected thyroid nodules. We therefore enrolled 496 patients (383 females, 113 males; mean age 52 years), for a total of 671 samples. FNAB were evaluated by...

Papillary thyroid carcinoma (PTC) is the most common malignancy originating from the thyroid gland. Although occurring predominantly as a sporadic disease, it may be associated with rare inherited circumstances such as familial adenomatous polyposis (FAP) FAP is an autosomal dominantly inherited cancer predisposition syndrome characterized by the progressive development of colorectal carcinoma. Most of available data report accompanying thyroid carcinoma in no more than 1&#150...

Aim: Colonic polyps and thyroid nodules are common diseases and frequency increases with age. In the literature, there is no study investigating the relationship between colonic polyps and thyroid nodules. Therefore, this study was designed to investigate thyroid nodule frequency in patients who have colonic polyps.Material and methods: Sixty-six patients with colonic polyps and 146 patients without colonic polyps enrolled in the study. Age and sex match...

Background: Thyroid ultrasound (US) is not routinely used in the evaluation of hyperthyroidism, although studies show that clinical exam may miss lesions up to 2 cm in diameter. We reviewed our department’s practice of thyroid US to consider (1) accuracy of our clinical diagnosis and (2) whether this could improve management. Our hospital has no facility for isotope scanning.Methods: Seventy-three cases (13 male, 60 female) identified from thyroid U...

Aim: The aim of this study was to compare clinical symptoms and TSH receptor antibodies (TRAb) in Graves orbitopathy (GO) in hyperthyroid patients to those patients with primarily hypothyroid and euthyroid status.Methods: Study group consisted of 54 primarily hyperthyroid (39 female, 14 male, 47±9 years) and 8 primarily hypothyroid and euthyroid patients (5 female, 3 male, 46±14 years). Clinical symptoms and TRAb were assessed. Assessment of th...

Background-aim: Normal thyroid function during pregnancy is critical for fetal development. Deficient maternal thyroid hormone levels are associated with impaired neuropsychological development in childhood, premature birth, preeclampsia and fetal mortality. Conversely, excessive maternal thyroid levels have been linked to fetal loss, disturbed fetal growth, preeclampsia and preterm delivery. Recent consensus guidelines do not advocate universal thyroid function screening duri...

Introduction: Autoimmune thyroid disease (AITD) is a common disease. It arise due to interactions between genetic background and environmental factors. However this interactions remain unclear. As it induces other autoimmune diseases, parvovirus is an attractive candidate.Objective: To investigate the presence of parvoviral DNA in postoperative thyroid tissues.Materials and methods: We collect prospectively postoperative thyroid sp...

Resistance to thyroid hormone (RTH) is a rare dominantly inherited condition of impaired tissue responsiveness to thyroid hormones. Different tissue may exhibit variable degree of resistance and clinical presentation probably depending on the heterogeneity of factors that modulate the isoform of thyroid hormone receptor (THR). The heart shows different isoforms of THR and few data is reported on the cardiac functionally effects of the phenotypic heterogeneity; echocardiography...

A 47-year-old, previously healthy, ex-smoker male presented with a two-week history of dyspnea grade 4 with progressive course, palpitations, orthopnea, and paroxysmal nocturnal dyspnea. There was no history of chest pain or fever, but he had noticed recent an unintentional 10 to 15 kg weight loss over the previous 3 months. There was no previous history of cardiorespiratory problems, hypertension, and diabetes. On examination he was dyspenic, anxious and tremulous. His temper...

One of the most important activating genetic aberrations in differentiated thyroid cancer (DTC) development pathways involves the RET/PTC–RAS–RAF–MAPK axis. Mutations in the RET gene are essential in medullary thyroid carcinoma (MTC). Sorafenib is the first compound to reach clinical practice that is capable of inhibiting all the RAF kinases. Moreover, it targets a panel of tyrosine kinase receptors, such as VEGF receptors which gives to sorafenib not only proap...

Hyperuricemia, results from the disorder of purine metabolism or endocrine system, leads to an inflammatory arthritis and gout. Sesame oil has been reported to have a potent anti-inflammatory effect in various animal models. The aim of the present study is to examine the therapeutic effect of sesame oil on monosodium urate monohydrate (MSU) crystal-induced acute inflammation in air pouch in unanaesthetised Sprague–Dawley rats. Air pouch, a commonly used model for gouty ar...

Genetic predisposition to autoimmunity is probably predominant. Major histocompatibility complex (MHC) alleles and non-MHC loci such as polymorphism of the cytotoxic T lymphocyte antigen-4 (CTLA4) gene have been identified as susceptibility markers. The autoimmune thyroid diseases are the most common organ-specific autoimmune diseases. They are characterized by the infiltration of the parenchyma by immune cells including T and B cells as well as macrophages. Ones a T cell is a...

Objective: The latest studies on Graves’ ophthalmopathy (GO) emphasize the importance of the orbital adipose tissue and fibroblasts in the pathogenesis of the disease by secreting proinflammatory cytokines. In vitro, these cytokines were proved to have a major role in the maintenance and progress of inflammation in the orbit. The aim of this study was to investigate serum cytokine levels in patients with GO.Materials and methods: Serum interl...

It is suggested that radioiodine therapy in hyperthyroidism can increase mortality because of cardiovascular diseases. To determine that fact we have evaluated how the levels of predictors of the cardiovascular risk in serum such as: glucose, insulin, total cholesterol and high-density cholesterol, low-density cholesterol and triglycerides as well as CRP, fibrinogen and D-dimers changed in hyperthyroidism cases before and 12 up to 16 and 24 up to 28 weeks after radioiodine the...

Thyroid lymphoma accounts for less than 5% of thyroid malignancies. The aim of this study was to analyze the particularities of 9 patients (7 females and 2 males, aged 42 to 76 years) diagnosed with thyroid lymphoma, representing 2.45% of 340 cases of thyroid malignancies. Patients were assessed by ultrasound examination (7 cases), fine needle biopsy (FNB) (8 cases), lymph node biopsy (2 cases), and histological examination after surgery (7 cases). Clinically, 6 cases presente...

Introduction: High-resolution US and US FNA are techniques of great relevance in the evaluation of thyroid nodules. They are being used much more often by endocrinologists all over the world. In our Endocrinology Department, we started them in 2006; since then they have been progressively amplified. We present our results of US FNA performed from January 2007 until December 2009.Patients and methods: Two thousand eight hundred and seventy-seven FNA were ...

Aim: Thyroid nodules are frequent in the adult population. Thyroid fine needle aspiration biopsy is the first choice for diagnosing cancer in the nodule. It is suggested that biopsy-proven benign thyroid nodules should be followed up clinically and if they grow, re-biopsy should be performed. However, certain growth criteria have not been defined yet.Method: We retrospectively reviewed thyroid fine needle aspiration records of all patients seen in our cl...

Purpose: Familial medullary thyroid carcinoma (FMTC) is an autosomal dominant inherited disease, characterized by germ-line mutations in the RET proto-oncogene, mainly in exons 10 and 11, but also in exons 13, 14 and 15. Activating germ-line mutations in the RET proto-oncogene cause the development of familial medullary thyroid carcinoma (FMTC) or medullary thyroid carcinoma (MTC) as a part of multiple endocrine neoplasia type 2 syndrome (MEN2).Me...

Fine needle aspiration biopsy is the cornerstone for cytologic evaluation of thyroid nodules. Thyroid nodule prevelance increases with age, however there is no cytologic study exclusively from geriatric patients.We examined the thyroid fine needle biopsy records taken from patients age 65 years or older between January 2006 and June 2009 at Dokuz Eylul University Hospital; and reviewed the cytological results of this group.We analy...

Introduction: Complement mannan-binding lectin (MBL) deficiency is associated with increased susceptibility to infections and autoimmune diseases. Previous studies suggested that the production of MBL is stimulated by thyroid hormones. The aim of our study was to investigate this association in patients with autoimmune thyroid diseases (AITD).Methods: Serum levels of MBL and parameters of the thyroid function were determined in 62 patients with Hashimoto...

Calcitonin (CT) is a sensitive marker for medullary thyroid carcinoma, but its routine measurement in patients with thyroid nodules is a controversial issue. Generally, an elevated serum calcitonin strongly suggests the presence of medullary thyroid carcinoma (MTC); however high CT levels may be found in other thyroid or non-thyroidal conditions. We report the case of a 49-year-old woman who consulted at the ambulatory of endocrinology for recent thyroid soreness. Biological f...

Aim: The role of statins on thyroid cell proliferation is of clinical interest. In this study, we investigated the effect of atorvastatin on papillary thyroid cell line (B-CPAP) and normal thyroid (Nthy-ori3-1) cell lines.Materials and methods: In this in vitro study, B-CPAP and Nthy-ori3-1 cell lines were treated with atorvastatin at 12.5, 25, 50, 100, 200 μM concentrations. At 48 and 72 h MTT, electron microscopy and immunohistochemistry we...

Introduction: Determining TSH in the serum is a basic test for the diagnosis of thyroid function in the general population. Its regulation is based on feedback, however during pregnancy there are other mechanisms – mainly suppression of TSH due to a high hCG and the iodine saturation.Aim: Results of TSH, anti TPOAb and FT4 by ADVIA Centaur (Siemens) in our group of 7530 women living in iodine sufficient area in 9–11 week of pregnancy...

Introduction: Highly sensitive TSH assay is required for thyroid exploration and free thyroxine (T4) concentrations should be measured in some cases of thyroid dysfunction.Objective: To study the analytical performances and reference ranges of new ultrasensitive TSH (TSH3-UL) and new free T4 (FT4) assays performed on the ADVIA Centaur® Immunoassay Systems (Siemens Healthcare Diagnostics).<p class="abst...

Introduction: Peroxisome proliferation-activated receptors-γ (PPAR-γ) have been shown to be involved in adipogenesis as well as in immunoregulation and inflammation control. Orbital fibroblast differentiation to adipocytes is a PPAR-γ dependent process essential for pathogenic tissue remodeling in Graves orbitopathy (GO).Purpose: We studied the occurrence and possible associations of the Pro115Gln and Pro12Ala in the ...

Aim: The aim of the study was to evaluate the patients’ age and goitre size in relation to the form of hyperthyroidism, as well as the relationship between patients’ age and goitre size and function.Material and methods: The subject group included 484 patients (420 females and 64 males) with hyperthyroidism. Graves’ disease (GD) was diagnosed in 171 subjects and toxic nodular goitre (TNG) was found in 313 subjects. FT3, fT4...

Objective: Currently there are three well-established treatment options for hyperthyroid Graves’ disease (GD): antithyroid drug therapy with thionamides, radioactive iodine (RAI) treatment with (131)I, and surgery. The aim of this study was to investigate retrospectively theurapeutic options of the patients with GD treated at outpatient clinics of Endocrinology and Metabolism between January 2007 and December 2009.Methods: We evaluated 122 patients ...

The anti-CD 20 antibody rituximab (RTX) has been employed in the treatment of several autoimmune diseases and its effect may not involve autoantibody secretion. Preliminary studies have shown that RTX induced improvement of active Graves’ orbitopathy (GO) but caused no change of serum anti-thyroid antibodies in relation to peripheral CD 20+ cells depletion, usually observed at the second week after therapy. A 50-year-old woman with GO predominantly active in the left eye ...

We retrospectively collected data from 62 pregnant females who were followed for hyperthyroidism (n=17), hypothyroidism (n=21), euthyroid Hashimoto’s thyroiditis (n=9), and simple goitre and other non-autoimmune thyroid diseases (n=15).Among them 33 showed at least once during pregnancy low FT4, or low FT3 and FT4 in total on 74 occasions. Low FT4 was found on 15, low FT3 on 15 and low FT<s...

Background: Total thyroidectomy is postulated by many centers as the standard procedure in treatment of benign nodular goiter (BNG) to avoid recurrent goiter (reported 30% and more). In our hospital a wide spectrum of methods regarding extent of resection is performed, adapted to morphology and respecting function.We advocate a variable strategy of operations for BNG (selective thyroid surgery, KOCHER 1917) and report on long-term results.<p class="a...

The aim of this study was to perform a randomized study to evaluate the role of haemorheopheresis in the treatment of severe thyroid associated ophtalmopathy (TAO). Twenty patients were enrolled. All patients were treated with methylprednisolone i.v. pulses (Solumedrol 1 g i.v. three times a week for 3 weeks – 9 pulses altogether). Ten randomly chosen patients were also subjected to haemorheopheresis (twice weekly for 2 weeks and than once in 3 weeks – 10 procedures ...

A novel solid-phase-extraction (SPE) method followed by liquid chromatography tandem mass spectrometry (LC-MS/MS) was established for the simultaneous detection and quantification of thyroid hormone profiles in one sample of human or mouse serum.Recovery during preanalytical steps was monitored by addition of an internal deuterated standard (d5-T4) to 200 μl serum, which was deproteinized by adding a precipitating agent consisting of 1% f...

Background: The thyroid isthmus contains no C-cells, thus we established IPTB for cases with nodular goiter and moderate hypercalcitonemia (stimulated up to 350 pg/ml). In these cases C-Cell-Hyperplasia is the primary pathologic correlate. Exclusion criteria were pre- or intraoperative signs of malignancy.We furthermore established IPTB as a prophylactic operation for patients with hereditary medullary thyroid carcinoma, excluding high-risk mutations.</p...

Introduction: Primary endocrine failure in β-Thal is caused by iron overload in epithelial cells and in interstitial macrophages. Autoimmune phenomena are not believed to play any significant role, although iron overload, through non-specific inflammatory process, could trigger autoimmunity, as recently suggested for the pathogenesis of diabetes mellitus in β-Thal patients.Purpose: We investigated thyroid function and anti-thyroid autoantibodie...

Free radicals and reactive oxygen species (ROS) participate in physiological and pathological processes in the thyroid gland. Oxidative stress caused by ROS is involved in many types of DNA damage that are associated with the initiation or the progression of numerous human cancers including thyroid tumors. One of the most mutagenic products of oxygen radical forming agents is 7,8-dihydro-8-oxoguanine (8-oxoG). The aim of the current study was to investigate expression of OGG1 ...

Background: Autoimmune thyroiditis (AIT) is associated with increased risk of cardiovascular disease.Objective: To evaluate the interrelationships between insulin resistance (IR) and other cardiovascular risk factors, such as high sensitivity CRP (C reactive protein) and homocysteine in patients with AIT.Patients and methods: We analysed thyroid function, anti-thyroid antibodies, BMI, indices of IR, such as HOMA-IR, HISI (Hepatic I...

Introduction: Thyroid hormones affect male and female sexual and reproductive function, but few studies have been performed on sexual dysfunctions in hyper- and hypothyroid women.Aim of the study: To evaluate female sexual function in untreated and treated hyper- and hypothyroidism and in euthyroid Hashimoto’s thyroiditis (HT).Patients and methods: Fifty consecutive women (38.5±8.2 years, range 18–53 years), 22 with ...

Background: Thyroid dysfunction and lipid profile are associated with cardiovascular disease in patients with autoimmune thyroiditis (AIT).Objective: To evaluate the association between thyroid function, lipid concentrations, C-reactive protein (CRP) and homocysteine in patients with AIT.Patients and methods: We assessed thyroid function tests, BMI, total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, triglycerides (TG), apoli...

Introduction: Fine needle biopsy (FNB) is a very important diagnostic tool in the assessment of thyroid nodules and plays a prominent role in therapeutic approach. It has a sensitivity around 83 to 85% and a specificity around 80 to 92%.Aims: To correlate cytological (FNB) and final histopathological data in patients with nodular thyroid pathology.Methods: A retrospective study of patients who underwent surgical procedure from Janu...

Introduction: There is no known reliability about an undetectable recombinant human TSH (rhTSH) stimulated serum thyroglobulin (Tg) concentrations, predicts no long-term relapse, or the threshold of it. An rhTSH-stimulated serum Tg determination was made to all patients with DTC that maintained undetectable baseline Tg and negative imaging tests. We correlate their findings with their long-term evolution.Methods: We collected 91 patients with DTC, 73 wom...

Differentiated carcinoma of the thyroid (DCT) of follicular origin is the most frequent endocrine neoplasia and it usually has a good prognosis even in the disseminated disease, due to its slow growing pattern and low dissemination rate. The prevalence of metastasis described in the literature varies between 5 and more than 20%.Aims: To analyze the clinical–pathological data and their relation with survival of patients (pts) with metastatic DTC....

Aim: The aim of the study was to evaluate the relationship between TSHAb levels and thyroid function and size in patients with Graves’ disease and then to estimate the influence of TSHAb on the outcome of 131I therapy.Material and methods: Two hundred and one patients (168 females and 33 males, mean age 47.76 years, range 18–84) with Graves’ disease were enrolled. Before therapy, plasma fT3, fT4, TSH (DELFI...

A 49-year-old man with history of nodular goitre operation was referred to our clinic because of MTC in postoperative pathology. He had hypertension, postoperative hypothyroidism, no family history of thyroid carcinoma and sudden death. Laboratuary investigations showed high level of calcitonin (C) (763 pg/ml; normal<150), Carcino embryogenic antigen (CEA) (175 ng/ml; normal<2.5), normal thyroid function tests, parathormone, urinary catecholamines. Ser904 polymorphism ...

Background: Robotic thyroid operation using the gasless transaxillary approach is an applicable and safe method providing a scarless in the neck result in selected patients. The application of robotic technology offer a three-dimensional view and tremor free movements which enable a potential advantage in recurrent laryngeal nerve and parathyroid glands preservation.Patients and methods: Seven patients with history of bad scars from previous surgeries un...

Usually, the first laboratory marker for thyroid disorders is TSH. FT4 and FT3 must not be measured unless TSH is out of the reference range. However, the reference range for TSH (and for free thyroid hormones) given by the manufacturers of immunoassays may be not completely valid for screening in iodine-deficient areas and among hospitalized patients either.Aim: Our aim was to constitute specific TSH, FT4, FT3...

Background: Fine Needle Aspiration (FNA) is currently the primary diagnostic procedure in diagnosing thyroid malignancy. The aim of this study was to report our experience with FNA, and its accuracy.Materials and methods: Retrospective analysis of 166 patients who were operated of thyroid nodule in our hospital from 2003 to 2008, all of them had a previous FNA cytology results. There were evaluated some clinical variables and the correlation with final h...

Introduction: Tyrosine Kinase Inhibitors (TKIs) are approved for the treatment of several cancers and can induce hypothyroidism by unclarified mechanisms.Objectives: To assess the prevalence of hypothyroidism in patients treated with TKIs.Methods: Retrospective review of clinical records of patients treated with TKIs in our institution between 2003 and 2009. We evaluated parameters such as sex, oncologic pathology, TKI used, TSH an...

Introduction: Procalcitonin (PCT) is currently used as a sepsis marker. Studies have shown that this prohormone is elevated in patients with medullary thyroid carcinoma (MTC) and, additionally, that its assay could have less limitation than calcitonin (CT).Objective: To evaluate the concordance between the values of CT and PCT.Methods: CT, PCT and carcinoembryonic antigen (CEA) were measured in a total of 57 subjects. CEA and CT we...

Introduction: Thyroid hemiagenesis (TH) is a rare inborn anomaly occurring if one of the thyroid lobes fails to develop. Due to limited literature data and lack of large-cohort case–control studies, the clinical significance and management with patients in whom TH was diagnosed, are still a matter of debate. The objective of the study was a complex analysis of a large group of patients with TH in comparison to a control group of subjects born with normal, bilobed thyroid ...

Autoimmune polyendocrinopathy syndromes (APS) gather a wide range of diseases. The association of autoimmune thyroid disease (ATD) with other organ specific diseases is frequent. Atrophic body gastritis (ABP) is characterized by the loss of ClH and intrinsic factor (IF) production. Both ATD and ABP are known to be associated since 1960 but there are scarce publications describing its clinical features.We review patients with this association selected fro...

Introduction: Thyroid hemiagenesis (TH) is a rare inborn anomaly presenting as developmental failure of one thyroid lobe. Recent research on the molecular background underlying thyroid dysgenesis have mainly focused on patients with congenital hypothyroidism. In contrast, subjects presenting TH were only sporadically involved. In addition, whether the same factors are responsible for development of TH and other forms of thyroid dysgenesis is still to be elucidated. Recent stud...

Introduction: Isolated maternal hypothyroxinemia leads to higher prevalence of children autism, attention-deficit/hyperactivity disorder and mild cognitive deficiency. Frequency of hypothyroxinemia among women with gestational diabetes mellitus (GDM) is unclear and routine screening is not well established.Objective: Find prevalence of maternal isolated hypothyroxinemia in women with GDM and assess relations with necessity of insulinotherapy.<p class...

Background: TSH levels within the normal range have been associated with increased blood pressure (BP). TSH itself might be involved, especially as extrathyroidal actions of TSH exist.We investigated whether elevated TSH levels after acute rhTSH administration may result in alterations in BP in euthyroid individuals.Methods: Twenty-six euthyroid female subjects thyroidectomised and on T4 suppressive dose, were evaluated ...

Chronic autoimmune thyroiditis and Graves’ disease (GD) are two forms of autoimmune thyroid disease (AITD).The association of GD or other thyrotoxic forms of autoimmune thyroiditis with one or several toxic nodules is the Marine – Lenhart syndrome (SML). It is a rare pathology with prevalence between 2.7 and 4.1%. Its physiopathology remains complicated and misunderstood, incriminating antithyroidian auto-antibodies such as TSH re...

Background: Subclinical hypothyroidism (SH) is an endocrine disorder defined by increased thyrotropin (TSH) levels associated with normal free thyroxine (fT4) and free triiodothyronine (fT3). Resistin is secreted from the adipose tissue and is reported to be associated with insulin resistance and/or inflammation. High-sensitive CRP (hs-CRP) is a reliable marker of inflammation. Data related to levels of resistin and hS-CRP in SH is limited.<p class="a...

Introduction: Diagnosis of autoimmune thyroiditis is made by determination of elevated antibodies against thyroid peroxidase and thyroglobulin, and a hypoechoic pattern in ultrasound. In the present study we have performed a grey-scale quantitative analysis of thyroid echogenicity in the patients affected by autoimmune thyroiditis, obtaining the degree of hypoechogenicity associated with the appearance of thyroid dysfunction.Material and methods: Six hun...

Objectives: Ultrasound-guided fine needle aspiration biopsy (US-FNAC) technique has the advantage of obtaining tissue for cytological examination. The diagnostic yield may depend on factors related to both technical aspects and the lesions sampled. However, the variability between experienced and inexperienced physicians in obtaining adequate cytological sample has not been specifically studied previously. The aim of the study was to determine whether there is a difference in ...

Introduction: Even the differentiated thyroid neoplasm have good prognostic, there are some particular cases that become very aggressive in short time, with poor management.Aim: We report a female case diagnosed with invasive papillary thyroid carcinoma.Case report: Seventy-three-year old female was diagnosed at age of 71 with a right lobe thyroid nodule (of almost 6 cm). At that moment the computed tomography (CT) of the cervical ...

Objective: The evidence regarding association between thyroid diseases and benign and malign breast diseases is increasing. It has been shown that thyroid disorders are more frequent in those with benign breast diseases and that different thyroid diseases have associations with benign and malign breast diseases and their outcomes. In this study, we aimed to reveal the frequency of benign breast conditions in patients with nodular thyroid disease and Hashimoto’s disease.</...

Background: Angiogenesis are correlated with the aggressiveness, evolution’s rapidity and appearance of the locally advanced and metastatic medullary thyroid cancer (CMT), but in the same time is a selection criteria for actual therapy tested in the clinical studies.Objective: Study of angiogenesis in patients diagnosticated with CMT.Methods: Our study is conducted for 20 patients with sporadic and familial CMT, who are diagno...

Measuring of goiter by ultrasonography is one of the generally accepted methods for iodine nutrition assessment. Discordance between previously used and lately proposed thyroid volume (TV) reference values (TVRV) is the subject of discussion and makes it difficult to properly interpret the effects of iodine prophylaxis.Aim: To establish TVRV for Polish schoolchildren population.Material and methods: 2903 schoolchildren aged 6–...

The aim of the study was to assess lipid status in subjects with hypothyroidism (overt and subclinical) and hyperthyroidism. Therefore, we analyzed the relationship between the levels of blood lipids (Lp(a), Apo AI, Apo B, Apo AI/B, total cholesterol (TC), triglyceride (TG), LDL, HDL, LDL) and TSH, FT4, T3, TPOAb concentration. The study groups included 38 subjects with overt hypothyroidism (mean±S.E.M., age 48.6±13.25 years), 30 ...

Introduction: Sorafenib, an orphan medication, is an oral protein kinase inhibitor, used in the treatment of hepatic, advanced renal and breast cancer, or metastatic iodine-refractary thyroid cancer. The drug also inhibits angiogenesis, and VEGF, having a dual effect on the tumor cells as well as on the tumor vasculature.Aim: We present a case with hyperthyroidism, as adverse effect of the therapy with sorafenib, but with no markers of thyroid autoimmuni...

Objective: The metabolic syndrome (MetS) is a cluster of metabolic abnormalities with insulin resistance (IR) as a major characteristic. It has been recently questioned that MetS and its related components are associated with functional and morphological alterations of thyroid gland. Aim of our study is to examine thyroid volume and nodule prevalence in patients with MetS in a mild-to-moderate iodine deficient area.Design: Two hundred and seventy-eight p...

Background: Few cases of hypersensitivity of thyroid–pituitary feedback in hypothyroid children were reported.Aim: To present a family with asymptomatic, severe biochemical primary autoimmune hypothyroidism who showed a marked sensitivity of pituitary feedback to levothyroxine treatment.Methods: TSH was measured by 3rd generation immunoassay kit.Case report: R.G, woman, aged 22, presented for asymptomati...

Differentiated thyroid carcinoma represents a small percentage of human carcinomas. However, it is the commonest endocrine neoplasm and if diagnosed and treated properly does not affect the long-term survival of the patients.Aim: The aim was to study differentiated thyroid carcinoma affecting young adults.Patients and methods: All patients presenting with thyroid carcinoma to the department from 01.01.2002 to 31.12.2008 were review...

We aim to distinguish malignant from benign thyroid nodules by their molecular profiles. To this end we employ a range of different genomic and epigenetic technologies such as classical whole genome microarray based transcriptomics, integration and meta analysis of published microarray data, DNA methylation testing and micro-RNA profiling. Our transcriptomics and meta analysis approaches include all major histological entities. The other approaches (DNA methylation and microRN...

Goiter frequency (GF) in schoolchildren and urinary iodine concentration (UIC) in an appropriately large population sample are iodine nutrition (IN) best indicators. GF in mildly iodine deficient areas should be assessed ultrasonographically, as palpation sensitivity in such cases is low.Aim: To assess thyroid volume reference values as IN marker in population with recently introduced obligatory iodine prophylaxis (OIP).Material an...

Background and aims: Thyroid disorders (TDs) are frequent in women of reproductive age, with a major influence on both female reproductive function and fetal development. During pregnancy, TDs associate a high risk of miscarriages, premature birth or neonatal morbidity. Our study aimed to assess both TDs prevalence in pregnant women and the need to adjust the necessary treatment during pregnancies complicated with TDs.Patients and method: This is a retro...

Aim: The aim of our study was to evaluate the short-term (5 years) effect of radioiodine therapy (RAIT) on the achievement of euthyroidism, and prevention evolvement to overt hyperthyroidism.Material and methods: We treated 150 patients, aged 30–70 years; 54 patients with multinodular goitre (MNG), and 96 patients with autonomous nodule (ATN). Malignant changes were excluded in all nodules by fine needle aspiration biopsy. All the patients had serum...

Oxidative stress plays an important role in hyperthyroidism-induced tissue damage. We aimed to determine whether radioiodine therapy has benefit effect on the oxidant and antioxidant status in patients with Graves’ Disease.Material and methods: We studied 30 patients with Graves’ disease, aged 18–48 years. 12 normal adult volunteers were studied as control group. All the patients were treated unsuccessfully by antithyroid drugs. The effect...

The widespread of sensitive imaging methods have substantially increased the incidental finding of subclinical thyroid nodules. The ‘epidemic’ of thyroid incidentaloma has raised numerous discussions regarding their management: Is it necessary to investigate all nodules or is surveillance sufficient? Which criteria should be used in order to identify the nodules which must be investigated by fine-needle aspiration (FNA) (size, echogenicity, vascularisation)? Should w...

Objective: Aiming at the highest specifity in differentiating benign from malignant thyroid nodules effects in new diagnostics developments. Recent technologies such as elastography enable determination of tissue stiffness difference between focal lesions and surrounding thyroid tissue – reference tissue. This method is based on quantifying the stiffness of the lesion – the malignant changes show decreased elasticity when compared to adjacent tissue. Tissue Doppler u...

Introduction: The recognition of thyroid microcarcinoma has been increasing in recent years probably as a result of the widespread use of ultrasound-guided fine-needle aspiration biopsies (FNAB) of small non palpable nodules and possibly of a more extensive histological examination.Objectives: To describe clinical and histological characteristics of papillary thyroid microcarcinoma and compare them according to its size (< or ≥5 mm).<p clas...

A young woman aged 23 years, with non-toxic goiter was treated in our Department. Serum levels of FT4, FT3 and TSH were within normal range, high resolution ultrasonography show very large glands (60 ml), with large nodule in left lobe and smaller one in the right lobe. Malignancy was ruled out by ultrasound-guided fine-needle aspiration biopsy. Thyroid radioiodine scintigraphy showed homogenous and diffuse uptake in the right lobe, with very low uptake i...

The aim of the study was to investigate the relationship among the indices of insulin resistance (IR), the lipid parameters and thyroid function in euthyroid adults.Material and methods: Two hundred and sixteen euthyroid adults, mean age 57.08±13.81 years (112 female and 104 male) were included. Serum lipirds, Immunoreactive insulin, glucose, TSH, waist circumference (WC), body height and weight were measured. HOMAi and BMI were calculated.<p cl...

Introduction: The relation of hypothyroidism with the breast cancer is described early in the literature based in some common pathophysiological paths which associate thyroid gland and breast tissue.Methods: A literature research in PubMed and Cochrane library database was performed for articles studying any possible association between the risk for development of breast cancer with the presence of hypothyroidism history in women.R...

We studied 152 patients with Graves’ disease mild orbitopathy (GO), with a disease duration of <18 months, who had been euthyroid for at least 2 months after antithyroid drug or surgery, or 6 months after 131-Iodine. No patient received previous treatment for GO, except for local measures. Patients were randomized to receive either selenium (SE), an antioxidant (as selenium selenite, 100 (g b.i.d), or pentoxifylline (PF), an anti-inflammatory and antifibrotic agent (6...