Endocrine Abstracts

Background: The clinical attitude to the treatment of Bethesda System Category III lesions has been under controversy. Our aim was to analyse three variables and to establish a possible predictive value for carcinoma in patients with AUS/FLUS nodules.Methods: Retrospective study of 671 thyroid fine-needle aspirations (FNAs) classified as AUS/FLUS between January 2012 and June 2015. Size, sex and age were analysed, using SPSS.Result...

Thyroid storm (TS) is a rare but life-threatening manifestation of thyrotoxicosis.Objective: To describe the clinical features and outcomes of patients admitted for TS according to Burch-Wartofsky’s score (BW).Methods: A retrospective review of subjects admitted to a single hospital from 2009 through 2015 was conducted.Results: 15 cases were identified. Etiology: autoimmune (n=8), factitious (<e...

Objective: Hashimoto’s thyroiditis (HT) is extremely common, particularly among women. Mean platelet volume (MPV) and platelet distribution width (PDW) are the measure of platelet size. We aimed to investigate MPV and PDW levels in euthyroid woman with HT.Methods: This was a retrospective study in which the data were obtained from a computerized patient registry database. We evaluated 145 women with HT and 60 matched healty controls, who applied to ...

Background: Insulin-like growth factor-1 (IGF-1) is known to be closely related to the growth of thyroid cells and thyroid diseases. However, the association between IGF-1, thyroid nodule, and thyroid cancer has not been clearly established yet. Therefore, this study investigated the association between IGF-1 and thyroid nodule size.Methods: A total of 346 patients with thyroid nodules confirmed by ultrasonography were included. For all participants, the...

It is known that thyroid peroxidase is expressed on the apical surface of thyrocytes, where catalyze the iodination of thyroglobulin and may, also, be a surface-cell antigen, which involves in the complement-dependent cytotoxicity reactions. Objective: to study the immune status indicies depending on thyroid peroxidase (anti-TPO) antibodies in patients with Graves’ disease (GD). Materials and methods. The study included 35 women aged from 18 to 55 years, mean age of 39.1&...

Objective: By the definition of vitamin D receptors in many tissues, many functions of vitamin D other than calcium homeostasis and bone metabolism were shown. A role for vitamin D is suggested in the pathogenesis of Graves disease because of the effects of vitamin D on the immune system. In our study the role of vitamin D deficiency in the activation of Graves disease, development of autoimmune thyroid disease and the relationship between vitamin D and inflammatory markers we...

Vitamin D has a role in the pathogenesis of thyroid autoimmunity.There is evidence in humans that serum levels of 1,25(OH) D3 were found to be significantly lower in patients with autoimmune thyroid diseases.We have evaluated all samples performed in the endocrine labs tested for vitamin D, AbTg, Ab-TPO and TSH from 2006 to 2015; 29216 samples for vitamin D and 41014 for TSH, AbTg and TPO were considered.We s...

Introduction: Polymorphisms of the receptor for advanced glycation end products (AGEs), RAGE, have been associated with autoimmune disorders and their complications. There are no studies concerning Hashimoto’s thyroiditis (HT); the aim of our study was to investigate the possible role of two RAGE polymorphisms (−429T>C, −374T>A) in combination with indices of oxidative status in women with HT.Design: We examined 300 euth...

Methods: To evaluate factors influencing the relative risk (RR) for vocal fold paralysis we analyzed 3019 patients (69.5% female) having surgery for benign thyroid diseases (58.7% nodular goiter, 17.5% inactive nodes, 16.3% thyroid autonomy, 6.5% Grave’s disease). Operations were performed with intraoperative neuromonitoring by general surgeons (GS, n=1637) or physicians specially trained for ENT (n=1382). 19.2% of the procedures were carried out by resi...

Introduction: Thyroid incidentaloma detected by FDG-PET/CT (flourodeoxyglucose positron emition tomography/computed tomography) is important because of high rate of malignancy. Elastosonograpghy has proven valuable in discriminating malign and benign thyroid lesions. In this study, we aimed to evaluate PET incidentalomas by ultrasonography and elastosonography and to compare cytopathological results with imaging findings.Methods: A total of 50 patients i...

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Introduction: Oxidative stress has been implicated in the pathogenesis of many thyroid diseases, such as non-toxic nodular goiter and Hashimoto’s thyroiditis. Nitric oxide synthases are responsible for the synthesis of nitric oxide from L-arginine. There are three isoforms of nitric oxide synthase (NOS): neuronal NOS (nNOS), endothelial NOS (eNOS) and inducible NOS (iNOS). They have important functions in inflammation and vasoregulation but their role in thyroid diseases ...

Introduction: Atrial fibrillation (AF) occurs in up to 15% of patients with hyperthyroidism. Although hyperthyroidism is usually regarded as a reversible cause of AF, spontaneous sinus conversion occurs in only 2/3 of patients upon the normalization of T4 levels. The aim of this study was to identify factors associated with persistent atrial fibrillation after restoration of euthyroid state.Methods: We conducted a retrospective study of 13 years. Twenty ...

Introduction: Smoking affects thyroid function, the magnitude and direction of the effect varies greatly with different studies. Less is known about the effect of smoking in thyroid function during pregnancy.Materials and methods: Healthy pregnant women with not known thyroid dysfunction were questioned about smoking habit in the first trimester of pregnancy. Blood samples for TSH, free T4 (fT4) and free T3 (fT3) were obtained in each trimester and for t...

Hyperthyroidism whether endogenous or exogenous in origin causes hemodynamic changes which associated with adverse cardiovascular outcomes. Ambulatory arterial Stiffness index (AASI) is a non invasive way of measuring arterial stiffness. Short term BP variability is derived from 24-hour ambulatory blood pressure monitoring (ABPM) recordings. BP variability and AASI are associtaed with increased cardiovascular risk.We aimed to investigate AASI and short t...

Aim: To investigate the herbal medicines (HM) used for thyroid disease, their effects and use rates in Turkey.Materials and methods: A total of 547 patients (494 females and 53 males) had a thyroid disease were included in the study. The patients were questioned whether they used any alternative therapies or HM for their thyroid disease. The patients who used HM were asked about the kind of the HM, and duration of use. The data regarding the dose of the ...

Widespread use of ultrasound has led an increase of patients with thyroid nodules. But individual scores of ultrasound images leads to different estimates of the results and the misunderstandings between specialists. A decision of problem is possible through standardization based on TIRADS.Purpose: Evaluated the impact the application of TIRADS and TBSRTC on medical assistance to patients with thyroid nodules. The examination dates of 4415 people was est...

Objectives: To define sonographic and color Doppler peculiarities of thyroid nodules influencing the efficacy and follow-up principles of percutaneous laser ablation (PLA).Methods: Three hundred forty-five thyroid nodules were treated with 1–3 PLA sessions and subsequently sonographically examined every three months within one year. Indication for PLA was increase sizes of nodules. All nodes were benign according to FNAB.Resul...

Background: The incidence and prevalence of overt hypothyroidism have been reported to be 2 to 4/1,000 population/year and 8 to 13/1,000 population, respectively, in foreign countries. As there has been no nationwide survey to obtain data in Korea, the present study investigated the incidence and prevalence of overt hypothyroidism in Korea using claims data provided by the Health Insurance Review and Assessment Service. The proportions of causative diseases for hypothyroidism ...

Introduction: The prevalence of palpable nodules varies between 3–7% and nodules diagnosed by ultrasonography between 20–76%. According to the American Thyroid Association’s guidelines it isn’t recommended to perform routine thyroid ultrasound for thyroid nodules diagnosis, unless they are palpable or there are any risk factors.Objective: Evaluation of sonographic and cytological differences between palpable and non-palpable thyroid n...

Background: Selenium is an important trace element for thyroid hormone metabolism and its deficiency can cause hypothyroidism. Serum or plasma selenium concentration has been known as best biomarker which reflects selenium intake and reserve. We preliminarily assessed the serum or urine selenium concentrations in patients with thyroid disease compared to healthy normal population. We also investigated the correlation of serum selenium concentration with urine selenium concentr...

Introduction: Association between high thyrotrophin receptor antibodies (TRAb) and relapse of thyroid cancer in Graves’ patients was reported previously. In this study, we aimed to investigate possible relation between TRAb and thyroid malignancies in patients with toxic multinodular (TMNG) and toxic nodular goiter (TNG).Methods: Thyroidectomized patients with a preoperative diagnosis of TMNG, TNG and euthyroid multinodular or nodular goiter (MNG/NG...

Introduction: The predictors of malignancy are important for decision of appropriate management in nodules with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS). Our aim was to determine the ultrasonographical, clinical and biochemical predictors of malignancy in these patients.Methods: A total of 427 patients with Bethesda Category III (AUS/FLUS) thyroid nodules were included in this retrospective study. We d...

Hashimoto’s thyroiditis is thought to result from the decreased of T helper type 2 (Th2) responses, leading to progressive destruction of thyrocytes. IFN-λ1, -λ2, and -λ3 (also known as IL-29, IL-28A, and IL-28B, respectively) is a recently described member of the IFN-λ family and has been shown to decrease production of Th2 cytokines in vitro. However, the role and mechanism of IFN-λ1 in Hashimoto’s thyroiditis remain unkno...

Background: Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) is a heterogeneous that cannot be definitively diagnosed as benign, malignancy-suspect, or malignant. The estimated risk of AUS/FLUS malignancy is reported 5% to 15% according to the Bethesda System (BS). This study was conducted to evaluate the ability of mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR) to predict the malignant potential of nodules diag...

Introduction: We aimed to determine demographical, hormonal, ultrasonography(US) and cytological features of cases with neck lesions that are located outside the thyroid region and have similar echogenity with thyroid tissue.Method: Neck US reports of patients who underwent fine needle aspiration(FNAB) under US guidance in our clinic in a period of one year were reviewed retrospectively. Lesions having similar echogenity with thyroid tissue and defined a...

The cellular structures lipid peroxidation related to immune system dysfunction seems to have a key role in autoimmune theory of Graves’ disease (GD). Aim: to investigate chemiluminescent (CL) activity of blood neutrophilic granulocytes in patients with GD. Materials and methods: Twenty six women, mean age 40.7±13.2, with manifestation of GD up to antithyroid therapy and 30 sex- and age-matched healthy subjects were examined. Serum thyroid hormone concentrations were...

Introduction: The usual treatment for autonomously functioning benign thyroid nodules was surgery until the advent of new techniques such as radiofrequency ablation (RFA). This study aimed at estimating RFA efficacy of autonomously functioning benign thyroid nodules.Material and Methods: The analysis included the results of treatment of 108 patients with autonomously functioning benign tumors of the thyroid gland, received in the Samara Oncology Center. ...

Background: Recent studies suggest enhanced peripheral thyroid hormone metabolism as an explanation for the changes in thyroid hormone levels in patient treated with Sorafenib.Methods: In this single centre, prospective, observational cohort study 60 patients with hepatocellular carcinoma were treated with Sorafenib. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) were measured at baseline (time-0), at 6 weeks (time-1) and at the end of therap...

Objective: The number of studies that investigate thyroid functions in obese patients is limited, and little known about the effect of co-existence of type 2 diabetes mellitus on thyroid functions. In our study, we aimed to evaluate the spectrum of thyroid function in the both diabetic and non-diabetic obese patients.Materials-Methods: 145 obese patients who were admitted to our department of endocrinology and metabolism, between June 2014 and December 2...

Introduction and aims: TGF-β1 participates in the pathogenesis of autoimmune diseases e.g. diabetes, Hashimoto disease, autoimmune digestive system disorders. The aim of our study was to evaluate TGF-β1 levels during pregnancy and after childbirth in women who developed postpartum thyroiditis (PPT) in comparison to the healthy control group (CG) and women with positive anti-thyroid antibodies (ATA+) who did not develop PPT.Material and method: ...

Introduction: Thyroid goiter may be present in different thyroid pathologies, such as non-toxic nodular goiter (NTNG) or Hashimoto’s thyroiditis (HT), as a result of focal hyperplasia of thyrocytes (nodal goiter) or generalized enlargement of thyroid (diffuse goiter). Previous studies have demonstrated that programmed cell death, known as apoptosis, plays an important role in the pathogenesis of many thyroid diseases, especially inflammatory conditions.<p class="abste...

Introduction: Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) termed as Bethesda Category III constitute 15–30% of thyroid cytology. However, the risk of malignancy in this heterogenous category is estimated as 5–15%. The recent studies has been reported the malignancy rate in the wide range of 6–48%. This causes surgical approach variability between different centers. We aimed to evaluate the initial malignancy rate...

Bakground: Thyroid-lobectomy is a frequent procedure performed in patients with a variety of thyroid conditions.The aim of this study is to determine the prevalence of post-operative hypothyroidism and the risk factors of hypothyroidism in patients undergoing thyroid-lobectomy.Patients and methods: We retrospectively reviewed patients who underwent a thyroid lobectomy for benign disease from january 2000 to 2014. Patients with known hypothyroidism before...

Introduction: Associations of autoimmune thyroid disease (AITD) with autoimmune gastri-tis and mental disorders have been suggested, but evidence for a connection is lacking.Methods: We compared the co-incidence of parietal cell antibodies (PCA>20 RE/ml), intrinsic factor antibodies (IFA>1.19 AU/ml), vitamin B12 plasma levels (<200 pg/ml) and mental illness in patients with AITD (n=398), e.g. active (TPO+), atrophic (TPO−) and ...

Objective: Hashimoto’s thyroiditis is a common autoimmune disorder. A few studies have analyzed the association between serum vitamin D levels and Hashimoto’s thyroiditis and available data remains inconclusive. The aim of this study was to evaluate the association between serum 25-Hydroxy vitamin D levels in pre- and postmenopausal woman with Hashimoto’s thyroiditis.Methods: We evaluated 120 premenopausal women with euthyroid Hashimoto&#1...

Introduction: Agranulocytosis represents a serious complication of thyreostatic (ATD) treatment. The aim of our work was to determine how often did agranulocytosis occur in Graves’ disease patients admitted to the thyroid treatment department of our clinic for RAI treatment between the years 1999 and 2014.Patients and methods: We have retrospectively analysed 699 patients (572 women and 127 men at the average age of 51.5±12.9 years). 327 (47%) ...

Objective: Whether additional immunosuppressive drugs to standard treatment with thyreostatic drugs reduce the risk for relapse in Graves’ disease is not well understood. We performed a systematic review and meta-analysis to study the effects of immunosuppressive drugs on relapse rate and treatment effect of patients with hyperthyroidism due to Graves’ disease.Methods: We searched PubMed, EMBASE and Cochrane in July 2015 for randomized-controll...

There is evidence that vitamin D has a variety of effects on immune system function, which may enhance innate immunity and inhibit the development of autoimmunity. It suppresses T-cell proliferation, and inhibits secretion of pro-inflammatory Th1- and Th2-related Cytokines. In Graves’ ophthalmopathy (GO), a diffuse infiltration of lymphocytes is seen in the orbital adipose tissues and extracellular muscles. Th1 and 2 appear to play a role GO.Aim: To...

Background: Amiodarone is an antiarrhytmic drug used mainly in atrial fibrillation. Amiodarone-induced thyrotoxicosis (AIT) is less common than hypothyroidism, but it represents a true therapeutic challenge. AIT can be due iodine load (type 1) or a destructive thyroiditis (type 2).Methods: Retrospective study of patients with AIT, diagnosed between 2010 and 2015, in a central hospital. We reviewed medical records regarding age, gender, amiodarone therapy...

Objective: It is recognized that autoimmun thyroid dysfunction is associated with weight and metabolic changes, insulin resistance and type 1 diabetes. In this study, we aimed to investigate whether thyroid autoimmunity had an effect on insulin sensitivity in euthyroid woman with Hashimoto’s thyroiditis.Methods: Forty-seven newly diagnosed euthyroid woman with Hashimoto’ thyroiditis with a mean age of 43 years were included in the study. The co...

Introduction: Thyroid dyshormonogenesis (TD) accounts for 15–20% of congenital hypothyroidism (CH). Levothyroxine is the treatment of choice with the immediate goal to raise the serum T4 as rapidly as possible. Surgical treatment is indicated in case of compressive or suspected goiter.Patients and methods: Seventeen patients with thyroid dyshormonogenesis belonging to 4 Tunisian families were included in a descriptive prospective study. They were fo...

Background: (Pro)renin receptor[(P)RR] is a multi-functioning transmembrane protein which plays key roles in the regulation of tissue renin-angiotensin system (RAS). (P)RR is cleaved by furin to generate soluble (P)RR[s(P)RR], which is secreted into extracellular space. We previously reported that high blood concentration of s(P)RR indicates poor organ prognosis in several diseases. In this way, s(P)RR is expected as a candidate biomarker for reflecting the tissue RAS status, ...

Introduction: We aimed to investigate the conjunctival surface changes in Hashimoto’s thyroiditis (HT) patients and controls comparatively, and search the correlation of these changes with thyroid functions and thyroid autoantibody level in patients without thyroid associated ophthalmopathy (TAO).Methods: A total of 25 patients with HT and 33 healthy individuals were enrolled in the study. Serum TSH, fT4 and fT3 level, and anti...

Introduction: During pregnancy, the thyroid volume (TV) increases by 20% to 35% in areas with iodine deficiency. In iodine-sufficient countries, while some studies showed an increase in TV by 10–15%, others did not observe any change in TV during pregnancy. Thyroid nodules may be present in up to 15–35% of pregnant women in areas with moderate iodine deficiency. However, in areas with iodine-sufficient, thyroid nodules were investigated in a few number of studies...

Introduction: The changes observed in thyroid ultrasound during pregnancy are related to the nutritional status of iodine, but its association with TSH levels or the presence of thyroid peroxidase antibodies (TPOAb) is unclear.Objective: To compare the relationship between the findings in thyroid ultrasound and thyroid function tests in the first trimester of pregnancy in an iodine sufficient area.Subjects and methods: We conducted...

Thyroid Doppler ultrasound (TDUS) is highly used in the evaluation of thyroid nodules (TN). Malignant thyroid pathology has been more frequently associated with central vascularization of such nodules. There is controversy regarding the usefulness of the Resistance Index (RI) in the assessment of TN.Our aim was to analyze the utility of vascularization characteristics and RI at TDUS in the distinction of benign and malignant TN.Mat...

Aim: Euthyroid sick syndrome can be described as abnormal findings on thyroid function tests that occur in the setting of a nonthyroidal illness (NTI) without preexisting hypothalamic-pituitary and thyroid gland dysfunction. In this study we tried to compare thyroid function tests between patients with acute kidney injury (AKI) and healthy controls.Materials and Methods: This study consisted of 31 patients with AKI and 26 healthy controls. All patients&#...

Background: Graves’ disease (GD) and Hashimoto’s thyroiditis (HT) are common disorders with an autoimmune etiology, which are known as autoimmune thyroid diseases (AITD). A specific seasonal pattern of the month of birth has been suggested in several autoimmune disorders, supporting the hypothesis of a link between viral infections and the development of aberrant immune-regulatory mechanisms. However, there are few studies which specifically address this issue in AIT...

Introduction: In hyperthyroid patients mortality is increased by 20%, the major causes of death being cardiovascular disorders. Recent data suggest that subclinical or treated thyroid disease is associated with increased long-term vascular risk despite restoration of euthyroidism.Methods: We measured high-sensitivity C reactive protein (hs-CRP) in 116 newly diagnosed Graves’ disease (GD) patients, without prior antithyroid treatment. Levels of hs-CR...

Introduction: Amiodarone induced thyrotoxicosis (AIT) occurs in 5–10% of patients and may occur at any time throughout the course of treatment including months after discontinuation. Two distinct forms of AIT are distinguished and treated differently. Iodine-induced hyperthyroidism, typically seen in patients with underlying thyroid disease, is referred to as typ1 AIT and treated with high doses of thionamide antithyroid drugs and perchlorate. Type 2 AIT is a destructive ...

In our centre, thyroid core-biopsy (CB) has replaced fine needle aspiration biopsy (FNAB) in the study of thyroid nodules because its better accuracy. International guidelines recommend repeating the FNA in cases of inadequate or insufficient first specimen, but nothing is published about the case in failed CB.Objective: To study the differences between nodules with inadequate and diagnostic thyroid Core Biopsy and the accuracy of repeating a CB after a ...

Background: Three deiodinase genes (DIO) play an important role in thyroid hormone metabolism. Among them, type 2 iodothyronine deiodinase (DIO2) converts T4 to T3 in brain and impaired psychological well-being was reported in minor variants of DIO2. However, the prevalence of three DIOs and their relation to neuropsychological status has not been evaluated in Asian hypothyroid subjects.Methods: We prospectively enrolled 196 subjects who were taking levo...

Background: It was noted in the last few years there was an increased incidence of vasculitis and vasculitic reactions in patients with thyrotoxicosis. Those vasculitic reactions ranged from simple purpuric skin lesion to sever intra-alveolar hemorrhage and even to Steven Johnson Syndrome, Most of those vasculitic reactions occurred in patients receiving propylthiouracil or methimazole. But many other cases were detected in thyrotoxic patients even be...

Introduction: Diagnosis of sub acute thyroiditis is readily considered in a patient presenting with classical history and characteristic clinical features. Confirmation of diagnosis is based on particular set of laboratory investigations and supported by characteristic imaging findingsof Tc-99 scan. However, prescence of sub acute thyroiditis with normal thyroid scintigraphy findings is exceedingly rare.Case report: 51 years old postmenopausal female wit...

Objective: Radioiodine (RAI), surgical and anti-thyroid drug therapy are the main options to treat Graves’ disease (GD). The aim of this study was to investigate theurapeutic options, their efficacy and adverse reactions of prophilthiouracil (PTU) and methimazole (MMI).Design: A total of 650 patients with GD were evaluated retrospectively. Treatments, adverse reactions, clinical and laboratory results were recorded. After 18 months of primary medica...

Introduction: Many original research studies describes significant impact of thyroid hormones on muscle tissue. Hypo- and hyperthyroidism cause both functional and structural damage of muscles presented by many signs and symptoms of thyroid myopathy. Thus, it is interesting to compare the impact of thyroid dysfunction on hormones secreted by muscles – myokines.Aim: The main goal of the project is to assess serum concentration of three myokines &#150...

Thyroid function in pregnancy differs between populations. The aim of the study was to assess thyroid parameters in Polish pregnant women. It included 1095 pregnant volunteers aged 16–42 years (174, 501, 420 in the 1st, 2nd, and 3rd trimester, respectively), who gave their informed written consent. In each woman thyroid ultrasound was performed, 90.7% had TSH, fT4 and a-TPO measured, and 84.0% iodine urinary concentration (UIC) in urine spot sample estimated.<p class=...

Levels of thyroid hormones may effect the levels of the glycation product and those of the oxidation products.Objective: To evaluate the relationship between skin autofluorescence (SAF), and serum advanced glycation end products (AGEs) parameters in hypothyroid and hyperthyroid patients.Method: Newlydiagnosed or untreated 100 overt and subclinical hypothyroid patients (42±13 yrs) and 50 overt-subclinical hyperthyroid patients ...

Introduction: Ectopic thyroid tissue (ETT) is a rare entity; it is more frequent in women (80%) and is usually located along the obliterated thyroglossal duct. ETT in the midline is even rarer (1.79%). Incidence of malignancy in this group is lower than in orthotopic thyroid nodules.Case report: A 40 years old woman, resident in iodine sufficient area, but originating from an iodine deficient area, presented for a midline neck mass. TSH and FT4 were meas...

Introduction: Thyroid dysfunction may cause various psychiatric symptoms and disturbances. In addition, many factors affect the variable responses to hormone replacement. Many patients treated for Hashimoto thyroiditis(HT) report persistent impairments in general well-being despite long-term L-thyroxine (LT4) replacement and restoration of biochemical euthyroidism.Aim: To investigate the prevalence of depression and anxiety in patients with HT on long-te...

Selenium (Se) supplementation has been adopted as treatment for patients with elevated autoantibodies or in patients with mild Graves’ orbitopathy. However, serum Se concentrations or other markers of Se status are usually not determined during treatment. The aim of our study was to measure serum Se concentrations at regular intervals during treatment and to register any side effects.Twenty patients with mild orbitopathy and twenty patients with act...

Introduction and aims: Subacute thyroiditis (ST) is a spontaneous remitting inflammatory disease of thyroid gland. Although there is no clear evidence for its specific etiology, multiple factors may responsible for this inflammatory reaction. Mean platelet volume (MPV) is a new important inflammatory marker that indicates disease activity. Aim of this study is to evaluate MPV value in patients with subacute thyroiditis.Materials and methods: Thirty-one p...

Introduction: Autoimmune thyroiditis (AIT), also called Hashimoto thyroiditis or chronic lymphocytic thyroiditis is characterized by destruction of the thyroid gland involving apoptosis of thyroid epithelial cells. It usually presents as euthyroidism or subclinically hypothyroidism, rarely as overt hypothyroidism. The cause of Hashimoto’s thyroiditis is thought to be a combination of genetic susceptibility and environmental factors. Bisphenol A (BPA), an endocrine-disrupt...

Introduction: The thyroid is generally resistant to infections due to its encapsulated location, high iodine concentration, hydrogen peroxide production, and high levels of blood and lymphoid circulation therefore acute suppurative thyroiditis is rarely seen. The most common agents are Staphilococcus and Streptococcus. In this case we present acute suppurative thyroiditis caused by Burkholdeira cepacia, that is a rare infectious agent in adults.Case: 34 ...

Introduction: Endocrine disorders can influence the hemostatic balance. Various abnormalities of coagulation-fibrinolytic system have been reported in patients with thyroid dysfunction. The aim of the study was to assess the immunohistochemical expression and distribution of coagulation and fibrinolysis markers in follicular cells of thyroid goiter.Materials and methods: 20 patients with thyroid goiter were included in the study: 11 cases with non-toxic ...

Introduction: Patients that were suspected to have thyroid agenesis on imaging procedures were retrospectively evaluated.Methods: Totally 4155 patients had scintigraphy imaging between years of 2010–2015 in our university. 4021 (96.77%) patients were adults (>18 years) and 134 patients (3.22%) were in the pediatric population. Among adult population, 3060 (76.1%) were female, and 1095 (27.2%) were male. In the pediatric population, 85 (63.4%) pa...

Introduction: Catalase is an enzyme, which functions in the detoxification of hydrogen peroxide, and is one of the most important antioxidant enzymes in humans. It is responsible for protecting the cell from oxidative damage by reactive oxygen species. Catalase promotes growth of cells including T-cells, B-cells, myeloid leukemia cells, melanoma cells, mastocytoma cells, and normal and transformed fibroblast cells. Nevertheless, the role of this enzyme in thyroid pathologies i...

Introduction: Permanent hypothyroidism is a common side effect of thyroidectomy. Thyroxine binding globulin (TBG) deficiency is characterized with low total thyroid hormones (TH) in the presence of normal free THs and thyroid stimulating hormone (TSH).Case report: A previously healthy 37-year-old man underwent annual health check-up. Thyroid US revealed a 24×14×19 mm isoechoic solid nodule in the left lobe. TSH was 1.4 (0.27–4.2 μIU/m...

Introduction: Propylthiouracil is a drug used in the treatment of hyperthyroidism and autoimmunity phenomena have been described as a side effect of its use. Despite anti-neutrophil cytoplasmic antibodies (anca) positivity is frequent in patients treated with propylthiouracil, the occurrence of clinically evident vasculitis is rare.Case report: A 65-year-old woman, diagnosed with hyperthyroidism 2 years ago and treated with propylthiouracil (50+...

Evaluation of the thyroid function in pregnant women is of extreme importance for maternal and neonatal health. The reference interval of thyroid function tests in pregnant women differs from that of the general population and among trimesters in the same patient. Trimester-specific thyrotropin (TSH) reference ranges for pregnant women are recommended in order to avoid misclassification of the thyroid dysfunction during pregnancy.Less data about the free...

Introducción: Thyroid nodule is a very frequent pathology that affects 4-8% of population. Fine-needle aspiration (FNA) guided by ultrasound (US) is considered the gold standard test in diagnostic evaluation of thyroid nodules. This technique is being assumed more and more frequently by endocrinologists.Description of Methods: We conducted a retrospective study that included all thyroid US-guided FNA performed in 2014. We considered the following va...

Background: Fixed-dose radioactive iodine therapy (RAI) is one of the standard therapy for Graves’ disease (GD). However, optimal RAI dose to achieve hypothyroidism in GD has been controversial.Methods: The clinical outcome of 124 patients with GD treated with a RAI between Apr. 2004 and Dec. 2014 was analyzed retrospectively. Responder group was defined as patients who were rendered hypothyroid by the RAI. Thyroid volume (TV) was assessed with sono...

The nodular goiter is the most prevalent thyroid disorder. Its prevalence increases with age and reaches over 70%. The aim of the study was to compare the nodule prevalence in two population-based studies, carried in Bulgaria in 2006 and 2012.Material and methods: Two thousand four hundred and two subjects (1347 female and 1053 male, age range 20–94 years) were included in 2006 and 2022 (1073 female and 949 male, 20–88 years) in 2012. All subje...

AbstractAim and objectives: To investigate the prevalence of relationships between kin/relatives with a known thyroid immune disorder related to Hashimoto thyroiditis.Material and method: 1. Thyroid disease diagnosis: a. ATPO > 34 u/ml = Hashimoto thyroiditis (HT); b. ATPO = normal but with high antithyroglobuline (ATG) = thyroiditis with only hyper-ATG (T-ATG); c. hypothyroidism without high ATPO/ATG = idiopat...

A 52 year old lady presented with a history of weight loss, tachycardia and tremor. She was diagnosed with primary hyperthyroidism; TFTs were TSH <0.02 mU/l and FT4 >100 pmol/l, LFTs were mildly deranged (ALT 79 u/l, ALP 101 u/l). TSH receptor antibodies were positive, suggestive of Graves’ disease.The patient was started on carbimazole, initially at 10 mg TDS which was titrated down to 5 mg TDS. Repeat LFT showed ALP at 219 u/l and a fluctu...

Introduction: Riedel thyroiditis is a rare form of infiltrative and fibrotic disease of the thyroid which may involve neighbouring tissues. The main differential diagnosis of Riedel thyroiditis includes malignant tumors and fibrosing Hashimoto’s thyroiditis.Herein, we report a case of concurrent Riedel’s disease and Hashimoto’s thyroiditis.Observation: A 45-year-old woman was diagnosed with goiter and hypothyroidism....

Introduction: Thyroid ophthalmopathy occurs generally due to Graves’ disease. Only a few cases were reported about ophthalmopathy in the years following a thyroidectomy and RAI therapy or metastatic papillary thyroid cancer.Case: A forty-six-year-old female patient was operated on for the fine needle aspiration biopsy (FNAB) result of a suspicious follicular neoplasia. A pathology examination showed a papillary microcarcinoma and Hashimoto thyroidit...

Introduction: In the modern day busy clinical practice the communication between patient and care giver is at minimal level. The patients feel apprehensive when advised about the surgical intervention. In such situation they feel the need of detail information from the care givers.Story telling is a tool which can be used for this problem. We intended to study the efficacy of storytelling technique on patients undergoing Hemithyroidectomy for benign cytology.<p class="abst...

Introduction: Hypothyroidism is characterized by a decrease in oxygen and substrate utilization by major organ systems of the body. Hence patients with angina have fewer symptoms if they become hypothyroid. Hypothyroidism also results in bradycardia and weakening of myocardial contraction. Cardiac preload is decreased, afterload is increased, and chronotropic and inotropic functions are reduced. The impairment of these measures leads to a reduction in cardiac output.<p cla...

Introduction: The diagnosis of thyroid orbitopathy is based on clinical symptoms and typical changes in laboratory tests confirming thyroid disease. In approximately 5% it is Hashimoto’s thyroiditis. Typical treatment is primarily steroids administered intravenously. But one disease does not exempts the other, and the drugs can not read. Therefore, we would like to present the history of our patient.Case report: 55 year-old man was admitted to the E...

Muscle involvement in hypothyroidism is a rare complication. These patients are often present with decreased muscle mass, cramps and myalgia. With these clinical symptoms increasing muscle enzyme suggests the rhabdomyolysis table. Rhabdomyolysis based on hypothyroidism is not a common condition. In this report, a case which detected rhabdomyolysis based on deep hypothyroidism will be discussed.Seventy-two years old male patient applied to our clinic with...

Thyroid disease is common among the population, and the prevalence increases with age. In patients with type 1 diabetes mellitus (T1DM) the risk of thyroid dysfunction and thyroid autoimmunity is increased. The aim of this study was to investigate the relationship between thyroid function and T1DM duration. There were evaluated 110 patients (71 women and 39 men) with T1DM between 2013 and 2015 and were appreciated antibodies against thyroid peroxidase (ATPO) (normal values...

The incidence of Graves disease in different regions of Russia ranges from 20 to 50 cases per 100000 population.Purpose: To improve the results of surgical treatment of patients with Graves disease by identifying the optimum amount of remaining thyroid tissue and prediction of thyroidal status in the long term.Methods and design: The 138 patients with Graves disease operated over the past 10 years: 131 women (94.9%) and 7 men (5.1%...

Objective: Vitamin D is an immune-modulator that may play a role in thyroid related autoimmunity. But the relation between Vitamin D and Graves’ disease (GD) is not well defined yet. The aim of this study was to investigate the association of 25-hydroxy-vitamin D (25[OH]D) levels and TSH receptor antibody (TRab) levels in GD.Design: A total of 429 GD patients were analyzed retrospectively. 122 of 429 patients had vitamin D levels were enrolled in th...

Introduction: Surgery for benign nodular goiter (NOD) is currently limited to cancer or cosmetic deformities. Most patients are, in principle, followed up for years or decades. The long-term outcome, however, is not always clear.Patients and methods: NOD was diagnosed as benign in 1,825 patients (1990–2015). 102 patients (5%) were treated by surgery. 95% returned to home doctors (69%) or continued to visit our clinic (518 patients, 31%). Follow-up e...

Introduction: In Romania universal salt iodization was implemented into practice since 2002, and iodine content of salt was gradually increased afterward. The efficiency and sustainability of this nationwide program were evaluated among school children from endemic regions of Mures and Harghita Counties. During these studies thyroid ultrasound characteristic for chronic autoimmune thyroiditis was observed in a considerable number of cases.Objective: To e...

Introduction: Radioiodine therapy is considered as a risk factor for the development of Graves’ orbitopathy (GO) de novo or worsening of pre-existing orbitopathy. This risk is estimated in the available literature as up to 15–20%. Steroid cover is considered to eliminated this risk.Objective: The aim of our study was to established the relationship between the occurrence of GO and treatment with radioiodine. And the analysis of the time of appe...

Some authors observed lower thyroid antibodies titers (AbT) in children than in the adult population. The aim of this work was to consider the prevalence of positive results in AbT and elevated TSH levels. We have considered AbT and TSH measurements in a large population. We divided samples in 7 age groups 0–18, 18–20, 20–40, 40–50, 50–60, 60–70 and >70 years old. Cut-off positivity for AbTg and AbTPO was 50 and for TSH was 10 mUI/ml.<p cl...

Background Insulin resistance (IR) is a state in which a given concentration of insulin produces biological effect less than expected and IR actually make up a broad clinical spectrum, including obesity, glucose intolerance, DM, and the metabolic syndrome that are associated with various endocrine, metabolic, & genetic conditions. There is an association of IR with thyroid abnormalities. Evidence for a relationship between T4 and T3 and glucose metabolism appeared over 100...

Introduction: Assessing the quality of life of patients with thyroid disease does represent a challenge. ThypRO questionnaire has been developed recently and comprises a reliable and valid scale structure of a patient-reported outcome measuring thyroid-specific quality of life.Material and methods: The standard methodology for translation of patient-reported outcomes was followed. Two independent translators, Greek native speakers, fluent in english, wer...

The most frequent side effects of antithyroid drugs are skin reactions (6%), gastrointestinal effects (5%) and arthralgia (5%). Other complications such as antithyroid arthritis syndrome (1%), agranulocytosis (0.5%) and hepatitis (0.2%) occur rarely.We describe the case of a 20-year-old woman with Graves’ disease. Two weeks after the beginning of carbimazole therapy, she developed an urticarial reaction that led to discontinuation of treatment. Neve...

Introduction: Subacute thyroiditis (ST) is a self limited condition; relapse is rarely seen. Anterior cervical complains and inflammatory syndrome is highly suggestive.Aim: We report a series of female cases associating arelapse of ST which was confirmed after the admission for atypical distant symptoms as diffuse headache or ear pain.Material and Methods: The endocrine profile is presented.Results: A 48-year...

Background: Hoffmann syndrome is a rare form of hypothyroid myopathy in adults characterized by presence of muscle weakness, stiffness and pseudo-hypertrophy. Here, we report a case of Hoffman syndrome aggravated by statin therapy.Case report: We describe the case of a 60 year old woman with primary hypothyroidism who presented with fatigue, cold intolerance, constipation, exertional breathlessness, progressive proximal muscle weakness and swelling of th...

Introduction: Thyrolipoma (focal adenolipoma of thyroid gland) and thyrolipomatosis (diffuse lipomatosis in the gland) are rarely encountered pathologies in daily practice. We reported a case of small thyrolipoma incidentally diagnosed in a multinodular goiter patient.Case report: A 56 year-old man was admitted to our out-patient clinics with the complaint of a lump in his cervical region. His thyroid function tests were normal. In physical examination, ...

Objective: The prevalence of overweight and obesity has been increasing for several decades. Few studies have recently showed functional and morphological changes of the thyroid gland in relation to obesity. The aim of this study was to correlate thyroid nodule size with body mass index (BMI), waist-hip ratio (WHR) and thyroid stimulating hormone (TSH) levels.Methods: A total of 119 patients diagnosed with euthyroidic nodular goiter were included in this...

Introduction: Hyperthyroidism in the elderly can present with subtle nonspecific complaints. Patients with long-standing goiter can develop autonomous nodules resulting in toxic nodular goiter.Case report: An 86 year old women was referred from gastroenterologist for thyroid disease because of low TSH. She had diarrhea with five to eight bowel movements a day for six months. She denied palpitations, heat intolerance or muscle weakness. She had been noted...

Background: High prevalence of thyroid disorders is more common in T1 compared to T2 Diabetes Mellitus due to the associated autoimmunity, with hypothyroidism being the most common disorder.Objectives: The aim of this study is to assess the prevalence of autoimmune thyroid dysfunction among T2 diabetic Egyptian females and to find the correlation between the metabolic syndrome components and autoimmune thyroid dysfunction.Methods: ...

Introduction: The thyroid gland plays an important role in metabolism of human body. Abnormal growth of this gland is called Goiter. Iodine deficiency was thought to be the main cause of goiter. However, despite years of salt iodization, goiter continues to be a major public health, worldwide. As the thyroid gland is the most common organ affected by autoimmune diseases, it is suggested that autoimmunity can disturb thyroid function and develop to goiter. This study tries to i...

Introduction: Thyroid fluid-filled cavities are mostly resulted from degenerating thyroid adenomas but blood vessel anomalies are also described. Despite the typical benign behavior the local anatomical effects may require fine needle aspiration or directly surgery.Materials and methods: This is series of cases presenting intermittent breathing problems leading to the diagnosis of thyroid cysts. Thyroid evaluation included ultrasound, computed tomography...

Introduction: Hashimoto’s thyroiditis (HT) is a well known risk factor for thyroid lymphoma. A rapidly enlarging goiter accompanied by lymph nodes pressure on surrounding structures usually suggest the development of thyroid lymphoma.Case report: An 85 years old hypertensive women presented for a massive goiter extending from the lower jaw to clavicle which increased in size for the last 5 months. She also complained of dysphagia, hoarseness and sho...

Objective: To evaluate the level of awareness among patients with thyroid disorders presenting to our hospital and determine patient profiles.Design: The present study was conducted using a survey technique on patients aged between 18 and 75 years, who were admitted to our hospital for follow-up between December 1, 2014 and December 31, 2014. The pregnant women and those with a thyroid malignancy and patients who did not consent for the study were exclud...

Thyroid hormones influence renal development, kidney structure, renal hemodynamics, glomerular filtration rate, the function of many transport systems along the nephron and sodium and water homeostasis. Patients with hypothryoidism can have clinically important reductions in glomerular filtration rate (GFR). 41 patients (mean age 31.5±11 years) newly diagnosed as Hashimoto thyroiditis with presence of high thyroid autoantibodies with gland heterogenity in ultrasound and a...

Introduction: Radioiodine (RAI) has been used for the treatment of Graves’ hyperthyroidism since 1940s. It is relatively safe and considered as one of the definitive therapies. Achievement of hypothyroidism or euthyroidism is defined as a successful therapy.Methods: The study was conducted in 366 patients (80.60% of women) with Graves’ disease (GD), aged 46.76±13.52 years. We analyzed retrospectively hormonal and imaging findings (scintigr...

Introduction: In iodine deficient regions maternal iodine supply is indispensable for the normal development of the fetus, but it might aggravate autoimmune thyroid diseases in the mother during pregnancy and postpartum. Selenium might be beneficent in these thyroid diseases by defending against the harmful effect of iodine on maternal thyroiditis.Objective: To study the course of Hashimoto’s thyroiditis in pregnant women, under combined therapy wit...

Introduction: Accessory thyroid tissue is a part of thyroid dysgenesis and sometime represents an incidental adult finding displaying a normal function.Material and Methods: This is a case presentation of an adult admitted for an atypical anterior cervical aspect which could not be recognized as accessory thyroid tissue only after surgery. Thyroid evaluation used imagery like ultrasound, computed tomography (CT), assays as TSH (Thyroid Stimulating Hormon...

Introduction: Adequate iodine intake is important in pregnant women.Objective: To determinate iodine status and thyroid volumen (TV) in healthy pregnant women from Navarra (Spain), and to evaluate possible influence of diet.Methods: A cross-sectional study of 144 women in the first trimester of pregnancy (single pregnancies) was carried during 2014. We measured thyroid-stimulating hormone (TSH), free thyroxine (fT4) and antithyroid...

Introduction: Graves ‘Orbitopathy (GO), is an autoimmune disease associated with Graves’ thyrotoxicosis (GT). The therapy is largely dependent on the severity and activity of ocular changes. Additionally, the severity of GO is influenced by exogenous factors, such as thyroid dysfunction, cigarette smoking or radioiodine therapy (RIT). The aim of the study was to indicate how radioiodine therapy (RIT) influences on GO in smoking and non-smoking patients.<p class="...

Aim: The biological diagnostic of Hashimoto thyroiditis (HT) is based on higher than normal levels of antithyroperoxydase antibodies (ATPO). Our goal was to establish the cut-off limit of normality (the upper limit) for ATPO in our thyroid normal patients. This limit and not that of the laboratory, should be used as diagnosis of Hashimoto thyroiditis.Material and method: 1. ATPO was investigated in patients with normal level of thyroid hormones (euthyroi...

Background: Psychiatric symptoms have been reported quite frequently in thyroid disease. Dementia associated with hyperthyroidism is less well documented.The case: We present the case of a 62 years old woman, who initially presented for a neurological consultation about her symptoms suggested Alzheimer’s disease. The patient had been under treatment for more than seven years for type 2 diabetes and developed frequently episodes of hypoglycemia. She ...

Clinical Case: We referred one case with primary hypothyroidism and tarsal tunnel syndrome. The boy 11 6/12 years old was presents in our clinic with fatigue, obesity, difficulty during walking, low performance in school, hyposthenia and dementia. His weight was 48 kg +3.8 DS; height 153 cm +2 DS; the patient has bilateral symptoms of the tarsal tunnel syndrome and his foot symptom was aggravated by walking. The hormonal values were: TSH 2.3 mUI/ml (0.35–4.04); FT4 0.54 n...

Introduction: Pregnancy is associated with significant reversible changes in thyroid functions due to certain hormonal changes e.g. HCG and estrogen.Objective: To study thyroid functions in different trimesters of pregnancy compared to control age matched non pregnant women.Design and Methods: Cross sectional study of 90 pregnant women divided into three groups in the three trimesters of pregnancy compared to 30 ages matched non-pr...

Background: Hashimoto’s Thyroiditis (HT) is the most common clinical expression of thyroid dysfunction and result from organ-specific autoimmune reaction. Cytokines are play an important role in autoimmunity, by stimulating B and T cells.The aim of this study is to examine the relationship between cytokines and thyroid function tests in patient with Hashimoto’s ThyroiditisMethods: 139 cases with HT included this study. Su...

Introduction: Our aim is to investigate whether ovarian reserve is decreased in patients with euthyroid Hashimoto’s thyroiditis (HT).Method: Our study included 110 euthyroid HT patients and 72 age matched healthy women (controls; C). In all patients FSH, LH E2, and P levels were measured from blood samples, and ovarian volumes (OV) and antral follicule count (AFC) were measured using ultrasonography at 3rd day of menstruation....

Introduction: The adverse impact of overt hypothyroidism that complicates pregnancy outcomes is well-established. In order to eliminate these complications has long been discussion about the need for early detection of the disease of the thyroid gland in the population of women planning pregnancy, respectively in early pregnancy. In Slovakia, this effort resulted in the approval of screening for thyroid diseases in pregnancy and has been enshrined in a legislative in 2009. Obl...

Introduction: Radioiodine (RAI) is used as a definitive therapy of hyperthyroidism due to toxic adenoma (TA) as well as toxic multinodular goiter (TMG). Achievement of hypothyroidism or euthyroidism is defined as a successful therapy.Methods: The study was conducted in 666 patients – 484 with TA and 182 with TMG (85.58% of women), aged 56.19±13.88 years. We analyzed retrospectively hormonal and imaging findings (scintigraphy, ultrasonography), ...

Introduction: Endocrine Illnesses have high prevalence on a global level due to multiple etiologies that can lead alterations to this system.Objective: Determine the epidemiological profile of hyperthyroid and hypothyroid patients that receive endocrinological services from a medical institution in Medellin (Colombia) between 2013 and 2015.Methodology: A descriptive, retrospective study was conducted and included the clinical recor...

Introduction: Overt hypothyroidism and severe subclinical hypothyroidism (ScH) are associated with dyslipidaemia, and its condition is reversible after thyroid replacement therapy. We investigated the effect of levothyroxine therapy on lipid parameters in patients with mild form of subclinical hypothyroidism (ScH).Material and methods: Fifty-seven patients with newly diagnosed ScH with TSH levels below 10 mU/l and 30 age and sex-matched healthy subjects ...

Introduction: Subacute (de Quervainś) thyroiditis is an uncommon altough not a rare condition. Pain in the thyroid and ill-defined hypoechogenic thyroid lesions in ultrasonography are typicall findings, occasionaly are increased thyroid hormones levels. Often preceded by upper respiratory tract infection. The disease is self-limited and often resolves spontaneously, usually without subsequent thyroid function abnormalities, or it may improve with anti-inflammatory drugs a...

Objectives: Various systemic symptoms may occur in patients with thyrotoxicosis. Gastrointestinal manifestations such as hyperphagia or frequent defecation, often coexist with other thyrotoxic symptoms. Vomiting also has been mentioned.In this setting, systemic symptoms of underlying malignancy may be confused with those of thyrotoxicosis leading to a delay in diagnosis.Methods: We report a case with delayed diagnosis of small bowe...