Endocrine Abstracts

Introduction: Thyroid carcinoma accounts for 1% of all thyroid tumours. Bone metastasis occurs in 10 to 40%, with skullmetastasis accounting for 2.5 to 5.8% of bone metastases. The largest series of skull metastasis from thyroid carcinoma described a frequency of only 2.5% among 473 patients. The majority of skull metastasis from thyroid cancers is of the follicular subtype. She can occur at any age, the youngest patient was just 18 years old but most patients are between 60 a...

Background: The association between autoimmune thyroid disease (AITD) and other autoimmune diseases is well-known. The prevalence of concurrent autoimmune gastritis and celiac disease in AITD has been estimated at approximately 20–25% and 2–5% respectively. Although both conditions have significant morbidity including malignancy and may necessitate dietary modifications and endoscopic evaluation, no recommendation exists to screen AITD patients for these autoimmune d...

Objectives: Assess the dose of levothyroxine in relation to TSH and FT4 at diagnosis of AHT in children with SH and OH.Methods: Two hundred one children (155 girls) with AHT were devided according to TSH and FT4 levels at diagnosis of hypothyroidism [SH-FT4 >1.0 ng/dl: Group 1: TSH: 5–7.5 mU/l, Group 2: TSH: >7.5 mU/l, OH: Group 3: TSH>7.5 mU/l and FT4 ≤1.0 ng/dl]. Mean L-T4 dose was reported in μg/Kg per day at diagnosis and ...

Aim: Radioactive iodine (RAI) is one of the treatment approaches in Graves and toxic nodular or multinodular goiter (TNG/TMNG) with low cost and high efficacy. In this study, we aimed to evaluate ultrasonographical and cytological features of thyroid nodules in patients who were treated with radioactive iodine for hyperthyroidism years ago.Methods: Patients who had a history of RAI treatment for hyperthyroidism and had thyroid nodules that were evaluated...

The role of adjuvant external beam radiotherapy (EBRT) in differenciated thyroid cancer (DTC) is controversial. It remains unknown whether EBRT in the neck following conventional treatment might improve progression-free survival (PFS) and overall survival (OS).Objective: To assess EBRT outcomes in patients with locally advanced DTC in terms of local disease progression, PFS and OS.Material and Methods: A multicentric retrospective ...

Introduction: First treatment in Graves’ disease consists in the administration of antithyroid drugs. The most common side effect is a rash, which affects about 5% patients and clears up if the drug is stopped. The other drug may then be used. The intolerance to both drugs is very rare, but in this situation early radioactive iodine or surgery may be the answer.Case report: Woman of 61 years old who developed primary hyperthiroidism, with levels of ...

Background: Differentiated thyroid carcinoma (DTC) has an excellent prognosis with a relatively low recurrent and mortality rate, but a small portion of DTC patients suffers from an aggressive form of the disease with tumor invasion and metastasis. Accurate identification of this group of DTC patients is of crucial importance to optimizing individualized DTC treatment. This study aimed to retrospectively investigate the clinicopathologic predictive factors of cervical lymph no...

Introduction: The aim of the study was estimate RFA efficacy of large benign thyroid nodules.Material and Methods: This is a retrospective analysis included the results of RFA treatment of 54 patients with large benign thyroid nodules at the Samara Oncology Center from November 2014 to December 2017. Patients were seeking the alternatives to thyroid surgery because of the unwillingness to be operated on. The mean volume of nodules was 48.5 (36.1–89....

Introduction: Thyrotoxicosis in the elderly may present differently than in younger indeviduals, and with the aging of the worlds’ population it is imperative to obtain data in this age group.Aim: Our aim was to identify and characterize clinical and biochemical parameters of thyrotoxicosis in the elderly and to compare them to those of younger patients.Methods: We retrospectively evaluated files of patients older than 40 who ...

Introduction: The incidence of thyroid nodules is increasing. Fine-needle aspiration (FNA) of all thyroid nodules is unnecessary, but it is necessary to provide a more precise identification of those nodules that are potentially malignant in nature. In the literature there are several suggested systems for assessing malignancy of nodules in the thyroid gland.Objective: To determine the differences between EU and ACR TIRADS recommendation for fine-needle ...

Introduction: Among all thyroid nodules 3 to 10% are Hürthle cell (HC) neoplasms classified as either HC adenomas or carcinomas. The presence of capsular or vascular invasion is indicative of a HC carcinoma whose incidence has been found to be 5 to 35%. Hürthle cell carcinoma could also lead to distant metastases and its decreased ability to uptake radioiodine worsens the prognosis. There are reports of histologically characterized HC adenomas with unpredictable clin...

Calcitonin is a polypeptide hormone synthesized and secreted by the parafollicular cells of the thyroid gland, and has been considered as a good marker for medullary thyroid carcinoma. But several physiologic and pathologic conditions other than medullary thyroid carcinoma have been associated with increased levels of calcitonin. A 39-year old woman was admitted to our hospital for further testing due to high calcitonin level (467 ng/L) measured by immunochemiluminometric assa...

Introduction: Pre-thrombotic states may be primary, related to a hereditary coagulation disorder or secondary (venous stasis or drug intake). We report a case of hyperthyroidism revealed by pulmonary embolism.Observation: A 82-year-old woman, with a forty years history of type 2 diabetes mellitus, was admitted to the emergency room in a respiratory distress condition. The clinical examination found a dyspnoeic patient with tachycardia, hypertension, and ...

Actuality: Goitre of the tongue root malformation of the thyroid gland is a violation of the process of migration from the tongue root to the definitive position at the level of the 2nd - 4th rings of the trachea, when the thyroid gland remains in whole or in part in the area of the blind opening of the tongue.The aim: To evaluate the results after operative complications, to determine the main changes in TTH and T4 after surgery in the debut of the dise...

Introduction: The autoimmune polyglandular syndrome (APS) is a complex, heterogeneous condition in which autoimmune diseases (AIs) of endocrine and non-endocrine organs can occur. There are four subgroups. The majority of patients are categorized as having APS II or APS III. In APS II, patients have Addison’s disease (AD) and autoimmune thyroid diseases (AITDs) or type I. diabetes mellitus (T1DM), while in the APS III, AITDs are combined with other autoimmune illnesses ex...

Introduction: Ultrasound guided Fine-Needle Aspiration (USFNA) of Thyroid is the gold standard for diagnosis of thyroid nodules. Nowadays, many patients are under anticoagulation and antiplatelet medication. Some of the rare complications of USFNA are haemorrhage therefore it’s not clear if performing thyroid USFNA in hypo-coagulated patients increase that risk of complications or if this medication should be stopped before the procedure. Additionally the influence that t...

Introduction: Nivolumab, an anti–programmed cell death-1 (PD-1) monoclonal antibody, is a promising treatment of variety advanced malignancies. Immune checkpoint inhibitors can cause immune-related adverse events, including endocrine pathology. Destructive thyroiditis is one of the most frequently observed nivolumab-induced endocrine irAEs which associated with the presence of anti–thyroid peroxidase antibodies (TPO-Abs) and anti-thyroglobulin antibodies (Tg-Abs) pri...

Introduction: The main objective in the management of primary hypothyroidism is to normalize thyrotropin (TSH) level with Levothyroxine replacement therapy. The optimal dose of Levothyroxine may be affected by several factors such as age, gender, body weight, some medical disorders and drugs intake. The aim of this study was to assess the relationship between thyroid antibody titers and Levothyroxine dose in patients with primary hypothyroidism secondary to Hashimoto thyroidit...

Thyroid dysfunction has been traditionally related to several lipid abnormalities. Indeed, even within the normal range of thyroid-stimulating hormone (TSH) values, a linear increase in total cholesterol, low-density lipoprotein cholesterol and triglycerides and a linear decrease in high-density lipoprotein cholesterol (HDL-C) levels has been observed with increasing TSH. With respect to serum high-density lipoprotein (HDL) cholesterol concentrations, high, normal, or low valu...

Introduction: Adverse events among patients treated for tuberculosis are under-researched and underreported. Two cases of hypothyroidism induced by tuberculosis drug were reported in two older women.Observations: Case 1: A 69-year-old male, complaining of asthenia and weight gain. He had been treated for his pulmonary tuberculosis during the past 6 months with a quadritherapy antituberculous regimen consisting of Rifampicin, isoniazid, ethambutol, pyrazi...

Aims: Presence of antinuclear antibodies (ANA) is correlated to tissue involutive lesions by microvascular alterations. The possible involvement of hypovitaminosis D as a negative immunomodulatory factor along with the presence of ANA and the incidence of chronic autoimmune thyroiditis (CAT) atrophic form is a complex mechanism with multiple pathological intercorrelations.Material and method: Inclusion criteria: patients - new cases diagnosed with CAT wi...

Aims: To evaluate the prevalence of antinuclear antibodies (ANA) in patients with chronic autoimmune thyroiditis (CAT) associated with periodontal disease (P.D).Material and methods: 42 patients with TCA and BP were tested for ANA (Group 1) and 50 patients with TCA without BP (Group 2). Inclusion criterias – absence of other autoimmune diseases associated with positive ANA patients. Thyroid hormone deficiency has established thyroid function. Patien...

The results of treatment of 72 patients with endocrine ophthalmopathy in the Clinical Hospital No. 10 in Minsk during 2 years are presented. Thyroid pathology was detected in 63 patients (87.5%): in 39 (54.2%) - Graves disease, in 24 (33.3%) - autoimmune thyroiditis. All patients with Graves’ disease received thyrostatic therapy; 10 persons developed ophthalmopathy after thyroidectomy. 11 patients with autoimmune thyroiditis had hypothyroidism and received levothyroxine, ...

Context: Monoclonal antibodies to Immune Check Point inhibitors (ICPis) are powerful anti-cancer drugs. They trigger the immune system against cancer cells, blocking inhibitory signals of T-Cells. However, ICPi therapy can also stimulate autoimmune reactions, inducing the so-called immune-related adverse events (irAEs). Endocrinopathies are common iRAEs and thyroid disfunction is the most common endocrinopathy during ICP therapy. We report three cases of thyroid disfunction du...

Introduction: In clinical practice guidelines for differentiated thyroid cancer (DTC) it has been proposed to perform thyroglobulin (Tg) stimulated by rTSH determination 6–12 months after initial therapy in patients with low or intermediate risk, in order to establish the absence of disease. The use of ultrasensitive Tg assays could avoid the need of stimulation to establish the absence of disease.Objectives: To evaluate the usefulness of the determ...

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, which pathogenesis remains elusive. Patients with SLE have a higher overall risk of malignancy than the general population. Herein, we report an original association of SLE with ovarian and thyroid malignancies.Case report: A 52-year-old woman was followed-up for 13 years in the dermatology department for SLE. Her disease remained stable under hydroxychloroquin with SLEDAI ...

Background and aim: The normal range of thyroid functions during pregnancy differs between ethnic groups. The aim of this work was to assess the thyroid functions in normal pregnant Egyptian females in order to establish a population-specific reference range. Thyroid peroxidase antibodies (TPO Abs) and thyroid volume were also assessed.Methods: The study included 150 normal pregnant Egyptian females (with no history suggestive of thyroid...

Introduction: The aim of this study is to investigate association between Hashimoto’s thyroiditis (HT) and vestibular function and the possible effect of levothyroxine (LT4) treatment on vestibular functionPatients and methods: We recruited 61 patients with HT and 30 age and gender matched healthy individuals for the study. Of 30 patients with HT were on LT4 treatment (group I) and 31 patients were treatment naive (group II). None of the patients ha...

Introduction: The goiter represents the most common of all the disorders of the thyroid gland. Many Factors may be involved in the evolution of multinodular goiter. Although thyroid stimulating hormone (TSH) was described as the most important goitrogen factor, impairment of TRH-induced TSH release was reported with nodular goiter, suggesting thyroid autonomy. Herein, we report two cases of an isolated thyrotropin deficiency in patient presented with a voluminous goiter.<p...

Objectives: Evaluation of functional thyroid alterations in correlation with hyperemesis gravidarum (HG).Material and method: Study performed on a group of 136 pregnant women with HG and a control group of 101 pregnant women. In both groups, cases with a known history of thyroid disease, molar pregnancy, multiple pregnancies or other systemic chronic diseases were excluded. Patients were clinically and serologically examined (TSH, FT4, ATPO, TRAb), the r...

Introduction: Hypothyroidism affects 2 to 3% of the elderly population. Its diagnosis and management can get difficult considering the clinical and biological particularities of this age range. The aim of this study is to describe the clinical characteristics, diagnosis and management data of elderly patients suffering from hypothyroidism.Materials and methods: This is a retrospective and descriptive study conducted in the Endocrinology-Diabetology-Nutri...

Objective: The aim of our study was to determine whether there is a relationship between oxidative stress parameters and subacute thyroiditis.Material and methods: The study included 55 subacute thyroiditis patients and 30 healthy volunteers. Total antioxidant status (TAS), total oxidant status (TOS), paraoxonase (PON) and thiol/disulfide homeostasis parameters were measured by a novel and automated assay in the patient and control groups.<p class="a...

Thyrotoxicosis is an uncommon cause of congestive heart failure with depressed ejection fraction. However, when it presented in patients without classical cardiovascular risk factors and high heart rate, that not response to usual therapy, other conditions should be considered.Case report: A 36-year-old male was admitted to our hospital’s Coronary Critical Care Unit in acute hypertensive pulmonary oedema. He had noted weight loss, palpitations, shor...

Data regarding hyperthyroidism is lacking in Nepal. We did a retrospective analysis of clinical profile and treatment modalities of hyperthyroidism patients in our center.Methodology: Retrospective data of 132 hyperthyroidism patients between March 2013 and April 2014 at Kathmandu Diabetes and Thyroid Center were analyzed. These patients’ records were followed up for one year.Results: Hyperthyroidism was common in females (73....

Nepal seems to have high thyroid disorder prevalence but there has been no prevalence studies done so far in general population. We do have a few hospital based prevalence studies of hypothyroidism in Nepal. Our study aims to find the prevalence of thyroid disorders in general population in Nepal.Methods: We did thyroid function tests of the general population through screening camps in different parts of Nepal. We screened people from 7 places in 5 dist...

Introduction: Hypothyroidism can be responsible for lipid abnormalities, which increases the risk of cardiovascular diseases and even morbi-mortality. The aim of this study is to analyze the lipid profile in patients with primary hypothyroidism while comparing between genders.Materials and methods: It is a retrospective and comparative study conducted on 57 patients with primary hypothyroidism in the Department of Endocrinology-Diabetology-Nutrition of O...

Grave’s disease (GD), like all autoimmune diseases, is predominantly female, with sex ratio to 3 women for one man. The treatment of first intension is based on antithyroid drugs (ATD). Our objective is to compare the clinical presentation and the evolution of GD by gender. It’s a retrospective study. We studied patients with a first diagnosis of GD, in the department of endocrinology in Farhat Hached hospital in Susah, between Juanuary 2010 and December 2015. The pa...

Background: Antithyroid drugs (ATD) are indicated as first intension in the treatment of Graves’disease (GD). Only two molecules are marketed in Tunisia: Benzylthiouracil (BTU) and Methimazole (MMI). There is still no clear conclusion about the choice of appropriate drug. Our objective was to compare the MMI treatment with the BTU in terms of efficacy and adverse effects (AEs).Methods: It’s a retrospective study. We studied patients with a firs...

Objective: To evaluate the prognostic value of interleukin-8 studies in the development of thyrotoxic cardiomyopathy in patients with Graves’ disease.Materials and methods: 86 patients with newly diagnosed Graves’ disease were examined, aged 18 to 55 years (mean age 37 years [28; 45]) without previous cardiovascular events. All patients were analyzed by interleukin-8 by immuno-enzyme analysis. To determine the threshold value for Interleukin-8,...

Background: The standard, lifelong therapy of phenylketonuria (PKU) is natural protein-restricted diet completed with Phenylalanine (Phe)-free L-amino acid mixtures that provide the daily necessary micronutrients, such as iodine and selenium. Our main objective in this study was to assess the iodine and selenium status of patients with PKU, based on their adherence to the low-Phe diet, compared to a healthy control group. Secondly, we aimed to asses whether adherence to therap...

Introduction: Previous studies have shown that the G691S and S904S variants of RET proto-oncogene are associated with Multiple Endocrine Neoplasia (MEN) 2A syndrome and have a modifier effect on the age of onset. They are also associated with Papillary Thyroid Carcinoma and with Pheochromocytoma without Medullary Thyroid Carcinoma (MTC). Nevertheless, the influence of these polymorphisms on cases of sporadic MTC is still unclear. We present a patient with sporadic Med...

Introduction: Most thyroid neoplasms arise from follicular cells and are well differentiated. We present an interesting case of a rare first manifestation of Papillary Thyroid Carcinoma (PTC) as a cervical cystic mass, as well as the therapeutic approach.Material-method: A 29 year-old-male, without personal or family history for PTC and no history of neck radiation referred to our department because of a slow growing right lateral cervical mass in the la...

Introduction: TSI (Thyroid Stimulating Immunoglobulin) antibodies are a form of immunoglobulin G (IgG) that can bind to thyrotropin receptors on the thyroid gland causing over-production of thyroid hormones and hyperthyroidism. The presence of positive TSI is considered pathognomonic for Graves’ disease. Although the association between Graves’ disease and thyroid cancer (TC) has been reported in previous studies, the association between the levels of TSI antibodies ...

Introduction: We report a case of papillary thyroid carcinoma recurrence. According to most of the guidelines, patients with PTC have recurrences in the first 5 years after diagnosis and the most rigorous follow-up is indicated in this time; however metastasis are reported beyond this period and are associated mostly with lack of adherence to follow-up.Case report: A 76-year-old female was admitted in our department for the evaluation of a 5 cm laterocer...

Aim: To evaluate the long-term efficacy of percutaneous ethanol injection treatment (PEIT) as an alternative to thyroid surgery in symptomatic thyroid cysts with a structured protocol.Methods: Seventy five subjects (48±12 years; 58% women) with symptomatic benign thyroid cysts relapsed after drainage were included. PEIT was conducted using the established procedure in our hospital, and the initial cyst volume, pain perceived by the patient and sympt...

Introduction: Thyroid microcarcinoma with palpable cervical node metastasis is a rare clinical situation. Through this work, we aim to study its clinical, therapeutic and evolutionary features.Material and methods: We conducted a retrospective study over 14 cases of thyroid microcarcinoma presenting with a palpable cervical lymph node metastasis collected on the ENT department of Farhat Hached hospital over 28 years (1990–2017).<p class="abstext...

Introduction: Riedl thyroiditis is a rare thyroid disorder of unknown etiology (autoimmune assumed), in which the gland is invaded by dense fibrous tissue, that extends in the vicinity. Goiter is usually painless and can be accompanied by other fibrous affections (retroperitoneal fibrosis, sclerosing cholangitis, mediastinal fibrosis).Case presentation: Patient, 39 years old, smoker, from nonendemic area, initially presents in 2011 with voluminous polyno...

Background: Fine needle aspiration (FNA) is the preferred method for assessing thyroid nodules but concern remains about false negative results. The primary aim of this study was to investigate the malignancy rate in nodules which were initially classified as benign (BTA classification Thy 2). The secondary aim was to look at the distribution of different cytological categories in a large cohort of patients.Methods: We retrospectively examined 719 nodule...

Background: Subclinical hypothyroidism (SH) is a frequent clinical condition with a prevalence of 3–15% in general population. It is defined by elevated TSH levels with normal thyroid hormones [free thyroxine (FT4) and free triiodothyronine (FT3)]. Similar to prolactin, high TSH levels may be caused by macroTSH, a large molecular sized TSH with a low bioactivity. The aim of the study was to assess the prevalence of macroTSH in patients with subclinical hypothyroidism....

Abstract: A transient thyrotoxicosis followed by a phase of hypothyroidism, sometimes transient and preceding full recovery, is a usual presentation of postpartum thyroiditis, a form of autoimmune thyroiditis occuring after a pregnancy with a worldwide prevalence averaging 5%. Far less commonly, the same presentation may be observed in various circumstances unrelated to pregnancy. We have observed this condition in 6 patients, 4 women, aged 30 to 44 years, and 2 men, 48 and 68...

Aim: The aim of the present study was to compare version 7 of ATA risk calculating tool, developed for the staging of well differentiated thyroid cancers,and is used commonly in the clinical practice with its version 8 developed in 2018 with respect to clinical staging.Material and method: 295 patients followed with the diagnosis of well differentiated thyroid cancer were included in the present study. According to pathology reports and clinical data, th...

Introduction: Thyroid nodules are very common in the general population (20–75% ultrasound). There are clinical management criteria established by international societies and standardized cytological diagnostic criteria (Bethesda). However, there is still uncertainty in the management of category 3 (follicular lesion of undetermined significance). Objectives: To evaluate the clinical attitude to the cytological diagnosis of Bethesda category 3 (B3) in thyroid fine-needle ...

Abstract: Gastrointestinal disorders may impair oral thyroxine (T4) absorption by either affecting the tablet dissolution or adsorbing the hormone in the first tract of intestinal lumen. Ulcerative colitis (UC) is an inflammatory disease whose interference with oral T4 treatment has been suggested but no evidence have been presented so far. This study was aimed at examining the presence of UC and its possible interference in the pharmacologic thyroid homeostasis, in a large co...

Background: Risk of cardiovascular disease (CVD) and mortality is increased in Graves’ disease (GD) even years after initial diagnosis and treatment. The mechanisms are incompletely understood. Vitamin D insufficiency is associated with an increased risk of CVD and has been reported to occur frequently in GD. Pulse wave velocity (PWV) and blood pressure (BP) are important predictors of CVD. We performed a clinical trial, testing whether vitamin D supplementation affects P...

Introduction: Severe thyroid disorders are usually associated with myopathy. Muscle weakness may occur in both hypothyroidism and hyperthyroidism. However, only hypothyroid patients experience increase in creatine kinase levels, depicting destruction of muscle fibers. There were recently some reports showing the lowering in serum concentrations of large sarcomere proteins – titin (TTN) and dystrophin (DMD) in patients with hypo- and hyperthyroidism....

Background: Incidence of thyroidectomies and awareness to postoperative quality measures have both increased in the last decade. Gender-specific indications and variations in clinical outcomes of patients undergoing thyroidectomy in Switzerland are of interest.Methods: We cross-sectionally compared administrative nationwide patient-level data for length of hospital stay (LOS), intensive care unit (ICU) admission, 30-day readmissions rates, and other qual...

Background: Matrix metalloproteinase-9 (MMP-9) is overexpressed in almost all human cancers (including thyroid). High serum levels are generally associated with an adverse prognosis, although the evidence related to thyroid cancer is still controversial.Aim: We aimed to evaluate pre- and post-surgical serum MMP-9 levels for its diagnostic and prognostic value in a series of patients with benign thyroid disease (BD) or differentiated thyroid carcinoma (DT...

Introduction: Thresholds of basal (bCT) or stimulated serum calcitonin (sCT) levels for the diagnosis of medullary thyroid carcinoma (MTC) aren’t specified in current revised MTC guidelines.Objective: We aim to setfemale (F) specific thresholds for bCT and sCT for MTC diagnosis.Methods: CT samples were measured during calcium-stimulation test (25 mg/kg BW adapted to ideal body mass index) before and at 2, 5 and 10 minutes afte...

Introduction: Venous thrombotic disease is a multicausal disease with many powerful risk factors (genetic, hormonal, environmental …). In recent years, several reports suggest possible relationships between hyperthyroidism and risk of venous thrombosis. We report the case of a patient with hyperthyroidism complicated by pulmonary embolism.Case report: A 43-year-old female patient, who’s under treatment for a relapse of Grave’s disease, sh...

Introduction: Graves’ disease is an autoimmune disease, it is considered to be the most common cause of hyperthyroidism. Autoimmune pluriendocrine syndromes include a diverse group of diseases characterized by functional impairment of at least two endocrine glands due to autoimmune events.Material and methods: This is a retrospective hospital record-based study of patients with Graves’ disease followed up in the day hospital of the department o...

Introduction: Hematological toxicity is considered as the main risk of synthetic antithyroid drugs; its major form consists of acute agranulocytosis which can be lethal and requires urgent and adequate management. We report the case of a patient who developed acute agranulocytosis within 1 month of therapy.Observation: A 24-year-old patient with no particular medical history was admitted for management of hyperthyroidism, with a history of weight loss, p...

The autoimmune thyroid disease (AITDs) comprises two clinical phenotype, Graves’ disease (GD) and autoimmune hypothyroidism (AIH), which include goitrous [Hashimoto thyroiditis (HT)] and non goitrous forms [Primary idiopathic myxoedema (PIM)]. These disorders are characterized by loss of immunological self tolerance including the presence of a thyroid lymphocytic infiltrate and autoantibodies to thyroglobulin (Tg) and thyroid peroxidase (TPO). Inheritance of AITDs is comp...

Cases of hyperthyroidism manifestation associated with previous secondary hypothyroidism are extremely rare. The article presents a rare clinical case of Graves’ disease manifestation in a patient with secondary hypothyroidism after radiosurgical treatment of acromegaly. A 38-year old woman with acromegaly and endo-supra-laterosellar pituitary adenoma had transsphenoidal non-radical surgery and subsequent radiosurgical treatment. After 2 years of radiation treatment, she ...

Autoimmune thyroid disease (AITD), including Graves’ disease (GD) and Hashimoto’s thyroiditis (HT), is caused by multiple genetic and environmental factors. The clinical and immunological features of GD and HT are distinct; however, there are multiplex families with both GD and HT. In order to study the genetic susceptibility factors to AITDs, we have followed up 115 control members belonging to a large Tunisian family with a high prevalence of AITDs (Akr family) dur...

Introduction and aims: Autoimmune thyroiditis represent a state predisposed for the development of hypothyroidism. It is known that subclinical and overt hypothyroidism are important risk factors associated with the development and progression of heart failure. These effects are due to the changes in the structure and function of the cardiac muscle, as well as the overall cardiac mechanics. The aim of our study was to examine the influence of autoimmune thyroiditis (Hashimoto ...

Introduction: Radioiodine ablation with a whole-body scan is a well known therapeutic regimen for differentiated thyroid cancer. I-131 uptake in the breast has been described with a variety of normal and pathologic conditions such as gynecomastia, supernumerary breasts, fibroadenoma and lactational duct cyst or galactocele. Here we report a case with an incidental radioiodine uptake in breast who turned out to be breast cancer.Case report: A 70 years old...

Introduction: Anti-thyrotropin receptor antibodies (TSHR-Abs) stimulating the thyroid (TSAb) are responsible for Graves’ disease. In some patients, the TSHR-Abs can block thyrotropin action (TBAb) and cause hypothyroidism, the switch between stimulating and blocking activity in Graves’ disease being well. This reports aims to describe clinical presentation of patients affected directly by hypothyroidism.Material and methods: Retrospective clini...

Introduction: Occult carcinoma of the thyroid is defined as a microcancer less than 1 cm in size, clinically undetectable. Discovered accidentally during routine radiological examination, cervical surgery of a benign thyroid tumor, varies from 0.01% to 35.6%. Mostly it is papillary type. Occult cancers revealed by bone metastasis have rarely been reported. We report two patient observations presenting bone localizations of occult thyroid carcinoma.Observ...

Introduction: Graves’ ophthalmopathy (GO) is an orbital autoimmune disorder closely linked to thyroid autoimmunity, mainly Graves’ disease. After an initial progressive inflammatory period (active phase), GO stabilizes and eventually subsides (inactive phase). Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient’s quality of life. Patients with active, mild disease generally benefit from local therapies ...

Lentigo malign melanoma corresponds to the main histological type of melanomas ‘in situ’, particularly affecting Caucasian elderly exposed chronically to the ultraviolet rays. The therapeutic course should be surgical, with careful resection of the tumor, allowing free and wide margins. Follicular thyroid carcinoma corresponds to the second most common histological type characterized as a well differentiated neoplasm. It presents markedly vascular dissemination, bein...