Endocrine Abstracts

Introduction: Patients with benign thyroid disease may present an impaired Quality of Life (QoL). However, evidence of cosmetic complaints in patients with thyroid disease is limited. The aim of the current study was to investigate the cosmetic complaints of patients with thyroid disease and determine any associations with specific clinical characteristics.Methods: A cross-sectional study was performed. Patients with benign thyroid disease who attended t...

Introduction: In everyday practice, doctors often have to deal with patients who show features of depression - it has been proven that in 20–30% of cases it may be related to the ocurrence of another disease, such as hypothyroidism.Aim of study: The aim of the study was to verify the frequency of occurrence features of depression (based on Beck’s scale) in the population of patients with hypothyroidism and comparison to the general population.<...

Stress is any uncomfortable emotional experience accompanied by predictable psychological, physiological and behavioral changes. A sudden and severe stress generally produces an increase in the heart rate and blood pressure and induces a state of alertness in an individual. Evidence indicates that chronic stress depresses thyroid function, resulting in low levels of T3 and T4, which affects cardiomyocytes’ function and leads to development of cardiov...

Introduction: The importance of telomerase reverse transcriptase promoter (TERTp) mutations in DTC is widely discussed. It has been demonstrated that the presence of TERTp mutations is associated with higher cancer aggressiveness, reflected by lymph node metastases, distant metastases, advanced tumor stage, recurrence, and even disease-specific mortality. Nevertheless, there is no clear evidence-based data demonstrating how to manage these patients. Therefore...

Background: The most common tool to test malignancy in the study of thyroid nodules (TN) is ultrasound and fine needle aspiration biopsy (FNAB). However, the sensitivity and specificity of the methods and the effectiveness in thyroid cancer are limited; therefore new methods to study thyroid nodules are required. In this way our goal is to introduce hybrid diffuse optical instruments that are capable to measure and discriminate altered microvascular blood flow, blood volume an...

Introduction: Sweet’s syndrome is a rare, acute febrile neutrophilic dermatosis, associated with a variety of inflammatory and neoplastic conditions, drug reactions and rarely with a spectrum of thyroid dysfunction. A possible link between thyroid autoimmunity and Sweet’s syndrome has been previously suggested by rare reports of Hashimoto’s thyroiditis, subacute thyroiditis and classic Graves’ disease. We describe a case of ‘atypical’ hyperthyroid...

Introduction: Thyroid dyshormonogenesis continues to be a significant cause of congenital hypothyroidism occurring due to a lack of enzymes necessary for the synthesis of thyroid hormones. Treatment can be medical or surgical. Early treatment is important to avoid mental retardation and growth abnormalities.Case reports: We report 3 cases of dyshormonogenetic goiter occurring in 1 female and 2 males. The medium age of the patients was 12 years ranging fr...

Introduction: Struma ovarii is a rare form of ovarian teratoma mostly composed of thyroid tissue. In about 5% of the cases, well-differentiated thyroid carcinoma may arise in struma ovarii. As this medical entity is so exceptional, there is still no consensus on diagnosis and treatment.Case Reports: A 52-year-old old woman was submitted in 2009 to total hysterectomy with bilateral adnexectomy and pelvic lymphadenectomy. Histopathology r...

Introduction: The majority of thyroid diseases in adults can also affect the child. Graves’ disease is characterized by the association of signs of hyperthyroidism and exophthalmia. It is a rare condition in pediatrics and especially affects the big child. Easy to diagnose, Graves’ disease in children requires strict management. We report 3 clinical cases of baseline disease, 2 of which required radical treatment.Case 1: A 9-year-old child cons...

Evidence on whether neonatal thyroid screening results are dependent on maternal thyroid function is limited.Objectives: To study the relationship between iodine status and maternal thyroid function in pregnancy, and neonatal screening results in a Northern Spanish population.Methods: Prospective, longitudinal study of 297 pregnant women recruited in 2 obstetric centers of Pamplona (Spain) at the first antenatal visit, and their ne...

Aim: The aim was to assess the expressions of GLP-1, IGF-1 and leptin in the paraffin sections of operated thyroid cancer and non-thyroid cancer patients, and show the relationship of GLP-1, IGF-1 and leptin receptor expressions with thyroid cancer, comparatively.Materials and Methods: This study was carried out retrospectively. The case groups consisted of 20 medullary thyroid cancer (MTC), 20 follicular thyroid cancer (FTC), 20 classical papillary thyr...

Congenital adrenal hyperplasia (CAH) is a group of diseases which develop as a result of deficient enzymes or co-factor proteins required for cortisol biosynthesis. Depending on the defect, the manifestations range from life-threatening salt-wasting syndrome to almost no symptoms. Nevertheless, some subclinical subtypes can cause impediments in particular situations. This case brings to light a possible manifestation of CAH, revealed in the process of in-vitro fertilization. W...

Carcinoma showing thymus-like differentiation (CASTLE) is a rare malignancy, localized in the thyroid parenchyma. As far as we know, only a few CASTLE cases are described in literature. The diagnosis is based on immunoreactivity, the main characteristic is positivity to CD5, which reveals a thymic differentiation. We report the case of a 63-years-old male, who presented with a 3 cm solid, hypoechoic nodule in the lower part of the left thyroid lobe, with underlying structures ...

Introduction: According to the literature, there is a link between obesity and thyroid cancer. A high body mass index (BMI) increases the risk of thyroid cancer and its progression, although their mechanism is still unknown.Objective: To evaluate the association between obesity and the clinical-biological profile of differentiated thyroid cancers.Materials and methods: We conducted a retrospective study carried out in the Endocrino...

Introduction: Thyrotoxicosis may be associated with anemia (10–34% of thyrotoxic patients), leucopenia (15–30%) and thrombocytopenia (2–5%). We present the case of a 13-year-old girl with Graves’ disease associated with severe pancytopenia.Case presentation: The patient presented with menorrahgia and symptoms suggestive of an upper respiratory tract infection. On examination she was afebrile with a pulse rate of 100/min at rest. She h...

Introduction: Biotin is a water-soluble vitamin involved in several and important metabolic processes, recommended daily intake for adults is 30–100 μg/day and normal plasma concentrations are 0.4–1.2 ng/day. Nowadays biotin is being used in inherited metabolic diseases, multiple sclerosis and as a supplement in, over the counter multivitamins widely used for common hair and skin problems. The supraphysiologic biotin intake has produced emerging problems with bi...

Introduction: Radioactive iodine-refractory differentiated thyroid cancer is a rare form of advanced thyroid cancer (approximately 4 cases per million population per year) defined by persistent disease after administration of a cumulative radioiodine dose of 600 mCi or at least one tumor without radioactive iodine uptake or by progression of the disease within one year after RAI treatment. Therapeutic options in this case include molecular-targeted therapies, like tyrosine kin...

Introduction: Autoimmune polyglandular syndrome (APS) is an autoimmune disorder that affects many endocrine glands. Until now four categories of APS are identified: APS-I includes at least two out of: mucocutaneous candidiasis, hypoparathyroidism and adrenocortical failure. APS-II, the most frequent, comprises of Addison’s disease, autoimmune thyroid disease and/or type 1 diabetes. APS-III is defined by the presence of autoimmune thyroid disease and other autoimmune disor...

Introduction: Papillary thyroid carcinoma (PTC) is the most common endocrine cancer however extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT) of the thyroid gland is quite rare. The simultaneous association of both cancers is much more rare.Case report: 65-year-old woman underwent a thyroid ultrasound examination due to palpable thyroid nodules. Thyroid ultrasound revealed thyroiditis and multiple nodules on the right and ...

Introduction: Thyroid amyloidosis is defined as amyloid protein and fat deposition within the thyroid gland. It is classified as either primary (idiopathic) or secondary to inflammatory/chronic disease. Albeit deposition of amyloid protein in thyroid tissue is frequent, amyloidosis affecting exclusively the thyroid gland without evidence of other organs involved is extremely rare. We report a clinical case of a patient who underwent lobectomy due to a toxic adenoma, whose hist...

Introduction: Patients with either papillary thyroid carcinoma or melanoma have an increased risk of developing the other cancer as a second primary malignant neoplasm. We report a rare case of malignant melanoma (CM) and papillary thyroid carcinoma (PTC) that were diagnosed and treated simultaneously.Observation: We report a case about a 46-year-old male, in whom examination of a skin biopsy that was obtained from a lesion in the right big toe revealed ...

Background: Several ultrasound (US) scoring systems have been proposed to provide rules for standardizing risk stratification of thyroid nodules and to select which nodules should have a fine needle aspiration (FNA) biopsy performed. TI-RADS classification is one of the most used in the daily practise. Recently, EU-TIRADS scoring system has been published to simplify the evaluation of thyroid nodules and to integrate previous classifications into a single system. We aimed to c...

Introduction: Differentiated thyroid cancers are rare (less than 1% of cancers), and generally have a positive prognosis: Their mortality rate increases steadily with age.Objective: To assess the biologic behavior of differentiated thyroid carcinoma in patients aged 65 years or older and evaluated factors that influenced long-term survival\.Patients and methods: We conducted a retrospective study of elderly patients (>65 years)...

Introduction: Simple aspiration is the first-line treatment used for benign cystic thyroid nodules. However, a high recurrence rate has been reported with this procedure. When this happens, percutaneous ethanol injection into the nodules has proven to be an effective technique which can reach a volume reduction of about 85% (Kim et al., Eur Radiol. 2012 Jul;22(7):1573–8).Material and methods: Descriptive analysis of percutaneous 96° et...

Background: Surgery is the standard treatment in patients with medullary thyroid carcinoma (MTC), 43% being biochemically cured postoperative in a large series, the most important prognostic factor being the stage of the disease.Material and methods: We present 3 cases of biochemical cured patients after surgery with different preoperative presentation. Calcitonin and carcinoembryonic antigen (CEA) were measured by chemiluminescence. Histological examina...

Introduction: Thyroid carcinoma (TC) is the most common endocrine malignancy. Although the overall prognosis for patients with TC is good, up to 20% of patients develop recurrent or persistent disease after conventional therapy by total thyroidectomy and radioactive iodine (RAI). Amiodarone is a highly efficient anti-arrhythmic drug with a very long half-life, so it may interfere with RAI many months after the drug withdrawal. This case report mirrors the challenges of thyroid...

Introduction: Thyroid disorders are quite common during pregnancy complicated by diabetes mellitus.Objective: The aim of our study was to detect thyroid disorders in a group of diabetic pregnant women.Patients and methods: Rétrospective study involving 243 pregnant women with diabetes followed in consultation or hospitalized in Endocrinology and Diabetology department of Ibn Rochd University Hospital of Casablanca, over a peri...

Introduction: Hashimoto’s thyroiditis is known to induce nodularity in the thyroid and in some cases to coexist with papillary thyroid carcinoma. However, the effect of the development of Hashimoto’s thyroiditis on the course of nodular goiter is not known.Aim: The aim was to describe the effect of the development of Hashimoto’s thyroiditis in the course of nodular goiter.Methods: A cohort of 12 patients, female, age...

Introduction: Graves’ disease is an autoimmune disease that leads to a generalized overactivity of the entire thyroid gland – hyperthyroidism. Although the link between Graves’ disease and thyroid carcinoma was widely explored, we cannot undermine the relationship between this condition and other common neoplasms.Materials and method: The retrospective analysis was performed using clinical data of 295 adult patients (225 women and 70 men) ...

Introduction: Grave’ disease is associated with extra thyroid auto-thyroid manifestations such as basal ophthalmopathy and/or. We report the case of two patients presenting with extrathyroid manifestations of the basic illness hospitalized at the department of diabetic endocrinology and metabolic diseases of Ibn Rochd University Hospital of Casablanca.Case 1: This is a patient aged 53 years, chronic smoking at 20 years, for low weight disease since ...

Introduction: Cervical lymphadenopathy is often a diagnostic challenge to medical professional due to its varied etiologies. Malignancies and infections are the main causative factors that should be included in the differential diagnosis. Cervical lymphadenitis is a common manifestation of extra-pulmonary invasion of the tuberculosis. A cervical tuberculous lymphadenitis could be confused with metastatic lymph node of thyroid cancer.Case reports: Case 1:...

Purpose: To evaluate the outcome of different Radioactive iodine-131 activity range for the treatment of hyperthyroidism assessed at 6 and 12 months.Material/method: We retrospectively reviewed data of patients who received Radioiodine treatment for benign thyroid disorder at our center between 2013 to 2015. Indication for treatment, radioiodine activity administered, type of hyperthyroidism, and biochemical outcome of thyroid function at 6 and 12 months...

Introduction: Follicular thyroid carcinoma (FTC) is the second most common malignancy of the thyroid gland. Distant metastasis, usually in bones or lungs, can be found in about 10%–15% of cases. A clinical case of FTC distant bone metastasis is presented.Case: A 62-year-old male came to endocrinologist for annual follow-up (FU) of multinodular goiter, euthyreosis in 2010. Two years before prostate carcinoma (T1N0M0) was also diagnosed for the patien...

Background: Assessment of response to therapy is a valid tool for dynamic risk stratification in patients with differentiated thyroid cancer (DTC). It is well documented in patients treated with total thyroidectomy and radioiodine ablation therapy (RAI), but data is still sparse regarding patients treated with lobectomy. Our study aimed to evaluate response to therapy in patients with DTC treated with lobectomy.Methods: We performed a retrospective study...

Introduction: Amiodarone is a widely used antiarrhythmic drug for refractory atrial or ventricular tachyarrhythmias. Amiodarone-induced thyrotoxicosis (AIT) occurs in up to 6% of patients taking this medication in iodine-sufficient areas of the world and in up to 10% in iodine deficient areas. AIT can be divided into two types: type 1 is a form of iodine-induced hyperthyroidism whereas type 2 is a drug-induced destructive thyroiditis. Type 1 AIT tends to occur in patients with...

Thyroid nodules have 3–7% freuquency in general population. FNA biopsy is an important diagnostic tool for patients with thyroid nodules. There are many reporting systems for FNA biopsy and Bethesda system is the most common one. The aim of this retrospective study, detect the atypia of undetermined significance (AUS) rates in the patients who performed FNA biopsy and evaluate the concomittant biopsy results of this patients and malignancy rates in the patients who were c...

Introduction: Cases of spinal ganglionic chains invasion due to a thyroid carcinoma are exceptional. We are reporting the observation of a patient with thyroid papillary carcinoma, with insular component, revealed by retro-spinal lymphadenopathy.Observation: Our patient is 55-year-old with no particular pathological history, consulting due to the development of a posterior cervical swelling gradually increasing in volume. A cervical ultrasound was perfor...

Introduction: Amiodarone is an effective drug in the management of supraventricular arrhythmias. Due to its composition rich in iodine and pharmacological properties can cause thyroid dysfunction in 15–20% of the treated patients. Clinically it can present in the form of amiodarone-induced hypothyroidism or amiodarone-induced thyrotoxicosis. This latter situation may result from an excess of iodine supply, glandular destruction or both pathogenic mechanisms.<p class="...

Introduction: Stress is a known risk factor for the development of Graves’ disease. We have previously described the role of bereavement as an inducing factor for Graves’ disease. Bereavement as an inducing factor for Graves’ disease was shown to affect primarily female patients after the loss of a loved one. However, it appears that other stressful life events may also cause Graves’ disease.Aim: The aim of the study was to describe t...

Introduction: Detection of TSH-receptor autoantibodies in the diagnosis of graves disease is well established. however these autoantibodies may not be always present in some forms of correctly observed autoimmune hyperthyroidism. Here, we describe a patient with hyperthyroid Graves’ disease without detectable thyrotropin receptor antibodies.Case report: She was A 55-year-old woman, presented with a 2 years history of increased sweating, palpitations...

Bone radioiodine (RAI) uptake without structural abnormality in thyroid cancer (TC) patients may be related to false positive or to microscopic foci of metastatic tissue. In such cases, outcome is reported to be excellent. Mrs D. had been operated for a pT3(m) poorly differentiated TC at the age of 43. The first post-therapeutic whole body scan revealed 3 foci of bone uptake (right clavicle, L2, L3). The elevated level of thyroglobulin (157 ng/mL) favoured the hypothesis of bo...

Background: Delayed new-onset Graves’ orbitopathy (GO) or worsening of existing GO occurs in approximately 15–20% of patients following radioiodine treatment (RAI), mostly within 12 month.Case Report: A 57-years-old woman was referred in April 2016 to our endocrinology department for Graves’ disease hyperthyroidism. Relevant medical history included chronic lymphocytic leukemia (2004), fludarabine-related interstitial pneumonia with tempor...

Background: The discovery of a thyroid nodule is a problem in thyroid cancer screening. Thus, the analysis of the criteria of malignancy remains the first step of study of a thyroid nodule. The objective of our study was the correlation between the clinical, ultrasonographic and cytologic malignancy criteria and the anatomopathological study results of the operative specimen.Materials and methods: For this we conducted an analytical cross-sectional study...

Introducion: Pituitary apoplexy is an endocrine emergency that is a rare complication of pituitary adenomas and exceptional in ACTH adenomas. We report a case of apoplexy on corticotropic adenoma with intermittent secretion.Case report: The patient was 41 years old woman, she presented in 2012 a period of symptomatic hypercortisolism. Urinary free cortisol was elevated to 113 μg/24H, Low-dose dexamethasone testing was negative, ACTH was elevated to ...

Introduction: Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) of Bethesda system for reporting thyroid cytopathology has emerged as most controversial category due to its heterogeneity and inconsistent usage. Initially associated risk of malignancy was estimated to be about 5–15%, but eventually different results have been obtained across institutions due to variable follow-ups and interpretation. The objective of this st...

Paraneoplastic manifestations of well-differentiated thyroid carcinoma are not so common but they can be the first signal of cancer. We present a case of a man with Raynaud’s phenomenon in the area of the lower limb fingers. Clinical signs of Raynaud’s phenomenon with ulceration and gangrene of fingers of both lower limbs appeared several months before the diagnosis of papillary microcarcinoma of the thyroid was made. The diagnosis of carcinoma of the thyroid was det...

Introduction: The aim of the present study was to compare follicular thyroid adenoma (FTA) and follicular thyroid carcinoma (FTC) using the wide oncological molecular panel and identify differences in mutational status which may aid in the preoperative differentiation between these two related thyroidal pathologies, as well as in an understanding their pathways of origin.Material and methods: We analyzed formalin-fixed paraffin-embedded (FFPE) samples ac...

Background: The evaluation of health-related Quality of Life (QoL) is becoming a key component in clinical assessment of thyreopathic patients, especially those thyroidectomized for differentiated thyroid cancer (DTC) and treated with levothyroxine (LT4).Aim: To evaluate QoL in different thyroid states in patients treated with total thyroidectomy for DTC and correlate it with thyroid function tests.Methods: Two hundred subjects (13...

Introduction: Thyroid dermopathy is a non-frequent manifestation of autoimmune thyroiditis. It complicates a small percentage of patients and is usually associated with ophtalmopathy and acropachy.Observation: A 46-year-old man presented to our department of endocrinology at the university hospital of Casablanca with 3 years history of Graves’ disease, developed gradual onset of exophthalmos and bilateral leg oedema starting from his pretibial areas...

Introduction: Differentiated thyroid carcinoma (DTC) can often be multifocal. However, the multifocal character as associated with a more pejorative prognosis remains controversial. The objective of our study is to describe the clinical, histological and evolutionary characteristics of multifocal DTCs.Materials and methods: Retrospective study including 159 patients diagnosed with a multifocal CDT, treated at the endocrinology service of the University H...

Introduction: Positive radiotracer uptake by the thyroid gland can occur in PET-CT. It’s meaning has led to conflicting results mainly resulting from small studies.Objective: We aim to present a large single institution consecutive case series.Material and methods: Observational, descriptive and retrospective study of the PET-CT scans performed between the years 2000–2017. We searched the word thyroid in the computer imag...

Introduction: Untreated hypothyroidism may lead to decompensation of a patient’s homeostasis. While the association between hypothyroidism and anemia has been noted previously, there are very few, cases of white cell lines and platelet counts being affected by hypothyroidism alone. To demonstrate a rare but significant manifestation of hypothyroidism, we present a unique and interesting case of pancytopenia secondary to severe hypothyroidismCase rep...

Introduction: Follicular or vesicular cancers represent 5 to 10% of differentiated thyroid cancers (CTD) and are therefore the second leading cause of endocrine tumors after papillary thyroid cancer. They can be minimally or massively invasive, and thus represent a more aggressive histological type compared to the papillary. The aim of our work is to describe in our context the clinical and evolutionary features of thyroid tumors of vesicular origin.Mate...

Objective: Owing to their remarkable stability in the serum, microRNAs are being investigated as circulating cancer biomarkers. Several studies have explored their plasma or serum levels in thyroid cancer in order to differentiate benign from malignant nodules preoperatively. However, very few studies have explored the role of microRNAs to detect recurrent disease during postoperative follow-up and none of them used high through-put technologies. Recombinant human TSH (rhTSH) ...

Introduction: Patients with systemic sclerosis may develop cancer. The development of malignant hematological diseases has also been described in patients with systemic sclerosis. These patients may also be prone to the development of lymphoma, in most cases a B-cell lymphoma.Aim: The aim was to describe the case of a patient with systemic sclerosis who had a non-Hodgkin’s lymphoma and developed primary hypothyroidism.Case rep...

Introduction: Hyperthyroidism (HT) has been associated with hepatic dysfunction in the presence or absence of congestive heart failure (CHF). Our objective is to study the correlation between the clinical and biological presentation of hepatic abnormalities and the cardiac status.Patients and methods: This retrospective study included 17 patients hospitalized in the endocrinology department of Hedi Chaker Hospital in Sfax over 20 years (1997–2017). ...

Case History: 38 year old male presented with thyrotoxic symptoms and exophthalmos with an initial Free T4 of > 100 pmol/l; TSH < 0.01 mIU/l and thyroid receptor antibody positivity. He had a platelet count of 72* 109 /L at presentation and was started on carbimazole. A month later he had platelet count of 9* 109 /L with normal white cell count and haemoglobin levels. He was switched to propylthiouracil, but was readmitted with platelet count of 1...

To our experience the presence of black pigmentation in vive thyroid tissue cervical lymph nodes before ligating the arteries was associated with differentiated thyroid cancer (DTC). The goal of this study was to evaluate the association between black pigmentation and DTC. 615 patients who were underwent thyroidectomy were assessed during operation by a single surgeon during 5 years from 2013 to 2018 and the presence of black pigmentation was evaluated in gross pathology befor...

Introduction: Lenvatinib is an oral tyrosine kinase inhibitor (TKI) used for treatment of progressive, clinically significant or symptomatic disease in patients with iodine-refractory differentiated thyroid cancer (DTC).Objective: To describe our clinical experience with lenvatinib in patients with iodine-refractory differentiated thyroid cancer.Methods: Restrospective cohort study of patients with iodine-refractory differentiated ...

Thyroid dermopathy or pretibial myxedema (PTM) is a rare extrathyroidal manifestation of Graves’ disease with diverse presentations. Therefore, information on the clinical data of PTM patients is scarce. In this study, we aimed to evaluate the clinical features of patients with thyroid dermopathy and Graves’ disease. A total of 43 patients with pathologically confirmed PTM were retrospectively recruited. According to the diagnosis, the clinical data and laboratory fi...

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women of reproductive age. Although some studies have suggested an association between PCOS and autoimmune thyroiditis, only a few cases indicating association between PCOS and Graves’ disease are reported.Case report: We present a woman aged 29 with Graves' disease certified by suppressed TSH (0.001 mUI/l), high FT4 (6.6 ng/dl) associated with elevated TRAb (...

Introduction: Primary thyroid angiosarcoma (TAS) is a rare malignancy that arises from endothelial cells, and nearly all reported cases originate from the Alpine region of central Europe. Most of the patients are female, elderly, with a history of goiter. Generally, TAS arises as a painless infiltrating mass and patients present with compression symptoms due to the brisk tumor growth. Other TAS clinical presentations are varied and highly non-specific. Metastasis occur early i...

Hashimoto thyroiditis (HT) is the most common cause of hypothyroidism in the world with iodine deficiency and its incidence is 0.3–1.5 per 1,000. The aim of this study is to retrospectively evaluate the demographic characteristics, clinical and laboratory findings of the patients with HT who applied to our endocrinology outpatient clinic. The findings were compared with the control group who had hypothyroidism with negative thyroid autoantibodies. For this purpose, a tota...

Introduction: Untreated hypothyroidism may lead to decompensation of a patient’s homeostasis. While the association between hypothyroidism and anemia has been noted previously, there are very few, cases of white cell lines and platelet counts being affected by hypothyroidism alone. To demonstrate a rare but significant manifestation of hypothyroidism, we present a unique and interesting case of pancytopenia secondary to severe hypothyroidism.Case re...

Introduction: Hyperthyroidism produce changes in cardiac contractility, blood pressure, and systemic or pulmonary vascular resistance. In almost all cases these cardiovascular changes are reversible when the underlying thyroid disorder is recognised and treated. Pulmonary hypertension (PAH) has been associated with hyroid dysfunction, but primaraly with hyperthyroidism. The vast majoity of patients with this form of PAH are usually older with toxic multinoduar goitre. The aim ...

Introduction: Papillary thyroid carcinoma is well known as a differentiated thyroid carcinoma with an established treatment protocol and high survival rates. Poorly differentiated thyroid carcinoma, or anaplastic, is highly aggressive, manifesting with local invasion, recurrence, and distant metastasis; it is well known that these two entities may be connected as a process of dedifferentiation, most commonly met in elderly people with a long term standing untreated well differ...

Introduction: Papillary thyroid cancer (PTC) has an excellent prognosis in most cases with a 10-year survival rate of more than 95% but decreases drastically in cases of PTC iodine-refractory, in recurrent and/or metastatic disease. Tyrosine kinase inhibitors, such as lenvatinib or sorafenib, have been approved in such cases and in some cases are able to stabilize the disease and prolong survival. However, serious side effects have been reported such as fistula formation, blee...

Introduction: Myxedema coma is a rare life-threatening clinical condition in patients with longstanding severe untreated hypothyroidism, in whom adaptive mechanisms fail to maintain homeostasis. Most patients, however, are not comatose, and, although strict criteria have been proposed, it is often difficult to differentiate it from very severe hypothyroidism, lacking only a precipitating event.Material and methods: We present the clinical picture of 70 c...

Background: Measurement of thyroglobulin (Tg) in the washout fluid of fine-needle aspirates (FNA-Tg) is useful for diagnosis of Cevical lymph node (CLN) metastasis in papillary thyroid carcinoma (PTC).Objective: The aim of this study was to evaluate the relationship between FNA-Tg levels and Sonographic findings in CLN in patients with PTC.Methods: Since January 2017 until December 2018, an ultrasound-guided fine-needle aspiration ...

Introduction: Abnormalities of lipid metabolism and arterial hypertension occur with increased frequency in hypothyroidism and are associated with a higher risk of premature atherosclerotic vascular disease. Therefore, a vigorous lipid lowering treatment seems mandatory, including quickly restoration of thyroid function, to reduce vascular risk. We evaluate benefits on lipid profile after intravenous thyroxine treatment in severe hypothyroid patients at three and thirty days.<...

Aim: To determine patient outcomes following radioactive iodine (I131) therapy in a UK district general hospital for the treatment of benign thyroid disease.Methods: A record of all patients at University Hospital Hairmyres (Scotland, UK) undergoing radioactive iodine therapy for benign thyroid disease was kept. Patients were identified using a unique community health index (CHI) number. A retrospective case note review was then carried out fo...

Introduction: Many studies have shown that cigarette smoking exerts multiple effects on the thyroid gland. Smoking seems to induce changes in thyroid function tests, like a left-shift in serum TSH level that is more apparent in iodine-deficient subjects and increase in thyroid hormones. We describe the effect of an intensive thyroxine intravenous treatment in severe hypothyroid patients and the results depending on their smoking status.Material and metho...

Alemtuzumab is an approved und well known Medication for the treatment of multiple sclerosis and it is a humanized anti-CD52 monoclonal antibody. Autoimmune diseases are the most common side effect of Alemtuzumab treatment. In our Case is after 18 Months of Alemtuzumab therapy a thyroid autoimmune disease developed. Patient with multiple sclerosis during the normal Follow up appear increased thyroid antibodies TPO 101 KU/L (normal <34) and TRAK 38.2 IU/L (normal <1.75)...

Introduction: Spontaneous thyroid hematoma is a rare entity that can be favored by anticoagulation therapy. Any neck swelling can be life-threatening by compression of the upper aerodigestive tract and adjacent vascular axes.Case report: We report the case of an 80-year-old patient with a previously existing goiter, started on vitamin K antagonists for atrial fibrillation, who presented to the emergency room for anterior neck mass that appeared 2 days be...