Endocrine Abstracts

Adult-onset hypothyroidism is related to anxiety, depression, and impaired neurocognition. Guidelines from all professional societies recommend levothyroxine (LT4) monotherapy as the treatment of choice. However, ~15% hypothyroid patients do not achieve a satisfactory functional level despite TSH within the reference range. The beneficial effects of combining LT4 and liothyronine (LT3) to improve neuropsychiatric functions remains unclear. Recently, 3-iodothyronamine (T1A...

Abnormalities in thyroid hormone (TH) availability and/or metabolism have been hypothesized to contribute to Alzheimer’s disease (AD) and to be a risk factor for stroke. Recently, 3-iodothyronamine (T1AM), an endogenous amine putatively derived from TH metabolism, gained interest for its ability to modulate the nervous and the vascular systems. In the present work, we studied the effect of T1AM on ischemia-induced synaptic dysfunction in the entorhinal cortex (EC), a bra...

Thyroid hormone (TH) plays an important role for brain development. As the fetal thyroid gland only starts providing hormone at the end of pregnancy, the developing brain crucially depends on maternal thyroid hormone in early developmental periods. In previous studies, we have observed that in particular the central control of cardiovascular functions critically depends on maternal thyroid hormone for proper development; however, the precise window when the hormone is benefici...

Background and Aim: The incidental detection of asymptomatic thyroid nodules (TNs) has increased over time. Over 90% of newly diagnosed TNs are either cytologically or sonographically benign. This study aimed to determine the frequency and magnitude of changes in TNs size over time.Methods: We performed a prospective, multicenter, observational study involving consecutive euthyroid patients with 1–4 asymptomatic, sonographically or cytological...

Objectives: Quality of life (QoL) is severely affected in Graves’ disease (GD) but long-term longitudinal assessment of QoL is lacking. Furthermore, whether QoL is comparable to controls after treatment of GD is unclear. For the first time, we present serial, longitudinal data on thyroid-related QoL during 24 months of follow-up in a cohort of newly diagnosed GD patients. In addition, we compare QoL in GD and controls.Methods: All patients were tre...

Objective: Guidelines recommend using fine needle aspiration cytology (FNAC) to guide thyroid nodule surgical indication, however to what extent these guidelines are followed remains unclear. This study aimed to analyze the quality of the preoperative care pathway and the influence of the care pathway on surgical indications relevance.Design: Nationwide historical cohort study based on data from a sample (1/97th) of French health insurance beneficiaries....

The newly created NIFTP category (non-invasive follicular thyroid neoplasm with papillary-like nuclear features) has had a notorious impact in the management of thyroid neoplasms. Its incidence appears to be higher in western countries than Asiatic, but there are few studies including more than one institution.Objectives: To evaluate retrospectively the incidence of NITFP in a multicentre study in two adjacent countries as well as to compare th...

Introduction: Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant hereditary tumor syndrome. Common manifestations include more than 20 tumors of the parathyroid, pituitary and pancreatic glands and others non-endocrine tumors. The majority of patients carry a germline mutation in a tumor-suppressor gene MEN1, that encodes nuclear protein menin, ubiquitously expressed. So fare, more than 600 germline or somatic mutations have been reported over the...

Introduction: The Sodium Iodide Symporter (NIS) is responsible for active transport of iodide into thyroid follicular cells, enabling the use of radioactive iodine (RAI) for treatment of metastatic disease. Still, a significant proportion of patients with advanced forms of thyroid cancer (TC) became refractory to RAI therapy. Defective NIS expression is the main reason for impaired iodide uptake in TC and NIS downregulation has been associated with several pathways linked to m...

Differentiated thyroid carcinoma (DTC) is viewed as an indolent disease but 5–15% of patients (pts) become refractory to RAI treatment. This is associated with poor prognosis, a 3–6 years life expectancy and accounts for approximately 200 deaths per year in Canada. There is no universal definition of rDCT and management evolves over time, with either monitoring or systemic therapy including LEN. In the Select Study on LEN in DTC, LEN provided a 19.4 month (mo) medi...

Introduction: Pre- and postsurgical differentiation between follicular thyroid adenoma (FTA) and follicular thyroid cancer (FTC) represents a significant diagnostic challenge. Typical markers of malignancy may appear as specific genetic alterations. Next-generation sequencing (NGS) studies bring information about single point mutations, however better insight into follicular thyroid lesions genetic landscape, encompassing bigger rearrangements, is needed.<p class="abstext"...

Objective: To understand the factors associated with changes in thyroid nodule volume with previous benign citology.Material and Methods: This is a prospective single-center observational study. We included patients with a benign citology from March/2016 to May/2018 and ultrasound follow-up after 12–24 months. Initially we determined the nodule size (volume in ml), and its risk of malignancy was classified according to ATA 2015 criteria. Volume cha...

Introduction: Graves’ ophthalmopathy (GO) is an autoimmune disorder that constitutes a major clinical and therapeutic challenge. Current treatment options for moderate-to-severe GO include immunotherapy, orbital radiotherapy and decompression surgery. Limited drugs of proven efficacy are available for the treatment of people with GO. Given the role in the pathogenesis of GO of interleukin (IL)-6 expression in adipocytes, fibroblasts and macrophages, the proposed theory i...

Objective: Oxidative stress has been implicated in the pathogenesis of several immune-mediated disorders, including autoimmune thyroid disease. Aim of our study was to investigate the relationship between dietary habit and redox homeostasis, in relationship with thyroid autoimmunity.Materials and methods: We enrolled 200 healthy subjects (173 F, mean age 35 ± 12). None of them was under any pharmacological treatment. Exclusion criteria: any infectio...

Introduction: Thyreotropin (TSH) is a glycoprotein containing an alpha-subunit similar to other glycoproteins (LH, FSH, ACTH, HCG) and a unique beta-subunit which reacts with the alpha-subunit in binding to the TSH-receptor. Low TSH levels are usually evidence of primary hyperthyreoidism as in Graves diseases/ toxic goiter or thyroiditis, or a result of secondary hypothyroidism in case of diseases of the pituitary gland. This case shows a rare variant causing apparently low TS...

Thyroid hormones (TH)s have as a major target the heart, where they regulate many different functions, including the modulation of the heart rate and myocyte contractility. Their effects on ventricular repolarization are controversial and QT prolongation was reported both in patients with hypothyroidism and hyperthyroidism, in their overt or subclinical forms. We analyzed the effects of 3.3',5.5'-tetraiodo-L-Thyronine (T4), 3.3',5-triiodo-L-Thyronine (T3) and of 3.3',5'-triiod...

Context: Radiofrequency ablation (RFA) was proven as effective in reducing thyroid nodules’ volume. However, whether technical procedure aspects could influence the volume reduction rate (VRR) has not been clarified.Objective: To analyze the correlation of RFA power, duration and energy with VRR.Design: Prospective study from June 2018 to December 2019.Setting: Two primary-care centers using the same RF...

Purpose: Exposure to ionizing radiation in childhood has been recognized as a risk factor for the development of thyroid cancer and possibly for other thyroid disorders. However, the effects of neonatal radiation exposure on thyroid functions have never been explored experimentally despite its potential importance. We have demonstrated that neonatal rat thyroid was sensitive to ionizing radiation, developing specific morphological changes characterized by smaller thyroid folli...

Background: Increased oxidative stress has been linked to both hypo- and hyperthyroidism. Whole-body oxidative stress can be estimated by the oxidized guanine nucleosides, 8-oxo-7.8-dihydroguanosine (8-oxoGuo) and 8-oxo-7.8-dihydro-2’-deoxyguanosine (8-oxodG), derived from RNA and DNA, respectively. These biomarkers have been associated with increased morbidity and mortality in several diseases but are not well explored in humans with thyroid disorders.<p class="abst...

Background: Cancer of thyroid gland is rare in childhood, representing 1% of all pediatric malignancies. Primary thyroid lymphoma (PTL) is even rarer accounting for 5% of thyroid malignancies and 2% of extranodal lymphomas. The disease affects mainly adults in thesixth orseventh decade of life, with a female predominance. Most thyroid lymphomas are non-Hodgkin’s lymphomas (nHL) of B-cell origin. The most common type is Diffuse Large B- cell Lymphoma (DLBCL). Patients wit...

Introduction: Metastases to the thyroid are rare (1.4–3% of malignant solid tumors). When present, metastatic cancers mimic the ultrasound image of the thyroid parenchyma, hindering diagnosis. Breast cancer rarely metastasizes to the thyroid.Case: A 61-year-old woman was referred for goiterin the context of post-surgery evaluation for breast cancer. Thyrotropin (1.14 mIU/l), calcitonin (0.5 pg/ml) and parathyroidhormone (54 pg/ml) levels were norma...

Introduction: Hashimoto’s Encephalopathy (HE) is an autoimmune inflammatory disease of the brain associated with the production of antithyroid antibodies.Objective: A clinical case of treatment of severe autoimmune encephalopathy in combination with autoimmune thyroiditis and thyrotoxicosis is presented.Results: A 59-year-old woman was transferred to the intensive care unit diagnosed with thyrotoxic crisis. Objectively: serio...

The ability of thyroid cell to accumulate iodine is due to presence of sodium iodide symporter (NIS). Differentiated thyroid cancer (DTC) maintain ability to express NIS and thus it makes possible to perform RAI treatment. In case of DTC cells loss the ability of NIS protein production and cell membrane embedding that leads to RAI treatment fail.The aim of our study was to find a relationship between the level of preoperatively defined NIS and recurrence...

Introduction: The use of multigene panels in thyroid nodule diagnosis is still limited, due to high costs and need for ad hoc sampling. Since BRAF-V600E is the commonest genetic alteration in differentiated thyroid cancer, this is the mostly tested genetic parameter in clinical practice.Aim: To evaluate the use of BRAF mutation analysis in wash-out liquid from fine needle aspiration (FNA) in clinical practice, characterizing th...

Background: Calcitonin (CT) is the most sensitive marker for MTC diagnosis. By the way, many pre-analytical, analytical and post-analytical pitfalls worsen its accuracy. Procalcitonin (proCT), a CT precursor, has been suggested as a valuable complementary test in MTC diagnosis, given its stability and the reproducibility between different assay kits.Material and Methods: basal CT (bCT) and proCT (bproCT) and stimulated CT (bCT) and proCT (sproCT) (2&#821...

Thyroid cancer (TC) is the most common endocrine tumor and its incidence has increased faster than in any other malignancy. Although TCs are usually well differentiated, disease recurrence or persistence is high, because of local and distant metastasis and therapeutic resistance. Among the different genetic alterations, BRAFV600E is the most frequent one. Several studies tried to establish a correlation between BRAFV600E and patients outcome, with controversial results. Nevert...

Introduction: There has been an increase in the use of new drugs called immune checkpoint inhibitors (ICPI) used in advanced tumors. Clinical trials have also reported an increased risk of developing immune-related adverse events (IRAEs). Endocrine IRAEs may be particularly relevant.Material and Methods: This is a retrospective study. Patients treated with ICPI were obtained from Medical Oncology departament of the General University Hospital of Albacete...

Introduction: Ectopic thyroid tissue is a rare developmental abnormality resulting from aberrant embryogenesis of the thyroid gland during its passage from the floor of the primitive foregut to its final pre-tracheal position. It may be the only functional thyroid tissue or may co-exist with normally located thyroid. Most of the cases are asymptomatic but symptoms related to location, size or function may occur. Possible malignancy potential has also been discussed.<p clas...

Background: Antithyroid drugs (ATDs) are the first line treatment for Graves’ disease in Europe and Asia. However, their long term-efficacy is doubtful, with a high disease relapse rate after discontinuation. Radioiodine and surgery can be used as a second line therapy as definitive approaches after ATDs failure. In recent years, the GREAT and the CSS scores have been suggested to assess the risk of relapse at the time of disease onset, but no data are available about th...

Introduction: Ectopic thyroid tissue is a rare developmental abnormality with the prevalence of 1 per 100.000–300.000 persons in the general population. It is most commonly detected in younger women and presented as lingual thyroid. Here we report a rare case of ectopic thyroid tissue in the left adrenal gland.Case report: A 29-year old female without previous medical history was incidentally diagnosed with left adrenal gland mass detected on routi...

Vitamin D plays an important role in the adaptive and innate immunity besides its skeletal effects. Some autoimmune disease is associated with vitamin D deficiency highlighting its crucial involvement in the onset of autoimmune diseases. This study investigated the relationship between the vitamin D supply and the serum IL-6, IL-17A and antibody levels against thyroid peroxidase (TPO) and TSH receptor in autoimmune thyroid diseases. Serum IL-6, IL-17A and antibody levels again...

Background: Recently many cross-sectional and a few longitudinal studies reported that thyroid hormones even within normal ranges are associated with measures of adiposity. We aim to assess if changes in TSH and Free T4 (FT4) over 10 years of follow-up would be associated with changes in BMI and waist circumference or risk of general and abdominal obesity.Methods: 4179 participants of Tehran Thyroid Study(TTS) who had attended at baseline(1999–2001...

Objective: To study the association between the state of iodine nutrition, and the risk of total and cause mortality in a representative sample of the Spanish adult population.Design: Longitudinal observational study to estimate mortality risk according to urinary iodine (UI) concentrations using a sample of 4370 subjects >18 years representative of the Spanish adult population participating in the national study Di@bet.es (2008–2010). We used ...

Introduction: Thyroid-associated ophthalmopathy is the most frequent extrathyroidal manifestation of Graves’ disease. Its treatment is based on the administration of intravenous corticosteroids, and the clinical activity score (CAS), TSH-binding inhibitor immunoglobulin (TBII) and TSH-receptor antibodies (TRAb) have been classically used to measure the response to treatment. However, in recent studies [1] it has been observed that other analytical parameters such as chol...

Introduction: According to the results of several studies and meta-analyses, certain ultrasound features are associated with increased risk of thyroid malignancy. However, most of those research papers included mainly papillary thyroid cancers (PTCs); these results cannot be simply extrapolated for the differentiation of follicular thyroid adenomas and cancers (FTAs and FTCs). The aim of the present study was to perform a meta-analysis of so far conducted research and identify...

Background: Concomitant thyroid cancer in patients with congenital thyroid dyshormonogesis (TD) is extremely rare and only few cases of differentiated thyroid cancer in patients with TD were reported in literature. We present the first case of anaplastic thyroid cancer (ATC) in woman with TD.Case: A 46-year-old female patient was referred to our hospital for thyroid surgery due to rapid tumor growing and compressive symptoms. The fine needle aspiration r...

Backgraund: The high incidence of cervical lymph nodes (LNs) metastasis in differentiated thyroid carcinoma (DTC) and lack of effective diagnostic tools determines the need for elaboration more specific tests.Aims: The aim of our study was to evaluate the accuracy and cut-off point of the thyroglobulin (Tg) in the washout fluid of fine-needle aspiration biopsy (FNA-Tg) in the diagnosis of DTC LNs metastasis.Materials and methods: A...

Introduction: Papillary thyroid cancer (PTC) is usually tied to an excellent prognosis, with a 10-year disease specific survival rate of 98%. Nevertheless, some clinicopathological features are associated with a worse outcome. Therefore, a precise risk assessment is crucial for the clinicians deciding the most appropriate treatment for each tumour. Multifocal tumours (MFPTC) appear to have be a worse prognosis than unifocal tumours (UFPTC) in some series, but this aspect is di...

Introduction: Cervical lymph node metastases from differentiated thyroid carcinomas occur mainly in the central compartment with an incidence between 20 and 90% (average 60%). The American Thyroid Association considers that the central compartment goes to the unnamed artery thus systematically including level VII to level VI. We report the case of a patient with resected level VII lymph thanks to identification by technetium99-nanocolloid.Observation: Pa...

Introduction: Germline mutations in tumour suppressor gene PTEN cause heterogeneous phenotypes, that comprise the spectrum of PTEN-hamartoma tumour syndrome (PHTS). Manifestations include macrocephaly, developmental delay, cutaneous lesions, intestinal polyposis and increased risk of neoplasms. Thyroid nodules are identified in about 75% of patients and follicular cell-derived cancer affects 35% of cases, some of which diagnosed as early as 7 years old.C...

Introduction: Biotin-streptavidin detection method is used in a majority of commercial immunoassay. Biotinylated antibodies (capture antibodies) bind strongly to streptavidin that anchors those antibodies to the solid phase of the assay. Thus, high biotin concentration in the serum interferes with this bond and alters the expected results. Clinical history of patient and additional laboratory test is important for troubleshooting of discordant thyroid function test result....

Background: The increasing age of the general population represents a new challenge for endocrinologists and caregivers since it is well know that the occurrence of thyroid dysfunction increases with age. It is still controversial whether or not reference values of thyrotropin (TSH) adapted to age and sex need to be used. Herein, we aimed to determine reference intervals, in males and females, suitable for thyroid disease exploration and follow-up during adult life in a tertia...

Objective: Thyroid hormones are required not only for central nervous system development in the early stages of life but also play a key role in the maintenance of adult brain function. It is known that in adults, thyroid diseases can lead to various clinical manifestations i.e affective disorders, depression, memory impairment. The effects of hypothyroidism on brain functions seem particularly pronounced in depression, but until now, the mechanism underlying this relationship...

Female patient (56 y) with hyperthyroidism (start TSH 0.01 mIU/l; fT3 15.8 pmol/l; fT4 39.4 pmol/l) one month after initiation of thiamazole therapy (10 mg 3 × 1/1 week, then 2 × 1) came to the emergency room with symptoms of sweating, palpitations, nervousness, itching, fever (37.6 C), icterus. In medical history: oesophageal achalasia surgery 5 years ago, non-smoker. Therapy: thiamazole, bisoprolol, alprazolam. Initially in laboratory findi...

Relevance: Question of standards of iodine intake in pregnant and lactating women remains relevant.Aim of study: to determine status and function of thyroid gland in pregnant and lactating women with and without antibodies to thyroid gland, on the background of taking different doses of iodine in 3 different regions of Russia with different iodine status.Materials and methods: This study included 414 women in the different trimeste...

Introduction: The relationship between thyroid function tests and lipid parameters is still under hot discussion. According to current recommendations thyroid stimulating hormone (TSH) levels should preferably be below 2.5 mIU/l in healthy women of childbearing age as well as in women on levothyroxine treatment.Aim: To compare lipid levels and atherogenic indices in premenopausal euthyroid healthy women and women with autoimmune thyroiditis (AIT) on levo...

Background: Ramadan fasting entails abstinence of food and drink from dawn to sunset for 30 days. Medication timing also changes; for patients with hypothyroidism this can be a challenge as levothyroxine (LT4) is normally taken on an empty stomach and at least half an hour before breakfast. Complying with this advice during Ramadan is impractical for religious and social reasons. Adverse changes in thyroid function in patients with hypothyroidism have been observed. Whether an...

Introduction: Non-thyroidal illness syndrome or low T3 syndrome is an alteration of thyroid hormone levels which occurs as a reaction to acute disease. It is characterized by low TSH levels and low T3 and T4 levels. It is transient. The severity of its expression may be related to the severity of the acute disease. It affects patients hospitalized for acute disease in the department of medicine or surgery and in the acute care unit.<p class...

Biotin is used in many hormone immunoassays as an immobilizing system as streptavidin binds biotin with high affinity. Recently, cases with spurious results from biotin interference have been increasing due to widespread use of vitamin supplements containing biotin. We report two cases of erroneously high total T3 levels caused by biotin interference.Case 1: A 88-year-old female who had total thyroidectomy for papillary thyroid cancer 10 years ago and ha...

Introduction: Ongoing scientific research indicates that there is a dangerous link between eating foods that contain gluten and Hashimoto’s thyroiditis (HT). Gluten can be an irritant to HT by creating inflammation in the thyroid gland. Selenium, an important oligoelement, is a component of the antioxidant system. Over the last decade, it has been ever more frequently discussed in the context of thyroid disorders. The purpose of this study was to highlight the positive r...

Background: The problem of iodine deficiency in Belarus remains topical, due to the historical understanding of iodine deficiency in the environment. As a result, the Republic of Belarus has developed and since 2000 implemented a strategy for iodine deficiency elimination, based on the use of iodized salt and food fortification.Aims: To determine iodine status in children living in Minsk region.Materials and methods: The study incl...

Introduction: In the treatment of amiodarone-induced type I or mixed thyrotoxicosis, sodium or potassium perchlorate is often associated to thionamides, when the latter are insufficient for a prompt control of thyroid hormone secretion. Perchlorate competes with iodine for entrance into the follicular cell, and also induces a discharge of iodine from these cells with each administration. We compare the effect of 3 different regimes of perchlorate with methimazole on control of...

Introduction and aim: Cytokines play a crucial role in modulating immune response in both Hashimoto’s thyroiditis (HT) and Graves’ disease (GD). They may contribute to drive the autoimmune response skewing toward the Th17 phenotype and away from Th1 or Th2 phenotypes. Recent studies revealed an essential role of Th17 cells and their cytokines in the development of autoimmune thyroid diseases (AITD). However, participation of Th17 cells in the pathogenesis of GD is ...

The treatment of orbitopathy in the course of Graves’ disease (GO, Graves’ Orbitopathy) still remains a serious therapeutic challenge. Modification of risk factors is considered to be the most important and the most effective method of treatment of benign GO. Treatment with intravenous glucocorticosteroid preparations remains the first-line therapy for moderate- to severe GO but is insufficient in some patients. Radiotherapy has been used in active GO therapy for d...

Background: Hashimoto thyroiditis (HT) is the most common autoimmune disease and patients may present different levels of thyroid dysfunction. The association between hypothyroidism and cardiovascular events is well established. However, it remains unclear how mild thyroid dysfunction, autoimmunity and chronic inflammation in HT contribute to an increased cardiovascular risk in euthyroid patients and in subclinical hypothyrodism. Therefore, this study aims to assess insulin re...

Introduction: Amiodarone-induced thyrotoxicosis (AIT) in patients with congenital heart disease (CHD) has an estimated cumulative incidence of 13–21%, and prompt reversal to euthyroidism is crucial in these patients. We present a case of refractory AIT in a patient with CHD who was treated with thyroid arterial embolization (TAE).Clinical case: A 34-year-old male with complex cyanotic CHD (great vessels transposition, interventricular communication...

Background: Depressive mood consequent to hypothyroidism can be reversed with levothyroxine (LT4) replacement therapy. However, it is unclear whether increasing LT4 dose confers additional mood benefits.Methods: This was a single-blind before-and-after study of 26 patients with hypothyroidism who were aged 65 years or older and undergoing LT4 replacement therapy. Geriatric Depression Scale (GDS-K) and Hyperthyroid Symptom Scale (HSS-K) were assessed at b...

Context: Thyrotoxicosis is the most common endocrine adverse event due totreatment with anti-PD1 and anti-PD-L1. The most common form is destructive thyrotoxicosis whereas persistent, supposedly autoimmune hyperthyroidism (Graves’ hyperthyroidism) is rare. The possible role of thyroid imaging (neck ultrasound and scintigraphy) in the differential diagnosis has never evaluated.Aim: To evaluate the usefulness of neck ultrasound and 99Tc- s...

Objective: Progesterone (P4) is essential for successful embryo implantation and preventing miscarriage. The strong connection between thyroid autoimmunity (TAI) and infertility is highlighted in literature. Follicular fluid (FF) is important for the oocyte maturation. The aim of the study was to assess the influence of FF P4 in TAI positive women on assisted reproductive technology (ART) outcome.Methods: The study included 52 women undergoing ART. Befor...

Introduction: Hypothyroidism has been reported as an important factor in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) but studies about the relation between subclinical hypothyroidism and NAFLD have shown contradictory findings. The aim of this study was to conduct a systematic review and meta-analysis exploring the association between subclinical hypothyroidism and NAFLD.Methods: MEDLINE, EMBASE, Cochrane Library and sources for grey li...

Background: Amiodarone-induced thyrotoxicosis (AIT) is a challenging disease associated with increased morbidity and mortality. The European Thyroid Association guidelines define the role for total thyroidectomy in the management of AIT. However, these recommendations were based on small series, which often lead to heterogeneous results and, importantly, did not identify patients who may benefit from surgery.Materials and methods: Observational longitudi...

Background: Hypothyroidism is defined as an elevated TSH (thyroid-stimulating hormone) and/or decreased free thyroxine (FT4) levels. Levothyroxine is now one of the most widely prescribed medications. However, treatment indications are controversial in subclinical hypothyroidism, defined as high TSH with normal T4 levels. Methods: We performed a cross-sectional study reviewing the blood samples received in our Laboratory for TSH determination during the ...

Citrus flavanone naringenin (NAR) is a potent antioxidant with ability to change pituitary-thyroid function. NAR increases concentration of thyroid-stimulating hormone (TSH) in serum by increasing Sirtuin1 expression in the pituitary thyrotrophs and improves thyroid hormonogenesis capacity in old-aged rats. Thyroid hormone production is followed by generation of large quantities of reactive oxygen species (ROS) which are essential for iodine organification. A master regulator ...

Background: Differentiated thyroid cancer (DTC) <1 cm without risk factors require only lobectomy, and there is no need for radioiodine remnant ablation (RRA). The approach for surgery and RRA after surgery is less clearly defined for tumours measuring 1–4 cm.Objectives: We aimed to evaluate the surgical approaches of DTC in stages pT1–2 in a moderate iodine deficient area. We compared our data to the current European Thyroid As...

Background: Screening serum calcitonin (sCT) measurement in patients with thyroid nodules is still debated. Moreover, sCt cutoffs for medullary thyroid carcinoma (MTC) are not univocally defined. Also, sensitivity of cytology by fine needle aspiration biopsy (FNAb) has been demonstrated to detect approximately half of MTCs. Ct measurement in fine-needle aspiration washout fluid (Ct-FNAb) has high sensitivity and specificity and is helpful in case of non-diagnostic cytology&#18...

Introduction: Studies suggest that disturbed thyroid hormones (TH) homeostasis may lead to increased cancer risk. However, the exact role of TH in cancerogenesis is unknown. We have previously identified 15 genes linked with TH signaling in 7 cancer types and 10.967 cancer patients. Here, we investigated the influence of hypothyroidism on the expression of these 15 genes in rat tissues/organs from which the previously identified, TH-related cancer types originate.<p class=...

Introduction: To date, only four tyrosine kinase inhibitors (TKIs) have demonstrated beneficial effect on progression free survival in advanced medullary thyroid cancer (MTC; vandetanib and cabozantinib) andradioiodine-refractory differentiated thyroid cancer (RR-DTC; sorafenib and lenvatinib). However, there is still lack of unequivocal proofs of their significant impact on overall survival. Therefore, treatment-related side effects and their potential impact on quality of li...

Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor of the parafollicular thyroid C cells. Although somatostatin (SS) receptors (SSTs) are expressed by MTCs, treatment with octreotide, specific for SST2, has shown poor efficacy in reducing MTC proliferation, whereas pasireotide, a multi-receptor SS analogue with preferential binding to SST5, has recently demonstrated antiproliferative effects in persistent postoperative MTCs. In vitro data in human MTC ce...

Introduction: The determination of basal and stimulated calcitonin (CT) is very important for the precocious diagnosis of medullary thyroid carcinoma (MTC) and for its dynamic follow-up. Unfortunately, monitoring is difficult when using assays with different detection systems. Our objective was to identify the correction factor between the reagents for CT measurement on the LiaisonXL and Cobase 601 assays (immunochemiluminescence, respectively electro-immunochemiluminescence)....

Aim/Introduction: Contrast-enhanced 18F-FDG PET/CT is an effective diagnostic procedure enabling a precise localization of remnants or recurrences in patients with radioiodine-negative differentiated thyroid carcinomas (DTCs). The detection of this lesions allows to cure patients without detectable distant metastases using a loco-regional surgical treatment. The aim of this study was to assess the influence of 18F-FDG PET/CT on indication of this type of ...

Introduction: American Thyroid Association (ATA) guidelines suggest considering hemithyroidectomy in patients with unifocal well-differentiated thyroid tumours,smaller than 4 cm, withoutpreoperative evidence of extrathyroidal extension (ETE) nor lymph node metastases. Although multifocal microcarcinomas are considered to increase the risk of structural disease recurrence from 1%–2% to 4%–6% compared to unifocal microcarcinomas, the ATA guidelines do not sugges...

Objectives: To assess whether the degree of heterogeneity of thyroid nodules defined by their elastographic characteristics is related to the cytological diagnosis and ultrasound classification of risk of malignancy.Material and Methods: Observational, prospective study. 101 thyroid nodules were analysed by quantitative elastographic analysis (shear-wave), measuring the stiffness of the lesion by global elastography and its standard deviation (s.d.</...

Radioiodine (131I, RAI) has traditionally been used in thyroid cancer treatment but its benefitshould be balanced against possible risks. Among them, salivary gland dysfunction has oftenbeen discussed, although the reported data have been inconsistent. While some authors reported functional changes following higher (mostly cumulative) activities, there have been scarce data on the activity of 3.7 GBq (100 mCi) that is most commonly used for RAI remnant ablation...

Introduction: Malignant struma ovarii is a rare disease, for which risk factors and prognostic features are not well-defined. We present a patient with concomitant Graves’ disease and metastatic follicular thyroid cancer arising from struma ovarii, and discuss the possible mechanism of this association.Clinical case: A 43 year old woman undergoing follow-up for Graves’ disease (GD) presented with an enlarging left lower abdominal mass. She ha...

Introduction: The sensitivity and specificity of biomarkers which have been used in clinical practice for diagnosis of papillary thyroid carcinoma (PTC) are low. It is essential to develop novel diagnostic biomarkers for PTC.Objective: We aimed to explore the expression levels of miR-222, – 146b, –181b in PTC tissue and plasma samples and to compare with benign thyroid nodules (BTN).Methods: We collected plasma samples ...

The purpose of the study was to evaluate the diagnostic capabilities of systems for assessing ultrasound thyroid imagines. The object of the study was 754 patients with thyroid nodules. Research methods: ultrasound in the framework of image evaluation systems TIRADS, EU-TIRADS, ARC-TI-RADS, BTA, TI-RADS K. For statistical analysis of systems and criteria was performed multidimensional statistical modeling using cluster, factor, discriminant, variance, and ROC analysis. The stu...

Thyroid hormone resistance (THR) is a rare dominantly inherited syndrome characterized by a reduced response of target tissues to thyroid hormone receptor. In most cases, THR is related to mutations in the thyroid hormone receptor beta gene (THRb). Management may be challenging in cases of gestation. Here we report the case of a pregnant patient with a possible not previously described mutation and negative genotype fetus.Case report: Thirty-two year old...

Introduction: The coexistence of Grave disease [GD] and Myasthenia gravis [MG] may present a diagnostic dilemma especially concerning ocular manifestations. 3–10% of myasthenic patients exhibit GD, while MG is reported in only <1% of patients with thyroid disorder.Observation:Case 1: A 32-year-old woman, with a medical history of vitiligo, was diagnosed with GD. Immunology revealed positive anti-thyroid peroxidase antibod...

Introduction: The thyroglossal duct develops during thyroid gland formation and usually involutes at 7–10 weeks gestation. Its residue can lead to formation of cysts as well as to develop neoplasms within the mass.Case report: A 40-year-old woman was admitted to Department of Otolaryngology because of an enlarging midline neck mass for the last few months, without other worrisome symptoms. A neck ultrasound and CT scan showed a cystic lesion with s...

Background: Thyroid storm is an extreme disorder that occurs in case of severe thyrotoxicosis. This is a life-threatening condition with mortality rates up to 10–20%. A typical dose of iodinated contrast media (ICM) contains approximately 13.500 µg of free iodide and 15 to 60 g of bound iodine, which represents an acute iodide load of 90 to several hundred thousand times the recommended daily intake of 150 µg. As a result of sudden exposure to high iodide loads...

Introduction: Immunoglobulin G4 related disease (IgG4-RD) is an immune-mediated fibro-inflammatory condition and is a widely recognised multi-organ system disease. The prevalence of IgG4-RD is 6/100 000, but it is likely to be underestimated. IgG4-RD is characterised by elevated serum levels of IgG4 and IgG4-positive lymphoplasmacytic infiltrative lesions in the body. Recent reports suggest disease involvement in various organs including thyroid and orbital tissues. Thyroid di...

Background: The prevalence of hypothyroidism is around 1–2% in the UK. Hashimoto’s thyroiditis is thought to cause 0.1–2% of overt disease and 10–15% of subclinical hypothyroidism. This case presents a patient with severe hypothyroidism, secondary to Hashimoto’s thyroiditis, found incidentally on a surgical admission. The case study discusses the challenges and management of severe hypothyroidism in the need for an acute surgical intervention....

Background: The clinical presentation of hyperthyroidism has been studied in the ambulatory caresetting. Our hospital performs a TSH test for all newly admitted patients.Aim: To describe the clinical presentation of patients with overt hyperthyroidism during hospitalization and to study the association between thyroid hormone levels and the clinical picture.Methods: A retrospective study of 250 hospitalized patients from an 11-year...

Background: The expression of thyroid-specific genes [thyroglobulin (Tg) and sodium iodide symporter (NIS)] is modulated by several cytokines (IL-1, IFNγ, TGF-ß) and it is down-regulated in Hashimoto’s thyroiditis (HT). Also, lymphocytic infiltration and inflammation in HT results in intra-thyroidal accumulation of hyaluronan (HA). During inflammation, HA can be degraded into small fragments, able to up-regulate pro-inflammatory genes by stimulating the toll-li...

Backgroud: Recent studies have shown an association between thyroid hormone levels and non-alcoholic fatty liver disease(NAFLD). However, there have been some inconsistencies between studies. Here, we evaluated the relationship between thyroid hormone levels and NAFLDin euthyroid subjects.Methods: A retrospective analysis of 27.719 euthyroid subjects who participated in comprehensive health examinations was performed. Subjects were grouped acco...

Background and aims: Coronary artery disease (CAD) plays an important role in global mortality worldwide. Risk assessment for patients with CAD through free triiodothyronine (FT3) remains unclear. Therefore, we aimed to investigate the impact of FT3 on the prognosis of patients with CAD.Methods: A total of 0 patients with CAD and available FT3 data, and without overt thyroid disease were enrolled in this study and grouped by tertiles. The primary outcome...

Objective: Myostatin may negatively regulate skeletal muscle mass. Serum myostatin levels have positive associations with obesity and insulin resistance. Thyroid dysfunction may affect body weight, energy expenditure, and glucose metabolism. We evaluated the serum myostatin levels in different thyroid function statuses.Subjects and methods: We recruited 30 newly-diagnosed hyperthyroid (HY) patients and treated them with anti-thyroid regimens as clinicall...

Introduction: Hypercalcitoninemia has frequently been reported as a marker for medullary thyroid carcinoma (MCT). Still, several physiologic and pathologic conditions other than MCT have been associated with increased levels of calcitonin, including neuroendocrine tumors that can ectopically secrete calcitonin.Case report: We present the case of a 78-year old female patient, incidentally diagnosed with multinodular goiter when performing Doppler ultrasou...

Background: Matrix metalloproteinase-9 (MMP-9) is an important mediator of invasion and metastasis in neoplasia. The single nucleotide 1562 C/T polymorphism in the promoter region of the MMP-9 genewas shown to increase gene expression and was studied as a susceptibility factor for various cancers.Aim: We aimed to evaluate the impact of the MMP-9 promoter genotype on the risk of developing papillary thyroid cancer (PTC) and to correlate cancer patient gen...

Objective: Althoughmost Papillary Thyroid Cancer (PTC) patients with biochemical incomplete response (BIR) to primary therapy have a good clinical outcome, some will develop disease progression. We aim to study baseline characteristics and long-term outcomes of PTC patients with BIR.Methods: Of 1049 PTC patients treated at 2 tertiary medical centers, 795 (75.8%) had excellent, 91 (8.7%) biochemical incomplete, 139 (13.2%) structural incomplete and 24 (2....

The goal was todetermine the optimal methods of postoperative monitoring of serum thyroglobulin (Tg) in differentiated thyroid cancer (DTC). This research intended to compare the prognostic value of immunometric methods with different functional sensitivity (FS) for Tg measurement for detecting recurrent disease.Design: During 2010–2012 years, 76 patients with treated DTC (a total thyroidectomy and adjuvant radioiodine therapy) were included. All p...

Introduction: Next-generation sequencing (NGS) in thyroid cancer allows for high-throughput sequencing analysis of various genetic alterations and provides a useful information of tumor biology. NGS Studies on follicular differentiated thyroid cancer have been scantyfrom Indian subcontinent. In this context, we set out study the prevalence of a genetic panel wide somatic mutations in thyroid cancer.Material and Methods: This prospective study was conduct...

Introduction: Although medullary thyroid cancer (MTC) constitutes 2–4% of all thyroid cancers, it is associated with higher mortality compared to differentiated thyroid carcinomas. Here we present long term clinical results of medullary carcinoma patients’ follow-up in our center.Methods and results: MTC was detected in 27 (3.73%) patients of 850 thyroid cancer cases who were followed-up between 2004 and 2020 at the Marmara University School ...

Introduction: Poorly differentiated thyroid cancer (PDC) is a relatively rare form of differentiated thyroid caner with intermediate prognosis between well differentiated (WDTC) and anaplastic cancers (ATC). But, this finding is debatable in literature. Genomics is the one of definitive modalities to resolve this conundrum. ATC tends to express P53 and KMT2D mutations frequently, while WDTC have no such mutations. Similar studies are scanty in PDC. In this context, we set out ...

Introduction: Differential diagnosis of thyroid nodules is one of the most frequently solved problems in the endocrinological practice. It is always necessary to determine their biological nature, which will decide about further therapeutic procedure, especially about early surgery in case of proven malignancy. In addition to sonographic examination and fine needle aspiration biopsy (FNAB), now we can also use the possibilities of molecular-genetic examination.<p class="ab...

Topicality: The most common cancer of the endocrine system is thyroid cancer. The main method of treatment for highly differentiated thyroid cancer is surgical.A special place among the complications of surgical treatment of thyroid cancer according to the severity of manifestation and the complexity of prevention is occupied by postoperative hypoparathyroidism.The purpose of the study.Minimize the risk of da...

Introduction: Advanced differentiated thyroid carcinoma (aDTC) – herein defined as locally unresectable or metastatic disease – is one of the most common late-stage endocrine neoplasias. However, available data about its natural history is limited. ERUDIT is a multicenter, observational, retrospective study of patients diagnosed with aDTC in Spain and Portugal. The study describes its natural history from the initial diagnosis until the advanced stages of disease, ...

TNM 8th edition introduces changes in the staging of patients with differentiated thyroid carcinoma (DTC). This study aims at assessing the ability of TNM 8th edition in predicting structural recurrence of DTC.480 DTC patients were retrospectively evaluated by 7th and 8th editions of TNM staging systems in relationship with risk stratification, response to therapy and recurrence of disease as defined by 2015 American Thyroid Association (ATA) guidelines. As compared to the 7th...

Our research subject is to study the importance of some favorable molecular biological markers for prognosis of premalignant characteristics of Hashimoto’s thyroiditis (HT) parenchyma. To clarify the pathogenetic link between these two pathologies (HT, PTC), we choose markers, indicating, at the one hand, on the tumor cell cycle, such Cyclin D1, at the second hand, RET/PTC rearrangement in HT, in order to determine molecular changes, connecting Hashimoto’s thyroidi...

Background: MTC tends to metastasize early in the course of the disease affecting usually regional lymph nodes; in 7–23% of patients distant metastases may be present at diagnosis (common metastatic sites:liver, lungs, bone). We present two MTC cases with unusual metastases to the breast, pancreas and mandible.Case presentation: Patient No 1A 48-year-old female was diagnosed with MTC in 1990. Total thyroidectomy was performed...

Background: Papillary thyroid carcinoma (PTC) is known as the most common histological subtype of thyroid carcinoma. The prognosis of PTC is generally favorable. However, small number of patients with PTC progressed with distant metastasis and invasion to adjacent organs. New diagnostic tool for early detection of PTC with poor outcome is desired. We previously reported that autoantibody to WD repeat domain 1 (AWA) in the serum was associated with the existence of undifferenti...

Introduction: Hyperthyroidism is characterised by an increased hormone synthesis, with non-specific and pleomorphic clinical features. Management strategy, depends entirely on the etiological status ; as part of an holistic vision. The purpose of this study is to shed light on epidemiological, clinical, etiological and therapeutic aspects of hyperthyroidism in Endocrinology & Diabetology department of Oujda’s Mohammed VI university hospital.<p class="abstext...

Introduction: The prevalence of manifest hypothyroidism by various data is 0.2–2%, sub-clinical – up to 3% in men and up to 10% in women, and in people over 70 years old – 13–14%. The presence of concomitant gastrointestinal diseases significantly limits the possibility of hypothyroidism compensation; these patients need higher doses of levothyroxine. According to a number of researchers, hypothyroidism is often accompanied by small intestinal bacterial...

Background: Thyroid hormones participate in maturation, differentiation and triggering of immunity, but little is known about the modulating role of thyroid hormones on intracellular enzymatic reactions of immune cells and their role in immunopathogenesis of Graves’ disease (GD).Methods: The activity of NAD(P)-dependent dehydrogenases in lymphocytes and neutrophils ofperipheral blood was studied in a group of 145 women with GD, 53 (36.5%) pati...

Introduction: Benign breast disease is the most common reason for senology consultation.Objectives: To investigate the possible involvement of thyroid autoimmunity and hypovitaminosis D in the development of mammary echo-structural lesions.Method: The BI-RADS score was assigned to categories 1–4 characteristic of benign mastopathy, in three groups of patients: Group 1 (n=167) – with chronic autoimmune thyro...

Aim: Study the correlation between leptin and renal malfunction in patients with primary hypothyroidism (PH).Methods: 161 patients suffering from PH took part in the investigation. Criteria of choice were as follows: patients’ age from 36 to 60 and presence of PH. Presence of any acute or chronic renal disease or ischemic heart disease was the criteria of exclusion. The diagnosis was made on the basis of complaints, family history, typical clinical...

Purpose: To study the possibilities of sonoelastography (SEG) in the diagnosis of thyroid tumors. Materials and methods: in 123 patients (27 with papillary thyroid cancer, 45 with thyroid adenomas, and 51 with colloid goiter), different versions of SEG were used at the preoperative stage: compression sonoelastography (CEG) and point shear wave elastography (ARFI). Together with the staining assessment, quantitative parameters were determined: the speed of the transverse wave (...

Graves’ disease is a common autoimmune condition, and the most common cause of hyperthyroidism. A number of definitive treatment options for this disease exist, including radioiodine (RI) and surgery. Surgery is often reserved for patients for whom RI is contraindicated or who have previously failed other treatments, including radioactive iodine ablation (RIA). The aim of this study was to assess the efficacy and safety of total thyroidectomy at our institution as a pref...

Background: KEAP1 gene (Kelch-like ECH-associated protein 1) that encodes the main inhibitor of nuclear factor erythroid 2-related transcription factor 2 (Nrf2), a central mediator of antioxidant responses, has been found to be one of the mutated genes that lead to familial multinodular goiter (MNG). The proposed association of KEAP1 with familial MNG is based on only two loss-of-function mutations in respective Japanese families. To date, there is no experim...

Problem: Interleukin-17A (IL-17A) has a role in sustaining normal pregnancy. IL-17A isalso associated with thyroid autoimmunity during pregnancy. This study sought to investigate whether IL-17A is a risk factor for thyroid dysfunction during pregnancy without thyroid autoimmunity.Methods of study: The study comprised 216 pregnant women with negative thyroid peroxidase antibody (TPOAb) andthyroglobulin antibodies (TGAb) during the second trimesterwho prov...

Background: Graves’ disease is a common cause of thyrotoxicosis,especially amongst females. In the UK,initial treatment is usually with anti-thyroid drugs, using either a ‘block and replace’ or a titrating regime. A meta-analysis suggests about 50% chance of relapse after the initial course of treatment and may then require definitive cure with radioactive iodine or surgery.Method: A retrospective audit of patients with Graves’ di...

Background: We aimed prospectively investigate the laboratory and electrocardiographic parameters (hearth rate, QRS, QT, QTc, Tpe, Tpe/QTc, arrhythmia prevalance) in patients with graves disease before and after antithyroid therapy.Methods: 71 patients (48 female, 23 male), age between 18–50 (mean ± s.d.: 36.48 ± 12.20) with GD were included into the study. Patients treated with antithyroid therapy (thionamids and/or surgical the...

Introduction: Thyroid ultrasound is the main technique to study this gland’s pathology. ACR TI-RADS system evaluates the malignancy risk in thyroid nodules according to their sonographic features and stablishes the size in which to perform fine needle aspiration (FNA) for its cytological study. Nodules diagnosed as Bethesda category 4 (B4) means are follicular neoplasms or suspicious for follicular neoplasms.Aim: Determine the pathology diagnosis o...

Introduction: Recently Roche Diagnostics (Rotkreuz, Switzerland) introduced the third generation of its Elecsys free thyroxine (FT4 iii) assay (in Greece from February 2019 onwards). The new assay is considered to have reduced biotin interference compared to its previous version (Ft4 ii). Kits of the FT4 ii assay are still available (and valid) according to the manufacturer’s expiration date. Using the FT4 ii assay per the manufacturer’s instructions we noticed FT4...

Background: Hashimoto’s thyroiditis (HT) is considered the most common autoimmune disease and the predominant cause of hypothyroidism in iodine sufficient countries. HT may appear clinically in approximately 0.1–2% of the population.Aim: The study in hand aimed at assessing the role of thyroid ultrasonography in the diagnosis of HT patients discriminating them from other causes of hypothyroidism. A scoring system of sonographic findings was a...

Objective: This study aims to investigate clinical and demographic variables associated with HRQoL as measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core Questionnaire (EORTC QLQ C30) Tagalog and the Thyroid Cancer-Specific Quality of Life Questionnaire (TCS QLQ) Tagalog.Methodology: 234 adult Filipinos with histopathologic-confirmed diagnosis of DTCafter thyroidectomy with or without radioactive ...

Background: Fine needle aspiration biopsy (FNAB) and Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) have proven to be the most valuable diagnostic procedure for preoperative discrimination of benign and malignant thyroid nodules. Thyroid surgery may cause regional scarring and some degree of fibrotic process which may result in problems when collecting FNAB samples and evaluating the cellular abnormalities. In this study, we aimed to determine whether the Bethesd...

Introduction: Significant hyponatremia may evolve in hypothyroidism, when however, elevated ADH levels have not been consistently demonstrated. On the other hand, it was shown that thyroid hormone substitution suppresses ADH, and its surrogate marker copeptin secretion. The aim of our present study was to investigate the possible humoral changes in a special model of resolution of short term severe hypothyroidism in differentiated thyroid cancer (DTC) patients.<p class="ab...

Objective: The aim of this study was to evaluate the capability of the thyroid nodule ultrasonography criteria of the European Thyroid Imaging and Reporting Data System (EU-TIRADS) to predict fine needle aspiration cytology results categorised by The Bethesda system.Methods: A retrospective analysis was made out of 310 cases of an outpatient clinic over a period of 1 year (2018.03–2019.03). We compared single-specialist-performed thyroid nodule ult...

Introduction: Multiple primary cancers are a rare entity; however their incidence is increasing due to advances in diagnostic methods and surveillance strategies. The coexistence in the same patient of several primary malignant tumors has been described in the literature with a frequency varying from 5.5% to 8.5%.The aim of this observation is to report a case associating 3 neoplasias:medullary thyroid carcinoma (MTC), papillary thyroid carcinoma (PTC) a...

Background: New emerging studies demonstrated that mortality from thyroid cancer and disease recurrence was significantly higher among Filipinos compared with other ethnic groups. However, exact mechanisms which could explain these findings among Filipino patients remain to be poorly understood. The risk factors associated with disease recurrence among adult Filipino patients with low-risk papillary thyroid cancer in Manila Doctors Hospital was assessed in this study.<p cl...

Introduction: ‘Forgotten goiter’ is defined as a mediastinal thyroid mass discovered after total thyroidectomy. It is a rare clinical finding, usually asymptomatic.Case report: 88-years old woman was admitted to the Endocrinology Department with a suspicion of the retrosternal goiter. In her medical history there was thyroidectomy performed 16 years before because of multinodular goiter and she had recurrent lower respiratory tract infections...

Introduction: A teratoma is a rare type of tumor deriving from the germ layer cells (ectoderm, mesoderm and endoderm), typically benign, more frequent in infants. Adult onset teratomas are most commonly gonadal cell tumors. Extra--gonadal teratomas generally affect the midline, most frequently anterior mediastinum, retroperitoneum, pineal and suprasellar area. Head and neck teratomas are an extremely rare entity and represent only 0.47–6% of all cases.<p class="abste...

Introduction: Intrathyroid metastases are rare (less than 1% of thyroid cancers). They can be synchronous or metachronous. The origin of primary cancer is variable; the kidney, lung, stomach and breast being the most described sites.Through this case, we describe the diagnostic difficulties that the pathologist may encounter in the identification of these metastases.Materials and methods: We report a case of intrathyroid metastasis...

Introduction: Hypothyroidism can cause various degrees of muscular disorders. It can lead to symptoms such as myalgia, weakness, fatigue and in rare cases to extreme muscular damage such as rhabdomyolysis, a potential life-threatening complication. We present the case of a 53 years old patient with acute renal failure due to rhabdomyolysis from severe hypothyroidism.Case description: The patient, a male from Albania was first admitted to the Emergency Ro...

Background: Hyperthyroidismcan be associated withorbitopathy that manifests as exophtalmos due to orbital tissue inflammation. Usually the diagnosis is straight forward when an autoimmune thyroid disorder is present, but conditions mimicking Graves orbitopathy can pose a diagnostic challenge.Case report: We report the case of a 51 year old caucasian woman who was referred to our clinic with asymmetrical exophtalmos in november 2019. The patient stated th...

Introduction: Hurthle cell carcinoma was considered to be a variant of follicular thyroid cancer. However, recent clinical and molecular studies clearly indicate that Hurthle cell cancer is a distinct tumor type. Histologically, it is characterized by the presence of a cell population of ‘oncocytes’, mostly eosinophilic oxyphilic cells and abundant cytoplasm,closely packed mitochondria, and round oval nuclei with prominent nucleoli. Unlike follicular thyroid cancer...

Introduction: Dual nivolumab and ipilimumab immunotherapy has the potential of causing an immune-mediated thyrotoxicosis, precipitating thyroid storm.Case details: A 62-year-old Caucasian woman with a history of Lung Carcinoma (Non small Cell Lung Carcinoma) presented to the emergency department, with a 3-day history of intractable nausea, severe headache, vomiting and anxiety.She had been initiated on dual nivolumab and ipilimumab...

Introduction: The management of patients with nodular goiter and thyroid neoplasms is one of the most important problems in modern thyroidology. There are several classifications based on thyroid ultrasound for selecting suspected malignant thyroid nodules. The Thyroid Imaging Reporting and Data System (TI-RADS) classification is an easy to apply for thyroid lesions, which might be helpful in clinical practice for the initial assessment of the thyroid lesion risk of malignancy...

Background: During the last decade, radiofrequency ablation (RFA) has emerged as a reliable alternative to surgery for the treatment of benign symptomatic thyroid nodules in terms of effectiveness and safety.Aim: The aim of this study were: (i) to evaluate the long-term efficacy (5 years) of RFA for the treatment of benign thyroid nodules, in terms oftechnical success and nodule regrowth, and (ii) to identify the predictive factors of t...

Introduction: With a prevalence of about one in 3000 newborns, congenital hypothyroidism (CH) is the leading cause of preventable mental retardation and growth failure. The objective of this work is to clarify the contribution of thyroid scintigraphy (TS) using technetium 99 m for the diagnosis of CH and this through the experience of the nuclear medicine department in Sahloul university Hospital.Materials and methods: This is a retrospective study inclu...

Background: Clinical scoring systems were used traditionally in the diagnosis of hypothyroidism before biochemical diagnosis became the norm. There are two well validated clinical scoring systems (Billewicz and Zulewski) for diagnosing hypothyroidism. Both these scores were validated in younger patients with hypothyroidism and may not be useful in older patients. We conducted this study to determine the clinical utility of these two scoring systems among patients over the age ...

Background: Effects of vitamin D on immune cells might affect diabetes mellitus (DM) development since inflammatory factors have been linked to insulin resistance (IR). The aim of this study was to investigate the effect of cholesterol treatment on insulin sensitivity metabolic markers in patients with chronic autoimmune thyroiditis.Materials and methods: In this double-blind, randomized, placebo-controlled trial, which was conducted from May to Septembe...

Introduction: Endoscopic surgery has found wide application in many areas of medicine in a short: endocrinology is no exception. The main advantages of endoscopic access to the thyroid gland are the possibility of conducting endovideoscopy, a low traumatic surgical intervention, shortening of the inpatient treatment duration, periods of incapacity for work, and cosmetic effectsGoal: Determine the appropriateness of using endoscopic technologies in compar...

Background: Radioactive iodine 131I (RAI) treatment is an effective definitive treatment of hyperthyroidism, used as a first line or second line treatment.Aims and objectives1. To evaluate the response of RAI therapy in Graves’ disease.2. To determine any factors predicting treatment failure.Study design: Retrospective study: Materials and methods: Clinical ...

Introduction: There is little data about the influence of immunosuppression on the recurrence rate of thyroid cancer. We aimed to evaluate the risk of recurrence and mortality of thyroid cancer after solid organ transplantation.Patients and Methods: We retrospectively evaluated 802 kidney and 283 liver transplant recipients who underwent transplantation between January 1999 and May 2019 in Bașkent University. We identified 14 patients with thyroid c...

Introduction: The aim of this work is the evaluation of usefulness of radioactive seed localization (RSL) for the detection of cervical recurrence of thyroid cancer in order to improve the surgical outcome.Material and method: Six patients with thyroid cancer with cervical recurrences evidenced by ultrasound, cytology/Tg-FNAB were selected for this procedure. A 125I seed was placed in the metastatic lesion using a needle guided by ultrasound. ...

Introduction: Cervical lymphadenopathy is a frequent reason for ENT consultation. In most cases the diagnosis is easy based on clinical, radiological and cytopathological data. However, in some situations, the diagnosis remains pending. The objective of this work is to study the possible difficulties face to a chronic cystic cervical lymphadenopathy.Materials and methods: It is a retrospective study bringing 4 cases of cervical cystic lymphadenopathy rev...

Background: Deciding whether patients with a cytologically indeterminate thyroid nodule should be referred for surgery or for active surveillance is an important challenge for clinicians. The aim of this study was to evaluate the performance of a novel dual-component molecular assay as an ancillary molecular method for resolving indeterminate thyroid nodule cytology.Methods: We selected 156 thyroid nodules from those that had undergone both FNA cytology ...

Purpose: This retrospective study is evaluated the efficacy of three doses of I-131 (1110 MBq vs 3700 MBq vs 5550 MBq) in differentiated thyroid carcinoma patients with cut-off serum thyroglobulin (TG) level after two weeks of thyroid hormone withdrawal for postoperative thyroid remnant ablation.Methods: A total of 97 patients with differentiated thyroid cancer treated with total thyroidectomy and radioactive iodine (RAI) therapy...

Introduction: TKIs including anti-VEGF receptor activity have been approved for the treatment of patients with radioiodine resistant thyroid carcinomas. For lenvatinib arterial thromboembolic events are listed as adverse events of special interest. In the phase III study of SELECT trial, arterial thromboembolic events were reported in 3% of lenvatinib-treated patients and 1% in the placebo group. Most of the patients had predisposing factors. Only one myocardial infarct was re...

Aim: To study the thyroid and cognitive status and psycho-emotional health of children and adolescents with Graves’ disease (GD).Materials and methods: 37 children and adolescents with GD examined in the Republican Medical Center of Endocrinology (Uzbekistan). The control group consisted of 19 healthy children and adolescents. Thyroid status was determined using a closed-type immunochemistry analyzer Cobas e411 Hitachi from HoffmanLeRoche (Switzerl...

Background: In the last years, Pembrolizumab has been used to treat solid and lymphatic neoplasms, showing improved patients’ survival. Due to its mechanism of action, Pembrolizumab may be responsible of several immune-related adverse events (irAEs). The most frequent endocrine-irAEs reported are thyroid diseases.Aims: The aim of this study was to evaluate differences in thyroid disease incidence and presentation between patients treated for lung c...

Long non-coding RNAs (lncRNAs) are a class of non-protein coding transcripts longer than 200 nucleotides that regulate complex cellular functions, such as cell growth, differentiation, metabolism, and metastasis. Thyroid hormone (T3) and its receptor (TR) are involved in cancer progression. To identify T3/TR-related lncRNAs that are differentially expressed in HCC, lncRNA expression profile screening was performed using the SYBR Green-based quantitative reverse transcription-P...