Endocrine Abstracts

Introduction: In the thyroid gland, humoral immunity manifests with thyroid peroxidase (TPO) antibodies. In our studies, when TPO concentrations increased, thyroid cancers of follicular origin (TCFO) tended to develop less frequently.1 Other studies, though, reported an opposite trend in less aggressive cancers. The present work was designed to characterize the differential role of TPO antibodies in aggressive forms of TCFO (AGG) as compared to non-aggressive (NAG) ...

The thyroid hormone (TH) transporters Mct8 (encoded by Slc16a2) and Oatp1c1 (encoded by Slco1c1) are critically involved in mediating TH passage across mouse brain barrier cells. Mct8/Oatp1c1 deficient mice (= DKO mice) exhibit a strongly reduced brain TH content and consequently, an impaired neuronal development and hypomyelination all of which are also seen in patients with MCT8 deficiency (Allan-Herndon-Dudley Syndrome, AHDS). Our recent studies of mouse mutants lacking bot...

Introduction: Primary thyroid lymphoma is a rare entity accounting for <5% of thyroid malignancies and <2% of extra-nodal lymphomas with diffuse large B-cell lymphoma (DLBCL) being the most common subtype. Plasmablastic lymphoma (PBL) is an uncommon and aggressive subtype of DLBCL mainly detected in patients with immunosuppression, especially related to HIV infection. Typically, PBL occurs in extra-nodal sites, usually the oral cavity and the gastrointestinal tract whi...

Introduction: Several cases of subacute thyroiditis (SAT) have been described in patients with SARS-CoV-2. However, no prospective data about follow-up in SARS-CoV-2-related SAT are known.Aim: The characterization of clinical peculiarities and response to medical treatment of SAT cases, correlating to virus exposure, ascertained with antibody (Ab) dosage.Methods: A prospective, 3-years, multicentre study was conducted, enrolling pa...

Immortalized human thyroid follicular epithelial cell lines represent a valuable tool for the investigation of thyroid physiology in vitro. While there is an extensive selection of human thyroid carcinoma cell lines, the number of healthy follicular epithelial cell lines is limited. The vast majority of studies on thyroid physiology is based on the human immortalized cell line Nthy-ori 3-1, leading to comprehensive characterization of this cell line. However, in 2021 ...

Introduction: Medullary thyroid carcinoma (MTC) constitutes 3.5-5% of all thyroid cancers. Routine biochemical diagnostics include determination of calcitonin (CT), procalcitonin (PCT) and carcinoembryonic antigen (CEA). XIAP (X-linked inhibitor of apoptosis protein) and survivin belong to the family of proteins – inhibitors of apoptosis (IAP). Using tissue microarrays, the expression levels of XIAP and survivin were tested in patients with medullary thyroid cancer. The s...

Introduction: The question of whether pregnancy has any impact on the prognosis of differentiated thyroid cancer diagnosed in pregnant women was addressed mainly in retrospective analyses, which showed no significant differences in overall and progression-free survival between women diagnosed during pregnancy in comparison to women whose thyroid cancer diagnosis was unrelated to pregnancy. Thus, following the recent guidelines, watchful waiting is the preferred option, and sur...

Introduction: Thyroid function tests (thyroid hormones and thyreotropin) are frequently used by physicians all over the world. The interpretation is usually quite simple and straight-forward, however sometimes there is a strange discrepancy between the laboratory findings and clinical presentation. There are several potential explanations to this discrepancy and interference in laboratory assay may be one of them.Observation: We present a case of a 73-ye...

Aim: Autoimmune thyroid disease (AITD) is the most common adverse effect in alemtuzumab (ALZ) treated relapsing–remitting (RR) multiple sclerosis (MS) patients. The objective of this prospective study was to analyze the occurrence, timing of onset, clinical course, and laboratory characteristics of AITD post-ALZ and subsequently the clinical outcome of AITD post-ALZ in patients who received ocrelizumab.Patients and methods: We evaluated 36 RRMS pati...

Introduction: Long pentraxin 3 (PTX3), a protein cells produce in response to several inflammatory stimuli, is essential in innate immunity, controlling inflammation, tissue remodeling, and cancer dynamics. PTX3 promotes the migration and invasion of cells in different tumor models. This study aims to (I) immunohistochemically assess the presence and distribution of PTX3 in tissue samples from non-medullary thyroid cancer (NMTC) and (II) (TC) to determine the differences of ci...

Introduction: Medullary thyroid cancer (MTC) is a rare tumour. Mostly sporadic, 25% are associated with multiple endocrine neoplasia (MEN2A/B) or isolated familial MTC. Surgery is the only curative option: its response is defined as complete (no evidence of biochemical or structural disease), incomplete (only structural response) and persistence of structural disease. We aimed to analyse the clinical and pathological factors associated with the prognosis of MTC.<p class="a...

Introduction: COVID-19 has been established as a multisystemic disease with the potential of affecting all the organs of the human organism including the thyroid gland which features ACE2 receptors for the cellular entry of SARS-CoV-2. Graves’ disease comprises the most common cause of thyrotoxicosis, manifests in genetically predisposed individuals with an autoimmune background and may be triggered by a variety of environmental factors, including viral infections. A few ...

Background: The concept of autoantibody-negative Graves’ disease (GD) is a subject of debate. Studies have revealed that autoantibody-negative GD does exist, albeit rare.1Method: Over a 3-year period, a total of 108 hyperthyroid patients who exhibited diffuse or normal thyroid uptake on thyroid scintigraphy, were assessed in a cross-sectional study. The thyroid function tests, TSH-receptor antibody (TRAb) levels, anti-thyroid peroxidase (anti-TPO) a...

Background: Thyrotoxic periodic paralysis (TPP) is a rare complication of thyrotoxicosis, characterized by recurrent hypokalemia, episodic muscle weakness and paralysis. It is potentially fatal in serious attacks with occurrence of life-threatening cardiopulmonary complications. Currently, lack of large cohorts comprising individuals with TPP history restrict the conduct of relevant epidemiology study.Methods: Clinical data from a population-wide electro...

Introduction: Subacute thyroiditis (SAT) can often resolve completely; however, it has been observed that in 11.6% of patients, permanent hypothyroidism (PHT) may develop the follow-up after diagnosis. Various studies have explored the relationship between thyroid volume at the time of diagnosis, post-treatment changes in thyroid volume, steroid therapy, and the development of PHT following SAT. While some studies suggest associations, there are also data indicating that no si...

Background: Thyroglobulin (Tg) is a protein exclusively synthesized by follicular thyroid cells. Serum Tg levels depend on thyroid volume, serum TSH levels, gender, age, smoking, and iodine intake. Consequently, serum Tg reference range may exhibit variations among different populations. It is crucial to establish population-specific reference ranges, especially when interpreting serum Tg values in the follow-up of patients with differentiated thyroid cancer who have undergone...

Introduction: Medullary thyroid carcinoma (MTC) is an uncommon thyroid malignancy arising from calcitonin-producing parafollicular cells. Micro-MTC is defined traditionally as MTC that measures ≤1 cm and represents a very rare entity. Ultrasound-guided fine-needle aspiration biopsy cytology (FNAB-C) sensitivity is about 63% for MTC and can be improved by measurement of calcitonin in the needle washout (FNA-CT). The value of FNA-CT in micro-MTC has not been studied. Our a...

Background: Post-treatment monitoring of thyroid cancer depends on risk stratification for future recurrence or possible extra-thyroidal metastasis. Current guidance suggests that patients with favourable prognostic factors and a low likelihood of recurrence can be effectively monitored in community settings. This study explores the safety of community-based surveillance for stable low-risk thyroid cancer patients discharged from specialised thyroid clinic.<p class="abstex...

Aim: Changes in thyroid functions, parenchymal structure and increased frequency of thyroid diseases in inflammatory bowel diseases(IBD) have been described in various studies. In the literature, studies using the data scanning method, most of which belong to the past period, stand out. In this study, we wanted to investigate the relationship between IBD and thyroid diseases in a non-retrospective study. The aim of this study is to systematically check whether there is a relat...

Background: The impact of subclinical hyperthyroidism (sHT) on lipids concentration is still unclear. The aim of the study was to prospectively evaluate the changes in lipid profile in patients with sHT and following restoration of euthyroid state.Patients and methods: The studied group consisted of 44 patients (37 females, 7 males), diagnosed with endogenous sHT in the course of either toxic multinodular goiter, diffused thyroid autonomy or autonomously...

Objectives: ALK fusion genes are a rare genetic alteration and have been described in various t types of thyroid carcinomas, particularly in papillary thyroid carcinomas (PTCs), poorly differentiated thyroid carcinomas (PDTCs) and anaplastic thyroid carcinomas (ATCs). The aim of this study was to identify ALK fusion genes in thyroid carcinoma samples, correlate them with clinical and histopathological features, and determine the prognostic significance of <em...

Introduction: Radiation exposure at young ages is a risk of thyroid cancer. Although early studies of the infants treated with X-rays already indicated an association, the risk became well-known by a rapid rise in childhood thyroid cancer cases after the Chernobyl nuclear plant accident. Human cases have been investigated extensively, but the underlying mechanisms have yet to be elucidated. Our previous investigation in rats found that neonatal X-irradiation induced long-term ...

Objective: Adequate thyroid hormone availability is essential for foetal neurodevelopment. While overt maternal hypothyroidism is associated with lower offspring IQ, recent studies suggested an inverse U-shaped association, with suboptimal offspring neurodevelopment for both the lower and higher thyroid function range. Our aim is to investigate the association of gestational thyroid function with offspring IQ scores, assess if this association is different based on the gestati...

Background: Elevated reverse triiodothyronine (rT3) is a characteristic feature of euthyroid sick syndrome (ESS), which is associated with mortality in critical patients. However, the lack of reference values limits the use of rT3 for ESS diagnosis and the prognostic value of rT3 is unclear. This study aimed to determine the reference range of rT3 in the ESS identification and mortality prediction in critically ill patients.Methods: This ongoing prospect...

Background: Papillary thyroid cancer (PTC) is a disease with an indolent course, excellent overall prognosis and long-term survival. However, some PTCs are associated with an increased risk of recurrent disease and aggressive behaviour. Many exogenous factors, as obesity, could be implicated in the pathogenesis of thyroid cancer but the biological mechanisms that may explain this connection have been only partially described. Potentially factors that combine overweight with th...

Introduction: Medullary thyroid cancer (MTC) is a rare thyroid neoplasm arising from parafollicular C-cells secreting calcitonin. Although it possesses specific histological and biochemical markers, real-life diagnosis and management remain challenging.Aim: A retrospective analysis of MTC patients from four Hungarian endocrine university centres over 23 years (2000-2023) was undertaken. Demographic data and biochemical markers, staging, germ-line RET mut...

Background: TSH is the first-line test for thyroid function. Since the 1990s, 3rd-generation assays have been available on automated platforms, and the normal ranges provided by manufacturers are generally used in diagnoses. In the age of gender medicine there is a need to refine normal TSH ranges. The aim of this study was to construct a normal TSH range in women living in our district.Methods: From 2005 to 2020, 4544 records from women under...

Objective: To present the rare case of a patient with cutaneous angiosarcoma, multiple benign skin lesions together with multiple thyroid nodules and to discuss his genetic diagnosis.Case Presentation: A 132/12 years-old boy was referred to the Endocrinology department, following chemotherapy and radiotherapy. His medical history was uneventful until the age of 8 years. His mother reported Graves’ disease and his maternal grandmother papi...

Introduction: major complications of thyroid surgery include; injury to the recurrent laryngeal nerve that can cause dysphonia and acute respiratory distress, postsurgical hematoma, infection and hypoparathyroidism, which can be transient or permanent.Objective: to analyze the complications observed after performing thyroid surgery with different pre-surgical diagnoses in our center.Methods: retrospective descriptive study of thyro...

Objectives: Phosphatase and tension homolog (PTEN) is a part of signal pathways which are essential for cell proliferation, cell cycle progression, and apoptosis. Variants in the PTEN gene occur in different types of thyroid tumors with unclear diagnostic and prognostic impact. Most variants are somatic, but they can also be germline, which are associated with PTEN hamartoma tumor syndrome (PHTS). PHTS includes Cowden syndrome, which is characterized by hamartomas, an...

Introduction: The management of small size (≤ 1 cm) papillary thyroid carcinoma, also known as papillary thyroid microcarcinoma (PTMC) is a debated topic as it includes tumors with a wide range of biological characteristics and behavior.Objectives: To describe prevalence, clinical and histological characteristics of PTMC with excellent response to treatment after a median follow up of 9.85±6.21 years.Methods: We did a re...

Introduction: The coexistence of myasthenia gravis (MG) and autoimmune thyroid disease (AITD) is well recognised, with 5-10% of MG patients also having an AITD1-2. Among AITD, hyperthyroidism association with MG is the most common3. Conversely, MG has a relatively low incidence of around 0.2% in individuals with hyperthyroidism2, 4. This implies a potential immunological cross-reactivity between the neuromuscular junction and thyroid components...

Introduction: Patients with multiple sclerosis (MS) demonstrate, in a number of studies, increased risk of acquiring another autoimmune disease compared to general population. Autoimmune thyroid diseases, type 1 diabetes, psoriasis and inflammatory bowel disease are the most common reported. The aim of our study is to determine potential factors that affect the presence of autoimmune endocrinopathies in patient with relapsing and remitting MS.Methods: We...

Aim: The aim of this study was to evaluate the association between thyroid function in Graves’ disease (GD) with high-sensitivity C-reactive protein (hs-CRP), lipid profile, homocysteine, folate, vitamin B12 and insulin resistance.Methods: We performed a cross-sectional of 104 patients with recently diagnosed GD. All participants were in the first cycle of treatment with methimazole. We collected demographic information, body mass indexes (BMI), lab...

Introduction: The thyroid hormone (TH) status is routinely assessed by thyrotropin (TSH) and thyroxine (T4). Both biomarkers are mainly regulated by thyroid hormone receptor beta, whereas many peripheral organs employ the alpha receptor. Serum CD5L is a liver-derived protein under control of both TH receptor isoforms, but the data base is small [1]. An additional biomarker of TH status is needed in particular during pregnancy, where the routine biomarkers become dynamically di...

Introduction: Thyroid fine-needle aspiration cytology (TFNA) is a widely used diagnostic method that is generally safe. Aiming to reduce haemorrhage doctors frequently advise patients to withdrawal antithrombotic/anticoagulant (AT/AC) drugs before TFNA. There are no guidelines recommending so and the so called ‘novel anticoagulants’ have been poorly studied in this context. Some patients are likely being exposed to increased thrombotic risk unnecessarily. Evidence is...

Graves’ disease and type 1 DM (T1DM) both have an autoimmune aetiology. Also, Thyrotoxicosis (TT) has previously been described as a possible precipitant of diabetic ketoacidosis (DKA) in patients with T1DM. Due to the similarities in their clinical presentation, DKA can mask the diagnosis of TT and vice versa. We report two cases of the simultenous presentation of thyrotoxicosis and diabetic keto-acidosis in two previously healthy men. Case 1: A 27-year-old man with...

Background: Treatment of subclinical hypothyroidism (ScH) when TSH is between the upper reference value and 7mU/L, especially in patients younger than 65 years is controversial.Objectives: To compare the risk factors for atherosclerosis and echocardiographic parameters in patients with ScH1 (4, 2≤TSH≤7mU/L) to euthyroid subjects and patients with ScH2 (TSH>7mU/L).Material and Methods: Prospectively 54 consecutive pa...

About 50% of women have nausea and vomiting during pregnancy. In about 35% of women who have these symptoms, nausea and vomiting are clinically significant, worsening their living conditions and consisting in a case of gender gap. The severe form, hyperemesis gravidarum, ranges from 0.3 to 1.0% of cases and is characterized by persistent vomiting, gestational thyrotoxicosis, weight loss of more than 5%, ketonuria, hypokalemia and dehydration, although the pathophysiological me...

CHEK2, located on chromosome 22q, is a tumor suppressor gene. Its’ pathogenic variants are often associated with a tumor predisposition syndrome 4, with an increased risk of breast, prostate and colorectal cancers. There are some reports of an increased risk of papillary thyroid cancer (PTC) in carriers of the CHEK2 pathogenic variants. Current guidelines, however, do not recommend general screening of TC patients. The study assessed the prevalence of pa...

Objectives: Distant metastases (DM) and/or biochemical persistent disease (BPD) in MTC, adversely affect disease prognosis. Calcitonin and CEA doubling-times (DTs) are the main prognostic indicators for disease progression. Liquid biopsy based on CTCs enrichment and characterization seems to be an intriguing non-invasive tool providing information about tumor biology and molecular identity. The aim of this study was the molecular characterization of CTCs in spMTC patients with...

Background: About 20% of thyroid-nodules have indeterminate-cytology (IDC), classified as Bethesda categories-III/ IV. They carry varying risks of malignancy (6-18%, 10-40% respectively). Ideal test to determine the risk of malignancy in IDC is unclear. Molecular-profiling has shown promise, but availability & affordability is an issue. We aim to evaluate diagnostic value of modified systemic inflammation score(mSIS) to determine malignancy in IDC.Me...

Background: The interplay of genetic, immune and environmental factors strongly contributes to the development of autoimmune thyroid disease (AITD) in the form of Graves’ disease (GD) and Hashimoto thyroiditis (HT). One of the most studied exogenous factors in the pathogenesis of AITD is selenium, which in the form of selenoproteins strengthens the antioxidative defence system of thyroid cells against superoxide production. Furthermore, it modulates inflammatory cytokine ...

Introduction: Graves’ disease (GD) can negatively affect the quality of life. Research on GD in childhood, accounting for 1-5% of cases, has so far predominantly focused on treatment results. There is limited knowledge about association with other diseases and long-term psychosocial effects.Aims: We aimed to compare disease burden and psychosocial outcomes between childhood/young adult GD patients and unexposed population controls.<p class="abst...

Background: There are two types of thyroid nodule biopsy: fine-needle aspiration (FNAB) and core-needle (CNB). Multiple studies mainly from Eastern Asia demonstrate safety and efficacy of CNB, however it is very rarely used in Europe.Methods: Retrospective analysis of the first 281 CNBs performed in Romania, including 8 lymph nodes and 3 thyroid bed lesions. We used the Korean Thyroid Association reporting system (KTA-CNB) for histology reports.<p cl...

Background: Thyroid nodules prevalence is high in adult population, approaching 60% in women and older people. Most thyroid nodules are benign and asymptomatic. However, a not negligible part of them causes compressive symptoms and/or cosmetic concerns and need treatment. In the last decades, minimally invasive treatments of the thyroid (MITT) have been proposed in clinical practice as reliable cost-effective alternative to surgery in patients with symptomatic benign thyroid n...

Background: A subset of Graves’ disease (GD) patients develops refractory hyperthyroidism, posing challenges in treatment decisions. The predictive value of baseline characteristics and early therapy indicators in identifying high risk individuals is an area worth exploration.Methods: A prospective cohort study (2018-2022) involved 597 newly diagnosed adult GD patients undergoing methimazole (MMI) treatment. Baseline characteristics and 3-month ther...

Introduction: Hashimoto’s thyroiditis (HT) is multifactorial disease, caused by a complex interplay of genetic, hormonal, and environmental influences that provoke the development of inappropriate immune responses against thyroid on multiple levels and the initiation of a long-standing autoimmune reaction. Interaction between cellular and humoral immunity is base of HT’s pathogenesis. Our research focuses on the functional activity and the quantity of T regulatory an...

Introduction: 18F- Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography (18F-PSMA PET/CT) is currently used in the evaluation of prostate cancer. Due to increased expression of PSMA in the neovascular endothelial cells of malignant lesions other than prostate cancer, PSMA PET/CT has become of interest to researchers in the management of thyroid cancer. The goal of this study was to evaluate the incidence and clinical signifi...

Introduction: Choriocarcinoma is a rare gynaecological cancer arising from the trophoblastic epithelium of the placenta. HCG induced thyrotoxicosis is a rare but recognised paraneoplastic phenomenon. The association of high BHCG levels and thyrotoxic state is thought to be secondary to similarities in the structure between HCG and pituitary hormones including TSH which share the same alpha unit and enables HCG to activate the TSH receptor at high levels. Kato et al in 2004 rep...

Introduction: The prevalence of primary hyperparathyroidism is increasing owing to the more the routinely measurements of serum calcium. A single benign para-thyroid adenoma is the most frequent cause of sporadic PHPT. Primary hyperparathyroidism can also be due to ectopic mediastinal parathyroid adenoma in 11-25% of patients, more frequently involving inferior parathyroid translated in anterior mediastinum. In general to detect ectopic adenoma recent guidelines recommend the ...

Radiofrequency ablation (RFA) is effective in the treatment of thyroid nodules, leading to a 50-90% reduction with respect to baseline. Current guidelines indicate the need for a benign cytology prior to RFA, though, on the other side, this procedure is also successfully used for the treatment of papillary microcarcinomas. No specific indications are available for nodules with an indeterminate cytology (Bethesda III and IV). Aim of the present study was to evaluate the efficac...

Background: Indirect methods is developed to estimate reference limits from patient data, i.e. data from a mix of sick and healthy people. The indirect methods use a large number of results. A prerequisite for the methods to work satisfactorily is that the proportion of patients is not too large (typically < 20-30%).Methods: We used direct and indirect methods for estimating reference limits for TSH, FT4, FT3, total T4 and total T3. All analysis were...

Most thyroid nodules are benign and majority do not require treatment, except for those large nodules that cause symptoms (compression, hormonal dysfunction and/or esthetic problems). Microwave ablation (MWA) is an attractive therapeutic option because it is minimally invasive, relatively inexpensive, capable of providing coagulative necrosis, and has a short treatment time. In the following, we present the experience of our hospital.Objective: To evalua...

Background: Collagen, whose biosynthesis is regulated by thyroid hormones, is the most abundant connective tissue protein. Ehlers–Danlos syndrome alters collagen structure, which may affect bone mineral density (BMD). The purpose of this study was to assess the effect of autoimmune thyroiditis on BMD in females with Ehlers–Danlos syndrome.Material and methods: The study involved a prospective assessment of 30 female patients, aged 20–53 ye...

Introduction: The Bethesda system gives each Fine Needle Aspiration (FNA) category a risk of malignancy (B1: 5-10%, B2: 0-3%, B3: 10-30%, B4: 25-40%, B5: 50-75%, B6: 97-99%). Based on this risk, therapeutic decisions are made that influence the patient’s life. It is important to check whether the percentage of malignancy obtained in our daily clinical practice is similar to that expected according to this system.Aim: To check whether the percentage ...

Objective: Adjuvant chemotherapy is often indicated in patients diagnosed with early breast cancer. Weight gain is one of the observed side effects of both chemotherapy and other cancer treatments, however, the mechanism is not well-described. In this study, we aimed to assess thyroid function before- and after the course of chemotherapy for early breast cancer.Methods: This study is a 5-year prospective cohort study of patients diagnosed with early brea...

Disorders of the thyroid gland in the Republic of Moldova rank second among endocrine diseases (after diabetes mellitus), hypothyroidism being one of the most widespread diseases. In communities, the prevalence of overt hypothyroidism is from 0.1 to 2 percent, and that of subclinical hypothyroidism is up to 10 percent of adults (increasing even more in women, and with advanced age). Regarding the prevalence of hypothyroidism in the Republic of Moldova, it is necessary to menti...