Endocrine Abstracts

The anti-CD 20 antibody rituximab (RTX) has been employed in the treatment of several autoimmune diseases and its effect may not involve autoantibody secretion. Preliminary studies have shown that RTX induced improvement of active Graves’ orbitopathy (GO) but caused no change of serum anti-thyroid antibodies in relation to peripheral CD 20+ cells depletion, usually observed at the second week after therapy. A 50-year-old woman with GO predominantly active in the left eye ...

A seasonal occurrence of Graves’ disease (GD) has been reported in previous studies, with a peak of frequency in the warmer half of the year (Ford 1988, 1991, Westphal 1994) or the period of the year with a higher iodine intake (Phillips 1985); other studies (Facciani 2000) have failed to find a different seasonal occurrence of Graves’ orbitopathy (GO). Aim of the present study was to evaluate a possible seasonal difference in the onset of GD and GO in a series of ou...

An increasing prevalence of papillary thyroid carcinomas (PTC) of small size have been recorded in recent years. These tumors have a favorable outcome in most cases, and total thyroidectomy without radioiodine therapy is suggested for microcarcinomas (defined as ≤1 cm). The 6th edition of the TNM staging system for thyroid cancers includes in the T1 category tumors ≤2 cm, limited to the thyroid. Aim of the present study was to evaluate the clinical/pathological fea...

Previous studies have shown that Rituximab (RTX) is effective as a disease modifying drug at doses of 500 mg or 1000×2 mg in active Graves’ orbitopathy (GO). We have conducted a pilot study (EUDRACT 2012-001980-53) in which patients with active moderate-severe GO were treated with a single infusion of low dose RTX (100 mg). Ten patients were enrolled of whom seven completed the study at 52 weeks. Five patients did not respond to a previous treatment with i.v. methylp...

Radioiodine (131I) administration has been found to be effective in the treatment of hyperfunctioning and normofunctioning multinodular goiter. Moreover, lithium therapy has been shown to enhance the radioiodine efficacy and to reduce the transient thyrotoxicosis induced by radioiodine.Aim of the present study was to evaluate the long term efficacy of 131I with or without lithium administration in the treatment of non toxic multinod...

We described a significant clinical response to RTX treatment in patients with active TAO. In order to understand the possible mechanisms of action of RTX, we measured serum concentrations of IL-6 and its soluble receptor (sIL-6R). We treated 10 patients with RTX: 8 women, 2 men aged 31–51 yr with Graves’ disease. We also treated 14 patients with i.v. steroids (IVGC). All had active TAO. In all patients we studied thyroid function, serum autoantibodies and peripheral...

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic disease (Covid-19) affects thyroid function with different mechanisms: non-thyroidal illness syndrome (NTIS), direct infection of thyroid gland and cytokine storm. We provided the first description of painless atypical thyroiditis coexisting with NTIS in patients hospitalised for moderate-to-severe Covid-19 disease. We aimed to: 1) correlate thyroid dysfunction with Covid-19 disease severity;...

It is known that high levels of TSH are associated with higher miscarriage risk, though the precise TSH cut-offs are debated. Aim of the present study was to evaluate if pre-conceptional TSH levels associate with increased risk of early miscarriage in a large series of infertile women submitted to IVF and to determine the threshold of TSH associated with the highest prevalence of pregnancy loss. We retrospectively studied 1484 infertile women (mean±age 36.7±4.1 years...

Background: BAFF is a Serum B cell stimulating factor shown elevated in Graves’ disease, compared to controls (Vannucchi 2012). BAFF and its receptor are expressed on lymphocytes infiltrating the thyroid in Graves’ disease as well as on thyrocytes themselves (Campi 2015).Aims: A single-blind randomized controlled trial (EudraCT 2015-002127-26) has been conducted to test the efficacy of the anti-BAFF monoclonal antibody belimumab (BMB) in acti...

Rituximab (RTX) is a monoclonal antibody which binds CD20 antigen and induces B cell depletion. It is not known if its therapeutic effect in autoimmune diseases is mediated by modifications of the humoral immune response, namely the antibody production. Aim of the present study was to evaluate the effect of RTX on serum TSH-receptor antibodies, both binding (TBII) and stimulating (TSAb) and on serum antibodies against three orbital antigens, calsequestrin, XIII collagen and th...