Endocrine Abstracts

L-T4 monotherapy remains the standard treatment of hypothyroidism, as RCTs comparing T4 and T4+T3 did not indicate superiority of the combination therapy. However, the issue is far from settled, as these RCTs can be criticized and 5–10% of patients on T4 have persistent complaints.i) Has T4+T3 therapy a true effect on serum thyroid hormones? Under T4 monotherapy serum FT4 is higher and serum FT3 is lower than in healthy subjects, giving ris...

Autoimmune endocrine diseases are seen as multifactorial ‘complex’ diseases in which immune reactions against self-antigens from endocrine glands develop against a particular genetic background facilitated by exposure to environmental factors. A number of these factors have been identified, and most interestingly they can be protective for one disease but a risk for another disease. Much has still to be learned about gene-environment interactions. As an example we wi...

Immunopathogenesis: Orbital fibroblasts are recognized as the prime target cells of the autoimmune attack. There is good circumstantial evidence that autoimmunity against the TSH receptor is primarily involved, but a suitable animal model of GO is lacking. Autoimmunity against the IGF-1 receptor is nonspecific for Graves’ disease, but might contribute to the immune response in the orbit.Diagnosis: Diagnosis of GO is based on: i) assessment of eye ch...

The European Group on Graves’ Orbitopathy was established in 1999 in the conviction that a multidisciplinary approach is required in order to make progress in the management of Graves’ Orbitopathy (GO). Consequently, one criterion for EUGOGO membership is the presence of combined thyroid-eye clinics, staffed by endocrinologists and ophthalmologists. EUGOGO nowadays consists of 13 centers in 9 European countries. The group objectives are to contribute towards understa...

Abstract unavailable....

Early stages of thyroid autoimmunity can be identified by thyroid hypoechogenecity and/or thyroid antibodies in serum. To get better insight in these early stages, we assembled a large group of women at risk for AITD (all had one or more 1st or 2nd degree relatives with AITD), who were in self-proclaimed good health and followed for 5 yr (the Amsterdam AITD cohort).At study entrance, euthyroid women had reduced CD25 expression on CD4+T-cells and lower se...

Graves’ ophthalmopathy (GO) remains the most enigmatic presentation of thyroid autoimmunity. Although many issues regarding its pathogenesis and management have been solved, they are still outnumbered by unresolved open questions.Pathogenesis: Orbital fibroblasts (OF) have been recognized as the primary target cells of the autoimmune attack. Cytokine-induced excessive secretion of glycosaminoglycans and differentiation of a subset of OF into adipocy...

Background: AIT type 2 is self-limiting in nature and therefore discontinuation of amiodarone may not be necessary; however, the feasibility of continuing amiodarone has never been tested formally. Potassium perchlorate (KClO4) may have advantage when prednisone is unsuccessful in AIT type 2, possibly due to mixed cases of types 1 and 2. KClO4 also mitigates the cytotoxic effect of desethylamiodarone on thyrocytes in vitro.Ob...

Background: Autoimmune hypophysitis can result in growth hormone deficiency (GHD). Although autoimmune hypophysitis is uncommon, it is associated with other autoimmune endocrine diseases like autoimmune hypothyroidism (AIH). Recent studies suggest a high prevalence (5%) of GHD in AIH, which could contribute to the reduced quality of life frequently observed in patients with AIH despite adequate treatment with thyroxine.Objective: To establish the prevale...

Background: Normal pregnancy is a state of physiological oxidative stress (OS) with oxidants facilitating the implantation of the embryo and optimal decidualisation but counterbalanced by antioxidants. Pro-oxidant processes exceeding the anti-oxidants capacity result in imbalanced OS, which has been associated with the ‘’big four’’ obstetric complications: pre-term birth, intra-uterine growth retardation, pre-eclampsia and diabetes gravidarum. Important OS ...