Endocrine Abstracts

The natural history of thyroid eye disease (TED), the most frequent extrathyroidal manifestation of Graves' disease, is not completely understood, nor it is clear whether treatments for concomitant hyperthyroidism can influence it. Neither thionamides nor thyroidectomy appear to be disease-modifying treatments. What about radioiodine (RI) therapy? Results are conflicting, owing to selection bias, nonstandardized ocular evaluation, and the retrospective and uncontrolled feature...

Management of Graves’ orbitopathy (GO) depends on the severity and activity of the disease. Guidelines for the management of GO have recently been published by EUGOGO (European Group on Graves’ Orbitopathy) (European Thyroid Journal 2016 5 9–26). Assessment of GO by standardized criteria is fundamental to determine the type of intervention. General measures for all patients with GO, irrespective of the degree of severity and activity, i...

Management of Graves’ orbitopathy (GO) is a challenge, and 30–50% of patients are eventually dissatisfied with medical treatment outcome. GO natural history is poorly understood, but some patients experience a progression of GO over time. Thus, prevention of development/progression by abolishing risk factors (e.g. smoking, thyroid dysfunction) is important. The recent results of a randomized clinical trial (RCT) carried out by the EUGOGO group showed that selenium (s...

Extrathyroidal manifestations of Graves’ disease include eye disease (Graves’ ophthalmopathy, GO), dermopathy (also known as pretibial myxedema) and nail changes (acropachy). While about 50% of Graves’ patients are affected with mild to moderately severe GO, dermopathy is present only in 1–4% of cases, and acropachy in 0.1–0.4%.Management of GO represents a complex and unresolved problem, and the treatment outcome is frequently u...

The ideal treatment of hyperthyroidism due to Graves’ disease (GD), an autoimmune disorder ultimately caused by TSH-receptor antibody, would consist of the elimination of disease triggers. Because this is not feasible, current management relies on either thyroid ablation (thyroidectomy and/or radioiodine) inevitably bound to subsequent hypothyroidism, or a conservative approach using antithyroid drug (ATD) treatment. The latter is associated with a high rate (about 40&#15...

Context: Amiodarone is a widely used anti-arrhythmic medication, however associated with a 15-20% rate of thyroid adverse effects. Amiodarone-induced thyrotoxicosis (AIT) is a complex disease due to diagnostic difficulties and therapeutic challenges. AIT patients often receive initial therapy for thyrotoxicosis before admission to a referral center. Whether the first-line medical therapy (i.e. therapies for thyrotoxicosis at first diagnosis of AIT) may affect the outcome of AI...

Background: Thyroid carcinoma represents the most frequent form of cancer of the endocrine glands. In Italy, temporal trend shows a significant increase of incidence rates. Papillary thyroid cancer is the most common thyroid malignancy. Papillary thyroid carcinoma happens to be a multicentric tumor and trends to spread to the lymph nodes in the early stage of the disease. Thus early diagnosis is vital to improve the outcome for patients with thyroid cancer. The aim of this stu...

Amiodarone induced thyrotoxicosis (AIT) may develop in patients with either underlying thyroid disorders (type 1) or normal gland (type 2). The latter is considered a drug-induced destructive thyroditis, usually responding to glucocorticoids. Further treatments after restoring euthyroidism are often not necessary. The former is a true form of iodine-induced hyperthyroidism the management of which includes thionamides, potassium perchlorate and thyrodectomy. The prevalence of t...

Background: Papillary thyroid cancer is a well-differentiated neoplasm and is the most common, accounting for 65–85% of all thyroid cancer. On the other hand, medullary carcinoma represents only 3–12%. The concurrence of distinct medullary and papillary carcinoma within the same thyroid has been sporadically described.Case presentation: We report a rare case of simultaneous sporadic both multicentric medullary and papillary thyroid cancer with ...

Whether TTA affects GO remains to be established. Here we studied the effects of TTA in 90 patients with mild-moderate GO randomized into 3 groups of thyroid treatment: MMI (methimazole), TX [near-total thyroidectomy (NTTX)], TTA (NTTX plus 131-I). Patients were treated with ivGC and evaluated at 3 and 9 mo. GO was considered improved or worsened when at least 2 of the following criteria changed, either positively or negatively: i) proptosis and/or eyelid width by at least 2 m...