Endocrine Abstracts

Introduction: Follow up of differentiated thyroid cancer requires periodic measurements of thyroglobulin (Tg) and Tg autoantibodies (TgAb) and neck ultrasound. Recurrence is suspected in presence of rising levels of Tg and/or TgAb. Positive cytology or detectable Tg in washout of fine needle aspiration (FNA) of neck lymph nodes or 131-I neck uptake confirm the diagnosis of metastatic lymph node.Case report: We report on a 25 year-old Caucasian man, affec...

Context: Subacute thyroiditis (SAT) is an inflammation of the thyroid, likely caused by a viral infection. IgG Autoantibodies (Ab) to the main thyroid antigens, including thyroglobulin (Tg) (TgAb) have been reported in a few patients with SAT and their appearance is usually transient. We investigated whether IgM TgAb can be detected in sera of patients with SAT.Design: Serum samples were collected from 17 patients with SAT, ten with Graves’ disease ...

Subacute thyroiditis (SAT) is an inflammation of the thyroid gland characterized by varying degrees of severity regarding thyrotoxicosis, inflammation and the incidence of hypothyroidism. The present study aims to identify whether the severity of SAT depends on the causative agent involved and to identify what is the optimal therapy. To this purpose we retrospectively evaluated 402 patients referred to of the University Hospital of Pisa because of to a SAT from January 2011 to...

PD-1/PD-L1 pathway is a key regulator in T-cell activation and tolerance. Nivolumab, pembrolizumab (a PD-1 inhibitors) and atezolizumab (a PD-L1 inhibitor) are monoclonal antibodies approved for treatment of advanced cancers. Autoimmune thyroid diseases are the most common immune-related adverse effects (IrAEs) occurring after anti-PD-1 or anti-PD-L1 therapy, whereas autoimmune hypophysitis is described more frequently in patients treated with anti-CTLA-4. IrAEs can be isolate...

Context: Monoclonal antibodies to Immune Check Point inhibitors (ICPis) are powerful anti-cancer drugs. They trigger the immune system against cancer cells, blocking inhibitory signals of T-Cells. However, ICPi therapy can also stimulate autoimmune reactions, inducing the so-called immune-related adverse events (irAEs). Endocrinopathies are common iRAEs and thyroid disfunction is the most common endocrinopathy during ICP therapy. We report three cases of thyroid disfunction du...

BackgroundSubacute thyroiditis (SAT) has been related to acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We evaluated the incidence and the severity of SAT due to SARS-CoV-2.MethodsA cross-sectional, retrospective study was conducted at the Endocrinology Unit of University-Hospital of Pisa, Italy. All patients experiencing SAT arisen within a period of 15 days earlier and yet untreated, assessed from J...

Introduction: The association between thyroid cancer and thyrotoxicosis is rare and, in particular, autonomous hyperfunctioning metastasis of differentiated thyroid cancer (TC) are seldom described, with a prevalence of 0.71%. Althought most hyperfunctioning metastasis are derived from follicular thyroid cancer (FTC), metastasis from papillary thyroid cancer (PTC) have been also reported. Bone metastasis account for the majority of cases. Hyperfunctioning TC metastasis have be...

Fine-Needle Aspiration Biopsy (FNAB) is the recommended diagnostic tool for differentiating malignant from benign thyroid nodules and provides indication for surgical decisions. According to the Italian system, thyroid nodules are classified as TIR 1/1C, TIR 2, TIR 3A, TIR3B, TIR4 or TIR5, which correspond to Thy I, Thy II, Thy III, Thy IV, Thy V and Thy VI categories of the Bethesda system. TIR 3 identifies the indeterminate nodules. Surgery is usually recommended for TIR 3B,...

Recently, we have reported a few cases of acute liver damage in patients with Graves’ ophthalmopathy (GO), during or following high dose intravenous (iv) glucocorticoid (GC) pulse therapy. In the present study we analyzed retrospectively liver enzymes (LE) in 294 consecutive patients with GO who underwent ivGC. LE were measured before or during ivGC, and in 91 patients also within 6 months after ivGC. An asymptomatic increase in LE (AST peak: 67–88 U/L, ALT peak: 75&...

Objective: Destructive thyroiditis is the most common endocrine immune related adverse event (iRAEs) in patients treated with anti-PD1/PD-L1 agents. Given its self-limited course, current guidelines recommend no treatment for this iRAE. Nevertheless in patients with enlarged thyroid volume and a poor performance status, thyrotoxicosis may be particularly severe and harmful. Aim of the study is to evaluate if steroid treatment might be useful in improving thyrotoxicosis in subj...