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Vishnu Garla, Karthik Kovvuru, Shradha Ahuja, Venkatataman Palabindala, Bharat Malhotra, Sohail Abdul Salim
Aim: To present a case of Graves' disease complicated by methimazole induced agranulocytosis treated with therapeutic plasma exchange (TPE) and review of the literature. Case Presentation: A 21-year-old patient with a history of Graves' disease presented to the endocrine clinic. His history was significant for heat intolerance, weight loss, and tremors. Upon examination he had tachycardia, smooth goiter, thyroid bruit, and hyperactive reflexes. He was started on methimazole and metoprolol and thyroidectomy was to be done once his thyroid function tests normalized...
2018: Case Reports in Endocrinology
Eashaa Kumar, Michael T McCurdy, Christian A Koch, Abdurrahman Hamadah, Tibor Fülöp, Kamel A Gharaibeh
Unexplained hypotension in the intensive care unit is commonly attributed to volume depletion, cardiorespiratory failure, sepsis, or relative adrenal insufficiency. In these acute conditions, thyroid hormone levels measured in blood, serum or plasma are often altered and solely attributed to critical illness. We report a series of 3 critically ill patients with prolonged respiratory failure, suppressed mental status and unexplained hypotension. Thyroid stimulating hormone levels ranged from normal to mildly elevated (2...
March 2018: American Journal of the Medical Sciences
Ludmila S Almeida, Maidane C Araújo, Denise E Zantut-Wittmann, Lígia V Assumpção, Thiago F Souza, Cleide M Silva, Juliana L Argenton, Allan O Santos, Jair Mengatti, Celso D Ramos, Elba C Etchebehere
BACKGROUND: Radioiodine-refractory thyroid carcinomas (RAIRs) are characterized by reduced expression of sodium-iodine symporter, rising serum thyroglobulin levels, and negative whole-body radioiodine scans. Interestingly, RAIRs continue to express somatostatin receptors and can be identified with Ga-DOTATATE PET/CT imaging. OBJECTIVE: The objective of this study was to compare lesion detectability in Ga-DOTATATE PET/CT performed with elevated thyroid-stimulating hormone (eTSH) levels with suppressed thyroid-stimulating hormone (sTSH) levels...
March 14, 2018: Nuclear Medicine Communications
Cobra Payghani, Fatemeh Khani, Aryan Rafieezadeh, Parham Reisi, Hojjatallah Alaei, Bahman Rashidi
Background: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system which has no any known definitive treatment. Studies have shown that thyroid hormones (THs) in addition to their roles in the development of the nervous system and the production of myelin have important roles in the adult's brain function. Since the only way to treat MS is the restoration of myelin, the aim of this study was to evaluate the effects of levothyroxine on visual evoked potential (VEP) impairment following local injections of lysolecithin into the rat optic chiasm...
2018: International Journal of Preventive Medicine
Ladan Mehran, Davood Khalili, Shahin Yarahmadi, Hossein Delshad, Yadollah Mehrabi, Atieh Amouzegar, Nasrin Ajang, Fereidoun Azizi
OBJECTIVE: To evaluate the newborn screening programme for congenital hypothyroidism (CH) in Iran from diagnosis to management and follow-up for 3 years from 2011 to 2014. DESIGN: Retrospective cohort. SETTING AND PATIENTS: Seventeen university districts were randomly selected from 30 provinces. Central data in each district were gathered and collectively analysed. Congenital hypothyroid subjects were followed for 3 years. MAIN OUTCOME MEASURES: Programme coverage, screening and treatment age, recall rate, compliance to follow-ups...
March 14, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
V Campbell, R Beckett, N Abid, S Hoey
Infantile hepatic hemangiomas (IHH), particularly of the diffuse subtype, can in severe cases be associated with hepatic and cardiac failure, compartment syndrome, and consumptive hypothyroidism. Early recognition and treatment of these pathologies is paramount in order to minimise the risk of longterm sequelae. We report an interesting case of a female infant who presented with systemic compromise, in the absence of large or obvious cutaneous infantile hemangiomas (IH). Imaging identified innumerable hepatic hemangiomas, consistent with diffuse infantile hepatic hemangiomatosis...
February 28, 2018: Journal of Clinical Research in Pediatric Endocrinology
Darko Solter, Miljenko Solter
OBJECTIVES: The search for optimal therapy for hypothyroidism is challenging and complex and is still going on. We investigated TSH-thyroid hormone feedback control in hypothyroid and athyreotic patients properly treated with levothyroxine (LT4), based on normal TSH values. MATERIAL AND METHODS: We randomly selected 150 hypothyroid, 110 athyreotic and 210 euthyroid subjects, determined their serum T4, T3 and TSH values and calculated T4/TSH and T3/T4 ratios. RESULTS: The TSH distribution in hypothyroidism was significantly shifted to the higher and that in athyreosis to the lower values from the normal distribution in euthyroid controls...
March 9, 2018: Annales D'endocrinologie
Daniela Metro, Valeria Cernaro, Mattia Papa, Salvatore Benvenga
Some natural compounds decrease serum levels of thyroid autoantibodies, but results are inconsistent and thyroid function has been evaluated infrequently; moreover, the effects of Aloe on thyroid autoimmunity and function have been examined in very few studies. This study stems from the observation of one co-author, who has Hashimoto's thyroiditis (HT)-related subclinical hypothyroidism (SCH). Upon checking her biochemical thyroid panel when taking daily Aloe barbardensis Miller juice (ABMJ) for thyroid-unrelated reasons, she noticed a decrease in serum thyroperoxidase autoantibodies (TPOAb) and thyrotropin (TSH) and an increase in serum free thyroxine (FT4)...
March 2018: Journal of Clinical & Translational Endocrinology
Vishnu Vardhan Garla, Sohail Abdul Salim, Licy L Yanes-Cardozo
A 27-year-old male patient who presented to the emergency room with complaints of sweating, palpitations, heat intolerance, insomnia and weight loss for the last 3 months. His medical history was significant for hypertension. On examination, he was tachycardic, hypertensive, had tremors of the upper extremities and a smooth goitre with a thyroid bruit. Laboratory assessment revealed a suppressed thyroid-stimulating hormone, high free thyroxine and positive thyroid receptor antibodies. Complete blood count showed pancytopenia...
March 9, 2018: BMJ Case Reports
Jing Xue, Ru Feng, Haixia Fu, Qian Jiang, Hao Jiang, Jing Lu, Hui Liu, Jingwen Wang, Ting Niu, Xin Wang, Yandi Xie, Hao Wang, Lanping Xu, Kaiyan Liu, Xiaojun Huang, Xiaohui Zhang
The aim of the present study was to investigate the relationship between hypothyroidism and thrombocytopenia in hepatitis Brelated compensatory liver cirrhosis and to determine whether treatment with levothyroxine and prednisone is superior in a multicenter, open-label, observational study in China. In total, 125 consecutive hepatitis B-related compensated liver cirrhosis patients with severe thrombocytopenia accompanied by hypothyroidism were included. The patients were divided into four groups according to treatment strategy: a control group (n=29), a prednisone group (n=25), a levothyroxine group (n=32) and a prednisone plus levothyroxine group (n=39)...
March 8, 2018: Science China. Life Sciences
Karla Duccini, Marcus Souza, Ricardo Delfim, Ana Paula Aguiar, Patricia Teixeira, Mario Vaisman
OBJECTIVE: This study assesses whether or not a simple biochemical parameter, serum thyrotropin (TSH), within the reference range can predict the likelihood of thyroid malignancy in subjects undergoing fine-needle aspiration biopsy (FNAB) for thyroid nodules. SUBJECTS AND METHODS: This cross-sectional study evaluated 236 patients without overt thyroid dysfunction who were not on levothyroxine therapy. They underwent FNAB of the thyroid nodules at the Clementino Fraga Filho University Hospital between 2011 and 2012...
March 7, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Mary H Samuels, Irina Kolobova, Meike Niederhausen, Jeri S Janowsky, Kathryn G Schuff
Background: The brain is a critical target organ for thyroid hormone, but it is unclear whether variations in thyroid function within and near the reference range affect quality of life, mood, or cognition. Methods: 138 subjects with L-T4 treated hypothyroidism and normal TSH levels underwent measures of quality of life (SF-36, ThyDQoL), mood (Profile of Mood States, Affective Lability Scale), and cognition (executive function, memory). They were then randomly assigned to receive an unchanged, higher or lower L-T4 dose in double blind fashion, targeting one of three TSH ranges (0...
March 2, 2018: Journal of Clinical Endocrinology and Metabolism
Robert Krysiak, Witold Szkróbka, Bogusław Okopień
OBJECTIVE: Even mild hypothyroidism in premenopausal women is accompanied by impaired sexual functioning. The study was aimed at comparing the effect of levothyroxine, administered alone or in combination with liothyronine, on sexual function and depressive symptoms in premenopausal women treated because of hypothyroidism. METHODS: This quasi-randomized, single-blind study included 39 young women receiving levothyroxine treatment who, despite thyrotropin and thyroid hormone levels within normal limits, still experienced clinical symptoms of hypothyroidism...
March 6, 2018: Current Medical Research and Opinion
Jianqiang Yang, Ning Yi, Junhui Zhang, Wen He, Di He, Wanwan Wu, Shuyang Xu, Feng Li, Guoping Fan, Xianmin Zhu, Zhigang Xue, Wensheng Zhou
Thyroid stimulating hormone receptor (TSHR), a G-protein-coupled receptor, is important for thyroid development and growth. In several cases, frameshift and/or nonsense mutations in TSHR were found in the patients with congenital hypothyroidism (CH), however they have not been functionally studied in an animal model. In the present work, we generated a unique TshrDf/Df rat model that recapitulates the phenotypes in TSHR Y444X patient by CRISPR/Cas genome editing technology. In this rat model, TSHR is truncated at the second transmembrane domain, leading to CH phenotypes as what was observed in the patients, including dwarf, thyroid aplasia, infertility, TSH resistant as well as low serum thyroid hormone levels...
March 5, 2018: Scientific Reports
Jairo Robledo-Sierra, Kerstin Landin-Wilhelmsen, Helena Filipsson Nyström, Robert Eggertsen, Lena Larsson, Amal Dafar, Gunnar Warfvinge, Ulf Mattsson, Mats Jontell
OBJECTIVE: To determine the levels of antithyroid antibodies and thyroid hormones in the sera of patients with oral lichen planus (OLP), and to quantify the expression of thyroid proteins in OLP lesions. SUBJECTS AND METHODS: Venous blood samples were drawn from 110 patients with OLP who had no history of thyroid disease or levothyroxine supplementation (OLP+/LT4 -). A random population sample of 657 healthy subjects was used as the control group. Two additional groups were used as comparators...
March 2, 2018: Oral Diseases
Charlotte S Schömig, Marie-Ève Robinson, Julia E von Oettingen
Congenital hypothyroidism requires prompt treatment to prevent adverse health outcomes. Poor intestinal levothyroxine absorption can complicate management. We present a case of a term female newborn with necrotizing enterocolitis (NEC) requiring subtotal ileum resection. Congenital hypothyroidism was diagnosed by newborn screening. Treatment was complicated by intestinal malabsorption of levothyroxine. Intravenous levothyroxine substitution restored euthyroidism and supraphysiologic PO doses subsequently maintained a euthyroid state...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Gisah Amaral Carvalho, Gilberto Paz-Filho, Cleo Otaviano Mesa Junior, Hans Graf
Hypothyroidism is one of the most common hormone deficiencies in adults. Most of the cases, particularly those of overt hypothyroidism, are easily diagnosed and managed, with excellent outcomes if treated adequately. However, minor alterations of thyroid function determine nonspecific manifestations. Primary hypothyroidism due to chronic autoimmune thyroiditis is largely the most common cause of thyroid hormone deficiency. Central hypothyroidism is a rare and heterogeneous disorder characterized by decreased thyroid hormone secretion by an otherwise normal thyroid gland, due to lack of TSH...
February 28, 2018: European Journal of Endocrinology
Tinh-Hai Collet, Gerasimos P Sykiotis, Carole E Aubert, Christine Baumgartner, Manuel R Blum, Martin Feller, Christoph Stettler, Nicolas Rodondi
Subclinical hypothyroidism, defined as an elevated level of thyrotropin hormone (TSH) and normal thyroxin, is more frequent in women and above 65 years old. This condition is associated with an increased cardiovascular risk, in particular with TSH > 10,0 mIU/L. Although overt hypothyroidism is rare (prevalence of 0,3 %), levothyroxine has become the most prescribed medication in the US, while its indications are still debated. The European-funded TRUST trial showed no improvement in Hypothyroid Symptoms and Tiredness scores among patients ≥ 65 years with subclinical hypothyroidism treated with levothyroxine, and no improvement in blood pressure, weight, muscle strength and cognition...
February 28, 2018: Revue Médicale Suisse
Hiroyuki Ariyasu, Hidefumi Inaba, Takayuki Ota, Hiroyuki Yamaoka, Yasushi Furukawa, Hiroshi Iwakura, Naotaka Doi, Yuki Yamamoto, Takashi Akamizu
BACKGROUND: Immune-checkpoint inhibitors (ICIs) are novel promising agents for the treatment of malignant tumors. However, critical endocrine immune-related adverse events (irAEs) by ICIs often occur. CASE REPORT: A 63-year-old woman with advanced malignant melanoma had received anti-PD-1 antibody (nivolumab, 2 mg/kg every 3 weeks) for 8 cycles (from day 0 to day 147). On day 168, nivolumab was switched to anti-CTLA-4 antibody (ipilimumab, 3mg/kg every 3 weeks)...
March 2018: In Vivo
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February 23, 2018: BMJ: British Medical Journal
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