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I Khan, O E Okosieme, J H Lazarus
Thyroid dysfunction is common in pregnancy and has adverse fetal and maternal health consequences. A number of challenges in the management of gestational thyroid dysfunction remain unresolved including uncertainties in optimal thresholds for correction of hypothyroidism and strategies for pharmacological management of hyperthyroidism. Areas covered: We addressed key challenges and areas of uncertainty in the management of thyroid dysfunction in pregnancy. Expert commentary: Gestational thyroid hormone reference intervals vary according to population ethnicity, iodine nutrition, and assay method and each population should derive trimester specific reference intervals for use in pregnancy...
October 26, 2016: Expert Review of Clinical Pharmacology
Tristan Struja, Hannah Fehlberg, Alexander Kutz, Larissa Guebelin, Christian Degen, Beat Muller, Philipp Schuetz
BACKGROUND: Identification of pre-treatment risk factors predicting relapse in patients with hyperthyroidism of Graves' disease after stopping anti-thyroid drugs [ATD] is decisive to guide therapeutic options. PURPOSE: We performed a systematic search and meta-analysis to study predictors for relapse after stopping ATD in patients with Graves' disease. METHODS: Based on a pre-specified protocol, we searched PubMed, EMBASE and Cochrane in July 2015 for case-control, controlled, and randomized-controlled trials reporting risk factors for relapse after stopping ATD...
October 25, 2016: European Journal of Endocrinology
Lana de Lourdes Aguiar Lima, Raphael Câmara Medeiros Parente, Izildinha Maestá, Joffre Amim Junior, Jorge Fonte de Rezende Filho, Carlos Antonio Barbosa Montenegro, Antônio Braga
Gestational trophoblastic disease is an abnormality of pregnancy that encompasses a group of diseases that differ from each other in their propensity for regression, invasion, metastasis, and recurrence. In the past, it was common for patients with molar pregnancy to present with marked symptoms: copious bleeding; theca lutein cysts; uterus larger than appropriate for gestational age; early preeclampsia; hyperemesis gravidarum; and hyperthyroidism. Currently, with early diagnosis made by ultrasound, most patients are diagnosed while the disease is still in the asymptomatic phase...
July 2016: Radiologia Brasileira
Anastasios Anyfantakis, Dimitrios Anyfantakis, Irene Vourliotaki
Resistance to thyroid hormone (RTH) is an extremely rare dominantly inherited condition of impaired tissue responsiveness to thyroid hormone (TH). Most patients with RTH have mutations in the gene that encodes the β isoform of the receptor of thyroid hormone (THR-β gene). Mutant receptors are unable to activate or repress target genes. The majority of them are asymptomatic or rarely have hypo- or hyperthyroidism. RTH is suspected by the finding of persistent elevation of serum levels of free T3 (FT3) and free T4 (FT4) and nonsuppressed TSH...
2016: Case Reports in Endocrinology
Eun Bin Cho, Ju-Hong Min, Hye-Jin Cho, Jin Myoung Seok, Hye Lim Lee, Hee Young Shin, Kwang-Ho Lee, Byoung Joon Kim
BACKGROUND: Neuromyelitis optica (NMO) sometimes coexists with serological marker-positive, non-organ-specific autoimmune disorders. We evaluated the prevalence of thyroid dysfunction and anti-thyroid antibodies in patients with NMO spectrum disorder (NMOSD) and investigated the associations between thyroid dysfunction/autoimmunity and clinical features of NMOSD. METHODS: Forty-nine NMOSD patients with anti-aquaporin-4 antibody and 392 age- and sex-matched healthy controls were included...
November 15, 2016: Journal of the Neurological Sciences
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October 22, 2016: Veterinary Record
Clement Chung
PURPOSE: Current strategies for managing neuroendocrine tumors (NETs) in adult patients are reviewed, with a focus on medication safety concerns. SUMMARY: NETs usually originate in the gastrointestinal or bronchopulmonary tract. Symptoms due to hormonal hypersecretion often occur in patients with foregut or midgut NETs or liver metastases. Surgical resection is recommended for most localized NETs, while systemic cytotoxic chemotherapy is typically used for high-grade and pancreatic tumors...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
Giles Whalen, Mary Sullivan, Louise Maranda, Robert Quinlan, Anne Larkin
BACKGROUND: A short course of potassium iodide (SSKI) has been traditionally used to prepare patients with Graves' disease for thyroidectomy. The rationale for this treatment has evolved over time; from control of hyperthyroidism to facilitating surgery by making the gland less friable and bloody. METHODS: Randomized trial of preoperative SSKI vs no SSKI to test whether that is true. RESULTS: Mean estimated blood loss in the SSKI group (62 mL) was less than in the control group (162 mL) as was the median estimated blood loss (50 vs 140 mL)...
August 4, 2016: American Journal of Surgery
Satoko Kinomoto-Kondo, Nagayoshi Umehara, Shiori Sato, Kohei Ogawa, Takeo Fujiwara, Naoko Arata, Haruhiko Sago
PURPOSE: To study the effects of gestational transient thyrotoxicosis (GTT) on pregnancy outcomes. METHODS: This case-control study retrospectively analyzed 7976 women with singleton pregnancies whose thyroid function was measured before 16 weeks of gestation and who delivered at ≥22 weeks of pregnancy. GTT was defined as hyperthyroidism (free thyroxine [FT4] level: ≥95th percentile) in the early pregnancy, which normalized in mid-pregnancy without thyroid-stimulating hormone receptor antibodies...
October 20, 2016: Archives of Gynecology and Obstetrics
Ichiro Chihara, Satoshi Nitta, Tomokazu Kimura, Shuya Kandori, Takashi Kawahara, Natsui Waku, Takahiro Kojima, Akira Joraku, Jun Miyazaki, Hitoshi Iwasaki, Hiroaki Suzuki, Koji Kawai, Hiroyuki Nishiyama
We reported two cases of hyperthyroidism that developed during induction chemotherapy for advanced germ cell tumors with high serum human chorionic gonadotropin (hCG) levels. Case 1 : An 18-year-old man with mediastinal choriocarcinoma complained of tachycardia and tremor. His pretreatment serum hCG level was 1.37 million mIU/ml. The free thyroxine (fT4) level measured on day 2 of the first course of bleomycin, etoposide and cisplatin (BEP) was elevated to 7.8 ng/dl (<1.7 ng/dl), whereasthe thyroidstimulating hormone (TSH) level was undetectable...
September 2016: Hinyokika Kiyo. Acta Urologica Japonica
Stephanie Rutledge, Michele Harrison, Martin O'Connell, Tadhg O'Dwyer, Maria M Byrne
BACKGROUND: We report the case of a giant intrathyroidal parathyroid adenoma weighing 59 g in a young woman presenting acutely with severe hypercalcemia requiring correction and adequate preoperative management prior to surgery. Parathyroid adenomas account for 85 % of cases of primary hyperparathyroidism. Those weighing more than 3.5g are classified as giant parathyroid adenomas. There are only 25 cases of parathyroid adenomas weighing over 30g reported in the literature. With the wide availability of biochemical screening tests in Western countries, mildly elevated calcium levels are often discovered incidentally...
October 19, 2016: Journal of Medical Case Reports
G Díaz-Soto, E Romero, J L Pérez-Castrillón, O I Jauregui, D de Luis Román
Although normocalcemic and asymptomatic hyperparathyroidism (HPT) are becoming more common, they remain only partially understood. Parathyroid hormone (PTH) polymorphisms have been associated with disease severity in classical HPT. The aim of the present study was to evaluate the clinical effect of PTH polymorphism (rs6254) in normocalcemic and asymptomatic HPT. A prospective study of 61 consecutive patients with normocalcemic or asymptomatic HPT was carried out. Secondary causes of HPT were ruled out. All patients were followed for≥1 year...
October 18, 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Yen-Ting Chen, Fen-Yu Tseng, Pei-Lung Chen, Yu-Chao Chi, Der-Sheng Han, Wei-Shiung Yang
Spot 14 (S14) is a protein involved in fatty acid synthesis and was shown to be induced by thyroid hormone in rat liver. However, the presence of S14 in human serum and its relations with thyroid function status have not been investigated.The objectives of this study were to compare serum S14 concentrations in patients with hyperthyroidism or euthyroidism and to evaluate the associations between serum S14 and free thyroxine (fT4) or thyroid-stimulating hormone (TSH) levels.We set up an immunoassay for human serum S14 concentrations and compared its levels between hyperthyroid and euthyroid subjects...
October 2016: Medicine (Baltimore)
Xiaojun Ren, Zhaowei Meng, Ming Liu, Mei Zhu, Qing He, Qing Zhang, Li Liu, Kun Song, Qiyu Jia, Qiang Jia, Xue Li, Jian Tan, Wei Zheng, Renfei Wang, Na Liu, Tianpeng Hu
Mean platelet volume (MPV) and platelet distribution width (PDW) are morphometric indices of size distribution and variability of platelet. We aimed to explore the associations between MPV or PDW and thyroid function in a large Chinese cohort.This was a cross-sectional study with a recruitment of 13,622 self-reported healthy Chinese (8424 males, 5198 females). Clinical data of the participants comprised of anthropometric measurements, hepatic function, renal function, serum levels of lipid, glucose, C-reactive protein, erythrocyte sedimentation rate, platelet, MPV, PDW, and thyroid hormones...
October 2016: Medicine (Baltimore)
Alfredo Campennì, Salvatore Giovinazzo, Salvatore Antonio Pignata, Francesca Di Mauro, Domenico Santoro, Lorenzo Curtò, Francesco Trimarchi, Rosaria Maddalena Ruggeri, Sergio Baldari
Parathyroid carcinoma is a rare malignancy, which usually occurs as a sporadic disease, and less frequently in the setting of genetic syndromes. Despite the association of parathyroid and thyroid disorders being quite common, the coexistence of parathyroid carcinoma and thyroid disease is rare. We reviewed the pertinent literature. The terms "parathyroid carcinoma" and "thyroid disease, hyperthyroidism, thyrotoxicosis, hypothyroidism, thyroid nodule(s), Graves' disease, autonomously functioning thyroid nodules" were used both separately and in reciprocal conjunction to search MEDLINE for articles published from January 2007 to March 2016...
October 15, 2016: Endocrine
Hsiang-I Wang, Giou-Teng Yiang, Chin-Wang Hsu, Jen-Chun Wang, Chien-Hsing Lee, Yu-Long Chen
BACKGROUND: Thyroid storm, an endocrine emergency, remains a diagnostic and therapeutic challenge. It is recognized to develop as a result of several factors, including infection, surgery, acute illness, and rarely, trauma. Recognition of thyroid storm in a trauma patient is difficult because the emergency physician usually focuses on managing more obvious injuries. OBJECTIVE OF THE REVIEW: We present a case of trauma-related thyroid storm and review the previous literature on posttraumatic thyroid storm to delineate risk factors of the disease...
October 11, 2016: Journal of Emergency Medicine
Sudipa Sarkar, Lindsay A Bischoff
Hyperthyroidism can occur during pregnancy and the postpartum period, and the treatment of hyperthyroidism should be considered in the preconception phase. Pregnancy has multiple normal physiologic effects on thyroid hormone, which is a separate process distinct from syndromes such as transient hyperthyroidism of hyperemesis gravidarum. The rationale regarding antithyroid drug use during different stages of pregnancy is reviewed, including the literature regarding adverse neonatal outcomes such as aplasia cutis and methimazole embryopathy in the setting of first trimester maternal methimazole use...
October 14, 2016: Seminars in Reproductive Medicine
Xiao-Yan Yi, Yao Wang, Qi-Fu Li, Rong Li, Shu-Min Yang, Guo-Qing Zhou, Zhi-Hong Wang
BACKGROUND: Propylthiouracil is the most common drug used to treat hyperthyroidism. However, this drug could cause a severe disease, antineutrophilic cytoplasmic antibody-associated vasculitis (AAV), which was usually misdiagnosed. METHODS: We reported a 60-year-old woman of propylthiouracil-induced AAV manifested as blood coagulation disorders. The patient was admitted because of hyperthyroidism and leukopenia. At the time of hospitalization, she suffered from dry cough, erythema and knee joints ache, and gradually became febrile...
October 2016: Medicine (Baltimore)
M H Listewnik, M J Listewnik, T Miazgowski, K Jaskólska, K Jasiakiewicz, B Birkenfeld
Introduction: Earlier studies suggest increased serum levels of thyroid peroxidase antibodies (TPOAb) in some cases with non-autoimmune hyperthyroidism. The aim of the study was to assess the incidence of hypothyroidism in patients with nodular toxic goitre and toxic adenoma at 12 months after radioactive iodine therapy in the relation to TPOAb levels. Patients & Measurements: The study comprised 100 patients (83 females; 17 males) treated with radioactive iodine therapy. Serum concentrations of thyrotropin, free thyroxin, TPOAb, and anti-TSH receptor antibodies were assessed at baseline and 12 months after radioactive iodine therapy...
October 2016: Experimental and Clinical Endocrinology & Diabetes
Man-Li Guo, Xiao Zheng, Liu-Xue Yang, Ya-Li Qiu, Liang Cheng, Shao-Gang Ma
Resistance to thyroid hormone (RTH) coexisting with ectopic thyroid is rare. Here we report a case of RTH with ectopic thyroid. A ten-year-old girl had been misdiagnosed as congenital hypothyroidism and treated with levothyroxine since she was born. Ten-year follow-up showed that the elevated thyrotropin was never suppressed by levothyroxine and no signs indicating hyperthyroidism or hypothyroidism despite elevated FT3 and FT4 levels. Therefore the girl developed no defects in physical and cognitive development...
October 10, 2016: Archives of Endocrinology and Metabolism
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