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https://www.readbyqxmd.com/read/28911144/randomized-trial-comparing-two-algorithms-for-levothyroxine-dose-adjustment-in-pregnant-women-with-primary-hypothyroidism
#1
Shannon D Sullivan, Erin Downs, Geanina Popoveniuc, Alexander Zeymo, Jacqueline Jonklaas, Kenneth D Burman
Context: Regulation of maternal thyroid hormones during pregnancy is crucial for optimal maternal and fetal outcomes. There are no specific guidelines addressing maternal levothyroxine (LT4) dose adjustments throughout pregnancy. Objective: To compare two LT4 dose-adjustment algorithms in hypothyroid pregnant women. Design: Thirty-three women on stable LT4 doses were recruited at <10 weeks gestation during 38 pregnancies and randomized to one of two dose-adjustment groups...
September 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28904805/high-dose-levothyroxine-for-the-management-of-bipolar-affective-disorder-two-case-reports
#2
Andy Zamar, Gurvinder Warrya, Christos Kouimtsidis
In this article, we report two cases from our centre: case A has the longest recovery period and case B is one of the most complex from a diagnostic and management perspective, highlighting how treatment resistance can be overcome depending on patient response and needs.
September 2017: JRSM Open
https://www.readbyqxmd.com/read/28894436/serum-thyroid-hormone-antibodies-are-frequent-in-patients-with-polyglandular-autoimmune-syndrome-type-3-particularly-in-those-who-require-thyroxine-treatment
#3
Roberto Vita, Maria Giulia Santaguida, Camilla Virili, Maria Segni, Marina Galletti, Mattia Mandolfino, Flavia Di Bari, Marco Centanni, Salvatore Benvenga
Polyglandular autoimmune syndrome (PAS) type 3 consists of autoimmune thyroid disease (AITD) coexisting with ≥1 non-thyroidal autoimmune disease (NTAID) other than Addison's disease and hypoparathyroidism. We evaluated the prevalence and repertoire of thyroid hormones antibodies (THAb) in PAS-3 patients. Using a radioimmunoprecipation technique, we measured THAb (T3IgM, T3IgG, T4IgM, and T4IgG) in 107 PAS-3 patients and 88 controls (patients with AITD without any NTAID). Based on the selective coexistence of AITD with one NTAID (chronic autoimmune gastritis, non-segmental vitiligo or celiac disease), patients were divided into group 1 (chronic autoimmune gastritis positive, n = 64), group 2 (non-segmental vitiligo positive, n = 24), and group 3 (celiac disease positive, n = 15)...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28884595/risk-of-osteoporosis-in-thyroid-cancer-patients-using-levothyroxine-a-population-based-study
#4
Shih-Yi Lin, Cheng-Li Lin, Hsien-Te Chen, Chia-Hung Kao
BACKGROUND: The outcomes of thyroid cancer patients using levothyroxine are largely undetermined. METHODS: The study population consisted of 9,398 patients newly diagnosed with thyroid cancer; their data was retrieved from a subset of the National Health Insurance Research Database of Taiwan during the period of 1999-2011. In this nationwide retrospective cohort study, we compared the risk of osteoporosis among thyroid cancer patients with levothyroxine use, those without levothyroxine use, and propensity score-matched nonthyroid controls...
September 8, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28828345/evaluation-of-bone-density-serum-total-and-ionized-calcium-alkaline-phosphatase-and-25-hydroxy-vitamin-d-in-papillary-thyroid-carcinoma-and-their-relationship-with-tsh-suppression-by-levothyroxine
#5
Ali Kachui, Seyed Mashaallah Tabatabaizadeh, Bijan Iraj, Hasan Rezvanian, Awat Feizi
BACKGROUND: This study aimed to evaluate the situation of Bone Mineral Density (BMD), Z score, T score, serum level of corrected and ionized calcium, alkaline phosphatase and 25-hydroxy vitamin D in percutaneous transhepatic cholangiography (PTC) patients and correlation of these variants with thyroid stimulating hormone (TSH) suppression level by levothyroxine. MATERIALS AND METHODS: Among the patients referred to Esfahan's endocrinology research center, 34 PTC patients (aged 20-50 years) with a history of thyroidectomy and conceived radioactive iodine and suppressive dose of levothyroxine were evaluated in this case-control study, and 38 healthy persons participated as the control group (matched by age and sex, body mass index)...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28804208/benign-course-after-acute-high-dose-levothyroxine-intoxication-in-a-3-year-old-boy
#6
Stan Hartman, Kees Noordam, Machiel Maseland, Petra van Setten
Acute ingestion of thyroid hormone preparations is a common intoxication, with 181 cases in children <12 yr in 2009 in the Netherlands, but generally has a mild course. However, some reports show that even low dosages may cause serious events such as seizures, thyroid storm and coma. We report a 3 yr old boy case with an acute intoxication with high dose levothyroxine (0.5 mg/kg). We describe the proper management of levothyroxine intoxication in children. A 3-year-old boy with no notable medical history ingested sixty tablets of levothyroxine 150 µg...
2017: Clinical Pediatric Endocrinology: Case Reports and Clinical Investigations: Official Journal of the Japanese Society for Pediatric Endocrinology
https://www.readbyqxmd.com/read/28794850/dual-control-of-pituitary-thyroid-stimulating-hormone-secretion-by-thyroxine-and-triiodothyronine-in-athyreotic-patients
#7
Rudolf Hoermann, John E M Midgley, Johannes W Dietrich, Rolf Larisch
BACKGROUND: Patient responses to levothyroxine (LT4) monotherapy vary considerably. We sought to differentiate contributions of FT4 and FT3 in controlling pituitary thyroid stimulating hormone (TSH) secretion. METHODS: We retrospectively assessed the relationships between TSH and thyroid hormones in 319 patients with thyroid carcinoma through 2914 visits on various LT4 doses during follow-up for 5.5 years (median, IQR 4.2, 6.9). We also associated patient complaints with the relationships...
June 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28741453/no-effect-of-levothyroxine-and-levothyroxine-induced-subclinical-thyrotoxicosis-on-the-pharmacokinetics-of-sorafenib-in-healthy-male-subjects
#8
Funan Huang, Antoinette Ajavon, Erya Huang, John Lettieri, Rong Liu, Carol Peña, Matthias Berse
BACKGROUND: Patients receiving the multikinase inhibitor sorafenib for locally recurrent or metastatic, progressive, differentiated thyroid carcinoma (DTC) refractory to radioactive iodine often receive concomitant levothyroxine for thyrotropin (TSH) suppression. In the Phase 3 DTC trial (DECISION), sorafenib exposure was approximately twofold higher than that observed in other cancers. This study assessed sorafenib pharmacokinetics without and with concomitant levothyroxine to examine whether a levothyroxine interaction or levothyroxine-induced subclinical thyrotoxicosis results in increased sorafenib exposure in patients with DTC...
September 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28697824/-analysis-of-treatment-efficacy-for-congenital-hypothyroidism-in-some-regions-of-yunnan-province-china
#9
Jing-Hui Yang, Jing-Hui Zhang, Yin-Hong Zhang, Xiao-Zhi Xu, Hong Chen, Yuan Li, Yan Jiang, Zheng Wang, Bao-Sheng Zhu, Li Li
OBJECTIVE: To observe the effects of initial doses and treatment timing of levothyroxine (L-T4) on the clinical efficacy in children with congenital hypothyroidism (CH). METHODS: This study included 98 children who had an abnormal level of thyroid stimulating hormone (TSH) in neonatal screening in four regions of Yunnan Province and who finally had a confirmed diagnosis of CH. They received treatment with L-T4 and were divided into standard dose group (10-15 μg/kg per day) and low dose group (<10 μg/kg per day) by the therapeutic dose of L-T4...
July 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28695483/diagnosis-and-management-of-treatment-refractory-hypothyroidism-an-expert-consensus-report
#10
REVIEW
M Centanni, S Benvenga, I Sachmechi
There is a frequently encountered subset of hypothyroid patients who are refractory to standard thyroid hormone replacement treatment and require unexpectedly high doses of levothyroxine. In addition to clinical situations where hypothyroid patients are non-compliant, or where there is the possibility of excipient-induced disease exacerbation (gluten/celiac disease), therapeutic failure may be due to impaired absorption of the administered drug. The common approach to managing patients with unusual thyroxine needs is to escalate the dose of levothyroxine until targeted TSH levels are achieved...
July 10, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28690990/predictors-of-transient-congenital-hypothyroidism-in-children-with-eutopic-thyroid-gland
#11
Il Soon Park, Jong Seo Yoon, Cheol Hwan So, Hae Sang Lee, Jin Soon Hwang
PURPOSE: Congenital hypothyroidism (CH) is the most common cause of preventable mental retardation. Recently, the detection of CH cases with eutopic thyroid gland has increased due to neonatal screening programs. In this study, we aimed to identify and evaluate predictive factors that could distinguish between permanent and transient CH in patients with eutopic thyroid gland. METHODS: We retrospectively reviewed 100 children diagnosed with CH and with eutopic thyroid gland...
June 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/28690988/intellectual-development-in-preschool-children-with-early-treated-congenital-hypothyroidism
#12
Min Kyoung Seo, Jong Seo Yoon, Chul Hwan So, Hae Sang Lee, Jin Soon Hwang
PURPOSE: Delayed treatment of congenital hypothyroidism (CH) is a common cause of mental retardation. The aim of the present study was to evaluate intellectual outcomes in preschool children with treated CH. METHODS: We retrospectively reviewed the clinical records of 43 children (age range: 13 to 60 days of life; 22 girls and 21 boys) diagnosed with CH. Children aged 5 to 7 years were examined using the Korean Wechsler Intelligence Scale for Children or the Korean Wechsler Preschool and Primary Scale of Intelligence...
June 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/28687188/-oral-and-dental-expression-of-thyroid-diseases
#13
Jean-Louis Wémeau, Christine Do Cao, Miriam Ladsous
Oral disorders were observed in children with congenital hypothyroidism, lately apparent because of difficulties of feeding, swallowing disorders, and macroglossia. Macroglossia was also a component of the severe acquired myxedema, particularly observed in hypothyroidism related to autoimmune atrophic thyroiditis beyond menopause. Lingual ectopy in children and adults could determine respiratory gene or swallowing difficulties, and were detectable by visual examination and the endobuccal touch. Expression of these events was completely minimized since the neonatal screening of congenital hypothyroidism, also by the common practice in adults of serum TSH determinations...
July 4, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28683242/targeted-levothyroxine-therapy-for-treatment-of-congenital-hypothyroidism
#14
Melissa J Schoelwer, Wanzhu Tu, Junyi Zhou, Erica A Eugster
OBJECTIVE: The purpose of this study was to determine if infants with congenital hypothyroidism (CH) whose initial dose of levothyroxine (LT4) is based on thyroid gland anatomy require fewer dose adjustments in the first six months of life than those who were started empirically on LT4. METHODS: Newborns with CH who had a thyroid ultrasound performed at diagnosis were eligible for this prospective, historical case-controlled study. The daily LT4 dose prescribed was based on results on the thyroid ultrasound as follows: 15 mcg/kg for athyreosis, 12 mcg/kg for a dysgenetic thyroid, and 10 mcg/kg for an anatomically normal gland...
July 6, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28680356/the-effect-of-early-substitution-of-subclinical-hypothyroidism-on-biochemical-blood-parameters-and-the-quality-of-life
#15
Milena S Pandrc, Anđelka Ristić, Vanja Kostovski, Marko Stanković, Vladimir Antić, Jelena Milin-Lazović, Jasmina Ćirić
BACKGROUND: Subclinical hypothyroidism (SCH) is defined as high TSH and normal thyroxine. Data on the effects of early substitution by levothyroxine on psychophysical health in SCH are still not consistent enough to support its introduction. METHODS: Clinical parameters, biochemical data and quality of life (Short Form 36 questionnaire) were measured before the intervention and 3 months after the euthyroid state had been achieved in SCH patients. RESULTS: Significant reduction in body weight (p=0...
April 2017: Journal of Medical Biochemistry
https://www.readbyqxmd.com/read/28652510/beta-blocker-and-steroid-therapy-in-the-treatment-of-infantile-hepatic-hemangioendothelioma
#16
Zeynep Canan Özdemir, Yeter Düzenli Kar, Nurullah Cihan Şöhret, Mahmut Kebapçı, Özcan Bör
Infantile hepatic hemangioendothelioma (IHHE) is the most common benign vascular liver tumor and typically occurs during the first 6 months of life. A 4-month-old male patient presented with abdominal distention. A physical examination revealed massive hepatomegaly. Liver enzyme levels were normal. The alpha fetoprotein level was 1,323 mg/dL (6-1,000). Abdominal magnetic resonance imaging (MRI) showed multiple, well-defined and hyperintense nodular lesions in the liver. MRI findings suggested IHHE. The thyroid stimulating hormone (TSH) level was high (177...
June 25, 2017: Drug Discoveries & Therapeutics
https://www.readbyqxmd.com/read/28648169/-the-incidence-of-congenital-hypothyroidism-is-increasing
#17
Tina Lund Leunbach, Pia Sønderby Christensen, Kurt Kristensen
The prognosis of primary congenital hypothyroidism, which has potentially devastating effects on neurodevelopment, has been almost eradicated after the implementation of the neonatal screening programme. Although early facilitation with substitution of levothyroxine is preventative, caution should still be taken in severe cases, as subtle psychomotor delays may occur. Treatment dose may be indicative of the severity and pathology behind the condition and can be used as guidance when deciding which patients should have a trial of levothyroxine in cases where the thyroid gland remains in situ...
June 26, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28635169/potential-drug-drug-interactions-in-older-adults-a-population-based-study
#18
Thalyta Renata Araújo Santos, Erika Aparecida Silveira, Lílian Varanda Pereira, Mércia Pandolfo Provin, Dione Marçal Lima, Rita Goreti Amaral
AIM: To evaluate the potential drug-drug interactions (PDDI) between drugs used by older adults, any associated factors and recommended clinical management. METHODS: A cross-sectional, population-based study was carried out through a home survey of 934 older adults (from December 2009 to April 2010). A questionnaire was applied, and the participants were asked to show all the drugs used and their respective prescriptions, thus providing data to identify polypharmacy, self-medication and PDDI...
June 21, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28632526/persistent-hypothyroid-symptoms-in-a-patient-with-a-normal-thyroid-stimulating-hormone-level
#19
Jacqueline Jonklaas
PURPOSE OF REVIEW: A subset of patients being treated for hypothyroidism do not feel well while taking levothyroxine (LT4) replacement therapy, despite having a normal serum thyroid stimulating hormone level. Pursuing a relative triiodothyronine deficiency as a potential explanation for patient dissatisfaction, has led to trials of combination therapy with liothyronine (LT3), with largely negative outcomes. This review attempts to reconcile these diverse findings, consider potential explanations, and identify areas for future research...
June 16, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28615186/subclinical-hypothyroidism-in-paediatric-population-treated-with-levothyroxine-a-real-world-study-on-2001-2014-italian-administrative-data
#20
Nella Augusta Greggio, Elisa Rossi, Silvia Calabria, Alice Meneghin, Joaquin Gutierrez de Rubalcava, Carlo Piccinni, Antonella Pedrini
OBJECTIVE: To estimate the prevalence of subclinical hypothyroidism (SH) among children, by using levothyroxine low dosage as disease proxy, and to describe prescription pattern. DESIGN: An historical cohort study was performed through administrative databases of 12 Italian Local Health Units covering 3,079,141 inhabitants. A cohort of children (aged 0-13 years) was selected in the period 2001-2014. A subgroup of new users (aged 0-9 years) was identified and followed up for 5 years...
August 2017: Endocrine Connections
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