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Thyroid hormone replacement

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https://www.readbyqxmd.com/read/28811719/refractory-hepatic-encephalopathy-in-a-patient-with-hypothyroidism-another-element-in-ammonia-metabolism
#1
Fernando Díaz-Fontenla, Marta Castillo-Pradillo, Arantxa Díaz-Gómez, Luis Ibañez-Samaniego, Pilar Gancedo, Juan Adan Guzmán-de-Villoria, Pilar Fernández-García, Rafael Bañares-Cañizares, Rita García-Martínez
Hepatic encephalopathy (HE) remains a diagnosis of exclusion due to the lack of specific signs and symptoms. Refractory HE is an uncommon but serious condition that requires the search of hidden precipitating events (i.e., portosystemic shunt) and alternative diagnosis. Hypothyroidism shares clinical manifestations with HE and is usually considered within the differential diagnosis of HE. Here, we describe a patient with refractory HE who presented a large portosystemic shunt and post-ablative hypothyroidism...
July 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28775186/are-thyroid-nodules-associated-with-sex-related-hormones-a-cross-sectional-spect-china-study
#2
Yi Chen, Yingchao Chen, Ningjian Wang, Chi Chen, Xiaomin Nie, Qin Li, Bing Han, Fangzhen Xia, Hualing Zhai, Boren Jiang, Zhoujun Shen, Yingli Lu
OBJECTIVE: Little is known about the association between thyroid nodules (TNs) and endogenous sex hormones. We aimed to investigate the relationship between TNs and sex-related hormones among men in China. SETTING: The data were obtained from a cross-sectional study Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China study, 2014-2015) based on the population. PARTICIPANTS: In total, 4024 men over 18 years of age who were not using hormone replacement therapy and who underwent complete assays of the serum total testosterone (T), oestradiol (E2), follicle-stimulating hormone (FSH), luteinising hormone (LH) and sex hormone-binding globulin (SHBG) levels as well as thyroid ultrasonography (US) enrolled in this study...
August 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28746208/myopathy-in-hyperthyroidism-as-a-consequence-of-rapid-reduction-of-thyroid-hormone-a-case-report
#3
Qianrui Li, Yuping Liu, Qianying Zhang, Haoming Tian, Jianwei Li, Sheyu Li
RATIONALE: Myalgia and elevated creatine kinase (CK) are occasionally observed during the treatment of hyperthyroid patients. Relative hypothyroidism resulted from rapid thyroid hormone reduction had been promoted as a plausible cause of these myopathic changes, however rarely reported. PATIENT CONCERNS: We hereby presented a 20-year-old female with Grave's disease, who developed myopathy and elevated CK during rapid correction of thyroid hormone. DIAGNOSES: Relative hypothyroidism-induced myopathy...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28695483/diagnosis-and-management-of-treatment-refractory-hypothyroidism-an-expert-consensus-report
#4
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/28693124/pediatric-toxic-polycystic-thyroid
#5
Janeil M Belle, Nektarios Vasilottos, Todd D Nebesio, Benjamin C James
BACKGROUND: Polycystic thyroid disease (PCTD) is a rare condition and has been described in adults in the setting of subclinical and clinical hypothyroidism. We present the first known case of a pediatric patient with diffuse macrocystic degeneration of the thyroid. CLINICAL PRESENTATION: A 6-year-old previously healthy patient was evaluated after presenting with a 16-month history of an enlarging polycystic thyroid and hyperthyroidism. Markers of autoimmune thyroid disease including thyroid stimulating immunoglobulin (TSI), thyroid stimulating hormone (TSH) receptor antibody, thyroid peroxidase antibody and thyroglobulin antibody were negative...
June 16, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28689073/endocrine-related-adverse-events-associated-with-immune-checkpoint-blockade-and-expert-insights-on-their-management
#6
REVIEW
Mario Sznol, Michael A Postow, Marianne J Davies, Anna C Pavlick, Elizabeth R Plimack, Montaser Shaheen, Colleen Veloski, Caroline Robert
Agents that modulate immune checkpoint proteins, such as cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed death receptor-1 (PD-1), have become a mainstay in cancer treatment. The clinical benefit afforded by immune checkpoint inhibitors can be accompanied by immune-related adverse events (irAE) that affect the skin, gastrointestinal tract, liver, and endocrine system. The types of irAEs associated with immune checkpoint inhibitors are generally consistent across tumor types. Immune-related endocrine events can affect the pituitary, thyroid, and adrenal glands, as well as other downstream target organs...
July 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28682843/diffuse-thyroid-metastasis-from-lung-cancer-mimicking-thyroiditis-on-99mtc-pertechnetate-scintigraphy
#7
Rui Gao, Shan Gao, Jinteng Feng, Yuanbo Wang, Guangjian Zhang
Possible thyroiditis was suspected in a 56-year-old man who initially presented sore throat because laboratory examinations revealed decreased serum thyroid hormone and the Tc-pertechnetate scintigraphy showed no tracer uptake by the thyroid gland. However, subsequent examination demonstrated that the absence of pertechnetate activity in the thyroid was due to complete replacement of thyroid gland by the metastasis from lung adenocarcinoma, which was unknown at the initial presentation.
September 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28673339/human-limbal-fibroblast-like-stem-cells-induce-immune-tolerance-in-autoreactive-t-lymphocytes-from-female-patients-with-hashimoto-s-thyroiditis
#8
Antonina Coppola, Laura Tomasello, Maria Pitrone, Salvatore Cillino, Pierina Richiusa, Giuseppe Pizzolanti, Carla Giordano
BACKGROUND: Due to their "natural immune privilege" and immunoregulatory properties human fibroblast-like limbal stem cells (f-LSCs) have acquired great interest as a potential tool for achieving immunotolerance. Hashimoto's thyroiditis (HT) is the most common thyroid autoimmune disease and cause of hypothyroidism. To date, conventional hormone replacement therapy and unspecific immunosuppressive regimens cannot provide a definitive cure for HT subjects. We explored the immunosuppressant potential of human f-LSCs on circulating lymphomonocytes (PBMCs) collected from healthy donors and female HT patients...
July 3, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28672775/pediatric-toxic-polycystic-thyroid
#9
Janeil M Belle, Nektarios Vasilottos, Todd D Nebesio, Benjamin C James
BACKGROUND: Polycystic thyroid disease (PCTD) is a rare condition and has been described in adults in the setting of subclinical and clinical hypothyroidism. We present the first known case of a pediatric patient with diffuse macrocystic degeneration of the thyroid. CLINICAL PRESENTATION: A 6-year-old previously healthy patient was evaluated after presenting with a 16-month history of an enlarging polycystic thyroid and hyperthyroidism. Markers of autoimmune thyroid disease including thyroid stimulating immunoglobulin (TSI), thyroid stimulating hormone (TSH) receptor antibody, thyroid peroxidase antibody and thyroglobulin antibody were negative...
July 26, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28671443/subclinical-hyperthyroidism-when-to-consider-treatment
#10
REVIEW
Ines Donangelo, Se Young Suh
Subclinical hyperthyroidism is defined by a low or undetectable serum thyroid-stimulating hormone level, with normal free thyroxine and total or free triiodothyronine levels. It can be caused by increased endogenous production of thyroid hormone (e.g., in Graves disease, toxic nodular goiter, or transient thyroiditis), by administration of thyroid hormone to treat malignant thyroid disease, or by unintentional excessive replacement therapy. The prevalence of subclinical hyperthyroidism in the general population is about 1% to 2%; however, it may be higher in iodinedeficient areas...
June 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28660996/models-of-cognitive-functions-with-respect-to-selected-parameters-of-functional-state-of-the-thyroid-gland-in-post-menopausal-women
#11
Mariusz Gujski, Jarosław Pinkas, Mariusz Witczak, Alfred Owoc, Iwona Bojar
INTRODUCTION: The objective of the study was the development of models of cognitive functions in a group of post-menopausal women, according to the concentration of the selected laboratory parameters evaluating the functional state of the thyroid gland. MATERIAL AND METHODS: The study was conducted during 2012-2014, and covered women aged 50-65 years, minimum two years after the last menstruation, without chronic diseases, cancerous diseases, mental disorders, addiction to drugs or alcohol, and who did not use hormone replacement therapy...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28632526/persistent-hypothyroid-symptoms-in-a-patient-with-a-normal-thyroid-stimulating-hormone-level
#12
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/28620499/intrauterine-death-following-intraamniotic-triiodothyronine-and-thyroxine-therapy-for-fetal-goitrous-hypothyroidism-associated-with-polyhydramnios-and-caused-by-a-thyroglobulin-mutation
#13
Pradeep Vasudevan, Corrina Powell, Adeline K Nicholas, Ian Scudamore, James Greening, Soo-Mi Park, Nadia Schoenmakers
In the absence of maternal thyroid disease or iodine deficiency, fetal goitre is rare and usually attributable to dyshormonogenesis, for which genetic ascertainment is not always undertaken in the UK. Mechanical complications include tracheal and oesophageal compression with resultant polyhydramnios, malpresentation at delivery and neonatal respiratory distress. We report an Indian kindred in which the proband (first-born son) had congenital hypothyroidism (CH) without obvious neonatal goitre. His mother's second pregnancy was complicated by fetal hypothyroid goitre and polyhydramnios, prompting amniotic fluid drainage and intraamniotic therapy (with liothyronine, T3 and levothyroxine, T4)...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28611949/pseudomalabsorption-of-levothyroxine-a-challenge-for-the-endocrinologist-in-the-treatment-of-hypothyroidism
#14
Nancy Van Wilder, Bert Bravenboer, Sarah Herremans, Nathalie Vanderbruggen, Brigitte Velkeniers
BACKGROUND: Hypothyroidism due to non-compliance with levothyroxine therapy (pseudomalabsorption) is rare. The diagnosis is considered in patients with persistent severe hypothyroidism despite treatment with large doses of levothyroxine. Intestinal malabsorption, drug and dietary interference with levothyroxine absorption and nephrotic syndrome should be excluded. The diagnosis of pseudomalabsorption can be demonstrated by using "an oral 1,000 µg of levothyroxine test" showing a rapid decrease in thyroid-stimulating hormone and increase in thyroxine...
February 2017: European Thyroid Journal
https://www.readbyqxmd.com/read/28608527/perfect-storm-therapeutic-plasma-exchange-for-a-patient-with-thyroid-storm
#15
Andrea M McGonigle, Aaron A R Tobian, Jennifer L Zink, Karen E King
Thyroid storm is a potentially lethal complication of hyperthyroidism with increased thyroid hormones and exaggerated symptoms of thyrotoxicosis. First-line therapy includes methimazole (MMI) or propylthiouracil (PTU) to block production of thyroid hormones as a bridge toward definitive surgical treatment. Untreated thyroid storm has a mortality rate of up to 30%; this is particularly alarming when patients cannot tolerate or fail pharmacotherapy, especially if they cannot undergo thyroidectomy. Therapeutic plasma exchange (TPE) is an ASFA category III indication for thyroid storm, meaning the optimum role of this therapy is not established, and there are a limited number of cases in the literature...
June 13, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28588554/female-reproductive-factors-and-differentiated-thyroid-cancer
#16
REVIEW
Mariacarla Moleti, Giacomo Sturniolo, Maria Di Mauro, Marco Russo, Francesco Vermiglio
Differentiated thyroid cancer (DTC) is markedly more common in women than men, the highest female-to-male ratio being recorded during the reproductive period. This evidence has led to the suggestion that female hormonal and reproductive factors may account for the observed DTC gender disparity. This review focuses on current evidence on the risk of DTC in conjunction with major female reproductive factors, including the impact of pregnancy on DTC occurrence and progression/recurrence. Overall, studies exploring the link between the risk of DTC and menstrual and menopausal factors, oral contraceptives and/or hormone replacement therapy, showed these associations, if any, to be generally weak...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28588551/functional-thyroid-follicular-cells-differentiation-from-human-induced-pluripotent-stem-cells-in-suspension-culture
#17
Ayumi Arauchi, Katsuhisa Matsuura, Tatsuya Shimizu, Teruo Okano
The replacement of regenerated thyroid follicular cells (TFCs) is a promising therapeutic strategy for patients with hypothyroidism. Here, we have succeeded in inducing functional TFCs from human-induced pluripotent stem cells (iPSCs) in scalable suspension culture. Differentiation of iPSCs with Activin A treatment produced Sox17- and FoxA2-expressing definitive endodermal cells that also expressed thyroid transcription factors Pax8 and Nkx2-1. Further treatment with thyroid-stimulating hormone (TSH) induced TFCs expressing various types of thyroid proteins including TSH receptor, sodium-iodide symporter, thyroglobulin, and thyroid peroxidase...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28583920/idiopathic-hypogonadotropic-hypogonadism-reversal-after-testosterone-replacement-in-a-34-year-old-male
#18
Owais Rashid, Nanik Ram, Saad Farooq, Zareen Kiran
A 34-year-old male presented to the endocrinology clinic with the complaint of the absence of facial, axillary and pubic hairs. Further history revealed absent ejaculations and decreased early morning erections. The patient had no history of headaches, visual problems or anosmia. On physical examination, there were sparse facial, axillary and pubic hairs, bilateral gynaecomastia, stretch penile length of 5 cm and bilateral testicular volume of 10 mL. Laboratory investigations showed low luteinising hormone, follicular stimulating hormone and testosterone with normal prolactin and thyroid profile...
June 5, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28578356/the-relationship-between-thyroid-antibody-titer-and-levothyroxine-dose-in-patients-with-overt-primary-hypothyroidism
#19
Nalan Okuroglu, Ali Ozdemir, Yasar Sertbas, Seda Sancak
BACKGROUND: Both excess and insufficient thyroid hormone replacement may produce adverse effects in various target tissues; therefore, understanding factors that affect achievement of target TSH levels is crucial. OBJECTIVE: Investigate the relationship between antibody titers and levothyroxine dose. DESIGN: Retrospective, review of data in medical records. SETTING: Thyroid center of Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey...
May 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28566564/effect-of-thyroxin-treatment-on-carotid-intima-media-thickness-cimt-reduction-in-patients-with-subclinical-hypothyroidism-sch-a-meta-analysis-of-clinical-trials
#20
Muhammad Aziz, Yugandhar Kandimalla, Archana Machavarapu, Anshul Saxena, Sankalp Das, Adnan Younus, Michelle Nguyen, Rehan Malik, Dixitha Anugula, Muhammad A Latif, Choudhry Humayun, Idrees M Khan, Ali Adus, Aisha Rasool, Emir Veledar, Khurram Nasir
AIM: Research shows that subclinical hypothyroidism (SCH) is related to an increased carotid intima-media thickness (CIMT), a surrogate marker of subclinical cardiovascular disease (CVD). It is controversial whether or not SCH should be treated to reduce CVD morbidity and mortality. This meta-analysis aimed to determine whether SCH is associated with an increase in CIMT as compared to Euthyroidism (EU) and whether thyroxin (T4) treatment in SCH can reverse the change in CIMT. METHODS: Two independent reviewers conducted an extensive database research up to December 2016...
July 1, 2017: Journal of Atherosclerosis and Thrombosis
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