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Thyrotoxicosis

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https://www.readbyqxmd.com/read/28319287/iatrogenic-thyrotoxicosis-and-the-role-of-therapeutic-plasma-exchange
#1
Kabeer K Shah, Michael M Mbughuni, Edwin A Burgstaler, Darci R Block, Jeffrey L Winters
Thyroid storm or severe thyrotoxicosis results from extreme thyroid hormone elevation. Therapy includes medical management to prevent hormone production, release, recycling, and peripheral conversion while stabilizing adrenergic tone. Thyroid dysfunction is the usual cause but it can be due to excessive thyroid hormone ingestion. Therapeutic plasma exchange (TPE) has been used to rapidly remove protein-bound thyroid hormone. American Society for Apheresis guidelines make a weak recommendation to perform TPE in selected patients in the treatment of thyrotoxicosis based on low quality evidence...
March 20, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28298837/a-study-of-acute-muscle-dysfunction-with-particular-reference-to-dengue-myopathy
#2
Rajesh Verma, Vikram V Holla, Vijay Kumar, Amita Jain, Nuzhat Husain, Kiran Preet Malhotra, Ravindra Kumar Garg, Hardeep Singh Malhotra, Praveen Kumar Sharma, Neeraj Kumar
BACKGROUND: Acute myopathy is a common cause of acute motor quadriparesis which has various etiologies with different courses of illness and prognosis depending on the cause. Understanding this diversity helps us in proper approach toward diagnosis, predicting the prognosis, and possible complications and in improving the treatments that are being provided. This study was planned to study the clinical, electrophysiological, and etiological profile of patients presenting with acute myopathy...
January 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28295509/measuring-tsh-receptor-antibody-trab-to-influence-treatment-choices-in-graves-disease
#3
Asha Hesarghatta Shyamasunder, Prakash Abraham
TSH receptor antibody (TRAb) plays a key role in the pathogenesis of Graves' disease (GD) and its levels correlate with the clinical course. The 2(nd) and 3(rd) generation TRAb assays have >95% sensitivity and specificity for the diagnosis of GD, and have improved the utility of TRAb to predict relapse. TRAb levels decline with antithyroid drug (ATD) therapy and after thyroidectomy. Its level increases for a year following radioactive iodine (RAI) therapy, with a gradual fall thereafter. TRAb level >12 IU/L at diagnosis of GD is associated with 60% risk of relapse at 2 years and 84% at 4 years...
March 13, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28293157/thyrotoxic-periodic-paralysis-a-case-report
#4
Barakat Lafi G Al Moteri, Mohammad Aslam
Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism characterized by episodes of muscle weakness and hypokalemia. TPP is typically present in young Asian men, female, and non-Asian ethnic group can also be affected. TPP is a curable cause of hypokalemic periodic paralysis, can often be the first manifestation of thyrotoxicosis. Factors such as high carbohydrate diet, strenuous exercise, emotional stress, and steroid can precipitate an attack of TPP. The presence of both hypokalemia and elevated level of thyroxine (T4) and triiodothyronine (T3) are important diagnostic features during the acute episode...
January 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28274949/management-of-endocrine-disease-subclinical-thyrotoxicosis-prevalence-causes-and-choice-of-therapy
#5
Allan Carle, Stine Linding Andersen, Kristien Boelaert, Peter Laurberg
Subclinical thyrotoxicosis is a condition affecting up to 10% of the population in some studies. We have reviewed literature and identified studies describing prevalences, causes and outcomes of this condition. Treatment should be considered in all subjects if this biochemical abnormality is persistent, especially in case of symptoms of thyrotoxicosis or in the presence of any complication. In particular, treatment should be offered in those subclinically thyrotoxic patients with a sustained serum TSH below 0...
March 8, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28228636/progressive-ischemic-stroke-due-to-thyroid-storm-associated-cerebral-venous-thrombosis
#6
Natsumi Tanabe, Eiji Hiraoka, Masataka Hoshino, Gautam A Deshpande, Kana Sawada, Yasuhiro Norisue, Jumpei Tsukuda, Toshihiko Suzuki
BACKGROUND Cerebral venous thrombosis (CVT) is a rare but fatal complication of hyperthyroidism that is induced by the hypercoagulable state of thyrotoxicosis. Although it is frequently difficult to diagnose CVT promptly, it is important to consider it in the differential diagnosis when a hyperthyroid patient presents with atypical neurologic symptoms. CASE REPORT A 49-year-old Japanese female with unremarkable medical history came in with thyroid storm and multiple progressive ischemic stroke identified at another hospital...
February 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28225316/adverse-event-reporting-in-patients-treated-with-thyroid-hormone-extract
#7
Rupendra T Shrestha, Alan Malabanan, Bryan R Haugen, Elliott G Levy, James V Hennessey
OBJECTIVE: Thyroid hormone extract is used for the treatment of thyroid disorders but limited data exist on adverse events commonly noted by the physicians associated with this use. The purpose of this survey was to report adverse events observed by expert physicians managing patients treated for thyroid disease with thyroid hormones. METHODS: Members of the American Thyroid Association, The Endocrine Society and the American Association of Clinical Endocrinologists developed a survey instrument modeled on the FDA's reported adverse events for levothyroxine that would effectively assess the clinical experience of frequent prescribers of thyroid hormone...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28219489/associations-between-autoimmune-diseases-and-attention-deficit-hyperactivity-disorder-a%C3%A2-nationwide-study
#8
Philip Rising Nielsen, Michael Eriksen Benros, Søren Dalsgaard
OBJECTIVE: Recent studies have suggested that autoimmune diseases and immune activation play a part in the pathogenesis of different neurodevelopmental disorders. This study investigated the association between a personal history and a family history of autoimmune disease and the risk of developing attention-deficit/hyperactivity disorder (ADHD). METHOD: A cohort was formed of all singletons born in Denmark from 1990 to 2007, resulting in a study population of 983,680 individuals followed from 1995 to 2012...
March 2017: Journal of the American Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/28217613/an-uncommon-cause-for-vomiting
#9
Samantha Sathyakumar, Sahana Shetty, Nitin Kapoor, Sunil Abraham, Thomas Vizhalil Paul
Thyrotoxicosis may present with a variety of non specific symptoms in elderly patients. Gastrointestinal symptoms such as nausea, vomiting and abdominal discomfort can occasionally be the presenting feature of thyrotoxicosis in this age group. We describe an elderly patient in whom thyrotoxicosis was diagnosed after extensive evaluation for nausea, vomiting and anorexia. This patient was also found to have hypercalcemia. This case highlights the importance of recognizing thyrotoxicosis in older patients presenting with GI symptoms and mild hypercalcemia...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217504/improving-iodine-nutritional-status-and-increasing-prevalence-of-autoimmune-thyroiditis-in-children
#10
Srinivasan Palaniappan, Lakshmi Shanmughavelu, Hemchand K Prasad, Sundari Subramaniam, Nedunchezian Krishnamoorthy, Lakshmi Lakkappa
OBJECTIVE: The objective of this study is to evaluate the link between excess iodine intake as evidenced by increased urinary iodine excretion (UIE) and autoimmune thyroiditis in children and to assess the correlation between UIE and thyroid microsomal antibody (thyroid peroxidase [TPO]) titers in children. MATERIALS AND METHODS: All children with goiter between age group 6 and 12 years, were subjected to blood tests for free thyroxine, thyroid stimulating hormone, and TPO antibody, fine needle aspiration was advised for all children with goiter...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28199740/incidence-of-abnormal-liver-biochemical-tests-in-hyperthyroidism
#11
Tiffany Y Lin, Anshula O Shekar, Ning Li, Michael W Yeh, Sammy Saab, Mark Wilson, Angela M Leung
OBJECTIVE: Abnormal serum liver function tests are common in patients with untreated thyrotoxicosis, even prior to the initiation of antithyroidal medications that may worsen their severity. There is a wide range of the incidence of these abnormalities in the published literature. The aim of this study was to assess the risks factors and threshold of thyrotoxicosis severity for developing an abnormal liver biochemical test upon the diagnosis of new thyrotoxicosis. DESIGN: Single-institution retrospective cohort study...
February 15, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28195550/novel-germline-mutation-leu512met-in-the-thyrotropin-receptor-gene-tshr-leading-to-sporadic-non-autoimmune-hyperthyroidism
#12
Stephanie A Roberts, Jennifer E Moon, Andrew Dauber, Jessica R Smith
BACKGROUND: Primary nonautoimmune hyperthyroidism is a rare cause of neonatal hyperthyroidism. This results from an activating mutation in the thyrotropin-receptor (TSHR). It can be inherited in an autosomal dominant manner or occur sporadically as a de novo mutation. Affected individuals display a wide phenotype from severe neonatal to mild subclinical hyperthyroidism. We describe a 6-month-old boy with a de novo mutation in the TSHR gene who presented with accelerated growth, enlarging head circumference, tremor and thyrotoxicosis...
March 1, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28148588/lesson-of-the-month-1-subacute-thyroiditis-a-rare-cause-of-fever-of-unknown-origin
#13
Fatima Amar Bahowairath, Nicholas Woodhouse, Samir Hussain, Mujahid Al Busaidi
Fever of unknown origin (FUO) is sometimes a diagnostic dilemma for clinicians. Endocrine causes reported in the literature include subacute thyroiditis, thyrotoxicosis, adrenal insufficiency and pheochromocytoma. Among these, subacute thyroiditis is often overlooked as it can occasionally lack typical symptoms. This case illustrates the fact that subacute thyroiditis should be considered as a possible cause of fever even if signs and symptoms of hyperthyroidism and thyroid tenderness are absent.
February 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28134999/pathogenesis-of-hyperthyroidism
#14
Ishita Singh, Jerome M Hershman
Hyperthyroidism is a form of thyrotoxicosis in which there is excess thyroid hormone synthesis and secretion. Multiple etiologies can lead to a common clinical state of "thyrotoxicosis," which is a consequence of the high thyroid hormone levels and their action on different tissues of the body. The most common cause of thyrotoxicosis is Graves' disease, an autoimmune disorder in which stimulating thyrotropin receptor antibodies bind to thyroid stimulating hormone (TSH) receptors on thyroid cells and cause overproduction of thyroid hormones...
December 6, 2016: Comprehensive Physiology
https://www.readbyqxmd.com/read/28131627/down-regulation-of-kir2-6-channel-by-c-termini-mutation-d252n-and-its-association-with-the-susceptibility-to-thyrotoxic-periodic-paralysis
#15
Rolf Matias Paninka, Estevão Carlos-Lima, Susan C Lindsey, Ilda S Kunii, Magnus R Dias-da-Silva, Manoel Arcisio-Miranda
Inward rectifying potassium - Kir - channels drive the resting potential to potassium reversal potential and, when disrupted, might be related to muscular diseases. Recently, Thyrotoxic Periodic Paralysis (TPP) has emerged as a channelopathy related to mutations in KCNJ18 gene, which encodes Kir2.6 channel. TPP is a neuromuscular disorder characterized by a triad of muscle weakness, hypokalemia, and thyrotoxicosis, the latter being essential for the crisis. Direct sequencing revealed two heterozygous mutations - D252N and R386C - in two TPP patients...
January 25, 2017: Neuroscience
https://www.readbyqxmd.com/read/28106465/evaluation-of-99m-tc-mibi-in-thyroid-gland-imaging-for-the-diagnosis-and-classification-of-amiodarone-induced-thyrotoxicosis
#16
Junqi Wang, Ruiguo Zhang
OBJECTIVE: Amiodarone-induced thyrotoxicosis (AIT) is caused by aminodaroneas a side effect of cardiovascular disease treatment. Based on the differences in their pathological and physiological mechanisms, many methods have been developed so far to differentiate AIT subtypes such as color flow Doppler sonography (CFDS)and 24 h radioiodine uptake (RAIU). However, these methods suffer from inadequate accuracy in distinguishing different types of AITs and sometimes lead to misdiagnosis and delayed treatments...
January 20, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28074218/-autoimmune-diseases-of-the-thyroid-gland
#17
S Allelein, J Feldkamp, M Schott
Autoimmune diseases of the thyroid gland are considered to be the most frequent cause of thyroid gland disorders. Autoimmune thyroid diseases consist of two subgroups: autoimmune thyroiditis (AIT) and Graves' disease. The AIT is the most common human autoimmune disease. Infiltration of the thyroid gland with cytotoxic T‑cells can lead to an initial thyrotoxicosis und during the course to hypothyroidism due to destruction of the thyroid gland. Substitution with Levothyroxine is indicated for manifest hypothyroidism and subclinical hypothyroidism with increased thyroid antibodies with the intention of normalizing the serum thyroid stimulating hormone (TSH)...
January 2017: Der Internist
https://www.readbyqxmd.com/read/28065164/plasma-proteome-and-metabolome-characterization-of-an-experimental-human-thyrotoxicosis-model
#18
Maik Pietzner, Beatrice Engelmann, Tim Kacprowski, Janine Golchert, Anna-Luise Dirk, Elke Hammer, K Alexander Iwen, Matthias Nauck, Henri Wallaschofski, Dagmar Führer, Thomas F Münte, Nele Friedrich, Uwe Völker, Georg Homuth, Georg Brabant
BACKGROUND: Determinations of thyrotropin (TSH) and free thyroxine (FT4) represent the gold standard in evaluation of thyroid function. To screen for novel peripheral biomarkers of thyroid function and to characterize FT4-associated physiological signatures in human plasma we used an untargeted OMICS approach in a thyrotoxicosis model. METHODS: A sample of 16 healthy young men were treated with levothyroxine for 8 weeks and plasma was sampled before the intake was started as well as at two points during treatment and after its completion, respectively...
January 9, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28063079/the-thyroid-the-eyes-and-the-gut-a-possible-connection
#19
REVIEW
D Covelli, M Ludgate
INTRODUCTION: Graves' disease (GD) is an autoimmune disorder responsible for 60-90% of thyrotoxicosis, with an incidence of 1 to 2 cases per 1000 population per year in England. Graves' orbitopathy (GO) is the most frequent extrathyroidal manifestation, not provoked directly by abnormal thyroid hormone levels, but by the consequence of the underlying autoimmune process. The aetiology of autoimmune disorders is due to an interplay between susceptibility genes and environmental factors, such as infections and stress...
January 7, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28061802/thyrotropin-producing-pituitary-adenoma-simultaneously-existing-with-graves-disease-a-case-report
#20
Nobuhiko Arai, Makoto Inaba, Takamasa Ichijyo, Hiroshi Kagami, Yutaka Mine
BACKGROUND: Thyrotropin-producing pituitary tumor is relatively rare. In particular, concurrent cases associated with Graves' disease are extremely rare and only nine cases have been reported so far. We describe a case of a thyrotropin-producing pituitary adenoma concomitant with Graves' disease, which was successfully treated. CASE PRESENTATION: A 40-year-old Japanese woman presented with mild signs of hyperthyroidism. She had positive anti-thyroid-stimulating hormone receptor antibody, anti-thyroglobulin antibody, and anti-thyroid peroxidase antibody...
January 6, 2017: Journal of Medical Case Reports
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