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https://www.readbyqxmd.com/read/29181135/graves-disease-thyrotoxicosis-and-propylthiouracil-related-agranulocytosis-successfully-treated-with-therapeutic-plasma-exchange-and-g-csf-followed-by-total-thyroidectomy
#1
Anna Candoni, Federico De Marchi, Fabio Vescini, Sara Mauro, Cristina Rinaldi, Marco Piemonte, Nicholas Rabassi, Maria Vittoria Dubbini, Renato Fanin
Antithyroid drugs can be a rare cause of agranulocytosis (0.5% of treated patients). Suspension of these drugs is mandatory in these patients and may result in worsening hyperthyroidism. We report the case of a 27-year-old woman who is 3 months post-partum, breastfeeding, and suffering with Graves' disease hyperthyroidism treated first with methimazole and then with propylthiouracil due to a methimazole allergy. She was admitted for urosepsis and agranulocytosis. The patient was diagnosed with propylthiouracil related agranulocytosis, diffuse toxic goiter and thyro-gastric syndrome...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29067240/benign-thyroid-disease-in-pregnancy-a-state-of-the-art-review
#2
REVIEW
Efterpi Tingi, Akheel A Syed, Alexis Kyriacou, George Mastorakos, Angelos Kyriacou
Thyroid dysfunction is the commonest endocrine disorder in pregnancy apart from diabetes. Thyroid hormones are essential for fetal brain development in the embryonic phase. Maternal thyroid dysfunction during pregnancy may have significant adverse maternal and fetal outcomes such as preterm delivery, preeclampsia, miscarriage and low birth weight. In this review we discuss the effect of thyroid disease on pregnancy and the current evidence on the management of different thyroid conditions in pregnancy and postpartum to improve fetal and neonatal outcomes, with special reference to existing guidelines on the topic which we dissect, critique and compare with each other...
December 2016: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/28965301/minimal-trauma-ankle-fractures-predominate-during-pregnancy-a-17-year-retrospective-study
#3
Madhuni Herath, Phillip Wong, Anne Trinh, Carolyn A Allan, Euan M Wallace, Peter R Ebeling, Peter J Fuller, Frances Milat
This study assessed all fractures occurring in pregnancy at a tertiary referral centre over a 17-year period. Most fractures were due to minimal trauma, and those involving the ankle were the most common. Women tended to fracture during their second and third trimesters and most required surgical intervention during pregnancy. PURPOSE: To characterise fractures in pregnancy over a 17-year period at a tertiary referral health service. METHODS: Medical records at the Monash Health in Australia were examined from 2000-2016 for fractures in pregnancy using the birthing outcome system database and the tenth revision of the International Statistical Classification of Diseases and Related Health Problems coding...
September 30, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28672769/reference-intervals-and-longitudinal-changes-in-copeptin-and-mr-proadm-concentrations-during-pregnancy
#4
Annemiek M C P Joosen, Ivon J M van der Linden, Lianne Schrauwen, Alisia Theeuwes, Monique J M de Groot, Antonius A M Ermens
BACKGROUND: Vasopressin and adrenomedullin and their stable by-products copeptin and midregional part of proadrenomedullin (MR-proADM) are promising biomarkers for the development of preeclampsia. However, clinical use is hampered by the lack of trimester-specific reference intervals. We therefore estimated reference intervals for copeptin and MR-proADM in disease-free Dutch women throughout pregnancy. METHODS: Apparently healthy low risk pregnant women were recruited...
June 16, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28662095/population-growth-is-limited-by-nutritional-impacts-on-pregnancy-success-in-endangered-southern-resident-killer-whales-orcinus-orca
#5
Samuel K Wasser, Jessica I Lundin, Katherine Ayres, Elizabeth Seely, Deborah Giles, Kenneth Balcomb, Jennifer Hempelmann, Kim Parsons, Rebecca Booth
The Southern Resident killer whale population (Orcinus orca) was listed as endangered in 2005 and shows little sign of recovery. These fish eating whales feed primarily on endangered Chinook salmon. Population growth is constrained by low offspring production for the number of reproductive females in the population. Lack of prey, increased toxins and vessel disturbance have been listed as potential causes of the whale's decline, but partitioning these pressures has been difficult. We validated and applied temporal measures of progesterone and testosterone metabolites to assess occurrence, stage and health of pregnancy from genotyped killer whale feces collected using detection dogs...
2017: PloS One
https://www.readbyqxmd.com/read/28500083/hepatic-thyroid-signaling-of-heat-stressed-late-pregnant-and-early-lactating-cows
#6
Joachim M Weitzel, Torsten Viergutz, Dirk Albrecht, Rupert Bruckmaier, Marion Schmicke, Armin Tuchscherer, Franziska Koch, Björn Kuhla
During the transition between late gestation and early lactation, dairy cows experience severe metabolic stress due to the high energy and nutrient requirements of the fetus and the mammary gland. Additional thermal stress that occurs with rising temperatures during the ongoing climate change has further adverse implications on energy intake, metabolism and welfare. The thyroid hormone (TH)-mediated cellular signaling has a pivotal role in regulation of body temperature, energy intake and metabolic adaptation to heat...
August 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28290237/multiple-nutritional-factors-and-the-risk-of-hashimoto-s-thyroiditis
#7
Shiqian Hu, Margaret P Rayman
BACKGROUND: Hashimoto's thyroiditis (HT) is considered to be the most common autoimmune disease. It is currently accepted that genetic susceptibility, environmental factors, and immune disorders contribute to its development. With regard to nutritional factors, evidence implicates high iodine intake and deficiencies of selenium and iron with a potential relevance of vitamin D status. To elucidate the role of nutritional factors in the risk, pathogenesis, and treatment of HT, PubMed and the Cochrane Library were searched for publications on iodine, iron, selenium, and vitamin D and risk/treatment of HT...
May 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28203373/a-silent-skull-metastatic-follicular-thyroid-carcinoma-mimicking-as-a-benign-scalp-tumor-in-a-pregnant-woman
#8
Tsung-Chun Huang, Yu-Kai Cheng, Tsung-Wei Chen, Yung-Chang Hsu, En-Wei Liu, Hsin-Han Chen
Thyroid cancer with cranial metastasis in a pregnant woman is very rare. In the literature, most cases are diagnosed early from neurogenic signs or symptomatic thyroid gland. Pregnancy also contributes to a hesitation toward early surgical and medical treatments. We reported a scalp tumor in a physically healthy 37-year-old pregnant female with a follicular thyroid carcinoma (FTC) with lung, bone and cranial metastasis in initial presentation. Silent neurogenic and physical examinations make an early diagnosis very challenging...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28092021/sunshine-vitamin-and-thyroid
#9
REVIEW
Immacolata Cristina Nettore, Luigi Albano, Paola Ungaro, Annamaria Colao, Paolo Emidio Macchia
Vitamin D exerts its canonical roles on the musculoskeletal system and in the calcium/phosphorus homeostasis. In the last years, increasing evidences suggested several extra-skeletal actions of this hormone, indicating that vitamin D may produce effects in almost all the body tissues. These are mediated by the presence of vitamin D receptor (VDR) and thanks to the presence of the 1-α-hydroxylase, the protein that converts the 25-hydroxyvitamin (calcidiol) to the active form 1,25-dihydroxyvitamin (calcitriol)...
September 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/27835925/response-to-therapy-status-is-an-excellent-predictor-of-pregnancy-associated-structural-disease-progression-in-patients-previously-treated-for-differentiated-thyroid-cancer
#10
Luba Rakhlin, Stephanie Fish, R Michael Tuttle
BACKGROUND: Pregnancy may be associated with an increased risk of recurrence/progression of differentiated thyroid cancer (DTC). However, it is unclear if the impact of pregnancy would differ based on pre-pregnancy response to therapy status. The objective of this study was to investigate the risk of recurrence/progression of DTC, applying the response to therapy assessments to pre-pregnancy status as recommended by the 2015 American Thyroid Association thyroid cancer guidelines. METHODS: This was a retrospective review of 235 women followed at Memorial Sloan Kettering Cancer Center for DTC who had a term pregnancy after initial treatment for DTC between 1997 and 2015...
March 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27827913/assessment-of-breast-milk-iodine-concentrations-in-lactating-women-in-western-australia
#11
Anita Jorgensen, Peter O'Leary, Ian James, Sheila Skeaff, Jillian Sherriff
Breast-fed infants may depend solely on an adequate supply of iodine in breast milk for the synthesis of thyroid hormones which are essential for optimal growth and cognitive development. This is the first study to measure breast milk iodine concentration (BMIC) among lactating women in Western Australian (n = 55). Breast milk samples were collected between 2014 and 2015 at a mean (±SD) of 38.5 (±5.5) days post-partum. The samples were analysed to determine median BMIC and the percentage of samples with a BMIC < 100 µg/L, a level considered adequate for breast-fed infants...
November 4, 2016: Nutrients
https://www.readbyqxmd.com/read/27538922/unexpected-elevated-free-thyroid-hormones-in-pregnancy
#12
Claudia Teti, Elena Nazzari, Marina Raffaella Galletti, Mattia Grazia Mandolfino, Francesca Pupo, Giampaola Pesce, Flavia Lillo, Marcello Bagnasco, Salvatore Benvenga
BACKGROUND: The use of thyrotropin and free thyroid hormone assays to evaluate thyroid function is widespread, but in some situations the results are inconsistent with the patient's thyroid status. SUMMARY: A 35-year-old woman with a known diagnosis of chronic autoimmune thyroiditis was referred to the authors' clinic at week 26 of her second pregnancy. The patient was clinically euthyroid. Consistent with this, her serum thyrotropin (TSH) was normal (0.79 mIU/L), but she had elevated free thyroid hormones-free triiodothyronine (fT3) and free thyroxine (fT4)-as determined by a one-step chemiluminescent assay...
November 2016: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27405776/a-primer-on-pituitary-injury-for-the-obstetrician-gynecologist-simmonds-disease-sheehan-s-syndrome-traumatic-injury-dahan-s-syndrome-pituitary-apoplexy-and-lymphocytic-hypophysitis
#13
Michael H Dahan, SeangLin Tan
The pituitary gland plays a critical role in reproduction. In response to the hypothalamus the anterior pituitary secretes prolactin, thyroid stimulating hormone (TSH), Adreno corticotropic hormone (ACTH), follicle stimulating hormone (FSH), luteinizing hormone (LH) and growth hormone. Dysregulation in these hormones often lead to reproductive failure. Multiple mechanisms of pituitary injury exist. Simmond's disease is atrophy or destruction of the anterior lobe of the pituitary gland resulting in hypopitiutaryism...
July 13, 2016: Minerva Ginecologica
https://www.readbyqxmd.com/read/27038492/hyperthyroidism
#14
REVIEW
Simone De Leo, Sun Y Lee, Lewis E Braverman
Hyperthyroidism is characterised by increased thyroid hormone synthesis and secretion from the thyroid gland, whereas thyrotoxicosis refers to the clinical syndrome of excess circulating thyroid hormones, irrespective of the source. The most common cause of hyperthyroidism is Graves' disease, followed by toxic nodular goitre. Other important causes of thyrotoxicosis include thyroiditis, iodine-induced and drug-induced thyroid dysfunction, and factitious ingestion of excess thyroid hormones. Treatment options for Graves' disease include antithyroid drugs, radioactive iodine therapy, and surgery, whereas antithyroid drugs are not generally used long term in toxic nodular goitre, because of the high relapse rate of thyrotoxicosis after discontinuation...
August 27, 2016: Lancet
https://www.readbyqxmd.com/read/26641966/tsh-and-ft4-during-pregnancy-an-observational-study-and-a-review-of-the-literature
#15
COMPARATIVE STUDY
Annemiek M C P Joosen, Ivon J M van der Linden, Neletta de Jong-Aarts, Marieke A A Hermus, Antonius A M Ermens, Monique J M de Groot
BACKGROUND: Trimester-specific reference intervals for TSH are recommended to assess thyroid function during pregnancy due to changes in thyroid physiology. Laboratories should verify reference intervals for their population and assay used. No consistent upper reference limit (URL) for TSH during pregnancy is reported in literature. We investigated the use of non-pregnant reference intervals for TSH, recommended during pregnancy by current Dutch guidelines, by deriving trimester-specific reference intervals in disease-free Dutch pregnant women as these are not available...
July 1, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/26197855/outcome-prediction-of-treatment-of-graves-hyperthyroidism-with-antithyroid-drugs
#16
REVIEW
E Piantanida, A Lai, L Sassi, D Gallo, E Spreafico, M L Tanda, L Bartalena
Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas and is ultimately due to antibodies interacting with the TSH receptor on thyroid follicular cells [TSH-receptor antibody (TRAb)]. Antithyroid drugs (ATDs) belonging to the family of thionamides are the first-line treatment in Europe. ATD treatment is commonly continued for 18-24 months. Its major limitation is the high rate of relapses after drug withdrawal. Factors particularly bound to subsequent relapses are the large thyroid volume, smoking habit, persistence of TRAb in the circulation at the end of treatment, and the post-partum period...
September 2015: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/26088475/selenium-and-iodine-in-autoimmune-thyroiditis
#17
REVIEW
Edoardo Guastamacchia, Vito Angelo Giagulli, Brunella Licchelli, Vincenzo Triggiani
Selenium and iodine are essential for thyroid hormone synthesis and function. Selenium, in form of selenocysteine, is found either in the catalytic center of enzymes involved in the protection of the thyroid gland from free radicals originating during thyroid hormone synthesis, and in three different iodothyronine deiodinases catalyzing the activation and the inactivation of thyroid hormones. Iodine is an essential constituent of thyroid hormones and its deficiency causes different disorders that include goiter, hypothyroidism, reduced fertility and alteration in growth, physical and neurological development...
2015: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/26060388/kikuchi-fujimoto-disease-masquerading-as-metastatic-papillary-carcinoma-of-the-thyroid
#18
Shailesh Garg, Manuel Villa, Jaya Ruth Asirvatham, Thomas Mathew, Louis-Joseph Auguste
Kikuchi-Fujimoto disease also known as histiocytic necrotizing lymphadenitis is a rare cervical inflammatory lymphadenitis that is most commonly seen in young Asian women. It is mainly characterized by lymphadenopathy, hepatosplenomegaly, fever, nocturnal sweats, myalgia, weight loss, and arthralgia, and commonly follows a self-limited course. The differential diagnosis is challenging as many other conditions such as malignant lymphoma, metastatic disease, tuberculosis and infectious lymphadenopathies can present in a similar way...
June 2015: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/26029700/developmental-neurotoxicity-of-3-3-4-4-tetrachloroazobenzene-with-thyroxine-deficit-sensitivity-of-glia-and-dentate-granule-neurons-in-the-absence-of-behavioral-changes
#19
G Jean Harry, Michelle J Hooth, Molly Vallant, Mamta Behl, Gregory S Travlos, James L Howard, Catherine J Price, Sandra McBride, Ron Mervis, Peter R Mouton
Thyroid hormones (TH) regulate biological processes implicated in neurodevelopmental disorders and can be altered with environmental exposures. Developmental exposure to the dioxin-like compound, 3,3',4,4'-tetrachloroazobenzene (TCAB), induced a dose response deficit in serum T4 levels with no change in 3,5,3'- triiodothyronine or thyroid stimulating hormone. Female Sprague-Dawley rats were orally gavaged (corn oil, 0.1, 1.0, or 10 mg TCAB/kg/day) two weeks prior to cohabitation until post-partum day 3 and male offspring from post-natal day (PND)4-21...
September 2014: Toxics
https://www.readbyqxmd.com/read/26028555/thyroid-disorders-during-pregnancy-and-postpartum
#20
REVIEW
Elizabeth N Pearce
An awareness of the gestational changes to thyroid physiology and the impact of uncontrolled thyroid disease on pregnancy and infant outcome is essential for the successful management of hypothyroidism and hyperthyroidism. This review summarizes strategies for the management of thyroid disease in pregnancy and post partum, and it highlights areas where there is still a lack of consensus.
July 2015: Best Practice & Research. Clinical Obstetrics & Gynaecology
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