Thyroid Science最新文献

筛选
英文 中文
Effectiveness of thrice-daily short-acting somatostatin analog testing in patients with thyrotropin-secreting pituitary neuroendocrine microtumor: A case report with review of literature 对分泌促甲状腺激素的垂体神经内分泌微瘤患者进行每日三次短效促甲状腺激素类似物试验的有效性:病例报告及文献综述
Thyroid Science Pub Date : 2024-11-01 Epub Date: 2024-07-27 DOI: 10.1016/j.thscie.2024.100017
Risako Harada , Keisuke Kakizawa , Kenji Ohba , Miho Yamashita , Shigekazu Sasaki , Mitsuaki Tokumaru , Mieko Nakamura , Koji Nagayama , Shinichiro Koizumi , Kazuhiko Kurozumi , Akio Matsushita
{"title":"Effectiveness of thrice-daily short-acting somatostatin analog testing in patients with thyrotropin-secreting pituitary neuroendocrine microtumor: A case report with review of literature","authors":"Risako Harada ,&nbsp;Keisuke Kakizawa ,&nbsp;Kenji Ohba ,&nbsp;Miho Yamashita ,&nbsp;Shigekazu Sasaki ,&nbsp;Mitsuaki Tokumaru ,&nbsp;Mieko Nakamura ,&nbsp;Koji Nagayama ,&nbsp;Shinichiro Koizumi ,&nbsp;Kazuhiko Kurozumi ,&nbsp;Akio Matsushita","doi":"10.1016/j.thscie.2024.100017","DOIUrl":"10.1016/j.thscie.2024.100017","url":null,"abstract":"<div><p>The laboratory diagnosis of thyrotropin-secreting pituitary neuroendocrine tumors (TSH-PitNETs) is characterized by the syndrome of inappropriate secretion of thyrotropin (SITSH), which presents as non-suppressed TSH levels despite hyperthyroxinemia. Differential diagnoses include resistance to thyroid hormone β (RTHβ) and a syndrome that is clinically and biochemically indistinguishable from RTHβ but without <em>THRB</em> mutations (non-TR-RTH). A 53-year-old Japanese woman without a family history of thyroid disease was referred to our hospital with suspected SITSH. <em>THRB</em> gene analysis revealed no mutations. Magnetic resonance imaging described a pituitary nodule with a maximum diameter of 8.5 mm, raising the suspicion of TSH-PitNET, or a combination of non-TR-RTH and pituitary incidentaloma. Among multiple evaluations we conducted, a 100 μg thrice-daily short-acting somatostatin analog octreotide suppression test significantly suppressed her TSH levels, indicative of a TSH-PitNET, which was confirmed postoperatively. However, the inconvenience of midnight octreotide injections in this protocol prompted further investigation into once- or twice-daily dosing regimens. A retrospective study was conducted on the suppressive effect of a single 100 μg dose of octreotide on TSH in 28 patients with acromegaly and three patients with TSH-PitNET who visited our hospital between 2008 and 2023. Significant differences in the suppressive effects at 12 h and 24 h post-injection suggest that a less frequent dosing regimen could be effective in diagnosing TSH-PitNET. In conclusion, this case report presents the first documented use of a thrice-daily octreotide test for diagnosing TSH-PitNET in Japan. We also discuss a potential less frequent octreotide dosing schedule based on our preliminary findings.</p></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"1 4","pages":"Article 100017"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950300024000107/pdfft?md5=b15be57618a3c449399cbd49381cd10b&pid=1-s2.0-S2950300024000107-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141962100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of levothyroxine treatment on serum thyroid hormone levels in euthyroid patients with papillary thyroid microcarcinoma 左甲状腺素治疗对甲状腺乳头状微癌甲状腺功能正常患者血清甲状腺激素水平的影响
Thyroid Science Pub Date : 2024-08-01 Epub Date: 2024-05-31 DOI: 10.1016/j.thscie.2024.100015
Yoshiki Furumura, Mitsuru Ito, Akira Miyauchi, Masashi Yamamoto, Makoto Fujishima, Yasuhiro Ito, Mitsushige Nishikawa, Takashi Akamizu
{"title":"Effects of levothyroxine treatment on serum thyroid hormone levels in euthyroid patients with papillary thyroid microcarcinoma","authors":"Yoshiki Furumura,&nbsp;Mitsuru Ito,&nbsp;Akira Miyauchi,&nbsp;Masashi Yamamoto,&nbsp;Makoto Fujishima,&nbsp;Yasuhiro Ito,&nbsp;Mitsushige Nishikawa,&nbsp;Takashi Akamizu","doi":"10.1016/j.thscie.2024.100015","DOIUrl":"https://doi.org/10.1016/j.thscie.2024.100015","url":null,"abstract":"<div><p>We recently reported that lowering serum thyroid stimulating hormone (TSH) levels with levothyroxine (LT4) may be associated with decreased tumor growth during active surveillance (AS) of papillary thyroid microcarcinoma (PTMC). Most clinicians might believe that low serum TSH levels following LT4 therapy indicate subclinical thyrotoxicosis. This study aimed to evaluate the effects of TSH-lowering therapy using small doses of LT4 on serum thyroid hormone levels in euthyroid patients with PTMC. We retrospectively analyzed data from 28 patients with low-risk PTMC who had undergone measurement of both FT4 and FT3 consecutively and received LT4 to achieve serum TSH levels of &lt; 0.5 μIU/mL and &gt; 0.05 μIU/mL between January 2012 and May 2018 at Kuma Hospital. There were 24 females and 4 males (aged 55 ± 12 years [mean ± standard deviation {SD}]). We compared their serum FT4 and FT3 levels at diagnosis with those following TSH-lowering therapy with LT4. Following LT4 therapy, the patients’ serum FT4 levels were significantly increased (<em>P</em> &lt; 0.001). Serum FT3 levels, however, remained unchanged (<em>P</em> = 0.10). The proportions of patients whose FT3 levels increased by more than 1 SD, remained unchanged, and decreased by more than 1 SD were 11 %, 57 %, and 32 %, respectively. Our study indicated that mild TSH-lowering doses of LT4 for euthyroid patients with PTMC increased serum FT4 levels but did not increase serum FT3 levels in most cases, suggesting that a mild TSH-lowering therapy for euthyroid patients may not necessarily cause thyrotoxicosis.</p></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"1 3","pages":"Article 100015"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950300024000089/pdfft?md5=2d60baf2e099b05b087a0213a1b7d20e&pid=1-s2.0-S2950300024000089-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141244029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Phosphorylated telomerase reverse transcriptase contributes to the progression of papillary thyroid carcinoma 磷酸化端粒酶逆转录酶有助于甲状腺乳头状癌的进展
Thyroid Science Pub Date : 2024-08-01 Epub Date: 2024-06-25 DOI: 10.1016/j.thscie.2024.100016
Koki Shio , Yukie Yamaya , Erina Suzuki , Takumi Sato , Yoshiko Matsumoto , Satoshi Suzuki , Hiroki Shimura , Shinichi Suzuki , Yuko Hashimoto , Fumihiko Furuya
{"title":"Phosphorylated telomerase reverse transcriptase contributes to the progression of papillary thyroid carcinoma","authors":"Koki Shio ,&nbsp;Yukie Yamaya ,&nbsp;Erina Suzuki ,&nbsp;Takumi Sato ,&nbsp;Yoshiko Matsumoto ,&nbsp;Satoshi Suzuki ,&nbsp;Hiroki Shimura ,&nbsp;Shinichi Suzuki ,&nbsp;Yuko Hashimoto ,&nbsp;Fumihiko Furuya","doi":"10.1016/j.thscie.2024.100016","DOIUrl":"https://doi.org/10.1016/j.thscie.2024.100016","url":null,"abstract":"<div><p>Somatic mutations in the promoter region of telomerase reverse transcriptase (<em>TERT</em>) occur at a high frequency in several cancer types and are associated with malignancy potential and prognosis. Protein levels of TERT and phosphorylated TERT (p-TERT) are related to malignancy potential. To explore the association of TERT phosphorylation and malignancy or prognosis of thyroid cancer, we analyzed the expression of p-TERT and the clinical features of papillary thyroid carcinoma (PTC) in a cohort of 120 patients. We found that TERT and p-TERT were more abundant in tumors harboring <em>TERT</em> promoter mutations. During the 5-year follow-up period, nine patients experienced disease recurrence. The hazard ratio for recurrence was higher in those with abundant TERT and p-TERT levels. The Kaplan–Meier analysis indicated that the recurrence-free survival was significantly worse in TERT-positive/p-TERT-positive patients than TERT-positive/p-TERT-negative and TERT-negative/p-TERT-negative patients. Higher p-TERT levels correlated with malignant clinicopathologic features and were an independent risk factor for PTC recurrence. These findings indicated the potential role of p-TERT level as a clinically prognostic biomarker in PTC.</p></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"1 3","pages":"Article 100016"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950300024000090/pdfft?md5=af20cd9931737e5cc8cb3563f72a6aad&pid=1-s2.0-S2950300024000090-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141539319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multiple ultrasound examination detected spontaneous regression of thyroid sarcoidosis: A case report 多次超声波检查发现甲状腺肉瘤自发消退病例报告
Thyroid Science Pub Date : 2024-05-01 Epub Date: 2024-03-10 DOI: 10.1016/j.thscie.2024.100012
Erika Yata , Masakazu Notsu , Mika Yamauchi , Fuminori Ishitobi , Mayuko Uegaki , Ryota Okazaki , Eri Nitta , Tsukimi Goto , Keizo Kanasaki , Shozo Yano
{"title":"Multiple ultrasound examination detected spontaneous regression of thyroid sarcoidosis: A case report","authors":"Erika Yata ,&nbsp;Masakazu Notsu ,&nbsp;Mika Yamauchi ,&nbsp;Fuminori Ishitobi ,&nbsp;Mayuko Uegaki ,&nbsp;Ryota Okazaki ,&nbsp;Eri Nitta ,&nbsp;Tsukimi Goto ,&nbsp;Keizo Kanasaki ,&nbsp;Shozo Yano","doi":"10.1016/j.thscie.2024.100012","DOIUrl":"https://doi.org/10.1016/j.thscie.2024.100012","url":null,"abstract":"<div><p>A 37-year-old woman was referred with a low-density area in her right thyroid lobe by CT scan. Ultrasonography showed a diffusely hypoechoic lesion with rough internal echo in the right lobe. Fine needle aspiration cytology revealed epithelioid cells and granulomas with multinucleated giant cells. With these findings and the presence of typical findings, she was diagnosed with thyroid sarcoidosis. After two months, the hypoechoic lesion was remarkably reduced without steroid therapy, suggesting spontaneous regression. Thyroid sarcoidosis should be considered in a case with systemic sarcoidosis, hypoechoic lesion without pain, and spontaneously regressed thyroid lesion detected by multiple ultrasonography.</p></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"1 2","pages":"Article 100012"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950300024000053/pdfft?md5=4ff82686ee3854cfcd25d2993b03cec6&pid=1-s2.0-S2950300024000053-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140134004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Influence of medication for lifestyle diseases on thyroid function during health examinations 健康检查中生活方式疾病药物对甲状腺功能的影响
Thyroid Science Pub Date : 2024-05-01 Epub Date: 2024-04-25 DOI: 10.1016/j.thscie.2024.100014
Mitsuaki Tokumaru , Kenji Ohba , Mieko Nakamura , Yoshie Goto , Takayuki Iwaki , Akio Matsushita , Shigekazu Sasaki , Kazuo Umemura , Takafumi Suda , Hiroyuki Takase
{"title":"Influence of medication for lifestyle diseases on thyroid function during health examinations","authors":"Mitsuaki Tokumaru ,&nbsp;Kenji Ohba ,&nbsp;Mieko Nakamura ,&nbsp;Yoshie Goto ,&nbsp;Takayuki Iwaki ,&nbsp;Akio Matsushita ,&nbsp;Shigekazu Sasaki ,&nbsp;Kazuo Umemura ,&nbsp;Takafumi Suda ,&nbsp;Hiroyuki Takase","doi":"10.1016/j.thscie.2024.100014","DOIUrl":"10.1016/j.thscie.2024.100014","url":null,"abstract":"<div><h3>Introduction</h3><p>Various drugs reportedly influence thyroid function. Lifestyle diseases such as diabetes, dyslipidemia, and hypertension are prevalent worldwide, and patients often take medications for these conditions. However, the relationship between these drugs and thyroid function, especially in the general population, remains incompletely understood.</p></div><div><h3>Methods</h3><p>This study aimed to investigate the independent effects of medications for lifestyle diseases on thyroid function through a retrospective cohort study of medical checkup participants who visited the Enshu Hospital between April 2010 and December 2020 (n = 2814). The clinical history as well as concurrent measurements including TSH, free thyroxine (FT4), and estimated glomerular filtration rate were reviewed to consider various confounding factors influencing thyroid function in individuals.</p></div><div><h3>Results</h3><p>When factors influencing FT4 levels were assessed through simple and multiple linear regression analyses, sulfonylureas (<em>β</em> = 0.041, <em>p</em> = 0.030), α-glucosidase inhibitors (<em>β</em> = 0.039, <em>p</em> = 0.036), and thiazolidinediones (<em>β</em> = 0.053, <em>p</em> = 0.004) emerged as independent predictors of elevated FT4 levels. Subsequent analyses, including unpaired <em>t</em>-tests after analysis of covariance adjusted for propensity scores, confirmed the association for thiazolidinediones (15.7 vs. 17.2 pmol/L, <em>p</em> = 0.027). Investigating the factors influencing thyroid-stimulating hormone levels revealed no significant predictors among various medications.</p></div><div><h3>Conclusions</h3><p>Sulfonylureas, α-glucosidase inhibitors, and thiazolidinediones independently contribute to elevated serum FT4 levels. While the clinical relevance might be limited, it is essential for physicians to consider these medications, especially thiazolidinediones, when interpreting thyroid function testing.</p></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"1 2","pages":"Article 100014"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950300024000077/pdfft?md5=e9688ba2d4906aadbe41bb870d49db76&pid=1-s2.0-S2950300024000077-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140771149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Remarkable improvement of bone mineral density concordant with calcium intake in hyperthyroidism patient with severe hypocalcemia following thyroidectomy – Case report 甲状腺切除术后伴有严重低钙血症的甲状腺功能亢进症患者骨矿物质密度的显著改善与钙摄入量一致--病例报告
Thyroid Science Pub Date : 2024-05-01 Epub Date: 2024-04-18 DOI: 10.1016/j.thscie.2024.100013
Yuki Nagata , Kazuma Sone , Norikazu Toi , Yuya Miki , Masafumi Kurajoh , Tomoaki Morioka , Yasuo Imanishi , Masanori Emoto
{"title":"Remarkable improvement of bone mineral density concordant with calcium intake in hyperthyroidism patient with severe hypocalcemia following thyroidectomy – Case report","authors":"Yuki Nagata ,&nbsp;Kazuma Sone ,&nbsp;Norikazu Toi ,&nbsp;Yuya Miki ,&nbsp;Masafumi Kurajoh ,&nbsp;Tomoaki Morioka ,&nbsp;Yasuo Imanishi ,&nbsp;Masanori Emoto","doi":"10.1016/j.thscie.2024.100013","DOIUrl":"https://doi.org/10.1016/j.thscie.2024.100013","url":null,"abstract":"<div><h3>Background</h3><p>Hyperthyroidism is one of the causes of secondary osteoporosis, with increased bone turnover and decreased bone mineral density (BMD). Although antithyroid medication and surgical treatment can improve BMD, the association of calcium intake with an increase in postoperative BMD remains unclear.</p></div><div><h3>Case presentation</h3><p>A 51-year-old postmenopausal woman after discontinuation of treatment for hyperthyroidism was diagnosed with thyrotoxicosis and osteoporosis with a high risk of fracture based on lumbar spine and femur BMD. She was prescribed antithyroid drug (methimazole 15 mg/day) and alendronate (35 mg/week). Following two months of administration, a thyroidectomy was performed, after which the patient noted numbness and cramps in the hands and feet, and was diagnosed with hypocalcemia (corrected serum calcium, 6.1 mg/dL). Increasing the dosage up to the maximum of alfacalcidol (8 µg/day) and calcium lactate (8000 mg/day) resulted in improved symptoms and normalized serum calcium level. One year after surgery, the total amount of calcium supplement was 190 g and estimated dietary calcium intake was 171 g, for a total annual intake of 361 g. On the other hand, the estimated total urinary calcium excretion amount for the year, calculated from urinary calcium and creatinine at each visit, was 82 g. Concordantly, BMD in both lumbar spine and femur increased approximately 50 %, presumably reflecting increases of calcium absorption from the intestinal tract by active vitamin D and uptake by bone.</p></div><div><h3>Conclusion</h3><p>Following surgery for hyperthyroidism, substantial improvement in BMD in patients with severe hypocalcemia can be anticipated with adequate calcium and vitamin D supplementation.</p></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"1 2","pages":"Article 100013"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950300024000065/pdfft?md5=8f53775c3311bf5be023f28251797b32&pid=1-s2.0-S2950300024000065-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140622418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Painless thyroiditis as a precursor to the relapse of Graves’ disease during remission 无痛性甲状腺炎是巴塞杜氏病缓解期复发的先兆
Thyroid Science Pub Date : 2024-02-01 Epub Date: 2023-12-10 DOI: 10.1016/j.thscie.2023.100003
Kenji Iwaku , Jaeduk Noh Yoshimura , Natsuko Watanabe , Kiminori Sugino , Koichi Ito
{"title":"Painless thyroiditis as a precursor to the relapse of Graves’ disease during remission","authors":"Kenji Iwaku ,&nbsp;Jaeduk Noh Yoshimura ,&nbsp;Natsuko Watanabe ,&nbsp;Kiminori Sugino ,&nbsp;Koichi Ito","doi":"10.1016/j.thscie.2023.100003","DOIUrl":"https://doi.org/10.1016/j.thscie.2023.100003","url":null,"abstract":"<div><p>The clinical profile of Graves’ disease (GD) after painless thyroiditis (PT) is nearly exclusively known from case reports, but it has never been investigated in depth. This study investigated the clinical characteristics of 18 patients (4 men, 14 women), with a median age of 32(25−48) years who developed GD out of a total of 862 patients who were diagnosed with PT based on high free thyroxine, suppressed thyroid-stimulating hormone, negative receptor antibody, and low 123I-uptake (&lt;5%). Additionally, we compared their clinical characteristics with 162 patients (39 men, 123 women), with a median age of 37 (7−71) years who had the new-onset GD. The patients who developed GD after PT included 12 (7.2%) of 167 patients who recovered from GD and 6 (1.1%) of 559 patients with chronic thyroiditis (p &lt; 0.0001). Of the 18 patients who developed GD following PT, 12 (66.7%) already recovered from a previous bout of GD and developed PT after having discontinued medical treatment and 16 (88.9%) developed GD 4–29 months after PT. The 2-year remission rates for the 16 patients who developed GD up to 29 months after PT and for the new-onset GD patients were 56.3% and 24.7% (p = 0.0070) and the 4-year remission rates were 75.0% and 38.3% (p = 0.0045), respectively. The development of PT after GD recovery may become a risk factor for GD recurrence. Patients who developed GD immediately after PT had comparatively milder disease and appeared to achieve remission in a short time.</p></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"1 1","pages":"Article 100003"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950300023000034/pdfft?md5=ed79d9bf27d471e8a8714ef909c3baf4&pid=1-s2.0-S2950300023000034-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138656991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recurrent massive hemoptysis from tracheal varices caused by a large goiter of Graves’ disease 巴塞杜氏病引起的大甲状腺肿导致气管静脉曲张反复大咯血。
Thyroid Science Pub Date : 2024-02-01 Epub Date: 2023-12-22 DOI: 10.1016/j.thscie.2023.100006
Hiroshi Katoh , Kana Aoki , Mariko Kikuchi , Takafumi Sangai
{"title":"Recurrent massive hemoptysis from tracheal varices caused by a large goiter of Graves’ disease","authors":"Hiroshi Katoh ,&nbsp;Kana Aoki ,&nbsp;Mariko Kikuchi ,&nbsp;Takafumi Sangai","doi":"10.1016/j.thscie.2023.100006","DOIUrl":"10.1016/j.thscie.2023.100006","url":null,"abstract":"<div><h3>Background</h3><p>Tracheal varices are rare but cause massive or repeated hemoptysis that can be life-threatening. Patients with Graves’ disease or adenomatous goiter sometimes show compressive symptoms by a diffuse large goiter. However, it is extremely rare to form tracheal varicose veins that cause hemoptysis. We herein report a case of massive hemoptysis from tracheal varices caused by a large Graves’ goiter.</p></div><div><h3>Case presentation</h3><p>An 82-year-old woman was diagnosed with Graves’ disease and had been treated with thiamazole for 15 years. She was taken to an emergency room because of massive hemoptysis. Bronchofiberscope revealed hemorrhage from remarkable varicose veins in the tracheal mucosa. Apixaban for concurrent paroxysmal atrial fibrillation was immediately withdrawn. After endotracheal epinephrine administration for recurrent bleeding, she was transferred to us. She presented with a large goiter that occupied her neck, suggesting that compression by the enlarged goiter may have caused tracheal varices. Preoperative echocardiography revealed tricuspid regurgitation and elevated pulmonary artery pressure that may have supported forming tracheal varices. Upon anesthesia induction, intubation was carefully conducted under bronchoscopy with endotracheal epinephrine administration, and total thyroidectomy was performed. The postoperative course was uneventful and she was discharged in 1 week. Bronchoscopy at 1 month after the operation showed complete disappearance of the tracheal varices.</p></div><div><h3>Conclusion</h3><p>Although tracheal varices due to compression by a large goiter are extremely rare, pulmonary hypertension may further accelerate establishing tracheal varices that leads to massive and recurrent hemoptysis. Tracheal varices associated with a large goiter can be treated by total thyroidectomy with careful intubation.</p></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"1 1","pages":"Article 100006"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S295030002300006X/pdfft?md5=41b7e487a38a8b5fcac9d8f6e051bebb&pid=1-s2.0-S295030002300006X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139015875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Novel thyroid-specific autoantibodies in patients with immune-related adverse events involving the thyroid gland 甲状腺免疫相关不良事件患者体内的新型甲状腺特异性自身抗体
Thyroid Science Pub Date : 2024-02-01 Epub Date: 2024-01-14 DOI: 10.1016/j.thscie.2024.100009
Ichiro Yamauchi , Akihiro Yasoda , Takuro Hakata , Takafumi Yamashita , Keisho Hirota , Yohei Ueda , Toshihito Fujii , Daisuke Taura , Masakatsu Sone , Nobuya Inagaki
{"title":"Novel thyroid-specific autoantibodies in patients with immune-related adverse events involving the thyroid gland","authors":"Ichiro Yamauchi ,&nbsp;Akihiro Yasoda ,&nbsp;Takuro Hakata ,&nbsp;Takafumi Yamashita ,&nbsp;Keisho Hirota ,&nbsp;Yohei Ueda ,&nbsp;Toshihito Fujii ,&nbsp;Daisuke Taura ,&nbsp;Masakatsu Sone ,&nbsp;Nobuya Inagaki","doi":"10.1016/j.thscie.2024.100009","DOIUrl":"https://doi.org/10.1016/j.thscie.2024.100009","url":null,"abstract":"<div><h3>Aims</h3><p>Programmed cell death-1 (PD-1) blockade therapy frequently results in immune-related adverse events involving the thyroid gland (thyroid irAEs). Although clinical features of thyroid irAEs are known, the mechanisms remain unclear. Here, we conducted a pilot study to investigate mechanisms of thyroid irAE development from the perspective of autoantibodies.</p></div><div><h3>Methods</h3><p>We performed immunoprecipitation-based assays using sera of 3 patients who developed thyroid irAEs with PD-1 blockade therapy by nivolumab and HEK293T cell lysates, including overexpressed proteins of interest (NKX2–1, PAX8, FOXE1, and HHEX; thyroid-specific transcriptional factors). The pellets were analyzed by western blot to detect the HiBit tag attached to the C-terminus of the proteins.</p></div><div><h3>Results</h3><p>Relevant changes to NKX2–1 bands were not seen in all 3 patients, but PAX8 bands were augmented in patient 2 with lung cancer and patient 3 with renal cell carcinoma. In addition, FOXE1 bands were augmented in patient 1 with malignant melanoma and patient 3, and a HHEX band was augmented in patient 3. Thus, we revealed novel thyroid-specific autoantibodies, PAX8Ab, FOXE1Ab, and HHEXAb. Expression patterns of the antigens recognized by these antibodies were not identical to the primary sites, so autoimmune responses in thyroid irAE may originate from the thyroid gland, and not the malignancy. Considering that TPOAb rather than TgAb is often negative in patients with thyroid irAEs, other mechanisms such as cytotoxic T cell and antigenicity of thyroglobulin may be involved.</p></div><div><h3>Conclusions</h3><p>Although the significance of these novel autoantibodies needs further examination, the present study provides new insights for thyroid autoimmunity.</p></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"1 1","pages":"Article 100009"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950300024000028/pdfft?md5=cea27a7a08c9a33f35c614e59570b18a&pid=1-s2.0-S2950300024000028-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139549007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Age-related reduction of the prevalence of ectopic intrathyroidal thymus in children and its size reduction with age 儿童甲状旁腺内异位胸腺患病率随年龄增长而降低及其大小随年龄增长而缩小
Thyroid Science Pub Date : 2024-02-01 Epub Date: 2023-12-20 DOI: 10.1016/j.thscie.2023.100004
Kenji Iwaku , Jaeduk Yoshimura Noh , Natsuko Watanabe , Kiminori Sugino , Koichi Ito
{"title":"Age-related reduction of the prevalence of ectopic intrathyroidal thymus in children and its size reduction with age","authors":"Kenji Iwaku ,&nbsp;Jaeduk Yoshimura Noh ,&nbsp;Natsuko Watanabe ,&nbsp;Kiminori Sugino ,&nbsp;Koichi Ito","doi":"10.1016/j.thscie.2023.100004","DOIUrl":"10.1016/j.thscie.2023.100004","url":null,"abstract":"<div><p>Ectopic intrathyroidal thymus in children refers to the failure of the thymus to descend from the thyroid during intrauterine development, and although rare, it presents with characteristic features on thyroid ultrasonography. The prevalence of ectopic intrathyroidal thymus and the changes in the size of intrathyroidal thymus over time were analyzed among 4130 children who underwent thyroid ultrasonography at the Ito Hospital from January 2003 to September 2015 (896 boys and 3234 girls; median age: 6 years [range: 0–15]). Male children (25 cases, 2.79%) more prominently demonstrated ectopic intrathyroidal thymus than female children (26 cases, 0.80%). The median age of the children with this condition was 6 years (range: 1–14 years), and the median maximum diameter of the ectopic thymus was 7.2 mm (range: 4.2–17.0 mm). The ectopic thymus was located in the right thyroid lobe in 24 (47.1%) cases, in the left thyroid lobe in 23 (45.1%) cases, and was bilateral in 4 (7.8%) cases. The prevalence decreased with age. The thymus size decreased by ≥ 20% in 11 (40.7%) cases, increased by ≥ 20% in 1 (3.7%) case, and changed in size (decreased or increased) by &lt; 20% in 15 (55.6%) cases among the 27 (52.9%) cases assessed for the changes in the sizes of ectopic intrathyroidal thymus glands over time. The ectopic intrathyroidal thymus decreases its prevalence with age. Additionally, the size of an ectopic intrathyroidal thymus frequently appears to decrease over time during follow-up of cases.</p></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"1 1","pages":"Article 100004"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950300023000046/pdfft?md5=c3d3ffc3708c66452cf797f676204f0e&pid=1-s2.0-S2950300023000046-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139020230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信
小红书