European Thyroid Journal最新文献

{"title":"ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism.","authors":"Marco Centanni, Leonidas Duntas, Ulla Feldt-Rasmussen, Josef Koehrle, Robin P Peeters, Salman Razvi, Pierpaolo Trimboli, Camilla Virili","doi":"10.1530/ETJ-25-0123","DOIUrl":"10.1530/ETJ-25-0123","url":null,"abstract":"<p><p>Sodium levothyroxine (LT4) as a monotherapy represents the mainstay of treatment of hypothyroidism, and its use has increased over time. Nevertheless, it faces several potential barriers in its 'real life' utilization, and hence its clinical effectiveness may be marred. This is suggested by the frequent situation of patients failing to reach the therapeutic goals of symptom relief and serum TSH control. Thus, an expert task force was approved by the Guidelines Board of the European Thyroid Association to examine the available data and to formulate recommendations based on the available evidence and the experts' deduction. The task force provides a body of suggestions to optimize the levothyroxine treatment in monotherapy, considering the key point in the individualization of treatment. Furthermore, the nutritional, pharmacological and pathological factors, potentially leading to the increased need for levothyroxine, are discussed, with a specific focus on the use of liquid and softgel formulations of the hormone.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk-adapted Therapy in Pediatric Thyroid Cancer: Initial Experience from a National Reference Program by the MET Group.","authors":"Michaela Kuhlen, Marina Kunstreich, Friederike Eilsberger, Kerstin Lorenz, Michael Abele, Ines B Brecht, Dominik T Schneider, Markus Luster, Antje Redlich","doi":"10.1530/ETJ-25-0035","DOIUrl":"https://doi.org/10.1530/ETJ-25-0035","url":null,"abstract":"<p><strong>Background: </strong>Pediatric differentiated thyroid carcinoma (pedDTC) is rare but increasingly prevalent, requiring multidisciplinary care to ensure optimal outcomes. In 2021, the Pediatric National Reference Program of the German Malignant Endocrine Tumor (MET) Registry was established to standardize the management of pedDTC, with a particular focus on radioactive iodine (RAI) use and minimizing treatment variability.</p><p><strong>Methods: </strong>This study evaluated the program's first 3.5 years, including 43 inquiries concerning 39 patients with confirmed or suspected pedDTC. A weekly national expert tumor board provided individualized recommendations based on multidisciplinary input and risk stratification. Data were analyzed for demographic trends, therapeutic decisions, and short-term outcomes.</p><p><strong>Results: </strong>Among 34 patients with confirmed pedDTC, RAI use was reduced or omitted in 70.6% of cases, particularly among low-risk patients, in alignment with the American Thyroid Association 2015 guidelines. Surgical strategies were modified in 61.5% of cases to balance disease control with treatment-related morbidity. No systemic medical therapy was recommended during initial management. At a mean follow-up of 0.7 years, all patients were alive; persistent disease was observed in 15.4%.</p><p><strong>Conclusions: </strong>The National Reference Program has successfully introduced a structured individualized approach to the management of pedDTC in Germany. Ongoing data collection and longer follow-up will be essential to assess the long-term impact of this centralized, risk-adapted model.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term exposure to PM1 and thyroid diseases in China.","authors":"Jing Wang, Di Teng, Kaijie Yang, Siying Liu, Cihang Lu, Zhongyan Shan, Weiping Teng, Yongze Li","doi":"10.1530/ETJ-25-0106","DOIUrl":"https://doi.org/10.1530/ETJ-25-0106","url":null,"abstract":"<p><strong>Background: </strong>Globally prevalent, thyroid diseases are linked to environmental factors like air pollution. This study examines the link between PM1 exposure and thyroid disease rates in China.</p><p><strong>Methods: </strong>We analyzed data from 73,900 adults across 31 Chinese provinces, using a high-resolution spatial‒temporal extremity tree model to estimate PM1 and PM2.5 levels, and thyroid function tests to assess disease prevalence. Multivariate-adjusted ORs evaluated PM1's link to thyroid disease. This cross-sectional study is adept at identifying associations but cannot establish causality due to its single-time data collection limitation.</p><p><strong>Results: </strong>Higher PM1 levels exposure were significantly linked to an increased prevalence of thyroid diseases, including overt hypothyroidism, autoimmune thyroiditis (AIT), and TgAb positivity. A linear dose‒response relationship was observed between PM1 concentration and both AIT and TgAb positivity. The study also revealed a significant association between PM1 exposure and autoimmune overt hypothyroidism, suggesting that thyroid dysfunction may be primarily mediated through autoimmune mechanisms. Additionally, Iodine status significantly influenced PM1's effects, with lower levels enhancing susceptibility to thyroid issues. Furthermore, every 1% increase in the PM1/PM2.5 ratio was related to the prevalence of overt hypothyroidism (OR, 1.03; 95% CI, 1.03-1.04) and Subclinical hypothyroidism (OR, 1.03; 95% CI, 1.03-1.04).</p><p><strong>Conclusions: </strong>PM1 exposure is associated with thyroid diseases, particularly AIT and TgAb positivity, with iodine status playing a modifying role. PM1 may be a key factor in PM2.5-related thyroid disease risk. Further prospective cohort studies are warranted to validate these findings.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiated thyroid cancer in two European referral centres: impact of different diagnostic and therapeutic strategies.","authors":"Daniele Ceruti, Petronella B Ottevanger, Simone De Leo, Han J Bonenkamp, Carla Colombo, Martin Gotthardt, Laura Fugazzola, Romana T Netea-Maier","doi":"10.1530/ETJ-25-0161","DOIUrl":"10.1530/ETJ-25-0161","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate differences in the presentation, diagnostic/therapeutic approaches and outcome of differentiated thyroid cancer (DTC) in an Italian and in a Dutch referral centre.</p><p><strong>Methods: </strong>We retrospectively included 919 patients (586 Italian, 333 Dutch), and compared the 2 cohorts as a whole, and according to ATA risk classes. Dynamic risk stratification (DRS) and Kaplan Meyer curves were used to compare progression free survival (PFS) and disease-specific survival (DSS).</p><p><strong>Results: </strong>Several differences (P <.001) were found in clinicopathological features and in diagnostic/therapeutic modalities. The Dutch cohort had a higher age at diagnosis, a higher number of patients presenting with metastatic disease, and patients with stage III/IV. Most Italian patients showed a low/intermediate ATA risk, while high risk patients represented half of the Dutch cohort. The Dutch cohort received a more intensive first treatment, and more additional treatments during follow up (i.e. surgery, radiotherapy, and systemic treatments). DRS analysis showed comparable excellent and biochemical incomplete responses, while the Dutch cohort had a lower rate of indeterminate and a higher rate of structural incomplete responses (P <.001). The Dutch cohort had a significantly worse 5-year PFS, and TC-related mortality was 10% and 1% for the Dutch and Italian cohort, respectively, in line with the higher rate of advanced disease at presentation, with DSS still excellent for both.</p><p><strong>Conclusions: </strong>Data reported in the present comparison between two European countries highlight a different prevalence, presentation and outcome of DTC, likely due to variabilities in health care systems, iodine nutritional status, diagnostic and treatments approaches.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient or permanent congenital hypothyroidism: from milestones to current and future perspectives.","authors":"Gaia Vincenzi, Ilenia Teresa Petralia, Marco Abbate, Maria Cristina Vigone","doi":"10.1530/ETJ-25-0019","DOIUrl":"https://doi.org/10.1530/ETJ-25-0019","url":null,"abstract":"<p><p>Primary congenital hypothyroidism (CH) is the most common endocrinopathy of developmental age. In recent years several studies from different countries have reported a significant increase in CH incidence detected by newborn screening programs, primarily \"mild\" forms of CH with gland in situ (GIS). However, more than one third of affected children with GIS present transient CH and recover endogenous thyroid function in early childhood, permitting the cessation of levothyroxine treatment by the end of the third year of life.Therefore, in CH patients with GIS, a clinical and biochemical reassessment is needed to determine whether the hypothyroidism is transient or permanent and to search for the underlying causes of the thyroid defect. Despite the presence of consensus guidelines for the management of CH in pediatric age, the screening strategy and management of the disease, especially at re-evaluation, differ significantly between centers and present some point of discussion.The following review summarizes the main pathophysiological mechanisms of transient and permanent forms of CH also underlining the importance of new genetic tools in order to guarantee to each patient the best diagnostic and therapeutical approach.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of treated hyper- and hypo-thyroidism and sociodemographic and geographic disparities in France in 2020.","authors":"Joël Coste, Laurence Mandereau-Bruno, Xavier Bertagna, Jean-Louis Wémeau","doi":"10.1530/ETJ-25-0041","DOIUrl":"10.1530/ETJ-25-0041","url":null,"abstract":"<p><strong>Background: </strong>Healthcare claims data are increasingly used to investigate the epidemiology of benign thyroid diseases. Here, we estimate the prevalence of treated hyper- and hypo-thyroidism and assess the potential sociodemographic and geographic disparities in France in 2020, given the country's poor epidemiological knowledge of these conditions.</p><p><strong>Methods: </strong>We used the French national healthcare data system, which covers nearly the entire population residing in France (over 67 million inhabitants in metropolitan and overseas departments). Prevalent cases were identified based on patients' long-term disease status, hospitalisation for hyper- and hypo-thyroidism and reimbursements for thyroid hormones, antithyroid drugs, iodine-131 and thyroid surgery. Thyroid-stimulating hormone, antithyroid antibodies and previous therapy for thyroid cancer and hyperthyroidism were considered to characterise the origin and surveillance of hypothyroidism.</p><p><strong>Results: </strong>In 2020, we identified 112,992 and 2,986,333 cases of treated hyper- and hypo-thyroidism, respectively, with an overall prevalence of 0.17 and 4.45 per 100 inhabitants. Marked differences were observed in terms of sex, age group and geographic area (department) for both conditions and deprivation level of the place of residence for hyperthyroidism only. The proportion of hypothyroidism following previous therapy for thyroid cancer or hyperthyroidism was less than 10%. Adequate monitoring (thyroid-stimulating hormone checked in the past year) occurred in 73.7% of hypothyroid subjects, with large variations across departments.</p><p><strong>Conclusions: </strong>This study provides prevalence estimates of treated hyper- and hypo-thyroidism at the national and departmental levels in France and improves epidemiological knowledge of both conditions. It also supports using healthcare claims data for their epidemiological surveillance.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter: 'why so many doses, and why now?'","authors":"Michaela Kuhlen, Marina Kunstreich, Friederike Eilsberger, Markus Luster, Antje Redlich","doi":"10.1530/ETJ-25-0155","DOIUrl":"10.1530/ETJ-25-0155","url":null,"abstract":"","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential of bone marrow mesenchymal stem cells in iodine-induced autoimmune thyroiditis therapy.","authors":"Xun Liu, Likun Cui, Jianwei Dong, Jiancong Ren, Dongdong Xu, Yanshuo Han, Jian Zhang","doi":"10.1530/ETJ-24-0137","DOIUrl":"10.1530/ETJ-24-0137","url":null,"abstract":"<p><strong>Objective: </strong>Hashimoto's thyroiditis (HT) is a prevalent autoimmune disease without a cure. Mesenchymal stem cells (MSCs) may offer the opportunity to improve autoimmune thyroiditis.</p><p><strong>Methods: </strong>We replicated the pathogenic factors of HT and established a stable autoimmune thyroiditis model in NOD.H-2h4 mice by administering iodine for 12 weeks. We used orthotopic injection to transplant bone MSCs (BMSCs) into the thyroid. Immunohistochemistry, enzyme-linked immunosorbent assay, flow cytometry, and hematoxylin and eosin and immunofluorescence staining were used to evaluate the effects of cell transplantation.</p><p><strong>Results: </strong>Orthotopic BMSC transplantation decreased serum thyroglobulin antibody and caspase 3 levels; increased proliferating cell nuclear antigen levels; decreased CD4+/CD3+ T cells, Th1/Th2, and Th17/Treg ratios; decreased TNF-alpha (a proinflammatory cytokine) and interferon-gamma levels; and increased transforming growth factor-beta and interleukin-10 levels. In addition, it increased CD90/S100A4 and CD90/TTF-1 co-expression.</p><p><strong>Conclusion: </strong>Orthotopic BMSC transplantation improved the inflammatory environment by regulating the secretion of anti-inflammatory cytokines, promoting regeneration, and reducing apoptosis in the thyroid tissue. Bone marrow-derived stem cells inhibited T cell activation, maintained a balance between T cell subpopulation ratios, and halted thyroiditis progression. Finally, transplanted BMSCs could transform into fibroblasts and thyroid cells. This study elucidated the pathogenesis of HT and provided evidence supporting the potential of MSCs in HT treatments.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of autoimmune thyroid disease on cognitive and psychiatric disorders: focus on clinical, pre-clinical and molecular studies.","authors":"Agnieszka Piekiełko-Witkowska, Monika K Duda, Joanna Bogusławska, Urszula Mackiewicz","doi":"10.1530/ETJ-24-0406","DOIUrl":"10.1530/ETJ-24-0406","url":null,"abstract":"<p><p>Autoimmune thyroid disease (AITD) is the most prevalent organ-specific autoimmune condition, encompassing Graves' disease (typically linked with hyperthyroidism) and Hashimoto's thyroiditis (generally associated with hypothyroidism). The growing body of evidence suggests that AITD can interfere with brain function. Here, we review the impact of AITD on cognition, mood, and psychiatric disorders by analysing data from clinical, animal, ex vivo and in vitro studies to reveal the molecular mechanisms by which AITD affects brain function. Most reports indicate a stronger association between cognitive impairments and hyperthyroidism (including AITD-related) than hypothyroidism. Both hypothyroidism and hyperthyroidism are linked with a higher risk of depression. At least some of those effects can be mediated by altered concentrations of T3 (3,3',5-triiodo-L-thyronine), which regulates gene expression in the brain microenvironment, affecting neurogenesis, angiogenesis, neurotransmitter release, and synaptic transmission. Diminished TSH (thyrotropin) signalling may also impair learning and memory by inhibiting the Wnt5a-β-catenin pathway. Thyroid disorders may also contribute to neurodegeneration by T3-mediated attenuation of amyloid-β elimination or TRH-induced formation of neurofibrillary tangles. Surprisingly, most clinical studies do not specify the immune origin of hypothyroidism or hyperthyroidism, therefore further studies involving large, well-characterised patient cohorts are needed to clarify the relationships between AITD and cognitive impairments and psychiatric disorders. Furthermore, data on the effect of anti-thyroid antibodies on brain function are scarce and inconclusive. Given the association between hyperthyroidism and an increased risk of dementia, cognitive impairment and mood disorders, adequate treatment and careful monitoring of AITD patients are essential to prevent the induction of exogenous hyperthyroidism.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insight into the metabolic shifts in Graves' hyperthyroidism: a study of acylcarnitine and lipid profiles.","authors":"Mikael Thomassen Neset, Arve Ulvik, Kristian Løvås, Johnny Laupsa-Borge, Lars Ertesvåg Breivik, Ann-Elin Meling Stokland, Bjørn Gunnar Nedrebø, Eyvind Rødahl, Eystein Husebye, Grethe Åstrøm Ueland, Hans Olav Ueland","doi":"10.1530/ETJ-25-0004","DOIUrl":"10.1530/ETJ-25-0004","url":null,"abstract":"<p><strong>Objective: </strong>Graves' disease increases metabolism and leads to net lipid degradation. Circulating acylcarnitines reflect lipid metabolism and the state of fatty acid oxidation in individuals. The aim of this study was to explore the lipid and acylcarnitine profiles in patients with Graves' disease.</p><p><strong>Methods: </strong>Seven lipids/apolipoproteins and 23 acylcarnitines were analysed in 100 newly diagnosed Graves' disease patients and validated in another 51 patients. Both groups were age- and sex-matched with healthy subjects.</p><p><strong>Results: </strong>The hyperthyroid Graves' disease patients (n = 88) from the main cohort (78 females, median age 42 (17-67) years) had significantly (P < 0.05) higher levels of medium- and long-chain acylcarnitines, and lower levels of short-chain acylcarnitines, compared with healthy subjects. Factor analysis showed that medium- and long-chain acylcarnitines explained most of the differences between the two groups. Serum levels of the five lipids/apolipoproteins were significantly lower in the hyperthyroid Graves' disease patients compared with healthy subjects. Patients (n = 21) treated with antithyroid drugs for 6 weeks had acylcarnitine levels closer to healthy subjects, compared with 79 treatment-naïve hyperthyroid patients. The main findings were confirmed in the validation group.</p><p><strong>Conclusion: </strong>Increased levels of medium- and long-chain acylcarnitines in patients with newly diagnosed Graves' disease may reflect accelerated catabolism. Lower levels of short-chain acylcarnitines point to Graves' disease being a catabolic condition, with a shift in energy source from carbohydrates to fat.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}