European Thyroid Journal最新文献

Management of benign nodular thyroid disease: a nationwide survey of endocrine specialists in Spain.

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-04-01 DOI: 10.1530/ETJ-24-0313

Juan J Díez, Juan C Galofré

{"title":"Management of benign nodular thyroid disease: a nationwide survey of endocrine specialists in Spain.","authors":"Juan J Díez, Juan C Galofré","doi":"10.1530/ETJ-24-0313","DOIUrl":"10.1530/ETJ-24-0313","url":null,"abstract":"Background: Management of benign nodular thyroid disease (BNTD) has changed dramatically over the past two decades, as reflected by international guideline recommendations.Purpose: We sought to document the preferences regarding the management of euthyroid BNTD among thyroid-dedicated members of the Spanish Society of Endocrinology and Nutrition (SEEN) and assess the extent to which present international guideline recommendations have been incorporated into ordinary practice.Methods: An online survey on the management of a standard case of BNTD among SEEN thyroid experts and exploration of variations in management following different clinical scenarios, in which variables such as sex, age, ultrasound characteristics, fine needle aspiration results or patient preferences change.Results: Two hundred and eleven (9% SEEN members) participated in the survey. Most of them, 147 (69.7%), recommended periodic monitoring, 43 (20.3%) surgery and 21 (10.0%) minimally invasive procedures (MIP). No participant opted for levothyroxine or radioiodine. Management of BNTD was modified based on patient preferences, both in favour of more aggressive (surgery) and more conservative (MIP or monitoring) options.Conclusions: The vast majority of Spanish thyroidologists followed the international guideline recommendations for BNTD management. The trend shows the positive impact of the guideline recommendations with a shift towards more conservative management, taking into account patient preference as a binding element in therapeutic decision-making.","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673815","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}

引用次数: 0

Genetics of primary congenital hypothyroidism: three decades of discoveries and persisting etiological challenges.

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-03-28 Print Date: 2025-04-01 DOI: 10.1530/ETJ-24-0348

Athanasia Stoupa, Aurore Carré, Michel Polak, Gabor Szinnai, Nadia Schoenmakers

引用次数: 0

Enhancing radioactive iodine (RAI) incorporation in RAI-refractory differentiated thyroid cancer: current insights.

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-03-24 Print Date: 2025-04-01 DOI: 10.1530/ETJ-24-0319

Tomo Hiromasa, Hiroshi Wakabayashi, Satoru Watanabe, Takafumi Yamase, Seigo Kinuya

引用次数: 0

Intramuscular and Subcutaneous Levothyroxine: Success in Treating Refractory Hypothyroidism.

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-03-01 DOI: 10.1530/ETJ-25-0012

Nadia Chaudhury, Winston Crasto, Ponnusamy Saravanan, Vinod Patel

{"title":"Intramuscular and Subcutaneous Levothyroxine: Success in Treating Refractory Hypothyroidism.","authors":"Nadia Chaudhury, Winston Crasto, Ponnusamy Saravanan, Vinod Patel","doi":"10.1530/ETJ-25-0012","DOIUrl":"https://doi.org/10.1530/ETJ-25-0012","url":null,"abstract":"Introduction: Refractory hypothyroidism often poses a clinical problem as treatment regimens are difficult to individualise to the patient and feasibility of its delivery is difficult to organise within a health care system. We present a patient who became intolerant of intramuscular (IM) levothyroxine (LT4) after 18 years of treatment, thus subcutaneous (SC) LT4 was initiated.Case presentation: 13-year-old female with newly-diagnosed hypothyroidism, remained hypothyroid despite escalating doses of oral LT4 and LT3. Thyroxine malabsorption was further suggested by nasogastric administration of LT4, whereby high dose thyroxine administration resulted in only 2.8 pmol/L increase in free T4 level (normal >5.14pmol/L). She eventually achieved long-term euthyroid status at age of 18 with fortnightly IM LT4, alongside oral LT4 and LT3. This was maintained for 18 years. Unfortunately, scar tissue developed around injection sites, resulting in increased pain and difficulty of administration. SC LT4 was trialled with success, and she has remained euthyroid for the last six years with self-administration and minimal side effects.Conclusion: Refractory hypothyroidism often presents a challenge for clinicians, both for diagnosis and management. We discuss a patient with longest follow-up to-date within the published literature for both IM and SC LT4 for patient-administered treatment of refractory hypothyroidism and review the literature on alternative formulations available.","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751799","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}

引用次数: 0

The Impact of Insulin Resistance on Thyroid Function and the Prevalence of Thyroid Follicular Nodular Disease in Pregnant Women.

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-03-01 DOI: 10.1530/ETJ-24-0317

Andrzej Nowak, Jacek Podlewski, Alicja Hubalewska-Dydejczyk, Małgorzata Trofimiuk-Müldner

{"title":"The Impact of Insulin Resistance on Thyroid Function and the Prevalence of Thyroid Follicular Nodular Disease in Pregnant Women.","authors":"Andrzej Nowak, Jacek Podlewski, Alicja Hubalewska-Dydejczyk, Małgorzata Trofimiuk-Müldner","doi":"10.1530/ETJ-24-0317","DOIUrl":"https://doi.org/10.1530/ETJ-24-0317","url":null,"abstract":"Introduction: Insulin resistance (IR) is a phenomenon commonly observed in pregnancy. Increased insulin concentrations might impact thyroid function and structure during gestation.Objectives: This study investigates the bidirectional relationship between IR indices and thyroid function and morphology in pregnant women.Methods: In 1069 gravid participants of the Polish National Programme for Elimination of Iodine Deficiency (2007-2017), blood samples were analyzed for TSH, FT3, FT4, aTPO, fasting glucose, and insulin concentrations, and the thyroid structure was assessed with ultrasound (in 1065 subjects). Based on calculated Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) values, participants were stratified into two subgroups: HOMA-nl (HOMA-IR <2.5) and HOMA-h (HOMA-IR ≥2.5) comprising 894, and 175 women, respectively.Results: Significant difference in mean TSH (1.77 ± 1.17 vs 1.96 ±1.04; P=0.008) and mean FT4 (12.65± 2.3 vs 11.47±1.9; P=0.001) concentrations between HOMA-nl and HOMA-h groups was found. The subgroups did not differ in thyroid nodularity or multinodular goiter prevalence. HOMA-IR positively correlated with TSH concentrations, BMI, and thyroid volume. Serum FT3 and FT4 concentrations showed negative correlations with HOMA-IR.Conclusions: IR seems to affect the thyroid function of gravid women by diminishing the ability to respond to increased thyroid hormones (TH) demand. Thyroid volume increase during pregnancy may be influenced by IR, however, its short-term effect on thyroid nodularity appears to be negligible.","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656701","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}

引用次数: 0

Anticancer Drug Therapy for Anaplastic Thyroid Cancer.

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-03-01 DOI: 10.1530/ETJ-24-0287

Naomi Kiyota, Taiji Koyama, Iwao Sugitani

引用次数: 0

CHANGING THE PARADIGM: LOBECTOMY FOR SPORADIC MEDULLARY THYROID CANCER.

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-03-01 DOI: 10.1530/ETJ-25-0040

Marina Lugaresi, Claudia Moneta, Giulia Saruggia, Gianlorenzo Dionigi, Giacomo Gazzano, Laura Fugazzola

{"title":"CHANGING THE PARADIGM: LOBECTOMY FOR SPORADIC MEDULLARY THYROID CANCER.","authors":"Marina Lugaresi, Claudia Moneta, Giulia Saruggia, Gianlorenzo Dionigi, Giacomo Gazzano, Laura Fugazzola","doi":"10.1530/ETJ-25-0040","DOIUrl":"https://doi.org/10.1530/ETJ-25-0040","url":null,"abstract":"Objectives: Total thyroidectomy is the treatment of choice for medullary thyroid cancer (MTC) though the sporadic forms are usually monocentric. Aim of the present study was to evaluate a) the performance of calcitonin (Ct) levels, ultrasound scans (US), and cytology in the preoperative identification of MTC and b) the number of total thyroidectomies that could have been avoided being the location of the MTC diagnosed preoperatively.Materials and methods: We retrospectively analysed 89 RET germline negative patients diagnosed with MTC in the last 30 years, treated with total thyroidectomy ± lymphadenectomy, and followed in our Tertiary Care Center. In a subgroup of 55 patients, divided in those with a mono- or bilateral goiter, we applied ex-post criteria for the pre-surgical identification of the lobe holding the MTC nodule.Results: Only 2/89 patients (2.2%) had a bilateral MTC at histology. A strongly significant correlation was found between preoperative basal Ct levels and MTC size. According to the ex-post identification criteria, the 84.4% and 56.5% of the nodules would have been identified preoperatively as MTC, in monolateral and bilateral goiters respectively.Conclusions: This is the first European study that aims to evaluate the feasibility of lobectomy as first line therapy for MTC based on the evaluation of thyroid US, and serum Ct levels. These tools have been shown to have a good accuracy in detecting the affected lobe and strongly support the possibility to perform a more conservative surgery to treat RET-negative patients with suspicious MTC and nodular goiter.","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751797","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}

引用次数: 0

Pediatric differentiated thyroid carcinoma leading to fatal lung fibrosis.

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-02-24 Print Date: 2025-02-01 DOI: 10.1530/ETJ-24-0341

Michaela Kuhlen, Marina Kunstreich, Friederike Eilsberger, Markus Luster, Antje Redlich

{"title":"Pediatric differentiated thyroid carcinoma leading to fatal lung fibrosis.","authors":"Michaela Kuhlen, Marina Kunstreich, Friederike Eilsberger, Markus Luster, Antje Redlich","doi":"10.1530/ETJ-24-0341","DOIUrl":"10.1530/ETJ-24-0341","url":null,"abstract":"Introduction: This case report aims to discuss the development of fatal lung fibrosis in a young boy following treatment of metastasized differentiated thyroid carcinoma (DTC).Case presentation: A 3.6-year-old boy was diagnosed in year 1995 with papillary thyroid carcinoma with extensive metastases. He underwent total thyroidectomy and received multiple courses of radioactive iodine (RAI) therapy between September 1995 and February 1998. The patient received six courses of RAI therapy within 30 months, cumulatively amounting to 10 GBq 131I, in response to significantly elevated thyroglobulin levels and morphologically persistent miliary lung metastases. Despite the significant regression of his metastatic disease, the patient exhibited progressive lung fibrosis 2.75 years after the sixth RAI therapy. This condition ultimately led to respiratory failure and resulted in the patient's death 6.7 years following the initial diagnosis.Discussion/conclusion: This case highlights the potential severe complications associated with several courses of RAI therapy in young children suffering from extensive lung metastases and underscores the need for careful treatment planning and long-term monitoring. Given the risks of RAI therapy, particularly the risk of fatal lung fibrosis, it is crucial to tailor RAI therapy carefully, especially in young patients. Notably, thyroglobulin levels can decrease even after cessation of RAI therapy, indicating that levels immediately post-therapy are not necessarily representing the development of the response over the following months.","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":"14 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536708","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}

引用次数: 0

Newborn screening for central congenital hypothyroidism: past, present and future.

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-02-19 Print Date: 2025-02-01 DOI: 10.1530/ETJ-24-0329

Mark R Garrelfs, Christiaan F Mooij, Anita Boelen, A S Paul van Trotsenburg, Nitash Zwaveling-Soonawala

{"title":"Newborn screening for central congenital hypothyroidism: past, present and future.","authors":"Mark R Garrelfs, Christiaan F Mooij, Anita Boelen, A S Paul van Trotsenburg, Nitash Zwaveling-Soonawala","doi":"10.1530/ETJ-24-0329","DOIUrl":"10.1530/ETJ-24-0329","url":null,"abstract":"Congenital hypothyroidism (CH) is defined as thyroid hormone deficiency at birth and constitutes one of the most common causes of preventable intellectual disability worldwide. Central CH is caused by insufficient pituitary or hypothalamic control of thyroid function, biochemically characterized by a low serum free thyroxine (fT4), in combination with a low, normal or mildly elevated thyroid-stimulating hormone (TSH). Central CH is less common than primary CH and is part of multiple pituitary hormone deficiencies (MPHD) in most of the cases. MPHD at birth, also known as 'congenital hypopituitarism', is a potentially life-threatening condition due to the possible co-occurrence of adrenocorticotropin hormone and growth hormone deficiency that can result in severe hypoglycemia and adrenal crisis. To date, central CH is the only pituitary hormone deficiency suitable for newborn screening (NBS), providing an opportunity for early detection of MPHD. Even though the first NBS programs utilized T4-based methods that were able to identify central CH, most countries have since transitioned to TSH-based approaches due to the high rate of false positives associated with T4-based strategies. Now, 50 years after the introduction of NBS for CH, only a few countries around the world have a screening program capable of detecting central CH. In this paper, we review the past, present and future of NBS for central CH. We will outline the importance of early detection of central CH and discuss the challenges and opportunities of screening for this condition.","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364161","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}

引用次数: 0

Higher prevalence of gestational diabetes in euthyroid women with thyroid autoimmunity who were expecting a female fetus.

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-02-17 Print Date: 2025-02-01 DOI: 10.1530/ETJ-24-0339

Madhu Prasai, Manon Lomré, Emna Jelloul, Pierre Kleynen, Flora Veltri, Georgiana Sitoris, Lidia Grabczan, Serge Rozenberg, Kris G Poppe

{"title":"Higher prevalence of gestational diabetes in euthyroid women with thyroid autoimmunity who were expecting a female fetus.","authors":"Madhu Prasai, Manon Lomré, Emna Jelloul, Pierre Kleynen, Flora Veltri, Georgiana Sitoris, Lidia Grabczan, Serge Rozenberg, Kris G Poppe","doi":"10.1530/ETJ-24-0339","DOIUrl":"10.1530/ETJ-24-0339","url":null,"abstract":"Objective: In the general population, women pregnant with a male fetus (MF) have a higher prevalence of gestational diabetes mellitus (GDM) compared with those pregnant with a female fetus (FF). Some studies suggest a higher prevalence of GDM in euthyroid pregnant women with thyroid autoimmunity (TAI+) compared with women without TAI (TAI-). However, whether the impact of TAI on GDM correlates with fetal gender has not been documented.Design/methods: A single-center cohort study including 1201 women who were screened at a median of 12 (11-14) weeks of pregnancy for thyroid disorders (TSH, free T4 and thyroid peroxidase antibodies (TPOAb)) and at 24-28 weeks for GDM with an oral glucose tolerance test. Exclusion criteria were pre-pregnancy diabetes or hypertension, thyroid dysfunction (treated or untreated) before and after screening, thyroid screening after 20 weeks of pregnancy and assisted pregnancies. The diagnosis of GDM was based on the 2013 WHO criteria, and that of TAI by increased TPOAb levels (≥60 kIU/L).Results: Overall, 622 women were expecting a FF (51.8%) and 579 a MF (48.2%). Seventy-five women were TAI+ (6.2%). The overall prevalence of GDM was 19.6%, 28% in TAI+ women and 19% in TAI- women (P = 0.008 after adjustment for confounders). In women who were expecting a FF, the prevalence of GDM was 34.4% in TAI+ women vs 19.2% in TAI- women; P = 0.002.Conclusions: The prevalence of GDM was increased in euthyroid TAI+ women, but only in the case of pregnancies with a FF. This is opposite to the result observed in the general population and deserves more research to explore the underlying mechanisms.","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070768","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}

引用次数: 0