European Thyroid Journal最新文献_第2页

Intramuscular and subcutaneous levothyroxine: success in treating refractory hypothyroidism. 肌肉注射和皮下注射左甲状腺素：成功治疗难治性甲状腺功能减退症。

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-04-10 Print Date: 2025-04-01 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":"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 the feasibility of its delivery is difficult to organise within a healthcare 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: A 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 a 2.8 pmol/L increase in free T4 level (normal >5.14 pmol/L). She eventually achieved long-term euthyroid status at the 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 in administration. SC LT4 was trialled with success, and she has remained euthyroid for the last 6 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 the 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":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020460/pdf/","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":"OA","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. 胰岛素抵抗对孕妇甲状腺功能和甲状腺滤泡结节病患病率的影响

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-04-03 Print Date: 2025-04-01 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":"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 1,069 gravid participants of the Polish National Programme for Elimination of Iodine Deficiency (2007-2017), blood samples were analyzed for thyroid-stimulating hormone (TSH), FT3, FT4, aTPO, fasting glucose and insulin concentrations, and the thyroid structure was assessed with ultrasound (in 1,065 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 hormone 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":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002732/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of benign nodular thyroid disease: a nationwide survey of endocrine specialists in Spain. 良性结节性甲状腺疾病的管理：西班牙内分泌专家的全国调查。

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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002734/pdf/","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":"OA","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. 原发性先天性甲状腺功能减退症的遗传学：三十年的发现和持续的病因学挑战。

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. 增强放射性碘（RAI）在RAI难治性分化甲状腺癌中的掺入：最新见解。

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

Analysis of immediate 503 thyroid carcinoma deaths: trend of single institution in 2005-2024. 甲状腺癌即刻死亡503例分析：2005-2024年单一机构趋势

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-03-18 Print Date: 2025-04-01 DOI: 10.1530/ETJ-24-0368

Haruhiko Yamazaki, Kiminori Sugino, Kosuke Inoue, Ryohei Katoh, Kenichi Matsuzu, Wataru Kitagawa, Mitsuji Nagahama, Aya Saito, Koichi Ito

{"title":"Analysis of immediate 503 thyroid carcinoma deaths: trend of single institution in 2005-2024.","authors":"Haruhiko Yamazaki, Kiminori Sugino, Kosuke Inoue, Ryohei Katoh, Kenichi Matsuzu, Wataru Kitagawa, Mitsuji Nagahama, Aya Saito, Koichi Ito","doi":"10.1530/ETJ-24-0368","DOIUrl":"10.1530/ETJ-24-0368","url":null,"abstract":"Background: This study aimed to investigate the changes in histological types and causes of death associated with thyroid carcinoma (TC) before and after the introduction of systemic drug therapy.Methods: The records of 503 deceased patients treated for TC and with death from TC between January 2005 and June 2024 were reviewed in this retrospective cohort study. Multivariate logistic regression was applied to assess whether the number of patients with anaplastic TC (ATC) at diagnosis and the number of local-related deaths changed before and after the introduction of lenvatinib (i.e. 2005-2014 vs 2015-2024).Results: Of the 503 patients, 157 (31%) had ATC, 253 (50%) had papillary TC (PTC), 67 (13%) had follicular TC (FTC), 17 (3%) had poorly differentiated TC, and nine (2%) had medullary TC. Respiratory insufficiency was the most common fatal condition, occurring in 192 cases (38%), followed by local-related death in 98 cases (19%) and brain-related conditions in 22 cases (4%). We found no difference in the frequency of patients with ATC at diagnosis (32 vs 30%; P-value = 0.772) and the frequency of local-related deaths (19 vs 20%; P-value = 0.736) between 2005-2014 and 2015-2024. These findings were supported by multivariate logistic regression models that adjusted for other covariates (adjusted P-value = 0.436 and 0.353, respectively).Conclusions: ATC, including anaplastic transformation from PTC and FTC, still accounts for approximately 40% of thyroid cancer deaths after the introduction of systemic drug therapy. Respiratory insufficiency is the most common immediate cause of death.","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566412","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

Differentiation versus dysfunction: thyroid hormone, deiodinases and retinal photoreceptors. 分化与功能障碍：甲状腺激素、脱碘酶和视网膜光感受器。

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-03-12 Print Date: 2025-04-01 DOI: 10.1530/ETJ-24-0315

Lily Ng, Ye Liu, Young-Wook Cho, Hong Liu, Douglas Forrest

{"title":"Differentiation versus dysfunction: thyroid hormone, deiodinases and retinal photoreceptors.","authors":"Lily Ng, Ye Liu, Young-Wook Cho, Hong Liu, Douglas Forrest","doi":"10.1530/ETJ-24-0315","DOIUrl":"10.1530/ETJ-24-0315","url":null,"abstract":"A growing body of evidence has established that thyroid hormone (triiodothyronine, T3) is a key factor in the differentiation and survival of the light-sensing photoreceptors in the retina. These functions include a critical role in generating the cone photoreceptor diversity that is required for color vision. Here, we review some of these functions of T3 and the critical mechanisms that regulate the T3 signal in the mammalian retina. The provision of T3, the active form of thyroid hormone, is determined by developmentally rising levels of T3 and its precursor T4 (thyroxine) in the circulation and by intrinsic control within the retina itself by deiodinase enzymes that deplete or amplify the available level of T3. Dynamic profiles of inactivating (DIO3) and activating (DIO2) deiodinases suggest that the T3 signal is progressively calibrated throughout early development, maturation and later functional maintenance of the retina. However, the benefits of T3 come at a cost: photoreceptors are susceptible to impairment and cell death when T3 signaling becomes imbalanced. These findings have implications regarding the influence of T3 in retinal diseases.","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522948","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

Long-term outcomes of LT4/LT3 combination treatment for persistent hypothyroid symptoms. LT4/LT3联合治疗持续性甲状腺功能减退症状的长期疗效

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-03-04 Print Date: 2025-04-01 DOI: 10.1530/ETJ-24-0275

Birte Nygaard, Christian Zinck Jensen, Mads Jorsal, Bjarke Røssnes Medici, Rudi Steffensen, Allan Carle, Jeppe Lerche la Cour

{"title":"Long-term outcomes of LT4/LT3 combination treatment for persistent hypothyroid symptoms.","authors":"Birte Nygaard, Christian Zinck Jensen, Mads Jorsal, Bjarke Røssnes Medici, Rudi Steffensen, Allan Carle, Jeppe Lerche la Cour","doi":"10.1530/ETJ-24-0275","DOIUrl":"10.1530/ETJ-24-0275","url":null,"abstract":"Objective: Patients are increasingly using and requesting LT4/LT3 combination treatment for persistent hypothyroid symptoms, but the efficacy and side effects of long-term therapy remain largely unexplored. This study aimed to describe the patient group experiencing a long-lasting impact of LT4/LT3 and evaluate their quality of life (QoL) and hypothyroid symptoms.Method: We performed a cross-sectional study of 66 hypothyroid patients who had previously initiated LT4/LT3 combination therapy. The patients were grouped by current treatment into patients still receiving LT4/LT3 treatment (T3 responders) and patients who had discontinued LT3 treatment due to lack of effect (T3 non-responders). ThyPRO was used to evaluate QoL, and a validated symptom score was used to assess hypothyroid symptoms. The paper describes a real-life study that depicts unsatisfied patients as they are met in an outpatient clinic.Results: The participants had a median age of 56 and had initiated LT4/LT3 combination therapy 5.4 years ago. Fifty-four patients still received LT4/LT3 therapy and 12 patients had discontinued LT3 treatment due to lack of effect. Patients in the T3 responder group experienced a QoL comparable to the background population. Surprisingly, symptom scores in the T3 responder group were at the same levels as seen in Danish females with overt hypothyroidism. Thyoid stimulating hormone (TSH) in the T3 responder group was less than 0.4 mU/L in 38% of patients, indicating overtreatment.Conclusion: LT4/LT3 treatment was well-tolerated with no side effects and high QoL, but patients still experienced many symptoms.","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472335","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

An anatomic checklist for accurate staging of grossly invasive thyroid cancer. 严重侵袭性甲状腺癌准确分期的解剖检查表。

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-03-03 Print Date: 2025-04-01 DOI: 10.1530/ETJ-24-0289

Mark L Urken, Margaret Brandwein-Weber, Raymond L Chai, Mark Zafereo, Maisie Shindo, Joseph Scharpf, Jun Fan, Alex Silberzweig, Justin K Joseph, Ronald Ghossein, Ashok Shaha, Zubair Baloch, R Michael Tuttle

{"title":"An anatomic checklist for accurate staging of grossly invasive thyroid cancer.","authors":"Mark L Urken, Margaret Brandwein-Weber, Raymond L Chai, Mark Zafereo, Maisie Shindo, Joseph Scharpf, Jun Fan, Alex Silberzweig, Justin K Joseph, Ronald Ghossein, Ashok Shaha, Zubair Baloch, R Michael Tuttle","doi":"10.1530/ETJ-24-0289","DOIUrl":"10.1530/ETJ-24-0289","url":null,"abstract":"Objective: The final surgical pathology report follows the patient throughout their cancer journey. For locoregionally advanced cancers, lack of surgeon-pathologist communication can lead to understaging, adversely impacting management. Our study aims to improve the accuracy of staging grossly invasive thyroid cancer by introducing an anatomic checklist, enhancing surgeon-pathologist communication.Methods: We studied 35 consecutive patients with either gross extrathyroidal or extranodal extension, 29 of whom underwent primary resections requiring AJCC staging. Surgeon A initially only dictated an operative report. Surgeon B transmitted an anatomic checklist to the pathologist in addition to the standard operative note. Final pathology reports were reviewed for AJCC staging accuracy. Surgeon A transitioned to submission of an anatomic checklist for his final six cases.Results: 13 of the 14 final pathology reports without a checklist were understaged. All 15 cases with a surgeon completed anatomic checklist were accurately staged. There was a statistically significant improvement in the accuracy of staging reported in the final pathology reports when an anatomic checklist was submitted as compared to when it was not (P < 0.01, Fisher exact test, two-tailed). All final pathology reports for recurrent cases without a checklist failed to define the anatomic parts that were resected. The time to complete the checklist was less than 90 s.Conclusion: A surgeon-completed anatomic checklist allows pathologists to more accurately stage grossly invasive thyroid cancers. This rapidly completed form eliminates the need for pathologists to analyze the operative note and facilitates both risk of recurrence and AJCC stage determination.","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413923","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 primary congenital hypothyroidism: past, present and future. 原发性先天性甲状腺功能减退症的新生儿筛查：过去，现在和未来。

IF 3.5 2区医学

European Thyroid Journal Pub Date : 2025-03-03 Print Date: 2025-04-01 DOI: 10.1530/ETJ-24-0358

Francisca Grob, Samantha Lain, Antonella Olivieri

引用次数: 0