European Thyroid Journal最新文献

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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
{"title":"Enhancing radioactive iodine (RAI) incorporation in RAI-refractory differentiated thyroid cancer: current insights.","authors":"Tomo Hiromasa, Hiroshi Wakabayashi, Satoru Watanabe, Takafumi Yamase, Seigo Kinuya","doi":"10.1530/ETJ-24-0319","DOIUrl":"10.1530/ETJ-24-0319","url":null,"abstract":"<p><p>Metastatic differentiated thyroid cancer (DTC) is responsible for most thyroid cancer-related deaths, with an even worse prognosis for patients with radioactive iodine (RAI)-refractory DTC (RAIR-DTC). While multikinase inhibitors (MKIs) and tyrosine kinase inhibitors (TKIs) offer effective treatments for RAIR-DTC, most patients remain noncurative and eventually experience disease progression. In addition, long-term use of these medications is hindered by adverse events, drug resistance and high cost. Recently, the use of MKIs and TKIs has reignited interest in enhancing RAI incorporation. This approach aims to restore the effectiveness of RAI therapy in patients with RAIR-DTC by using agents that increase RAI uptake, potentially overcoming current treatment challenges. This review covers the molecular mechanisms behind RAI resistance, the definition of RAIR-DTC and the efforts to enhance RAI incorporation through various agents, including those currently undergoing clinical trials.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604433","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
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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","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":"<p><p>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.</p>","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":"<p><strong>Objective: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>LT4/LT3 treatment was well-tolerated with no side effects and high QoL, but patients still experienced many symptoms.</p>","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":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","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
{"title":"Newborn screening for primary congenital hypothyroidism: past, present and future.","authors":"Francisca Grob, Samantha Lain, Antonella Olivieri","doi":"10.1530/ETJ-24-0358","DOIUrl":"10.1530/ETJ-24-0358","url":null,"abstract":"<p><p>This manuscript reviews the evolution of newborn screening for primary congenital hypothyroidism (CH) and explores future strategies to enhance diagnostic accuracy. Over the past few decades, newborn screening has expanded globally, significantly reducing the incidence of severe forms of the disease. However, challenges persist, especially regarding the overdiagnosis of mild cases of primary CH, which may not require treatment. Omic sciences may help researchers to enhance the understanding of primary CH and to uncover new biomarkers to identify mild cases with altered proteomic and/or metabolic profiles associated with the need for treatment. Record-linkage studies can help deepen knowledge on the long-term outcomes of affected children identified through newborn screening. Nevertheless, despite 50 years of newborn screening for primary CH, a minority of newborns currently benefit from this critically important public health intervention. Efforts should be done to expand access to newborn screening globally, especially for those born in developing countries.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":"14 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540797","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
Comparison of short-term outcomes following minimally invasive (endoscopic/robotic) vs open thyroidectomy for patients with thyroid cancer. 微创(内镜/机器人)与开放式甲状腺切除术对甲状腺癌患者短期疗效的比较
IF 3.5 2区 医学
European Thyroid Journal Pub Date : 2025-03-03 Print Date: 2025-04-01 DOI: 10.1530/ETJ-24-0134
Tingting Li, Yu Gui, Xiang Cui, Xin Wu, Xi Yang, Jing Liu, Shichao Li, Li Chen
{"title":"Comparison of short-term outcomes following minimally invasive (endoscopic/robotic) vs open thyroidectomy for patients with thyroid cancer.","authors":"Tingting Li, Yu Gui, Xiang Cui, Xin Wu, Xi Yang, Jing Liu, Shichao Li, Li Chen","doi":"10.1530/ETJ-24-0134","DOIUrl":"10.1530/ETJ-24-0134","url":null,"abstract":"<p><strong>Background: </strong>Selection between open thyroidectomy (OT) and minimally invasive (endoscopic/robotic) thyroidectomy for patients with thyroid cancer has been a subject of considerable debate. Comprehensive analysis of the short-term outcomes of endoscopic thyroidectomy (ET), robotic-assisted thyroidectomy (RT) and open thyroidectomy (OT) for thyroid cancer using a large-scale dataset is important.</p><p><strong>Methods: </strong>This cohort study evaluated the outcomes of patients receiving ET, RT or OT for thyroid cancer from January 1, 2003, to December 31, 2022. Propensity score matching (PSM) was performed among patients treated with ET, RT or OT to balance covariates distribution. This study involved single-institution patients (aged 18-70) who had undergone ET, RT or OT for thyroid cancer.</p><p><strong>Results: </strong>The study included 11,066 thyroid cancer patients (OT group- mean (SD) age: 42.45 (10.84) years; ET group- mean (SD) age: 36.75 (9.32) years and RT group- mean (SD) age: 40.27 (10.42) years). After PSM for demographic and clinical characteristics, 908 matched pairs of patients (ET vs OT) and 1480 matched pairs (RT vs OT) were included for further analysis. Complication analysis revealed that RT was associated with a lower rate of transient hypoparathyroidism (339 (22.9%) vs 687 (46.4%); P < 0.001), a lower rate of permanent hypoparathyroidism (4 (0.3%) vs 16 (1.1%); P = 0.012) and a lower rate of transient recurrent laryngeal nerve injury (63 (4.3%) vs 89 (6.0%); P = 0.037).</p><p><strong>Conclusion: </strong>This cohort study analyzed the short-term outcomes between ET, RT and OT in a large sample of patients with thyroid cancer over a period of two decades. PSM provided a comparable cohort, and the results suggested the advantage of RT, which reduced Clavien-Dindo grade Ⅰ complications in the surgical treatment of thyroid cancer.</p>","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/PMC11896686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022657","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
Pediatric differentiated thyroid carcinoma leading to fatal lung fibrosis. 小儿分化型甲状腺癌导致致死性肺纤维化。
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":"<p><strong>Introduction: </strong>This case report aims to discuss the development of fatal lung fibrosis in a young boy following treatment of metastasized differentiated thyroid carcinoma (DTC).</p><p><strong>Case presentation: </strong>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.</p><p><strong>Discussion/conclusion: </strong>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.</p>","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. 中枢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 : 2025-02-19 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":"<p><p>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.</p>","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. 妊娠期糖尿病在甲状腺功能正常且有甲状腺自身免疫的孕妇中发病率较高。
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":"<p><strong>Objective: </strong>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.</p><p><strong>Design/methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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
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