Mats Holmberg, Helge Malmgren, Peter F Berglund, Birgitta Johansson, Helena Filipsson Nyström
{"title":"Psychiatric complications in Graves' disease.","authors":"Mats Holmberg, Helge Malmgren, Peter F Berglund, Birgitta Johansson, Helena Filipsson Nyström","doi":"10.1530/ETJ-23-0247","DOIUrl":"10.1530/ETJ-23-0247","url":null,"abstract":"<p><strong>Background: </strong>Mood disorders are common in Graves' disease despite treatment. The pathogenic mechanisms involved are unknown and so is whether previous psychiatric disease influences these symptoms.</p><p><strong>Methods: </strong>This is a longitudinal study conducted in Sweden on 65 women with newly diagnosed Graves' disease and 65 matched controls. Participants were examined during hyperthyroidism and after 15 months of treatment. Examinations included blood sampling, and psychiatric testing with the Comprehensive Psychopathological Rating Scale for Affective Syndromes and the Structured Clinical Interview for DSM-IV - Axis I Disorders. We also performed two analyses of a national population-based registry to determine previous psychiatric diagnoses and previous prescriptions of psychoactive drugs in (i) all patients we asked to participate and (ii) all Swedish women given a diagnosis of hyperthyroidism during 2013-2018, comparing them to matched controls.</p><p><strong>Results: </strong>There was no increased previous psychiatric comorbidity in Graves' patients compared to controls. There was no higher prevalence of psychiatric diagnoses and prescriptions of psychoactive drugs between (i) included GD patients compared to those who declined participation and (ii) women with a hyperthyroidism diagnosis in 5 years prior to their diagnosis, compared to matched controls. Depression scores and anxiety scores were higher in patients compared to controls both during hyperthyroidism (depression (median (IQR): 7.5 (5.0-9.5) vs 1.0 (0.5-2.5) P < 0.001), anxiety: 7.7 (5.0-11) vs 2.5 (1.0-4.0) P < 0.001) and after treatment (depression: 2.5 (1.5-5.0) vs 1.5 (0.5-3.5) P < 0.05), anxiety: 4.0 (2.5-7.5) vs 3.0 (1.5-5.0) P < 0.05). Patients with a previous psychiatric condition, mild eye symptoms, and a younger age had more anxiety at 15 months compared to patients without these symptoms and a higher age (all p<0.05).</p><p><strong>Conclusion: </strong>Graves' disease affects patients' mood despite treatment. A previous psychiatric condition, mild eye symptoms, and a younger age increase the vulnerability for long-lasting symptoms and require specific attention.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139432364","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}
Rodrigo Moreno-Reyes, Ulla Feldt-Rasmussen, Agnieszka Piekiełko-Witkowska, Adriana Gaspar da Rocha, Corin Badiu, Josef Koehrle, Leonidas Duntas
{"title":"The ETA-ESE statement on the European Chemicals Agency opinion on iodine as an endocrine disruptor.","authors":"Rodrigo Moreno-Reyes, Ulla Feldt-Rasmussen, Agnieszka Piekiełko-Witkowska, Adriana Gaspar da Rocha, Corin Badiu, Josef Koehrle, Leonidas Duntas","doi":"10.1530/ETJ-23-0244","DOIUrl":"10.1530/ETJ-23-0244","url":null,"abstract":"<p><p>In 2022, the European Chemicals Agency (ECHA) made a statement concluding that iodine is an endocrine disruptor (ED). \"We stress the fact that the ECHA opinion ECHA/BPC/357/2022 is based on their misguidedly zooming in on exclusively the biocidal products (e.g., hand disinfectants, disinfection of animals' teats/udder, embalming fluids before cremation, etc.) that contain molecular iodine (I2), entirely neglecting [see the 2013 ECHA Regulation (EU) n°528/2012 describing iodine as being of \"great importance for human health\". Clearly, the current sweeping and erroneous classification of \"iodine\" as an endocrine disruptor is ill-advised. We moreover call upon the scientific and medical community at large to use the accurate scientific nomenclature, i.e., iodide or iodate instead of \"iodine\" when referring to iodized salts and food prepared there with. Drugs, diagnostic agents, and synthetic chemicals containing the element iodine in the form of covalent bonds must be correctly labelled ''iodinated'', if possible, using each time their distinctive and accurate chemical or pharmacological name.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10959048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697229","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 diagnostic value of GICA used for intraoperative lymph node FNA-Tg measurement to evaluate thyroid cancer metastases.","authors":"Shaodong Hou, Yiceng Sun, Zeyu Yang, Mi Tang, Tingjie Yin, Cong Shao, Cunye Yan, Linlong Mo, Yuquan Yuan, Supeng Yin, Fan Zhang","doi":"10.1530/ETJ-23-0182","DOIUrl":"10.1530/ETJ-23-0182","url":null,"abstract":"<p><strong>Objective: </strong>It is crucial to diagnose lymph node (LN) metastases (LNM) before or during thyroid carcinoma surgery. Measurement of thyroglobulin (Tg) in the fine needle aspirate washout (FNA-Tg) is useful to assist in the diagnosis of LNM for papillary thyroid carcinoma (PTC). This study aimed to assess the diagnostic performance of a new technique based on a colloidal gold-based immunochromatographic assay (GICA) for intraoperative FNA-Tg in diagnosing LNM.</p><p><strong>Clinical trial information: </strong>This study is registered with chictr.org.cn, ID: ChiCTR2200063561 (registered 11 September, 2022).</p><p><strong>Methods: </strong>This prospective study enrolled 51 PTC patients who underwent cervical LN dissection. A total of 150 LNs dissected from the central and lateral compartments were evaluated by FNA-Tg-GICA at three different time points and compared with frozen sections and the conventional Tg measurement method electrochemiluminescence immunoassay (ECLIA). Receiver operating characteristic curve (ROC) and area under the curve (AUC), cutoff value to discriminate benign and malignant LNs, sensitivity, specificity, and accuracy were provided.</p><p><strong>Results: </strong>The cutoff value of FNA-Tg to predict LNM was 110.83 ng/mL for ECLIA and 13.19 ng/mL, 38.69 ng/mL, and 77.17 ng/mL for GICA at 3, 10, and 15 min, respectively. There was no significant difference between the AUCs of GICA at different time points compared to using ECLIA and frozen sections. Besides, the diagnostic performance of GICA and ECLIA showed no significant difference in evaluating LNM from central and lateral compartments or between the TgAb-positive subgroup and TgAb-negative subgroup.</p><p><strong>Conclusion: </strong>GICA is a promising method for intraoperative FNA-Tg measurement and has high value in predicting LNM. It may be a novel alternative or supplementary method to frozen section or ECLIA.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106078","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}
Emilie Brûlé, Xiang Zhou, Ying Wang, Evan R S Buddle, Luisina Ongaro, Mary Loka, Anita Boelen, Daniel Bernard
{"title":"The hypothalamic-pituitary-thyroid axis is intact in male insulin receptor substrate 4 knockout mice.","authors":"Emilie Brûlé, Xiang Zhou, Ying Wang, Evan R S Buddle, Luisina Ongaro, Mary Loka, Anita Boelen, Daniel Bernard","doi":"10.1530/ETJ-23-0054","DOIUrl":"10.1530/ETJ-23-0054","url":null,"abstract":"<p><strong>Objective: </strong>Loss of function mutations in the insulin receptor substrate 4 (IRS4) gene cause a rare form of X-linked congenital central hypothyroidism in boys and men. Affected individuals show decreased thyroid-stimulation hormone (TSH) secretion. Members of the IRS family canonically act as scaffold proteins between tyrosine kinase receptors and downstream effectors. How loss of IRS4 affects TSH synthesis or secretion is unresolved. We therefore assessed IRS4's role in the hypothalamic-pituitary-thyroid axis of Irs4 knockout mice.</p><p><strong>Methods: </strong>We generated two global Irs4 knockout mouse lines harboring either two or four base-pair deletions that result in frameshifts and loss of most of the IRS4 protein.</p><p><strong>Results: </strong>Under normal laboratory conditions, Irs4 knockout males did not exhibit impairments in pituitary expression of TSH subunit genes (Tshb or Cga) or in the thyrotropin-releasing hormone (TRH) receptor. Additionally, their serum thyroid hormone, T3 (triiodothyronine) and T4 (thyroxine), and hypothalamic Trh expression levels were normal. When Irs4 knockouts were rendered hypothyroid with a low-iodine diet supplemented with propylthiouracil (PTU) for 3 weeks, their serum TSH increased similarly to wild-type males.</p><p><strong>Conclusions: </strong>Overall, Irs4 knockout mice do not exhibit central hypothyroidism or otherwise appear to phenocopy IRS4 deficient patients. Compensation by another IRS protein may explain euthyroidism in these animals.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139563315","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}
Grace Segall, Ravinder Singh, Min-Hua Jen, Isaac Sanderson, Alex Rider, Katie Lewis, Urpo Kiiskinen
{"title":"Real-world clinical profile, RET mutation testing, treatments, and PROs for MTC in Europe.","authors":"Grace Segall, Ravinder Singh, Min-Hua Jen, Isaac Sanderson, Alex Rider, Katie Lewis, Urpo Kiiskinen","doi":"10.1530/ETJ-23-0172","DOIUrl":"10.1530/ETJ-23-0172","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe real-world patient and physician characteristics, rearranged during transfection (RET) mutation testing and results, treatment patterns, and patient-reported outcomes (PROs) in advanced or metastatic medullary thyroid cancer (aMTC) across five populous European countries.</p><p><strong>Methods: </strong>Cross-sectional physician and patient surveys were used to collect quantitative and qualitative data in France, Germany, Italy, Spain, and the UK from July to December 2020, prior to the introduction of selective RET inhibitors in Europe. Physicians completed patient record forms and a survey about their specialty and practice site. Patients were asked to provide PRO data using four validated instruments, including the EuroQol 5 Dimension (EQ-5D) questionnaire.</p><p><strong>Results: </strong>The physician-reported sample included 275 patients with aMTC, including 79 patients with RET mutation-positive disease; median age was 60 and 56 years, respectively. Overall, 75% were tested for RET mutation (35% germline only, 21% somatic only, 44% both). Common physician-cited barriers to RET mutation testing included high cost, difficulty accessing latest tests, and time delay for results. First-line systemic therapy (most commonly vandetanib or cabozantinib) was prescribed for 69% of patients overall and 82% of the RET mutation-positive subgroup. Second-line therapy was prescribed for 12% of patients who received first-line therapy; most patients remained on first-line therapy at data capture. PROs revealed substantial disease/treatment burden.</p><p><strong>Conclusions: </strong>Patients with aMTC report substantial disease/treatment burden. Outcomes could be improved by identifying patients eligible for treatment with selective RET inhibitors through more optimal RET mutation testing.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377437","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}
Jean-Charles Martin, Thierry Pourcher, Guillaume Phan, Julien Guglielmi, Caroline Crambes, François Caire-Maurisier, Dalila Lebsir, David Cohen, Clément Rosique, Lun Jing, Maha Hichri, Lisa Salleron, Jacques Darcourt, Maamar Souidi, Marc Benderitter
{"title":"Review of the PRIODAC project on thyroid protection from radioactive iodine by repeated iodine intake in individuals aged 12.","authors":"Jean-Charles Martin, Thierry Pourcher, Guillaume Phan, Julien Guglielmi, Caroline Crambes, François Caire-Maurisier, Dalila Lebsir, David Cohen, Clément Rosique, Lun Jing, Maha Hichri, Lisa Salleron, Jacques Darcourt, Maamar Souidi, Marc Benderitter","doi":"10.1530/ETJ-23-0139","DOIUrl":"10.1530/ETJ-23-0139","url":null,"abstract":"<p><strong>Background: </strong>Intake of potassium iodide (KI) reduces the accumulation of radioactive iodine in the thyroid gland in the event of possible contamination by radioactive iodine released from a nuclear facility. The WHO has stated the need for research for optimal timing, appropriate dosing regimen and safety for repetitive iodine thyroid blocking (ITB). The French PRIODAC project, addressed all these issues, involving prolonged or repeated releases of radioactive iodine. Preclinical studies established an effective dose through pharmacokinetic modeling, demonstrating the safety of repetitive KI treatment without toxicity.</p><p><strong>Summary: </strong>Recent preclinical studies have determined an optimal effective dose for repetitive administration, associated with pharmacokinetic modelling. The results show the safety and absence of toxicity of repetitive treatment with KI. Good laboratory practice level preclinical studies corresponding to individuals > 12 years have shown a safety margin established between animal doses without toxic effect. After approval from the French health authorities, the market authorization of the 2 tablets of KI-65mg/day was defined with a new dosing scheme of a daily repetitive intake of the treatment up to 7 days unless otherwise instructed by the competent authorities for all categories of population except pregnant women, and children under the age of 12 years.</p><p><strong>Conclusions: </strong>This new marketed authorization resulting from scientific-based evidence obtained as part of the PRIODAC project may serve as an example to further harmonize the application of KI for repetitive ITB in situations of prolonged radioactive release at the European and International levels, under the umbrella of the WHO.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139502201","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}
Janice Ser Huey Tan, Timothy Kwang Yong Tay, Enya Hui Wen Ong, Michael Fehlings, Daniel Shao-Weng Tan, Nadiah Binte Sukma, Eileen Xueqin Chen, Jen-Hwei Sng, Connie Siew Poh Yip, Kok Hing Lim, Darren Wan-Teck Lim, Narayanan Gopalakrishna Iyer, Jacqueline Siok Gek Hwang, Melvin Lee Kiang Chua, Mei-Kim Ang
{"title":"Combinatorial Hypofractionated Radiotherapy and Pembrolizumab in Anaplastic Thyroid Cancer.","authors":"Janice Ser Huey Tan, Timothy Kwang Yong Tay, Enya Hui Wen Ong, Michael Fehlings, Daniel Shao-Weng Tan, Nadiah Binte Sukma, Eileen Xueqin Chen, Jen-Hwei Sng, Connie Siew Poh Yip, Kok Hing Lim, Darren Wan-Teck Lim, Narayanan Gopalakrishna Iyer, Jacqueline Siok Gek Hwang, Melvin Lee Kiang Chua, Mei-Kim Ang","doi":"10.1530/ETJ-23-0144","DOIUrl":"10.1530/ETJ-23-0144","url":null,"abstract":"<p><p>Objectives Anaplastic thyroid cancer (ATC) is an aggressive disease associated with poor outcomes and resistance to therapies. Our study aim was to evaluate the activity of a combinatorial regimen of sandwich sequencing of pembrolizumab immunotherapy and hypofractionated radiotherapy (RT). Methods In this case series, patients with ATC received hypofractionated RT (QUAD-shot) and intravenous pembrolizumab 200mg every 3-4 weeks. Pembrolizumab was continued until disease progression or up till 24 months. Concurrent Lenvatinib treatment was allowed. Primary endpoint was best overall response (BOR) and progression-free survival (PFS). Additionally, we performed immune profiling of circulating T cells in a responder to investigate the immune response to our combinatorial treatment. Results At median follow-up of 32.6 months (IQR: 26.4-38.8), of a cohort of 5 patients, BOR was 80%; with 2 complete responses (CR) and 2 partial responses (PR). Patients who achieved CR remained disease-free at last follow-up. Median PFS was 7.6 months (IQR: 6.2-NR), and 1-year PFS and overall survival rate was 40% (95% CI: 13.7-100) for both. Treatment was well-tolerated, with mostly grade 1-2 adverse events. Immune profiling of one partial responder revealed an increase in activated CD4 and CD8 T cells post-QUAD-shot RT, which was further enhanced during the maintenance phase of pembrolizumab. Conclusions Herein, we reported a case series of 5 patients with ATC, with 2 long-term survivors who were treated with surgical debulking followed by QUAD-shot RT and pembrolizumab, possibly due to synergy of local and systemic treatments in activating anti-tumour immunogenic cytotoxicity. This regimen warrants further investigation in a larger cohort of patients.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106077","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}
Rachelle Mendoza, Richard Cody Simon, Nicole A Cipriani, Tatjana Antic
{"title":"The Diagnostic Utility of Repeat Fine-needle Aspirations of Benign Thyroid Nodules.","authors":"Rachelle Mendoza, Richard Cody Simon, Nicole A Cipriani, Tatjana Antic","doi":"10.1530/ETJ-23-0153","DOIUrl":"10.1530/ETJ-23-0153","url":null,"abstract":"<p><p>Objective This study aims to analyze the diagnostic utility of multiple repeat FNA on thyroid nodules with initially benign diagnosis. Methods In a 5-year period, 1658 thyroid nodules with initially benign FNAs were retrospectively reviewed and followed for subsequent resection and repeat biopsy. Results Out of 2150 thyroid nodules, 1658 (77.1%) were diagnosed as benign on FNAs. The average age was 57.4 years (range 11-93 years), and most were females (83.8%). Repeat FNA was performed on 183 benign nodules, of which 141 (8.5%) were sampled a second time and 42 (2.5%) had 2 or more repeat samplings. For the benign nodules without repeat FNAs, 124 had benign resection. Of cases with one-time repeat FNA, most (n=101) remained benign on repeat FNAs, 13 of which were benign on resection. Eleven had atypical repeat FNAs, 5 were resected, 4 of which were benign and one was atypical follicular neoplasm with HRAS and TERT promoter mutations. Of cases with multiple repeat FNA, most (n=35) were still benign on repeat FNAs, one had benign resection. Two had atypical repeat biopsies, one was PTC on resection with CCD6::RET fusion. The positive predictive value significantly decreased from 41.1% on single FNA to 8.3% on one-time repeat (p<0.001) and 16.7% on multiple repeat (p=0.002). The total cost for workup of previously benign nodules was $285,454. Conclusions Repeat FNA biopsies did not provide an additional diagnostic value in the evaluation of benign thyroid nodules, and often led to unwarranted follow-up procedures and significantly increased health care cost.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10959051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139416691","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}
Camilla Larsen, Kristian Hillert Winther, Per Karkov Cramon, Åse Krogh Rasmussen, Ulla Feldt-Rasmusssen, Nils Jakob Knudsen, Jakob Bue Bjorner, Lutz Schomburg, Kamil Demircan, Thilo Samson Chillon, Jeppe Gram, Stinus Gadegaard Hansen, Frans Brandt, Birte Nygaard, Torquil Watt, Laszlo Hegedus, Steen Joop Bonnema
{"title":"Selenium supplementation and placebo are equally effective in improving quality of life in patients with hypothyroidism.","authors":"Camilla Larsen, Kristian Hillert Winther, Per Karkov Cramon, Åse Krogh Rasmussen, Ulla Feldt-Rasmusssen, Nils Jakob Knudsen, Jakob Bue Bjorner, Lutz Schomburg, Kamil Demircan, Thilo Samson Chillon, Jeppe Gram, Stinus Gadegaard Hansen, Frans Brandt, Birte Nygaard, Torquil Watt, Laszlo Hegedus, Steen Joop Bonnema","doi":"10.1530/ETJ-23-0175","DOIUrl":"10.1530/ETJ-23-0175","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated whether selenium supplementation improves quality-of-life (QoL) in patients with autoimmune thyroiditis (ID:NCT02013479).</p><p><strong>Methods: </strong>We included 412 patients ≥18 years with serum thyroid peroxidase antibody (TPOAb) level ≥100 IU/mL in a multicentre double-blinded randomised clinical trial. The patients were allocated 1:1 to daily supplementation with either 200 μg selenium as selenium-enriched yeast or matching placebo tablets for 12 months, as add-on to levothyroxine (LT4) treatment. QoL, assessed by the Thyroid-related Patient-Reported-Outcome questionnaire (ThyPRO-39), was measured at baseline, after six weeks, three, six, 12, and 18 months.</p><p><strong>Results: </strong>In total, 332 patients (81%) completed the intervention period, of whom 82% were women. Although QoL improved during the trial, no difference in any of the ThyPRO-39 scales was found between the selenium group and the placebo group after 12 months of intervention. In addition, employing linear mixed model regression no difference between the two groups was observed in the ThyPRO-39 composite score (28.8 [95%CI:24.5-33.6] and 28.0 [24.5-33.1], respectively; P=0.602). Stratifying the patients according to duration of the disease at inclusion, ThyPRO-39 composite score, TPOAb level, or selenium status at baseline did not significantly change the results. TPOAb levels after 12 months of intervention were lower in the selenium group than in the placebo group (1995 [95%CI:1512-2512] vs. 2344 kIU/L [1862-2951]; P=0.016) but did not influence LT4 dosage or free triiodothyronine/free thyroxin ratio.</p><p><strong>Conclusion: </strong>In hypothyroid patients on LT4 therapy due to autoimmune thyroiditis, daily supplementation with 200 μg selenium or placebo for 12 months improved QoL to the same extent.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139432365","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}
Helene Theodon, Erell Guillerm, Johanna Wassermann, Gabrielle Deniziaut, Loic Jaffrelot, Jérôme Alexandre Denis, Nathalie Chereau, Claude Bigorgne, Wiame Potonnier, Florence Coulet, Laurence Leenhardt, Camille Buffet
{"title":"Next-Generation-Sequencing on fine needle aspirates in neck recurrence of thyroid cancers.","authors":"Helene Theodon, Erell Guillerm, Johanna Wassermann, Gabrielle Deniziaut, Loic Jaffrelot, Jérôme Alexandre Denis, Nathalie Chereau, Claude Bigorgne, Wiame Potonnier, Florence Coulet, Laurence Leenhardt, Camille Buffet","doi":"10.1530/ETJ-23-0164","DOIUrl":"10.1530/ETJ-23-0164","url":null,"abstract":"<p><strong>Objectives: </strong>Tumor molecular genotyping plays a key role in improving the management of advanced thyroid cancers. Molecular tests are classically performed on Formalin-Fixed Paraffin-Embedded (FFPE) carcinoma tissue. However alternative molecular testing strategies are needed when FFPE tumoral tissue is unavailable. The objective of our study was to retrospectively assess the performance of targeted DNA and RNA-based Next Generation Sequencing (NGS) on the fine needle aspirate from thyroid cancer cervical recurrences to determine if this strategy is efficient in clinical practice.</p><p><strong>Design/methods: </strong>A retrospective study of 33 patients who had had DNA and/or RNA-based NGS on ultrasound (US)-guided fine needle aspirates of cervical thyroid cancer recurrences in our Department from July 2019 to September 2022.</p><p><strong>Results: </strong>In total, 34 DNA and 32 RNA-based NGS analyses were performed. Out of the 34 DNA-based NGS performed, 27 (79%) were conclusive allowing the identification of an oncogenic driver for 18 patients (53%). The most common mutation (n = 13) was BRAF c.1799T>A. Out of the 32 RNA-based NGS performed, 26 were interpretable (81%) and no gene fusion was found. The identification of a BRAFV600E mutation was decisive for one patient in our series, who was prescribed dabrafenib and trametinib.</p><p><strong>Conclusions: </strong>NGS performed on fine needle aspirates of neck lymph node metastases enabled the identification of an oncogenic driver alteration in 53% of the cases in our series of advanced thyroid cancer patients and could significantly alter patient management.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139490650","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}