Thyroid Research最新文献

{"title":"Time to euthyroidism and its predictors among thyrotoxicosis patients on antithyroid drugs at tertiary hospitals, Western Oromia, Ethiopia: a retrospective cohort study.","authors":"Bokasa Negeri, Emiru Merdassa, Meseret Belete Fite, Tesfaye Shibiru, Firomsa Bekele","doi":"10.1186/s13044-026-00303-9","DOIUrl":"10.1186/s13044-026-00303-9","url":null,"abstract":"<p><strong>Introduction: </strong>Thyrotoxicosis is characterized by excessive action of thyroid hormones in tissues, leading to significant morbidity and mortality. Anti-thyroid drugs are the primary treatment for thyrotoxicosis; however, the time required to achieve euthyroid status varies among patients. The aim of this study was to determine the time to euthyroidism and its predictors among thyrotoxicosis patients on anti-thyroid drugs at tertiary hospitals in Nekemte city.</p><p><strong>Methods: </strong>A five-year hospital-based retrospective cohort study (from January 1, 2020, to December 31, 2024) was conducted among patients treated with anti-thyroid drugs at Wollega University and Nekemte Comprehensive Specialized Hospitals. Data were extracted using a checklist, entered into Epi Data 4.6, cleaned, exported, and analyzed in STATA 14.1. Descriptive statistics (mean, median, incidence, interquartile range) were used to summarize the data. A Kaplan-Meier curve was used to estimate survival probabilities and compare between groups. The log-rank test was utilized to assess the existence of differences in survival probability. Bi-variable Cox regression analysis (with P ≤ 0.25) was performed to identify candidate predictors. The proportional hazards assumption was assessed using a global test. Subsequently, in suba multivariable Cox regression analysis was conducted to determine the independent predictors of time to euthyroidism, with variables considered statistically significant at p-values < 0.05.</p><p><strong>Results: </strong>In this study, the median time to euthyroidism was 10.8 months. The incidence rate of achieving euthyroidism among thyrotoxicosis patients was 67.91 per 1000 person-months. The following factors were significantly associated with time to euthyroidism: Graves' disease (AHR = 2.50; 95% CI: 1.23-5.07), WHO goiter grade 3 (AHR = 1.98; 95% CI: 1.55-2.54), overt hyperthyroidism (AHR = 1.48; 95% CI: 1.04-2.10), congestive heart failure (AHR = 0.56; 95% CI: 0.35-0.91), and renal disease (AHR = 0.40; 95% CI: 0.21-0.79).</p><p><strong>Conclusion: </strong>The time to euthyroidism in this study was comparatively long; however, the rate of normalization at the end of follow-up was relatively high. The study found that Graves' disease, overt hyperthyroidism, WHO grade 3 goiter, congestive heart failure, and renal disease were significant predictors of time to euthyroidism in patients treated with anti-thyroid drugs. These findings emphasize the importance of prioritizing the management of these factors to improve euthyroidism outcomes in thyrotoxicosis patients.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal thyroid disease and the risk of excessive bleeding in pregnancy: a Danish nationwide cohort study.","authors":"Ida Marie Nørum Wigh, Jesper Karmisholt, Peter Vestergaard, Stig Andersen, Søren Risom Kristensen, Stine Linding Andersen","doi":"10.1186/s13044-026-00302-w","DOIUrl":"10.1186/s13044-026-00302-w","url":null,"abstract":"<p><strong>Objective: </strong>Thyroid hormones are involved in the regulation of haemostasis, and it has been hypothesised that abnormal levels of thyroid hormones are associated with an increased risk of excessive bleeding. However, this association is yet to be investigated in pregnant women.</p><p><strong>Methods: </strong>We performed a retrospective nationwide cohort study of Danish pregnant women from 1999 to 2015. Information on maternal hyperthyroidism and hypothyroidism diagnosed before/during or after the pregnancy, as well as outcomes of bleeding in early and late pregnancy, was collected via the Danish nationwide health registers on hospital diagnoses and drug prescriptions. Multivariate logistic regression was used to calculate adjusted odds ratio (aOR) with a 95% confidence interval (95% CI) for the association between maternal thyroid disease and outcomes of bleeding.</p><p><strong>Results: </strong>The study cohort included 1,149,871 pregnancies. Maternal hyperthyroidism was diagnosed in 17,702 pregnancies and hypothyroidism in 27,674 pregnancies. Maternal hyperthyroidism diagnosed before/during (aOR 1.11 (95% CI 1.02;1.21)) and after the pregnancy (aOR 1.11 (95% CI 1.01;1.22)) as well as hypothyroidism diagnosed before/during (aOR 1.11 (95% CI 1.03;1.19)) and after the pregnancy (aOR 1.10 (95% CI 1.02;1.18)) were associated with an increased risk of bleeding in the early pregnancy. For bleeding diagnosed in late pregnancy, we found an association only when maternal hypothyroidism was first diagnosed after the pregnancy (aOR 1.22 (95% CI: 1.07;1.40)).</p><p><strong>Conclusion: </strong>In a large, nationwide cohort, maternal hyperthyroidism and hypothyroidism showed associations with diagnoses of bleeding in pregnancy. Results provide clues on the role of undiagnosed and untreated maternal thyroid disease in pregnancy.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid hormone measurement items in patients with Hashimoto's thyroiditis on levothyroxine monotherapy: management based on thyroid tissue volume.","authors":"Mitsuru Ito, Yoshiki Furumura, Itaru Monno, Hanna Deguchi-Horiuchi, Chisako Imamura, Sawako Takahashi, Hiroyuki Yamaoka, Mako Hisakado, Kazuyoshi Kohsaka, Eijun Nishihara, Shuji Fukata, Mitsushige Nishikawa, Akira Miyauchi, Takashi Akamizu","doi":"10.1186/s13044-026-00300-y","DOIUrl":"10.1186/s13044-026-00300-y","url":null,"abstract":"<p><strong>Background: </strong>We have demonstrated that mild suppression of thyrotropin (TSH) using levothyroxine (LT₄) is necessary to achieve normal free triiodothyronine (FT₃) levels and a metabolic euthyroid state in athyreotic patients. Consequently, management strategies based on thyroid volume (TV) have been implemented in patients receiving LT₄ at Kuma Hospital. While Hashimoto's thyroiditis (HT) can vary from atrophic to diffusely enlarged thyroid volumes.</p><p><strong>Methods: </strong>In this retrospective study, we aimed to evaluate the composition of thyroid hormone measurement items (serum FT₄, FT₃, and FT₄+FT₃) in patients receiving LT₄ monotherapy for HT, stratifying them by TV, as assessed using ultrasonography.</p><p><strong>Results: </strong>We identified 7,576 consecutive patients from their medical records. These patients were classified into five groups based on TV: atrophic thyroid (TV ≤ 10 mL); normal thyroid (TV 10-20 mL); mildly enlarged thyroid (TV 20-50 mL); moderately enlarged thyroid (TV 50-80 mL); and large thyroid (TV > 80 mL). In all patient groups, FT₄ measurements constituted the majority or nearly half of all assessments. However, the proportion of FT₃ measurements increased notably in the atrophic thyroid group (34%) and in the large goiter group (29%). Patients receiving LT₄ were evaluated based on their TSH levels. In the reduced TSH group, FT₃ accounted for nearly half of all measurements (47%). Conversely, in the normal TSH group, FT₄ accounted for the majority of all measurements (76%).</p><p><strong>Conclusion: </strong>This study revealed that FT₃, rather than FT₄, was the predominant thyroid hormone measured in a significant number of patients with HT on LT₄ monotherapy at our hospital. Furthermore, our study highlights a management approach whereby TSH levels were intentionally suppressed in some patients.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global and Indian perspectives on trimester-specific reference intervals for thyroid hormones in pregnant women: a systematic review.","authors":"Periyasamy Kuppusamy, Jaiganesh Chinnasamy, Khushi Pankaj Jain, Kasthuri Kannayiram, Sasidharan Sivakumar, Nilesh Chandra","doi":"10.1186/s13044-026-00298-3","DOIUrl":"10.1186/s13044-026-00298-3","url":null,"abstract":"<p><p>Establishment of trimester-specific reference intervals (RIs) for thyroid hormones is essential to avoid misdiagnosis and misinterpretation in pregnant women. This systematic review comprehensively analysed gestational age-specific reference intervals in different populations. The electronic databases such as Medline, Embase, Scopus, and Google Scholar were searched to identify relevant articles. The reference population, consisting of healthy pregnant women in the first, second, and third trimesters of pregnancy, meeting eligibility, such as the absence of thyroid disease, a negative thyroid peroxidase (TPO) antibody test, and sufficient urinary iodine concentration (UIC), was selected for the present study. Of the 1,160 studies identified in the databases, 48 were eligible for the systematic review. Data on trimester-specific RIs, established from a 95% confidence interval (CI) between the 2.5th percentile (lower limit) and the 97.5th percentile (upper limit) of thyroid hormones, were extracted. In most studies, the upper limit of TSH in healthy pregnant women during the first (85.4%), second (94.1%), and third trimesters (72%) was determined to be 2.15-4.51 mIU/L, 2.73-4.84 mIU/L, and 2.90-4.91 mIU/L, respectively. Furthermore, the lower and upper limits of FT4 during the first (80.5% and 87.8%), second (83.3% and 90%), and third trimesters (82.1% and 96.4%) have been reported as being between 10.17 and 14.16 pmol/L and 15.22-23.94 pmol/L, 8.31-11.71 pmol/L and 15.47-20.59 pmol/L, and 7.39-9.78 pmol/L and 12.03-19.82 pmol/L, respectively. The study results showed that reference value for thyroid hormones vary within the same population and also between different populations, particularly for TSH. Given this high variability, even within the Indian population, it is imperative to establish population-specific reference values.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple machine learning models for the prediction of an early response to radioactive iodine therapy in hyperthyroidism: ablative dose concept.","authors":"Nikola Pantic, Bogdan Pantic, Strahinja Odalovic, Branislava Radovic, Milica Kotur, Dragana Sobic-Saranovic, Lenka Grujicic, Jelena Malicevic-Crevar, Miona Mihajlovic, Isidora Grozdic-Milojevic, Slobodanka Beatović, Vera Artiko, Jelena Petrovic","doi":"10.1186/s13044-026-00299-2","DOIUrl":"10.1186/s13044-026-00299-2","url":null,"abstract":"<p><strong>Background: </strong>The aim of this novel study was to explore the possibility of the development of a machine learning (ML) model that can predict early response to radioactive iodine (RAI) therapy in patients with hyperthyroidism on the basis of demographic, clinical, laboratory, and imaging features.</p><p><strong>Methods: </strong>A total of 914 patients who received RAI for the treatment of hyperthyroidism between January 2000 and December 2023 were included in the study. The early positive response, defined as an accomplishment of hypothyroidism (thyroid-stimulating hormone (TSH) > 4 mIU/L) in the 6-month period following RAI therapy, was accomplished in 336 patients (36.76%) (hypothyroidism group), whereas hypothyroidism was not accomplished in 578 patients (63.24%) (control group). The training data consisted of 90% of the sample (822 patients), whereas the test set contained 92 patients. Multiple ML models, including k-nearest neighbors, random forest, various gradient boosting algorithms, and neural networks, were trained via AutoGluon.</p><p><strong>Results: </strong>The neural network model performed the best, with a balanced accuracy of 68.81%, sensitivity of 61.76%, specificity of 75.86%, PPV of 60.0%, NPV of 77.19%, and F1 score of 60.87%, with the area under the curve (AUC) of 0.706 (95% confidence interval [CI]: 0.593-0.809; receiver operating characteristic [ROC] curve analysis). In the development of the top-performing model, baseline TSH, age, 24-h radioactive iodine uptake, dose, and duration of previous treatment with antithyroid drugs (ATDs) were the most important features.</p><p><strong>Conclusions: </strong>We developed models for the prediction of the response to RAI in patients with hyperthyroidism. However, these models require further development before they can be applied in clinical practice. By introducing more variables and increasing the sample size, the model performance can increase further.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid functional state-dependent dysbiosis of gut microbiota in Hashimoto's thyroiditis: a cross-sectional metagenomic profiling study.","authors":"Jie Li, Suhang Guo, Hua Yu, Xiaobo Hong, Jing Nie, Hua Sun","doi":"10.1186/s13044-026-00297-4","DOIUrl":"10.1186/s13044-026-00297-4","url":null,"abstract":"<p><strong>Background: </strong>Hashimoto's thyroiditis (HT) is a prevalent autoimmune thyroid disease (AITD) closely linked to genetic predisposition and environmental factors. Gut microbiota dysbiosis has recently been implicated as a critical contributor to AITDs' pathogenesis. Our study aims to systematically investigate the dynamic alterations in gut microbial communities under varying thyroid functional statuses and elucidate their underlying mechanisms.</p><p><strong>Methods: </strong>67 HT patients with varying thyroid functional statuses and 23 healthy controls were enrolled. Fecal 16 S rDNA sequencing and analyses (alpha diversity, LEfSe, correlation, functional pathways) assessed microbiota-thyroid function links.</p><p><strong>Results: </strong>HT patients with hypo/hyperthyroidism had lower gut microbiota richness than euthyroid patients (more reduced in hyperthyroidism). The hyperthyroid group exhibited enrichment of Fusobacterium, the hypothyroid group was dominated by Clostridium sensu stricto_1, and the euthyroid group showed a predominance of short-chain fatty acid (SCFA)-producing bacteria (e.g., Lactobacillus). Clostridium sensu stricto_1 positively correlated with TPO-Ab levels but negatively correlated with FT3.Pro-inflammatory genera(e.g., Escherichia-Shigella, Streptococcus) demonstrated negative correlations with FT3.Functional prediction analysis revealed potential associations with L-tyrosine degradation in the hyperthyroid group, reduced proportions of bile acid metabolism pathways in the hypothyroid group, and enriched proportions of fatty acid metabolism pathways in the euthyroid group.</p><p><strong>Conclusions: </strong>This study revealed that gut microbiota dysbiosis is closely associated with thyroid functional statuses in HT. Specific bacterial genera, such as Clostridium sensu stricto_1 and Fusobacterium, may contribute to immune regulation and disease progression. The dynamic alterations in gut microbial profiles provide potential biomarkers for precision diagnosis and treatment of HT.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"19 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring thyroid-stimulating hormone receptor antibodies using the IMMULITE^® 2000 TSI assay is better than using the BRAHMS TRAK assay in an unselected clinical population, but both perform worse than expected: a real-world retrospective observational study.","authors":"Sofia Manousou, Anders Olsson, Zoi Mamasoula, Mina Abdi Saran, Göran Oleröd, Helena Filipsson Nyström","doi":"10.1186/s13044-026-00296-5","DOIUrl":"10.1186/s13044-026-00296-5","url":null,"abstract":"<p><p>BACKGROUND: Graves’ hyperthyroidism is caused by stimulatory autoantibodies. Its diagnosis and monitoring are commonly based on measurement of thyrotropin receptor antibodies (TRAb) with unspecific immunoassays, that also detect neutral and blocking antibodies. TRAb analyzed using the Siemens IMMULITE® 2000 TSI immunoassay (TRAb-IM), designed to target stimulatory immunoglobulins, represents a promising alternative. This study aimed to determine the clinical performance of TRAb-IM and the Thermo Fisher BRAHMS TRAK KRYPTOR immunoassay (TRAb-KR) in a real-world setting. METHODS: Over 3 months, TRAb-IM was analyzed in samples collected to measure TRAb-KR after referral for thyrotoxicosis or at the time of discontinuation of antithyroid drugs (n = 168). Data on thyroid hormones, TRAb-KR, and date of start/discontinuation of antithyroid drugs was collected. RESULTS: Agreement analysis for Graves’ disease diagnosis between the assays yielded a Gwet’s AC1 of 0.69 (95% confidence interval [CI] 0.51–0.86) for the samples collected after referral for thyrotoxicosis (n = 122). In this group, sensitivity (95% CI) for TRAb-IM and TRAb-KR was 97% (86–100) and 78% (62–90), respectively, in overt hyperthyroidism (n = 49), and 71% (42–92) and 43% (18–71), respectively, in subclinical hyperthyroidism (n = 46). Specificity was 100% (74–100) for both assays in overt hyperthyroidism, and 97% (84–100) and 100% (89–100), respectively, in subclinical hyperthyroidism. When TRAb-IM and TRAb-KR results were used as predictors for recurrence at the time of discontinuation of antithyroid drugs, the ROC AUC was 0.65 (95% CI 0.47–0.82; p = 0.07) and 0.57 (95% CI 0.41–0.73; p = 0.40), respectively. CONCLUSIONS: The TRAb-IM assay presented better clinical performance at both diagnosis of Graves’ disease and prediction of its recurrence compared to the TRAb-KR assay. Nonetheless, endocrinologists should be aware that both assays are weak in diagnostic of subclinical cases and in the prediction of recurrence, when used at the time of discontinuation of antithyroid drugs. </p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"19 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial fibrillation and associated cardiovascular disorders in adults with hyperthyroidism: a retrospective cohort study from two teaching hospitals.","authors":"Biruk T Mengistie, Yamama Farouk Shakir, Fraol Dereje Bekele, Biniyam Fiseha Abera, Chernet T Mengistie, Mikiyas G Teferi, Abel A Gelan, Caleb M Hailemariam, Mihret Derbie Asfaw, Asteway M Haile, Ezekiel A Eneyew","doi":"10.1186/s13044-026-00295-6","DOIUrl":"10.1186/s13044-026-00295-6","url":null,"abstract":"<p><p>INTRODUCTION: Atrial fibrillation (AF) is a major cardiovascular complication of thyrotoxicosis but its burden and predictors are poorly described in sub-Saharan Africa. We assessed the prevalence, clinical course, and predictors of AF and related cardiovascular complications in adults with hyperthyroidism at two tertiary hospitals in Addis Ababa, Ethiopia. METHODS: Retrospective cohort study of adults (≥ 18 years) with biochemically confirmed hyperthyroidism managed between April 2019 and September 2024. Clinical, ECG and echocardiographic data were abstracted from records; primary outcomes were AF at presentation and persistent AF on follow-up. Associations were examined with multivariable logistic regression. RESULTS: Of 174 patients (mean age 41.2 ± 11.6 years; 91.9% female), 43 (24.7%) had AF at presentation and 34 (19.5%) remained in persistent AF. Thromboembolic events (echocardiographic contrast n = 2; LV thrombus n = 1; ischemic stroke n = 1) occurred only in persistent AF. Independent predictors of AF included left atrial enlargement (LA ≥ 3.8 cm; AOR 8.6, 95% CI 1.9–38.5), NYHA class III–IV at presentation (AOR 8.9, 95% CI 2.5–33.0), diastolic dysfunction (AOR 5.4, 95% CI 1.4–21.5) and elevated baseline free T3 (AOR 12.5, 95% CI 3.1–50.2). Most patients received propylthiouracil (97.7%) and beta-blockers; anticoagulation was infrequently prescribed (n = 3). Biochemical normalization was slow, and AF was associated with delayed thyroid hormone normalization. CONCLUSION: In this Ethiopian tertiary-care cohort, AF was common and frequently persistent; elevated thyroid hormone levels and atrial structural changes were strong predictors. Early ECG and targeted echocardiography, prompt restoration of euthyroidism, and guideline-directed anticoagulation for high-risk patients are warranted to reduce thromboembolic and heart-failure complications. </p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"19 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world agreement in the ultrasound classification of subcapsular thyroid nodules: comparison with expert assessment.","authors":"Pierpaolo Trimboli, Enrico Papini, Roberto Novizio, Maurilio Deandrea, Andrea Frasoldati, Cosimo Durante, Andrea Leoncini, Rinaldo Guglielmi","doi":"10.1186/s13044-026-00294-7","DOIUrl":"10.1186/s13044-026-00294-7","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound (US) is the most accurate tool for the assessment of thyroid nodules (TNs). Despite the subcapsular position of TNs may represent a game changer for clinical practice in selecting cases for biopsy or surgery, this parameter is not included in US-based risk stratification systems. The present study evaluated the agreement of endocrinologists using US in clinical practice with the experts' results employed as reference standard.</p><p><strong>Methods: </strong>A sub-series of TNs for which the agreement between US expert endocrinologists and radiologists was perfect was assumed as reference. Participants of the 2025 Thyroid Update of Associazione Medici Endocrinologi (AME) were asked to assess TNs in a 3-choice answer: subcapsular, non-subcapsular, or uncertain. The agreement was determined according to majority consensus (i.e., ratings > 50% = final consensus outcome) and Fleiss κ (from 0.1 to 1.0).</p><p><strong>Results: </strong>The series included 13 TNs (6/13 cancer, 7/13 echographically at high risk) whose median distance from the anterior and posterior thyroid capsule was 0 and 1.5 mm, respectively. One hundred and six endocrinologists (females, 62%; age, < 40 years 33%; specialized professionals, 81%) participated as raters. The TNs assessed by experts as subcapsular were judged as subcapsular in 90% to 97% of votes. The TNs assessed as non-subcapsular by experts were classified as non-subcapsular by 3% to 48% of votes. The majority consensus fully matched the experts' assessment (κ = 1.0, p = 0.0003). The distance from the anterior thyroid capsule was an independent factor of assessment (p = 0.005, R² = 0.86).</p><p><strong>Conclusions: </strong>Clinical endocrinologists largely agree with experts' assessment in subcapsular cases where experts had perfect concordance while uncertainty is present for non-subcapsular nodules. Future studies should establish a standardized definition of subcapsular TN.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"19 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A preliminary study developing a scoring model incorporating fibrinogen-like protein 2 for predicting glucocorticoid resistance in thyroid eye disease.","authors":"Kazuhiko Matsuzawa, Shoichiro Izawa, Kanako Kadowaki, Kenji Fukaya, Kazuhisa Matsumoto, Keiko Nagata, Tsuyoshi Okura, Shinya Fujii, Dai Miyazaki, Shin-Ichi Taniguchi, Kazuhiro Yamamoto, Takeshi Imamura","doi":"10.1186/s13044-026-00293-8","DOIUrl":"10.1186/s13044-026-00293-8","url":null,"abstract":"<p><p>OBJECTIVE: Intravenous glucocorticoids are the first-line therapy for moderate-to-severe active thyroid eye disease (TED), but some patients demonstrate steroid resistance. Therefore, identifying reliable pre-treatment biomarkers to predict the therapeutic response to intravenous glucocorticoids is of considerable clinical importance. METHODS: In the discovery phase, pre-treatment serum samples from 10 patients with TED treated with intravenous glucocorticoids (six responders, four non-responders), along with samples from three patients with Graves’ disease without TED and three healthy controls, were subjected to data-independent acquisition proteomics analysis. Candidate biomarkers were validated in an expanded cohort (21 responders, 10 non-responders, 14 Graves’ disease patients, and 14 healthy controls). RESULTS: Data-independent acquisition proteomics analysis revealed 263 differentially abundance proteins between responders and non-responders. Among them, transforming growth factor-β, heparanase, and fibrinogen-like protein 2 were identified as potential biomarker candidates. In the validation phase, only fibrinogen-like protein 2 was significantly elevated in non-responders. Although fibrinogen-like protein 2 alone achieved an area under the curve of 0.76, Least Absolute Shrinkage and Selection Operator regression incorporating clinical parameters identified smoking and high thyroid-stimulating antibody as additional predictors. A three-factor scoring system (fibrinogen-like protein 2 > 39.5 ng/mL, thyroid-stimulating antibody > 2597%, and current smoking; each 1 point) yielded an area under the curve of 0.86, with good reproducibility in bootstrap validation. CONCLUSIONS: Elevated pre-treatment serum fibrinogen-like protein 2 is a promising biomarker for predicting steroid resistance in TED. Combining fibrinogen-like protein 2 with thyroid-stimulating antibody and current smoking provides a clinically useful scoring system to guide personalized treatment. </p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"19 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}