Endocrine最新文献

{"title":"Pathophysiology and evaluation of bone health in adrenal diseases.","authors":"M M Uygur, L di Filippo, S Frara, S Menotti, A Giustina","doi":"10.1007/s12020-025-04260-5","DOIUrl":"10.1007/s12020-025-04260-5","url":null,"abstract":"<p><p>Adrenal diseases are associated with an increased risk of osteopenia/osteoporosis and fragility fractures. Although dual-energy X-ray absorptiometry remains the gold standard for assessing bone mineral density, its limitations in accurately predicting vertebral fractures underscore the need for complementary diagnostic tools, particularly in the context of adrenal disorders. Vertebral fractures, often asymptomatic, may go undetected without targeted assessments such as morphometric evaluation. Incorporating advanced diagnostic tools, such as the trabecular bone score, into the evaluation of adrenal disorder-related skeletal fragility may enhance the identification of high-risk patients and support tailored therapeutic strategies. This review explores skeletal fragility from pathophysiological, clinical, and diagnostic perspectives and provides guidance to physicians for the management of adrenal disorders to improve bone health outcomes.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"325-337"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parathyroid weight estimation: beyond ellipsoid volume.","authors":"Haley Corbin, Nathalia Josette Roth, Linwah Yip, Sally E Carty, Raja R Seethala","doi":"10.1007/s12020-025-04273-0","DOIUrl":"10.1007/s12020-025-04273-0","url":null,"abstract":"<p><strong>Purpose: </strong>Parathyroid weight is a simple, robust functional status indicator and cornerstone of gross/intraoperative assessment, though sometimes unobtainable. We evaluate models to estimate weight from size and create an online calculator.</p><p><strong>Methods: </strong>Actual weights (AW), cellularity, prosector identity and size were prospectively collected for 124 parathyroids (111 hypercellular, 13 normocellular) in 76 patients (4-6/2023). Simple volumetric weight estimates (VWE) for: ellipsoid, capsular, the novel capsuloid, and box shapes were compared with AW. Multiple linear regression (MLR) was performed with internal (k-fold) validation and external validation on an archival cohort (263 adenomas, 2016-2022). Subsets with surgeon's weight estimates, serum values, and microscopic surface area measured using the QuPath surface area tool were correlated with AW.</p><p><strong>Results: </strong>The optimal MLR model included capsuloid VWE, cellularity, and prosector identity (R²:0.92, p < 0.0001). A more generalizable model without including prosector identity (R²: 0.89, p < 0.0001) was used for the online calculator weight estimate (CWE). The calculator was a good predictor of AW on the adenoma dataset (R²: 0.86, normalized root mean squared error (nRMSE): 0.058). Interestingly, the surgeon's weight estimate (n = 31) was more favorable (R²: 0.97, nRMSE: 0.087) in this subset. QuPath assisted surface area-based weight estimates showed weaker correlation with AW. Neither AW, CWE, nor size correlated strongly with serum values.</p><p><strong>Conclusion: </strong>An online calculator modeling capsuloid VWE and cellularity is a good predictor of AW. Variance in prosector measurements is important but impractical to model. Surgeon's estimates were quite accurate, emphasizing the value of this skill.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"587-594"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of fibrinogen/albumin ratio and Castelli risk index 2 (CRI-2=LDL-C/HDL-C) with severity of coronary artery lesions in different glucose metabolism states.","authors":"Yue Liu, Xiandu Jin, Wenjun Jia, Xiuju Guan, Hao Wu, Jiao Li, Min Cui, Hanmo Zhang, Liping Wei, Xin Qi","doi":"10.1007/s12020-025-04259-y","DOIUrl":"10.1007/s12020-025-04259-y","url":null,"abstract":"<p><strong>Background: </strong>The fibrinogen to albumin ratio (FAR) is a novel inflammatory indicator correlating with the severity of coronary artery disease (CAD). An indicator of atherosclerosis is the Castelli Risk Index 2 (CRI-2=LDL-C/HDL-C). Yet, little research has focused on the link between both of indicators and CAD in different glucose metabolic states. Thus, this study aimed to investigate the association between FAR, CRI-2, and the severity of coronary artery lesions in patients with CAD in different glucose metabolic states.</p><p><strong>Method: </strong>In this investigation, coronary angiography was performed about 2825 individuals suffering from symptomatic CAD at Tianjin Union Medical Center from 2016-2023.The number of stenotic arteries in the coronary arteries was counted. The Gensini scores were taken into account. Normal glucose regulation (NGR), pre-diabetes mellitus (Pre-DM), and diabetes mellitus (DM) were the three categories of glucose status according to the WHO diabetes guidelines. Patients were also divided into FAR index and CRI-2 quartiles to look into the link between FAR index and CRI-2 and coronary artery lesions in CAD patients with different glucose metabolic states. Receiver operating characteristic (ROC) curves were constructed to analyze the predictive value of the FAR index and CRI-2 for coronary artery lesions.</p><p><strong>Result: </strong>According to logistic regression analysis, the FAR index and CRI-2 were statistically associated with coronary artery disease (P < 0.05). The FAR index was linked with severity of coronary artery lesions regardless of glucose metabolism states (P < 0.05). The CRI-2 was strongly linked with severity of coronary artery lesions in both NGR and DM status (P < 0.05). Yet, there was no statistical significance in Pre-DM states (P > 0.05). The FAR index and CRI-2 exhibited higher regions underneath the ROC curve in forecasting severity of coronary artery lesions.</p><p><strong>Conclusion: </strong>The FAR index and CRI-2 were significantly associated with severity of coronary artery lesions in different glucose metabolic states. FAR index and CRI-2 have predictive value for coronary artery lesions.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"401-415"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial complete androgen insensitivity syndrome (CAIS): a case series of three siblings with emphasis on diagnosis, management, and psychosocial outcomes.","authors":"Vaishnavi Rajaraman, Usha Vishwanath, Lawrence D Cruze","doi":"10.1007/s12020-025-04264-1","DOIUrl":"10.1007/s12020-025-04264-1","url":null,"abstract":"<p><strong>Objective: </strong>To highlight the clinical presentation, diagnostic challenges, and management of Complete Androgen Insensitivity Syndrome (CAIS) through a case series of three sisters, emphasizing the importance of early recognition and multidisciplinary care.</p><p><strong>Methods: </strong>Three phenotypically female siblings with primary amenorrhea underwent hormonal evaluation, imaging, and genetic testing. Hormonal studies revealed elevated serum testosterone levels, while imaging confirmed the absence of a uterus and ovaries. Karyotyping identified a 46, XY genotype with the presence of the SRY gene, confirming CAIS.</p><p><strong>Results: </strong>All three sisters exhibited normal female secondary sexual characteristics despite a 46, XY karyotype. The absence of Müllerian structures on imaging and elevated testosterone levels guided the diagnosis. Multidisciplinary management, including hormonal therapy, psychological support, and surgical planning, was discussed.</p><p><strong>Conclusion: </strong>CAIS should be considered in individuals with primary amenorrhea and normal female phenotype. Early diagnosis is crucial for appropriate management, including psychological counseling, gonadectomy when indicated, and hormonal therapy to optimize long-term health and quality of life.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"627-631"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adrenal crisis: incidence, clinical presentation and risk factors in patients with Addison's disease.","authors":"Alberto Scala, Marianna Torchio, Fabio Presotto, Caterina Mian, Filippo Ceccato, Carla Scaroni, Corrado Betterle, Chiara Sabbadin","doi":"10.1007/s12020-025-04242-7","DOIUrl":"https://doi.org/10.1007/s12020-025-04242-7","url":null,"abstract":"<p><strong>Purpose: </strong>Adrenal crisis (AC) is the most severe manifestation of primary adrenal insufficiency (PAI) and is associated with high mortality. Its insidious presentation often leads to a delayed diagnosis and treatment. In this study, we aim to determine the incidence, characteristics, precipitating and predisposing factors for AC.</p><p><strong>Methods: </strong>A total of 132 patients with PAI were evaluated retrospectively. Patients' features and information on their previous AC were collected through a structured interview and clinical documentation, supplied by patients or retrieved from archives of the Hospitals of Padova and Venice-Mestre.</p><p><strong>Results: </strong>Among enrolled patients, 95 (71.9%) were females, the mean age was 48.8 ± 13.5 years, and the mean PAI duration was 14.9 ± 11.8 years. The most frequent cause of PAI was autoimmune adrenalitis (92.4%), mainly associated with other autoimmune comorbidities. The 65.9% of patients experienced at least one AC, with an incidence of 10.5/100 patient-years. A significant number of AC (116/206) occurred in patients already undergoing glucocorticoid therapy. The most frequent features of AC were fatigue (96%), gastrointestinal symptoms (85%), and hyponatremia (77%). The most frequent triggers were vomiting and/or diarrhoea (65%), infections (38%), and emotional stress (29%). Patients with more autoimmune comorbidities and those with premature ovarian insufficiency (POI) were at higher risk of AC (p < 0.02).</p><p><strong>Conclusions: </strong>AC is still a frequent complication of patients with PAI, particularly in those with additional autoimmune comorbidities or with POI. Awareness of AC among clinicians, patients, and care-givers is crucial for the prevention, recognition, and proper treatment of this life-threatening complication.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discontinuation of levothyroxine therapy in patients with subclinical hypothyroidism: a pilot randomized clinical trial.","authors":"Spyridoula Maraka, Richard R Owen, Naykky M Singh Ospina, Micheal Knox, Terri Dodds, Jeff D Thostenson, Katherine Dishongh, Rebecca A Raciborski, Arwa Albashaireh, Aashka Shah, Sabah Syed, Syeda Naqvi, Hooman Motahari, Soumya Thumma, Freddy Toloza, Elena Ambrogini, Juan P Brito","doi":"10.1007/s12020-025-04371-z","DOIUrl":"https://doi.org/10.1007/s12020-025-04371-z","url":null,"abstract":"<p><strong>Purpose: </strong>Randomized clinical trials (RCTs) have shown no benefit of levothyroxine for subclinical hypothyroidism (SCH) in improving well-being, cardiovascular outcomes, or mortality. We aimed to evaluate study procedures' feasibility, safety, and preliminary effects of levothyroxine discontinuation in adults with SCH.</p><p><strong>Methods: </strong>We conducted a pilot, double-blind, placebo-controlled RCT with 6-month follow-up at a Veterans Affairs Medical Center. Adults with SCH on levothyroxine ≤75 mcg daily were randomized to continue levothyroxine or switch to placebo. The primary outcome was feasibility.</p><p><strong>Results: </strong>Fifty participants were randomized (32% enrollment rate); five were excluded post-randomization due to unconfirmed SCH, yielding 45 participants (21 levothyroxine, 24 placebo). One patient in the placebo group withdrew for personal reasons (98% completion rate). Participants' mean age was 68.2 years (SD 9.7); 80% were male, and 86.7% were White. At 6 months, there was no statistically significant difference between the placebo and levothyroxine groups in ThyPRO-Hypothyroid Symptoms [28.3 (22.8) vs. 22.9 (19.5)], Tiredness [27.6 (22.8) vs. 32.8 (22.1)], and EQ-5D score [0.750 (0.232) vs. 0.741 (0.180)]. The only notable adverse event was rib fractures in a placebo group participant (TSH 3.04 mIU/L at 6 months). Two participants in the placebo group restarted levothyroxine (n = 1, TSH > 10 mIU/L; n = 1, fatigue).</p><p><strong>Conclusion: </strong>We demonstrated feasibility of study procedures for discontinuing levothyroxine in patients with SCH and obtained preliminary effects on well-being. The low occurrence of adverse events suggests that levothyroxine discontinuation may be well-tolerated. These findings support conducting a larger multi-site RCT to comprehensively assess the effects of levothyroxine discontinuation.</p><p><strong>Clinical trial registration number: </strong>NCT04288115.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-energy X-ray absorptiometry and bioelectrical impedance analysis are useful for predicting metabolic syndrome and nonalcoholic fatty liver disease in children and adolescents.","authors":"Kyungchul Song, Eunju Lee, Hye Sun Lee, Hana Lee, Joon Young Kim, Youngha Choi, Hyun Wook Chae","doi":"10.1007/s12020-025-04336-2","DOIUrl":"https://doi.org/10.1007/s12020-025-04336-2","url":null,"abstract":"<p><strong>Purpose: </strong>Assessing body composition is essential for evaluating metabolic syndrome (MS) and nonalcoholic fatty liver disease (NAFLD). However, studies on the relationship between these conditions and dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA) in children and adolescents remain limited. This study aimed to investigate the associations between DXA and BIA parameters, and their utility in predicting MS and NAFLD in the youth.</p><p><strong>Methods: </strong>Data from the Korea National Health and Nutrition Examination Survey 2009-2011 and 2022 were analyzed, including 1661 children and adolescents who underwent DXA, and 359 who underwent BIA; 712 were matched through propensity score matching. Pearson correlation and logistic regression analyses (with MS and NAFLD as dependent variables) were used to assess associations between DXA and BIA parameters. Predictive performance was evaluated using area under the receiver operating characteristic (ROC) curve comparisons.</p><p><strong>Results: </strong>Pearson correlation analyses revealed significant positive correlations between DXA and BIA parameters. In the logistic regression analyses, fat-related parameters were positively associated with MS and NAFLD, whereas muscle-related parameters showed negative associations, even after adjusting for age and sex. In the ROC analyses, BIA body fat mass had the highest predictive performance for both MS and NAFLD, followed by DXA body fat mass and percentage of body fat. Fat-related parameters were superior to muscle-related parameters for predicting MS and NAFLD.</p><p><strong>Conclusion: </strong>BIA and DXA are useful tools for assessing MS and NAFLD in children and adolescents, and their complementary use enhances predictive accuracy, particularly through fat-related parameters.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the predictive role of thyroglobulin antibodies combined with thyroid peroxidase antibodies on adverse pregnancy outcomes during early pregnancy.","authors":"Peiheng Zhang, Weijie Sun, Jing Wang, Yang Zhang, Huixia Yang, Ying Gao","doi":"10.1007/s12020-025-04309-5","DOIUrl":"https://doi.org/10.1007/s12020-025-04309-5","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to explore whether combined assessment of TgAb and TPOAb perform a higher predictive value to adverse pregnancy outcomes than isolated TPOAb during early pregnancy.</p><p><strong>Methods: </strong>This was a retrospective study of 4678 pregnant women receiving prenatal care at Peking University First Hospital from October 2017 to August 2018. Demographic and clinical data, including thyroid hormone levels, were retrieved from electronic medical records. The general information and incidence of adverse pregnancy outcomes were compared between different subgroups of thyroid function and antibody status.</p><p><strong>Results: </strong>In total, 2673 women were enrolled. 6.70% (179/2673) and 8.27% (221/2673) of the pregnant women were TPOAb positive and TgAb positive, respectively. The median thyroid-stimulating hormone (TSH) level was higher in the TPOAb or TgAb positive group than in the antibody-negative group [1.40 (0.96, 2.01) vs. 1.34 (0.86, 1.92), P = 0.045]. The prevalence of maternal composite outcomes (66.08% vs. 58.90%, p = 0.09) and fetal loss (10.49% vs. 5.78%, P = 0.02) was greater among women with 2.5 < TSH ≤ 4.08 mIU/L than among those with 0.23 < TSH ≤ 2.5 mIU/L. When the TSH concentration ranged from 0.23 to 2.5 mIU/L, the prevalence of fetal loss was greater in the TPOAb or TgAb positive group than in the antibody-negative group (8.33% vs. 5.43%, P = 0.04). Compared with TPOAb measruement alone, the predictive value of the TPOAb and TgAb combined assessment for maternal (AUC values: 0.509, 95% CI = 0.485 ~ 0.532) and fetal (AUC values: 0.512, 95% CI = 0.458 ~ 0.565) adverse outcomes was not higher.</p><p><strong>Conclusion: </strong>Under current treatment recommendations, the combined assessment of TPOAb and TgAb during pregnancy has limited predictive value for maternal-fetal adverse outcomes among euthyroid women compared with isolated TPOAb.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Number of comorbidities predicts adrenal incidentaloma and autonomic cortisol secretion in obese individuals: A two-center cohort study.","authors":"Elif Güneş, Mutlu Güneş, Muhammet İlker Kaya, Murat Yüksel, Sümeyye Memet, Beyza Kibar, Cem Kaya, Fatih Hakan Tufanoğlu, Behiye Oral","doi":"10.1007/s12020-025-04355-z","DOIUrl":"https://doi.org/10.1007/s12020-025-04355-z","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to investigate the association between number of comorbidities (NOC) with adrenal incidentaloma (AI) and autonomic cortisol hypersecretion (ACS) in obese individuals.</p><p><strong>Methods: </strong>This cohort study included 855 obese individuals (males/females: 175/680), who presented with obesity and were screened with 1 mg dexamethasone suppression test (DST). Hypertension (HT); type 2 diabetes mellitus (T2DM); hyperlipidaemia (HL); coronary artery disease (CAD); frequency of AI (in 255 patients with imaging) data were obtained from patient files. Patients were categorized according to DST cortisol levels as <0.9 μg/dL (group 1 [G1]), 0.9-1.8 μg/dL (G2) and >1.8 μg/dL (G3, defined as ACS).</p><p><strong>Results: </strong>Frequency of ACS and AI according to NOC; NOC-0 (0.5%, 2.5%), NOC-1 (0.9%, 15.8%), NOC-2 (3.4%, 23.5%), NOC-3 (4.1%, 15.1%), NOC-4 (13.6%, 35.7%). Increased frequency of ACS and AI in NOC-2, NOC-3, NOC-4 vs. NOC-0 group (P < 0.05 for all). The prevalence of T2DM, HT, HL CAD and AI was lower in the group with a G1 (18.5%, 19.5%, 31.7%, 3.6%, 3%) compared to those in the G2 (43.8%, 70.5%, 52.7%, 12.5%, 52.4%, P < 0.001 for all) and G3 (42.9%, 78.6%, 78.6%, 21.4%, 61.5%, P < 0.001 for all), frequency of comorbidities and AI in G2 vs. G3 are similar. DST result was found to be an independent factor the presence of any comorbidity.</p><p><strong>Conclusion: </strong>In obese individuals, NOC-2 and higher levels are associated with an increased incidence of AI and ACS. DST is a simple and reliable test to demonstrate this association, and a cut-off of 0.9 μg/dL may be more sensitive.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum-negative chronic thyroiditis: an insidious nosographic entity cause of hypothyroidism, goiter and difficult thyroidectomy.","authors":"Giuseppe Santangelo, Elvira La Mantia, Immacolata Cozzolino, Ludovica Aliberti, Massimo De Falco","doi":"10.1007/s12020-025-04361-1","DOIUrl":"https://doi.org/10.1007/s12020-025-04361-1","url":null,"abstract":"<p><strong>Purpose: </strong>Although there are no histological diagnoses of certainty, the existence of antibody-negative chronic follicular thyroiditis has recently been hypothesized. Therefore, we conducted a study correlating the histopathological data with the clinical and surgical outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted including all patients who underwent thyroidectomy between November 2014 and October 2020 at the Surgery Division of the AOU \"Luigi Vanvitelli\" in Naples. Patients were classified into three groups, correlating the histological data to the anti-thyroperoxidase and anti-thyroglobulin antibodies levels. We distinguished patients without thyroiditis (TF), with antibody-positive thyroiditis (SPT), and with seronegative thyroiditis (SNT). Surgical complications and pre-operative hypothyroidism were evaluated and compared statistically.</p><p><strong>Results: </strong>We enrolled 476 patients divided into three groups: TF (322 patients), SPT (116 patients), and SNT (38 patients). Regarding complications, we observed 6.5% of transient hypoparathyroidism in the TF group, 14.7% in the SPT group and 13.2% in the SNT group (p < 0.05). There were no statistical differences among groups regarding permanent hypoparathyroidism, recurrent laryngeal nerve paralysis and postoperative bleeding. We observed 6.2% of hypothyroidism in the TF group, 33.6% in the SPT group, and 23.7% in the SNT group (p 0.01). In the SPT and SNT groups, the frequency of hypothyroidism was comparable (p: 0.31).</p><p><strong>Conclusions: </strong>These results show that chronic serum-negative thyroiditis represents a nosographic entity, comparable to antibody-positive chronic thyroiditis and statistically correlated to an increase of post-operative hypoparathyroidism and pre-operative hypothyroidism. Serum-negative follicular thyroiditis is a cause of hypothyroidism, goiter in the absence of iodine deficiency, and difficult thyroidectomy.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}