Journal of thyroid disorders & therapy最新文献

{"title":"Refractory Gravesandrsquo; Disease with Ophthalmopathy in a 19-year Old Girl ManagedEndoscopically: A Case Report","authors":"Gyan Ch, Nneka A Sunday-Nweke, Mallika Dh","doi":"10.35248/2167-7948.20.09.234","DOIUrl":"https://doi.org/10.35248/2167-7948.20.09.234","url":null,"abstract":"Graves’ disease is an autoimmune disease of the thyroid gland which results from production of thyroid stimulating immunoglobulins-TSI. These thyroid stimulating immunoglobulins bind to the thyroid stimulating hormone-TSH. This leads to overproduction of thyroid hormones, necessitating excessive functions of these hormones in the body. The commonest presentation is features of hyperthyroidism, occasionally with extra thyroidal features. Graves’ disease is rare in children and adolescents, greater numbers are seen in adults, between fifth and sixth decades of life. We report a case of 19-year-old girl who presented with anterior neck swelling of two years, associated with features of hyperthyroidism and ophthalmopathy which were present at onset. Prior to presentation had received anti thyroid treatments with drugs and radioiodine ablation one year ago and refractory to above treatment. Investigations showed raised thyroxine, tri-iodothyronine, reduced thyroid stimulating hormone and markedly raised thyroid antibody. Thyroid ultrasound showed enlargement of both lobes and isthmus with lobulated outlines, echotexture and heterogenous fibrous bands. She was treated by endoscopic total thyroidectomy (Bilateral axillary and breast approach) without postoperative complication and had since remained euthyroid with good cosmetic outcome. She is currently on outpatient follow up. Graves’ disease in teen age with ophtalmopathy is rare, and refractory with medical and RAI therapy. This can be well managed endoscopically in expert hands.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"9 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69994142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid Function Status by Paired Test","authors":"T. Ahmed, H. Mahtab, T. Tofail, A. Morshed, S. A. Khan","doi":"10.35248/2167-7948.19.08.232","DOIUrl":"https://doi.org/10.35248/2167-7948.19.08.232","url":null,"abstract":"Aim and methods: To understand the utility of paired FT4 and TSH test in determining functional status of Thyroid in diagnostic and follow up settings, we studied 34159 test results. We divided the population into all 9 nine possible classes by using the reference values of the FT4 and TSH. Then we determined class frequency, reference ranges of FT4 and TSH for each class, their Mean Differences (MD) between classes and pattern of association between them within a class. Results: Euthyroid population has FT4 and TSH (14.83–14.90 pmol/ml) and (2.40–2.43 μIU/ml) respectively as 95% Confidence Interval and there is no association between them (r=-0.056; sig. 0.000). Major bulk of abnormal thyroid function (98.15%) is constituted by 4 classes namely Primary Hypothyroid, Primary Hyperthyroid, Compensated Hypothyroid and Compensated Hyperthyroid. The MDs of hormones between groups/ classes are significant (sig.<0.009) in 91.67% (66 of 72) equations and documented FT4 alone can identify 5 classes (Euthyroid, Primary Hyperthyroid, Compensated Hypothyroid, Compensated Hyperthyroid and Secondary Hypothyroid) as their FT4 are significantly different from those of all rest 8 classes and for TSH it is true in only 2 classes (Primary Hypothyroid and Primary Hyperthyroid). Correlations between FT4 and TSH in all 9 classes with abnormal functions are different and none is strong (r<-0.5) therefore only TSH should not be used in diagnostic or follow-up setting. Conclusion: Paired Test can defines 9 classes with class specific FT4 or/and TSH ranges and their correlation pattern. We opine, to use this tool to determination of functional status and utilize reference range of FT4 of Euthyroid as the treatment target for cases with abnormal function.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"8 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69993546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing the Chemo-Sensitivity of Weekly Paclitaxel for Anaplastic Thyroid Cancer: A Clinico-Pathologic Analysis of Cases Enrolled in a Clinical Trial","authors":"N. Onoda, M. Hirokawa, K. Kakudo, A. Sakamoto, K. Sugino, N. Nakashima, N. Suganuma, Shin-ichi Suzuki, Ken-ichi Ito, I. Sugitani","doi":"10.24105/2167-7948.8.231","DOIUrl":"https://doi.org/10.24105/2167-7948.8.231","url":null,"abstract":"This study was conducted to identify the clinico-pathologic factors influencing the response to weekly paclitaxel treatment for Anaplastic Thyroid Cancer (ATC), a rare refractory disease. We investigated clinico-pathological factors as well as the expressions of Ki67, p53, MAD2, TLE3, ALDH1, β-tubulin, E-cadherin and vimentin among the subjects enrolled in a recent nationwide clinical trial of 56 patients with ATC in Japan. We compared the factors of eight responders and eight non-responders. The responders survived significantly longer than the non-responders (median 11.6 vs. 3.6 months, p=0.039). No significant between-group difference was found in histological subtype, TNM classification, or the expression of Ki67, p53, MAD2, TLE3, ALDH1, β-tubulin, E-cadherin or vimentin. When the patients' Prognostic Index (PI) was determined with the sum of four clinical factors, i.e., (1) Acute symptom within 1 month, (2) Tumor size >5 cm, (3) Distant metastasis, and (4) Leukocytosis ≥10,000/mm3, a response in the target lesion was observed significantly more frequently in the patients with a low PI score (0 or 1 positive factor) (5/5, 100%) compared to those with a high PI score (more than two positive factors) (4/11, 36.4%) (p=0.034). In conclusion, ATC patients who responded to chemotherapy with weekly paclitaxel survived significantly longer than non-responders. Patients with a low PI commonly showed a response to this chemotherapy","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"8 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69014704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introductory Chapter: Introduction to Thyroid Disorders","authors":"P. G. Raman","doi":"10.5772/intechopen.82044","DOIUrl":"https://doi.org/10.5772/intechopen.82044","url":null,"abstract":"Thyroid disorders are most common endocrine problem next to diabetes mellitus. Thyroid disorders affect women more compared to men. Thyroid glands secrete, store, and release triiodothyronine (T3) and thyroxine (T4). The hormone T4 gets converted into T3 at tissue level and produces its effect. Iodine is necessary for production of thyroid hormone. Iodine in food is trapped by thyroid gland and is utilized in hormone production. Pituitary and hypothalamus control thyroid gland hormone secretion. TRH from hypothalamus modulates through pituitary to produce TSH, which in turn controls thyroid hormone production. If T4 and T3 are low, TSH level increases to stimulate thyroid gland to secrete more hormone. T3 and T4 hormones have profound effect on the body. Almost all the tissues are stimulated, and body metabolism is increased. T3 and T4 affect cardiovascular system, GI tract, brain, metabolism, weight, bone, etc. With increased T4 and T3, there is tachycardia, diarrhea, hyperglycemia, lowering of cholesterol, increased growth rate in infant, normal brain development, and sexual function. Undiagnosed hypothyroidism in infants not only affects physical and bony growth but also damages brain growth. If untreated, it leads to permanent damage.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"283 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76827256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid Cancer: Diagnosis, Treatment and Follow-Up","authors":"M. Siderova","doi":"10.5772/INTECHOPEN.77163","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.77163","url":null,"abstract":"Thyroid cancer is the most common malignancy of the endocrine system and it is usually presented as nodular goiter, the last being extremely a common clinical and ultrasound finding. The widespread use of ultrasonography during the last decades has resulted in a dramatic increase in the prevalence of clinically inapparent thyroid nodules, which only in 5.0–10.0% harbor thyroid carcinoma. The goal of the initial sonographic assessment of thyroid nodules is to distinguish benign nodules that could be managed conservatively from those with suspicious or malignant features requiring further management, including fine needle aspiration biopsy (FNAB), some axillary molecular techniques and thyroid surgery. Since over 90% of malignant thyroid nodules are differentiated thyroid carcinomas (DTCs) with good prognosis, it is necessary to establish strict criteria for diagnosis, treatment and follow-up in order to minimize the potential harm of over-treatment of low-risk patients and to provide adequate therapy to patients at high risk. This often requires an interdisciplinary approach involving endocrinologists, surgeons, pathologists, radiologists and oncologists.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87290338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inferior Parathyroid Gland Preservation In Situ during Central Neck Dissection for Thyroid Papillary Carcinoma","authors":"L. Xie, Jian-Biao Wang, Liang Zhou","doi":"10.5772/INTECHOPEN.78636","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.78636","url":null,"abstract":"Hypoparathyroidism is the most common and a potentially serious complication of thyroid surgery; therefore, it becomes very important for thyroid surgeons to preserve the parathyroid glands in situ during the thyroid operation. Because of the application of “meticulous capsular dissection,” the problem about how to preserve the parathyroid gland in thyroidectomy has become minor. Because inferior parathyroid glands enjoy a more variable position in the adult neck and they are located in the area of central neck lymph node dissection, how to preserve them in situ during central neck dissection is regarded as a major problem. To solve it, a new operation concept, “a layer of thymusblood vessel-inferior parathyroid gland,” is mainly introduced in this chapter.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88112506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuclear Medicine in the Assessment of Thyrotoxicosis Associated with Increased Thyroid Function and Radioiodine 131 Ablative Therapies","authors":"E. Muñoz","doi":"10.5772/INTECHOPEN.77161","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.77161","url":null,"abstract":"Nuclear medicine is directly involved in both the diagnosis and treatment of benign thy- roid disease. Thyroid scintigraphy (most commonly with technetium-99 m pertechne-tate) should be used as the imaging modality of choice for assessment of thyrotoxicosis, since it demonstrates the functional state of the thyroid gland. An adequate understand-ing of the pathophysiological mechanisms and characteristics of the patient is essential, as well as the different treatments of thyroid disorders that present with hyperthyroid ism ( Graves’ disease , toxic multinodular goiter, and toxic adenoma-Plummer’s disease). Therapeutic modalities include antithyroid drugs, radioiodine and surgery. Antithyroid drugs are the first line of therapy and regarding the use of radioiodine, current recom - mendations consider it a safe and effective therapeutic alternative in hyperthyroidism. Finally, we highlight the existence of some special situations (children, pregnancy, thy- roid eye disease, chronic renal failure and dialysis patients) and the importance of radiation protection measures to the patient, the public and professionals.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"470 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77751597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Main Prognostic Factors for Well Differentiated Thyroid Cancer: Analis of Combined Patients Treatment Results during 20 Years after Surgery","authors":"Guda Bb, A. E. Kovalenko, Bolgov My, Taraschenko Ym, Mykhailenko Ni","doi":"10.4172/2167-7948.1000228","DOIUrl":"https://doi.org/10.4172/2167-7948.1000228","url":null,"abstract":"Background: Thyroid surgeries are among the most common operations performed in the world. Hypocalcemia following total thyroidectomy is a common complication that is sometimes difficult to correct. The aim of this study was to compare two groups of patients: those with normocalcemia and those with hypocalcemia following total thyroidectomy upon discharge from the hospital and 6 to 12 months following surgery as well as to determine the clinical value. Methods: From January 2015 through April 2017, 400 patients were included in this prospective multicenter study. All the patients underwent total thyroidectomy due to various thyroid diseases. The following risk factors were analyzed: preoperative and postoperative biochemical blood parameters, clinical effects and factors related to surgery, the patient and the disease. By way of random of selection, 2 groups of patients were formed: 30 patients who had a normal level of calcium detected in the blood upon discharge from the hospital following total thyroidectomy (normocalcemia group), and 30 patients who had a reduced level of calcium in the blood upon discharge from the hospital (hypocalcemia group). In these groups of patients, the following parameters were determined: calcium, ionized calcium, 25-hydroxyvitamin D, parathyroid hormone, clinical expression of hypocalcaemia and the use of calcium and 25-hydroxyvitamin D preparations upon discharge from the hospital and 6 to 12 months following surgery. Results: Based on the data of our study, the comparison of patient groups with normocalcemia and hypocalcemia upon discharge from the hospital and 6 to 12 months following surgery demonstrated that there were no statistically significant factors for postoperative hypocalcaemia. Generally, there were no differences between the groups 6 to 12 months following surgery. A reduced level of calcium was determined only in 2 of 30 patients with hypocalcaemia 6 to 12 months following surgery. In the group of patients with normocalcemia, the level of calcium remained normal both on day 2 when they were discharged from the hospital and 6 to 12 months following surgery. Comparing the normocalcemia and hypocalcemia groups on day 2 following surgery and 6 to 12 months following surgery, McNemar’s test showed a statistically significant distribution between these patient groups (p<0.01). Of the 2 mentioned patients with hypocalcemia, clinical symptoms were not observed in 1 patient 6 to 12 months following surgery. The patient did not take calcium and calcitriol preparations. Another patient complained about numbness of fingers. The patient used calcium and calcitriol preparations. In the hypocalcemia group, a reduced level of parathyroid hormone was determined in 9 patients on day 1 following surgery. A reduced level of parathyroid hormone was determined in 1 patient of this group 6 to 12 months following surgery. Conclusion: Hypocalcemia following total thyroidectomy is among the most common complications. Treat","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"2018 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46227956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Thyroid Functions in Patients with Multiple Sclerosis Before and after Treatment with Interferon Beta","authors":"Magda Shokry Mohammed, N. Shoeib, I. Sabry, D. Gawad, A. Bahaaeldin, N. Adly","doi":"10.4172/2167-7948.1000227","DOIUrl":"https://doi.org/10.4172/2167-7948.1000227","url":null,"abstract":"Background: Multiple sclerosis (MS) is a multi-component disease characterized by inflammation, neurodegeneration and failure of central nervous system (CNS) repair mechanisms. Autoimmune thyroid disease is a frequently studied disorder in MS, most studies have focused primarily on the increased prevalence of thyroid dysfunction and anti-thyroid antibodies (ATAs) in MS patients compared with a control population.Objectives: To investigate the effect of treatment with interferon beta on thyroid functions and autoimmune thyroid markers in patients with multiple sclerosis.Subjects and Methods: This prospective study was conducted on 100 subjects recruited from the inpatient and outpatient clinic of Internal Medicine department and Neurology Unit of Ain Shams University Hospitals. They were divided into group 1, which included 50 patients newly diagnosed with multiple sclerosis according to Macdonald’s criteria 2010 and group 2, which included 50, age and sex matched healthy volunteers. All participants were exposed before and 6 months after treatment with interferon beta to Expanded disability status scale (EDSS), which is a method of quantifying disability in multiple sclerosis, Free T4, Free T3 and TSH, Anti thyroid peroxidase (anti- TPO) and anti-thyroglobulin (anti TG) antibodies, MRI brain and neck ultrasonography.Results: Anti thyroid peroxidase antibody levels were significantly higher in the drug naive patients group after treatment with interferon beta (29.660 ± 28.755 IU/ml) in comparison to their baseline values (17.580 ± 4.982 IU/ml) (p-value=0.004). Anti-thyroglobulin antibody levels were significantly higher too after treatment with interferon beta (33.920 ± 32.553 IU/ml) in comparison to baseline values (24.560 ± 20.101 IU/ml) (p- value=0.01).Conclusion: IFN-β therapy has a strong impact on the auto-immune thyroid markers status and levels in drug naive MS patients causing increase in both anti TPO and anti TG positivity statues and numerical values.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"7 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46919503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subclinical Hypothyroidism and its Associated Disorders","authors":"Shah Sb","doi":"10.4172/2167-7948.1000230","DOIUrl":"https://doi.org/10.4172/2167-7948.1000230","url":null,"abstract":"Subclinical hypothyroidism is an early, mild form of hypothyroidism, a condition in which the body doesn’t produce enough thyroid hormones. These hormones are required for normal heart, brain, and metabolic functions. Subclinical hypothyroidism is diagnosed with a blood test. Normal reference range for TSH is considered to be 4.5 mIU/L or 5.0 mIU/L slightly elevated TSH levels along with normal range T3 and T4 hormones are considered to be presentation of SCH. Whether to treat these patients with thyroxine is still a question of debate. SCH is associated with various signs and symptoms. It is highly recommended to use thyroxine in SCH pregnant patients as there are convincing reports of danger to mother and fetus. Infertile SCH females have also shown to benefit with thyroxine therapy. SCH has also been linked with effects on cardiovascular disorders, lipid abnormalities, DVT, weight changes, neuropsychiatric disorders and male infertility. The data, however, is not adequate and further large-scale studies are required.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"7 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70841628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}