Year : 2012 | Volume
: 9 | Issue : 1 | Page : 23--24
Mini G Pillai
Department of Endocrinology, Consultant Endocrinologist, PVS Hospital, Kochi, Kerala, India
Mini G Pillai
Department of Endocrinology, Lakshmi Hospital, Cochin, Kerala
|How to cite this article:|
Pillai MG. Thyroid watch.Thyroid Res Pract 2012;9:23-24
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Pillai MG. Thyroid watch. Thyroid Res Pract [serial online] 2012 [cited 2020 Oct 22 ];9:23-24
Available from: https://www.thetrp.net/text.asp?2012/9/1/23/92394
Simultaneous occurrence of subacute thyroiditis and Graves' disease. This case report describes a 41-year-old woman who presented with 10 days of neck pain, dysphagia, and hyperthyroid symptoms and signs. Laboratory tests revealed thyrotoxicosis with elevated thyroglobulin antibody, thyroperoxidase antibody, thyroid-stimulating hormone receptor antibody, thyroid-stimulating immunoglobulins as well as very high erythrocyte sedimentation rate and C-reactive protein. Human leukocyte antigen (HLA) typing revealed DRB1, DR8, B35, B39, DQB1, DQ4, and DQ5. Ultrasound showed an enlarged heterogeneous gland with mild hypervascularity. Fine-needle aspiration biopsy revealed granulomatous thyroiditis. The thyroid scan showed a diffusely enlarged gland and heterogeneous trapping with a focal area of relatively increased radiotracer accumulation in the right upper pole. The patient was treated symptomatically. Over the next several weeks, she developed hypothyroidism requiring levothyroxine treatment. A strong family history of autoimmune thyroid disorders was noted in this patient. Genetic predilection was also shown by HLA typing. Subacute thyroiditis (SAT)-induced autoimmune alteration may promote the development of Graves' disease in susceptible patients.
Thyroid. 2011 Dec;21(12):1397-400.Factors affecting neonatal screening thyroid-stimulating hormone: A multivariate analysis of factors affecting neonatal screening thyroid stimulating hormone (TSH) levels was done. This retrospective study included 6 498 infants screened during a 12-week period in UK. Screening TSH level showed negative correlation with gestational age and birth weight. Multiple linear regression analysis revealed low birth weight as the only independent factor affecting screening TSH level.
J Pediatr Endocrinol Metab. 2011;24(9-10):727-32.Congenital hypothyroidism in chromosome 3p25.3-pter deletion: A neonate presenting with many of the typical phenotypic characteristics of chromosome 3p deletion including hypertelorism, flat nasal bridge, flat philtrum, thin lips, low-set ears, post-axial polydactyly, single palmar creases, and rocker bottom feet along with a high TSH noted on newborn screening and confirmed later is described. A karyotype confirmed chromosome 3p25.3-pter deletion with normal parental karyotypes. Thyroid nuclear imaging was suggestive of dyshormonogenesis.
J Pediatr Endocrinol Metab. 2011;24(9-10):787-8.Fucus vesiculosus-induced hyperthyroidism: Fucus vesiculosus is a marine alga rich in iodine, which is being used in alternative medicine as a laxative, diuretic, and as a complement for weight loss diets. This case report describes a 60-year-old male patient, diagnosed with bipolar disorder and under treatment with lithium concomitantly with a herbal preparation, including Fucus vesiculosus as a laxative. He developed hyperthyroidism that remitted once the herbal preparation was withdrawn.
Actas Esp Psiquiatr. 2011 Nov;39(6):401-3. Hyperthyroidism and pulmonary hypertension: The literature on the association between hyperthyroidism and pulmonary hypertension is reviewed. Twenty publications reporting 164 patients with hyperthyroidism and pulmonary hypertension were included. The patients were treated with antithyroid medications, radioactive iodine, and surgery. The mean pretherapy pulmonary artery (PA) systolic pressure was 39 mm Hg; the mean post-treatment pressure was 30 mm Hg. Thus, pulmonary hypertension should be considered in a hyperthyroid patient with dyspnea.
Am J Med Sci. 2011 Dec;342(6):507-12.Differentiated thyroid carcinoma in children: In a retrospective analysis of the records of patients with differentiated thyroid cancer (DTC) seen over a period of 20 years in a single pediatric endocrine center, it was seen that of the 45 patients (median age, 13.7 years; 36 female) diagnosed with DTC were papillary and the rest, follicular; most presented as solitary nodule, rest as thyroid nodule with cervical adenopathy and multinodular goiter. All underwent total thyroidectomy with resection of suspicious cervical lymph nodes. DTC was multicentric in 59% and revealed extrathyroidal extension in 44%. Initially, 44% had cervical lymph node (CLN) metastases and 24% distant metastases. All patients underwent thyroid remnant ablation with 131I and suppressive treatment. Median follow-up was 5.1 years with a disease-free survival rate at 5 years of follow-up of 75%. Thus, pediatric DTC had an aggressive behavior at presentation. Higher preoperative TSH levels were significantly associated with a more advanced disease at diagnosis.
J Pediatr Endocrinol Metab. 2011;24(9-10):743-8.NT-pro-brain natriuretic peptide in patients with thyroid disease:
The study included 101 patients with overt hyperthyroidism, subclinical hyperthyroidism, overt hypothyroidism, and subclinical hypothyroidism and control subjects with normal thyroid profile. All were free of any cardiovascular disease. Compared with control subjects, hyperthyroid patients were characterized by higher plasma levels of NT-pro-BNP, especially so in overt disease. Hypothyroidism was not associated with any significant changes in this peptide. Plasma levels of NT-pro-BNP did not differ between patients with Graves' disease and toxic nodular goiter. Thus, the thyrometabolic state of the patient should always be taken into consideration when NT-pro-BNP is assessed as a marker of cardiac dysfunction.
Pol J Endocrinol 2011; 62 (6): 523-528.Surgical completeness of thyroidectomy with bilateral axillo-breast approach robotic thyroidectomy vs conventional open thyroidectomy: Of the patients who underwent total thyroidectomy between 2008 and 2010, the completeness of thyroidectomy was assessed in 174 bilateral axillo-breast approach robotic thyroidectomy (BABA RoT) and 237 open thyroidectomy (OT) patients who received radioactive iodine (RAI) ablation. The BABA RoT and OT cohorts were not different with regard to the RAI uptake ratio, stimulated thyroglobulin (Tg) levels, or proportion of patients with stimulated Tg levels <1.0 ng/ml on the first ablation. The number of RAI ablation sessions and RAI doses needed to achieve a complete ablation also did not differ significantly.
Surgery. 2011 Dec;150(6):1266-74.Risk stratification of indeterminate thyroid fine-needle aspiration biopsy specimens based on mutation analysis: A mutation analysis model using the prevalence of BRAF, RET, RAS, and PAX8/peroxisome proliferator-activated receptor-g mutations in indeterminate lesions was applied retrospectively to a study cohort of 466 consecutive indeterminate lesions that underwent hemi- or total thyroidectomy for definitive diagnosis. Of 466 indeterminate lesions in the study, 30% were malignant. These included 66 cases of papillary thyroid cancer, 45 cases of follicular variant of papillary thyroid cancer, 18 cases of follicular thyroid cancer, and 10 others. The risk of malignancy was 42% when cytologic atypia was present vs 17% without. The mutation analysis model correctly identified only 34% of malignant indeterminate lesions. Thus, indeterminate lesions with a negative mutation analysis still carry a significant risk of malignancy, especially in the presence of atypia, requiring surgery for definitive diagnosis.
Surgery. 2011 Dec;150(6):1085-91.Survivin-delta Ex 3: A novel biomarker for diagnosis of papillary thyroid carcinoma: This study evaluated the expression level of survivin, an inhibitory protein in the apoptotic pathway and one of its splice variants, survivin-deltaEx3 in thyroid nodules. Samples were collected from 61 thyroid nodules including malignancy, adenoma, non-tumoral (goiter and thyroiditis) as well as non-neoplastic normal tissues. Transcriptional levels were measured using semi-quantitative reverse transcriptase-polymerase chain reaction. It was seen that survivin-deltaEx3 is significantly upregulated from normal to malignant thyroid carcinoma tissues (approximately ten fold). Thus, survivin gene expression and its splice variant, survivin-deltaEx3, can be potential new markers in diagnosis of human thyroid carcinoma.
J Cancer Res Ther. 2011 Jul;7(3):325-30.