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Simpson JB, Walker ME, Sekela JJ, Ivey SM, Jariwala PB, Storch CM, Kowalewski ME, Graboski AL, Lietzan AD, Walton WG, Davis KA, Cloer EW, Borlandelli V, Hsiao YC, Roberts LR, Perlman DH, Liang X, Overkleeft HS, Bhatt AP, Lu K, Redinbo MR. Gut microbial β-glucuronidases influence endobiotic homeostasis and are modulated by diverse therapeutics. Cell Host Microbe 2024; 32:925-944.e10. [PMID: 38754417 DOI: 10.1016/j.chom.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/18/2024] [Accepted: 04/24/2024] [Indexed: 05/18/2024]
Abstract
Hormones and neurotransmitters are essential to homeostasis, and their disruptions are connected to diseases ranging from cancer to anxiety. The differential reactivation of endobiotic glucuronides by gut microbial β-glucuronidase (GUS) enzymes may influence interindividual differences in the onset and treatment of disease. Using multi-omic, in vitro, and in vivo approaches, we show that germ-free mice have reduced levels of active endobiotics and that distinct gut microbial Loop 1 and FMN GUS enzymes drive hormone and neurotransmitter reactivation. We demonstrate that a range of FDA-approved drugs prevent this reactivation by intercepting the catalytic cycle of the enzymes in a conserved fashion. Finally, we find that inhibiting GUS in conventional mice reduces free serotonin and increases its inactive glucuronide in the serum and intestines. Our results illuminate the indispensability of gut microbial enzymes in sustaining endobiotic homeostasis and indicate that therapeutic disruptions of this metabolism promote interindividual response variabilities.
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Affiliation(s)
- Joshua B Simpson
- Department of Chemistry, University of North Carolina, Chapel Hill, NC, USA
| | - Morgan E Walker
- Department of Chemistry, University of North Carolina, Chapel Hill, NC, USA
| | - Joshua J Sekela
- Department of Chemistry, University of North Carolina, Chapel Hill, NC, USA
| | - Samantha M Ivey
- Department of Chemistry, University of North Carolina, Chapel Hill, NC, USA
| | - Parth B Jariwala
- Department of Chemistry, University of North Carolina, Chapel Hill, NC, USA
| | - Cameron M Storch
- Department of Chemistry, University of North Carolina, Chapel Hill, NC, USA
| | - Mark E Kowalewski
- Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill, NC, USA
| | - Amanda L Graboski
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC, USA
| | - Adam D Lietzan
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - William G Walton
- Department of Chemistry, University of North Carolina, Chapel Hill, NC, USA
| | - Kacey A Davis
- Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill, NC, USA
| | - Erica W Cloer
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Valentina Borlandelli
- Department of Bioorganic Synthesis, Leiden Institute of Chemistry, Leiden University, Leiden, the Netherlands
| | - Yun-Chung Hsiao
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Lee R Roberts
- Exploratory Science Center, Merck & Co., Inc., Cambridge, MA 02141, USA
| | - David H Perlman
- Exploratory Science Center, Merck & Co., Inc., Cambridge, MA 02141, USA
| | - Xue Liang
- Exploratory Science Center, Merck & Co., Inc., Cambridge, MA 02141, USA
| | - Hermen S Overkleeft
- Department of Bioorganic Synthesis, Leiden Institute of Chemistry, Leiden University, Leiden, the Netherlands
| | - Aadra P Bhatt
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Division of Gastroenterology and Hepatology, Department of Medicine, Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kun Lu
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Matthew R Redinbo
- Department of Chemistry, University of North Carolina, Chapel Hill, NC, USA; Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill, NC, USA.
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Allahwasaya A, Wang R, Akhund R, McLeod C, Chen H, Lindeman B, Fazendin J, Gillis A, McMullin JL. Does Graves' Disease Truly Increase the Risk of Complications After Total Thyroidectomy? J Surg Res 2024; 300:127-132. [PMID: 38805845 DOI: 10.1016/j.jss.2024.04.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 05/30/2024]
Abstract
INTRODUCTION Total thyroidectomy (TTx) has been reported to be more challenging in patients with Graves' disease, especially in those who are hyperthyroid at the time of surgery. Our aim was to compare outcomes in patients undergoing TTx for Graves' disease compared to other thyroid diseases at a large academic institution with high-volume fellowship-trained endocrine surgeons. METHODS In our retrospective analysis from December 2015 to May 2023, patients undergoing TTx for Graves' disease were compared to those undergoing TTx for all other indications excluding advanced malignancy (poorly differentiated thyroid cancer and concomitant neck dissections). Patient demographics, biochemical values, and postoperative outcomes were compared. A subgroup analysis was performed comparing hyperthyroid to euthyroid patients at the time of surgery. RESULTS There were 589 patients who underwent TTx, of which 227 (38.5%) had Graves' disease compared to 362 (61.5%) without. Intraoperatively in Graves' patients, nerve monitoring was used more frequently (65.6% versus 57.1%; P = 0.04) and there was a higher rate of parathyroid autotransplantation (32.0% versus 14.4%; P < 0.01). Postoperatively, transient voice hoarseness occurred less frequently (4.8% versus 13.6%; P < 0.01) and there was no difference in temporary hypocalcemia rates or hematoma rates. In our subgroup analysis, 83 (36%) of Graves' patients were hyperthyroid (thyroid-stimulating hormone < 0.45 and free T4 > 1.64) at the time of surgery and there were no differences in postoperative complications compared to those who were euthyroid. CONCLUSIONS At a high-volume endocrine surgery center, TTx for Graves' disease can be performed safely without significant differences in postoperative outcomes. Hyperthyroid patients demonstrated no differences in postoperative outcomes.
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Affiliation(s)
- Ashba Allahwasaya
- Department of Surgery, University of Alabama at Birmingham, Birmingham Alabama
| | - Rongzhi Wang
- Department of Surgery, University of Alabama at Birmingham, Birmingham Alabama
| | - Ramsha Akhund
- Department of Surgery, University of Alabama at Birmingham, Birmingham Alabama
| | - Chandler McLeod
- Department of Surgery, University of Alabama at Birmingham, Birmingham Alabama
| | - Herbert Chen
- Department of Surgery, University of Alabama at Birmingham, Birmingham Alabama
| | - Brenessa Lindeman
- Department of Surgery, University of Alabama at Birmingham, Birmingham Alabama
| | - Jessica Fazendin
- Department of Surgery, University of Alabama at Birmingham, Birmingham Alabama
| | - Andrea Gillis
- Department of Surgery, University of Alabama at Birmingham, Birmingham Alabama
| | - Jessica Liu McMullin
- Department of Surgery, University of Alabama at Birmingham, Birmingham Alabama; Department of Surgery, University of Utah, Salt Lake City, Utah.
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Kim KJ, Choi J, Kim KJ, Song E, Yu JH, Kim NH, Yoo HJ, Seo JA, Kim NH, Choi KM, Baik SH, Kim SG. Cancer Risk in Graves Disease with Radioactive 131I Treatment: A Nationwide Cohort Study. J Nucl Med 2024; 65:693-699. [PMID: 38548348 DOI: 10.2967/jnumed.123.266531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 02/20/2024] [Indexed: 05/03/2024] Open
Abstract
Radioactive 131I (RAI) therapy has potential effects for the treatment of Graves disease (GD). However, whether RAI therapy for GD increases cancer risk remains controversial in medicine and public health. We aimed to investigate whether the risk of cancer increases in patients with GD receiving RAI therapy compared with those who did not. Methods: We used the Korean National Health Insurance Service's National Health Information Database from 2004 to 2020 and defined GD as prescribing antithyroid drugs, RAI, or thyroidectomy as a treatment for GD (International Classification of Diseases, 10th revision, E05 group). We investigated the hazard ratios (HRs) of overall and site-specific cancers associated with RAI in patients with GD. Subsequent cancer was defined as a primary malignancy treated at least 1 y after RAI therapy. Results: In total, 10,737 patients with GD who received RAI therapy (7,193 women, 67.0%; mean age, 43.7 ± 13.4 y) were matched to 53,003 patients with GD who had never received RAI treatment (35,471 women, 66.9%; mean age, 43.8 ± 13.2 y) in a 1:4-5 ratio by age, sex, and health checkup data. The median follow-up duration was 8.7 y (interquartile range, 5.2-12.1 y), and the median cumulative RAI dose was 555 MBq (interquartile range, 370-630 MBq) in the RAI therapy group. During 2004-2020, the overall subsequent cancer rates were 5.66 and 5.84 per 1,000 person-years in the RAI and non-RAI groups, respectively, with an unadjusted HR of 0.97 (95% CI, 0.88-1.06); this remained at 0.96 (95% CI, 0.83-1.10) after adjustment for multiple clinical confounding factors. For cancer subtypes, the risk of leukemia was significantly increased, with an HR of 2.39 (95% CI, 1.17-4.91). However, a loss of statistical significance was observed after adjusting for confounding factors, which may be attributed to the limited number of absolute events. Moreover, cancer-specific mortality was not different between the RAI and the non-RAI groups, with an adjusted HR of 0.99 (95% CI, 0.66-1.47). Conclusion: This study identified that the overall cancer risk in patients with GD who received RAI therapy compared with those who did not was not significant in Korea. Further long-term studies are needed to determine the risks and advantages of RAI therapy in patients with GD.
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Affiliation(s)
- Kyeong Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jimi Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eyun Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji Hee Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
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Yuan A, Wu J, Huang H. Comparison of treatment outcome between glucocorticoids and non-steroidal anti-inflammatory drugs in subacute thyroiditis patients-a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1384365. [PMID: 38715797 PMCID: PMC11075098 DOI: 10.3389/fendo.2024.1384365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/11/2024] [Indexed: 05/23/2024] Open
Abstract
Importance Subacute thyroiditis (SAT) is a self-limiting and inflammatory thyroid disease. Although SAT usually improves on its own within weeks, it needs treatment when patients have pain, fever, and symptoms of thyrotoxicosis. Therapeutic drugs mainly include non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids. Currently, there is no systematic review or meta-analysis of the comparison of outcomes between NSAIDs and glucocorticoids for the treatment of SAT. Objectives To conduct a systematic review and meta-analysis on the outcomes in subacute thyroiditis patients treated with glucocorticoids or NSAIDs. Data sources Using the four electronic databases, including PubMed, Embase, Cochrane Library, Wanfang database and Web of Science. All publications until 21 June 2023 were searched. The reference lists of all selected articles were independently screened to identify additional studies left out in the initial search. Study selection The literature comparing outcomes between glucocorticoids and non-steroidal anti-inflammatory drugs for patients with subacute thyroiditis will be included. Data extraction and synthesis Two independent investigators (Anqi Yuan and Jialu Wu) extracted the data following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (PRISMA) and then evaluated the quality of the eligible studies with the Newcastle-Ottawa Scale. Fixed-effects models for the meta-analyses were applied. Heterogeneity was assessed with the chi-squared (x²) test (Cochran's Q) and inconsistency index (I²). The robustness of the results was tested with the sensitivity analyses. The bias of publication was assessed with the Harbord test. Main outcomes and measures The incidence of permanent hypothyroidism in SAT patients treated with corticosteroids or NSAIDs. Results Our study included a total of ten comparative cohort studies with 1337 participants. We found that the incidence of developing permanent hypothyroidism in the SAT patients who received glucocorticoids treatment was significantly lower than those who received NSAIDs treatment. (OR, 0.56; 95% CI, 0.36-0.88; P = 0.01). The risk of permanent hypothyroidism in patients who received prednisone at an average initial dose < 40 mg/d was significantly lower than that in patients who received NSAIDs (OR, 0.37; 95% CI, 0.14-0.94; P = 0.04). There was no significant difference in the occurrence of permanent hypothyroidism between SAT patients who received an average initial dose ≥ 40 mg/d of prednisone and those who received only NSAIDs (OR, 0.7; 95% CI, 0.14-3.53; P = 0.67). In addition, the recurrence rate was observably higher in those receiving glucocorticoids than in those receiving NSAIDs (OR, 1.98; 95% CI, 1.12-3.5; p = 0.02). The recurrence rate was significantly higher in patients with an average initial prednisone dose of < 40 mg/d than in the NSAIDs group. There was no significant difference in the recurrence rate between patients in the mean initial prednisone dose ≥ 40 mg/d group and those in the NSAIDs group. Conclusions and relevance In this meta-analysis, we compared the treatment outcomes of SAT patients between glucocorticoids and NSAIDs. Our results indicated that glucocorticoid treatment was associated with a lower incidence of permanent hypothyroidism than NSAID treatment. Patients treated with NSAIDs might have a lower recurrence rate. This finding might help to understand the outcome of the disease when choosing different drugs and help physicians to make appropriate decisions. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023427332.
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Affiliation(s)
| | | | - Hui Huang
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
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Lin M, Mao D, Hu KL, Zhou P, Liu FT, Yin J, Zhang H, Li R. Impact of mildly evaluated thyroid-stimulating hormone levels on in vitro fertilization or intracytoplasmic sperm injection outcomes in women with the first fresh embryo transfer: a large study from China. J Assist Reprod Genet 2024; 41:683-691. [PMID: 38403803 PMCID: PMC10957836 DOI: 10.1007/s10815-023-03014-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/20/2023] [Indexed: 02/27/2024] Open
Abstract
PURPOSE This study aimed to investigate the association between mild elevation of thyroid-stimulating hormone (TSH) levels and pregnancy outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatments in women with the first fresh embryo transfer. METHODS Large single-center retrospective cohort study of 15,728 patients from January 2018 to December 2022 were enrolled in the analyses. Clinical pregnancy rates, live birth rates, miscarriage rates, and ectopic pregnancy rates were compared between the TSH levels < 2.5 mIU/L group (N = 10,932) and TSH levels ≥ 2.5 mIU/L group (N = 4796). Subgroup analysis was performed for patients with TSH levels ≥ 2.5 mIU/L, dividing them into the thyroid peroxidase antibody (TPO)-negative group (N = 4524) and the TPO-positive group (N = 272). RESULTS There were no significant differences in the aforementioned pregnancy outcomes between the TSH levels < 2.5 mIU/L group and TSH levels ≥ 2.5 mIU/L group. Similarly, no significant differences were observed in the pregnancy outcomes between the TPO-negative group and the TPO-positive group. CONCLUSION Mildly elevated pre-conception TSH levels in thyroid-normal infertile patients did not have an impact on pregnancy outcomes of IVF/ICSI treatments.
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Affiliation(s)
- Mingmei Lin
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Di Mao
- Peking University Health Science Center, Beijing, China
| | - Kai-Lun Hu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Ping Zhou
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Fen-Ting Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Jingwen Yin
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Hua Zhang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital), Beijing, China.
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China.
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China.
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Chahed F, Ben Fredj N, Ben Romdhane H, Chadli Z, Chaabane A, Fadhel NB, Aouam K. Methimazole-induced urticaria in hyperthyroid patients: A safe re-administration protocol. Therapie 2024:S0040-5957(24)00026-X. [PMID: 38403562 DOI: 10.1016/j.therap.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/17/2023] [Accepted: 12/19/2023] [Indexed: 02/27/2024]
Abstract
PURPOSE The safety profile of methimazole (MMI) seems to be better than propylthiouracil in the management of hyperthyroidism. It is therefore advisable to use IMM as the first choice in Graves' patients. It is important to keep this drug in patients regardless of minor side effects. We report a case series of MMI-induced urticaria and provide a stepwise protocol for the safe re-administration of MMI. METHODS It was a retrospective case series including all patients having manifested urticaria following MMI intake for hyperthyroidism; notified to the Pharmacovigilance Unit of the Clinical Pharmacology Department (March 2013-January 2022). RESULTS We have included 11 patients (SR: 0.22). The median time interval between the start of MMI and the onset of urticaria averaged 14.5 days. The median daily dose of MMI was 40mg. MMI was interrupted in all patients. Urticaria has progressively resolved after drug interruption and antihistamine intake. Reintroduction of MMI was performed in 10/11 patients as follows: one quarter of the daily dose on the first day, half of the daily dose on the 4th day, the three quarters of the daily dose on the 7th day, to reach the scheduled total dose on the 10th day. Cetirizine was added at the time of reintroduction and withdrawn 2 weeks later. All the patients were successfully controlled. CONCLUSION Given the importance of this drug in the management of hyperthyroidism, MMI should not be withdrawn in cases of urticaria. After the resolution of urticaria, a gradual reintroduction of MMI should be attempted with concomitant antihistamine therapy.
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Affiliation(s)
- Ferdaous Chahed
- Department of Clinical Pharmacology, University Hospital/Faculty of Medicine of Monastir, University of Monastir, 5000 Monastir, Tunisia.
| | - Nadia Ben Fredj
- Department of Clinical Pharmacology, University Hospital/Faculty of Medicine of Monastir, University of Monastir, 5000 Monastir, Tunisia
| | - Haifa Ben Romdhane
- Department of Clinical Pharmacology, University Hospital/Faculty of Medicine of Monastir, University of Monastir, 5000 Monastir, Tunisia
| | - Zohra Chadli
- Department of Clinical Pharmacology, University Hospital/Faculty of Medicine of Monastir, University of Monastir, 5000 Monastir, Tunisia
| | - Amel Chaabane
- Department of Clinical Pharmacology, University Hospital/Faculty of Medicine of Monastir, University of Monastir, 5000 Monastir, Tunisia
| | - Najah Ben Fadhel
- Department of Clinical Pharmacology, University Hospital/Faculty of Medicine of Monastir, University of Monastir, 5000 Monastir, Tunisia
| | - Karim Aouam
- Department of Clinical Pharmacology, University Hospital/Faculty of Medicine of Monastir, University of Monastir, 5000 Monastir, Tunisia
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Zheng P, Raj P, Wu L, Mizutani T, Szabo M, Hanson WA, Barman I. Quantitative Detection of Thyroid-Stimulating Hormone in Patient Samples with a Nanomechanical Single-Antibody Spectro-Immunoassay. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2305110. [PMID: 37752776 PMCID: PMC10922205 DOI: 10.1002/smll.202305110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/12/2023] [Indexed: 09/28/2023]
Abstract
Functional disorders of the thyroid remain a global challenge and have profound impacts on human health. Serving as the barometer for thyroid function, thyroid-stimulating hormone (TSH) is considered the single most useful test of thyroid function. However, the prevailing TSH immunoassays rely on two types of antibodies in a sandwich format. The requirement of repeated incubation and washing further complicates the issue, making it unable to meet the requirements of the shifting public health landscape that demands rapid, sensitive, and low-cost TSH tests. Herein, a systematic study is performed to investigate the clinical translational potential of a single antibody-based biosensing platform for the TSH test. The biosensing platform leverages Raman spectral variations induced by the interaction between a TSH antigen and a Raman molecule-conjugated TSH antibody. In conjunction with machine learning, it allows TSH concentrations in various patient samples to be predicted with high accuracy and precision, which is robust against substrate-to-substrate, intra-substrate, and day-to-day variations. It is envisioned that the simplicity and generalizability of this single-antibody immunoassay coupled with the demonstrated performance in patient samples pave the way for it to be widely applied in clinical settings for low-cost detection of hormones, other molecular biomarkers, DNA, RNA, and pathogens.
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Affiliation(s)
- Peng Zheng
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States
| | - Piyush Raj
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States
| | - Lintong Wu
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States
| | - Takayuki Mizutani
- Beckman Coulter Diagnostics – Immunoassay Business Unit, 1000 Lake Hazeltine Dr, Chaska, MN 55318
| | - Miklos Szabo
- Beckman Coulter Diagnostics – Immunoassay Business Unit, 1000 Lake Hazeltine Dr, Chaska, MN 55318
| | - William A. Hanson
- Beckman Coulter Diagnostics – Immunoassay Business Unit, 1000 Lake Hazeltine Dr, Chaska, MN 55318
| | - Ishan Barman
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
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8
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Dietlein M, Grünwald F, Schmidt M, Kreissl MC, Luster M. [Guideline for Radioiodine Therapy for Benign Thyroid Diseases (6/2022 - AWMF No. 031-003)]. Nuklearmedizin 2024; 63:8-20. [PMID: 37871629 DOI: 10.1055/a-2185-7885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
This version of the guideline for radioiodine therapy of benign thyroid disorders is an update of the version, which was published by the German Society of Nuclear Medicine (Deutsche Gesellschaft für Nuklearmedizin, DGN) in co-ordination with the German Society of Endocrinology (Deutsche Gesellschaft für Endokrinologie, DGE, Sektion Schilddrüse) and the German Society of General- and Visceral-Surgery (Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie, DGAV) in 2015. This guideline was harmonized with the recommendations of the European Association of Nuclear Medicine (EANM). According to the German "Directive on Radiation Protection in Medicine" the physician specialised in nuclear medicine ("Fachkunde in der Therapie mit offenen radioaktiven Stoffen") is responsible for the justification to treat with radioiodine. Therefore, relevant medical indications for radioiodine therapy and alternative therapeutic options are discussed within the guideline. This procedure guideline is developed in the consensus of an expert group. This fulfils the level S1 (first step) within the German classification of Clinical Practice Guidelines.
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Affiliation(s)
- M Dietlein
- Klinik und Poliklinik für Nuklearmedizin des Universitätsklinikums Köln
| | - F Grünwald
- Klinik für Nuklearmedizin des Universitätsklinikums Frankfurt
| | - M Schmidt
- Klinik und Poliklinik für Nuklearmedizin des Universitätsklinikums Köln
| | - M C Kreissl
- Bereich Nuklearmedizin, Klinik für Radiologie und Nuklearmedizin des Universitätsklinikums Magdeburg
| | - M Luster
- Klinik für Nuklearmedizin des Universitätsklinikums Marburg
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Clemente-Suárez VJ, Redondo-Flórez L, Rubio-Zarapuz A, Martín-Rodríguez A, Tornero-Aguilera JF. Microbiota Implications in Endocrine-Related Diseases: From Development to Novel Therapeutic Approaches. Biomedicines 2024; 12:221. [PMID: 38255326 PMCID: PMC10813640 DOI: 10.3390/biomedicines12010221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
This comprehensive review article delves into the critical role of the human microbiota in the development and management of endocrine-related diseases. We explore the complex interactions between the microbiota and the endocrine system, emphasizing the implications of microbiota dysbiosis for the onset and progression of various endocrine disorders. The review aims to synthesize current knowledge, highlighting recent advancements and the potential of novel therapeutic approaches targeting microbiota-endocrine interactions. Key topics include the impact of microbiota on hormone regulation, its role in endocrine pathologies, and the promising avenues of microbiota modulation through diet, probiotics, prebiotics, and fecal microbiota transplantation. We underscore the importance of this research in advancing personalized medicine, offering insights for more tailored and effective treatments for endocrine-related diseases.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.R.-Z.); (J.F.T.-A.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
| | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/ Tajo s/n, 28670 Villaviciosa de Odón, Spain;
| | - Alejandro Rubio-Zarapuz
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.R.-Z.); (J.F.T.-A.)
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.R.-Z.); (J.F.T.-A.)
| | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.R.-Z.); (J.F.T.-A.)
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10
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Zeng J, Jia A, Zhang J, Gao B, Xu J, Xing Y, Jing X, Jiao Y, Wang J, Xu W, Gao L, Shang L, Xu S. Comparison of the therapeutic effects of 15 mg and 30 mg initial daily prednisolone doses in patients with subacute thyroiditis: a multicenter, randomized, open-label, parallel-controlled trial. Ann Med 2023; 55:2288941. [PMID: 38048390 PMCID: PMC10836262 DOI: 10.1080/07853890.2023.2288941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/22/2023] [Indexed: 12/06/2023] Open
Abstract
INTRODUCTION Current guidelines recommendations for the initial dose of prednisolone (PSL) in the treatment of subacute thyroiditis (SAT) are based on low-quality studies. We designed a randomized controlled trial (RCT) to compare the efficacy and safety of using a low initial dose of PSL with a standard initial dose of PSL in SAT patients. PATIENTS AND METHODS This open-label RCT was conducted at five hospitals in China from June 2019 to January 2022. SAT patients with moderate-to-severe pain or a poor response to non-steroidal anti-inflammatory drugs (NSAIDs) were randomly assigned in a 1:1 ratio to the experimental and control groups. The initial dose of PSL was 15 mg/d in the experimental group and 30 mg/d in the control group. The primary outcome was the total duration of PSL treatment, with non-inferiority prespecified with a margin of 7 days. Clinical trial registration number: ChiCTR1900023884. RESULTS The full analysis set included 60 patients (30 in each group). The mean duration of PSL treatment in the experimental and control group was 34.62 ± 14.12 and 41.18 ± 16.89 days, respectively, meeting the non-inferiority criterion (pnon-inferiority = 0.0006). The total dose of PSL used in the experimental group was lower than in the control groups (330 vs 595 mg, p < 0.0001). There were no differences in the mean time to pain relief and complete resolution, the occurrence of recurrence, hypothyroidism, or adverse events between the groups. CONCLUSIONS The initial dose of 15 mg/d of PSL was not inferior to the dose of 30 mg/d in terms of efficacy and showed a similar safety profile. A low initial dose of PSL could be recommended for Chinese adult SAT patients who have a suboptimal response using NSAIDs or experience moderate-to-severe pain.KEY MESSAGESLow initial dose (15 mg/d) of prednisolone was non-inferior to the standard initial dose of prednisolone (30 mg/d) in treatment duration, time to pain relief, or the prevalence of hypothyroidism, recurrence, and adverse reactions in the treatment of subacute thyroiditis.Patients with subacute thyroiditis administered a low initial dose of prednisolone had a lower total dose of prednisolone compared to those receiving the standard dose of prednisolone.
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Affiliation(s)
- Jingjing Zeng
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
- Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Aihua Jia
- Department of Endocrinology, No.1 Hospital of Yulin, Yulin, China
| | - Juan Zhang
- Department of Endocrinology, 3201 Hospital of Xi’an Jiao tong University Health Science Center, Hanzhong, Shaanxi, China
| | - Bin Gao
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Shaanxi, China
| | - Jing Xu
- Department of Endocrinology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ying Xing
- Department of Endocrinology, Daxing Hospital, Xi’an, China
| | - Xiaorui Jing
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Shaanxi, China
| | - Yang Jiao
- Department of Endocrinology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jie Wang
- Department of Endocrinology, Daxing Hospital, Xi’an, China
| | - Wenlei Xu
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Ling Gao
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Lei Shang
- Department of Health Statistics, Shaanxi Key Laboratory of Free Radical Biology and Medicine and the Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi’an, Shaanxi, China
| | - Shaoyong Xu
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
- Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
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11
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Elkhoury D, Patel P, Sastry S, Tajik A, Elkhoury C, Montalbano M. Advancing Preoperative Strategies for Thyroidectomy in Graves' Disease: A Narrative Review. Cureus 2023; 15:e48156. [PMID: 38046703 PMCID: PMC10693191 DOI: 10.7759/cureus.48156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 12/05/2023] Open
Abstract
Graves' disease is an autoimmune disorder characterized by thyroid-stimulating antibodies that can potentially lead to thyrotoxicosis, goiter, skin disease, and eye disease. Available treatment options for Graves' disease include management with antithyroid drugs (ATDs), thyroid ablation with radioactive iodine (RAI), and surgical thyroid gland removal. For individuals unable to reach a normal thyroid hormone level, promptly considering a thyroidectomy is essential. Preoperative strategies to achieve a euthyroid state prevent thyroid storms and minimize postoperative complications and are therefore crucial. While variations in professional guidance exist, this review focuses on standard medical interventions as well as compares respective guidelines set forth by the American Thyroid Association, the European Thyroid Association, the American Association of Clinical Endocrinology, and the American Association of Endocrine Surgeons. There is consensus among these organizations underscoring the importance of rendering patients euthyroid prior to surgery and the use of ATDs. Most guidelines recommend screening for vitamin D deficiency as well as endorse thyroidectomy as the preferred treatment option for hyperthyroidism with skilled surgeons. Nevertheless, discrepancies do become apparent in aspects such as potassium iodide (SSKI) course duration and preoperative dexamethasone administration. By understanding these differing approaches, healthcare professionals can more effectively manage Graves' disease prior to surgery, resulting in improved patient outcomes and enhanced surgical success.
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Affiliation(s)
- David Elkhoury
- Anatomical Sciences, St. George's University School of Medicine, Saint George's, GRD
| | - Pruthvi Patel
- Anatomical Sciences, St. George's University School of Medicine, Saint George's, GRD
| | - Saalini Sastry
- Anatomical Sciences, St. George's University School of Medicine, Saint George's, GRD
| | - Alireza Tajik
- Anatomical Sciences, St. George's University School of Medicine, Saint George's, GRD
| | - Christina Elkhoury
- Health Sciences, Trident University International, Chandler, USA
- Molecular Pharmacology and Toxicology, University of Southern California, Los Angeles, USA
| | - Michael Montalbano
- Anatomical Sciences, St. George's University School of Medicine, Saint George's, GRD
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12
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Yan S, Li X, Yan B. Letter to the Editor: Could Radioactive Iodine Be a Preferred Therapy for Graves' Hyperthyroidism Patients with Large Goiters? A Viewpoint from China. Thyroid 2023; 33:1380-1381. [PMID: 37594743 DOI: 10.1089/thy.2023.0332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Affiliation(s)
- Shangcheng Yan
- Department of General Surgery, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin Li
- Department of General Surgery, Peking University Third Hospital, Beijing, China
| | - Bing Yan
- Department of Nuclear Medicine, Beijing Hope Hospital, Beijing, China
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13
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MacKay M, Clewis MC, Sweet P. Antithyroid Drug-Induced Agranulocytosis: A Case Report. Cureus 2023; 15:e48264. [PMID: 38054132 PMCID: PMC10695326 DOI: 10.7759/cureus.48264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2023] [Indexed: 12/07/2023] Open
Abstract
Agranulocytosis is a rare but life-threatening complication of methimazole and propylthiouracil, antithyroid drugs (ATDs) prescribed for the treatment of hyperthyroidism. We report the case of a 41-year-old female who presented to our institution with complaints of fevers, chills, sore throat, myalgias, and generalized weakness one month after treatment initiation with methimazole. A complete blood count at admission revealed agranulocytosis with an absolute neutrophil count of 0/μl. After discontinuation of the medication, she was treated with granulocyte-colony stimulating factor and intravenous broad-spectrum antibiotics, which improved her condition on day seven of hospitalization. Although agranulocytosis is a rare complication of antithyroid drugs, providers must maintain a high index of clinical suspicion as prompt diagnosis and treatment are essential. After the diagnosis is confirmed with an absolute neutrophil count <500/μl, management involves discontinuation of the offending agent and initiation of intravenous broad-spectrum antibiotics. Granulocyte-colony stimulating factor, commonly employed in addition to antibiotics, is a controversial treatment option and more research demonstrating its efficacy is necessitated. Preventing mortality associated with antithyroid drug-induced agranulocytosis is achieved through patient education at the time of ATD initiation.
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Affiliation(s)
- Micaela MacKay
- Internal Medicine, University of Texas Medical Branch, Galveston, USA
| | - Madison C Clewis
- Internal Medicine, University of Texas Medical Branch, Galveston, USA
| | - Patrick Sweet
- Internal Medicine, University of Texas Medical Branch, Galveston, USA
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14
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García Gómez C, Navarro E, Alcázar V, López-Guzmán A, Arrieta F, Anda E, Biagetti B, Guerrero-Pérez F, Villabona C, de Assín Valverde AR, Lamas C, Lecumberri B, Rosado Sierra JA, Sastre J, Díez JJ, Iglesias P. Therapeutic Management and Long-Term Outcome of Hyperthyroidism in Patients with Antithyroid-Induced Agranulocytosis: A Retrospective, Multicenter Study. J Clin Med 2023; 12:6556. [PMID: 37892693 PMCID: PMC10607319 DOI: 10.3390/jcm12206556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Antithyroid drug-induced agranulocytosis (AIA) (neutrophils <500/µL) is a rare but serious complication in the treatment of hyperthyroidism. METHODOLOGY Adult patients with AIA who were followed up at 12 hospitals in Spain were retrospectively studied. A total of 29 patients were studied. The etiology of hyperthyroidism was distributed as follows: Graves' disease (n = 21), amiodarone-induced thyrotoxicosis (n = 7), and hyperfunctioning multinodular goiter (n = 1). Twenty-one patients were treated with methimazole, as well as six patients with carbimazole and two patients with propylthiouracil. RESULTS The median (IQR) time to development of agranulocytosis was 6.0 (4.0-11.5) weeks. The most common presenting sign was fever accompanied by odynophagia. All of the patients required admission, reverse isolation, and broad-spectrum antibiotics; moreover, G-CSF was administered to 26 patients (89.7%). Twenty-one patients received definitive treatment, thirteen patients received surgery, nine patients received radioiodine, and one of the patients required both treatments. Spontaneous normalization of thyroid hormone values occurred in six patients (four patients with amiodarone-induced thyrotoxicosis and two patients with Graves' disease), and two patients died of septic shock secondary to AIA. CONCLUSIONS AIA is a potentially lethal complication that usually appears around 6 weeks after the initiation of antithyroid therapy. Multiple drugs are required to control hyperthyroidism before definitive treatment; additionally, in a significant percentage of patients (mainly in those treated with amiodarone), hyperthyroidism resolved spontaneously.
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Affiliation(s)
- Carlos García Gómez
- Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), 28222 Madrid, Spain; (J.J.D.); (P.I.)
- Department of Medicine, Universidad Autónoma de Madrid, 28046 Madrid, Spain
| | - Elena Navarro
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain;
| | - Victoria Alcázar
- Department of Endocrinology and Nutrition, Hospital Universitario Severo Ochoa, 28914 Madrid, Spain;
| | - Antonio López-Guzmán
- Department of Endocrinology and Nutrition, Complejo Asistencial de Ávila, 05004 Ávila, Spain;
| | - Francisco Arrieta
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | - Emma Anda
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain;
| | - Betina Biagetti
- Department of Endocrinology and Nutrition, Hospital Universitari Vall d’Hebrón, 08035 Barcelona, Spain;
| | - Fernando Guerrero-Pérez
- Department of Endocrinology and Nutrition, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.G.-P.); (C.V.)
| | - Carles Villabona
- Department of Endocrinology and Nutrition, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.G.-P.); (C.V.)
| | - Andrés Ruiz de Assín Valverde
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Albacete, 02008 Albacete, Spain (C.L.)
| | - Cristina Lamas
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Albacete, 02008 Albacete, Spain (C.L.)
| | - Beatriz Lecumberri
- Department of Endocrinology and Nutrition, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | | | - Julia Sastre
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Toledo, 45007 Toledo, Spain;
| | - Juan José Díez
- Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), 28222 Madrid, Spain; (J.J.D.); (P.I.)
- Department of Medicine, Universidad Autónoma de Madrid, 28046 Madrid, Spain
| | - Pedro Iglesias
- Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), 28222 Madrid, Spain; (J.J.D.); (P.I.)
- Department of Medicine, Universidad Autónoma de Madrid, 28046 Madrid, Spain
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15
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Arai Y, Wang D, Takeuchi M, Utsunomiya S, Degawa T, Kai A, Ichikawa H, Chiba R, Yoshimura T. Development of a quantitative thyroid-stimulating hormone assay system for a benchtop digital ELISA desktop analyzer. Front Bioeng Biotechnol 2023; 11:1227357. [PMID: 37811377 PMCID: PMC10551129 DOI: 10.3389/fbioe.2023.1227357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Regular checkups for thyroid-stimulating hormone (TSH) levels are essential for the diagnosis of thyroid disease. The enzyme-linked immunosorbent assay (ELISA) technique is a standard method for detecting TSH in the serum or plasma of hospitalized patients. A recently developed next-generation ELISA, the digital immunoassay (d-IA), has facilitated detection of molecules with ultra-high-sensitivity. In this study, we developed a TSH assay system using the d-IA platform. By utilizing the ultrasensitivity of d-IA, we were able to use a sample volume of as little as 5 µL for each assay (the dead volume was 5 µL). The limits of blank, detection, and quantification (i.e., functional sensitivity), were 0.000346, 0.001953, and 0.002280 μIU/mL, respectively, and the precision of the total coefficient of variation did not exceed 10%. The correlation between serum and plasma levels indicated good agreement. Thus, our system successfully measured TSH using d-IA with a small sample volume and equal functional sensitivity to the current third generation like ARCHITECT TSH assay, which has a functional sensitivity of 0.0038 μIU/mL.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Toru Yoshimura
- Research and Development, Abbott Japan LLC, Chiba, Japan
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16
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Campennì A, Avram AM, Verburg FA, Iakovou I, Hänscheid H, de Keizer B, Petranović Ovčariček P, Giovanella L. The EANM guideline on radioiodine therapy of benign thyroid disease. Eur J Nucl Med Mol Imaging 2023; 50:3324-3348. [PMID: 37395802 PMCID: PMC10542302 DOI: 10.1007/s00259-023-06274-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/18/2023] [Indexed: 07/04/2023]
Abstract
This document provides the new EANM guideline on radioiodine therapy of benign thyroid disease. Its aim is to guide nuclear medicine physicians, endocrinologists, and practitioners in the selection of patients for radioiodine therapy. Its recommendations on patients' preparation, empiric and dosimetric therapeutic approaches, applied radioiodine activity, radiation protection requirements, and patients follow-up after administration of radioiodine therapy are extensively discussed.
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Affiliation(s)
- Alfredo Campennì
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, Unit of Nuclear Medicine, University of Messina, Messina, Italy
| | - Anca M Avram
- Departments of Radiology and Medicine, MetroHealth Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Frederik A Verburg
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.
| | - Ioannis Iakovou
- Academic Department of Nuclear Medicine, University Hospital AHEPA, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Academic Department of Nuclear Medicine, General Hospital Papageorgiou, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Heribert Hänscheid
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Bart de Keizer
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Petra Petranović Ovčariček
- Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Luca Giovanella
- Clinic for Nuclear Medicine, Ente Ospedaliero Cantonale, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland
- Clinic for Nuclear Medicine, University Hospital and University of Zurich, Zurich, Switzerland
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de Souza APC, Gabriel FC, Fontes-Mota GCH, Silva MDS, Ribeiro E. Evidence-based pharmacological prophylaxis recommendations for venous thromboembolism in hospitalized acutely ill medical patients: a systematic review of clinical practice guidelines. J Vasc Bras 2023; 22:e20230067. [PMID: 37576726 PMCID: PMC10421586 DOI: 10.1590/1677-5449.202300672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/06/2023] [Indexed: 08/15/2023] Open
Abstract
Venous thromboembolism is a complex multifactorial disease considered the most common cause of preventable deaths in hospitalized patients. Recommendations about pharmacological venous thromboembolism prophylaxis in adult hospitalized patients are available in clinical practice guidelines for optimization of healthcare delivery and improvement of patient outcomes. We conducted a systematic review of clinical practice guidelines using ADAPTE to synthesize recommendations for pharmacological prophylaxis of venous thromboembolism in hospitalized medical patients at a medium complexity university hospital. Recommendations for pharmacological prophylaxis were extracted from seven clinical practice guidelines considered of high quality after assessment with the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. These recommendations will support discussion with specialists and implementation of practices in the setting of the hospital studied.
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18
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Kwon H. The Current Status of Hyperthyroidism in Korea. Endocrinol Metab (Seoul) 2023; 38:392-394. [PMID: 37649418 PMCID: PMC10475960 DOI: 10.3803/enm.2023.401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023] Open
Affiliation(s)
- Hyemi Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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19
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Shemesh R, Ben Simon GJ, Zloto O. The Role of Thyroid Antibodies in Thyroid Eye Disease. Int Ophthalmol Clin 2023; 63:225-231. [PMID: 37439620 DOI: 10.1097/iio.0000000000000451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
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Saboo K, Gemnani RR, Manuja N, Kumar S, Acharya S. Propylthiouracil-Induced Neonatal Goiter: An Avoidable Problem. Cureus 2023; 15:e40389. [PMID: 37456378 PMCID: PMC10344733 DOI: 10.7759/cureus.40389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
We present a case of neonatal goiter caused by exposure to propylthiouracil (PTU) during pregnancy in this case report. The mother was treated with PTU while pregnant and had a history of Graves' illness. The baby had a neck tumor and was having breathing problems when they were first seen. A big thyroid gland was detected by a neck CT scan. This instance serves as a reminder of the significance of managing maternal thyroid problems appropriately during pregnancy as well as the requirement for careful thyroid function monitoring in newborns exposed to PTU. Given the possible hazards to the growing baby, it also calls into question whether PTU is an effective first-line treatment for maternal Graves' illness during pregnancy. This case report highlights the importance of shared decision-making with patients (by discussing different treatment options and their side effects).
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Affiliation(s)
- Keyur Saboo
- Department of Medicine, Jawaharlal Nehru Medical College, Wardha, IND
| | - Rinkle R Gemnani
- Department of Medicine, Jawaharlal Nehru Medical College, Wardha, IND
| | - Nishtha Manuja
- Department of Internal Medicine, Jawaharlal Nehru Medical College, Wardha, IND
| | - Sunil Kumar
- Department of Medicine, Jawaharlal Nehru Medical College, Wardha, IND
| | - Sourya Acharya
- Department of Medicine, Jawaharlal Nehru Medical College, Wardha, IND
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Baghaffar MH, Samargandy S. A Case of Recurrent Thyrotoxicosis in a Thyroglossal Duct Cyst 18 Years Following Thyroid Surgery. Cureus 2023; 15:e39829. [PMID: 37397661 PMCID: PMC10314736 DOI: 10.7759/cureus.39829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2023] [Indexed: 07/04/2023] Open
Abstract
Graves' disease (GD) is an immune-mediated condition related to high thyroid-stimulating immunoglobulin levels. Here, we present a rare case of recurrent thyrotoxicosis that developed in a thyroglossal duct cyst (TGDC) and the residual thyroid tissue in a 46-year-old female following subtotal thyroidectomy. In 2005, she was diagnosed with GD causing thyrotoxicosis and treated with subtotal thyroidectomy. In 2022, she was seen at our clinic with a neck swelling gradually growing in size over the last 10 years. On examination, the mass was found to be moving with tongue protrusion. She was on thyroxin 100 mcg daily, and the dose was reduced gradually until she was maintained on no therapy for hypothyroidism and was still thyrotoxic. The combined clinical, laboratory thyroid scintigraphy and ultrasonographic features favored early developing recurrent Graves' disease in the thyroid residual and TGDC. She was started on carbimazole and was referred for surgery. Our case represents a rare occurrence of recurrent GD in the thyroid residual and TGDC.
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Affiliation(s)
- Mariam H Baghaffar
- Internal Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Shaza Samargandy
- Endocrinology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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Farasati Far B, Broomand Lomer N, Gharedaghi H, Sahrai H, Mahmoudvand G, Karimi Rouzbahani A. Is beta-carotene consumption associated with thyroid hormone levels? Front Endocrinol (Lausanne) 2023; 14:1089315. [PMID: 37305054 PMCID: PMC10250628 DOI: 10.3389/fendo.2023.1089315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
The thyroid hormones play a pivotal role in various physiological processes, including growth, metabolism regulation, and reproduction. While non-modifiable factors are known to impact thyroid function, such as genetics and age, nutritional factors are also important. Diets rich in selenium and iodine are conventionally acknowledged to be beneficial for the production and release of thyroid hormones. Recent studies have suggested a potential link between beta-carotene, a precursor to vitamin A (retinol), and thyroid function. Beta-carotene is known for its antioxidant properties and has been shown to play a role in the prevention of various clinical conditions such as cancer and cardiovascular and neurological diseases. However, its impact on thyroid function is still unclear. Some studies have suggested a positive association between beta-carotene levels and thyroid function, while others have found no significant effect. Conversely, the hormone produced by the thyroid gland, thyroxine, enhances the conversion of beta-carotene to retinol. Furthermore, vitamin A derivatives are being explored as potential therapeutic options for thyroid malignancies. In this review, we highlight the mechanisms through which beta-carotene/retinol and thyroid hormones interact and review the findings of clinical studies examining the association between beta-carotene consumption and thyroid hormone levels. Our review underscores the need for further research to clarify the relationship between beta-carotene and thyroid function.
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Affiliation(s)
- Bahareh Farasati Far
- Department of Chemistry, Iran University of Science and Technology, Tehran, Iran
| | | | | | - Hadi Sahrai
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Golnaz Mahmoudvand
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
- USERN Office, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Arian Karimi Rouzbahani
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
- USERN Office, Lorestan University of Medical Sciences, Khorramabad, Iran
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Xiaoyin T, Bingwei L, Min D, Yan L, Ping L, Bo Z. Preliminary Results of Utrasound-Guided Percutaneous Radiofrequency Ablation in the Treatment of Refractory Non-nodular Hyperthyroidism. Cardiovasc Intervent Radiol 2023:10.1007/s00270-023-03401-5. [PMID: 37142800 DOI: 10.1007/s00270-023-03401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 02/21/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE To assess the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation (RFA) for the treatment of refractory non-nodular hyperthyroidism. METHODS This was a single-center retrospective study in 9 patients with refractory non-nodular hyperthyroidism (2 males, 7 females; median age, range, 36 years, 14-55 years) who underwent RFA between August 2018 and September 2020. The incidence of post-procedural complications, changes in thyroid volume, thyroid function and the use and dosages of anti-thyroid drugs, were compared pre- and post-RFA. RESULTS All patients completed the procedure successfully, and no serious complications occurred. Three months after ablation, thyroid volumes were significantly decreased with the mean volumes of the right and left lobes reduced to 45.6% (10.9 ± 2.2 ml/23.9 ± 7.2 ml, p < 0.001) and 50.2% (10.8 ± 7.4 ml/21.5 ± 11.4 ml, p = 0.001) of the volumes within 1 week after ablation. The thyroid function was gradually improved in all patients. At 3 months post-ablation, the levels of FT3 and FT4 were returned to the normal range (FT3, 4.9 ± 1.6 pmol/L vs. 8.7 ± 4.2 pmol/L, p = 0.009; FT4, 13.1 ± 7.2 pmol/L vs. 25.9 ± 12.6 pmol/L, p = 0.038), the TR-Ab level was significantly lower (4.8 ± 3.9 vs. 16.5 ± 16.4 IU/L, p = 0.027), and the TSH level was significantly higher (0.76 ± 0.88 vs. 0.03 ± 0.06, p = 0.031) than that before-ablation. Additionally, three months after RFA, the anti-thyroid medication dosages were reduced to 31.25% compared to baseline (p < 0.01). CONCLUSION Ultrasound-guided RFA in the treatment of refractory non-nodular hyperthyroidism was safe and effective in this small group of patients with limited follow-up. Further studies with larger cohorts and longer follow-up are needed to validate this potential new application of thyroid thermal ablation.
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Affiliation(s)
- Tang Xiaoyin
- Department of Tumor Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China
| | - Lu Bingwei
- Department of Anesthesiology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China
| | - Ding Min
- Department of Tumor Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China
| | - Lin Yan
- Department of Tumor Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China
| | - Li Ping
- Department of Tumor Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Zhai Bo
- Department of Tumor Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
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Quiroz-Aldave JE, Durand-Vásquez MDC, Lobato-Jeri CJ, Muñoz-Moreno JM, Deutz Gómez Condori DC, Ildefonso-Najarro SP, Contreras-Yametti F, Zavaleta-Gutiérrez F, Concepción-Urteaga L, Concepción-Zavaleta MJ. Thyrotoxic Cardiomyopathy: State of the Art. TOUCHREVIEWS IN ENDOCRINOLOGY 2023; 19:78-84. [PMID: 37313242 PMCID: PMC10258619 DOI: 10.17925/ee.2023.19.1.78] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/04/2023] [Indexed: 06/15/2023]
Abstract
Thyroid hormones, mainly triiodothyronine, have genomic and non-genomic effects on cardiomyocytes related to the contractile function of the heart. Thyrotoxicosis, which is the set of signs and symptoms derived from the excess of circulating thyroid hormones, leads to increased cardiac output and decreased systemic vascular resistance, increasing the volume of circulating blood and causing systolic hypertension. In addition, the shortening of the refractory period of cardiomyocytes produces sinus tachycardia and atrial fibrillation. This leads to heart failure. Approximately 1% of patients with thyrotoxicosis develop thyrotoxic cardiomyopathy, a rare but potentially fatal form of dilated cardiomyopathy. Thyrotoxic cardiomyopathy represents a diagnosis of exclusion, and prompt identification is crucial as it is a reversible cause of heart failure, and heart function can be recovered after achieving a euthyroid state using antithyroid drugs. Radioactive iodine therapy and surgery are not the best initial therapeutic approach. Moreover, it is important to manage cardiovascular symptoms, for which beta blockers are the first-line therapeutic option.
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Using the Random Forest Algorithm to Detect the Activity of Graves Orbitopathy. J Craniofac Surg 2023; 34:e167-e171. [PMID: 35996213 DOI: 10.1097/scs.0000000000008946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/12/2022] [Indexed: 10/15/2022] Open
Abstract
PURPOSE The aim of this study is to establish a random forest model to detect active and quiescent phases of patients with Graves Orbitopathy (GO). METHODS A total of 243 patients (486 eyes) diagnosed with GO in Beijing TongRen hospital were included in the study. The Clinical Activity Score of GO was regarded as the golden standard, whereas sex, age, smoking status, radioactive I131 treatment history, thyroid nodules, thyromegaly, thyroid hormone, and Thyroid-stimulating hormone receptor antibodies were chosen as predictive characteristic variables in the model. The random forest model was established and compared with logistic regression analysis, Naive Bayes, and Support vector machine metrics. RESULTS Our model has a sensitivity of 0.81, a specificity of 0.90, a positive predictive value of 0.87, a negative predictive value of 0.86, an F1 score of 0.85, and an out-of-bag error of 0.15. The random forest algorithm showed a more precise performance compared with 3 other models based on the area under receiver operating characteristic curve (0.92 versus 0.77 versus 0.76 versus 0.75) and accuracy (0.86 versus 0.71 versus 0.69 versus 0.66). CONCLUSIONS By integrating these high-risk factors, the random forest algorithm may be used as a complementary method to determine the activity of GO, with accurate and reliable performance.
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Bolakale-Rufai IK, Abioro I, Ngene SO, Woldeamanuel Y. Efficacy of methimazole before the administration of radioactive iodine in the management of Graves' disease: a systematic review and meta-analysis. SAO PAULO MED J 2023; 141:e2022225. [PMID: 36629663 PMCID: PMC10065113 DOI: 10.1590/1516-3180.2022.0225.r1.19102022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/19/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The efficacy of anti-thyroid drugs in conjunction with radioactive iodine therapy in the management of Graves' disease is still controversial. OBJECTIVE To compare the efficacy of pretreatment with methimazole before the administration of radioactive iodine for the treatment of Graves' disease. DESIGN AND SETTING A systematic review and meta-analysis was conducted at a teaching/tertiary hospital in Ibadan, Nigeria. METHODS A systematic search of the PubMed, Embase, Cochrane Library, and Web of Science databases was performed from inception to December, 2021. RESULTS Five studies with 297 participants were included. There was no difference in the risk of persistent hyperthyroidism when radioactive iodine was used in conjunction with methimazole compared with when radioactive iodine was used alone (relative risk: 1.02, 95% confidence interval, CI: 0.62-1.66; P = 0.95, I2 = 0%). Subgroup analysis based on the duration between discontinuation of methimazole and the administration of radioactive iodine showed a lower risk of persistent hyperthyroidism when methimazole was discontinued within 7 days before radioactive iodine use, although this did not reach statistical significance (risk ratio: 0.85, CI: 0.28-2.58). CONCLUSIONS The use of methimazole before radioactive iodine administration was not associated with an increased risk of persistent hyperthyroidism. Concerns about medication toxicity and adverse effects should be considered when clinicians make decisions on combination therapies for the treatment of Graves' disease. PROSPERO REGISTRATION CRD42020150013, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=150013.
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Affiliation(s)
| | - Imodoye Abioro
- MD. Physician, Department of Medicine, University College Hospital Ibadan, Ibadan, Oyo, Nigeria
| | - Samuel Osobuchi Ngene
- MPH. Postgraduate Scholar, Swansea University Medical School, Swansea University, Wales, United Kingdom
| | - Yohannes Woldeamanuel
- MD, PhD. Expert Physician, Medical Scientist and Instructor at Department of Neurology, School of Medicine, Stanford University, California, United States
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Dwivedi SN, Kalaria T, Buch H. Thyroid autoantibodies. J Clin Pathol 2023; 76:19-28. [PMID: 36270794 DOI: 10.1136/jcp-2022-208290] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 09/24/2022] [Indexed: 12/26/2022]
Abstract
Thyroid-stimulating hormone (TSH) receptor antibody (TSH-R-Ab or TRAb) testing plays a pivotal role in arriving at the aetiological diagnosis in patients with thyrotoxicosis. A positive test establishes the diagnosis of Graves' disease (GD) while a negative result in conjunction with imaging studies supports other possible aetiologies. In patients with GD, TRAb levels at diagnosis and at the time of withdrawal of antithyroid drugs can identify patients who are unlikely to achieve remission and guide clinical management decisions. We provide an algorithm that incorporates TRAb in the decision-making process for the management of thyrotoxicosis. The utility of TRAb in predicting the risk of fetal and neonatal thyroid dysfunction is established and widely accepted in guidelines. TRAb may also help in the diagnosis of Graves' orbitopathy, especially in euthyroid or hypothyroid patients and its role in guiding its management is evolving as a useful adjunct to the clinical parameters used in making therapeutic decisions.Anti-thyroid peroxidase antibodies (TPOAb) and anti-thyroglobulin antibodies (TgAb) indicate thyroid autoimmunity. The most common use of TPOAb is to identify patients at a higher risk of progression to treatment-requiring hypothyroidism. They also aid the diagnosis of immune thyroiditis and Hashimoto's encephalopathy. Thyroglobulin measurement is used to help guide differentiated thyroid cancer treatment. TgAb is used as an accompanying test with thyroglobulin measurement as its presence can interfere with the thyroglobulin assay. A negative TgAb result reduces the likelihood of, but does not exclude, interference with thyroglobulin assay.
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Affiliation(s)
| | - Tejas Kalaria
- Clinical Biochemistry, New Cross Hospital, Black Country Pathology Services, Wolverhampton, UK
| | - Harit Buch
- Endocrinology and Diabetes, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
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Xu C, Jiang R, Liu JY. Emerging trends and hot spots in subacute thyroiditis research from 2001 to 2022: A bibliometric analysis. Front Endocrinol (Lausanne) 2023; 14:1144465. [PMID: 37008914 PMCID: PMC10064097 DOI: 10.3389/fendo.2023.1144465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/03/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Subacute thyroiditis (SAT) is the most prevalent self-limiting thyroid disease that causes pain, accounting for about 5% of all clinical thyroid disorders. Numerous clinically noteworthy results have been published in this area over the last 20 years. However, no article has comprehensively assessed the relevant literature yet. We conducted a bibliometric analysis of SAT to provide light on the dynamic nature of scientific advancement and aid researchers in gaining a global perspective while examining research core themes and hotspots. METHODS SAT-related articles and reviews from 2001 to 2022 were retrieved from the Science Citation Index-Expanded of Web of Science Core Collection (WoSCC). We analyzed current research trends and hotspots in this area using CiteSpace and Vosviewer. RESULTS A total of 568 studies associated with SAT research were published in 282 academic journals by 2,473 authors in 900 institutions from 61 countries/regions. The United States was a crucial link in inter-country/region collaboration and was the most frequently involved country in international cooperation. The University of Missouri System was the top organization, and Braley-Mullen H. was the most productive researcher. Thyroid published the most papers, with 36 publications. The most co-cited article was "Clinical features and outcome of subacute thyroiditis in an incidence cohort: Olmsted County, Minnesota, study" (by Fatourechi V., 2003). The clustered network and timeline view of keywords showed that the prevalence, diagnosis, and treatment of SAT were the research core themes during the past 20 years. Analysis of keyword bursts indicated that the clinical characteristic and the influence of COVID-19 on SAT appeared to be the current research hotspots. CONCLUSION This bibliometric analysis conducted a thorough review of the SAT research. The clinical characteristics and the genetic background of SAT under the influence of COVID-19 are current research hotspots. However, there is still a need for further study and global collaboration. Our findings can aid researchers in understanding the current status of SAT research and immediately pinpoint new directions for further investigation.
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Ze Y, Shao F, Feng X, Shen S, Bi Y, Zhu D, Zhang X. Effect of liver dysfunction on outcome of radioactive iodine therapy for Graves' disease. BMC Endocr Disord 2022; 22:319. [PMID: 36522617 PMCID: PMC9753361 DOI: 10.1186/s12902-022-01242-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Liver dysfunction is a common complication of Graves' disease (GD) that may be caused by excessive thyroid hormone (TH) or anti-thyroid drugs (ATDs). Radioactive iodine (RAI) therapy is one of the first-line treatments for GD, but it is unclear whether it is safe and effective in patients with liver dysfunction. 510 consecutive patients with GD receiving first RAI were enrolled in the study, and followed up at 3-, 6- and 12-month. Liver dysfunction was recorded in 222 (43.5%) patients. GD patients with liver dysfunction had higher serum levels of free triiodothyronine (FT3) (median 27.6 vs. 20.6 pmol/L, p < 0.001) and free thyroxine (FT4) (median 65.4 vs. 53.5 pmol/L, p < 0.001) levels than those with normal liver function. Binary logistic regression analysis showed that duration of disease (OR = 0.951, 95% CI: 0.992-0.980, p = 0.001) and male gender (OR = 1.106, 95% CI: 1.116-2.384; p = 0.011) were significant differential factors for liver dysfunction. Serum TSH levels were higher in patients with liver dysfunction at all 3 follow-up time points (p = 0.014, 0.008, and 0.025 respectively). FT3 level was lower in patients with liver dysfunction at 3-month follow-up (p = 0.047), but the difference disappeared at 6 and 12 months (p = 0.351 and 0.264 respectively). The rate of euthyroidism or hypothyroidism was higher in patients with liver dysfunction than in those with normal liver function at 3 months (74.5% vs 62.5%; p = 0.005) and 6 months (82.1% vs 69.1%; p = 0.002) after RAI treatment, but the difference did not persist at 12-month follow-up (89.6% vs 83.2%, p = 0.081).There were no statistically significant differences in treatment efficacy (94.48% vs 90.31%, p = 0.142), incidence of early-onset hypothyroidism (87.73% vs 83.67%, p = 0.277), and recurrence rate (4.91% vs 7.14%, p = 0.379) between the 2 groups at 12-month follow-up. In conclusion, the efficacy of RAI was comparable in GD patients with liver dysfunction and those with normal liver function.
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Affiliation(s)
- Yuyang Ze
- Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School, Branch of National Clinical Research Centre for Metabolic Diseases; Endocrine and Metabolic Disease Medical Center, Drum Tower Hospital affiliated to Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210000, Jiangsu, China
- Department of Endocrinology and Metabolism, the Fifth People's Hospital of Suzhou Wujiang, No. 555, Xinyou Road, Suzhou, 215200, China
| | - Fei Shao
- Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School, Branch of National Clinical Research Centre for Metabolic Diseases; Endocrine and Metabolic Disease Medical Center, Drum Tower Hospital affiliated to Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210000, Jiangsu, China
- Department of Endocrinology and Metabolism, Langxi Hospital of Traditional Chinese Medicine, No. 99 Tingzishan Road, Jianping Town, Langxi County, Xuancheng City, 242100, Anhui, China
| | - Xuefeng Feng
- Department of Nuclear Medicine, Drum Tower Hospital affiliated to Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210000, China
| | - Shanmei Shen
- Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School, Branch of National Clinical Research Centre for Metabolic Diseases; Endocrine and Metabolic Disease Medical Center, Drum Tower Hospital affiliated to Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210000, Jiangsu, China
| | - Yan Bi
- Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School, Branch of National Clinical Research Centre for Metabolic Diseases; Endocrine and Metabolic Disease Medical Center, Drum Tower Hospital affiliated to Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210000, Jiangsu, China
| | - Dalong Zhu
- Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School, Branch of National Clinical Research Centre for Metabolic Diseases; Endocrine and Metabolic Disease Medical Center, Drum Tower Hospital affiliated to Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210000, Jiangsu, China.
| | - Xiaowen Zhang
- Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School, Branch of National Clinical Research Centre for Metabolic Diseases; Endocrine and Metabolic Disease Medical Center, Drum Tower Hospital affiliated to Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210000, Jiangsu, China.
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Mechanisms and Management of Thyroid Disease and Atrial Fibrillation: Impact of Atrial Electrical Remodeling and Cardiac Fibrosis. Cells 2022; 11:cells11244047. [PMID: 36552815 PMCID: PMC9777224 DOI: 10.3390/cells11244047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia associated with increased cardiovascular morbidity and mortality. The pathophysiology of AF is characterized by electrical and structural remodeling occurring in the atrial myocardium. As a source of production of various hormones such as angiotensin-2, calcitonin, and atrial natriuretic peptide, the atria are a target for endocrine regulation. Studies have shown that disorders associated with endocrine dysregulation are potential underlying causes of AF. The thyroid gland is an endocrine organ that secretes three hormones: triiodothyronine (T3), thyroxine (T4) and calcitonin. Thyroid dysregulation affects the cardiovascular system. Although there is a well-established relationship between thyroid disease (especially hyperthyroidism) and AF, the underlying biochemical mechanisms leading to atrial fibrosis and atrial arrhythmias are poorly understood in thyrotoxicosis. Various animal models and cellular studies demonstrated that thyroid hormones are involved in promoting AF substrate. This review explores the recent clinical and experimental evidence of the association between thyroid disease and AF. We highlight the current knowledge on the potential mechanisms underlying the pathophysiological impact of thyroid hormones T3 and T4 dysregulation, in the development of the atrial arrhythmogenic substrate. Finally, we review the available therapeutic strategies to treat AF in the context of thyroid disease.
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Karakus N, Catak M, Kutluturk F, Kocak M, Akman Ekici M, Citir M. The effects of circulating MIR22-3p and MIR16-1-3p levels in different stages of subacute thyroiditis. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2022; 42:436-447. [PMID: 36484570 DOI: 10.1080/15257770.2022.2154360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Subacute thyroiditis (SAT) is an inflammatory thyroid disease with a frequency is 5% among all thyroid diseases. miRNAs are endogenous, non-coding RNAs ranging in length from 19 to 25 nucleotides. They play an important role in the posttranscriptional regulation of gene expression. In this study, we aimed to investigate whether the expression levels of two circulating miRNAs, MIR22 and MIR16-1, can be used as a parameter in the diagnosis and follow-up of SAT disease. Fifty patients diagnosed with SAT and 41 healthy controls were included in this study. Expression levels of miRNAs were determined by real time-PCR method. Expression data of miRNAs were calculated by fold change (2-ΔΔCt) method. The statistical significance of miRNA expression was evaluated by t-test. The expression levels of MIR22-3p and MIR16-1-3p were not found to be statistically different between SAT patients and controls and also between the patients in different stages (hyperthyroid, euthyroid, and hypothyroid) of the disease. According to correlation analyses, we observed a positive strong correlation between erythrocyte sedimentation rate (ESR) and the expression levels of MIR22-3p and MIR16-1-3p (r = 0.960, p = 0.000 and r = 0.865, p = 0.006, respectively), and a positive strong correlation between fT4 and the expression levels of MIR22-3p in SAT patients in euthyroid stage (r = 0.712, p = 0.047). In this study, we showed that the expression levels of MIR22-3p and MIR16-1-3p have correlation with clinical characteristics of SAT disease. Our results suggest that MIR22 and MIR16-1 may be effective in the pathogenesis of SAT.
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Affiliation(s)
- Nevin Karakus
- Department of Medical Biology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Merve Catak
- Department of Internal Medicine, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Faruk Kutluturk
- Department of Internal Medicine, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Mustafa Kocak
- Department of Medical Biology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Merve Akman Ekici
- Department of Medical Biology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Muhterem Citir
- Department of Internal Medicine, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
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Metwalley KA, Farghaly HS. Subclinical hyperthyroidism in children. J Pediatr Endocrinol Metab 2022; 36:342-345. [PMID: 36473171 DOI: 10.1515/jpem-2022-0534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
Subclinical hyperthyroidism (SH) is defined as serum thyroid-stimulating hormone (TSH) below the lower limit of the reference range in the presence of normal free T4 and free T3 levels. Depending on the degree of TSH suppression, SH could be defined as mild (TSH, 0.1-0.45 mU/L) or severe (TSH<0.1 mU/L). Patients with SH are often asymptomatic when symptoms are present, they are similar to the symptoms in patients with overt hyperthyroidism, although they are usually milder. The management of the SH is uncertain and should be individualized. We present this review after an extensive literature search and long-standing clinical experience. This review provides the prevalence, causes, clinical presentation, investigation, and therapeutic approach of SH in children.
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Affiliation(s)
- Kotb Abbass Metwalley
- Department of Pediatrics, Faculty of Medicine, Pediatric Endocrinology Unit, Assiut University, Assiut, Egypt
| | - Hekma Saad Farghaly
- Department of Pediatrics, Faculty of Medicine, Pediatric Endocrinology Unit, Assiut University, Assiut, Egypt
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Hu X, Hao H, Guo M, Ma SG. Real-world effect of the treatment for painful subacute thyroiditis: The combined injection of lidocaine and triamcinolone using an insulin pen. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 67:306-313. [PMID: 36468926 DOI: 10.20945/2359-3997000000542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective : Intrathyroidal injection using an insulin pen filled with a mixture of lidocaine and triamcinolone acetonide is a therapy for subacute thyroiditis (SAT) reported by us previously. We aimed to evaluate the clinical efficacy of ultrasound-guided intrathyroidal injection in the treatment of SAT. Subjects and methods A total of 93 patients with SAT completed the study. All patients were evaluated via a history and clinical examination followed by thyroid function tests and ultrasonography of the thyroid. After ultrasound-guided intrathyroidal injection, the patients were followed up with respect to the injection frequency, treatment duration, and patient satisfaction. The visual numerical rating scale was used as a pain questionnaire for a given interval. Results Thyroid pain instantly decreased to scores below 3.0 following the first injection. Sixty-three patients (67.74%) avoided relapse of thyroid pain within 3 injections, which occurred within only 3 days after the first injection. The pain in 27 patients (29.03%) disappeared completely after 4-6 injections. Only 3 patients (3.23%) were found to need more than 6 injections, with 10 cited as the maximum number of injections, the injection took only 17 days altogether. The mean treatment cycle of the intrathyroidal injection was 3.98 days. There were no other associated complications with the novel therapy except infrequent small subcutaneous hematomas, which could be prevented with skilled practice. The average patient satisfaction score was as high as 9.0. Conclusion Intrathyroidal injection of lidocaine and triamcinolone acetonide using an insulin pen was found to be an advantageous and satisfactory treatment for SAT.
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Abdelhamed HM, Abdo Soliman MS, Mahmoud AA, Mohamed R, Ali IM, Abdelhai SF. The utility of technetium-99m pertechnetate thyroid scintigraphy assessing thyroid/salivary ratio as an alternative to thyroid uptake percentage in evaluation of thyroid function, with establishing normal reference values of both parameters: single Egyptian center study. Nucl Med Commun 2022; 43:1181-1187. [PMID: 36345762 DOI: 10.1097/mnm.0000000000001620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND/OBJECTIVE Management of thyroid disorders depends on accurate clinical assessment, appropriate investigations and radionuclide imaging, which plays an established important role either qualitatively or quantitatively. The aim of this study was to assess the utility of the thyroid/salivary ratio (TSR) as an alternative to technetium-99m (Tc99m) pertechnetate thyroid uptake (TcU) percentage in the evaluation of thyroid function and in the same time to establish reference range for the thyroid uptake of Tc99m-pertechnetate and TSR among Egyptian populations. PATIENTS AND METHODS This retrospective study enrolled 270 patients, out of which 250 with different thyroid disorders and 20 without thyroid diseases, as a control group who all underwent full clinical examination, thyroid function tests and Tc99m pertechnetate thyroid scintigraphy. The TcU percentage and TSR were calculated and then correlated to the thyroid hormonal profile. RESULTS The normal reference ranges of TcU and TSR were 0.75-3.5% and 1.25-4.8%, respectively. The sensitivity and specificity of TSR to diagnose hyperthyroidism were slightly lower compared with TcU (84.5 and 92.3% vs. 86.2 and 98.3%, respectively) at TSR cutoff value of more than 4.8 and TcU cutoff value of more than 3.5. Meanwhile, they had comparable sensitivity and specificity to diagnose hypothyroidism (86.0 and 93.3% vs. 86.5 and 94.5%) at cutoff values <0.75 and <1.25, respectively. CONCLUSION The current study established a reference range for TcU and TSR in our institution. TSR is comparable to TcU in the evaluation of thyroid function among hyper-and hypothyroid patients and TSR can be used in doubtful cases of mal-thyroid function for confirmation of the diagnosis.
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Affiliation(s)
| | | | | | - Ramadan Mohamed
- Nuclear Medicine Unit, Department of Radiology, Zagazig University
| | - Ismail M Ali
- Radiology Department, Zagazig University, Zagazig, Egypt
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Rivkees SA. Approach to the Patient: Management and the Long-term Consequences of Graves' Disease in Children. J Clin Endocrinol Metab 2022; 107:3408-3417. [PMID: 36184734 DOI: 10.1210/clinem/dgac573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Indexed: 02/13/2023]
Abstract
In children, Graves' disease (GD) is the most common cause of hyperthyroidism. Most pediatric patients with GD will not go into lasting remission, even following many years of antidrug therapy. Thus, most pediatric patients will require radioactive iodine (RAI) or surgery. When antithyroid drugs are used, methimazole is the drug of choice. When methimazole is used in children, up to 20% will have minor adverse reactions and serious adverse events occur in up to 1%. RAI is an effective form of therapy when the thyroid size is less than 80 g. Because of concerns of whole-body radiation exposure, it is recommended that RAI be avoided in children under 5 years of age, and dosages less than 10 mCi be used between 5 and 10 years of age. Surgery is an effective treatment in children if performed by a high-volume thyroid surgeon. Because of the scarcity of high-volume pediatric thyroid surgeons, a multidisciplinary approach using pediatric surgeons and endocrine surgeons can be considered. Whereas there is a trend toward long-term antithyroid drug therapy in adults, for several reasons, this approach may not be practical for children. Determining the optimal treatment for the pediatric patient with GD, requires consideration of the risks and benefits relating to age and likelihood of remission.
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Affiliation(s)
- Scott A Rivkees
- School of Public Health, Brown University, Providence, RI 02912, USA
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Muacevic A, Adler JR. Utility of Antibodies in the Diagnoses of Thyroid Diseases: A Review Article. Cureus 2022; 14:e31233. [PMID: 36514581 PMCID: PMC9733813 DOI: 10.7759/cureus.31233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/08/2022] [Indexed: 11/10/2022] Open
Abstract
Thyroid problems are among the most widespread endocrine illnesses, affecting individuals in India and the global population. A thyroid function test is used to diagnose, screen, and monitor patients. Hyperthyroidism is a clinical condition due to excessive circulation of thyroid hormone; in contrast, hypothyroidism is due to a deficiency of thyroid hormone. Graves' disease (GD) is a form of hyperthyroidism due to thyroid-stimulating hormone receptor autoantibodies (TRAb), and anti-thyroid peroxidase antibodies (anti-TPO antibodies). The most common reason for hypothyroidism is Hashimoto's thyroiditis (HT), in which patients have thyroid receptor antibodies (TRAb), antibodies to thyroid peroxidase (TPO), and thyroglobulin antibodies. Many essential genes, including the thyroid-specific genes thyroglobulin (TSGT), TSH-receptor gene, human leukocyte antigen (HLA) genes, cytotoxic T lymphocyte-associated antigen (CTLA) genes, thyroglobulin gene, vitamin D receptor gene, and many immune-regulatory genes were associated with autoimmune thyroid diseases' (AITDs') etiology. This review paper aims to determine if antibodies are beneficial in detecting autoimmune thyroid disease or not. We have also discussed the etiology of autoimmune thyroid illness, serum antibodies in autoimmune thyroid disease, pathophysiology, and TSH receptor features.
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Azeez TA, Lamidi AO, Osin IO. A systematic review and meta-analysis of the etiology and treatment patterns of thyrotoxicosis in Africa. Expert Rev Endocrinol Metab 2022; 17:563-572. [PMID: 36267032 DOI: 10.1080/17446651.2022.2136165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/11/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Thyrotoxicosis is one of the most common endocrine disorders seen in clinical practice. This study aims to determine the etiologies and treatment modalities of thyrotoxicosis in Africa. AREAS COVERED The study design is a systematic review with a meta-analysis. Medical databases and the gray literature were systematically searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies done in Africa on the etiology and treatment of thyrotoxicosis were selected. EXPERT OPINION In Africa, it is still believed that autoimmune diseases, generally, are not as common as what is seen in the western world. The frequency of Graves' disease is reportedly lower in Africa. The treatment of thyrotoxicosis depends on the cause. Therefore, it is of substantial importance to establish the etiology following the diagnosis of the clinical syndrome.
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Gölz L, Baumann L, Pannetier P, Braunbeck T, Knapen D, Vergauwen L. AOP Report: Thyroperoxidase Inhibition Leading to Altered Visual Function in Fish Via Altered Retinal Layer Structure. ENVIRONMENTAL TOXICOLOGY AND CHEMISTRY 2022; 41:2632-2648. [PMID: 35942927 DOI: 10.1002/etc.5452] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
Thyroid hormones (THs) are involved in the regulation of many important physiological and developmental processes, including vertebrate eye development. Thyroid hormone system-disrupting chemicals (THSDCs) may have severe consequences, because proper functioning of the visual system is a key factor for survival in wildlife. However, the sequence of events leading from TH system disruption (THSD) to altered eye development in fish has not yet been fully described. The development of this adverse outcome pathway (AOP) was based on an intensive literature review of studies that focused on THSD and impacts on eye development, mainly in fish. In total, approximately 120 studies (up to the end of 2021) were used in the development of this AOP linking inhibition of the key enzyme for TH synthesis, thyroperoxidase (TPO), to effects on retinal layer structure and visual function in fish (AOP-Wiki, AOP 363). In a weight-of-evidence evaluation, the confidence levels were overall moderate, with ample studies showing the link between reduced TH levels and altered retinal layer structure. However, some uncertainties about the underlying mechanism(s) remain. Although the current weight-of-evidence evaluation is based on fish, the AOP is plausibly applicable to other vertebrate classes. Through the re-use of several building blocks, this AOP is connected to the AOPs leading from TPO and deiodinase inhibition to impaired swim bladder inflation in fish (AOPs 155-159), together forming an AOP network describing THSD in fish. This AOP network addresses the lack of thyroid-related endpoints in existing fish test guidelines for the evaluation of THSDCs. Environ Toxicol Chem 2022;41:2632-2648. © 2022 SETAC.
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Affiliation(s)
- Lisa Gölz
- Aquatic Ecology and Toxicology Research Group, Centre for Organismal Studies, University of Heidelberg, Heidelberg, Germany
| | - Lisa Baumann
- Aquatic Ecology and Toxicology Research Group, Centre for Organismal Studies, University of Heidelberg, Heidelberg, Germany
| | - Pauline Pannetier
- Aquatic Ecology and Toxicology Research Group, Centre for Organismal Studies, University of Heidelberg, Heidelberg, Germany
| | - Thomas Braunbeck
- Aquatic Ecology and Toxicology Research Group, Centre for Organismal Studies, University of Heidelberg, Heidelberg, Germany
| | - Dries Knapen
- Zebrafishlab, Veterinary Physiology and Biochemistry, Department of Veterinary Sciences, University of Antwerp, Wilrijk, Belgium
| | - Lucia Vergauwen
- Zebrafishlab, Veterinary Physiology and Biochemistry, Department of Veterinary Sciences, University of Antwerp, Wilrijk, Belgium
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Zhu X, Zhang Y, Zhao X, Zhang X, Ru Z, Wu Y, Yang X, Hou B, Qiao H. The relationship between atherosclerotic disease and relapse during ATD treatment. Front Cardiovasc Med 2022; 9:1039829. [DOI: 10.3389/fcvm.2022.1039829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/29/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundClinical relapse is a potential risk for traditional antithyroid drug (ATD) treatment in hyperthyroid patients. Evidence suggests that atherosclerotic disease is closely associated with hyperthyroidism, while the relationship between atherosclerosis and relapse remains unclear.MethodsTwo hundred and twenty-five patients with GD who underwent ATD as their first treatment were studied; 88 and 137 patients were categorized as drug reduction relapse and drug reduction remission, respectively. Logistic regression was used to analyze risk factors of drug reduction relapse in patients with GD.ResultsDuring a median of 48 months followed up 88 patients who relapsed. According to multivariate analyses, atherosclerosis related diseases, FT4, goiter, and anxiety rating scores are independent risk factors for drug reduction. According to K-M survival analysis, patients with atherosclerosis related diseases, FT4 > 18.82 pmol/L, anxiety rating scores > 23, and gradation of goiter ≥ Grade II had a higher risk of relapse than those with lower levels. ROC analysis shown atherosclerosis related diseases significantly improved the predictive accuracy of relapse.ConclusionsAtherosclerotic disease is closely related to the relapse of hyperthyroidism, ATD treatment in hyperthyroid patients with atherosclerosis should be given more attention.
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Kataoka S, Matsuno K, Sugano K, Takahashi K. Thyroid storm induced by combined nivolumab and ipilimumab immunotherapy in advanced non-small cell lung cancer. BMJ Case Rep 2022; 15:15/10/e250696. [PMID: 36223974 PMCID: PMC9562321 DOI: 10.1136/bcr-2022-250696] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Thyroid storm is a rare and life-threatening condition associated with excess thyroid hormones. Early detection of thyroid storm is the key to decreasing the morbidity and mortality associated with this condition. We present a rare case of thyroid storm induced by combination therapy with nivolumab and ipilimumab in a patient with advanced non-small cell lung cancer (NSCLC). Because of prominent hyperthyroidism with gastrointestinal symptoms and signs of heart failure, the patient was diagnosed with thyroid storm 3 weeks after initiating this combination immunotherapy. The patient had no history of thyroid disease but was positive for antithyroid antibodies. This case report suggests that thyroid function and symptoms of suspected thyroid storm should be evaluated routinely within 3 weeks from the initiation of therapy when combination therapy is administered in patients with NSCLC positive for antithyroid antibodies.
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Affiliation(s)
- Shunichi Kataoka
- Division of Respiratory Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Tokyo, Japan
| | - Kei Matsuno
- Division of Respiratory Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Tokyo, Japan
| | - Koji Sugano
- Division of Respiratory Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Tokyo, Japan
| | - Kazuhisa Takahashi
- Juntendo University School of Medicine Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
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Liu S, Miao JJ, Zhou X, Sun Q, Mao XM. High levels of thyroid hormones promote recurrence of Graves' disease via overexpression of B-cell-activating factor. J Clin Lab Anal 2022; 36:e24701. [PMID: 36097969 PMCID: PMC9550970 DOI: 10.1002/jcla.24701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 11/19/2022] Open
Abstract
Background Elevated thyroid hormone (TH) levels have been suggested to be associated with the pathological progression of Graves' disease (GD). However, direct evidence from clinical studies remains unclear. Methods Peripheral blood samples were collected from patients with or without the recurrence of Graves' hyperthyroidism (GH) and healthy donors. Thyroid tissue samples were obtained from patients with benign thyroid nodules. To assess the differentiation of autoreactive B cells, the expression of B‐cell‐activating factor (BAFF) and the proportion of CD11c+/–IgG+/− subsets of B cells stimulated by high levels of triiodothyronine (T3) in vivo and in vitro were examined by ELISA, flow cytometry, western blotting, and qRT‐PCR. Results Serum BAFF levels in patients with GD were significantly and positively correlated with FT3, FT4, and TRAb levels. Furthermore, the ratio of abnormally differentiated CD11c+ autoreactive B cells positively correlated with BAFF and TRAb. High levels of triiodothyronine (T3) induced BAFF overexpression in thyroid follicular cells and mononuclear cells of the normal thyroid in vitro, thereby promoting the differentiation of CD11c+IgG+ autoreactive secretory B cells (ASCs). However, the precise knockdown of BAFF expression significantly inhibited the abnormal differentiation of ASCs. Conclusion The pathological progression of GD was prolonged and exacerbated by autoimmune positive feedback modulation caused by high TH levels. BAFF could be considered a potential target for localized thyroid immunosuppressive treatment of Graves' hyperthyroidism recurrence.
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Affiliation(s)
- Shu Liu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jing-Jing Miao
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiao Zhou
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Qi Sun
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiao-Ming Mao
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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Shaka H, Salim M, DeHart L, El-amir Z, Wani F, Kichloo A. A decade of hospitalizations for hyperthyroidism in the US. Proc AMIA Symp 2022; 35:773-777. [DOI: 10.1080/08998280.2022.2106452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Affiliation(s)
- Hafeez Shaka
- Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
| | - Michael Salim
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, Illinois
| | - Luke DeHart
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, Michigan
| | - Zain El-amir
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, Michigan
| | - Farah Wani
- Department of Medicine, Samaritan Medical Center, Watertown, New York
| | - Asim Kichloo
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, Michigan
- Department of Medicine, Samaritan Medical Center, Watertown, New York
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Abstract
Subclinical thyroid dysfunction is defined by serum thyroid-stimulating hormone (TSH) levels either greater or less than the reference range with normal thyroxine (T4) concentrations, and consists of subclinical hypothyroidism (SCH) and subclinical hyperthyroidism (SCHyper). For the proper diagnosis of SCH, it is most important to be able to correctly evaluate the serum TSH levels, which have numerous unique characteristics. We also need to be versed in TSH harmonization, which was recently launched world-wide. In this review, we will attempt to determine the best clinical approaches to the treatment of subclinical thyroid dysfunction based on recent guidelines published from several countries and novel findings of several recent large-scale clinical studies.
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Affiliation(s)
- Koshi Hashimoto
- Department of Diabetes, Endocrinology, and Hematology, Dokkyo Medical University Saitama Medical Center, Saitama 343-8555, Japan
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de Mul N, Immink RV. How to survive the thyroid storm: what we can learn from case reports. Br J Anaesth 2022; 129:e76-e77. [PMID: 35871022 DOI: 10.1016/j.bja.2022.05.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/30/2022] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Nikki de Mul
- Department of Anaesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Rogier V Immink
- Department of Anaesthesiology, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Chai J, Zhang R, Zheng W, Zhang G, Jia Q, Tan J, Meng Z, Wang R. Effect of Lugol's solution on 131I therapy efficacy in Graves' disease. Clin Exp Med 2022:10.1007/s10238-022-00859-4. [PMID: 35840869 DOI: 10.1007/s10238-022-00859-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Lugol's solution could control thyroid function and suppress 131I uptake in hyperthyroidism. This study aimed to investigate the appropriate time to withdraw Lugol's solution before 131I therapy (RIT) in Graves' disease (GD) patients, and how this should influence 131I uptake and RIT outcome. METHODS Two groups (125 cases and 1805 cases) of GD patients received RIT, who were pre-treated with and without Lugol's solution (RI-CI group and RI group). The RI-CI group was further divided into the following sub-groups depending on the duration span between Lugol's solution withdrawal and RIT: sub-group A, 4-7 d (n = 49); sub-group B, 8-14 d (n = 41); and sub-group C, 15-30 d (n = 35). The highest radioactive iodine uptake rate (RAIUmax), effective half-life (Teff), TRAb, and free triiodothyronine (FT3) and free thyroxine (FT4) levels were compared, and therapeutic outcome was evaluated. RESULTS There were no significant differences in RAIUmax, TRAb, and Teff among the four sub-groups (P > 0.05). Both FT3 and FT4 levels in sub-groups A and B were lower than those in group RI and sub-group C (P < 0.05). The outcome of non-hyperthyroidism (euthyroidism + hypothyroidism) in groups RI-CI and RI was significantly different at post-RIT month 1 and 3 (P < 0.05). However, intergroup differences at 6 and 12 months were not significant (P > 0.05). CONCLUSIONS Withdrawal of Lugol's solution 4-7 or 8-14 d before RIT does not influence 131I uptake and RIT efficacy in GD. Moreover, in order to avoid a rapid increase in thyroid hormone levels at the same time, Lugol's solution should be withdrawn 4-7 d before RIT.
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Affiliation(s)
- Jinyan Chai
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, People's Republic of China
| | - Ruiguo Zhang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, People's Republic of China
| | - Wei Zheng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, People's Republic of China
| | - Guizhi Zhang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, People's Republic of China
| | - Qiang Jia
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, People's Republic of China
| | - Jian Tan
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, People's Republic of China
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, People's Republic of China.
| | - Renfei Wang
- Department of Nuclear Medicine, Tongji University Tenth People's Hospital, Shanghai, 200000, People's Republic of China.
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Fan HX, Sheng S, Zhang F. New hope for Parkinson's disease treatment: Targeting gut microbiota. CNS Neurosci Ther 2022; 28:1675-1688. [PMID: 35822696 PMCID: PMC9532916 DOI: 10.1111/cns.13916] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/21/2022] [Accepted: 06/25/2022] [Indexed: 12/14/2022] Open
Abstract
There might be more than 10 million confirmed cases of Parkinson's disease (PD) worldwide by 2040. However, the pathogenesis of PD is still unclear. Host health is closely related to gut microbiota, which are affected by factors such as age, diet, and exercise. Recent studies have found that gut microbiota may play key roles in the progression of a wide range of diseases, including PD. Changes in the abundance of gut bacteria, such as Helicobacter pylori, Enterococcus faecalis, and Desulfovibrio, might be involved in PD pathogenesis or interfere with PD therapy. Gut microbiota and the distal brain achieve action on each other through a gut‐brain axis composed of the nervous system, endocrine system, and immune system. Here, this review focused on the current understanding of the connection between Parkinson's disease and gut microbiota, to provide potential therapeutic targets for PD.
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Affiliation(s)
- Hong-Xia Fan
- Laboratory Animal Center and Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education and Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, Guizhou, China
| | - Shuo Sheng
- Laboratory Animal Center and Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education and Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, Guizhou, China
| | - Feng Zhang
- Laboratory Animal Center and Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education and Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, Guizhou, China
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Choi R, Lee SG, Lee EH. Patient Population and Test Utilization for Thyroid Function in Local Clinics and Hospitals in Korea. Diagnostics (Basel) 2022; 12:diagnostics12071638. [PMID: 35885541 PMCID: PMC9321883 DOI: 10.3390/diagnostics12071638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 12/11/2022] Open
Abstract
We evaluated the utilization and characteristics of thyroid function test (TFT) results, including serum thyroid stimulating hormone (TSH), free thyroxine (free T4), and total triiodothyronine (total T3) in Korean adults who visited local clinics and hospitals between 2018 and 2020. We obtained TFT results for 69,575 specimens from 47,685 adult Korean patients (4878 men and 42,807 women) with a mean age of 42.7 (standard deviation of 13.2) years. Among them, 23,581 specimens were tested for TSH only, 38,447 specimens were tested for TSH and free T4 (including 17,978 specimens without total T3), and 20,469 specimens were tested for all three, i.e., TSH, free T4, and total T3. The proportion of euthyroid was 80.0% among all 69,575 specimens, 71.2% among specimens with TSH and free T4, and 64.2% among specimens with all three TFTs. TFT patterns that were difficult to interpret and needed more clinical information were observed for about 6.9% of the 20,469 specimens with all three TFTs. Among the 20,469 specimens with all three TFTs, no specimen had increases in all three. Information on the prevalence of specimen results of TFTs would be helpful to expand our knowledge of patient population characteristics and to improve test utilization.
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Affiliation(s)
- Rihwa Choi
- Department of Laboratory Medicine, Green Cross Laboratories, Yongin 16924, Korea;
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Sang Gon Lee
- Department of Laboratory Medicine, Green Cross Laboratories, Yongin 16924, Korea;
- Correspondence: (S.G.L.); (E.H.L.); Tel.: +82-31-260-9209 (S.G.L.); +82-31-260-9201 (E.H.L.)
| | - Eun Hee Lee
- Green Cross Laboratories, Yongin 16924, Korea
- Correspondence: (S.G.L.); (E.H.L.); Tel.: +82-31-260-9209 (S.G.L.); +82-31-260-9201 (E.H.L.)
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Hoang TD, Stocker DJ, Chou EL, Burch HB. 2022 Update on Clinical Management of Graves Disease and Thyroid Eye Disease. Endocrinol Metab Clin North Am 2022; 51:287-304. [PMID: 35662442 PMCID: PMC9174594 DOI: 10.1016/j.ecl.2021.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The management of hyperthyroidism and extrathyroidal manifestations of Graves disease remains complex. Considerations that include patient preference, age, comorbidity, pregnancy, tobacco smoking, and social determinants of health must all be weaved into a cohesive management plan. A multidisciplinary team is required to manage all aspects of Graves disease, particularly thyroid eye disease, for which new therapeutic options are now available.
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Affiliation(s)
- Thanh D Hoang
- Division of Diabetes, Endocrinology and Metabolism, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20819, USA; Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Derek J Stocker
- Department of Radiology, Nuclear Medicine Service, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20819, USA; Departments of Internal Medicine, Pathology, and Radiologic Sciences Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Eva L Chou
- Department of Ophthalmology, Oculoplastic Service, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20819, USA; Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Henry B Burch
- Division of Diabetes, Endocrinology and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 6707 Democracy Boulevard, Room 6054, Bethesda, MD 20892-5460, USA; Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
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ÇETİN Z, KÖSEOĞLU D, ÖZDEMİR BAŞER Ö. Clinical, sonographical and cytological comparison of toxic and non-toxic thyroid nodules. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1089028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: To compare patients with toxic and non-toxic nodular/multinodular goiter in terms of clinical, sonographical and cytological features.
Material and Method: The medical data of 326 patients were reviewed retrospectively. Clinical and sonographic features were examined. Four hundred and eighty-one nodules were compared sonographically and cytologically. One hundred twenty-four patients had toxic nodular goiter and 202 of them had non-toxic nodular goiter.
Results: The toxic nodular goiter group was older, they had more male sex, more multi-nodularity, larger thyroid glands and nodules with more sonographically suspicious features (p 40 mm in 13.9% of the nodules in the toxic group and 5.4% of those in the non-toxic group (p= 0.003). Central vascularization (p
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Hamid Al-Sultan RM, Abdulsalaam Al-Sultan A, Hayawi MA, Aldahham BJM, Saleh MY, Mohammed HA. The effect of subclinical thyroid dysfunction on B- type natriuretic peptide level. BIONATURA 2022. [DOI: 10.21931/rb/2022.07.02.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Thyroid hormones (THs) have a significant effect on the cardiovascular system. THs increase myocardium stretch, leading to the release of B-type Natriuretic Peptide (BNP), which is considered a diagnostic biomarker of heart failure (HF). Thyroid dysfunctions (subclinical hypothyroidism; SCH and subclinical hyperthyroidism; SCHyper) stimulate several changes in the heart by causing either diastolic or systolic left ventricular dysfunctions leading to HF. This study aims to measure the changes of B- type NP levels in cases of subclinical hypo and hyperthyroidism. The present study aims to measure the changes in B-type Natriuretic Peptide (BNP) levels in subclinical hypo and hyperthyroidism (SCH and SCHyper). A theoretical study was also conducted using a docking program to find the effectiveness of some drugs in inhibiting or promoting B-type Natriuretic Peptide (BNP).
A case study was conducted in a private clinic, Mosul- Iraq, from (April 1st – Sep 1) 2021, with 25 healthy participants with normal functioning thyroids as a control group (EU). A newly diagnosed 25 SCH and 17 SCHyper patients participated in this study, considering that none of them have thyroid dysfunctions taking medicine, hypertension, heart diseases, renal failure, and pregnant women. They all were checked for Thyroid Function Tests (TFTs), Free Triiodothyronine (FT3), Free Thyroxin (FT4) and Thyroid Stimulating Hormone (TSH). The plasma level of BNP was measured in all participants of the three groups. The results showed that the plasma level of BNP was higher in SCHyper patients (10.97 pg/ml) as compared to that of SCH patients (8.09 pg/ml) and EU subjects (8.27 pg/ml). Hereby, we could state that subclinical hyperthyroidism, SCHyper, triggers BNP release. Therefore, it should be kept in mind that any high BNP levels due to SCHyper should be considered a reliable diagnostic biomarker of heart failure (HF).
Keywords. Thyroid hormone(TH), Subclinical hypothyroidism(SCH), Subclinical hyperthyroidism(SCHyper), Chronic heart disease(CHD), Heart failure(HF), B-type natriuretic peptide(BNP), Docking Study.
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Affiliation(s)
| | - Ammar Abdulsalaam Al-Sultan
- Head & founder of the department of cardiac surgery Mosul Center for Cardiology and Cardiac surgery, Directorate of Health , Nineveh, Ministry of Health
| | - Mohammed A. Hayawi
- Department of Basic Science, College of Nursing , University of Mosul , Mosul, Iraq
| | - Bilal J M Aldahham
- Department of Applied Chemistry, College of Applied Sciences-Hit, University Of Anbar, Hit 31007, Anbar, Iraq
| | - Mohanad Y. Saleh
- Department of Chemistry, College of Education for pure Science, University of Mosul, Mosul, Iraq
| | - Hazim A. Mohammed
- Department of Biochemistry, College of Medicine, University of Mosul, Mosul, Iraq
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