Thyroid Dysfunction and Cytological Patterns among Patients Requested for Thyroid Function Test in an Endemic Goiter Area of Gondar, North West Ethiopia

Determination of Serum Zinc and Phosphorus Levels in Patients with Hypothyroidism

Various studies reported that serum zinc (Zn) and phosphorus (P) levels altered in patients with hypothyroidism and vice versa, but results were found inconsistent. It was aimed to find the association between serum Zn and P in patients with hypothyroidism. In this case-control study, a total of 100 subjects (50 newly diagnosed patients of hypothyroidism and 50 controls) were enrolled aged between 25 and 60 years. Biochemical parameters such as thyroid profile, serum Zn, and P were estimated in each subject. A p < 0.05 was considered statistically significant. The mean level of body mass index (BMI), thyroid-stimulating hormone (TSH), and serum P was found significantly elevated in cases compared to controls (p < 0.001). However, the mean level of total triiodothyronine (T3), thyroxine (T4), and serum Zn was found significantly reduced in cases compared to controls (p < 0.001). The serum Zn has shown a significant negative correlation with T3 and BMI among cases (r =  - 0.313 p < 0.05, r =  - 0.338 p < 0.05, respectively). However, serum P has shown a significant positive correlation with TSH and BMI among cases (r = 0.310 p < 0.05, r = 0.449 p < 0.01, respectively). Regression analysis indicated that serum Zn significantly predicted hypothyroidism (p < 0.00). Similarly, serum P significantly predicted hypothyroidism (p < 0.007). Results showed that serum Zn levels were significantly reduced and serum P levels were significantly elevated in cases compared to controls. The serum Zn and serum P both significantly associated with hypothyroidism.

Perioperative management of the thyrotoxic patients: A systematic review

Background

Thyrotoxicosis is a clinical syndrome produced by a multitude of disorders. Thyrotoxicosis is a serious medical condition that, if left untreated, can lead to a fatal illness. This review of recent evidences give additional input for perioperative management of thyrotoxic patients.

Methods

The literatures were found with Boolean operators in the form of thyrotoxicosis AND anesthesia, antithyroid medications AND perioperative optimization AND beta blockers OR calcium channel blockers in electronic data base sources such as the Cochrane library, PubMed, and Google scholar. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement.

Conclusions

and recommendations: Before surgery and anesthesia, manifestation of thyrotoxicosis including palpitation, irritability etc should be ruled out.

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Thyrotoxicosis is a clinical syndrome produced by a multitude of disorders.

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Hyperthyroidism is a prevalent clinical condition that raises the risk of complications.

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Surgery and anesthesia should be postponed in elective thyrotoxicosis patients.

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Patients with thyrotoxicosis symptoms and elevated thyroid function tests should be optimized for 12–18 months.

Morphology and one immunohistochemical marker are enough for diagnosis of primary thyroid angiosarcoma

Primary thyroid angiosarcoma is a very rare and extremely aggressive mesenchymal malignant neoplasm showing morphological and immunophenotypic evidence of endothelial cell differentiation. Early diagnosis of this tumor along with radical thyroidectomy followed by postoperative radiotherapy and chemotherapy are essential for adequate management of the patient. Currently available data on diagnosis and treatment options of this neoplasm are limited because it is a rare disease in endocrine organs. Raising awareness regarding its diagnosis can help to optimize the treatment and to improve the survival of the patient. We present the case of a 72-year-old female patient with multiple comorbidities who addressed to the hospital with obstructive respiratory symptoms: dyspnea, wheezing and hoarseness. The investigations, both clinical and paraclinical, identified a local invasive cervical mass located mainly in the left thyroid lobe, whose immunohistochemical examination confirmed primary thyroid angiosarcoma. Although this type of neoplasm is described mainly in the Alpine regions, it can appear in lower altitude regions and this tumor needs to be differentiated from a high-grade neoplasm (anaplastic thyroid carcinoma).

Primary thyroid angiosarcoma in a non-endemic region - a rare case

Thyroid angiosarcoma (AS) is a specific type of vascular tumor that arises from the endothelial cells, being highly aggressive, with increased recurrence rates and metastasis. It is characterized by positive endothelial markers and co-positive markers for cytokeratins and epithelial membrane antigen. We are describing the case of a 76-year-old patient who presented to the hospital for dyspnea and asthenia. The clinical and paraclinical investigations confirmed the presence of a right large thyroid nodule, which turned out positive at immunostaining for AS. Even if thyroid AS is a rare type of tumor, mainly described in the Alps, one has to take into account that it can evolve in any other regions and should be considered as a differential diagnosis.