Toxic Multinodular Goiter and Solitary Toxic Adenoma

2017 ◽  
pp. 135-140
Author(s):  
Milan Halenka ◽  
Zdeněk Fryšák
Keyword(s):  
Multinodular Goiter ◽  
Toxic Adenoma ◽  
Toxic Multinodular Goiter

scholarly journals SAT-415 Clinical Performance of Thyroid-Stimulating Immunoglobulin for Graves′ Disease Diagnosis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Suemi Marui ◽  
Aline Lenczuk ◽  
Nelisa Helena Rocha ◽  
Tomoco Watanabe ◽  
Luciana Pinto Brito
Keyword(s):  
Multinodular Goiter ◽  
Clinical Performance ◽  
Graves Disease ◽  
Toxic Adenoma ◽  
Serum Samples ◽  
Toxic Multinodular Goiter ◽  
Analytical Range ◽  
Roche Diagnostics ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

Abstract INTRODUCTION The diagnosis of Graves′disease (GD) is likely when patient presents hyperthyroidism, symmetrical goiter and orbitopathy and further evaluation is unnecessary. Nevertheless patient with nodular thyroid or in the absence of clinical orbitopathy, measurement of TSH receptor antibodies (TRAb) is recommended to distinguish GD from toxic multinodular goiter, toxic adenoma and other etiologies. Radioiodine uptake (RAIU) also helps to diagnosis when TRAb is unavailable. Third generation TRAb assays measure all types of TSH receptor antibodies: stimulating, blocking and neutral with an excellent sensitivity and specificity for GD diagnosis. Recently, an automated bioassay for the thyroid stimulating immunoglobulin (TSI) was introduced to improve GD diagnosis. OBJECTIVE To analyze clinical performance of TSI and compare with TRAb assay for GD diagnosis. MATERIAL AND METHODS Serum samples of 117 patients with thyrotoxicosis due to GD, toxic multinodular goiter and toxic adenoma were runned simultaneously in two analytical system commercially available. TRAb was analyzed by Elecsys Anti-TSHR assay (Roche Diagnostics, Germany) in a Cobase411 analyzer (Roche Diagnostics, Germany) and results, according to the manufacturer interval reference, were negative if < 1.75 IU/L (analytical range: 0.3 to 40 IU/L). TSI was measured by Immulite TSI assay (Siemens Healthcare, UK) in Immulite XPi 2000 and results, according to the manufacturer interval reference, were negative if < 0.55 IU/L (analytical range: 0.1 to 40 IU/L). Clinical diagnoses of thyrotoxicosis were determined according to ATA guideline (2016). Statistical analyses were performed using SPSS and MedCalc softwares. Comparison were evaluated by regression equations and were considered significant when p values were < .05. RESULTS From 2017 to 2019 a total of 312 serum samples from 117 patients (96 females) were evaluated with mean age 49.5 ±15.8 years-old (18 to 90 yrs). We excluded 26 results above the analytical measurement range of both assays. A high degree correlation was observed with a slope of 0.647 and an intercept -.094 IU/L. Spearman correlation coefficient was 0.858 (p < 0.0001, 95% CI 0.825 to 0.886). TSI assay had higher sensibility and negative predictive value compared to TRAb (95.6% vs 88.5% and 83.6% vs 54.8%, respectively) but lower specificity and positive predictive value (90.3% vs 100% and 97.5% vs 100%, respectively). The results of TSI assay showed good agreement with those of the TRAb assay (k=0.74). A total of 31 samples were discordant, favoring to TSI assay in all but one case of GD according to clinical diagnosis (TRAb positive and TSI negative). CONCLUSION TSI assay showed an excellent performance for GD diagnosis with a better sensibility than TRAb assay.

scholarly journals Thyroid Cancer in Patients with Hyperthyroidism

2015 ◽  
Vol 7 (2) ◽  
pp. 29-32 ◽  
Author(s):  
Baki Tastan ◽  
Alper Dogu ◽  
Yusuf Sevim
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Cancer ◽  
Multinodular Goiter ◽  
Malignant Tumors ◽  
Graves Disease ◽  
Thyroid Malignancy ◽  
Toxic Adenoma ◽  
Endocrine Organs ◽  
Toxic Multinodular Goiter ◽  
Hyperthyroid Patients

ABSTRACT Background and objective Malignant tumors of the thyroid gland are the most common of the endocrine malignancies. Although, patients with thyroid cancer have high 5 years survival rate, thyroid cancer is the most seen cause of mortality among cancers of the endocrine organs. The incidence of thyroid cancer in hyperthyroid patients varies from 0.1 to 21% in the literature. We aimed in this study to analyze the frequency of coexisting thyroid cancer and hyperthyroidism in our experience. Results Total 230 patients, who were operated for hyperthyroidism without the suspicion of thyroid malignancy between January 2005 and September 2010 were included in our study. Toxic multinodular goiter, toxic adenoma and Graves’ disease were diagnosed preoperatively in 187, 16 and 27 patients respectively. Histopathological thyroid malignancy was detected in 13 patients (5.7%). Conclusion Thyroid cancer with variable incidence up to 21% should be remembered in differential diagnosis of hyperthyroid patients. How to cite this article Tastan B, Dogu A, Sevim Y. Thyroid Cancer in Patients with Hyperthyroidism. World J Endoc Surg 2015;7(2):29-32.

scholarly journals Thyroglobulin as a possible predictor of doses radioiodine therapy in hyperthyroidism

2018 ◽  
Vol 48 (1-2) ◽  
Author(s):  
Salih Azabagić
Keyword(s):  
Multinodular Goiter ◽  
Radioiodine Therapy ◽  
Cost Effective ◽  
Antithyroid Drugs ◽  
Toxic Adenoma ◽  
Effective Treatment Option ◽  
Average Value ◽  
Cost Effective Treatment ◽  
Toxic Multinodular Goiter

Introduction According to guidelines for the management of hyperthyroidism, patients with hyperthyroidism should be treated with radioactive iodine, antithyroid drugs, or thyroidectomy. Oral administration of radioiodine is a safe and cost effective treatment option for patients with toxic multinodular goiter (TMG)/toxic adenoma (TA) or Grave’s disease (GD). The aim of the study was to evaluate the use of thyroglobulin values as a possible predictor of a dose of radioiodine therapy (RAI) in hyperthyroidism in patients GD, TA and TMG. Results The study included 105 patients (14.4 % males and 85.6% females). The average duration of the disease was 9 years. Graves’s disease is registered among 50.68%, toxic multinodular goiter among 30.83% and toxic adenoma among 18.49% of patients. Patients were divided into four groups, and they received four doses of radioiodine therapy: 10mCi, 15mCi, 20mCi and 25mCi. The values of thyroglubulin were measured before RAI, and in period of one, three and six months after the therapy. Conclusion It can be concluded that the higher average value of thyroglobulin before therapy suggests the need for administering a higher doses of RAI, so determination of thyroglobulin levels in serum, may serve as a good predictor to assist in monitoring the administered dose of RAI in patients with hyperthyroidism.

scholarly journals A Patient With Graves’ Disease And Thyroid-Associated Orbitopathy Undergoing Radioactive Iodine in Dr. Soetomo General Academic Hospital, Surabaya

2021 ◽  
Vol 4 (1) ◽  
pp. 48
Author(s):  
Rizki Adrian Hakim ◽  
Stepanus Massora ◽  
Delfitri Lutfi ◽  
Hermina Novida
Keyword(s):  
Multinodular Goiter ◽  
Radioactive Iodine ◽  
Graves Disease ◽  
Academic Hospital ◽  
Toxic Adenoma ◽  
Relative Contraindication ◽  
Graves Ophthalmopathy ◽  
Common Etiology ◽  
Toxic Multinodular Goiter

Graves’ Disease (GD) is the most common etiology of thyrotoxicosis, followed by toxic multinodular goiter and toxic adenoma. GD can be managed with anti-thyroid drugs (ATDs), surgery, or radioactive iodine (RAI). Thyroid-associated orbitopathy (TAO) or Graves’ Ophthalmopathy (GO) affects 25%-50% patients with GD, and its presence usually dissuade clinicians to use RAI in treating hyperthyroidism. The presence of GO is a relative contraindication use of RAI in patients with GD, as RAI can worsen existing GO. Corticosteroid prophylaxis can be given to such patients to reduce likelihood of worsening of GO. However, patient with moderate to severe active GO is currently advised against undergoing RAI. Established guidelines recommend the use of corticosteroid prophylaxis in these patients. We reported a patients with GD and orbitopathy who was treated with RAI and was given steroid prophylaxis to prevent worsening of GO.

Frequency of Pathological Types of Hyperthyroidism in Thyroid Scan Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Ali Pooria ◽  
Afsoun Pourya ◽  
Alireza Gheini
Keyword(s):  
Multinodular Goiter ◽  
Clinical Information ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Toxic Adenoma ◽  
Aged Patients ◽  
Cross Sectional ◽  
Radioiodine Uptake ◽  
Systemic Disorder ◽  
Toxic Multinodular Goiter

Background: Hyperthyroidism is a common systemic disorder where Graves’ disease is known as the leading cause of the disease. Thyroid stimulating hormone, T4 and T3 antibody assay are usually performed for the diagnosis of the pathology. However, with uncertainty in the results and in order to estimate the magnitude and the exact cause of the disease, radioactive iodine uptake (RAIU) test is recommended. The aim of this study is to evaluate underlying pathology in the patients presenting hyperthyroidism using RAIU test results. Methods: This is a cross-sectional retrospective study conducted on the patients with hyperthyroidism referred to Shahid Madani Hospital in Khorramabad. Data regarding the biochemical analysis and RAIU test was collected from the records and a questionnaire based on demographic and clinical information was completed for each patient. Results: Of 137 patients presenting hyperthyroidism, 62.04% were presented with Graves’ disease, 24.08% with toxic multinodular goiter and 13.86% with toxic adenoma. 24-hour RAIU test showed that the percent of radioiodine uptake was most in toxic adenoma 67.7%, Graves’ disease 53.5% and multinodular goiter 39%, respectively. From the age-based analysis, we found that Graves’ was most common in 20-30 years old individuals 34%, multinodular goiter in 50+ aged individuals 36.3% and toxic adenoma was most prevalent in 30-40 and 50+ aged patients, 26.3% each. In our population of interest, 81.8% toxic multinodular goiter patients were females. Conclusions: Our study presents the outcome of RAIU tests in hyperthyroidism based on the underlying pathologies. We also conclude, in light of other findings, Graves’ disease is the most common cause of hyperthyroidism in our population.

The risk factors for malignancy in surgically treated patients for Graves' disease, toxic multinodular goiter, and toxic adenoma

Surgery ◽  
2008 ◽  
Vol 144 (6) ◽  
pp. 1028-1037 ◽  
Author(s):  
Yasemin Giles (Senyurek) ◽  
Tunca Fatih ◽  
Boztepe Harika ◽  
Kapran Yersu ◽  
Terzioglu Tarik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multinodular Goiter ◽  
Graves Disease ◽  
Toxic Adenoma ◽  
Toxic Multinodular Goiter

scholarly journals Immigration and the incidence of Graves' thyrotoxicosis, thyrotoxic multinodular goiter and solitary toxic adenoma

2009 ◽  
Vol 160 (2) ◽  
pp. 201-206 ◽  
Author(s):  
Mikael Lantz ◽  
Mirna Abraham-Nordling ◽  
Johan Svensson ◽  
Göran Wallin ◽  
Bengt Hallengren
Keyword(s):  
Urban Area ◽  
Multinodular Goiter ◽  
Genetic Factors ◽  
Geographic Origin ◽  
Southern Sweden ◽  
Toxic Adenoma ◽  
Open Label ◽  
Age Related ◽  
Total Incidence ◽  
Toxic Multinodular Goiter

ObjectiveEnvironmental and genetic factors influence thyrotoxicosis, but how population migration affects the disease panorama is not known. In an urban area in southern Sweden, during the years 1990 until 2003, the population increased from 232 000 to 267 000. In parallel, the proportion of inhabitants born outside Sweden increased.The aim was to investigate whether the incidence of Graves' thyrotoxicosis (GD), toxic multinodular goiter (TMNG), and solitary toxic adenoma (STA) has changed in Malmö since 1990 and to study the influence of geographic origin.Design and methodAn open label prospective registration of thyrotoxicosis, gender, age, smoking habits, and ethnic background during 2003–2005 in an urban area in southern Sweden (Malmö) was undertaken.ResultsThe total incidence of thyrotoxicosis has changed from 43 to 41.6 cases/100 000/year from the years 1988–1990 to 2003–2005 (p-value 0.72). GD increased from 22 to 29.6 (p-value 0.0051), TMNG decreased from 16 to 9.9 (p-value 0.0011) and STA from 4.8 to 2.1 (p-value 0.0054)/100 000/year. The total incidence of GD was higher in inhabitants born outside Sweden up to the age of 69 years and age-specific incidence showed a peak in women aged 50–59 years old in both groups. The greatest difference between immigrants and Swedes up to the age of 69 years was observed in women aged 20–29 years old.ConclusionThe incidence of GD has increased and of TMNG has decreased in Malmö since 1990. Geographic origin seems to affect the incidence of GD. Whether the observed peak in age-related incidence in women 50–59 years is explained by menopausal changes has to be further investigated.

Rare association of primary hyperparathyroidism and toxic multinodular goiter

2018 ◽  
Author(s):  
Hamza Elfekih ◽  
Mouna Elleuch ◽  
Dorra Ghorbel ◽  
Faten Hadjkacem ◽  
Mouna Ammar ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Multinodular Goiter ◽  
Rare Association ◽  
Toxic Multinodular Goiter
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