Free triiodothyronine toxicosis in a patient with multinodular goiter

SummaryAge-related trends in serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations were measured in 7248 euthyroid subjects (age-range 3 months to 106 years). 5700 were patients referred to hospitals for investigation of suspected thyroid dysfunction, but who were diagnosed euthyroid. 1548 were healthy blood donors (age-range 18-63 years) with no indication of thyroid dysfunction. FT4 concentrations were little affected by the age, the sex or the state of health of the subjects in either group. Serum FT3 concentrations were significantly affected by both age and health factors. The upper limit of the euthyroid reference range for young subjects up to 15 years was about 20% higher (10.4 pmol/1) than for adult subjects older than 25 years (8.8 pmol/1). The change in the upper limits typical of young subjects to that typical of adults occurred steadily over the decade 15–25 years. After this age, little further change occurred, especially in healthy subjects. Additionally, the lower limit of the euthyroid range for FT3 was extended by the inclusion in the reference group of patients referred to hospitals. Compared with the lower limit of the FT3 range for healthy subjects (5 pmol/1), the corresponding limit for referred subjects (young or adult) was 3.5–3.8 pmol/1. Broadening of the FT3 reference range was probably brought about by a significant number of patients in the hospital-referred group with the “1OW-T3 syndrome” of mild non-thyroidal illness. Accordingly, FT3 was inferior to FT4 in the discrimination of hypothyroidism, as FT4 was unaffected by this phenomenon. Effects of age and non-thyroidal illness on serum FT3 concentrations require great care when selecting subjects for a laboratory euthyroid reference range typical of the routine workload. Constraints on the choice of subjects for FT4 reference ranges are less stringent.

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Early change of thyroid hormone concentration after 131I treatment in patients with solitary toxic adenoma

Nuklearmedizin ◽

10.1055/s-0038-1623893 ◽

2002 ◽

Vol 41 (04) ◽

pp. 178-183 ◽

Cited By ~ 1

Author(s):

V. Fidler ◽

K. Zaletel ◽

S. Gaberšček ◽

S. Hojker ◽

E. Pirnat

Keyword(s):

Thyroid Hormone ◽

Antithyroid Drugs ◽

Prospective Clinical Study ◽

Hormone Concentration ◽

Toxic Adenoma ◽

Free Triiodothyronine ◽

Thyroid Cells ◽

131I Treatment ◽

Before And After ◽

Thyroid Hormone Concentration

Summary Aim: In spite of extensive use of 131I for treatment of hyperthyroidism, the results of early outcome are variable. In our prospective clinical study we tested whether 131I induced necrosis causing clinical aggravation of hyperthyroidism and increasing the free thyroid hormone concentration in the serum of patients with solitary toxic adenoma not pretreated with antithyroid drugs. Patients and methods: 30 consecutive patients were treated with 925 MBq 131I. Serum concentration of thyrotropin (TSH), free thyroxine (fT4), free triiodothyronine (fT3), thyroglobulin (Tg), and interleukin-6 (IL-6) were measured before and after application of 131I. Results: After application of 131I no clinical worsening was observed. FT4 and fT3 concentration did not change significantly within the first five days, whereas both of them significantly decreased after 12 days (p <0.0001). Slight and clinically irrelevant increase in the level of the two thyroid hormones was observed in 9 patients. Furthermore, we observed a prolonged increase in Tg concentration and a transient increase in IL-6 concentration. Conclusion: Neither evidence of any clinical aggravation of hyperthyroidism nor any significant increase in thyroid hormone concentration by 131I induced necrosis of thyroid cells was found. Therefore, the application of 131I may be considered as a safe and effective treatment for patients with hyperthyroidism due to toxic adenoma.

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CHROMATOGRAPHIC STUDIES ON 131I-COMPOUNDS IN FAECES AND BILE

Acta Endocrinologica ◽

10.1530/acta.0.0470343 ◽

1964 ◽

Vol 47 (2) ◽

pp. 343-352

Author(s):

B. Blomstedt ◽

H. Y. Neujahr

Keyword(s):

Intravenous Administration ◽

Glucuronic Acid ◽

Free Triiodothyronine ◽

Considerable Part ◽

Human Faeces ◽

Total Excretion

ABSTRACT The occurrence of 131I-compounds in human faeces was studied after intravenous administration of 131I-thyroxine. The excretion of the radioactivity during 12 days ranged from 7.8 to 32.1 per cent of the dose administered with a mean of 16.0 (± 1.76). The radioactivity in the faeces was derived from free 131I-thyroxine. The total amount of faeces did not seem to influence the total excretion of the dose administered. After administration of 131I-triiodothyronine to rats and humans, triiodothyronine occurred in the bile mainly conjugated with glucuronic acid, but a considerable part of the radioactivity was found in diiodotyrosine. The radioacivity of human faeces after the administration of 131I-triiodothyronine was derived from free triiodothyronine. After injection of 131I-diiodotyrosine only labelled iodide was detected in the bile of rats. In the bile of humans most of the radioactivity was derived from iodide, and a small part of it was found in diiodotyrosine.

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Thyroid arterial embolization for the treatment of large multinodular goiter and hyperthyroidism

Endocrine Abstracts ◽

10.1530/endoabs.56.p999 ◽

2018 ◽

Author(s):

Gul Ozen Oz ◽

Soner Cander ◽

Pinar Sisman ◽

Aytul Cosar ◽

Canan Ersoy ◽

...

Keyword(s):

Multinodular Goiter ◽

Arterial Embolization

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Rare association of primary hyperparathyroidism and toxic multinodular goiter

Endocrine Abstracts ◽

10.1530/endoabs.56.p1025 ◽

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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Alteration of Trace Elements in Multinodular Goiter, Thyroid Adenoma, and Thyroid Cancer

Biological Trace Element Research ◽

10.1007/s12011-020-02542-9 ◽

2021 ◽

Author(s):

Aleksandar Stojsavljević ◽

Branislav Rovčanin ◽

Jovana Jagodić ◽

Đurđa Krstić ◽

Ivan Paunović ◽

...

Keyword(s):

Trace Elements ◽

Thyroid Cancer ◽

Multinodular Goiter ◽

Thyroid Adenoma

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Gene expression profile in functioning and non-functioning nodules of autonomous multinodular goiter from an area of iodine deficiency: unexpected common characteristics between the two entities

Journal of Endocrinological Investigation ◽

10.1007/s40618-021-01660-y ◽

2021 ◽

Author(s):

P. Agretti ◽

G. De Marco ◽

E. Ferrarini ◽

C. Di Cosmo ◽

L. Montanelli ◽

...

Keyword(s):

Gene Expression ◽

Gene Expression Profile ◽

Expression Profile ◽

Multinodular Goiter ◽

Kinase Inhibitor ◽

Wnt Signaling Pathway ◽

Iodine Intake ◽

Healthy Tissue ◽

Specific Gene ◽

Complement Components

Abstract Purpose Toxic multinodular goiter is a heterogeneous disease associated with hyperthyroidism frequently detected in areas with deficient iodine intake, and functioning and non-functioning nodules, characterized by increased proliferation but opposite functional activity, may coexist in the same gland. To understand the distinct molecular pathology of each entity present in the same gland, the gene expression profile was evaluated by using the Affymetrix technology. Methods Total RNA was extracted from nodular and healthy tissues of two patients and double-strand cDNA was synthesized. Biotinylated cRNA was obtained and, after chemical fragmentation, was hybridized on U133A and B arrays. Each array was stained and the acquired images were analyzed to obtain the expression levels of the transcripts. Both functioning and non-functioning nodules were compared versus healthy tissue of the corresponding patient. Results About 16% of genes were modulated in functioning nodules, while in non-functioning nodules only 9% of genes were modulated with respect to the healthy tissue. In functioning nodules of both patients and up-regulation of cyclin D1 and cyclin-dependent kinase inhibitor 1 was observed, suggesting the presence of a possible feedback control of proliferation. Complement components C1s, C7 and C3 were down-regulated in both types of nodules, suggesting a silencing of the innate immune response. Cellular fibronectin precursor was up-regulated in both functioning nodules suggesting a possible increase of endothelial cells. Finally, Frizzled-1 was down-regulated only in functioning nodules, suggesting a role of Wnt signaling pathway in the proliferation and differentiation of these tumors. None of the thyroid-specific gene was deregulated in microarray analysis. Conclusion In conclusion, the main finding from our data is a similar modulation for both kinds of nodules in genes possibly implicated in thyroid growth.

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