Five-Year Prospective Evaluation of Thyroid Function Test Evolution in Children with Hashimoto's Thyroiditis Presenting with Either Euthyroidism or Subclinical Hypothyroidism

Introduction. Different types of thyroiditis may share some parallel clinical and biochemical features. Timely intervention can significantly reduce morbidity and mortality. Aim. Aim of this study is to find the frequency of various thyroiditis, study the cytomorphological features and correlate with clinical findings including radiological findings, thyroid function test, and anti-thyroid peroxidase antibodies (Anti-TPO antibodies). Materials and Methods. The study included consecutive 110 cases of thyroiditis. Detailed cytomorphological features were studied and correlated with ultrasonography findings, thyroid function test, anti-thyroid peroxidase antibodies (anti-TPO) and histopathological features where thyroidectomy specimens were received for histopathological examination. Results. The majority were Hashimoto’s thyroiditis (n=100) and females (n=103). Other forms of thyroiditis were Hashimoto’s thyroiditis with colloid goiter (n=5), De Quervain’s thyroiditis (n=3), and one case each of postpartum thyroiditis and Hashimoto’s thyroiditis with associated malignancy. The majority of patients were in the age group of 21–40 (n=70) and the majority (n=73) had diffuse enlargement of thyroid. The majority of patients were hypothyroid (n=52). The serum anti-TPO antibodies were elevated in 47 patients out of 71 patients. In the 48 patients who underwent ultrasonography, 38 were diagnosed as having thyroiditis. The most consistent cytomorphological features seen in fine-needle aspiration smears of Hashimoto’s thyroiditis were increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. Conclusion. The diagnostic cytological features in Hashimoto’s thyroiditis are increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. FNAC remains the “Gold Standard” for diagnosing Hashimoto’s thyroiditis. Clinical history, thyroid function, and biochemical parameters are the key for diagnosis of other forms of thyroiditis.

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A prospective study for the assessment of thyroid function by pre and post supervised exercise protocol in newly diagnosed patients of subclinical hypothyroidism

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20190451 ◽

2019 ◽

Vol 6 (2) ◽

pp. 253

Author(s):

Dharmendra Jhavar ◽

Naresh K. Patel ◽

V. P. Pandey

Keyword(s):

Physical Exercise ◽

Thyroid Function ◽

Subclinical Hypothyroidism ◽

Thyroid Function Test ◽

Exercise Group ◽

P Value ◽

Newly Diagnosed ◽

Function Test ◽

Thyroid Profile ◽

Regular Physical Exercise

Background: The presence of raised serum TSH with serum free T4 and T3 within the reference range falls in subclinical hypothyroidism. It is a well-known fact that exercise affects the activity of thyroid glands and the production of their hormones. Author studied the effect of regular exercise in patients of newly diagnosed subclinical hypothyroidism. Pre and post-exercise thyroid function tests were evaluated to decide about the necessity to start thyroid replacement therapy or to adopt wait and watch policy.Methods: Study enrolled 100 newly diagnosed subclinical hypothyroidism patients attending this tertiary care hospital and randomised them in two groups, one group was subjected to regular physical exercise of 45-60 minutes daily along with supervised treadmill exercise stage 0 for 45-60 minutes once weekly followed by re-evaluation of thyroid function test after 30 days and second group was re-evaluated for thyroid function test without exercise after 30 days.Results: Thyroid profile parameters were compared and analysed by paired ‘t’ test, statistically significant increase in serum T3 (p value <0.05) and serum T4 (p value <0.05), along with significant reduction in TSH level (p value <0.05) were found in exercise group, while in non-exercise group changes in thyroid profile parameters were statistically not significant. There was significant reduction in mean weight in exercise group (p value <0.05), while in non-exercise group changes in weight were not significant.Conclusions: Present study concluded that regular physical exercise can improve thyroid function in patients of newly diagnosed subclinical hypothyroidism and convert them to euthyroid state.

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Effect of small doses of iodine on thyroid function in patients with Hashimoto's thyroiditis residing in an area of mild iodine deficiency

Acta Endocrinologica ◽

10.1530/eje.0.1390023 ◽

1998 ◽

pp. 23-28 ◽

Cited By ~ 31

Author(s):

W Reinhardt ◽

M Luster ◽

KH Rudorff ◽

C Heckmann ◽

S Petrasch ◽

...

Keyword(s):

Thyroid Hormone ◽

Thyroid Function ◽

Iodine Deficiency ◽

Subclinical Hypothyroidism ◽

Hashimoto’S Thyroiditis ◽

Thyroid Volume ◽

Treated Group ◽

Hashimoto's Thyroiditis ◽

Control Group ◽

Small Doses

OBJECTIVE: Several studies have suggested that iodine may influence thyroid hormone status, and perhaps antibody production, in patients with autoimmune thyroid disease. To date, studies have been carried out using large amounts of iodine. Therefore, we evaluated the effect of small doses of iodine on thyroid function and thyroid antibody levels in euthyroid patients with Hashimoto's thyroiditis who were living in an area of mild dietary iodine deficiency. METHODS: Forty patients who tested positive for anti-thyroid (TPO) antibodies or with a moderate to severe hypoechogenic pattern on ultrasound received 250 microg potassium iodide daily for 4 months (range 2-13 months). An additional 43 patients positive for TPO antibodies or with hypoechogenicity on ultrasound served as a control group. All patients were TBII negative. RESULTS: Seven patients in the iodine-treated group developed subclinical hypothyroidism and one patient became hypothyroid. Three of the seven who were subclinically hypothyroid became euthyroid again when iodine treatment was stopped. One patient developed hyperthyroidism with a concomitant increase in TBII titre to 17 U/l, but after iodine withdrawal this patient became euthyroid again. Only one patient in the control group developed subclinical hypothyroidism during the same time period. All nine patients who developed thyroid dysfunction had reduced echogenicity on ultrasound. Four of the eight patients who developed subclinical hypothyroidism had TSH concentrations greater than 3 mU/l. In 32 patients in the iodine-treated group and 42 in the control group, no significant changes in thyroid function, antibody titres or thyroid volume were observed. CONCLUSIONS: Small amounts of supplementary iodine (250 microg) cause slight but significant changes in thyroid hormone function in predisposed individuals.

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Clinical Characteristics and Follow-Up of 19 Children With Hashimoto’s Thyroiditis Aged Below 3 Years: A Single-Center Retrospective Analysis

Frontiers in Endocrinology ◽

10.3389/fendo.2021.737527 ◽

2021 ◽

Vol 12 ◽

Author(s):

Shi Tang ◽

Min Yang ◽

Dan Zhang ◽

Ya-jie Tong ◽

Ying Xin

Keyword(s):

Early Diagnosis ◽

Developmental Delay ◽

Thyroid Function ◽

Subclinical Hypothyroidism ◽

Hashimoto’S Thyroiditis ◽

Clinical Characteristics ◽

Diagnosis And Treatment ◽

Hashimoto's Thyroiditis ◽

Global Developmental Delay

AimTo analyze the clinical characteristics of Hashimoto’s thyroiditis (HT) in children below 3 years of age in order to improve the understanding of the disease, avoid misdiagnosis, and achieve early diagnosis and treatment.MethodsThe study retrospectively analyzed the clinical data of 19 patients diagnosed with HT in the first three years of life.ResultsThe patients (12 female, 7 male) had an average age of 26.1 ± 8.2 months (range 10–36 months). At presentation, one patient had euthyroidism, ten had hypothyroidism, seven had subclinical hypothyroidism, and one had hyperthyroidism. The most common reasons for doctor’s visits were thyroid enlargement (21.1%), global developmental delay (21.1%), and routine thyroid function tests in patients with type 1 diabetes (26.3%). Sixteen patients provided follow-up data, and the mean follow-up time was 23.31 ± 16.44 months (range 1–48 months). In the hypothyroidism group, one patient stopped levothyroxine (LT4) treatment after 2 months; the remaining patients had been treated with LT4 since their diagnosis. In the subclinical hypothyroidism group, one patient whose thyroid function returned to normal after 1 month of being diagnosed was not treated. The remaining patients received LT4 treatment at their diagnosis or during follow-up. The patient with hyperthyroidism was treated with methimazole after diagnosis, but treatment was discontinued 11 months later and LT4 was initiated 26 months after diagnosis. One in four patients with global developmental delay approached normal mental development after LT4 treatment. Four in six patients with short stature achieved height catch-up.ConclusionAt their initial HT diagnosis, most of the children showed hypothyroidism or subclinical hypothyroidism. Children with global developmental delay require continual screening, even if the thyroid function is normal after birth, to determine whether they have HT-induced hypothyroidism. Thyroxine replacement could partially relieve the clinical manifestations of hypothyroidism and early diagnosis and treatment are essential for improving patient prognosis.

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Status of Thyroid Disorder among the Thyroid Function Test Samples Received in a Laboratory among Postmenopausal Women: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6191 ◽

2021 ◽

Vol 59 (234) ◽

Author(s):

Manoranjan Shrestha ◽

Reshmi Shrestha

Keyword(s):

Postmenopausal Women ◽

Thyroid Function ◽

Subclinical Hypothyroidism ◽

Thyroid Dysfunction ◽

Thyroid Function Test ◽

Cross Sectional Study ◽

Reference Laboratory ◽

Sectional Study ◽

Cross Sectional ◽

Function Test

Introduction: Thyroid dysfunction prevalence is high in females worldwide which increases with age. Postmenopausal and elderly women are particularly at risk of developing comorbidities and mortality related to thyroid dysfunction. We aimed to study the prevalence of thyroid dysfunction in postmenopausal women in the National Reference Laboratory of Nepal. Methods: A descriptive cross-sectional study was conducted in National Reference Laboratory from January 2019 to June 2019 including postmenopausal females, ≥49 years. The database of thyroid function test result was used for statistical analysis and proportion of thyroid dysfunction was calculated. The data was collected after approval from the institutional review committee. Statistical Package for Social Sciences version 21 was used to study descriptive data. Results: Out of a total of 160 postmenopausal females with thyroid function tests, 71 (44.4%) had thyroid dysfunction. Subclinical hypothyroidism was the frequently occurring thyroid dysfunction 51 (32%) followed by subclinical hyperthyroidism 13 (8%), hypothyroidism 3 (2%) and hyperthyroidism 3 (2%). In our study population, thyroid dysfunction peaked at 49 to 58 years of age interval 53 (33.1%) and subclinical hypothyroidism was the most frequent form 38 (23.7%). Conclusions: Subclinical hypothyroidism was the common thyroid dysfunction in postmenopausal age which peaked at 49 to 58 years of age group. Early postmenopausal females are predisposed to increased risk of comorbidities (cardiovascular disease, osteoporosis with high fracture, depression) which could be exacerbated with thyroid dysfunction; therefore awareness of thyroid dysfunction prevalence and thyroid screening for early management seems appropriate in Nepalese postmenopausal women.

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Thyroid Function Test (TSH, T3, T4) and Associated Factors in Early Gestation Among Pregnant Women Attending ANC Clinic in Nekemte Referral Hospital Western Oromia, Ethiopia.

10.21203/rs.3.rs-103720/v1 ◽

2020 ◽

Author(s):

Regea Dabsu Hirpa ◽

Worku Dechassa Heyi ◽

Elias Merdassa Roro

Keyword(s):

Drinking Water ◽

Pregnant Women ◽

Thyroid Function ◽

Subclinical Hypothyroidism ◽

Associated Factors ◽

Health Workers ◽

Thyroid Function Test ◽

Referral Hospital ◽

Early Gestation ◽

Function Test

Abstract Introduction: Thyroid function testing in pregnancy is an area of concern for pregnant women, doctors and laboratories. Some women are known to have thyroid disease before pregnancy and require monitoring to ensure no harm comes to them or their baby. Thyroid disorders can have adverse reproductive and pregnancy implications. Thus, the aim of this study was to assess blood level of thyroid function test during early gestation and assess associated factors among pregnant women attending antenatal care clinic in Nekemte Referral Hospital.Methods: Facility-based Cross-sectional study design was deployed to collect information from 300 Pregnant women (<20 gestation weeks) attending antenatal clinic from March to May, 2017. Interviewer-administered structured questionnaire was used to obtain information and blood samples were collected from pregnant women for estimation of thyroid function test after getting written consent. Data was entered to Epi info version 3.5.3, cleaned and analyzed using SPSS version 24 and Multivariable analysis were used to examine the association between dependent and independent variables. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. Significance was declared at P-value 0.05.Result: A total of 300 pregnant women were interviewed and blood sample collected from them for thyroid function test with a response rate of 90.1%. Among the study subjects 14(4.7%) have Subclinical Hypothyroidism (SCH). Husband occupation, presence of Radio in the household, presence of television in their house and treating drinking water at household level were among factors associated with development of Hypothyroidism.Conclusion and Recommendation: In this study, Subclinical Hypothyroidism (SCH) among pregnant women in early gestation is significant 14(4.7%) above the expected 2.5% of American thyroid association cut point. Husband occupation, Presence of media for information and treatment of drinking water were the associated factors. So, health workers should always update pregnant women on importance of consuming proper utilization of iodized salt. Health workers shall also teach pregnant women on personal and environmental hygiene.

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A Nearly Missed Hashimoto’s Thyroiditis: A Case of Refractory Anaemia

Journal of Clinical and Health Sciences ◽

10.24191/jchs.v5i1.9823 ◽

2020 ◽

Vol 5 (1) ◽

pp. 75

Author(s):

Sharifah Azimah Wan Ali ◽

Mohamed Syarif Mohamed Yassin ◽

Suraya Abdul Razak

Keyword(s):

Hashimoto’S Thyroiditis ◽

Primary Care Clinic ◽

Thyroid Function Test ◽

The Elderly ◽

Hashimoto's Thyroiditis ◽

Test Results ◽

Care Clinic ◽

Function Test ◽

Symptomatic Anaemia

This is a case of a 68-year-old man who was diagnosed late with Hashimoto’s thyroiditis following a few admissions for symptomatic anaemia. Although hypothyroidism is common among the elderly, the classic symptoms are less likely to be evident and anaemia can be the first sign of hypothyroidism. This patient had multiple comorbidities including ischaemic heart disease, diabetes and chronic kidney disease which might have contributed to the delay in finding the underlying cause of his anaemia. He initially presented with symptomatic anaemia and received blood transfusions and iron supplementation. On subsequent follow up, his anaemia failed to improve. He was then referred to our primary care clinic. Hashimoto’s thyroiditis was diagnosed based on his clinical features, thyroid function test results and antithyroid peroxidase level. This case highlights the importance of determining the cause of anaemia as his haemoglobin level improved significantly after thyroxine was commenced. It also serves as a reminder that hypothyroidism should be considered in patients with anaemia, especially in those with uncertain aetiology.

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