scholarly journals Amyloid Accumulation in the Toxic Nodule of the Thyroid Gland in a Patient with End Stage Renal Failure

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Umut Mousa ◽  
Sema Aktas ◽  
Halit Uner
Keyword(s):  
Thyroid Gland ◽  
Thyroid Tissue ◽  
Nodular Goiter ◽  
The Body ◽  
Medullary Thyroid ◽  
End Stage Renal Failure ◽  
Toxic Nodular Goiter ◽  
Amyloid Accumulation ◽  
End Stage ◽  
Thyroid Parenchyma

Amyloidosis is characterized by accumulation of amorphous, proteinaceous material in various organs and tissues of the body. Amyloid may accumulate in the thyroid gland in cases of medullary thyroid carcinoma and systemic amyloidosis. Amyloid accumulates extracellularly in the thyroid parenchyma and disrupts the normal follicular patterns. Most of the cases reported up to now were clinically euthyroid, but many presentation forms and overlaps have been reported. Herein we present a patient with toxic nodular goiter with amyloid deposition in the toxic nodule as well as the remaining thyroid tissue.

scholarly journals The results of ultrasound examination of the thyroid gland in children with hypothyroidism

2021 ◽  
Vol 11 (9) ◽  
pp. 852-861
Author(s):  
Snizhana Sokolnyk ◽  
Iryna Sokolnyk ◽  
Dmytro Nechytaylo ◽  
Dmytro Kolesnik ◽  
Mykola Hinhuliak ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Ultrasound Examination ◽  
Pathological Condition ◽  
Thyroid Tissue ◽  
Thyroid Stimulating Hormone ◽  
The Body ◽  
Sonographic Examination ◽  
High Level ◽  
Thyroid Parenchyma ◽  
Stimulating Hormone

Diseases of thyroid gland (TG) rank first among all endocrine pathologies and remain one of the most difficult problems. According to the statistics of Ministry of Health of Ukraine, the prevalence of hypothyroidism in children does not exceed 0.035%. However, the relatively low rate can be explained by the low level of detection and diagnosis of this pathological condition due to the variability and low specificity of its symptoms. More acceptable for practice are methods of ultrasound diagnosis of the thyroid gland and laboratory examination of the content of thyroid-stimulating hormone in the serum. Aim. To evaluate the results of ultrasound examination of the thyroid gland in children with hypothyroidism. Methods. The results are based on a survey of 94 children with hypothyroidism living in the Chernivtsi region aged 2 to 10 years. An ultrasound examination of the thyroid gland, determination of the level of thyroid hormones (thyroid stimulating hormone (TSH), free thyroxine (fT4) was performed. Statistical analysis was performed using standard methods using the StatSoft software package © Statistica® 6.0 for Microsoft® Windows XP. Results. Analysis of the results of the study showed that in 59.6% of cases (56 out of 94) the diagnosis was made by screening for congenital hypothyroidism, and in 40.4% of cases (38 out of 94) the disease was diagnosed outside the screening. According to the results of our ultrasound, it was found that in 29 patients the thyroid tissue was not visualized in a typical place or its total volume was much less than normal. Of these, in 12 individuals, thyroid tissue was not reliably visualized at the site of TG projection, and in 17 cases was hypoplasia. In 65 patients, the TG was in a typical place, and its volume corresponded to the norm on the surface area of the body. In 85 people, regardless of the state of functional activity of the TG had a heterogeneous echostructure of the thyroid parenchyma), in 9 people the echostructure of the thyroid parenchyma was homogeneous. In thyroid hypoplasia, the level of TSH was at lower values (p <0.05) compared with thyroid dystopia. Conclusion. Sonographic examination of the thyroid gland has a high level of information. In cases of malformations of the thyroid gland there is a more pronounced degree of thyroid insufficiency.

scholarly journals Certain peculiarities of parenchymal-stromal correlations in the thyroid gland with nodular forms of goiter with its rucurrent and non-recurrent course

2020 ◽  
Vol 19 (1) ◽  
pp. 53-60
Author(s):  
N. P. Tkachuk ◽  
I. S. Davydenko
Keyword(s):  
Thyroid Gland ◽  
Slow Growth ◽  
Thyroid Tissue ◽  
Nodular Goiter ◽  
Specific Weight ◽  
Pathological Changes ◽  
Normal Thyroid Tissue ◽  
Normal Thyroid ◽  
Stromal Component ◽  
Correlation Parameters

In spite of a considerable efficacy of conservative treatment of goiter, surgery remains the main method of treatment of such patients. Though, on the one hand, total thyroidectomy inevitably results in the development of postsurgical hypothyroidism, on the other hand – in case organ-saving surgery is performed the risk of postsurgical relapse arises. Modern morphological methods are directed to detection of oncological risk of nodular formations, and recommendations concerning an adequate volume of surgery taking into account probability of relapse are practically lacking. Therefore, the objective of the study was finding criteria of a relapsing risk by means of investigation of morphological peculiarities of the parenchymal-stromal correlations in the thyroid gland with recurrent nodular and primary nodular (multinodular) goiter without signs of functional disorders. In the course of the research according to the examined correlation parameters of the parenchyma and stroma various forms of nodular goiter were found to differ from the thyroid tissue without pathological changes by a number of parameters. In particular, specific weight of the parenchyma on an average increases reliably in the tissue of nodular goiter with its various variants in comparison with the thyroid gland without pathological changes. Together with the increase of the parenchymal specific weight in nodular goiter the amount of colloid on an average decreases, and a specific dependence on the kind of goiter is observed – colloid volume decreases from goiter with slow growth to goiter with quick growth, and it is the smallest with goiter relapse. Quantitative analysis of the goiter tissue stromal component demonstrates a considerable increase of its specific volume in comparison with normal thyroid tissue. Evaluation of changes of the morphometric parameters in the thyroid follicles found that in case of nodular goiter with slow growth the percentage of follicles with colloid is close to 100%. On an average it does not differ from that of the normal thyroid tissue. At the same time, in case of nodular goiter with quick growth the percentage of follicles with colloid decreases sharply, and in case of relapse it appears to be still less than that in nodular goiter with quick growth. Besides, with nodular goiter the diameter of follicles on an average increases in comparison with the normal thyroid tissue. In a number of cases it can be estimated as macrofollicular goiter. At the same time, the diameter of follicles is smaller in nodular goiter with quick growth. It is still less in case of goiter relapse. The size of follicles becomes sharply diverse in case of nodular goiter with slow growth, but it decreases in case of nodular goiter with quick growth and relapse. Consequently, recurrent nodular goiter is mostly similar to that of primary nodular goiter with a quick growth, though certain differences between them exist. The peculiarities found enable to suggest that nodular goiter with a quick growth possesses more chances for relapse.

scholarly journals Ectopic thyroid tissue presenting as an external auditory canal mass

2019 ◽  
Vol 5 (2) ◽  
pp. 476
Author(s):  
Nishikanta Verma ◽  
Samuel Devanesan Abishegam ◽  
Abdul Razak Bin Haji Ahmad
Keyword(s):  
Thyroid Gland ◽  
Thyroid Tissue ◽  
The Body ◽  
Ectopic Thyroid ◽  
Thyroid Function Tests ◽  
External Ear ◽  
Ear Canal ◽  
Developmental Defects ◽  
External Ear Canal ◽  
Ectopic Thyroid Tissue

<p class="abstract">An ectopic thyroid is a rare occurrence with a majority of ectopic thyroid tissue located in the lingual region or in the midline. The abnormal sites represent developmental defects in migration from the floor of the primitive foregut at the foramen caecum of the tongue to the final pre-tracheal position of the gland. A few cases of ectopic thyroid tissue have also been reported from sites seemingly unrelated to the normal development of the thyroid gland.  We report a case of ectopic thyroid in the external ear canal, which presented as a small reddish mass in the external ear canal. To the best of our knowledge, this is the first such reported case in literature and adds to the body of knowledge in such cases. Although such a finding is exceedingly rare, the authors recommend routine histopathology in all cases of polyps in the external canal and standard investigation for the status of the residual thyroid gland via isotope scans, ultrasonography or thyroid function tests.</p>

scholarly journals Adenomatous hyperplastic intratracheal ectopic thyroid tissue: a case report

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052097143
Author(s):  
Shiyang Liu ◽  
Wanju Wang ◽  
Lu Zhao ◽  
Kun Wang ◽  
Jing Xu ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Tissue ◽  
Nodular Goiter ◽  
Respiratory Illness ◽  
Ectopic Thyroid ◽  
Imaging Features ◽  
Tracheal Tumor ◽  
Bronchoscopic Biopsy ◽  
History Of ◽  
Resection And Anastomosis

Intratracheal ectopic thyroid (ITET) is a rare disease, with limited cases reported in the literature. ITET is an unusual congenital abnormality and can be easily mistaken for a respiratory illness. We present a case of a 61-year-old man with a history of slight discontinuous hemoptysis for 2 years. A tracheal mass, which appeared to be connected to the left thyroid gland, was found by chest computed tomography scan. Ultrasound revealed one suspiciously malignant, solid and hypoechoic nodule in the left thyroid gland. After the thyroid origin of the mass was confirmed by bronchoscopic biopsy, the patient underwent segmental resection and anastomosis of the trachea, together with left thyroidectomy. Histopathology of the tracheal tumor showed adenomatous hyperplastic ITET, and the orthotopic left thyroid gland showed nodular goiter with atypical adenomatous hyperplasia. Clinical suspicion is warranted in patients presenting with a tracheal tumor seemingly connected to the thyroid gland, particularly in patients who have imaging features suggestive of a malignant tumor in the orthotopic thyroid but without confirmative histopathology of malignancy before surgery.

scholarly journals INFLUENCE OF ALIMENTARY DEPRIVATION ON MORPHOLOGICAL CHANGES OF RAT'S THYROID GLAND

2021 ◽  
Vol 26 (2(49)) ◽  
pp. 89-97
Author(s):  
R. V. Yanko
Keyword(s):  
Thyroid Gland ◽  
Functional Activity ◽  
Morphological Changes ◽  
Thyroid Tissue ◽  
Digital Camera ◽  
The Body ◽  
Standard Diet ◽  
Thyroid Cells ◽  
Experimental Animals ◽  
The Impact

Introduction: Despite the well-studied effect of alimentary deprivation on the body, the literature data on its effect on functional activity and, in particular, on morphological changes in the thyroid gland are single and often contradictory, which does not allow unambiguous conclusions. All this requires a more detailed study of the role and mechanisms of the impact of restricted nutrition on the thyroid gland. Aim: To investigate the effect of alimentary deprivation on morphological changes in the thyroid gland of young rats. Methods: The study was conducted on 24 male Wistar rats aged 3 months. Rats of all groups were in uniform conditions, on a standard diet. Animals of the experimental group, for 28 days, received a diet reduced by 30 %. Work with rats was carried out in accordance with the principles of the Declaration of Helsinki. Histological preparations were made from the central areas of the thyroid tissue according to the standard method. Using a digital camera, the micropreparations were photographed under a Nikon Eclipse E 100 microscope (Japan). Morphometry was performed using a computer program "Image J". Results: Histological analysis of the rat's thyroid gland affected by alimentary deprivation revealed that it had an unchanged physiological structure. The follicles were mostly of oval shape and of various sizes. Colloid in the follicles of experimental animals is of moderate density and contains numerous resorption vacuoles. Thyroid cells are of prismatic and cubic shape. It was found that in the thyroid gland of experimental rats the area of ​​follicles, colloid, their inner diameter decreases, the height of thyrocytes increases, the stereological resorption index increases and the colloid accumulation index decreases, the number of interfollicular islands increases. Also in experimental animals there was a decrease in the width of the interlobar and interfollicular connective tissue. Conclusion: In rats fed on a reduced diet, morphological signs of increased functional activity of the thyroid gland were found.

scholarly journals Peculiarities of the clinical course of hypothyroidism during pregnancy

2021 ◽  
Keyword(s):  
Thyroid Gland ◽  
Pregnant Women ◽  
Hormone Replacement ◽  
Thyroid Tissue ◽  
The Body ◽  
Overt Hypothyroidism ◽  
Lactation Period ◽  
Planning Stage ◽  
Thyroid Pathology ◽  
First Case

The article presents an analysis of resources about the course of thyroid pathology, specifically hypothyroidism, during pregnancy. This problem is of current interest, because hypothyroidism can cause infertility or miscarriage. This applies not only to overt but also to the subclinical one. The physiological changes that occur in the thyroid gland during pregnancy are described. Attention is drawn to the signs that can be mistaken for pathological. In addition, the reference values of hormonal thyroid parameters during pregnancy differ significantly from those in non-pregnant women. This should also be taken into account in the diagnosis of appropriate disorders. The presented resources data are illustrated by two clinical cases. The first case history demonstrates the deterioration of the autoimmune process on the background of the pregnancy. Interesting is the fact that this effect was delayed, ie during pregnancy, compensatory mechanisms created a proper supply of the body of a woman and two fetuses with thyroid hormones. At the same time, during lactation period there was a pronounced decompensation of the patient's condition, which was manifested by activation of autoimmune aggression against thyroid tissue with increasing titer of antithyroid antibodies, the development of overt hypothyroidism and deepening structural changes in the thyroid gland. The need for further follow-up of postpartum women with autoimmune thyroiditis is emphasized, even if no thyroid dysfunction has been reported throughout pregnancy. The second clinical case illustrates the importance of following the recommendations of the European and American thyroid associations regarding the level of thyroid-stimulating hormone (TSH) during pregnancy. When planning the first pregnancy of this patient, the doctor did not pay attention to the fact that TSH level, being within normal values for non-pregnant women, did not meet international guidelines for planning a pregnancy and its first trimester. This had extremely adverse consequences in the form of two miscarriages. The prescription of an appropriate hormone replacement therapy and careful monitoring of the patient both at the planning stage and throughout the pregnancy, led to the birth of a healthy baby. Thus, compliance with the principles of management and use of the proposed treatment regimens for pregnant women with thyroid pathology will ensure the normal course of pregnancy and the birth of a healthy child.

scholarly journals Graves’ Disease

2021 ◽  
Author(s):  
Paula Aragão Prazeres de Oliveira ◽  
Beatriz Nayara Muniz de Oliveira ◽  
Eduarda da Silva Souza Paulino ◽  
Fernanda Carolinne Marinho de Araujo ◽  
Paula Gabriele Tabosa Lyra
Keyword(s):  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Radioactive Iodine ◽  
Clinical Manifestations ◽  
Nodular Goiter ◽  
Graves Disease ◽  
Decompression Surgery ◽  
Excessive Sweating ◽  
Toxic Nodular Goiter ◽  
Diffuse Goiter

DG presents with three main presentations: hyperthyroidism with diffuse goiter, infiltrative ophthalmopathy and pre-tibial myxedema. Patients with Graves’ disease can rarely develop severe hyperthyroidism. The hyperthyroidism of Graves’ disease is characterized immunologically by the lymphocytic infiltration of the thyroid gland and by the activation of the immune system with elevation of the circulating T lymphocytes. In GD, goiter is characteristically diffuse. May have asymmetric or lobular character, with variable volume. The clinical manifestations of hyperthyroidism are due to the stimulatory effect of thyroid hormones on metabolism and tissues. Nervousness, eye complaints, insomnia, weight loss, tachycardia, palpitations, heat intolerance, damp and hot skin with excessive sweating, tremors, hyperdefecation and muscle weakness are the main characteristics. In the laboratory diagnosis, biochemical and hormonal exams will be done to assess thyroid hormones and the antithyroid antibodies. Additionally, imaging tests may be performed, such as radioactive iodine capture in 24 hours, ultrasonography, thyroid scintigraphy and fine needle aspiration. It is necessary to make the differential diagnosis of Graves’ disease for thyrotoxicosis, subacute lymphocytic thyroiditis and toxic nodular goiter. The treatment of DG aims to stop the production of thyroid hormones and inhibit the effect of thyroid hormones on the body. Hyperthyroidism caused by DG can be treated in the following ways: it may be the use of synthetic antithyroid medicines, thionamides, MMI being a long-term medicine, it allows a single daily dose, and adherence to treatment occurs, a disadvantage is that it cannot be used in pregnant women; beta-blockers, preferably used in the initial phase of DG with thionamides; radioactive iodine therapy (RAI), being the best cost–benefit and preventing DG recurrence; finally the total thyroidectomy, causing the withdrawal of the thyroid gland. Therefore, it should be discussed with the patient what is the best treatment for your case, with a view to the post and against each approach. If the patient develops Graves ophthalmopathy, in lighter cases the artificial tears should be used, and in more severe cases can be used as treatment, corticosteroids, orbital decompression surgery, prisms and orbital radiotherapy. In addition, the patient should keep their body healthy, doing exercise and healthy eating, following the guidance of their doctor.

Hypothyroidism and Thyrotoxicosis

2019 ◽  
Author(s):  
Paul W. Ladenson
Keyword(s):  
Thyroid Tissue ◽  
Elevated Serum ◽  
Nodular Goiter ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Toxic Nodular Goiter ◽  
Total Thyroxine ◽  
Characteristic Features ◽  
Toxic Goiter

Thyroid disorders are the most common endocrine conditions encountered in clinical practice and can range from clinically obvious to clinically silent. This review provides the definition and epidemiology of the conditions of hypothyroidism and hyperthyroidism. Hypothyroidism can be congenital or acquired, and its pathogenesis, diagnosis, and management are presented. The three most common disorders of thyrotoxicosis (diffuse toxic goiter [Graves disease], toxic nodular goiter, and iatrogenic thyrotoxicosis in thyroid hormone–treated patients are addressed, as well as the many diseases in each of these categories. This review also discusses thyroiditis, goiter, thyroid nodules, and thyroid cancer. Tables list the causes of elevated serum thyroid-stimulating hormone (TSH) levels, the etiologic classification of thyrotoxicosis, characteristic features of thyroiditis, and causes of elevated serum total thyroxine levels. Figures show the prevalence of abnormalities in thyroid function tests in different populations, certain forms of hyperthyroidism that result from pathophysiologic activation of the TSH receptor, and inflammation of thyroid tissue in acute thyroiditis.   This review contains 3 figures, 12 tables, and 61 references. Key Words: Hypothyroidism, Thyrotoxicosis, Thyrotropin, celiac disease, vitiligo, pernicious anemia, Sjögren syndrome, Graves disease, Munchausen syndrome

DOMINAN FACTORS RELATED TO QUALITY OF LIFE OF PATIENTS WITH END STAGE RENAL FAILURE UNDERGOING HEMODIALYSIS AT TABANAN GENERAL HOSPITAL

2018 ◽  
Vol 2 (2) ◽  
pp. 195
Author(s):  
Anselmus Aristo Parut ◽  
I Gusti Ayu Puja Astuti Dewi
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
General Hospital ◽  
Hemodialysis Patients ◽  
The Body ◽  
Dominant Factor ◽  
Life Questionnaire ◽  
End Stage Renal Failure ◽  
End Stage

Background : Renal failure is a clinical condition which irreversible reduction in renal function and need hemodialysis as replacement for kidney function. Hemodialysis is a dialysis that perform outsite the body. Indonesian Association Of Nephrology (Pernerfi) stated that new hemodialysis and active hemodialysis patients in Indonesia since 2007-2018 increased, 14.644 new hemodialysis patients and 7.276 active hemodialysis patients.Method : This is a descriptive analysis study with cross-sectional design and multiple logistic regression to identify dominant factor related to quality of life hemodialysis patients. Location of this research was Tabanan General Hospital. The sampling technique was nonprability sampling with total population were 166 patients. Data collected using insomnia questionnaire, family support questionnaire, quality if life questionnaire and complication observation form. Result : The result showed that, higher OR found in intra hemodialysis variabel (OR:180,917), which mean that intra hemodialysis complication is a dominan factor related to quality of life hemodialysis patients. Patients who had complication were more likely to have low quality of life. Further study are needed to identify factors related to intra hemodialysis complications.  Keywords : Dominan factors, intra hemodialysis complications, quality if life, end stage renal failure, hemodialysis.  

Pharmacokinetics of Recombinant Hirudin in Hemodialyzed End-stage Renal Failure Patients

1997 ◽  
Vol 77 (04) ◽  
pp. 650-655 ◽  
Author(s):  
R Vanholder ◽  
A Camez ◽  
N Veys ◽  
A Van Loo ◽  
A M Dhondt ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Residual Renal Function ◽  
Hemodialysis Patients ◽  
The Body ◽  
Pharmacokinetic Data ◽  
High Flux ◽  
Recombinant Hirudin ◽  
End Stage Renal Failure ◽  
End Stage

SummaryRecently, hirudin was used for the first time as an anticoagulant during hemodialysis in men. Pharmacokinetic data of this compound in end-stage renal failure are however not available. In this study, the pharmacokinetics of recombinant hirudin (HBW 023) was evaluated in hemodialysis-treated end-stage renal failure patients. HBW 023 was administered as a bolus at the start of a single dialysis (0.02 to 0.08 mg/kg) in 20 patients, and plasma hirudin levels were followed during this and the 5 following dialyses, without additional hirudin administration. The initial dialysis (HDj) was performed with a low flux polysulfone dialyzer; the following dialyses (up to HD6) with a high flux polysulfone dialyzer and regular heparin. Hirudin levels averaged 504.0 ± 214.0 and 527.7 ± 217.1 ng/ml in the middle and at the end of HDj, and then gradually decreased to 15.2 ± 15.2 ng/ml at the end of HD6. Pharmacokinetic data were compared to those obtained in healthy controls (n = 5), receiving the same dose, and reaching the same peak hirudin level. Hirudin half-life was >30 times longer in hemodialysis patients (51.8 ± 15.6 vs. 1.7 ± 1.5 h, p <0.001), whereas area under the curve was >60 times higher (34,669 ± 14,898 vs. 545 ± 205 ng/ml X h, p <0.001). Distribution volume was lower in hemodialysis patients (11.0 ± 3.1 vs. 14.1 ± 2.0 1, p <0.05). Hirudin disappearance rate was the same during high flux polysulfone dialysis as during interdialytic periods. Hirudin removal was markedly higher in those patients still maintaining some residual renal function and parameters of hirudin removal were significantly correlated to residual creatinine clearance. It is concluded that hirudin removal from the body is markedly depressed in hemodialyzed end-stage renal failure patients and that even minor residual renal function may increase this removal rate.

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