Hearing Impairment and Audiological Alterations in Euthyroid Hashimoto’s Thyroiditis

ORL ◽  
2021 ◽  
pp. 1-9
Author(s):  
Ömercan Topaloğlu ◽  
Bayram Şahin
Keyword(s):  
Hearing Impairment ◽  
Hashimoto’S Thyroiditis ◽  
Hearing Threshold ◽  
Otoacoustic Emission ◽  
Hashimoto's Thyroiditis ◽  
Close Monitoring ◽  
Acoustic Reflex ◽  
Antigliadin Antibodies ◽  
The Right ◽  
Air Conduction

<b><i>Introduction:</i></b> Hearing loss may be associated with autoimmune diseases, but it was less studied in Hashimoto’s thyroiditis (HT). We aimed to evaluate hearing impairment and audiological alterations in adults with euthyroid HT. <b><i>Methods:</i></b> Adult patients with euthyroid HT (normal thyroid functions, positive antithyroid peroxidase (anti-TPO)/anti-thyroglobulin, and sonographic findings) were compared with controls. We excluded pregnant or older patients (&#x3e;40 years), those with a history of otological/audiological disease or surgery, otitis media, acoustic trauma, chronic illnesses, use of alcohol, cigarette, medications, rheumatoid factor, antinuclear, antimitochondrial, antiparietal, antineutrophil cytoplasmic, anti-smooth muscle, or antigliadin antibodies, abnormal biochemical or otological findings. Tympanometry which indicates tympanic peak pressure (TPP, daPa), acoustic reflex testing (ART), pure-tone average (PTA), and transient evoked otoacoustic emission (TEOAE) were performed. We grouped the participants according to ART (positive/negative), TEOAE (normal/undetected), and PTA (≤20/&#x3e;20 decibel). <b><i>Results:</i></b> Air conduction thresholds on the right ear at 500, 4,000, 6,000, and 8,000 Hz, PTA, and the left ear at 250, 4,000, 6,000, and 8,000 Hz were higher in euthyroid HT (<i>n</i> = 36) than in controls (<i>n</i> = 40) (<i>p</i> &#x3c; 0.05). We found less negative TPP and a higher ratio of negative ART in euthyroid HT (<i>p</i> &#x3c; 0.05). Euthyroid HT predicted undetected TEOAE and increased hearing threshold on the right ear at 500 and 8,000 Hz (<i>p</i> &#x3c; 0.001). TEOAE detected audiological abnormality at a higher rate. Anti-TPO was positively correlated with TPP and air conduction thresholds, except the right ear at 8,000 Hz. <b><i>Discussion/Conclusion:</i></b> Hearing and audiological tests may be impaired in euthyroid HT. We recommend close monitoring of audiological functions in these patients. TE­OAE more specifically indicates audiological abnormality.

Hearing loss associated with weapons noise exposure: when to investigate an asymmetrical loss

1995 ◽  
Vol 109 (4) ◽  
pp. 291-295 ◽  
Author(s):  
H. J. Cox ◽  
G. R. Ford
Keyword(s):  
Hearing Loss ◽  
Noise Exposure ◽  
Hearing Threshold ◽  
Routine Testing ◽  
Threshold Levels ◽  
Average Loss ◽  
The Right ◽  
Air Conduction ◽  
Selection Of

AbstractThe air conduction thresholds in the right and left ears, and the interaural asymmetry of thresholds at 0.5, 1, 2, 3, 4 and 6 kHz were measured in a group of 225 soldiers exposed to a variety of weapon noise who were referred for assessment because of a deterioration in hearing on routine testing. At 0.5 and I kHz the threshold levels rarely exceeded 25 dB and the interaural asymmetry was 10 dB or less in 90 per cent of cases. The degree of hearing loss and interaural asymmetry increased as the frequency increased, with the average loss being significantly greater in the left ear at 2, 3, 4 and 6 kHz.Recommendations are made for the selection of cases of asymmetrical hearing loss exposed to weapon noise which require further investigation to exclude a retrocochlear cause or to define spurious hearing threshold levels.

scholarly journals Relationship between Smoking and Hearing Impairment of Automotive Industry Workers Exposed to Noise

2018 ◽  
Author(s):  
Iraj Alimohammadi ◽  
Fakhradin Ahmadi Kanrash ◽  
Kazem Rahmani(MSc)
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
P Value ◽  
Noisy Environments ◽  
Significant Difference ◽  
Keywords Hearing Loss ◽  
Hearing Test ◽  
The Mean ◽  
The Right ◽  
Air Conduction

Introduction: Working in noisy environments may cause hearing loss. Studies have shown that some factors along with noise are independently involved in hearing loss, one of which is cigarette smoking. The aim of this study was to evaluate the effects of smoking on hearing loss in workers exposed to occupational noise. Materials and Methods: The workers’ hearing loss was measured through a tonal hearing test (air-conduction). Their demographic information was also recorded and evaluated using some checklists. Results: A total of 250 people were enrolled in this study, of whom 133 were smokers and 117 were non-smokers. The mean age of the participants was 36.07 ± 3.66 years, and there was no significant difference between the two groups in terms of age. The mean sound pressure level in the work environment was 86 dB based on the ISO standard. There was a significant difference between the hearing loss levels in the right ears and the left ears of the two groups of smokers and non-smokers (P value <0.001). Conclusion: In general, smoking plays a significant role in hearing loss along with other factors, such as noise in the workplace, and conducting periodic audiometry tests to identify smokers with hearing impairment can be effective in primary or secondary prevention of occupational hearing impairment. Keywords: Hearing Loss, Smoking, Noise, Occupational  

scholarly journals Coexistence of Hashimoto's thyroiditis and papillary thyroidal carcinoma with papillary carcinoma of thyreoglossal duct

2007 ◽  
Vol 64 (10) ◽  
pp. 714-718
Author(s):  
Milica Cizmic ◽  
Mile Ignjatovic ◽  
Snezana Cerovic ◽  
Boris Ajdinovic
Keyword(s):  
Thyroid Gland ◽  
Papillary Carcinoma ◽  
Hashimoto’S Thyroiditis ◽  
Clinical Investigation ◽  
The Body ◽  
Whole Body ◽  
Hashimoto's Thyroiditis ◽  
Thyroglossal Duct ◽  
Right Lobe ◽  
The Right

Background. Simultaneous presence of Hashimoto's thyroiditis and papillary thyroidal carcinoma in thyroidal gland with papillary carcinoma association in thyroglossal duct is quite rare. The questions like where the original site of primary process, is where metastasis is, what the cause of coexisting of these diseasesis present a diagnostic dilemma. Case report. We presented a case of a 53-year old female patient, with the diagnosis of Hashimoto's thyroiditis and symptoms of subclinical hypothyreosis and nodal changes in the right lobe of thyroidal gland, according to clinical investigation. Morphological examination of thyroidal gland, ultrasound examination and scintigraphy with technetium (Tc) confirmed the existence of nonhomogenic tissue with parenchyma nodular changes in the right lobe of thyroidal gland that weakly bonded Tc. Fine needle biopsy in nodal changes, with cytological analyses showed no evidence of atypical thyreocites. Hashimoto's thyroiditis was confirmed on the basis of the increased values of anti-microsomal antibodies, the high levels of thyreogobulin 117 ng/ml and TSH 6.29 ?IU/ml. The operation near by the nodular change in the right lobe of thyroidal gland revealed pyramidal lobe spread in the thyroglossal duct. Total thyroidectomia was done with the elimination of thyroglossal duct. Final patohystological findings showed papillary carcinoma in the nodal changes pT2, N0 and in the thyroglossal duct with the presence of Hashimoto's thyroiditis in the residual parenchyme of the thyroid gland. After the surgery the whole body scintigraphy with iodine 131 (131I) did not reveal accumulation of 131I in the body, while the fixation in the neck was 1%. After that, the patient was treated with thyroxin with suppressionsubstitution doses. Conclusion. Abnormality in embrional development of thyroidal tissue might be the source of thyroidal carcinoma or the way of spreading of metastasis of primary thyroidal carcinoma from thyroid gland. The cause of this process is most probably a hereditary mutation in RET oncogenes.

scholarly journals A Rare Case of a Toxic Thyroid Nodule Found in a Hypothyroid Patient on Levothyroxine Therapy

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A915-A915
Author(s):  
Tiffany Purewal ◽  
Christopher Lesniak ◽  
Andrew Ravin ◽  
Jennifer Cheng
Keyword(s):  
Thyroid Nodule ◽  
Hashimoto’S Thyroiditis ◽  
Thyroid Nodules ◽  
Middle Lobe ◽  
Hashimoto's Thyroiditis ◽  
Hot Nodule ◽  
History Of ◽  
Right Middle Lobe ◽  
The Right ◽  
Hypothyroid Patients

Abstract Introduction: A hyperfunctional thyroid nodule can lead to symptoms of overt or subclinical hyperthyroidism but the association between a hyperfunctional thyroid nodule and hypothyroidism has not been well reported. We present a patient with a prior history of hypothyroidism previously controlled on Levothyroxine who later presented with an enlarging hot nodule. Case Presentation: A 62-year-old female with a history of factor V Leiden, hypothyroidism on levothyroxine therapy, and a meningioma presented to an outpatient clinic with complaints of fatigue, constipation, and 37-pound weight loss in one year. She was diagnosed with hypothyroidism 7 years ago after delivering her third child, but the underlying cause of her disease was unknown. She began taking levothyroxine 50mcg every morning after her diagnosis. She reported compliance and proper pill taking technique. Physical examination revealed a palpable thyroid nodule. The patient had a previous work up for thyroid nodules with a thyroid uptake and scan a few years prior, which showed a 1.42 x 0.96 x 1.87 cm hot nodule at the right middle lobe with a 24-hour uptake of 15.3%. The patient was asymptomatic at that time and thyroid function tests were within normal limits. She was instructed to continue taking levothyroxine. Repeat RAI Uptake scan at the time of her presentation to our office again showed the right middle lobe hot thyroid nodule with an increased 24-hour uptake of 27.5%. Ultrasound showed bilateral thyroid nodules and a hypervascular solid nodule measuring 2.28 x 1.27 x 1.9 cm that has increased in size. Lab work at this visit revealed a TSH of 0.329 uIu/mL, and free T4 of 1.25 ng/dL. Due to her low TSH and clinical presentation, the levothyroxine was discontinued. Anti-thyroid peroxidase antibodies were obtained to assess for Hashimoto’s Thyroiditis but were found to be normal. The patient was later referred to an endocrine surgeon for a total thyroidectomy. Conclusion: Although uncommon, hyperfunctional nodules in hypothyroid patients can create a confusing clinical picture with overlapping symptoms of underactive and overactive thyroid disease. It has been reported that patients with Hashimoto’s Thyroiditis can have hot nodules and coexisting hypothyroidism but the prevalence of hyperfunctional nodules in hypothyroid patients without Hashimoto’s Thyroiditis, as in this case, is not well-documented. Patients with hypothyroidism are treated with Levothyroxine but if coexisting hyperfunctional nodules are not detected, the patient may develop thyrotoxicosis. Clinicians should be aware of this rare but potentially life-threatening clinical condition.

scholarly journals Hashimoto’s Thyroiditis Associated Thyroid Eye Disease:A Success Story of Teprotumumab

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A932-A932
Author(s):  
Issra Jamal
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Thyroid Eye Disease ◽  
Hashimoto's Thyroiditis ◽  
Eye Disease ◽  
Fat Pad ◽  
Inferior Rectus ◽  
Thyroid Associated Ophthalmopathy ◽  
History Of ◽  
Graves Orbitopathy ◽  
The Right

Abstract Background: Thyroid-associated eye disease is more common in patients with Graves’ disease. However, patients with Hashimoto’s may also be affected by thyroid-associated eye disease in up to 6% of patients. Clinical Case: 44 year old female patient with history of Hashimoto’s thyroiditis presented to the clinic for her hypothyroidism and evaluation of thyroid eye disease. The patient was experiencing episodes of bilateral and unilateral inflammation of her eyes described as redness, dryness, bulging of the eyes. She was evaluated by ophthalmology and was diagnosed with thyroid eye disease and was prescribed a course of steroids with partial improvement of the symptoms. Orbital MRI was ordered and it showed symmetrical enlargement of the inferior rectus muscles bellies bilaterally with the left being slightly more enlarged than the right, retro orbital fat pad was grossly inflamed. TPO was elevated,TSI and TRAb were negative. Patient continued to have frequent flare ups with suboptimal response to steroid therapy. A discussion about starting Teprotumumab was made due to lack of optimal response to steroids and worsening of her symptoms and therapy was started. Patient did develop significant hyperglycemia, but she did not have recurrent flare ups. Studies have found that Thyroid-associated eye disease was present in up to (6%) of Hashimoto’s thyroiditis patients, those with thyroid-associated eye disease tended to be older, have a longer duration of Hashimoto’s thyroiditis, heavy smokers, and were less likely to present with another associated autoimmune disease. TSAb was positive in 5.5% in the patients with Hashimoto’s and thyroid-associated eye disease. Teprotumumab ([IGF-1] receptor inhibitor) was approved for the treatment of Graves’ orbitopathy by the (FDA) in 2020. Conclusion: Hashimoto’s thyroiditis associated thyroid eye disease is a rare clinical presentation. Teprotumumab is a new FDA approved treatment for thyroid eye disease that was successful in treating the symptoms and prevented flare ups in this patient. Careful monitoring of side effects is recommended. References: Kahaly GJ et al Thyroid stimulating antibodies are highly prevalent in Hashimoto’s thyroiditis and associated orbitopathy. J Clin Endocrinol Metab. March 10, 2016\Krassas GE, Wiersinga WM. - Thyroid eye disease: current concepts and the EUGOGO perspective. Thyroid International. 2005;4:3–4. Teprotumumab for Thyroid-Associated Ophthalmopathy. Smith TJ, Kahaly GJ, Ezra DG, Fleming JC, Dailey RA, Tang RA, Harris GJ, Antonelli A, Salvi M, Goldberg RA, Gigantelli JW, Couch SM, Shriver EM, Hayek BR, Hink EM, Woodward RM, Gabriel K, Magni G, Douglas RS SO N Engl J Med. 2017;376(18):1748.

scholarly journals Histological Study on the Thyroid Tissue Adjoining the Noninvasive Thyroid Follicular Neoplasm With Papillary-Like Nuclear Features, Seeking a Possible Association With Hashimoto’s Thyroiditis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A861-A862
Author(s):  
Paola N Pereira
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Histological Study ◽  
Psychological Impact ◽  
Thyroid Tissue ◽  
Hashimoto's Thyroiditis ◽  
Follicular Neoplasm ◽  
Research Committee ◽  
Non Invasive ◽  
Right Lobe ◽  
The Right

Abstract Papillary thyroid carcinoma (PTC) is the most frequent type of thyroid cancer (TC), and advances in ultrasound methods resulted in better and higher detection of this tumor. Thus, the increase in the incidence of PTC is due to the detection of microcarcinomas by ultrasound, as well as partially, due to the increased diagnosis of the encapsulated and/or well-defined non-invasive follicular variant of thyroid papillary carcinoma (NIEFVPTC). Recently, there was a change in the histological classification of NIEFVPTC, currently known as non-invasive follicular thyroid neoplasm with papillary-like features (NIFTP), thus the clinical evidence leads to an excellent prognosis once its a indolent neoplasia, dismissing additional treatments as lymphadenectomy and radioiodotherapy, therefore reducing psychological impact. This study was approved by the ethics and research committee and addressed the analysis and review of histological slides of thyroid neoplasia that currently meet the criteria for NIFTP. Furthermore, the study sought to evaluate the concomitant existence of NIFTP with histological findings consistent with Hashimoto’s Thyroiditis (HT). Underlying studies evoke a possible increase in the imperil of developing PTC when associated with HT. It should be noted that this morphological correlation is poorly described in the literature. Accordingly, a retrospective study was carried out by histological review of 232 cases diagnosed as PTC from total thyroidectomies with cervical lymphadenectomy from 1993 to 2014, previously diagnosed as NIEFVPTC. The histological slides of these cases came from the Surgical Pathology files of the Pathology Department of UNICAMP, Brazil. After histological review, 14 cases reclassified as NIFTP were selected, all referring to female patients, of which 6 presented histological criteria of NIFTP associated with HT. Additionally, a histological and laboratory correlation of the 14 selected cases was performed through the dosages of relevant serum titers of antithyroid antibodies (anti-TPO and TgAb). Out of the 6 patients detected with association of NIFTP and TH, 5 had significant titers above 65IU/ml for anti-TPO and 120IU/ml for TgAb. Additional data from thyroid ultrasonography were collected and showed that cases of NIFTP without association with HT, presented nodules ranging from 1.5 cm to 5.1 cm, predominantly hypoechoic, solid, with regular contours, peripheral vascularization and located predominantly in the right lobe. In conclusion, 14 cases of NIFTP were detected, among 232 cases of PTC, with 6 cases being histologically associated with HT. Of these, 5 cases had laboratory tests with positive antithyroid antibody titers, proving this association, from a clinical point of view. All cases of NIFTP with and without HT association were female, with nodules ranging from 0.3cm to 5.0cm to ultrasound, predominantly in the right lobe.

Vitamin D Treatment in Patients with Hashimoto’s Thyroiditis may Decrease the Development of Hypothyroidism

2016 ◽  
Vol 86 (1-2) ◽  
pp. 9-17 ◽  
Author(s):  
Bekir Ucan ◽  
Mustafa Sahin ◽  
Muyesser Sayki Arslan ◽  
Nujen Colak Bozkurt ◽  
Muhammed Kizilgul ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Hashimoto’S Thyroiditis ◽  
Healthy Control Group ◽  
Hashimoto's Thyroiditis ◽  
Control Group ◽  
Endocrine Society ◽  
Thyroid Autoantibody ◽  
Healthy Control ◽  
The Mean

Abstract.The relationship between Hashimoto’s thyroiditis and vitamin D has been demonstrated in several studies. The aim of the present study was to evaluate vitamin D concentrations in patients with Hashimoto’s thyroiditis, the effect of vitamin D therapy on the course of disease, and to determine changes in thyroid autoantibody status and cardiovascular risk after vitamin D therapy. We included 75 patients with Hashimoto’s thyroiditis and 43 healthy individuals. Vitamin D deficiency is defined as a 25-hydroxy vitamin D (25(OH)D3) concentration less than 20ng/mL. Vitamin D deficient patients were given 50.000 units of 25(OH)D3 weekly for eight weeks in accordance with the Endocrine Society guidelines. All evaluations were repeated after 2 months of treatment. Patients with Hashimoto’s thyroiditis had significantly lower vitamin D concentrations compared with the controls (9.37±0.69 ng/mL vs 11.95±1.01 ng/mL, p < 0.05, respectively). Thyroid autoantibodies were significantly decreased by vitamin D replacement treatment in patients with euthyroid Hashimoto’s thyroiditis. Also, HDL cholesterol concentrations improved in the euthyroid Hashimoto group after treatment. The mean free thyroxine (fT4) concentrations were 0.89±0.02 ng/dL in patients with Hashimoto’s thyroiditis and 1.07±0.03 ng/dL in the healthy control group (p < 0.001). The mean thyroid volumes were 7.71±0.44 mL in patients with Hashimoto’s thyroiditis and 5.46±0.63 mL in the healthy control group (p < 0.01). Vitamin D deficiency is frequent in Hashimoto’s thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases

2000 ◽  
Vol 39 (05) ◽  
pp. 133-138 ◽  
Author(s):  
W. Dembowski ◽  
H.-J. Schroth ◽  
K. Klinger ◽  
Th. Rink
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Thyroid Volume ◽  
Nodular Goiter ◽  
Thyroid Diseases ◽  
Hashimoto's Thyroiditis ◽  
Graves Disease ◽  
Normal Range ◽  
Serum Thyroglobulin ◽  
Diffuse Goiter ◽  
Hyperthyroid Patients

Summary Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto’s thyroiditis and 30 hyperthyroid patients with Graves’ disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto’s thyroiditis showed slightly decreased Tg levels. In Graves’ disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range (< 30 ng/ml). Conclusion: Elevated Tg levels indicate a high probability of thyroid diseases, such as malignancy, autonomy or Graves’ disease. However, as low Tg concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases.

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