scholarly journals Autoimmune Alternating Hypo- and Hyperthyroidism in Children

2011 ◽  
Vol 50 (11) ◽  
pp. 1040-1044 ◽  
Author(s):  
Revi P. Mathew ◽  
Daniel J. Moore
Keyword(s):  
Total Thyroidectomy ◽  
Replacement Therapy ◽  
Thyroid Function ◽  
Clinical Presentation ◽  
Drug Regimen ◽  
Thyroid Antibodies ◽  
Single Drug ◽  
Levothyroxine Replacement

Two children presented with autoimmune alternating hypo- and hyperthyroidism related to the presence of blocking and stimulating thyroid antibodies. It was difficult to control their thyroid function adequately with an appropriate single drug regimen, and both children underwent total thyroidectomy with subsequent stable management with levothyroxine replacement therapy postsurgically. Although this phenomenon is well described in adults, this report is the first of such occurrence in children. The possible mechanism for the variation in the type of clinical presentation and options for management are discussed.

scholarly journals Thyroid hormones modulate irisin concentrations in patients with recently onset hypothyroidism following total thyroidectomy

2020 ◽  
Author(s):  
R. Bocale ◽  
A. Barini ◽  
A. D‘Amore ◽  
M. Boscherin ◽  
S. Necozione ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Thyroid Hormones ◽  
Total Thyroidectomy ◽  
Replacement Therapy ◽  
Thyroid Function ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Levothyroxine Replacement ◽  
Circulating Levels

Abstract Purpose Irisin is a newly discovered adipo-myokine known for having significant effects on body metabolism. Currently, there is a discussion regarding the relation between thyroid function and irisin concentration. This study was designed to evaluate the influential role of levothyroxine replacement therapy on circulating levels of irisin in patients with recently onset hypothyroidism following total thyroidectomy. Methods Circulating levels of thyroid hormones, irisin and other metabolic parameters, were assessed in 40 recently thyroidectomized patients (34 females, mean age 50.1 ± 15.2 years) at baseline (5–7 day after surgery) and after 2 months under replacement therapy with levothyroxine. Results At baseline, circulating levels of thyroid hormones were indicative of hypothyroidism (TSH 12.7 ± 5.0 μU/mL, FT3 1.9 ± 0.7 pg/mL, FT4 8.7 ± 3.6 pg/mL). Mean serum irisin concentrations significantly increased after 2 months under replacement therapy with levothyroxine (from 2.2 ± 0.6 to 2.9 ± 0.6 μg/mL, p < 0.0001). Variations of circulating levels of irisin under levothyroxine replacement therapy were directly correlated with those of FT3 (Rho = 0.454, p = 0.0033) and FT4 (Rho = 0.451, p = 0.0035). Multivariate regression analysis revealed that changes in thyroid hormones concentrations explained up to 10% of the variations of serum irisin levels under levothyroxine replacement therapy (FT3 R2 = 0.098, FT4 R2 = 0.103). Conclusion Our study suggests that levothyroxine replacement therapy mildly influences irisin metabolism in patients with recently onset hypothyroidism following total thyroidectomy.

scholarly journals Long-Term Cardiovascular Effects of Levothyroxine Therapy in Young Adults with Congenital Hypothyroidism

2008 ◽  
Vol 93 (7) ◽  
pp. 2486-2491 ◽  
Author(s):  
Mariacarolina Salerno ◽  
Ugo Oliviero ◽  
Teresa Lettiero ◽  
Vincenzo Guardasole ◽  
Dario Maria Mattiacci ◽  
...  
Keyword(s):  
Young Adults ◽  
Replacement Therapy ◽  
Exercise Capacity ◽  
Congenital Hypothyroidism ◽  
Intima Media Thickness ◽  
Normal Range ◽  
Levothyroxine Replacement ◽  
Levothyroxine Treatment ◽  
Tsh Levels

Abstract Context: Congenital hypothyroidism (CH) is the most prevalent endocrine disorder in the newborn and is routinely treated with life-long levothyroxine replacement therapy. Although several studies have demonstrated that such therapy may impact on the cardiovascular system, little is known with regard to the effects of long-term levothyroxine administration in patients with CH. Objective: The aim of the current study was to evaluate whether long-term levothyroxine replacement therapy in young adults with CH is associated with cardiovascular abnormalities. Patients and Methods: Thirty young adults with CH aged 18.1 ± 0.2 yr and 30 age- and sex-matched controls underwent cardiac and carotid Doppler ultrasound and symptom-limited cardiopulmonary exercise testing. Hypothyroidism was diagnosed by neonatal screening, and levothyroxine treatment was initiated within the first month of life and carefully adjusted to maintain TSH levels in the normal range and free T4 in the high-normal range. Results: Compared with controls, hypothyroid patients exhibited left ventricular diastolic dysfunction, impaired exercise capacity, and increased intima-media thickness. At multiple regression analysis, the number of episodes of plasma TSH levels less than 0.5 mU/liter and greater than 4.0 mU/liter from the age of 1 yr onward, and mean TSH plasma levels during puberty were independent predictors of diastolic filling and cardiopulmonary performance indexes (multiple r values: 0.61–0.75). Conclusions: Long-term levothyroxine treatment in young adults with congenital hypothyroidism is associated with impaired diastolic function and exercise capacity and increased intima-media thickness.

Levothyroxine Replacement Therapy and Overuse: A Timely Diagnostic Approach

Thyroid ◽  
2018 ◽  
Vol 28 (12) ◽  
pp. 1580-1586 ◽  
Author(s):  
Sarantis Livadas ◽  
Christina Bothou ◽  
Ioannis Androulakis ◽  
Anastasios Boniakos ◽  
Nicholas Angelopoulos ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Diagnostic Approach ◽  
Levothyroxine Replacement

scholarly journals Hashimoto’s Encephalopathy Presenting with Unusual Behavioural Disturbances in an Adolescent Girl

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Murugan Selvaraj Karthik ◽  
Kulothungan Nandhini ◽  
Viswanath Subashini ◽  
Ramasamy Balakrishnan
Keyword(s):  
Clinical Presentation ◽  
Autoimmune Disorder ◽  
High Serum ◽  
Thyroid Antibodies ◽  
Antipsychotic Medications ◽  
Hashimoto’S Encephalopathy ◽  
Neuropsychiatric Manifestations ◽  
Euthyroid Status ◽  
Very High

Hashimoto’s encephalopathy (HE) is a rare autoimmune disorder with neurological and neuropsychiatric manifestations and elevated titres of anti-thyroid antibodies. Here we are reporting a case of HE in a 19-year-old girl who presented with seizure-like episodes, confusion, and behavioural disturbances with catatonic symptoms such as posturing, echopraxia, echolalia, and ambivalence. Patient did not respond to antipsychotics and anticonvulsants. On further investigation, patient was found to have high serum anti-TPO antibodies of about 1261 U/mL with euthyroid status, which supported a suspicion of HE. Our consultant neurologist confirmed the diagnosis and she was started on injection of methylprednisolone 750 mg OD. Since patient started showing clinical improvement, her antipsychotic medications were tapered off. On follow-up, patient has recovered and is functioning well. Since HE is a diagnosis of exclusion, very high anti-TPO antibodies and good response to steroids supported the diagnosis of HE in this patient after excluding other etiological possibilities. This case has been reported because the clinical presentation was predominantly neurobehavioural manifestations which is uncommon with HE.

Sign in / Sign up

Export Citation Format

Share Document