scholarly journals COVID-19 Infection Causing Atypical Thyroiditis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A925-A926
Author(s):  
Rujuta Baban Katkar
Keyword(s):  
Thyroid Function ◽  
Thyroid Disease ◽  
Severe Disease ◽  
Thyroid Function Test ◽  
Thyroid Peroxidase ◽  
Close Monitoring ◽  
Thyroid Function Tests ◽  
Upper Respiratory Tract ◽  
Significant Past Medical History ◽  
Function Test

Abstract Introduction: Coronavirus disease 2019 (COVID-19) has caused significant health burden across the world. Identification of factors contributing to severe disease is important to enable stratification of risk, optimize the reallocation of hospital resources, and guide public health recommendations and interventions. Subacute thyroiditis is an inflammatory thyroid disease characterized by neck pain and is usually preceded by an upper respiratory tract infection. It may be caused by a viral infection or a post-viral inflammatory reaction, and many viruses have been linked to the disease. We present case of atypical thyroiditis associated with COVID-19 infection. Case Report: 27-year-old female with no significant past medical history apart from recent COVID-19 infection is referred to endocrinology for evaluation of abnormal thyroid function test. Patient states around three months ago she was experiencing the symptoms like unintentional weight loss, nausea, palpitation, insomnia, anxiety, fatigue similar to symptoms she experienced 9 years ago while she was pregnant with her daughter so she thought she is pregnant again and visited her gynecologist. But patient had pregnancy test was done and she was found to be negative but her thyroid function test showed low TSH 0.32mIU/ml (0.47-4.68mIU/ml). Patient states around same time she was diagnosed with COVID-19 infection and she lost 5 pounds during that time but even after recovery from the infection she continued to lose weight and lost a total of 18 pounds in 3 months. Patient states during the time of COVID-19 infection she was having difficulty swallowing and painful swallowing but following infection patient denied any current difficulty swallowing or breathing, headache, vision changes, cold or heat intolerance, diarrhea or constipation, tremors, proximal muscle weakness, bulging of her eyes. Patient continue to have regular monthly menstrual cycles. Three months following infection patients repeat thyroid function tests were done and it showed normal TSH 0.56mIU/ml(0.47-4.68mIU/ml),free T4 1.05ng/dL(0.78-2.19ng/dL) and negative thyroid antibodies like TSI index<1.0, Thyroid peroxidase Antibodies 1.4 IU/mL, Thyrotropin Receptor Ab <1.00 IU/L. Patient also had normal thyroid ultrasound. Patient had complete resolution of hyperthyroid symptoms and did not require any medications. Conclusion: In conclusion, physicians should be engaged in close monitoring of thyroid disease in patients with suspected COVID-19, for timely detecting signs of disease progression. Finally, the presence of thyroid disease shall be regarded as an important factor in future risk stratification models for COVID-19.

scholarly journals The Characteristics of Children with Abnormalities Detected in Thyroid Function Tests, and Distribution of Diagnoses

2020 ◽  
Author(s):  
Elif Çelik ◽  
Ayşe Anık
Keyword(s):  
Thyroid Function ◽  
Thyroid Disease ◽  
Correct Diagnosis ◽  
Thyroid Function Test ◽  
Hashimoto Thyroiditis ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Test Results ◽  
Function Tests ◽  
Function Test

INTRODUCTION: Thyroid function tests are among the most frequently implemented laboratory tests in primary, and secondary healthcare institutions. The aim of the present study was to investigate the demographic and clinical characteristics and final diagnosis of children referred by primary and secondary healthcare institutions with the suspicion of an abnormality in thyroid function test and/or with the initial diagnosis of specific thyroid disease. METHODS: A total of two hundred eighty-nine pediatric patients, aged between 4 and 18 years admitted to the outpatient clinics of Behçet Uz Children’s Health and Diseases Hospital between January 2018 and January 2020, were included in the study. The patient data were obtained retrospectively from the hospital records. RESULTS: A total of 66% of the patients who were included in the study were female with a median age of 12 years (8.7-14.4), while 64% of them were pubertal; and 78% of the cases were referred by secondary healthcare institutions. The most common reason for referral was isolated elevation of thyroid stimulating hormone (TSH). A total of 56% of the patients were asymptomatic at the time of admission, and thyroid function test results of 75% of them were within normal limits. When evaluated according to their final diagnoses, the children were normal/healthy (64%), diagnosed with Hashimoto thyroiditis (30%), nodular thyroid disease (3%), Graves disease (2%) and isolated increase of TSH was related to obesity in 5 patients (1%). DISCUSSION AND CONCLUSION: It is essential to evaluate children with abnormal thyroid function test results with detailed history and physical examination. Besides, the thyroid function tests should be performed with reliable and sensitive methods in standardized laboratories to reach the correct diagnosis in these children.

scholarly journals Turning to Thyroid Disease in Pregnant Women

2020 ◽  
Vol 9 (5) ◽  
pp. 225-233 ◽  
Author(s):  
Stine Linding Andersen ◽  
Stig Andersen
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Thyroid Function Test ◽  
Thyroid Function Tests ◽  
Routine Testing ◽  
Randomized Controlled ◽  
Function Test ◽  
Fetal Complications ◽  
Maternal Thyroid

Thyroid disease in pregnant women needs attention from a clinical and scientific standpoint due to the potential severe adverse consequences. It is well-established that overt thyroid disease in pregnant women should be treated to prevent maternal and fetal complications, but routine testing for overt thyroid function test abnormalities has not been implemented. In contrast, the scientific focus has shifted towards smaller aberrations in maternal thyroid function including subclinical thyroid disease and isolated deviations in maternal thyroxine. In this focused review, we touch upon the assessment of maternal thyroid function in pregnancy and how the historical advancements in thyroid function tests parallel with the thyroid function test abnormalities described. Furthermore, we discuss how the scientific focus has evolved and how the field could turn in view of the existing discrepancies between results of observational studies and randomized controlled trials.

Identification of thyroid disease in pregnant women varies by analytical method and type of thyroid function test

2020 ◽  
Author(s):  
Andersen Stine Linding ◽  
Christensen Peter Astrup ◽  
Louise Knøsgaard ◽  
Stig Andersen ◽  
Aase Handberg ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Analytical Method ◽  
Thyroid Disease ◽  
Thyroid Function Test ◽  
Function Test

scholarly journals Triiodothyronin, Thyroxine and Thyrotropin in Vitiligo

2012 ◽  
Vol 9 (2) ◽  
pp. 7-10
Author(s):  
K Subba ◽  
D Karn ◽  
R Khatri
Keyword(s):  
Thyroid Function ◽  
Thyroid Function Test ◽  
Cross Sectional Study ◽  
Thyroid Function Tests ◽  
Thyroid Disorder ◽  
Age Group ◽  
Cross Sectional ◽  
Function Test ◽  
High Level

BackgroundVitiligo is a common pigmentary disorder of the skin, affecting individuals globally. Not only is this ailment psychologically incapacitating, it also has a high incidence of autoimmunity, signifying that its manifestations may be the portrayal of dysfunction of immune system. ObjectiveThe aim of this study is to find out the situations of abnormal thyroid function test (TFT) in vitiligo patients. MethodsA prospective cross sectional study was conducted at the Dhulikhel Hospital, KUTH, Dhulikhel during November 2008 to January 2011 with the objective to assess the thyroid function tests in vitiligo patients. ResultsTotal 66 vitiligo patients with male 30 (45%) and female 36 (55%). Total 26 (39.39%) vitiligo patients have been found to have abnormal thyroid function test. Among them 10 had abnormal T3, seven had abnormal T4 and 12 had abnormal TSH level. Thyroid function test were normal in other vitiligo patients. Total seven vitiligo had high level of T3 than normal value, four male and three female. Two had higher level of T4 above 2.0 ng/dl and all were male, while five had abnormally low level of T4 with three male and two female. There were seven vitiligo patient with increased T3 level and three with decreased T3 level, among them six were males and four were females, the age group was ranged from seven to 68 years old. The T4 level were found abnormal in seven vitiligo patients among which five were males and two were females with the age group ranging from 7 to 51 years. ConclusionsThere has been significant association of thyroid disorder in the patient with vitiligo. Therefore, patient with vitiligo need to undergo thyroid function test to rule out the thyroid disorder and prevent from long-term complications.DOI: http://dx.doi.org/10.3126/kumj.v9i2.6279Kathmandu Univ Med J 2011;9(2):7-10 

Thyroid Disease in Pregnancy

2008 ◽  
Vol 04 (01) ◽  
pp. 100
Author(s):  
N Pearce Elizabeth ◽  
M Leung Angela
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Thyroid Function Test ◽  
Autoimmune Thyroid ◽  
Thyroid Screening ◽  
Function Test ◽  
In Pregnancy

The spectrum of thyroid disease in pregnancy has implications for both the mother and the developing fetus. Here we review the interpretation of thyroid function test values, thyrotoxicosis, hypothyroidism, iodine requirements, autoimmune thyroid disease, and thyroid screening recommendations as they pertain to pregnant women. It should be noted that the management of thyroid dysfunction in pregnancy should be closely co-ordinated with obstetricians and other providers.

scholarly journals Cytomorphological Spectrum of Thyroiditis: A Review of 110 Cases

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Shirish S. Chandanwale ◽  
Rahul Nair ◽  
Anushree Gambhir ◽  
Supreet Kaur ◽  
Aditi Pandey ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Thyroid Function Test ◽  
Lymphocytic Infiltration ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Thyroid Follicular Cell ◽  
Cell Clusters ◽  
Thyroid Peroxidase Antibodies ◽  
Function Test

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.

scholarly journals MON-475 Discrepant Thyroid Function Tests in Adenocarcinoma-Is This a True Thyroid Disorder?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Mohammed Al Tameemi ◽  
Janice L Gilden
Keyword(s):  
Thyroid Function ◽  
Thyroid Function Test ◽  
Amiodarone Therapy ◽  
Thyroid Function Tests ◽  
Thyroid Disorder ◽  
Check Point ◽  
Free T4 ◽  
Function Tests ◽  
Function Test ◽  
Check Point Inhibitors

Abstract Background: Many causes of abnormal thyroid function tests (TFTs) occur that may or may not reflect a true thyroid disorder. The most common include: immune check point inhibitors therapies (ICI) used to treat various types of cancers; biotin supplements, which may interfere with thyroid function test assays; euthyroid sick syndrome; as well as amiodarone therapy for cardiac disorders. Clinical Case: A 67-year old female patient with type 2 diabetes mellitus, taking insulin and oral antihyperglycemic agents, with hyperlipidemia, hypertension and coronary artery disease, who had abnormal TFTs (TSH was 3.7 to 4.9 uIIu/ml; ref range 0.27-4.2 uIU/mL), and Free T4 was 0.92 to 1.06 ng/dL; ref range 0.55-1.6 ng/dl) prior to the diagnosis of metastatic adenocarcinoma of the lungs. She was initially treated with radiation. TFTs were unchanged. Her CEA was noted to be 129.5 (0-3.0 ng/mL). However, following chemotherapy with Tarceva (Erlotinib) 50 mg po daily, the TSH increased to 7.6 uIU/ml with Free T4 of 3.19 ng/dL. She remained clinically euthyroid. A thyroid ultrasound showed 1 -small sub centimeter nodule in each thyroid lobe. The patient later admitted to also taking biotin for an unknown period of time. TSH antibodies and TSI were both negative. Free T4 by dialysis was normal. While still taking Tarceva her TSH was noted to be 2.5 to 3.8 uIU/ml and both Free T4 and Free T3 were elevated and was 6.57 pg/ml;ref range=2.52-4.34 pg/mL). Six months later, the Free T4 decreased to 1.08 ng/dL. Thyroid antibodies and thyroglobulin remain normal. The patient remained clinically euthyroid. Conclusion: It is important to note that several factors can cause abnormal thyroid function tests, such as Immune check point inhibitors therapy, with the exact mechanism for abnormal TFTs unknown, and can also be associated with either Grave’s hyperthyroidism or Hashimoto’s hypothyroidism,as well as other autoimmune endocrine disorders. Biotin, a common supplement, has also been reported to interfere with the thyroid function test assays for free thyroxine (T4), total T4, free triiodothyronine (T3), total T3, TSH, and various cancer markers. However, It is important to clinically evaluate the patient for thyroid disorders, and recognize that therapy may not always be required, when discrepant and fluctuating thyroid function tests are obtained, such as in this patient. References: (1) Holmes EW, Samarasinghe S, Emanuele MA, Meah. Biotin interference in clinical immunoassays: a cause for concern. . Arch Pathol Lab Med. 2017;141:1459-1460. (2) Rossi E, Sgambato, De Chaira G, et al. Thyroid-induced toxicity of check-point inhibitors immunotherapy in the treatment of advance non-small cell lung cancer. J. Endocrinol Diabetes 2016;3:1-10.

Immunoradiometric assay of thyrotropin as a "first-line" thyroid-function test in the routine laboratory.

1986 ◽  
Vol 32 (4) ◽  
pp. 691-693 ◽  
Author(s):  
M R Hopton ◽  
J S Harrop
Keyword(s):  
Thyroid Function ◽  
Thyroid Function Test ◽  
Primary Hypothyroidism ◽  
Thyroid Function Tests ◽  
Immunoradiometric Assay ◽  
Routine Laboratory ◽  
First Line ◽  
Function Test ◽  
Antithyroid Treatment

Abstract We compared the utility of a sensitive immunoradiometric assay for serum thyrotropin as a "first-line" thyroid-function test with a strategy based on first measuring total thyroxin in serum. The immunoradiometric assay appears to distinguish primary hypothyroidism and hyperthyroidism from euthyroidism in "new" patients. The role of this test in monitoring antithyroid treatment or thyroxin-replacement therapy is not yet established, there being particular difficulty in interpreting low thyrotropin concentrations in such patients. Nevertheless, because a normal thyrotropin concentration in most, if not all, situations signifies the euthyroid state, thyrotropin determination by immunoradiometric assay merits consideration as an initial test by laboratories performing thyroid-function tests.

scholarly journals A Rare Phenomenon of Hashimotos Thyroiditis Converting to Graves Disease

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A917-A917
Author(s):  
Ahl Jeffrey Caseja ◽  
Samer Nakhle
Keyword(s):  
Thyroid Function ◽  
Thyroid Function Test ◽  
Primary Care Providers ◽  
Deficiency Anemia ◽  
Graves Disease ◽  
Close Monitoring ◽  
Thyroid Function Tests ◽  
Care Providers ◽  
History Of

Abstract Introduction: Hashimotos thyroiditis and Graves disease are two distinct autoimmune disorders of the thyroid. Conversion of hypothyroidism to hyperthyroidism is even more rare. We report a case of an established Hashimotos thyoiditis patient who converted into Graves disease. Case Description: 67-year old female with a past medical history of iron-deficiency anemia, dyslipidemia, and depression presented with a six-month history of fatigue, cold-intolerance, hair loss, and weight gain in September of 2015. Laboratory tests confirmed diagnosis of Hashimotos thyroiditis with an elevated TSH 80.7 (0.40-4.50 mIU/L), FT4 0.2 (0.8-1.8 ng/dL), and positive thyroid antibodies TPO 24 (0.0-8.9 IU/mL). She was started on Levothyroxine 88 mcg daily. Gradually she had a decreased requirement of Levothyroxine; from February 2016 to March 2017 she maintained a normal TSH range while on 50 mcg/day with resolution of her symptoms. The patient was then lost to follow-up until she presented in the clinic in September 2018 with complaints of several weeks of easy fatigability, 10lb-weight loss, and periorbital edema. She was found to have a suppressed TSH 0.01, and elevated FT4 2.3, and FT3 8.4 (2.3-4.2 pg/mL). Her Levothyroxine 50 mcg/day was discontinued for four days and labs were repeated which still showed suppressed TSH and elevated FT4 and FT3. She was found to have a positive TRAB and a positive TSI which are consistent with hyperthyroidism. Thyroid ultrasound was performed which showed a heterogeneous thyroid gland with increased vascularity, confirming the diagnosis of Graves disease. She was started on Methimazole 10 mg daily. Her Methimazole dose was adjusted according to her thyroid function test until she had a total thyroidectomy in October 2019. She was started on levothyroxine post-operatively and as of March 2020 is on Levothyroxine 50 mcg/daily. Conclusion: Despite the rarity of Hashimotos thyroiditis converting to Graves disease, it is possible that those affected can be encountered by primary care providers and hospitalists and could easily be mistaken for over-replacement of levothyroxine. Close monitoring of the patient along with regular thyroid function tests will be required for ongoing follow-up.

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