scholarly journals Pathophysiology and Clinical Features of Neuropsychiatric Manifestations of Thyroid Disease

2022 ◽  
Author(s):  
Marilu Jurado-Flores ◽  
Firas Warda ◽  
Arshag Mooradian
Keyword(s):  
Thyroid Disease ◽  
Molecular Mechanisms ◽  
Overt Hypothyroidism ◽  
Barrier Dysfunction ◽  
Autoimmune Thyroid ◽  
Organ Systems ◽  
Increased Risk ◽  
Neuropsychiatric Manifestations ◽  
Cell Gene Expression ◽  
The Central Nervous System

Abstract Thyroid hormones (TH) have a cardinal role in the development of the central nervous system during embryogenesis and early infancy. However, the TH responsive genes in the developing brain cease to respond to TH in adulthood. Nevertheless, thyroid dysfunction in adults is commonly associated with a host of cognitive and psychiatric problems. Cognitive decline, dysphoria and depression are common manifestations of overt hypothyroidism while hyperthyroidism can cause agitation, acute psychosis and apathy especially in older people. Whereas levothyroxine treatment can reverse dementia in the setting of hypothyroidism, the effect of levothyroxine on depressive symptoms in subjects with subclinical hypothyroidism is controversial. The use of supraphysiologic doses of TH to treat depression refractory to antidepressant remains a viable therapeutic tool with the caveat that excessive doses of thyroid hormone to treat depression may have potentially damaging effects on other organ systems. The present communication describes the pathophysiology of neuropsychiatric manifestations of thyroid disease including changes in neurotransmission, alterations in neuronal or glial cell gene expression, blood-brain barrier dysfunction, increased risk of cerebrovascular disease and occasionally cerebral inflammatory disease in the context of autoimmune thyroid disease. Elucidating the molecular mechanisms of TH effect on cerebral tissue will help identify novel therapeutic targets for managing people with neuropsychiatric disorders.

Autoimmune thyroid disease in diabetic children and adolescents: a single center study from south Punjab

2021 ◽  
Vol 71 (7) ◽  
pp. 1804-1807
Author(s):  
Waqas Imran Khan ◽  
Erum Afzal ◽  
Sajjad Hussain
Keyword(s):  
Children And Adolescents ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Glycosylated Hemoglobin ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Pediatric Endocrinology ◽  
Autoimmune Thyroid ◽  
Thyroid Peroxidase Antibody ◽  
Diabetic Children

Objective: To evaluate the prevalence of autoimmune thyroid disease (AITD) in diabetic children in south Punjab. Methods: This was an observational cross sectional study from Jan 2019 to Dec 2019 in the outpatient diabetic clinic of the department of pediatric endocrinology at Children Hospital and The Institute of Child Health Multan. A total of 161 consecutive patients of both genders with TIDM were enrolled in this study after taking informed consent. Blood samples for Thyroid functions testes including thyroid stimulating hormone (TSH), free thyroxin (fT4), Thyroid peroxidase antibody (TPO-Ab), thyroglobulin antibody (TG-Ab) and glycosylated hemoglobin (HbA1C) level were sent. Results: Among diabetic children males were 83 (51.6%). Age range was 2-15 years. Mean age and standard deviation was 9.7± 4.3. TPO-Ab was positive in 34 patients (21.1%) and TG-Ab in 27 patients (16.7%), whereas both antibodies were positive in 17 patients (10.5%). Six patients (3.7%) had evidence of subclinical hypothyroidism, 8 patients (4.9%) had overt hypothyroidism and 1 patient (0.62%) had hyperthyroidism Conclusion: The prevalence of AITD among children and adolescents with type 1 diabetes mellitus was 21.1% in our study. Hypothyroidism was more prevalent in these children compared to hyperthyroidism. All diabetic children should be screened for AITD. Thyroid functions should be checked where TPO antibody is positive. Keywords: Autoimmune thyroid disease, anti thyroid peroxidase antibody, anti thyroglobulin Continuous...

scholarly journals Inflammatory complications of CGRP monoclonal antibodies: a case series

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jason C. Ray ◽  
Penelope Allen ◽  
Ann Bacsi ◽  
Julian J. Bosco ◽  
Luke Chen ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
Molecular Mechanisms ◽  
Case Series ◽  
Preventive Treatment ◽  
The Body ◽  
Temporal Association ◽  
Organ Systems ◽  
Calcitonin Gene ◽  
Close Proximity ◽  
The Central Nervous System

Abstract Background Calcitonin gene-related peptide (CGRP) is expressed throughout the body and is a known mediator of migraine, exerting this biological effect through activation of trigeminovascular, meningeal and associated neuronal pathways located in close proximity to the central nervous system. Monoclonal antibodies (mAb) targeting the CGRP pathway are an effective new preventive treatment for migraine, with a generally favourable adverse event profile. Pre-clinical evidence supports an anti-inflammatory/immunoregulatory role for CGRP in other organ systems, and therefore inhibition of the normal action of this peptide may promote a pro-inflammatory response. Cases We present a case series of eight patients with new or significantly worsened inflammatory pathology in close temporal association with the commencement of CGRP mAb therapy. Conclusion This case series provides novel insights on the potential molecular mechanisms and side-effects of CGRP antagonism in migraine and supports clinical vigilance in patient care going forward.

scholarly journals The role of selenium in the pathogenesis of thyroid disease

2019 ◽  
Vol 14 (4) ◽  
pp. 192-205 ◽  
Author(s):  
Ekaterina A. Troshina ◽  
Evgeniya S. Senyushkina ◽  
Maria A. Terekhova
Keyword(s):  
Immune Response ◽  
Thyroid Disease ◽  
Animal Experiments ◽  
Optimal Level ◽  
Thyroid Diseases ◽  
Autoimmune Thyroid Diseases ◽  
Autoimmune Thyroid ◽  
Increased Risk ◽  
Combined Deficiency

The past few years have been actively discussing the role of individual macro- and micronutrients as factors regulating the functional activity of organs and systems and reducing the risk of developing a number of diseases, including thyroid diseases. Selenium is one of the most important and intensively studied at present microelements. According to several studies, its low plasma level is associated with an increased risk of developing autoimmune thyroid diseases. In animal experiments, it was shown that a combined deficiency of selenium and iodine leads to more pronounced hypothyroidism than iodine deficiency alone. Some authors believe that cretinism in the newborn is a consequence of the combined deficiency of these two elements in the mother. It is also important that the optimal level of selenium is necessary both to initiate an immune response and to regulate an excessive immune response, as well as chronic inflammation. The review article discusses the relationship between selenium and thyroid pathology, discusses the role of selenium in the physiology of the thyroid gland and in the development of autoimmune diseases. The biochemical aspects of the pathogenesis of thyroid disease are presented.

scholarly journals Meta-Analysis of the Association between Vitamin D Receptor Polymorphisms and the Risk of Autoimmune Thyroid Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-15 ◽  
Author(s):  
Xue-Ren Gao ◽  
Yong-Guo Yu
Keyword(s):  
Vitamin D ◽  
Vitamin D Receptor ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Meta Analysis ◽  
Autoimmune Thyroid ◽  
Asian Populations ◽  
Increased Risk ◽  
African Populations ◽  
Reduced Risk

The association between vitamin D receptor (VDR) polymorphisms (rs731236, rs1544410, rs2228570, and rs7975232) and the risk of autoimmune thyroid disease (AITD) had been investigated in previous studies. However, the results of these studies remained controversial. Thus, a meta-analysis was performed to derive a more precise conclusion. All related articles were systematically searched by PubMed, Embase, Google Scholar, and Chinese National Knowledge Infrastructure (CNKI). The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of association. The overall results indicated thatVDRrs731236 and rs2228570 polymorphisms were significantly associated with a reduced risk of AITD. However, a stratification analysis based on clinical types showed thatVDRrs731236 and rs2228570 polymorphisms were associated only with a reduced risk of HT. A stratification analysis by ethnicity showed thatVDRrs731236 polymorphism was significantly associated with a reduced risk of AITD in Asian and African populations.VDRrs2228570 polymorphism was associated with a reduced risk of AITD in Asian populations.VDRrs1544410 polymorphism was associated with a reduced risk of AITD in European and African populations, but with an increased risk of AITD in Asian populations.VDRrs7975232 polymorphism was significantly associated with an increased risk of AITD in African populations. In conclusion, the present study suggested thatVDRrs731236, rs1544410, rs2228570, and rs7975232 polymorphisms were significantly associated with AITD risk. However, more well-designed studies should be performed to verify the current results.

scholarly journals Celiac-Associated Autoimmune Thyroid Disease: A Study of 16 Patients with Overt Hypothyroidism

1995 ◽  
Vol 9 (5) ◽  
pp. 242-246 ◽  
Author(s):  
Hugh J Freeman
Keyword(s):  
Celiac Disease ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Dermatitis Herpetiformis ◽  
Overt Hypothyroidism ◽  
Careful Monitoring ◽  
Autoimmune Thyroid ◽  
Intestinal Neoplasm ◽  
Adult Celiac Disease ◽  
Small Intestinal

Previous reports have suggested that autoimmune thyroid disorders (including Hashimoto’s or lymphocytic thyroiditis) may occur in patients with celiac disease. In this study, the prevalence of thyroid disease was explored in a series of 96 consecutive patients seen with biopsy-defined adult celiac disease (average age 47.3 years). Sixteen celiac patients (average age 58.1 years) were detected with hypothyroidism, including four treated with radio-iodine ablation or thyroidectomy for Grave’s disease. In addition to celiac disease, almost half had dermatitis herpetiformis, a small intestinal neoplasm (particularly lymphoma) or both. Diagnosis of thyroid disease preceded diagnosis of celiac disease in 13 patients or was made concurrently in two patients. In only one patient was thyroid disease detected after celiac disease was diagnosed. This indicates that thyroid diseases occur more commonly in celiac disease than is currently appreciated, possibly due to shared embryological origins or common immunopathological features, and may be the presenting clinical manifestation in adults especially if there is coexistent dermatitis herpetiformis. Careful monitoring of this subgroup may be warranted because of the frequency of neoplastic intestinal diseases, particularly lymphoma.

Subclinical hypothyroidism

2019 ◽  
Vol 12 (3) ◽  
pp. 131-135
Author(s):  
Adam Grice
Keyword(s):  
Cardiovascular Disease ◽  
Subclinical Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Normal Serum ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid ◽  
Thyroid Peroxidase Antibodies ◽  
Increased Risk ◽  
Stimulating Hormone

Subclinical hypothyroidism is a common condition associated with a raised thyroid-stimulating hormone and a normal serum free thyroxine that affects about 10% of females over 55 years in age. The most common cause is autoimmune thyroid disease, with 2.5% of patients with subclinical hypothyroidism progressing to clinically overt hypothyroidism each year. The rate of progression is higher in patients with anti-thyroid peroxidase antibodies and higher levels of thyroid-stimulating hormone. Only a small proportion of patients with subclinical hypothyroidism have symptoms, and although there is some debate in the literature about which patients should be treated, the National Institute for Health and Care Excellence clinical knowledge summaries give clear recommendations. There is an increased risk of cardiovascular disease in patients with subclinical hypothyroidism; it is uncertain whether treatment with levothyroxine reduces this risk. When deciding whether to treat subclinical hypothyroidism consider the patient’s age, symptoms, presence of anti-thyroid peroxidase antibodies, thyroid-stimulating hormone levels and risk factors such as cardiovascular disease.

scholarly journals Increased Risk of Polycystic Ovary Syndrome and It’s Comorbidities in Women with Autoimmune Thyroid Disease

2020 ◽  
Vol 17 (7) ◽  
pp. 2422
Author(s):  
Chun-Wei Ho ◽  
Hsin-Hung Chen ◽  
Ming-Chia Hsieh ◽  
Ching-Chu Chen ◽  
Sheng-Pang Hsu ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Polycystic Ovary ◽  
Group Method ◽  
Control Group ◽  
Ovary Syndrome ◽  
Autoimmune Thyroid ◽  
Increased Risk ◽  
Artery Disease

Objective: To investigate the prevalence of polycystic ovary syndrome (PCOS) and its comorbidities in patients with autoimmune thyroid disease (AITD). Population: In this cohort study, patients newly diagnosed as having Hashimoto thyroiditis (HT) or Grave disease (GD) were recruited into the AITD group. Method: The logistic regression model was used to investigate the association between exposure, endpoint, later diseases and treatment. Main Outcome Measures: We assessed the cumulative incidence using the Kaplan–Meier method and verified the difference by the log-rank test. Results: The AITD group included 3599 GD patients and 1332 HT patients. PCOS risk in patients with AITD was higher than that in the control group (adjusted hazard ratio = 1.39; 95% confidence interval = 1.07–1.71). In patients with both AITD and PCOS, the odds ratios of diabetes, hyperlipidemia and coronary artery disease were 2.48, 2.05 and 2.63, respectively. Conclusions: The risks of PCOS and its comorbidities such as diabetes, dyslipidemia and cardiac artery disease are high in patients with AITD in Taiwan.

Increased Risk of Autoimmune Thyroid Disease in Hepatitis C vs Hepatitis B Before, During, and After Discontinuing Interferon Therapy

1998 ◽  
Vol 158 (13) ◽  
pp. 1445 ◽  
Author(s):  
Luisa Fernandez-Soto ◽  
Amalia Gonzalez ◽  
Fernando Escobar-Jimenez ◽  
Rafael Vazquez ◽  
Esther Ocete ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Hepatitis B ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Interferon Therapy ◽  
Autoimmune Thyroid ◽  
Increased Risk

scholarly journals MECHANISMS IN ENDOCRINOLOGY: Autoimmune thyroid disease: old and new players

2014 ◽  
Vol 170 (6) ◽  
pp. R241-R252 ◽  
Author(s):  
Grigoris Effraimidis ◽  
Wilmar M Wiersinga
Keyword(s):  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Twin Studies ◽  
Susceptibility Genes ◽  
Antithyroid Drugs ◽  
Autoimmune Thyroid ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
Fetal Microchimerism ◽  
Low Selenium

The last 10 years have seen some progress in understanding the etiology of autoimmune thyroid disease (AITD). The female preponderance can now be explained – at least in part – by fetal microchimerism and X-chromosome inactivation. The number of identified susceptibility genes for AITD is increasing (among others now includingTSHR,TG,HLA,CTLA4,PTPN22,CD40,FCRL3,IL2RA, andFOXP3), but these genes together probably do not explain more than about 10% of the heritability of AITD. As twin studies indicate that genes contribute for 70% of AITD, it follows that there must be many more loci, each of them contributing a little. While the genetic studies have clarified why various autoimmune diseases so often cluster in the same patient, the molecular mechanism of action of these genetic polymorphisms (frequently located in introns) has hardly been explained. Polymorphisms in AITD susceptibility genes may become helpful in clinical practice, e.g. in assessing risk of recurrent Graves' hyperthyroidism (GH) after a course of antithyroid drugs. Moderate alcohol intake decreases the risk on overt GH and overt Hashimoto's hypothyroidism. Current smokers – as well known – are at increased risk for Graves' disease, but – surprisingly – at diminished risk for Hashimoto's thyroiditis. Low selenium and low vitamin D levels might increase the risk of developing AITD, but data are still inconclusive. Current options for preventive interventions in subjects at risk to develop AITD are very limited.

scholarly journals Relation of prediabetes and type 2 diabetes mellitus to thyroid cancer

2020 ◽  
Vol 9 (7) ◽  
pp. 607-616
Author(s):  
T Grimmichova ◽  
M Haluzik ◽  
K Vondra ◽  
P Matucha ◽  
M Hill
Keyword(s):  
Type 2 Diabetes ◽  
Thyroid Cancer ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Malignant Tumors ◽  
Thyroid Volume ◽  
Biochemical Tests ◽  
Autoimmune Thyroid ◽  
Increased Risk

Objective Patients with type 2 diabetes (T2DM) generally experience a higher incidence of cancer. However, the association between T2DM and thyroid cancer is inconclusive. Methods Case-control prospective study, where 722 patients were screened for T2DM and prediabetes (PDM) and underwent thyroid ultrasound and biochemical tests. The patients were assigned to groups of PDM (n = 55), T2DM (n = 79) or a non-diabetes group (NDM) (n = 588). Fine-needle aspiration biopsy was carried out in 263 patients. Histological examinations were done for 109 patients after surgery, with findings of 52 benign (BS) and 57 malignant tumors (MS). Results Thirty-three percent of patients with T2DM and especially PDM were newly diagnosed by our screening: 6.5% with T2DM and 72% with PDM, respectively. The percentage of thyroid cancers did not significantly differ between the groups (χ2 test = 0.461; P = 0.794). Relevant positive thyroid predictors for T2DM (t-statistic = 25.87; P < 0.01) and PDM (21.69; P < 0.01) contrary to NDM (−26.9; P < 0.01) were thyroid volume (4.79; P < 0.01), thyroid nodule volume (3.25; P < 0.01) and multinodular thyroid gland (4.83; P < 0.01), while negative relevant predictors included the occurrence of autoimmune thyroid disease (AITD) (−2.01; P < 0.05). Conclusion In general, we did not observe an increased risk for thyroid cancer in the diabetic and prediabetic groups in comparison to controls, in spite of well-established increased risk for other malignancies. Structural and benign changes such as larger and multinodular thyroid glands, in comparison to autoimmune thyroid disease, are present more often in diabetics.

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