Transient pituitary hypothyroidism in a patient with ectopic adrenocorticotrophic hormone secretion

2000 ◽  
Vol 37 (3) ◽  
pp. 298-303 ◽  
Author(s):  
J Rodríguez-Espinosa ◽  
E Urgell ◽  
J Montesinos ◽  
P D Omingo ◽  
S M Webb
Keyword(s):  
Small Cell Lung Carcinoma ◽  
Hormone Secretion ◽  
Serum Cortisol ◽  
Thyroid Stimulating Hormone ◽  
Independent Effect ◽  
Thyroid Function Tests ◽  
Adrenocorticotrophic Hormone ◽  
Cell Lung Carcinoma ◽  
Factor Α ◽  
Serum Tsh

We report the case of a 55-year-old woman who presented with hypercortisolism secondary to ectopic adrenocorticotrophic hormone secretion and severe non-thyroidal illness syndrome (NTIS) due to metastatic small cell lung carcinoma associated with severe infections. The patient initially showed hormonal profiles of pituitary hypothyroidism and gonadal hypofunction. After decrease in cortisol production following treatment with chemotherapy and metyrapone, serum thyroid hormones and thyroid-stimulating hormone (TSH) concentrations normalized. Study of the relative contributions of cortisol and pro-inflammatory cytokines (interleukin-6 and tumour necrosis factor α) to the overall variability in thyroid function tests disclosed a significant and independent effect of serum cortisol on serum TSH concentrations; the variability in free thyroid hormone concentration was explained only by changes in TSH concentration. These observations indicate that cortisol could be the major determinant of changes in serum TSH concentrations in clinical conditions accompanied by hypercortisolism, as occurs in NTIS.

Subclinical hypothyroidism

2011 ◽  
pp. 543-547
Author(s):  
Jayne A. Franklyn
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Expert Panel ◽  
Elevated Serum ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Thyroid Function Tests ◽  
Free Triiodothyronine ◽  
Function Tests ◽  
Serum Tsh

Subclinical hypothyroidism is defined biochemically as the association of a raised serum thyroid-stimulating hormone (TSH) concentration with normal circulating concentrations of free thyroxine (T4) and free triiodothyronine (T3). The term subclinical hypothyroidism implies that patients should be asymptomatic, although symptoms are difficult to assess, especially in patients in whom thyroid function tests have been checked because of nonspecific complaints such as tiredness. An expert panel has recently classified individuals with subclinical hypothyroidism into two groups (1): (1) those with mildly elevated serum TSH (typically TSH in the range 4.5–10.0 mU/l) and (2) those with more marked TSH elevation (serum TSH >10.0 mU/l).

scholarly journals Thyroid dysfunction in preterm infants born before 32 gestational weeks

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hye-Rim Kim ◽  
Young Hwa Jung ◽  
Chang Won Choi ◽  
Hye Rim Chung ◽  
Min-Jae Kang ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Thyroid Dysfunction ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Academic Center ◽  
Pituitary Thyroid Axis ◽  
Thyroid Axis ◽  
Delayed Maturation ◽  
Levothyroxine Treatment ◽  
Serum Tsh

Abstract Background Thyroid hormones are critical for growth and brain development during the newborn period and infancy. Because of delayed maturation of the hypothalamic-pituitary-thyroid axis in preterm infants, thyroid dysfunction is common, and thyroid stimulating hormone (TSH) elevation is often delayed in preterm infants. The objective of this study was to determine the incidence of thyroid dysfunction requiring levothyroxine treatment and to identify its risk factors in preterm infants. Methods A retrospective cohort study was performed on preterm infants who were born before 32 gestational weeks and admitted to a single tertiary academic center for more than 8 weeks between January 2008 and December 2014. In these infants, serial thyroid function tests (TFTs) measuring serum TSH and free thyroxine (fT4) were routinely performed at 1, 3, and 6 weeks of postnatal age. Results Of the 220 preterm infants enrolled, 180 infants underwent TFTs at 1, 3, and 6 weeks of postnatal age and were included in the study. Of the 180 infants, 35 infants (19.4%) were started on levothyroxine treatment based on the results of serial TFTs. Among the 35 infants who were treated with levothyroxine, 16 infants (45.7%) had normal results on the initial TFT. Three of these 16 infants continued to have normal results on the second TFT. Thyroid dysfunction requiring levothyroxine treatment was significantly associated with maternal pregnancy-induced hypertension (adjusted odds ratio 2.64, 95% confidence interval 1.02–6.81). Conclusions Thyroid dysfunction requiring levothyroxine treatment occurred in nearly one-fifth of preterm infants born before 32 gestational weeks. Nearly half of the preterm infants who were treated with levothyroxine had normal TSH and fT4 levels at 1 week of postnatal age. The findings of the present study suggest that serial TFTs is important to find preterm infants who require levothyroxine treatment.

scholarly journals Thyroid Hormones, Autoantibodies, Ultrasonography, and Clinical Parameters for Predicting Thyroid Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Lin-zheng He ◽  
Tian-shu Zeng ◽  
Lin Pu ◽  
Shi-xiu Pan ◽  
Wen-fang Xia ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Characteristic Curve ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Preoperative Serum ◽  
Thyroglobulin Antibody ◽  
Increased Risk ◽  
Risk Of Malignancy ◽  
Punctate Calcification ◽  
Serum Tsh

Our objective was to evaluate thyroid nodule malignancy prediction using thyroid function tests, autoantibodies, ultrasonographic imaging, and clinical data. We conducted a retrospective cohort study in 1400 patients with nodular thyroid disease (NTD). The thyroid stimulating hormone (TSH) concentration was significantly higher in patients with differentiated thyroid cancer (DTC) versus benign thyroid nodular disease (BTND) (p=0.004). The receiver operating characteristic curve of TSH showed an AUC of 0.58 (95% CI 0.53–0.62,p=0.001), sensitivity of 74%, and specificity of 57% at a cut-off of 1.59 mIU/L. There was an incremental increase in TSH concentration along with the increasing tumor size (p<0.001). Thyroglobulin antibody (TgAb) concentration was associated with an increased risk of malignancy (p=0.029), but this association was lost when the effect of TSH was taken into account (p=0.11). Thyroid ultrasonographic characteristics, including fewer than three nodules, hypoechoic appearance, solid component, poorly defined margin, intranodular or peripheral-intranodular flow, and punctate calcification, can be used to predict the risk of thyroid cancer. In conclusion, our study suggests that preoperative serum TSH concentration, age, and ultrasonographic features can be used to predict the risk of malignancy in patients with NTD.

Evasion mechanisms to tumor necrosis factor α (TNF-α) of small cell lung carcinoma and non-small cell lung carcinoma cell lines: comparison with the erythroleukaemia K-562 cell line

Lung Cancer ◽  
2000 ◽  
Vol 27 (3) ◽  
pp. 177-187 ◽  
Author(s):  
José Sullivan López-González ◽  
Alejandro Hernández Garcı́a ◽  
Marı́a Isabel Ponce Noyola ◽  
Dolores Aguilar Cázares ◽  
Juan José Mandoki ◽  
...  
Keyword(s):  
Lung Carcinoma ◽  
Carcinoma Cell ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Carcinoma Cell Lines ◽  
Tnf Α ◽  
Factor Α ◽  
Necrosis Factor
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