scholarly journals Behavioral assessment of children and adolescents with Graves’ disease: A prospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248937
Author(s):  
Sherifa Ahmed Hamed ◽  
Fadia Ahmed Attiah ◽  
Samir Kamal Abdulhamid ◽  
Mohamed Fawzy
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Children And Adolescents ◽  
Behavioral Problems ◽  
Child Behavior Checklist ◽  
Linear Regression Analysis ◽  
Age At Onset ◽  
Graves Disease ◽  
Healthy Children ◽  
Active Disease

Previous studies have identified frequent comorbid neuropsychiatric disorders and conditions in adults with thyrotoxicosis. These studies are scarce or even lacking in pediatric population. This work aimed to study the behavior of children and adolescents with Graves’ disease (GD). This study included 35 children with GD (boys = 15; girls = 25; mean age: 11.45±1.50yrs) and 40 healthy children (boys = 20; girls = 20; mean age: 12.54±1.62yrs). Behavior was assessed using Child Behavior Checklist (CBCL). Children with GD were assessed during periods of thyroid hormone elevation (active disease) and normalized thyroid hormones (with anti-thyroid drugs or ATDs). Compared to healthy children, patients during periods of thyroid hormone elevation (74.29%) and normalized thyroid hormones (31.43%) had higher frequencies of behavioral abnormalities and scorings of total CBCL scale (P = 0.01; P = 0.04, respectively) and its subscales’ [Anxious/Depressed (P = 0.02; P = 0.04), Withdrawn/Depressed (P = 0.03; P = 0.04) and Somatic Complaints (P = 0.03; P = 0.127) and Social (P = 0.01; P = 0.225), Thought (P = 0.01; P = 0.128) and Attention (P = 0.01; P = 0.01) problems], indicating internalizing and externalizing problems. The majority of patients had at least two different behavioral problems. Marked improvement was found during period of normalized thyroid hormones (P = 0.001). Correlation analyses showed significant associations between total CBCL scoring and age at onset (P = 0.01; P = 0.001) and lower concentrations of thyroid stimulating hormone (TSH) (P = 0.001; P = 0.04) and higher concentrations of free thyroxine (fT4) (P = 0.01; P = 0.02), triiodothyronine (fT3) (P = 0.01; P = 0.03) and thyrotropin receptor antibodies (TRAbs) (P = 0.001; P = 0.01) during periods of thyroid hormone elevation and normalized thyroid hormones, respectively. Multiple linear regression analysis showed that "at presentation" lower concentrations of TSH (P = 0.001; P = 0.03) and higher concentrations of fT4 (P = 0.001, P = 0.01), fT3 (P = 0.01; P = 0.06) and TRAbs (P = 0.001; P = 0.001) were predictors of behavioral problems during periods of active disease and normalized thyroid hormones. We conclude that GD is associated with higher frequencies and severities of anxiety, depression and inattention during periods of thyroid hormone elevation as well as normalized thyroid hormones with ATDs. Therefore, early diagnosis and optimizing management are required to improve children’s social life.

Autoantibodies to thyroxin and triiodothyronine in the immunoglobulin G fraction of serum.

1988 ◽  
Vol 34 (12) ◽  
pp. 2561-2562 ◽  
Author(s):  
L Li Calzi ◽  
S Benvenga ◽  
S Battiato ◽  
F Santini ◽  
F Trimarchi
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Human Serum ◽  
Immunoglobulin G ◽  
Subacute Thyroiditis ◽  
Total Serum ◽  
Graves Disease ◽  
Carrier Proteins ◽  
Weak Binding ◽  
Idiopathic Myxedema

Abstract Thyroid hormone antibodies (THAbs)--i.e., antibodies to thyroxin (T4) and triiodothyronine (T3)--are detected rarely in human serum, where they are searched for, possibly because of a quantitatively minimal interaction between thyroid hormones (the haptens) and serum IgGs (the antibodies). The weak binding could result from these facts: (a) there are already six physiological carrier proteins for thyroid hormones; (b) THAbs usually account for a very small fraction of the total serum IgGs; (c) THAbs may have--as reported in the literature--a relatively low affinity. To ascertain whether THAbs could pass undetected in serum, we measured antibodies to T3 and T4 in both the serum and the corresponding IgG fraction of six normal persons and 45 patients with various thyroid diseases (Graves' disease, idiopathic myxedema, Hashimoto's thyroiditis, subacute thyroiditis, tumors), using radioimmunoprecipitation. The prevalence of antibodies to T4 was 0/51 in both the sera and the IgG fractions; the prevalence of antibodies to T3 was 1/51 in both materials. Because all of the sera that tested THAb negative were confirmed to be so in the THAb assay of the IgG fraction, we conclude that the prevalence of serum THAbs is not underestimated and that autoimmunization against thyroid hormones is really a rare phenomenon.

scholarly journals Dendritic cells produce interleukin-12 in hyperthyroid mice

1999 ◽  
pp. 625-629 ◽  
Author(s):  
M Tamura ◽  
B Matsuura ◽  
S Miyauchi ◽  
M Onji
Keyword(s):  
Dendritic Cells ◽  
Thyroid Hormone ◽  
Mouse Model ◽  
Thyroid Hormones ◽  
Normal Subjects ◽  
Interleukin 12 ◽  
Graves Disease ◽  
Hyperthyroid State ◽  
Thyroid Glands

We previously reported that serum interleukin-12 (IL-12) levels were significantly increased in patients with hyperthyroid Graves' disease and in normal subjects after administration of thyroid hormone. In the present study, we investigated which cells produce IL-12 and the interactions between IL-12 and thyroid hormones, using a hyperthyroid mouse model. Thyroid hormones induced IL-12 production, and IL-12 was mainly produced by dendritic cells outside the thyroid glands in a hyperthyroid state.

scholarly journals Age-Related Changes in Auditory Nogo-N200 Latency in Medication-Naïve Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

2020 ◽  
Vol 17 (7) ◽  
pp. 702-709
Author(s):  
Yeon Jung Lee ◽  
Mi Young Jeong ◽  
Seoyoung Park ◽  
Jung Ho Kim ◽  
Ji-Sun Kim ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Child Behavior Checklist ◽  
Rating Scale ◽  
Event Related Potential ◽  
Healthy Children ◽  
Hyperactivity Disorder ◽  
Age Related ◽  
Age Related Changes

Objective Event-related potential (ERP) changes with brain development in healthy children and adolescents. However, few studies have focused on age-related changes in the N200 and P300 components among individuals with attention-deficit/hyperactivity disorder (ADHD). Therefore, this study aimed to assess age-related differences in the auditory nogo-N200 components in individuals with ADHD.Methods We enrolled 46 participants with auditory nogo-N200 and nogo-P300 components. We assessed ADHD symptoms using the Advanced Test of Attention (ATA) and Korean ADHD Rating Scale-IV (K-ARS-IV). Moreover, we assessed emotional and behavioral problems using the Korean Child Behavior Checklist (K-CBCL). Further, we measured auditory ERPs.Results There were no differences with respect to sex or ATA, K-ARS-IV, and K-CBCL scores between the groups. With a 1-year increase in age, the nogo-N200 latency at Fz and Cz decreased by 6.08 ms and 4.88 ms, respectively; this result was statistically significant in multivariable linear regression adjusted by sex and dominant hand.Conclusion Our findings revealed age-related changes in nogo-N200 latency at the Fz and Cz electrodes in individuals with ADHD. Future studies should perform comparisons with healthy controls to determine whether auditory nogo-N200 can be used to evaluate the developmental level in individuals with ADHD.

scholarly journals Thyroid arterial embolization for the treatment of hyperthyroidism in a patient with thyrotoxic crisis

2009 ◽  
Vol 32 (1) ◽  
pp. 78 ◽  
Author(s):  
Wei Zhao ◽  
Bu-Lang Gao ◽  
Gen-Fa Yi ◽  
Hui-Ying Yang ◽  
Hong Li
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Young Woman ◽  
Effective Means ◽  
Arterial Embolization ◽  
Graves Disease ◽  
Thyrotoxic Crisis ◽  
History Of ◽  
Serum Thyroid Hormones

Purpose: We report a case of hyperthyroidism in a young woman caused by Graves’ disease that was successfully treated with thyroid arterial embolization. Clinical details: A 35 year-old woman with a history of thyrotoxic crises was admitted after the last thyroid crisis. Thyroid arterial embolization was used to treat the hyperthyroidism after it had been controlled. Immediately after embolization, the enlarged thyroid gland shrank and vascular murmurs disappeared. Serum thyroid hormones increased on day 3 following embolization but decreased gradually. Thyroid hormone returned to normal 2 months after embolization and remained normal at three years. Conclusion: Thyroid arterial embolization is an effective means to treat refractory hyperthyroidism.

Hyperthyroidism

1994 ◽  
Vol 15 (11) ◽  
pp. 417-421
Author(s):  
Irene N. Sills
Keyword(s):  
Thyroid Hormone ◽  
Children And Adolescents ◽  
Radioactive Iodine ◽  
Clinical Findings ◽  
Autoimmune Response ◽  
Graves Disease ◽  
Thyroid Antibodies ◽  
Thyroid Hormone Levels ◽  
Therapeutic Alternatives ◽  
Physical Findings

Hyperthyroidism in children and adolescents usually is due to Graves disease. The diagnosis may not be recognized promptly, and clinical findings initially may be attributed incorrectly to cardiac or psychological disorders. Once suspected, history and physical findings and measurements of TSH level, thyroid hormone levels, and thyroid antibodies make the diagnosis apparent. Treatment varies among endocrinologists and includes antithyroid medication, surgery, and radioactive iodine. Much is being learned about the autoimmune response that causes the disease, and the hope is that therapies directed at altering the autoimmune abnormalities ultimately will offer the best therapeutic alternatives.

scholarly journals Associations between Inadequate Parenting Practices and Behavioral Problems in Children and Adolescents with Attention Deficit Hyperactivity Disorder

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Maria Cristina Triguero Veloz Teixeira ◽  
Regina Luisa de Freitas Marino ◽  
Luiz Renato Rodrigues Carreiro
Keyword(s):  
Children And Adolescents ◽  
Parenting Style ◽  
Behavioral Problems ◽  
Parenting Practices ◽  
Child Behavior Checklist ◽  
Spearman Correlation ◽  
Educational Strategies ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Age Range

Children and adolescents with ADHD present behaviors such as impulsiveness, inattention, and difficulties with personal organization that represent an overload for parents. Moreover, it also increases their level of stress and leads them to resort to inadequate educational strategies. The present study verifies associations between inadequate parenting practices and behavioral profiles of children and adolescents with ADHD. The sample was composed of 22 children with ADHD (age range 6–16 years) and their mothers. Spearman correlation analyses were made with the scores of Parenting Style Inventory (PSI) and Child Behavior Checklist for ages 6–18 (CBCL/6–18). Results indicate statistically significant associations between behavioral problems and the use of punishment practices and negligence. When assessing a child with ADHD, it is important to verify the predominant types of parenting practices that can influence both immediate interventions and the prognosis of the disorder.

Clinical assessment and systemic manifestations of thyrotoxicosis

2011 ◽  
pp. 441-452
Author(s):  
Claudio Marcocci ◽  
Filomena Cetani ◽  
Aldo Pinchera
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Clinical Manifestations ◽  
Clinical Syndrome ◽  
Graves Disease ◽  
Free Triiodothyronine ◽  
Excessive Secretion ◽  
Almost All ◽  
Symptoms And Signs

The term thyrotoxicosis refers to the clinical syndrome that results when the serum concentrations of free thyroxine, free triiodothyronine, or both, are high. The term hyperthyroidism is used to mean sustained increases in thyroid hormone biosynthesis and secretion by the thyroid gland; Graves’ disease is the most common example of this. Occasionally, thyrotoxicosis may be due to other causes such as destructive thyroiditis, excessive ingestion of thyroid hormones, or excessive secretion of thyroid hormones from ectopic sites; in these cases there is no overproduction of hormone by thyrocytes and, strictly speaking, no hyperthyroidism. The various causes of thyrotoxicosis are listed in Chapter 3.3.5. The clinical features depend on the severity and the duration of the disease, the age of the patient, the presence or absence of extrathyroidal manifestations, and the specific disorder producing the thyrotoxicosis. Older patients have fewer symptoms and signs of sympathetic activation, such as tremor, hyperactivity, and anxiety, and more symptoms and signs of cardiovascular dysfunction, such as atrial fibrillation and dyspnoea. Rarely a patient with ‘apathetic’ hyperthyroidism will lack almost all of the usual clinical manifestations of thyrotoxicosis (1). Almost all organ systems in the body are affected by thyroid hormone excess, and the high levels of circulating thyroid hormones are responsible for most of the systemic effects observed in these patients (Table 3.3.1.1). However, some of the signs and symptoms prominent in Graves’ disease reflect extrathyroidal immunological processes rather than the excessive levels of thyroid hormones produced by the thyroid gland (Table 3.3.1.2).

Age Moderates the Impact of TRAbs on Thyroid Hormones and Hepatic Function in Patients with Graves’ Disease

2021 ◽  
Vol 53 (07) ◽  
pp. 453-460
Author(s):  
Kai Guo ◽  
Hongwei Ling ◽  
Xiaoyan Zhou ◽  
Changjiang Ying
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Hepatic Function ◽  
Graves Disease ◽  
Newly Diagnosed ◽  
Younger Patients ◽  
Hormone Levels ◽  
Thyroid Hormone Levels ◽  
Antibody Levels ◽  
The Impact

AbstractThyrotropin receptor antibodies (TRAbs) play a significant role in the course of hepatic dysfunction (HDF) in patients with Graves’ disease (GD). However, few studies have considered the factors that influence the relationships among TRAbs, thyroid hormone levels, and hepatic function in subjects with newly diagnosed GD. Here we investigated the associations of TRAbs with thyroid hormones and hepatic function and assessed potential factors that can influence these associations among patients with GD. A total of 368 patients newly diagnosed with GD were collected in this cross-sectional study. Patients who had received antithyroid drugs, radioactive iodine, or surgery were excluded. Levels of TRAbs and thyroid hormones and hepatic function were recorded. Linear and binary logistic regression analysis models were applied to investigate associations among these variables after adjusting for confounding characteristics. There was a significant difference in TRAbs indices between the HDF and normal hepatic function groups (p <0.05). After adjusting for confounders, the relationship between TRAbs and thyroid hormones was nonlinear, showing a curve with an initial positive slope and a subsequent flattening (p <0.05). Higher TRAbs were associated with HDF [odds ratio (OR) 1.036, 95% confidence interval (CI) 1.018–1.053 per 1-IU/l increase]. These associations were modified by age, but not by gender, smoking status, Graves’ orbitopathy, thyroid-peroxidase antibody levels, or thyroglobulin antibody levels. In younger patients, increasing TRAbs were correlated with higher thyroid hormones and HDF (OR 1.034, 95% CI 1.017–1.052) per1-IU/l increase). In older patients, TRAbs were not correlated with thyroid hormones or HDF (OR 1.024, 95% CI 0.993–1.056) per 1-IU/l increase. Age can affect the impact of TRAbs on thyroid hormone levels and hepatic function in GD. TRAb measurement can have good predictive value in younger patients.

scholarly journals Comparison of Intra-Operative Vital Sign Changes during Total Thyroidectomy in Patients with Controlled and Uncontrolled Graves’ Disease

2018 ◽  
Vol 7 (12) ◽  
pp. 566
Author(s):  
Hyeong Yu ◽  
In Bae ◽  
Su-jin Kim ◽  
Young Chai ◽  
Jae Moon ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Total Thyroidectomy ◽  
Vital Sign ◽  
Operation Time ◽  
Thyroid Storm ◽  
Graves Disease ◽  
Free T4 ◽  
Sign Changes ◽  
The Mean

Thyroid storm (TS) is a life-threatening emergency endocrine condition. Thyroid hormones should be normalized before thyroidectomy is performed in patients with Graves’ disease. However, thyroid hormone levels are inevitably high in patients undergoing surgery. This study analyzed differences in vital sign changes during thyroidectomy between patients with controlled and uncontrolled Graves’ disease and assessed thyroid hormone cutoffs for TS. Preoperative levels of the thyroid hormones free T4 (FT4), T3, and thyroid stimulating hormone (TSH) were retrospectively analyzed in patients who underwent total thyroidectomy for Graves’ disease. Patients were divided into those with uncontrolled Graves’ (UG) disease, defined as preoperative TSH <0.3 µIU/mL and FT4 >1.7 ng/dL, those with controlled Graves’ (CG) disease, those with extremely uncontrolled Graves’ (EUG) disease, defined as TSH <0.3 µIU/mL and FT4 >3.4 ng/dL, and finally, those without EUG (non-EUG). The 29 patients with Graves’ disease included 12 with CG group and 17 with UG. FT4 and T3 concentrations were significantly higher in the UG group. There were no differences in vital sign and anesthetic agent. These 29 patients could also be divided into those with (n = 4) and without EUG (n = 25). The mean age was lower (21.5 vs. 40.9 years, p < 0.001) and the mean operation time was shorter (121.4 vs. 208.8 min, p = 0.003) in the EUG group. Requirements for anesthetic agents were greater in the EUG group. Mean FT4 concentration in the EUG group was 3.8 ng/dL, and there were no changes in vital signs during surgery. Vital sign change during thyroid surgery was not observed in patients with uncontrolled Graves’ disease up to the twice upper normal limit of T4 level.

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