LONG-ACTING THYROID STIMULATOR (LATS) IN TOXIC NODULAR GOITRE, TOXIC ADENOMA AND GRAVES' DISEASE

ABSTRACT The long-acting thyroid stimulator (LATS) was determined by means of the McKenzie assay in 68 patients with hyperthyroidism. The patients were classified into the following groups: Group 1. Graves' disease (diffuse goitre with hyperthyroidism with or without exophthalmos). Of the 35 patients tested 25 (71 %) were LATS-positive. Group 2. Graves' disease with nodular goitre (nodular goitre with hyperthyroidism and with exophthalmos). The present series includes only 4 such patients, although this combination is by no means uncommon in Finland. Two of the patients were LATS-positive. It has been suggested that these patients represent Graves' disease superimposed upon endemic nodular goitre. Group 3. Toxic nodular goitre. The present series comprises 23 patients with toxic multinodular goitre, of whom 10 (44%) were LATS-positive. In view of the findings on thyroid palpation, on thyroid scintigraphy, the presence or absence of LATS in the blood and some other criteria, these patients can be divided into two categories, (a) one with Graves' disease superimposed upon nodular goitre of endemic origin (see group 2) and (b) the other with classical multinodular goitre. Analysis of the scintigrams showed that in some patients (with either exophthalmos or LATS in the blood and nodular goitre = Graves' disease + nodular goitre) it was not the nodules that were activated but the paranodular tissue, a finding which gave a scintigram typical of patients with classical Graves' disease. In some LATS-positive cases, however, some nodules were also activated to the same extent. The difference between these scintigrams and those typical of classical multinodular goitre is particularly stressed since in Finland »toxic nodular goitre« is the prevailing type of hyperthyroidism. Group 4. Single toxic adenoma. Two patients out of 6 were LATS-positive. This is in contrast to the findings of other authors according to which LATS has never been found in patients with toxic adenoma. A hypothesis is put forward that in these patients subclinical Graves' disease (LATS in the blood) coincided with a primarily autonomous, hyperactive but not necessarily toxic single thyroid adenoma, which was more susceptible to the stimulating activity of LATS than the surrounding tissue.

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Incidence of hyperthyroidism in Stockholm, Sweden, 2003–2005.

Acta Endocrinologica ◽

10.1530/eje-07-0877 ◽

2008 ◽

Vol 158 (6) ◽

pp. 823-827 ◽

Cited By ~ 33

Author(s):

Mirna Abraham-Nordling ◽

Ove Törring ◽

Mikael Lantz ◽

Bengt Hallengren ◽

Hans Ohrling ◽

...

Keyword(s):

Nuclear Medicine ◽

Adult Population ◽

Graves Disease ◽

Multinodular Goitre ◽

Stockholm County ◽

Toxic Adenoma ◽

Nodular Goitre ◽

Total Incidence ◽

First Time ◽

Toxic Nodular Goitre

ObjectivesTo investigate the incidence of hyperthyroidism in Stockholm County, in those patients who were diagnosed with hyperthyroidism for the first time during the years 2003–2005.DesignAll new cases of hyperthyroidism ≥18 years of age were prospectively registered to calculate the total incidence of hyperthyroidism, as well as the incidence of the subgroups: Graves' disease (GD), toxic multinodular goitre and solitary toxic adenoma (STA). Eight specialized units/hospitals in Stockholm County participated in the registration. The participating physicians were all specialists in medical endocrinology, oncology, nuclear medicine or surgery.ResultsDuring a 3-year period, 1431 new patients of hyperthyroidism were diagnosed in a well-defined adult population (>18 years of age) of in average 1 457 036 inhabitants. This corresponds to a mean annual incidence of hyperthyroidism of 32.7/100 000. The incidence of GD was 24.5/100 000 per year, toxic nodular goitre was 3.3/100 000 per year and STA was 4.9/100 000 per year.ConclusionsThe total incidence of hyperthyroidism in Stockholm County was found to be 32.7/100 000 per year, of which 75% had GD. There were a higher percentage of smokers among the patients with hyperthyroidism compared with the overall population in Stockholm, but no difference in the frequency of smoking between patients with GD and toxic nodular goitre.

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Influence of antithyroid drugs on the outcome of radioiodine therapy in Graves’ disease and toxic nodular goitre

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-001-0673-5 ◽

2001 ◽

Vol 29 (1) ◽

pp. 160-161

Author(s):

O. Sabri ◽

M. Zimny ◽

U. Buell

Keyword(s):

Radioiodine Therapy ◽

Antithyroid Drugs ◽

Graves Disease ◽

Nodular Goitre ◽

Toxic Nodular Goitre

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The influence of non-radioactive iodine (127I) on the outcome of radioiodine (131I) therapy in patients with Graves’ disease and toxic nodular goitre

Nuclear Medicine Review ◽

10.5603/nmr.2011.0003 ◽

2011 ◽

Vol 14 (1) ◽

pp. 9-15 ◽

Cited By ~ 2

Author(s):

Franciszek Rogowski ◽

Saeid Abdelrazek ◽

Piotr Szumowski ◽

Anna Zonenberg ◽

Adam Parfienczyk ◽

...

Keyword(s):

Radioactive Iodine ◽

131I Therapy ◽

Graves Disease ◽

Nodular Goitre ◽

Toxic Nodular Goitre

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Antithyroid drugs as a factor influencing the outcome of radioiodine therapy in Graves' disease and toxic nodular goitre?

European Journal of Nuclear Medicine ◽

10.1007/s002590100565 ◽

2001 ◽

Vol 28 (9) ◽

pp. 1360-1364 ◽

Cited By ~ 21

Author(s):

C. Körber ◽

P. Schneider ◽

N. Körber-Hafner ◽

H. Hänscheid ◽

C. Reiners

Keyword(s):

Radioiodine Therapy ◽

Antithyroid Drugs ◽

Graves Disease ◽

Nodular Goitre ◽

Toxic Nodular Goitre

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Kinetics of the iodide trapping mechanism in normal and pathological human thyroid slices

Acta Endocrinologica ◽

10.1530/acta.0.1030034 ◽

1983 ◽

Vol 103 (1) ◽

pp. 34-39 ◽

Cited By ~ 10

Author(s):

Bernardo Ernesto Gluzman ◽

Hugo Niepomniszcze

Keyword(s):

Human Thyroid ◽

Toxic Adenoma ◽

Nodular Goitre ◽

Iodide Transport ◽

Trapping Mechanism ◽

Normal Human ◽

Kinetics Of ◽

And Diffusion ◽

Toxic Nodular Goitre ◽

Maximal Capacity

Abstract. Kinetics of the iodide trapping mechanism in thyroid slices was studied in human and animal tissues. Slices were incubated with several medium iodide concentrations, ranging from 5 × 10−6 m to 2 × 10−4 m, in order to calculate in the steady state the following kinetic parameters of the iodide transport: Km, maximal capacity (C) and diffusion factor (D). Results indicated that the Km was similar in magnitude (10−5 m) in all cases where trapping activity was present, while maximal capacity (C) values showed significant differences between those pathologies in which trapping activity was hyperstimulated (dishormonogenetic goitre, Graves' disease, toxic adenoma) and those where thyroid tissues presented focal or total alterations on its structure (non-toxic nodular goitre, Hashimoto's thyroiditis, thyroid cancer) or where thyroid tissues were not sufficiently stimulated by TSH (extranodular tissue of toxic adenoma). 'Warm' nodules were not significantly different from normal human thyroid. These results suggest that the scattered trapping values observed in the different thyroid pathologies correspond to quantitative differences between them rather than to qualitative alterations in the thyroid iodide pump.

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Appearance of thyroid stimulating antibody and Graves' disease after radioiodine therapy for toxic nodular goitre

Clinical Endocrinology ◽

10.1111/j.1365-2265.1994.tb02516.x ◽

1994 ◽

Vol 40 (6) ◽

pp. 803-806 ◽

Cited By ~ 51

Author(s):

Luca Chiovato ◽

Ferruccio Santini ◽

Paolo Vitti ◽

Giovanna Bendinelli ◽

Aldo Pinchera

Keyword(s):

Radioiodine Therapy ◽

Graves Disease ◽

Nodular Goitre ◽

Thyroid Stimulating Antibody ◽

Toxic Nodular Goitre

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LONG ACTING THYROID STIMULATOR (LATS) AND IODO-AMINO ACIDS IN LOCALIZED PRETIBIAL MYXOEDEMA

Acta Endocrinologica ◽

10.1530/acta.0.0590409 ◽

1968 ◽

Vol 59 (3) ◽

pp. 409-416 ◽

Cited By ~ 2

Author(s):

Sven-Mårten Samuelsson ◽

Ivar Werner

Keyword(s):

Amino Acids ◽

High Titre ◽

Graves Disease ◽

Nodular Goitre ◽

The Third ◽

Serum Titre ◽

Long Acting ◽

Pretibial Myxoedema

ABSTRACT Three patients with so-called localized pretibial myxoedema were studied. The serum titre of LATS activity and the contents of iodo-amino acids were determined. One patient who simultaneously developed a diffuse toxic goitre and pretibial myxoedema showed a high titre of LATS. The second patient who developed pretibial myxoedema showed no LATS activity. This patient probably had a recurrence of Graves' disease in a nodular goitre. The third patient who developed pretibial myxoedema a few years after thyroidectomy for diffuse toxic goitre possibly had a low titre of LATS. The serum contents of iodo-amino acids were increased in cases 1 and 2. The analysis was unsuccessful in case 3. The significance of the findings is briefly discussed. It is concluded that the development of pretibial myxoedema is not correlated with the occurrence of LATS.

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Thyroid autoimmunity in hyperprolactinaemic disorders

Acta Endocrinologica ◽

10.1530/acta.0.1040035 ◽

1983 ◽

Vol 104 (1) ◽

pp. 35-41 ◽

Cited By ~ 43

Author(s):

C. Ferrari ◽

M. Boghen ◽

A. Paracchi ◽

P. Rampini ◽

F. Raiteri ◽

...

Keyword(s):

Thyroid Function ◽

Thyroid Autoimmunity ◽

Empty Sella ◽

Primary Hypothyroidism ◽

Graves Disease ◽

Toxic Adenoma ◽

Central Hypothyroidism ◽

Nodular Goitre ◽

The One ◽

Tsh Levels

Abstract. Circulating thyroglobulin antibodies (TgAb) and microsomal antibodies (MsAb) and thyroid function (total and free T4 and T3, TSH basal and after TRH) have been evaluated in 92 hyperprolactinaemic patients (82 females and 10 males; 9 with macroprolactinoma, 22 with microprolactinoma, 4 with acromegaly, 5 with organic lesions of the hypothalamus, 2 with empty sella, 2 with idiopathic hypopituitarism, 2 with primary hypothyroidism, and 46 with idiopathic hyperprolactinaemia). Thyroid function was normal in all cases except 3 with hypothalamic disease and central hypothyroidism, the 2 patients with primary hypothyroidism and 2 with thyrotoxicosis (one due to Graves' disease and one to autonomous thyroid adenoma). High titres of TgAb (≥1/1250) and/or MsAb (≥ 1/1600) were found in the subject with Graves' disease, in one acromegalic, in the 2 primary hypothyroids, and in 12 women with either adenomatous or idiopathic hyperprolactinaemia; low titres of one or both antibodies were found in 9 other euthyroid women and in the one with toxic adenoma. In a control population of 185 subjects studied with the same methods, the prevalence of TgAb and/or MsAb positive (low titres) was 3.3% in females and 2.5% in males. Diffuse thyroid hyperplasia was clinically detectable in 12 euthyroid women and in the one with Graves' disease; 3 others had been previously operated for nodular goitre with histological evidence of Hashimoto's thyroiditis (2 cases) or for a cold nodule; a single thyroid nodule was present in the woman with toxic adenoma and in one euthyroid woman. Most of these subjects also had circulating TgAb and/or MsAb, and a few had increased TSH secretion. No significant differences were found in mean thyroid hormone and TSH levels between euthyroid hyperprolactinaemic subjects and healthy controls, but TRH-stimulated TSH levels were significantly higher in thyroid antibodies positive than negative subjects. These data, in agreement with a few previous reports, suggest that autoimmune thyroid disorders (especially asymptomatic autoimmune thyroiditis) occur in hyperprolactinaemic women with a prevalence far exceeding that observed in many surveys in the general population.

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