Hypothyroidism following subacute thyroiditis

1982 ◽  
Vol 101 (3) ◽  
pp. 348-353 ◽  
Author(s):  
Matti J. Tikkanen ◽  
B.-A. Lamberg
Keyword(s):  
Characteristic Feature ◽  
Acute Phase ◽  
Autoimmune Thyroiditis ◽  
Subclinical Hypothyroidism ◽  
Subacute Thyroiditis ◽  
Overt Hypothyroidism ◽  
Thyroid Antibodies ◽  
Cytological Evidence ◽  
Transient Rise

Abstract. The occurrence of permanent overt or subclinical hypothyroidism following subacute thyroiditis (SAT) was studied in 32 patients during 0.75–13 years (mean 4.2 years) of follow-up. Permanent hypothyroidism developed in 2 patients in whom a characteristic feature was persistence of circulating thyroid antibodies in high titres from the onset of SAT indicating the presence of autoimmune thyroiditis. One also showed cytological evidence of autoimmune thyroiditis. In another patient subclinical hypothyroidism demonstrated by an exaggerated TSH-response to TRH, persisted after hemithyroidectomy during the acute phase. In addition, transient overt hypothyroidism developed immediately after the acute phase in 3, and subclinical hypothyroidism in 2 patients. Apart from the 2 patients with evidence of autoimmune thyroiditis, circulating thyroid antibodies were found in 15 others. The titres were usually low and disappeared in most cases after a transient rise. It is concluded that permanent hypothyroidism is likely to develop after SAT only in the presence of autoimmune thyroiditis or after thyroid surgery.

Thyroiditis de Quervain

2013 ◽  
Vol 52 (04) ◽  
pp. 137-140 ◽  
Author(s):  
R. Klett ◽  
S. Braun ◽  
M. Zimny ◽  
S. Schenke
Keyword(s):  
Predictive Factors ◽  
Hormone Replacement ◽  
Thyroid Volume ◽  
Subacute Thyroiditis ◽  
Overt Hypothyroidism ◽  
Morphological Parameters ◽  
De Quervain ◽  
Overt Hyperthyroidism

SummaryBackground: Subacute thyroiditis is a usually self-limiting disease of the thyroid. However, approximately 0.5–15% of the patients require permanent thyroxine substitution. Aim was to determine predictive factors for the necessity of long-term hormone-replacement (LTH). Patients, methods: We retrospectively reviewed the records of 72 patients with subacute thyroiditis. Morphological and serological parameters as well as type of therapy were tested as predictive factors of consecutive hypothyroidism. Results: Mean age was 49 ± 11 years, f/m-ratio was 4.5 : 1. Thyroid pain and signs of hyperthyroidism were leading symptoms. Initial subclinical or overt hyperthyroidism was found in 20% and 37%, respectively. Within six months after onset 15% and 1.3% of the patients developed subclinical or overt hypothyroidism, respectively. At latest follow-up 26% were classified as liable to LTH. At onset the thyroid was enlarged in 64%, and at latest follow-up in 8.3%, with a significant reduction of the thyroid volume after three months. At the endpoint the thyroid volume was less in patients in the LTH group compared with the non-LTH group (41.7% vs. 57.2% of sex-adjusted upper norm, p = 0.041). Characteristic ultrasonographic features occurred in 74% of the patients in both lobes. Serological and morphological parameters as well as type of therapy were not related with the need of LTH. Conclusions: In this study the proportion of patients who received LTH was 26%. At the endpoint these patients had a lower thyroid volume compared with euthyroid patients. No predictive factors for LTH were found.

scholarly journals Prospective evaluation of autoimmune and non-autoimmune subclinical hypothyroidism in Down syndrome children

2020 ◽  
Vol 182 (4) ◽  
pp. 385-392 ◽  
Author(s):  
Giorgia Pepe ◽  
Domenico Corica ◽  
Luisa De Sanctis ◽  
Mariacarolina Salerno ◽  
Maria Felicia Faienza ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Subclinical Hypothyroidism ◽  
Heart Defects ◽  
Thyroid Autoimmunity ◽  
Overt Hypothyroidism ◽  
Sh Group ◽  
History Of ◽  
Group A ◽  
Group B

Objective To evaluate the prevalence and natural course of autoimmune and non-autoimmune subclinical hypothyroidism (SH) in Down syndrome (DS) children and adolescents. Design Prospective multicenter study. Methods For the study, 101 DS patients with SH (TSH 5–10 mIU/L; FT4 12–22 pmol/L), aged 2–17 years at SH diagnosis were enrolled. Annual monitoring of TSH, FT4, BMI, height, and L-thyroxine dose was recorded for 5 years. Thyroid autoimmunity was tested at diagnosis and at the end of follow-up. Results Thirty-seven out of 101 patients displayed autoantibody positivity (group A); the remaining 64 were classified as non-autoimmune SH (group B). Group A was characterized by higher median age at SH diagnosis and by more frequent family history of thyroid disease (6.6 vs 4.7 years, P = 0.001; 32.4% vs 7.8%, P = 0.001 respectively), whereas congenital heart defects were more common in group B (65.6% vs 43.2%, P = 0.028). Gender, median BMI (SDS), height (SDS), FT4, and TSH were similar in both groups. At the end of follow-up: 35.1% of group A patients developed overt hypothyroidism (OH) vs 17.2% of group B (P = 0.041); 31.25% of group B vs 10.8% of group A became biochemically euthyroid (P = 0.02); and 37.8% of group A vs 51.5% of group B still had SH condition (P = 0.183). Logistic regression suggested autoimmunity (OR = 3.2) and baseline TSH values (OR = 1.13) as predictive factors of the evolution from SH to OH. Conclusions In DS children, non-autoimmune SH showed higher prevalence and earlier onset. The risk of thyroid function deterioration over time seems to be influenced by thyroid autoimmunity and higher baseline TSH values.

Can Anti-Thyroid Antibodies Influence the Outcome of Primary Chronic Immune Thrombocytopenia in Children?

2020 ◽  
Vol 20 (3) ◽  
pp. 351-355 ◽  
Author(s):  
Paola Giordano ◽  
Maurizio Delvecchio ◽  
Giuseppe Lassandro ◽  
Federica Valente ◽  
Valentina Palladino ◽  
...  
Keyword(s):  
Autoimmune Thyroiditis ◽  
Immune Thrombocytopenia ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Clinical Signs ◽  
Thyroid Antibodies ◽  
Chronic Itp ◽  
Immune Mediated

Background: Immune thrombocytopenia (ITP) is an acquired immune mediated disorder characterized by isolated thrombocytopenia. Pediatric ITP patients can develop autoantibodies such as anti-thyroglobulin (TG) and anti-thyroperoxidase (TPO), even in the absence of clinical signs of autoimmune disease. Objective: The purpose of this article is to provide a review about: 1) the prevalence of positivity of anti-thyroid antibodies (TPO and TG) in pediatric patients with chronic ITP; 2) the role of autoimmune thyroiditis on the outcome of chronic ITP. Method: The authors individually completed a review of the literature for this article. Retrospective and prospective clinical studies with pediatric cohorts were considered. Results: From the analysis of data, we found 4 papers which included studies only on pediatric population, and which corresponded to selected criteria. Pediatric ITP patients have been shown to have a statistically significant prevalence of anti-thyroid antibodies over healthy controls (11.6-36% versus 1.2-1.3%). No correlation has been found between the platelet count and the prevalence of positive anti-thyroid antibodies at any time of the follow up. Conclusion: The results of our bibliographic research demonstrated that: a) pediatric patients with chronic ITP tend to have a statistically significant prevalence of anti-thyroid antibodies positivity respect to general pediatric population; b) there are no clear data about the role of autoimmune thyroiditis as prognostic factor for chronic course of ITP in pediatric age.

Thyroid evaluation of children and adolescents with Williams syndrome in Zhejiang Province

2017 ◽  
Vol 30 (12) ◽  
Author(s):  
Wei-Jun Chen ◽  
Chai Ji ◽  
Dan Yao ◽  
Zheng-Yan Zhao
Keyword(s):  
Children And Adolescents ◽  
Thyroid Function ◽  
Williams Syndrome ◽  
Subclinical Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Zhejiang Province ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Thyroid Antibodies ◽  
Free Triiodothyronine

AbstractBackground:The objective of the study was to describe the prevalence of abnormal thyroid function and volume in children and adolescents with Williams syndrome (WS) in Zhejiang Province, China.Methods:Thyroid function, including thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and thyroid antibodies (thyroid peroxidase and thyroglobulin) were measured in 83 patients with WS, aged 0.2–16.5 years. Twenty-three patients were followed for an average of 1.7 years (0.4–4.1), and multiple TSH determinations were considered. Thyroid ultrasonography was performed on 49 patients.Results:One patient was diagnosed with overt hypothyroidism, and 23 patients (27%) had subclinical hypothyroidism (SH). Thyroid antibodies were absent in all patients. In five age groups (0–1 years, 1–3 years, 3–6 years, 6–9 years, 9–18 years), the prevalence of patients with subclinical hypothyroidism was 25%, 28.5%, 44.4%, 16.7% and 4.7%, respectively. Through ultrasound examination, 21 patients (42%) were observed to have thyroid hypoplasia (TH), and there were no cases of thyroid haemiagenesis. The incidence rate of TH increased with age, rising from 20% in the youngest group to 66% in the oldest.Conclusions:SH and TH is common in children and adolescents with WS. Yearly evaluation of thyroid must be performed in all patients in this population, regardless of the result of the neonatal screening. Age under 6 years and existing thyroid abnormalities are risk factors for developing SH, and a shorter follow-up interval is needed for screening in these individuals, SH is often self-limiting, and clinicians should be alert to overt hypothyroidism.

scholarly journals Hemogram parameters in the patients with subacute thyroiditis

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Hasret Cengiz ◽  
Ceyhun Varım ◽  
Taner Demirci ◽  
Sedat Cetin
Keyword(s):  
Thyroid Function ◽  
Acute Phase ◽  
Subacute Thyroiditis ◽  
Thyroid Function Tests ◽  
Operating Characteristics ◽  
Acute Phase Reactants ◽  
Lymphocyte Ratio ◽  
Function Tests ◽  
Subacute Granulomatous Thyroiditis

Background & Objective: Subacute Granulomatous Thyroiditis (De Quervain’s Thyroiditis) is an acute painful inflammatory disease of the thyroid. We aimed to investigate easily accessible and cheap hemogram based parameters of Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) in the follow up of inflammatory thyroid disease. Methods: Patients admitted to Sakarya University Education and Research Hospital Endocrinology and Metabolism Outpatient Clinic and diagnosed as Subacute Granulomatous Thyroiditis between May 2017 and November 2018 were included in the study. Hemogram, thyroid function tests and acute phase values ​​of these patients were recorded and compared with the values ​​after treatment and disease recovery. On the sixth month, thyroid function tests were repeated and the rate of permanent hypothyroidism was screened. The relationships between initial hemogram parameters and acute phase reactants were evaluated. Results: Total 71 patients were included in our study. 60 (84.5%) were female and 11 (15.5%) were male. The F/M ratio was found to be 6/1. Mean age was 43 ± 9.95 years. Receiver Operating Characteristics (ROC) Curve Analysis was performed and values for Area Under the Curve (AUC) for NLR and PLR, respectively, were 0.739 (95% CI 0.657-0.820 p<0.0001) and 0.772 (95% CI 0.694-0.850 p<0.0001), which are significant and associated with disease activity. However, the AUC for MPV parameter was: 0.578 (95% CI 0.484-0.672 P: 0.10) and was not significant. The cut off values defined as 2.4 (80% sensitivity and 51% specificity) for NLR and 146.84 (83% sensitivity and 54% specificity) for PLR for the acute phase of the disease. In the Correlation Analysis, NLR and PLR values ​​were significantly correlated with ESR and CRP parameters, which are the most commonly used acute phase reactants. Conclusion: According to the present study, we believe that the NLR and PLR parameters will be of benefit in the follow-up the disease, accurately demonstrate the inflammatory load in the acute phase of the disease, and correlate with the common acute phase reactants. doi: https://doi.org/10.12669/pjms.36.2.1063 How to cite this:Cengiz H, Varim C, Demirci T, Cetin S. Hemogram parameters in the patients with subacute thyroiditis. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1063 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Transient high thyroid stimulating hormone and hypothyroidism incidence during follow up of subclinical hypothyroidism

2021 ◽  
Vol 55 (4) ◽  
pp. 204-214
Author(s):  
Munir Abu-Helalah ◽  
Hussam Ahmad Alshraideh ◽  
Sameeh Abdulkareem Al-Sarayreh ◽  
AbdelFattah Al-Hader
Keyword(s):  
Subclinical Hypothyroidism ◽  
Screening Program ◽  
Thyroid Stimulating Hormone ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
High Prevalence ◽  
Levothyroxine Replacement ◽  
Stimulating Hormone

Abstract Objectives. Given the high prevalence of subclinical hypothyroidism (SCH), defined as high thyroid stimulating hormone (TSH) and normal free thyroxine (FT4), and uncertainty on treatment, one of the major challenges in clinical practice is whether to initiate the treatment for SCH or to keep the patients under surveillance. There is no published study that has identified predictors of short-term changes in thyroid status amongst patients with mild elevation of TSH (4.5–10 mIU/L). Subjects and Results. A cohort study was conducted on patients with SCH detected through a general population screening program, who were followed for six months. This project identified factors predicting progression to hypothyroid status, persistent SCH and transient cases. A total of 656 participants joined the study (431 controls and 225 were patients with SCH). A part of participants (12.2%) developed biochemical hypothyroidism during the follow-up, while 73.8% of the subjects became euthyroid and the remained ones (13.4%) stayed in the SCH status. The incidence of overt hypothyroidism for participants with TSH above 6.9 mIU/L was 36.7%, with incidence of 42.3% for females. Anti-thyroid peroxidase antibodies (TPO) positivity is an important predictor of development of hypothyroidism; however, it could be also positive due to transient thyroiditis. Conclusions. It can be concluded that females with TSH above 6.9 mIU/L, particularly those with free triiodothyronine (FT3) and FT4 in the lower half of the reference range, are more likely to develop biochemical hypothyroidism. Therefore, it is recommended to give them a trial of levothyroxine replacement. It is also recommended to repeat TSH after six months for male subjects and participants with baseline TSH equal or less than 6.9 mIU/L.

Thyroid Dysfunction States and Incident Cardiovascular Events: The Tehran Thyroid Study

2017 ◽  
Vol 50 (01) ◽  
pp. 37-43 ◽  
Author(s):  
Maryam Tohidi ◽  
Arash Derakhshan ◽  
Samaneh Akbarpour ◽  
Atieh Amouzegar ◽  
Ladan Mehran ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Middle Eastern ◽  
Thyroid Stimulating Hormone ◽  
Overt Hypothyroidism ◽  
Subclinical Hyperthyroidism ◽  
Significant Difference ◽  
Middle Eastern Population

AbstractThe objective of the study was to investigate the relation of different thyroid function states with the incidence of cardiovascular disease (CVD)/coronary heart disease (CHD) among a Middle-Eastern population with a high incidence of CVD/CHD. A total of 3975 participants entered the study (43.6% men). According to their thyroid stimulating hormone (TSH) and free thyroxin (FT4) levels, the participants were categorized into 5 groups: euthyroid, subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism, and overt hyperthyroidism. Multivariable Cox proportional hazard models were used to assess the relation of different thyroid function states with incident CVD/CHD, with euthyroid state as reference. The mean age (SD) of the participants was 46.5 (12.0) years. At baseline, no significant difference was observed in the frequency of prevalent CVD cases (n=201) between all groups. No significant interaction was found between prevalent CVD and different thyroid function states with outcomes, hence, we did not exclude participants with prevalent CVD from data analysis. A total of 400 CVD events (358 CHD cases) during a median follow-up of 11.2 years (inter-quartile range: 1.96) occurred. During the follow-up, even in the age and sex adjusted model, no association was observed between different states of thyroid dysfunction and incidence of CVD/CHD. The multivariable hazard ratios (95% CI) of subclinical hypothyroidism, hypothyroidism, subclinical hyperthyroidism, and hyperthyroidism for CVD events were 1.21 (0.77–1.88), 0.76 (0.33–1.69), 0.81 (0.46–1.41) and 1.48 (0.70–3.16), respectively. Both at baseline and during follow-up, no relation was observed between different states of thyroid function with prevalence and incidence of CVD/CHD.

scholarly journals Hormonal Defects Are Common during Puumala Hantavirus Infection and Associate with Disease Severity and Biomarkers of Altered Haemostasis

Viruses ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1818
Author(s):  
Marlene Tarvainen ◽  
Satu Mäkelä ◽  
Outi Laine ◽  
Ilkka Pörsti ◽  
Sari Risku ◽  
...  
Keyword(s):  
Acute Phase ◽  
Severe Disease ◽  
Kidney Injury ◽  
Hantavirus Infection ◽  
Overt Hypothyroidism ◽  
Severe Thrombocytopenia ◽  
Normal Thyroid Function ◽  
Coagulation Abnormalities ◽  
The One

Central and peripheral hormone deficiencies have been documented during and after acute hantavirus infection. Thrombocytopenia and coagulation abnormalities are common findings in haemorrhagic fever with renal syndrome (HFRS). The associations between coagulation and hormonal abnormalities in HFRS have not been studied yet. Forty-two patients diagnosed with Puumala virus (PUUV) infection were examined during the acute phase and on a follow-up visit approximately one month later. Hormonal defects were common during acute PUUV infection. Overt (clinical) hypogonadism was identified in 80% of the men and approximately 20% of the patients had overt hypothyroidism. At the one-month follow-up visit, six patients had central hormone deficits. Acute peripheral hormone deficits associated with a more severe acute kidney injury (AKI), longer hospital stay and more severe thrombocytopenia. Half of the patients with bleeding symptoms had also peripheral hormonal deficiencies. Patients with free thyroxine levels below the reference range had higher D-dimer level than patients with normal thyroid function, but no thromboembolic events occurred. Acute phase hormonal abnormalities associate with severe disease and altered haemostasis in PUUV infection.

scholarly journals Carotid Intima-Media Thickness in Patients with Subclinical Hypothyroidism: A Prospective Controlled Study

2021 ◽  
Vol 44 (4) ◽  
pp. E39-45
Author(s):  
Anally J. Soto-García ◽  
Guillermo Elizondo-Riojas ◽  
Rene Rodriguez-Gutiérrez ◽  
Leonardo G. Mancillas-Adame ◽  
J. Gerardo González-González
Keyword(s):  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Subclinical Hypothyroidism ◽  
Common Carotid Artery ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Controlled Study ◽  
Overt Hypothyroidism ◽  
Media Thickness

Purpose: The association between subclinical hypothyroidism (SCH) and cardiovascular risk, particularly with a TSH <10 µIU/ml, remains controversial. The objective of our study was to assess the association between SCH and cardiovascular risk through carotid intima-media thickness, and alternatively, to evaluate its change after treatment with levothyroxine. Methods: A total of 54 individuals were included in the study: 18 with SCH; 18 with overt hypothyroidism (OH); and 18 healthy controls (HC). The carotid intima-media thickness was measured in each group. In SCH, follow-up was performed at three and six months after the start of levothyroxine treatment. Results: The mean age of the total population at baseline was 35.8 years. The median TSH in SCH was 6.15 µIU/ml. The carotid intima-media thickness (mean and standard deviation) was greater in SCH in comparison to the HC group: right common carotid artery (RCCA), 0.486 ± 0.106 mm and 0.413 ± 0.075 mm in SCH and HC, respectively, p=0.01 and left common carotid artery (LCCA), 0.511 ± 0.144 mm and 0.427 mm ± 0.090 in SCH and HC, respectively, p=0.03). In patients with SCH, there was a decrease in the carotid intima-media thickness after treatment with levothyroxine (RCCA and LCCA, p <0.05 at three and six months). Conclusions: There was an association between increased carotid intima-media thickness in patients with SCH in comparison with HC, even with a TSH <10 µIU/ml. The increase was reversed with levothyroxine therapy. The association of this increased thickness with important cardiovascular outcomes remains uncertain and should be evaluated in future studies.

Efficacy of homeopathic intervention in subclinical hypothyroidism with or without autoimmune thyroiditis in children: an exploratory randomized control study

Homeopathy ◽  
2014 ◽  
Vol 103 (04) ◽  
pp. 224-231
Author(s):  
Vijay K. Chauhan ◽  
Archana Narang ◽  
Raman K. Marwaha ◽  
Saurav Arora ◽  
Latika Nagpal ◽  
...  
Keyword(s):  
Autoimmune Thyroiditis ◽  
Subclinical Hypothyroidism ◽  
Control Group ◽  
Overt Hypothyroidism ◽  
Normal Limits ◽  
Group A ◽  
Clinical Dilemma ◽  
Group B ◽  
And Control ◽  
Serum Tsh

Introduction: The decision to treat subclinical hypothyroidism (SCH) with or without autoimmune thyroiditis (AIT) in children, presents a clinical dilemma. This study was undertaken to evaluate the efficacy of individualized homeopathy in these cases.Methods: The study is an exploratory, randomized, placebo controlled, single blind trial. Out of 5059 school children (06–18 years) screened for thyroid disorders, 537 children had SCH/AIT and 194 consented to participate. Based on primary outcome measures (TSH and/or antiTPOab) three major groups were formed: Group A – SCH + AIT (n = 38; high TSH with antiTPOab+), Group B – AIT (n = 47; normal TSH with antiTPOab+) and Group C – SCH (n = 109; only high TSH) and were further randomized to two subgroups-verum and control. Individualized homeopathy or identical placebo was given to respective subgroup. 162 patients completed 18 months of study.Results: Baseline characteristics were similar in all the subgroups. The post treatment serum TSH (Group A and C) returned to normal limits in 85.94% of verum and 64.29% of controls (p < 0.006), while serum AntiTPOab titers (Group A and B) returned within normal limits in 70.27%of verum and 27.02%controls (p < 0.05). Eight children (10.5%) progressed to overt hypothyroidism (OH) from control group.Conclusion: A statistically significant decline in serum TSH values and antiTPOab titers indicates that the homeopathic intervention has not only the potential to treat SCH with or without antiTPOab but may also prevent progression to OH.

Sign in / Sign up

Export Citation Format

Share Document