scholarly journals Increased serum CXCL10 in Graves’ disease or autoimmune thyroiditis is not associated with hyper- or hypothyroidism per se, but is specifically sustained by the autoimmune, inflammatory process

2006 ◽  
Vol 154 (5) ◽  
pp. 651-658 ◽  
Author(s):  
Alessandro Antonelli ◽  
Poupak Fallahi ◽  
Mario Rotondi ◽  
Silvia Martina Ferrari ◽  
Paola Romagnani ◽  
...  
Keyword(s):  
Autoimmune Thyroiditis ◽  
Nodular Goiter ◽  
Interferon Γ ◽  
Graves Disease ◽  
List Type ◽  
Longitudinal Assessment ◽  
Toxic Nodular Goiter ◽  
Autoimmune Conditions ◽  
Per Se ◽  
Recombinant Tsh

Objective: Serum CXCL10 (an interferon-γ-inducible chemokine) levels (sCXCL10) are increased in several autoimmune conditions, including Graves’ disease (GD) and autoimmune thyroiditis (AT). Longitudinal assessment of sCXCL10 in autoimmune hypo- or hyperthyroidism has not yet been performed. Design and methods: We longitudinally assayed sCXCL10 in the following groups: thirty-three GD and 11 toxic nodular goiter (TNG) patients when hyperthyroid (Hyper) and when reaching euthyroidism (Eu) with methimazole therapy (MMI) sixty-six AT (33 hypothyroid (Hypo) and 33 Eu) patients, basally and after reaching EU (for Hypo) with levothyroxine (L-T4) therapy twenty-two patients with thyroid cancer (CA) under L-T4-suppressive treatment, of whom 11 were re-evaluated after L-T4 withdrawal for diagnostic WBS, and 11 after recombinant TSH (rhTSH) administration thirty-three healthy controls. Results: At initial evaluation, Hyper GD and AT (Hypo significantly higher than Eu) showed significantly higher mean sCXCL10 than all other groups. MMI treatment led to a significant decrease in sCXCL10 only in GD (not in TNG), while restoration of Eu, in Hypo AT, by L-T4 was not accompanied by significant sCXCL10 change. CA showed sCXCL10 comparable to controls, and both Hypo after L-T4 withdrawal and rhTSH injection had no effect on sCXCL10. Conclusions: Treatment of Hyper leads to a significant decrease in sCXCL10 only in GD, and this probably depends upon the MMI immunomodulatory effect. L-T4 correction of Hypo is not accompanied by significant modification of sCXCL10 in AT. Increased sCXCL10 is not associated with Hyper or Hypo per se, but is specifically sustained by the autoimmune inflammatory event occurring in both GD and AT.

scholarly journals Radioiodine Treatment of Hyperthyroidism—Prognostic Factors for Outcome

2001 ◽  
Vol 86 (8) ◽  
pp. 3611-3617 ◽  
Author(s):  
Amit Allahabadia ◽  
Jacquie Daykin ◽  
Michael C. Sheppard ◽  
Stephen C. L. Gough ◽  
Jayne A. Franklyn
Keyword(s):  
Single Dose ◽  
Prognostic Factors ◽  
Nodular Goiter ◽  
Fixed Dose ◽  
Graves Disease ◽  
Cure Rate ◽  
Toxic Nodular Goiter ◽  
Large Size ◽  
Lower Cure Rate ◽  
Lower Cure

There is little consensus regarding the most appropriate dose regimen for radioiodine (131I) in the treatment of hyperthyroidism. We audited 813 consecutive hyperthyroid patients treated with radioiodine to compare the efficacy of 2 fixed-dose regimens used within our center (185 megabequerels, 370 megabequerels) and to explore factors that may predict outcome. Patients were categorized into 3 diagnostic groups: Graves’ disease, toxic nodular goiter, and hyperthyroidism of indeterminate etiology. Cure after a single dose of 131I was investigated and defined as euthyroid off all treatment for 6 months or T4 replacement for biochemical hypothyroidism in all groups. As expected, patients given a single dose of 370 megabequerels had a higher cure rate than those given 185 megabequerels, (84.6% vs. 66.6%, P < 0.0001) but an increase in hypothyroidism incidence at 1 yr (60.8% vs. 41.3%, P < 0.0001). There was no difference in cure rate between the groups with Graves’ disease and those with toxic nodular goiter (69.5% vs. 71.4%; P, not significant), but Graves’ patients had a higher incidence of hypothyroidism (54.5% vs. 31.7%, P< 0.0001). Males had a lower cure rate than females (67.6% vs. 76.7%, P = 0.02), whereas younger patients (<40 yr) had a lower cure rate than patients over 40 yr old (68.9% vs. 79.3%, P < 0.001). Patients with more severe hyperthyroidism (P < 0.0001) and with goiters of medium or large size (P < 0.0001) were less likely to be cured after a single dose of 131I. The use of antithyroid drugs, during a period 2 wk before or after 131I, resulted in a significant reduction in cure rate in patients given 185 megabequerels 131I (P < 0.01) but not 370 megabequerels. Logistic regression analysis showed dose, gender, goiters of medium or large size, and severity of hyperthyroidism to be significant independent prognostic factors for cure after a single dose of 131I. We have demonstrated that a single fixed dose of 370 megabequerels 131I is highly effective in curing toxic nodular hyperthyroidism as well as Graves’ hyperthyroidism. Because male patients and those with more severe hyperthyroidism and medium or large-sized goiters are less likely to respond to a single dose of radioiodine, we suggest that the value of higher fixed initial doses of radioiodine should be evaluated in these patient categories with lower cure rates.

SEQUENTIAL OCCURRENCE OF TOXIC NODULAR GOITER FOLLOWED BY GRAVES' DISEASE

1998 ◽  
Vol 4 (3) ◽  
pp. 150-152 ◽  
Author(s):  
Alan H. Seplowitz, MD ◽  
Beth Ann Ditkoff, MD ◽  
Anastasios D. Papadopoulos, MD ◽  
Paul Lo Gerfo, MD
Keyword(s):  
Nodular Goiter ◽  
Graves Disease ◽  
Toxic Nodular Goiter

HLA antigens in Greek patients with thyrotoxicosis (Graves’ disease and toxic nodular goiter)

1984 ◽  
Vol 7 (4) ◽  
pp. 283-286 ◽  
Author(s):  
C. Papasteriades ◽  
Maria N. Alevizaki-Harhalaki ◽  
J. Economidou ◽  
D. G. Ikkos
Keyword(s):  
Hla Antigens ◽  
Nodular Goiter ◽  
Graves Disease ◽  
Toxic Nodular Goiter

Graves' Disease and Toxic Nodular Goiter Are Both Associated with Increased Mortality But Differ with Respect to the Cause of Death: A Danish Population-Based Register Study

Thyroid ◽  
2013 ◽  
Vol 23 (4) ◽  
pp. 408-413 ◽  
Author(s):  
Frans Brandt ◽  
Marianne Thvilum ◽  
Dorthe Almind ◽  
Kaare Christensen ◽  
Anders Green ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Nodular Goiter ◽  
Population Based ◽  
Register Study ◽  
Graves Disease ◽  
Danish Population ◽  
Toxic Nodular Goiter

scholarly journals Serum thyroglobulin level in newly detected thyrotoxicosis and its role in differential diagnosis of thyrotoxicosis

2021 ◽  
Vol 8 (3) ◽  
pp. 433
Author(s):  
Mohammad Omar Faruque ◽  
A. B. M. Kamrul-Hasan ◽  
M. Ahamedul Kabir ◽  
Rehnuma Nasim ◽  
Mohammad Jahangir Alam ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Elevated Serum ◽  
Nodular Goiter ◽  
Tertiary Hospital ◽  
Subacute Thyroiditis ◽  
Graves Disease ◽  
Serum Thyroglobulin ◽  
Cross Sectional ◽  
Toxic Nodular Goiter ◽  
Thyroglobulin Level

Background: Elevated serum thyroglobulin (Tg) level is commonly observed in various forms of thyrotoxicosis; the levels vary according to different etiologies. This study aimed at identifying the value of serum Tg level in the differential diagnosis of common etiologies of thyrotoxicosis.  Methods: This cross-sectional study was conducted at the endocrine outpatient department of a tertiary hospital in Bangladesh from March 2015 to May 2017. In this study, 200 subjects with newly detected untreated thyrotoxicosis were evaluated. Serum Tg was assayed by chemiluminescent immunometric assay.  Results: Serum Tg level was raised in 48% of subjects. Subjects aged ≥40 years, and those having a family history of thyroid disorders had relatively higher thyroglobulin levels. The frequency of subjects with an elevated Tg was highest in subacute thyroiditis (89.5%) followed by toxic nodular goiter (77.3%) and Graves’ disease (32.9%); the difference in the frequencies was statistically significant (p<0.001). Median Tg was highest in the subjects with subacute thyroiditis (132.6 ng/ml) followed by toxic nodular goiter (99.55 ng/ml); those with Graves’ disease had the lowest Tg level (12.5 ng/ml); the differences in median Tg levels across the three groups were also statistically significant (p<0.001).  Conclusions: Serum thyroglobulin level may be useful for the etiological diagnosis of thyrotoxicosis.

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