Hormonal contraception in women with diffuse nontoxic goiter and autoimmune thyroiditis

2013 ◽  
Vol 62 (5) ◽  
pp. 45-51
Author(s):  
Galina Petrovna Pologoyko

The article considers the influence of combined oral contraceptives on size and function of thyroid gland in women of reproductive age. We examined 215 women, taking low dose and microdose combined oral contraceptives for 12 months as monotherapy or in combination with potassium iodide. The first group consisted of 75 women with diffuse nontoxic goiter, second – of 70 women with autoimmune thyroiditis. Control group consisted of 70 women without pathology of thyroid gland. Prior to therapy with combined contraceptives and after 12 months of treatment, we determined serum levels of free triiodothyronine, free thyroxine, and thyrotropin releasing hormone, antibodies to thyroid peroxidase and antibodies to thyroglobulin (ELISA) and performed sonography of thyroid gland. Results of our study suggest that combined oral contraceptives may increase the size of thyroid gland among women with diffuse nontoxic goiter without changing its function. In women with autoimmune thyroiditis, application of combined oral contraceptive significantly decreases blood levels of autoantibodies to thyroid peroxidase and thyroglobulin. Application of combined oral contraceptives in healthy women doesn’t influence the size and function of thyroid gland.

2013 ◽  
Vol 62 (6) ◽  
pp. 40-46
Author(s):  
Galina Petrovna Pologoyko ◽  
Maria Igorivna Yarmolinskaya ◽  
Tatyana Mihajlovna Lekareva

The article represents influence of gestagen desogestrel on size and function of thyroid gland in women of reproductive age. Into the study we included 70 women who were prescribed gestagen desogestrel in a daily dose of 75 mg for a period of 12 months. All the patients were devided into two groups. The first group consisted of 20 women with diffuse nontoxic goiter, the second consisted of 30 women with autoimmune thyroiditis. Control group consisted of 20 women without thyroid gland pathology. Prior to therapy with desogestrel and after 12 month of treatment, serum levels of free triiodothyronine, free thyroxine and thyrotropin releasing hormone, thyroperoxidase antibodies were determined and thyroid gland sonigraphy was performed in all the patients. Obtained data show that gestagen desogestrel doesn’t influence the size and function of thyroid gland in healthy women and in patients with diffuse non-toxic goiter. In women with autoimmune thyroiditis implication of desogestrel significantly decreases blood levels of thyroperoxidase autoantibodies.


Author(s):  
А. V. Shidlovskyi ◽  
V. А. Shidlovskyi ◽  
M. I. Sheremet ◽  
A. V. Lazaruk ◽  
O. H. Netsiuk ◽  
...  

Aim — to study the possibility of determining the indications for choice of the extent of surgery in patients with unilateral nodular goiteragainst the background of autoimmune thyroiditis(AIT) with compression syndrome and prognosis for the long-term results of surgical treatment.Materials and methods. The analysis has been performed for the long-term results of hemithyroidectomy in 101 women aged from 23 to 72, patients with unilateral nodular goiteragainst the AITbackground with compression syndrome. It has been established what exactly indications to the surgery,includingvolume of the gland, echostructure variant, blood levels of thyroid stimulating hormone(TSH), free thyroxine and triiodothyronine, thyroid peroxidase(TPO) antibodies, apoptosis and proliferation indicators, provided satisfactory and unsatisfactory treatment results.Results. Based on the results of investigation in 3 years after hemithyroidectomy, no violations of the functional state of the thyroid glandwere revealed in 75 patients; in them ultrasoundinvestigation of parenchyma of the remaining lobe of the gland showed that pre-operativeAITsigns did not progress or progressed without hypothyroidism and changes of the variant of ultrasound picture (satisfactory result). In 26 patients an increase in the volume of the remaining part of the thyroid gland and progression of the autoimmune process with the development of hypothyroidism were established (unsatisfactory result).One can expect the satisfactory result of hemithyroidectomy in the treatment of patients with unilateral nodular goiteragainst the AIT backgroundwith compression syndrome in cases where at the time of surgery the volume of the lobe does not exceed 10 cm3, its echostructure corresponds to hypoechoic and heterogeneous and pseudomicronodular variants, TSH is not higher than 2.85 IU/L, levels of free thyroxine and triiodothyronine are not lower than 16.7 and 5.3 pmol/l, respectively, TPO antibodies level is not higher than 150 IU/ml.Conclusions. One of the possible options for surgical treatment of patients with unilateral nodular goiteragainst the AIT background with compression syndrome may be hemithyroidectomy with preserved hormonal function of the gland and structural changes in the parenchyma in the lobe, which remains at the level of hypoechoic and heterogeneous or pseudomicrous variants. Hemithyroidectomy is contraindicated in cases of pseudolarge nodular and severe variants of parenchyma echostructure of the thyroid gland.


2021 ◽  
Vol 7 (9) ◽  
pp. 354-359
Author(s):  
N. Mazhitova ◽  
R. Kalmatov ◽  
G. Abdykaimova ◽  
Zh. Abdullaeva

Research relevance: Autoimmune pathology of the thyroid gland is one of the urgent problems of modern endocrinology, and this is due to the lack of clarity of pathogenetic mechanisms and the lack of objective and reliable diagnostic methods, including immunological. The mechanisms of autoimmune thyroid diseases have not yet been fully elucidated, although about a hundred years have passed since the first description of autoimmune thyroiditis. According to world statistics, thyroid disease occurs in almost 30% of the world’s population. According to the latest data, in Kyrgyzstan, they are found in 10–30 percent of the population. Objectives of the study: Clinical and pathological substantiation of ways to optimize the diagnosis of autoimmune thyroiditis in residents of the southern region of the Kyrgyz Republic. Research methods: clinical and immunological (determination of the titer of antibodies to thyroid peroxidase (AT TPO); cytokines); static method; laboratory (content of free thyroxine (T4); thyroid-stimulating hormone (TSH); free triiodothyronine (T3); hematological, biochemical blood test; ultrasound of the thyroid gland. Conclusions: Lack of iodine causes irreparable harm to absolutely every person: child and adult, men and women. Iodine deficiency is most common in women who are in late pregnancy.


GYNECOLOGY ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 27-30
Author(s):  
Elena N. Andreeva ◽  
Olga R. Grigoryan ◽  
Yulia S. Absatarova ◽  
Irina S. Yarovaya ◽  
Robert K. Mikheev

The reproductive potential of a woman depends on indicators of the ovarian reserve, such as the anti-Muller hormone (AMH) and the number of antral follicles (NAF). Autoimmune diseases have a significant effect on fertility and contribute to the development of premature ovarian failure. Aim.To evaluate the parameters of the ovarian reserve in patients with type 1 diabetes mellitus, carriers of antibodies to the thyroid gland in a state of euthyroidism and compare them with similar parameters in healthy women. Materials and methods.In the first block of the study, the level of AMH, follicle-stimulating hormone, luteinizing hormone, NAF was studied among 224 women with diabetes and 230 healthy women in the control group. In block II, the level of the above hormonal indices was studied in 35 carriers of antithyroid antibodies in the state of euthyroidism and 35 healthy women. Results.In patients with type 1 diabetes, the level of AMH, NAF was statistically significantly lower when compared with the control group. Among carriers of antithyroid antibodies and healthy women, no difference in AMH and NAF was found. Conclusion.The autoimmune processes accompanying diabetes are more influenced by the ovarian reserve indices than autoimmune aggression to the tissues of the thyroid gland.


GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 101-107
Author(s):  
Vera N. Prilepskaya ◽  
Lana L. Bostandzhian

Since the first pill, there has been a significant evolution of hormonal contraception: low- and micro-dose drugs have appeared, drugs with components as close as possible to endogenous hormones have been developed, new dosage regimens and routes of contraceptive administration have been created. Modern combined oral contraceptives are not only used to prevent unwanted pregnancies, but are also widely used to treat a number of gynecological and non-gynecological diseases. In recent years, two new combined oral contraceptives with folate supplementation have been developed. The main purpose of adding folate to contraceptives is the prevention of fetal malformations, which is ensured by an increase in the level of folate in the body of women of reproductive age against the background of contraception and after its withdrawal.


Viruses ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 689 ◽  
Author(s):  
Alina Sultanova ◽  
Maksims Cistjakovs ◽  
Liba Sokolovska ◽  
Katerina Todorova ◽  
Egils Cunskis ◽  
...  

The aim of this study was to investigate the role of human herpesvirus-6 (HHV-6) in autoimmune thyroiditis (AIT) development. We examined the possible involvement of HHV-6 gene expression encoding immunomodulating proteins U12 and U51 in AIT development and their role in the modulation of chemokine signaling. One hundred patients with autoimmune thyroiditis following thyroidectomy were enrolled in this study. Nested polymerase chain reaction (nPCR) was used to detect the HHV-6 sequence in DNA samples. Reverse transcription PCR (RT-PCR) with three different HHV-6 gene targets (U79/80, U51 and U12) was to detect active infection markers. HHV-6 load was identified using a commercial real-time PCR kit. Immunohistochemistry was performed to investigate the expression of the HHV-6 antigen and RANTES (Regulated upon Activation, Normal T Cell Expressed and Secreted) in thyroid gland tissue. Different commercial immunosorbent assay kits were used for the detection of RANTES, IFNγ, IL-6, and TNFα levels in the AIT patient group and controls. We detected 98% presence of the HHV-6 genomic sequence in AIT patients’ thyroid gland tissues. Markers of active HHV-6 infection (HHV-6 U79/80, U12 and/or U51 mRNA) were predominant in AIT patients’ thyroid tissue samples in comparison with the control group (56% vs. 6%). Evidence from immunofluorescence microscopy showed that HHV-6 can persist in thyrocytes and can interact with RANTES. Visual confirmation of the intense immunofluorescence signal of RANTES detected in thyroid tissues could indicate high expression of this chemokine in the thyroid gland. On the other hand, immunosorbent assays showed very low RANTES levels in AIT patients’ peripheral plasma. These results indicate that RANTES level in AIT patients could be influenced by HHV-6 activation, which in turn may aid AIT development.


Author(s):  
Amita Sharma ◽  
Surabhi Porwal ◽  
Manoj Tyagi

Background: According to WHO 2009, 60-70% women use one of the method of contraception. 8.8% to 15.4% women use oral contraceptives. Objective of present study was to investigate the effect of oral contraceptives on androgen profile and tear film parameters in females within child bearing age.Methods: Present study involve 100 healthy women between 20-45 years, who presented in family planning clinic. Two groups were made according to the use of oral contraceptive pills. Study group consist of 50 women who were on OCPs (Oral contraception pills) and 50 as control group were not taking any hormonal contraceptives. Serum testosterone and DHEA levels of all subjects was done by Enzyme Immuno Assay on blood samples which were collected during 3th to 7th day of menstrual cycle. Quantitative test for tear secretion was done by Schirmer’s test. Stability of tear film was measured by Tear Breakup time (TBUT). Statistical analysis was done to determine the correlation between use of OCPs and androgen profile and tear film parameters.Results: Present results shows decreased androgen levels in women taking oral contraceptives as compared with age matched women who were not taking oral contraceptives. Tear secretion was significantly reduced in study group as indicated by decreased Schirmer’s test values in study group as compared to control group, the tear film stability was also significantly decreased in women taking oral contraceptives.Conclusions: Present study suggest that androgen profile decrease in women taking oral contraceptives. These results support that use of oral contraceptives may be an important etiological factor in pathogenesis of dry eye disease reproductive age group women.


2019 ◽  
Vol 51 (12) ◽  
pp. 792-797 ◽  
Author(s):  
Viktoria F. Koehler ◽  
Natalie Filmann ◽  
W. Alexander Mann

AbstractA lack of vitamin D seems to be related to autoimmune diseases including autoimmune thyroiditis (AIT). This study intends to determine the correlation between improvement of 25-hydroxyvitamin D [25(OH)D] levels and AIT in patients from an outpatient endocrine clinic in Frankfurt, Germany. This study included 933 patients with thyroid peroxidase antibodies (anti-TPO-Ab) ≥34 kIU/l, including most patients with clear AIT due to a concurrent sonographic evidence of reduced echogenicity. We performed clinical evaluation and laboratory analysis at five points in time within two years retrospectively. Due to a high dropout rate within the observation period, we excluded the last two time points from analysis. Data from 933 AIT patients revealed 89% having vitamin D deficiency or insufficiency [25(OH)D <75 nmol/l] with a median 25(OH)D level of 39.7 nmol/l. At baseline, a weak inverse correlation between 25(OH)D and anti-TPO-Ab was observed during winter (rs=–0.09, p=0.048*), but not during summer time (p>0.2). We discovered 58 patients having initially a 25(OH)D level < 75 nmol/l (median: 40.2 nmol/l), which improved over time to a 25(OH)D level ≥ 75 nmol/l (median: 83.2 nmol/l, p<0.0005***). Simultaneously, the median anti-TPO-Ab level showed a significant decrease of 25% from 245.8 to 181.3 kIU/l (p=0.036*). A significant reduction of the median anti-TPO-Ab level of 9% was also observed in the control group, which consisted of patients having constantly a 25(OH)D level <75 nmol/l. The result may suggest that in particular patients with 25(OH)D levels < 75 nmol/l benefit from an increase of 25(OH)D levels ≥ 75 nmol/l. Further prospective randomized controlled clinical trials are needed to finally evaluate if vitamin D has immunmodulatory effects in AIT.


2021 ◽  
Vol 93 (4) ◽  
pp. 369-375
Author(s):  
Anna R. Khachatryan ◽  
Goar J. Vardanyan ◽  
Garnik A. Avetisyan ◽  
Aram S. Chomoyan ◽  
Satenik E. Baghdasaryan ◽  
...  

Aim. To determine the features of visualization of papillar thyroid cancer (PTC) in presence of autoimmune thyroiditis (AIT) according to sonoelastography data. Materials and methods. 155 patients were examined (75 PTC, 30 AIT, 20 PTC in presence of AIT and 30 with diffuse parenchymal changes) and 30 patients of the control group. Among patients with PTC 68 (90.7%) were represented by female (mean age 46.713.12 years) and 7 (9.3%) by male (average age 48.14.05 years) patients, PTC in presence of AIT by 19 female (average age 46.916.98 years) and 1 male (22 years) patients. Ultrasound investigation was performed with devices Toshiba Aplio-400 and Toshiba Aplio-500 (Japan) by the standard method and using elastography. A surface transducer with a frequency of 1014 MHz was used. An analysis of the thyroid ultrasound image was performed in correspondence with TI-RADS. For a qualitative assessment of the elastographic picture of thyroid foci, the TsukubaUeno assessment visual standardized system was implemented. Results. According to the TI-RADS scale, most nodular formations are assigned to category 4. With TPC with an unchanged thyroid gland, category 4 was determined in 52 patients (69.3%), and with PR in presence of AIT 15 patients (75%). When determining the qualitative criteria for Tsukuba Ueno, the majority of tumors were assigned to types 3b and 4: cancers in presence of AIT 95% and cancers with no changes to thyroid gland 81.3%. Sonoelastographic criteria for thyroid parenchyma with AIT with a high degree of confidence are significantly higher than in the control group (p0.000). In a comparative analysis of thyroid sonoelastography in PTC with unchanged parenchyma and AIT, changes according to compression elastography are statistically unreliable. In shear wave elastography, sonoelastographic criteria for PTC are significantly higher in patients with AIT (p0.02 when measured in kPa, p0.01 when measured in m/s). Conclusion. Sonoelastography data can be used as additional criteria in the differential diagnosis of focal thyroid formations.


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