Treatment of diffuse toxic goiter with lithium electrophoresis

1986 ◽  
Vol 67 (5) ◽  
pp. 333-335
Author(s):  
N. M. Petrov
Keyword(s):  
Thyroid Gland ◽  
Thyroid Diseases ◽  
Antithyroid Therapy ◽  
Diffuse Goiter ◽  
Toxic Goiter

The purpose of this work was to clinically evaluate the efficacy of lithium electrophoresis in some thyroid diseases. We examined 28 patients with primary toxic diffuse goiter aged from 20 to 54 years (2 men and 26 women). Seventeen patients had mild thyrotoxicosis, nine had moderate, and two had severe thyrotoxicosis. Diffuse increase of thyroid gland of I-II degree was found in 22 patients, III - in 6 patients. thyrogenic ophthalmopathy of I-II degree was observed in 6 patients. Conservative antithyroid therapy was required in 23 patients, and 5 patients underwent strumulectomy.

Evolution of Autonomy in Idiopathic Non-Toxic Goiter, Evaluated by Regional Suppressibility of 99mTc-Uptake and TSH Response to TRH

1976 ◽  
Vol 15 (04) ◽  
pp. 197-200 ◽  
Author(s):  
O. J. Clemmensen ◽  
L. Hummer ◽  
H. Dige-Petersen
Keyword(s):  
Thyroid Gland ◽  
Gamma Camera ◽  
Nodular Goiter ◽  
Normal Range ◽  
Percent Change ◽  
Before And After ◽  
Diffuse Goiter ◽  
Functional Autonomy ◽  
Nodular Tissue ◽  
Toxic Goiter

SummarySeventeen euthyroid patients with non-toxic goiter were studied, 7 had diffuse goiters and 10 had nodular goiters. The TSH response to TRH and the 99mTc-uptake were measured before and after T3 suppression. The uptake, measured with a gamma camera, was calculated for the whole gland and for a maximum of 6 regions within the thyroid gland.The suppressibility of 99mTc-uptake (percent change of uptake) ranged from 0 to 95%, it was significantly greater in patients with diffuse than in those with nodular goiters, and was alike in nodular and inter-nodular tissue. The patients with diffuse goiter were significantly younger than those with nodular goiter. Abolished TSH response to TRH was seen in 2 patients with negative T3 suppression tests. In another 2 patients impaired TSH response was associated with impaired suppressibility. In 13 patients with normal TRH tests, the suppression of uptake was normal in 8 and subnormal in 5.The results suggest that nodularity and functional autonomy may develop in non-toxic goiters. In some of these goiters the mass of autonomous tissue may be large enough to cause negative TRH tests, probably indicating hypersecretion of thyroid hormones, although not necessarily above the normal range.

scholarly journals Epidemiology and results of surgical treatment of euthyroid and toxic goiter depending on the peculiarities of clinical course, tracheal compression and comorbidity

2020 ◽  
Vol 66 (1) ◽  
pp. 87-92
Author(s):  
Elena A. Ilyicheva ◽  
Gleb A. Bersenev ◽  
Valeriy N. Makhutov ◽  
Gennadiy Yu. Aldaranov ◽  
Eugene G. Grigoryev
Keyword(s):  
Pulmonary Hypertension ◽  
Surgical Treatment ◽  
Thyroid Gland ◽  
Multinodular Goiter ◽  
Thyroid Diseases ◽  
External Respiration ◽  
Tracheal Compression ◽  
Toxic Goiter ◽  
Endocrine Surgeon ◽  
Benign Thyroid

BACKGROUND: At the time of seeking medical help, some patients have nodular/multinodular goiter of large and gigantic sizes, which leads to compression of the neck organs. In the structure of benign diseases, neck compression is diagnosed in 10% of cases, and tracheal narrowing is found in 84% of patients in this group. It was experimentally established that narrowing of the trachea leads to the development of hypertension in the pulmonary circulation. Patients with nodular/multinodular goiter with compression of the neck organs belong to the age group of 50 years and older, the peculiarity of which is comorbidity of varying severity. Cardiopulmonary syndromes may mask compression of the organs of the neck by the thyroid gland. As a rule, patients come and/or go to a cardiologist, pulmonologist, gastroenterologist and other specialists, as a result of which the timelines for timely surgical treatment are missed. Often, patients are delivered to the endocrine surgeon urgently due to the development of asphyxiation. The symptoms of impaired external respiration and the initial manifestations of pulmonary hypertension, as a result of compression syndrome, preceding this condition are evaluated only retrospectively. AIMS: To study the frequency of tracheal compression and symptoms of chronic hypoxia in the structure of benign thyroid diseases requiring surgical treatment, as well as an assessment of the nature of comorbid pathology and the results of surgical treatment. METHODS: A retrospective analysis of the results of surgical treatment of benign thyroid diseases for the period from March to August 2019 was carried out (100 observations). RESULTS: Toxic goiter prevailed in the structure of benign thyroid diseases (74%). Tracheal compression was observed in 69% of cases. When trachea was compressed, arterial hypertension statistically significantly prevailed (2, p0.01). The appearance of wheezing on inhalation/exhalation and an increase in its frequency were detected when the trachea narrowed to the thyroid gland to 10 mm or less in 10 cases (10%) with a statistically significant prevalence of pulmonary hypertension (2, p0.01). Thyroidectomy prevailed in the structure of operations (80%). There was no statistically significant increase in surgical complications depending on the severity of tracheal compression, age, and concomitant pathology. There were no fatal outcomes. CONCLUSIONS: Surgical treatment of patients with benign thyroid diseases complicated by compression of the neck organs is also shown safely regardless of age and associated pathology.

scholarly journals HYGIENIC ASSESSMENT OF THE EFFECTS OF PESTICIDES APPLICATION ON CHILDREN POPULATION MORBIDITY WITH THYROID GLAND DISEASES

2019 ◽  
Vol 72 (2) ◽  
pp. 267-270 ◽  
Author(s):  
Anna M. Antonenko ◽  
Olena P. Vavrinevych ◽  
Maria M. Korshun ◽  
Sergii T. Omelchuk
Keyword(s):  
Thyroid Gland ◽  
Plant Protection ◽  
Scientific Information ◽  
Maximum Level ◽  
Plant Protection Products ◽  
Thyroid Diseases ◽  
Chemical Plant ◽  
Theoretical Research ◽  
Pesticide Application ◽  
Diffuse Goiter

Introduction: It is proved that some groups of fungicides and herbicides are capable of affecting the thyroid gland, provoking its growth, leading to a compensatory change in the activity of the hormones synthesis. Therefore, the presence of their residual amounts in plant may affect the level of thyroid gland pathology. The aim of the work was to analyze the influence of pesticide application on the Ukrainian child population morbidity with thyroid diseases in the period from 2001 to 2014. Materials and methods: The methods of empirical and theoretical research of scientific information, namely analysis, synthesis, induction, deduction and systematization, epidemiological, cartographic and statistical methods were used. Review: The maximum level of thyroid pathology was found in the northern, western and northwestern regions, where the diffuse goiter dominates in the morbidity and prevalence of thyroid diseases; minimal – in the southern, eastern and south-eastern regions. It was established that the highest volumes of application of chemical plant protection products in the period 2001-2013 took place in the southern and central regions of Ukraine, namely in Poltava, Vinnitsa, Kharkiv, Dnipropetrovsk, Khmelnytsky regions. Sufficiently high levels of pesticide application were in the Kyiv, Kherson regions, Zaporizhia, Kirovograd and Cherkasy regions. Conclusions: The probability of the active chemical plant protection products application effect on the level of thyroid cancer, various types of goiter, hypothyroidism, thyrotoxicosis and thyroiditis in the central and southern regions was determined. These are regions with well-developed agricultural production.

scholarly journals Evaluation of Total Thyroidectomy for Treatment of Benign Diseases of Thyroid Gland

2020 ◽  
Vol 8 (B) ◽  
pp. 166-170
Author(s):  
Risto Cholancheski ◽  
Natasha Tolevska ◽  
Ardit Qafjani ◽  
Ilir Vela ◽  
Borislav Kondov ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Laryngeal Nerve ◽  
Thyroid Diseases ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Laryngeal Nerve Palsy ◽  
Toxic Goiter ◽  
Benign Thyroid

BACKGROUND: The controversy of using total thyroidectomy (TT) in treatment of benign thyroid diseases still remains controversial over the rates of complication, mostly recurrence nerve palsy and hypocalcemia, compared to non-total thyroidectomies. The latest reports in this field of research showed that that the number of complications of TT is decreasing as the skills of surgeons increase. AIM: In this study, we reviewed 209 cases of total thyroidectomies for benign thyroid diseases where such surgery was indicated. The results were evaluated whether they support the previous reports that TT is save method of treatment of diffuse multinodular goiters, Graves’ disease thyroid adenomas with diffuse goiters and thyroiditis. METHODS: Two hundred and nine patients, 36 males and 173 females, medium age 47 (17–77) operated with TT between 2016 and 2018 were included in the evaluation study. We evaluated the: Diagnosis, indications for operation, pre-operative medication administration, laryngeal recurrent nerve palsy, hypocalcemia, hypoparathyroidism, and patohistology findings. The follow-up for hypocalcemia and laryngeal nerve palsy was performed 1 year postoperatively. RESULTS: The age of the patients was between 17 and 77 years, medium-range 47 years old. Of 209 patients, 173 (83%) were female and 36 (17%) male with a gender ratio of 1:4.8 males to females. Diagnoses before surgery were established as follows: Multinodular euthyroid goiter (MNEG) n = 106 (48.80%), multinodular toxic goiter n = 12 (5.74%), Graves’s disease n = 6 (2.87%), adenoma with multinodular goiter n = 73 (34.92%), and n = 16 (7.65%) patients with thyroiditis. Recurrence laryngeal nerve palsy (RLNP) occurred in 6 patients (2.87%), temporary within 3 months after the operation in 4 patients (1.92%) and permanent palsy within 6 months and more after an operation in 2 patients (0.95%). Voice hoarseness immediately and within 1 month after the operation was registered in 32 patients (15.3%). RLNP and hoarseness were registered mostly in patients with pre-operative problems, mostly with extra big MNEG. One of the permanent injuries of RLN was bilateral and all others were one sided. All patients were operated with normal pre-operative vocal cord movement findings. Post-operative hypocalcemia was registered in 35 patients (16.74%). Temporary nonsignificant hypocalcemia in 10 (4.78%), temporary significant hypocalcemia in 17 (8.13%), temporary severe hypocalcemia in 6 patients (2.87%), and permanent hypocalcemia in 2 patients (0.95%). CONCLUSION: Many studies have shown that the rate of complications is almost even for TT and NTT done for benign and malignant diseases of thyroid gland. Our data have shown that the risk of post-operative complications with TT is proportional to the number of complicated pre-operative findings of benign thyroid glands.

Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases

2000 ◽  
Vol 39 (05) ◽  
pp. 133-138 ◽  
Author(s):  
W. Dembowski ◽  
H.-J. Schroth ◽  
K. Klinger ◽  
Th. Rink
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Thyroid Volume ◽  
Nodular Goiter ◽  
Thyroid Diseases ◽  
Hashimoto's Thyroiditis ◽  
Graves Disease ◽  
Normal Range ◽  
Serum Thyroglobulin ◽  
Diffuse Goiter ◽  
Hyperthyroid Patients

Summary Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto’s thyroiditis and 30 hyperthyroid patients with Graves’ disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto’s thyroiditis showed slightly decreased Tg levels. In Graves’ disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range (< 30 ng/ml). Conclusion: Elevated Tg levels indicate a high probability of thyroid diseases, such as malignancy, autonomy or Graves’ disease. However, as low Tg concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases.

scholarly journals Thyrotoxicosis treatment with lithium corbanate. Cases reported

2021 ◽  
Vol 17 (3) ◽  
pp. 22-26
Author(s):  
I. A. Matsueva ◽  
A. B. Dalmatova ◽  
T. V. Andreychenko ◽  
E. N. Grineva
Keyword(s):  
Side Effects ◽  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Toxic Hepatitis ◽  
Lithium Carbonate ◽  
Graves Disease ◽  
Allergic Reactions ◽  
Low Doses ◽  
Short Course ◽  
Toxic Goiter

Treatment of thyrotoxicosis caused by Graves’ disease or multinodular toxic goiter, is not difficult, in most cases, since the prescription of thionamides allows to normalize the level of thyroid hormones quickly and safety. But in a number of cases this therapy might be associated with serious side effects (agranulocytosis, toxic hepatitis, cholestasis), severe allergic reactions and also individual intolerance on thionamides. In such cases lithium carbonate is used, especially in severe thyrotoxic syndrome. It is known, that lithium can accumulate in the thyroid gland at a concentration 3–4 times higher than in the plasma. Perhaps, lithium uses Na+/I- ions. It can inhibit the synthesis and secretion thyroid hormones of thyroid gland. The article presents the cases reported the use of lithium carbonate in thyrotoxicosis treatment before thyroidectomy. Administering low doses of carbonate lithium (900 mg/ per day) renders significant decrease or normalization of thyroid hormones concentration within 7–14 days, thus it let perform thyroidectomy on the patients. No side effects have been identified with such a short course of lithium carbonate treatment.

Thyroid Diseases

2019 ◽  
pp. 62-64
Author(s):  
Kevin B. Hoover
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Treatment Options ◽  
Normal Function ◽  
Thyroid Diseases ◽  
Hormone Levels ◽  
Musculoskeletal Manifestations ◽  
Hyperthyroid Patients ◽  
Serum Testing ◽  
Radioactive Iodine Ablation

Chapter 81 discusses thyroid diseases. Thyroid hormone is a regulator of normal physiology, including normal function of the musculoskeletal system. The most important causes of both elevated thyroid hormone levels (hyperthyroidism) and decreased hormone levels (hypothyroidism) are diseases of the thyroid gland. These are primarily diagnosed using serum testing and thyroid imaging. Muscle weakness is a common musculoskeletal complaint in both hyperthyroidism and hypothyroidism. In adults, osteoporosis is often evaluated in hyperthyroid patients using DXA, however, other musculoskeletal manifestations are often incidentally detected. Treatment options include radioactive iodine ablation of the thyroid gland, medical therapy, and surgery.

scholarly journals Effect of Single Dose of Radioiodine Therapy on Volume Reduction of Thyroid Gland in Hyperthyroidism

2019 ◽  
Vol 21 (2) ◽  
pp. 87-91
Author(s):  
Shamrukh Khan ◽  
Faridul Alam ◽  
Fatima Begum ◽  
Sadia Sultana ◽  
Zeenat Jabin ◽  
...  
Keyword(s):  
Single Dose ◽  
Thyroid Gland ◽  
Radioactive Iodine ◽  
Volume Reduction ◽  
Radioactive Iodine Therapy ◽  
Short Term ◽  
Hormone Levels ◽  
Toxic Goiter ◽  
Primary Hyperthyroidism ◽  
Hormone Assay

Introduction: Radioactive iodine therapy (RAIT) in patients with hyperthyroidism (HT) causes apoptosis of thyrocytes to bring about restoration of thyroid function. The aim of the study was to find the short term extent of reduction of thyroid gland volume (TGV) by non-invasive quantitative assessment using ultrasound imaging (USG). Patients and Methods: This prospective study was conducted on a group of patients who had received RAIT due to  primary hyperthyroidism at National Institute of Nuclear Medicine & Allied Sciences (NINMAS). Pre-therapy work up included hormone assay and baseline measurement of TGV by US before administration of  appropriate fixed dose RAIT. Short term follow-up with hormone assay and serial measurements of TGV on two occasions were done at three and six months following the RAIT. Observed temporal changes of parameters were analyzed using appropriate statistics. Results: Total 117 patients with primary hyperthyroidism had received RAIT with diagnosis of diffuse toxic goiter in 86 patients, toxic multinodular goiter in 21 cases and single toxic nodular goiter in 10 cases. There was a decline of mean TGV from the baseline level of 24 ml to 14 ml at three months followed by a further decline to 9.1 ml at six months. Thus the volume reduction of thyroid gland was calculated to be 42% at three months and 62% at six months. The volume reduction was observed to be in a correlative trend with the normalization of hormone levels. The proportion of patients who showed persistent hyperthyroidism till the study end point was 23%. Conclusion: Single dose of radioactive iodine therapy resulted in reduction of TGV up to 62% till six months after RAIT while 23% patients showed persistent hyperthyroidism. The correlative trend of volume reduction with normalization of hormone levels indicates potentiality of TGV to emerge as an adjunct to conventional assessment of treatment efficacy following RAIT.   Bangladesh J. Nuclear Med. 21(2): 87-91, July 2018

Primary Malignant Tumors of the Thyroid Gland. Histology, Age and Sex Distribution and Pathologic Correlations in 139 Cases

1983 ◽  
Vol 69 (3) ◽  
pp. 205-213 ◽  
Author(s):  
Carlo D. Baroni ◽  
Liborio Manente ◽  
Vincenzo Maccallini ◽  
Giorgio Di Matteo
Keyword(s):  
Thyroid Gland ◽  
Malignant Tumors ◽  
Regional Lymph Node ◽  
Age Groups ◽  
Young Patients ◽  
The Elderly ◽  
Regional Metastases ◽  
Total Female ◽  
Toxic Goiter ◽  
University Of Rome

The classification proposed by Woolner et al. (1961, 1971) has been applied to 139 cases of primary malignant tumors of the thyroid gland diagnosed in one of the largest hospitals of Rome, Italy, over a period of 5 years, from 1977 to 1981. These cases come from 1418 patients with enlargement of the thyroid surgically treated at the 5th Surgical Clinic of the University of Rome. All the histologic slides were re-examined, and the pathology records were re-evaluated. Of these tumors, 56.8% were papillary, 30.9% follicular, 9.3% anaplastic or undifferentiated, and 2.1% medullary. There was a female predominance in all age groups and for all types of tumors, reflecting a total female to male ratio of 1.9:1. Papillary carcinoma occurred most commonly in young and young-adult patients, follicular in the middle-age group, and anaplastic in the elderly. The extent of the primary tumor, the presence of regional metastases, and the association with other thyroid nonneoplastic diseases such as lymphocytic and Hashimoto's thyroiditis, and nontoxic and toxic goiter were also recorded. Multicentric rumors were found in 38.9% of cases principally represented by papillary carcinomas. Regional lymph node metastases were observed mainly in young patients, and no correlation was found between thyroid cancer incidence and other nonneoplastic thyroid diseases.

scholarly journals Prevalence of thyroid diseases in patients with acromegaly: experience of a Brazilian center

2013 ◽  
Vol 57 (9) ◽  
pp. 685-690 ◽  
Author(s):  
Helena Bandeira de Melo Paiva Uchoa ◽  
Giovanna Aparecida Balarini Lima ◽  
Lívia Lugarinho Corrêa ◽  
Ana Paula Sieiro Vidal ◽  
Suzana Aquino Cavallieri ◽  
...  
Keyword(s):  
Thyroid Volume ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Thyroid Diseases ◽  
Thyroid Disorders ◽  
Free T4 ◽  
Age Related ◽  
Igf I ◽  
Diffuse Goiter ◽  
Antibody Levels

OBJECTIVES: Acromegaly is frequently associated with thyroid diseases. In this study, we evaluated the frequency of thyroid disorders in a series of acromegalic patients. SUBJECTS AND METHODS: We evaluated 106 acromegalic patients using thyroid ultrasonography (US) and measurements of GH, IGF-I, free T4, TSH and anti-thyroperoxidase antibody levels. IGF-I was expressed in mass units and age-related standard deviation scores (SD-scores). Fine-needle aspiration biopsy (FNAB) was performed on thyroid nodules with a diameter greater than one centimeter or with suspicious characteristics. RESULTS: Thyroid disorders were found in 75 patients. Eleven patients had diffuse goiter, 42 patients had nodular goiter, and 22 patients had unspecific morphological abnormalities. Four patients (3.8%) had thyroid carcinoma. Considering the patients with diffuse or nodular goiter, thyroid volume was greater in patients with active acromegaly, and was positively correlated with GH, IGF-I, and IGF-I SD-score. CONCLUSIONS: Our study confirmed that benign thyroid diseases are frequent in acromegalic patients. The prevalence of thyroid cancer was higher than in the overall population. We suggest that thyroid US should be routinely performed in patients with acromegaly.

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