The association of neuropsychiatric disorders and endocrine parameters in hashimoto thyroiditis

Hashimoto thyroiditis is the most common thyroid disease. This form of pathology has a diverse clinical picture, including neuropsychiatric disorders. There are frequent cases of comorbidity of autoimmune thyroiditis and psychiatric forms of pathology, along with such a nosological entity as Hashimotos encephalopathy (aka: Steroid-responsive encephalopathy of autoimmune thyroiditis), characterized by an increased level of antithyroid autoantibodies and various mental disorders, with still unclear pathogenesis. The question arises, how to regard patients with psychiatric disorders and Hashimoto thyroiditis either as patients having autoimmune thyroiditis, comorbid with psychiatric forms of pathology, or as patients with Hashimotos encephalopathy? We studied groups of patients with autoimmune thyroiditis free from any psychiatric disorders, autoimmune thyroiditis comorbid with psychiatric forms of pathology, and a group of healthy donors similar as regards to their age and sex. We also studied medical history, clinical manifestations of the disease, instrumental data and the serum levels of thyrotropin, thyroid hormones, various antithyroid autoantibodies, and prolactin. We analyzed the correlation of laboratory and instrumental parameters and clinical data in all groups of patients. Therewas a significant relationship (p 0,05) between various psychiatric symptoms and a decreased level of free thyroxine, an increased level of thyroid stimulating hormone (TSH), an increased level of prolactin and an increased volume of a thyroid gland. Asignificant relationship (p 0,05) was also found between various symptoms of hypothyroidism and a decreased level of free triiodothyronine (FT3), an increased level of antibodies to thyroglobulin (anti-TG Ab), and an increased level of antibodies to thyroid peroxidase (anti-TPO Ab).

Download Full-text

Transcriptome analysis of the effect of diosgenin on autoimmune thyroiditis in a rat model

Scientific Reports ◽

10.1038/s41598-021-85822-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Chengfei Zhang ◽

Lingling Qin ◽

Boju Sun ◽

You Wu ◽

Fengying Zhong ◽

...

Keyword(s):

Autoimmune Thyroiditis ◽

Calcium Binding ◽

Binding Protein ◽

Thyroid Tissue ◽

Intervention Group ◽

Camp Response Element Binding ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Free Triiodothyronine ◽

Element Binding Protein

AbstractIn a mouse model of Graves’ disease (GD), diosgenin has been shown to have a therapeutic effect on GD by alleviating goitre. However, research on the effect of diosgenin on autoimmune thyroiditis (AIT) is lacking. In this study, transcriptomics was used to comprehensively analyse the protective effect of diosgenin against AIT in rats and the possible mechanism. The results showed that in the diosgenin-intervention group, compared to the model group, the expression of serum triiodothyronine, thyroxine, free triiodothyronine, and free thyroxine was decreased and that of thyroid-stimulating hormone was increased; these changes were accompanied by the downregulation of thyroglobulin, TSH receptor antibody and thyroid peroxidase expression in serum. Furthermore, transcriptome detection, RT-qPCR and immunohistochemistry verification revealed that in thyroid tissue, the relative mRNA and protein expression of cyclic adenosine 3′,5′-monophosphate (cAMP), protein kinase A (PKA) and cAMP response element-binding protein (Creb) were increased and the mRNA expression of S100 calcium-binding protein A9 (S100A9) was decreased in the diosgenin groups. In summary, diosgenin alleviates the development of AIT, possibly via the activation of the cAMP/PKA/Creb pathway and downregulation of S100A9 gene expression.

Download Full-text

Switching of Hashimoto Thyroiditis Into Graves’ Disease: A Case Report and Literature Review

Disease and Diagnosis ◽

10.34172/ddj.2021.16 ◽

2021 ◽

Vol 10 (2) ◽

pp. 82-85

Author(s):

Rajab Maksoud ◽

Nour Maksoud ◽

Lubana Wannous ◽

Samaher Almousa

Keyword(s):

Laboratory Tests ◽

Hashimoto Thyroiditis ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Graves Disease ◽

Free Triiodothyronine ◽

Full Remission ◽

History Of ◽

Tsh Levels

Background: Hashimoto thyroiditis (HT) and Graves’ disease (GD) are autoimmune inflammatory thyroid disorders. The evolution from GD into HT is the most common scenario while the conversion from HT into GD seems to be less common. Case Presentation: A 20-year-old female patient referred to the endocrinology clinic with a three-month history of fatigue, lethargy, lack of appetite, constipation, menorrhagia, cold intolerance, and 5 kg weight gain in the last two months. Clinical examination showed dry skin, scalp hair loss, and painless hard goiter whereas thyroid ultrasound revealed generalized homogeneous hypoechoic thyroid hypertrophy. Laboratory tests demonstrated increased serum thyroid-stimulating hormone (TSH) 210 µIU/L (normal: 0.25-4.50), decreased free thyroxine (FT4) 0.37 ng/L (normal: 0.8-1.8) and free triiodothyronine (FT3) 1.94 pg/mL (normal: 1.8-4.6), and finally, increased thyroid peroxidase antibodies (anti-TPO) 462 IU/mL (normal: up to 34). Based on observations, HT was diagnosed and thus daily treatment with levothyroxine 75 mcg was started for the patient. Two months later, she referred with symptoms suggestive of hyperthyroidism with reduced TSH levels, which did not improve after levothyroxine cessation, thus more laboratory tests were conducted and revealed decreased TSH levels, increased T3 and T4, and TSH receptor stimulating antibody (TSAb)levels, and increased radioactive iodine uptake at 24 hours. Therefore, the diagnosis of GD was made. Five weeks after treatment, she was in full remission. Conclusion: Although the switch from HT into GD is rare, it can occur at any time during the disease. Nonetheless, early diagnosis and treatment would improve the quality of care.

Download Full-text

Hypothyroidism in a physician’s practice: difficulties of diagnostics and treatment

Medical Council ◽

10.21518/2079-701x-2019-21-206-212 ◽

2020 ◽

pp. 206-212

Author(s):

A. F. Verbovoy ◽

Yu. A. Dolgikh

Keyword(s):

Cardiovascular Disease ◽

Body Weight ◽

Autoimmune Thyroiditis ◽

Clinical Manifestations ◽

Drug Dose ◽

Iodine Intake ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Chronic Autoimmune Thyroiditis ◽

Cardiovascular Therapy

Hypothyroidism is the most common endocrine disease after diabetes mellitus. Its frequency depends on age, sex and iodine intake. The highest prevalence of hypothyroidism is observed in older women. Chronic autoimmune thyroiditis is the most common cause of this condition. The peculiarity of hypothyroidism is an erased clinical picture, diversity and nonspecific symptoms. This makes it difficult to diagnose the disease, leads to an erroneous diagnosis and later detection of thyroid insufficiency. This article discusses the various «masks» of hypothyroidism and peculiarities of clinical manifestations. The main «masks» are: cardiological, dermatological, urological, gastroenterological, endocrine and reproductive system disorders, neurological, psychiatric, hematological, rheumatological. Free thyroxine and thyroid-stimulating hormone are used to diagnose hypothyroidism, as well as antibody titer to thyroid peroxidase and thyroglobulin to detect chronic autoimmune thyroiditis. Levothyroxine preparations are used as a substitution therapy. The dose of the drug depends on the age of the patient and the presence of cardiovascular disease. Patients under 50 years of age without a severe concomitant cardiovascular disease are given 1.6 µg of levothyroxine per kg of body weight. In persons over 50 years of age with cardiovascular diseases, the drug dose is prescribed at the rate of 0.9 µg per kg of body weight. The therapy starts with small doses, slowly increasing it under the control of electrocardiography. At occurrence or strengthening of symptoms of angina a dose of levothyroxine is reduced to the previous one and the cardiovascular therapy is corrected. Evaluation of the effectiveness of the treatment is carried out on the level of thyroid hormone.

Download Full-text

Clinical-pathological Changes in Reproductive Age Women With Autoimmune Thyroiditis

Bulletin of Science and Practice ◽

10.33619/2414-2948/70/31 ◽

2021 ◽

Vol 7 (9) ◽

pp. 354-359

Author(s):

N. Mazhitova ◽

R. Kalmatov ◽

G. Abdykaimova ◽

Zh. Abdullaeva

Keyword(s):

Thyroid Gland ◽

Autoimmune Thyroiditis ◽

Thyroid Stimulating Hormone ◽

Diagnostic Methods ◽

Reproductive Age ◽

Thyroid Peroxidase ◽

Kyrgyz Republic ◽

Free Triiodothyronine ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Pathology

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.

Download Full-text

SWEET SYNDROME AND HASHIMOTO THYROIDITIS: A CASE REPORT AND REVIEW OF THE LITERATURE

AACE Clinical Case Reports ◽

10.4158/accr-2019-0579 ◽

2020 ◽

Vol 6 (4) ◽

pp. e179-e182

Author(s):

Jacob Goodwin ◽

Samuel Ives ◽

Hiba Hashmi

Keyword(s):

Thyroid Dysfunction ◽

Case Reports ◽

Hashimoto Thyroiditis ◽

Skin Lesions ◽

Thyroid Stimulating Hormone ◽

Disease Stage ◽

Thyroid Peroxidase ◽

Thyroid Function Tests ◽

Sweet Syndrome ◽

Pubmed Database

Objective: Sweet syndrome (SS) is characterized by an inflammatory rash that has been associated with a number of drugs and malignant, inflammatory, and infectious conditions. Rare accounts of Hashimoto thyroiditis (HT) presenting with SS exist in the literature. HT is usually identified after the onset of skin lesions and without signs of overt thyroid dysfunction, and the stage of thyroid disease stage at presentation is variable. Methods: A search of the PubMed database was performed using search criteria involving combinations of “Sweet syndrome” and “Hashimoto thyroiditis,” “autoimmune thyroiditis,” or “thyroiditis,” and the search was filtered for clinical case reports. Five case reports were identified to describe the coexistence of Sweet syndrome and Hashimoto thyroiditis, and full-text versions of these reports were obtained and reviewed. Of note, cases involving subacute or other types of thyroiditis were excluded. Results: A 57-year-old man presented with painful eruptions on his hands; he was initially treated with antibiotics for presumed cellulitis without relief. Skin biopsy later confirmed SS and subsequent workup identified underlying HT with an elevated thyroid-stimulating hormone of 19.24 mU/L (normal, 0.30 to 4.30 mU/L) and positive thyroid peroxidase (TPO) antibody at 236.4 IU/mL. Conclusion: Thyroid function tests should be universally evaluated in the workup of SS, and it may be appropriate to test for TPO antibodies even in the absence of objective thyroid dysfunction. Both SS and HT show immune diathesis, so further work should be undertaken to establish whether a common immunologic trigger exists.

Download Full-text

Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis

International Journal of Endocrinology ◽

10.1155/2017/2549491 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Maurizio Nordio ◽

Sabrina Basciani

Keyword(s):

Autoimmune Thyroiditis ◽

Single Case ◽

Elevated Serum ◽

Thyroid Stimulating Hormone ◽

Free Triiodothyronine ◽

Hyperthyroid Patient ◽

Normal Thyroid Function ◽

Complete Restoration

Clinical evidences have highlighted the efficacy of myo-inositol and selenium in the treatment of autoimmune thyroiditis. Aim of this study was to further analyze the role of myo-inositol plus selenium (Myo-Ins-Se) in restoring a normal thyroid function of Hashimoto’s patients with subclinical hypothyroidism. Eighty-six patients with Hashimoto’s thyroiditis having thyroid-stimulating hormone (TSH) levels between 3 and 6 mIU/L, elevated serum antithyroid peroxidase (TPOAb) and/or antithyroglobulin (TgAb), and normal free thyroxine (fT4) and free triiodothyronine (fT3) levels were enrolled in the study: one hyperthyroid subject with TSH about 0.14 μU/ml was included in this trial as a single case. Patients were assigned to receive Myo-Ins-Se. TSH, TPOAb, and TgAb levels were significantly decreased in patients treated with combined Myo-Ins-Se after 6 months of treatment. In addition, a significant fT3and fT4increase, along with an amelioration of their quality of life, was observed. Remarkably, TSH values of the hyperthyroid patient increased from 0.14 μU/ml up to 1.02 μU/ml, showing a complete restoration of TSH values at a normal range. In conclusion, the administration of Myo-Ins-Se is significantly effective in decreasing TSH, TPOAb, and TgAb levels, as well as enhancing thyroid hormones and personal wellbeing, therefore restoring euthyroidism in patients diagnosed with autoimmune thyroiditis.

Download Full-text

RECURRENT PAINFUL HASHIMOTO THYROIDITIS SUCCESSFULLY TREATED BY THYROIDECTOMY

AACE Clinical Case Reports ◽

10.4158/accr-2019-0184 ◽

2020 ◽

Vol 6 (1) ◽

pp. e9-e13

Author(s):

Carol Chiung-Hui Peng ◽

Kashif M. Munir ◽

Linda Song ◽

John C. Papadimitriou ◽

Majorie A. Pennant

Keyword(s):

Neck Pain ◽

Hashimoto Thyroiditis ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Ultrasound Images ◽

Upper Respiratory Tract ◽

Anterior Neck ◽

Laboratory Findings ◽

Thyroid Goiter ◽

Oral Corticosteroids

Objective: Painful Hashimoto thyroiditis (HT) is a rare HT variant characterized by neck pain. The clinical differentiation between painful HT and subacute thyroiditis is challenging, as the diagnosis cannot be confirmed without histopathological evidence. Here we present a patient who had anterior neck pain who was diagnosed with HT. Methods: We present the patient's clinical examinations and laboratory findings (white blood cell count, thyroid-stimulating hormone, free thyroxine, thyroid peroxidase antibody, and erythrocyte sedimentation rate). Ultrasound images of the thyroid gland and pathology images representative of marked HT with positive IgG4 immunohistochemical stain after thyroidectomy are also presented. Results: A 42-year-old female with a 3-year history of HT developed recurrent anterior neck pain with bilateral radiation to the ears as well as a tender, enlarging thyroid goiter. She had no signs of fever or a preceding infection of the upper respiratory tract. Her pain was only temporarily alleviated by oral corticosteroids. According to the serial ultrasound records, both thyroid lobes decreased in size after 2 pain episodes. She eventually underwent total thyroidectomy and remained pain-free for 1.5 years, up to the last office follow-up visit. Histopathology confirmed the diagnosis of HT. Conclusion: In patients with HT, recurrent thyroid pain despite steroid treatment is the clinical hallmark of diagnosis of painful HT. The reference standard of diagnosis is pathology. Thyroidectomy may be considered after recurrent painful episodes.

Download Full-text

Thyroid Functions in Bamboo-Shoots Consuming Children of Tripura, North-east India

10.21203/rs.3.rs-615916/v1 ◽

2021 ◽

Author(s):

Indrajit Ray ◽

A. K. Chandra ◽

Saru Kumar Debbarma ◽

Sekhar Kumar Mookerjee ◽

Ajoy Datta ◽

...

Keyword(s):

Urinary Iodine ◽

Thyroid Volume ◽

Thyroid Stimulating Hormone ◽

Consumption Pattern ◽

Thyroid Peroxidase ◽

Free Triiodothyronine ◽

Cross Sectional ◽

North East ◽

Bamboo Shoots ◽

The Village

Abstract PurposeInformation on thyroid functions in populations consuming potent antithyroidal bamboo-shoots (BS) was found scanty. Therefore, to assess thyroid function in BS consuming children was found relevant.MethodsThis cross-sectional study included 127 children from 3 villages. Thyroid volume (TV), free thyroxine (FT4), free triiodothyronine (FT3), thyroid stimulating hormone (TSH), thyroglobulin antibody (Tg-Ab), thyroid peroxidase antibody (TPO-Ab), urinary iodine (UI), urinary thiocyanate (USCN), salt iodine (SI), water iodine (WI), and BS consumption pattern were assessed. ResultsVariable-wise overall mean±SDs/medians/interquartile ranges (IQR) were - age: 8.69±1.69/8.77/7.22-9.74 y, TVol: 0.82±0.27/0.82/0.67-0.96 ml, FT4: 19.5+5.6/20.1/16.9-22.0 pmol/L, FT3: 4.27+1.24/4.22/3.35-4.96 pmol/L, TSH: 2.44+1.39/2.33/1.60-3.15 mIU/L, Tg-Ab: 15.2+10.0/12.5/11.1-14.5 IU/ml, TPO-Ab: 5.58+12.25/3.89/2.90-5.11 IU/ml, UI: 117.4±58.5/108/73-160.5 µg/L, USCN: 0.99+0.67/0.8/0.5-1.2 mg/dl, WI: 4 .69±4.56/3.0/1.35–7µg/L, and BS consumption: 153.8±01.4/119/71.4–214.3 g/person/day respectively. Only 80.3% salt samples had ≥15 ppm iodine. Thyroid dysfunction prevalence was 6.3%. There were positive correlations between TV and FT4 (r=0.2466, p=0.005), UI and TSH (r=0.2633, p=0.003), TSH and FT4 (r=0.2135, p=0.016), TSH and FT3 (r=0.1898, p=0.033), USCN and FT4 (r=0.2477, p=0.005), Tg-Ab and TPO-Ab (r=0.3768, p=<0.001), and negative correlations between Tg-Ab and TSH (r=-0.2024, p=0.023), Tg-Ab and FT4 (r=-0.1869, p=0.035). In boys, USCN had a positive correlation with TPO-Ab (r=0.3069, p=0.018). The village having highest levels of BS consumption (p=0.037) and median UI showed higher TSH levels (p=0.037) and higher FT3 level (p=0.001) compared to the village of lowest BS consumption.ConclusionsThe BS consuming children appear at risk of developing hypothyroidism by Tg-Ab, which may partly be diminished by reducing BS consumption.

Download Full-text

THYROID STATUS OF ATHLETES IN VARIOUS DISCIPLINES

Human Sport Medicine ◽

10.14529/hsm20s101 ◽

2020 ◽

Vol 20 (S1) ◽

pp. 5-12

Author(s):

R Radzhabkadiev ◽

K Vybornaya ◽

C Lavrinenko ◽

A Vasilev

Keyword(s):

Female Athletes ◽

Elite Athletes ◽

Reference Intervals ◽

Thyroid Stimulating Hormone ◽

High Serum ◽

Thyroid Peroxidase ◽

Thyroid Status ◽

Free Triiodothyronine ◽

Male Athletes ◽

Normal Limits

Aim. The article deals with the assessment of the thyroid status of athletes engaged in physical activity of varying intensity. Materials ant methods. 146 elite athletes involved in bobsleigh, biathlon, shooting and snowboarding participated in the study. We determined the serum concentration of thyroid stimulating hormone (TSH), free triiodothyronine (f.T3), free thyroxin (f.T4) and thyroid peroxidase antibodies (TPO-ab) with the COBAS e411 immunochemistry analyzer (Roche, Germany). The integral thyroid index ((f.T3 + f.T4)/TSH) was used for the assessment of the level of function of the thyroid proper. The conversion index of thyroxin to triiodothyronine (f.T4/ f.T3) was also studied. Results. 40 % of the bobsleigh athletes examined and 29 % of the snowboarders had high serum f.T3. The concentration of f.T4 in all examined athletes both male and female was within normal limits. Approximately 25 % of the male athletes examined had low II values. Among female athletes, 25 % of shooters and 33 % of bobsleigh athletes had low II values. In male biathletes and bobsleigh athletes, TPO-ab was 56 % higher than in shooters and snowboarders. In 43 % of bobsleigh athletes, 19 % of shooters, 10 % of biathletes and snowboarders, the content of TSH in males exceeded the reference intervals. Among females, TSH was high in 25 % of shooters and bobsleigh athletes. Conclusion. There were no statistically significant differences in the content of thyroid hormones in the compared sports groups, which can probably be explained by the activity of deiodinases at the local, intracellular level. At the same time, in a large number of respondents surveyed, the indicators of II and TPO-ab were outside the physiological norm.

Download Full-text

Relationship between Different Psoriasis Types and Thyroid Dysfunction: A Retrospective Analysis

Scanning ◽

10.1155/2021/1834556 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Juan Du ◽

Chunyue Ma ◽

Runnan Wang ◽

Lanmei Lin ◽

Luhui Gao ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Thyroid Function ◽

Thyroid Dysfunction ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Thyroid Function Tests ◽

Free Triiodothyronine ◽

Hormone Levels ◽

Significant Difference ◽

Total Thyroxine

Objective. The aim of this study was to investigate the relationship between different psoriasis types and thyroid dysfunction. Methods. The data of patients diagnosed with psoriasis between January 2013 and October 2018 who underwent thyroid function tests were collected. Free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4), thyroid-stimulating hormone (TSH), thyroglobulin antibody (TGAb), and thyroid peroxidase antibody (TPOAb) were measured. The thyroid function of patients with psoriasis vulgaris, pustular psoriasis, erythrodermic psoriasis, and psoriatic arthritis was evaluated, and the differences in hormone levels and antibodies in the pituitary-thyroid axis with psoriasis type were analyzed. Results. The data of a total of 468 patients were analyzed in this study. The proportion of normal hormone levels was higher among vulgaris patients ( P < 0.001 ), while the erythrodermic patients were more likely to have decreased FT3 or FT4 but normal TSH ( P < 0.001 ). FT3 levels were lower in pustular patients ( P < 0.05 ), FT4 levels were lower in erythrodermic patients ( P < 0.05 ), and TSH levels were higher in patients with psoriatic arthritis ( P < 0.05 ). TPOAb levels were higher than normal in all patients, but there was no significant difference in the levels of TPOAb and TGAb among 4 types of the patients. Conclusion. Psoriasis is related to thyroid dysfunction, especially in patients with atypical psoriasis types. The possibility of complications should be considered in erythrodermic patients.

Download Full-text