scholarly journals Predicting difficulty of thyroidectomy preoperatively

2017 ◽  
Vol 4 (5) ◽  
pp. 1605
Author(s):  
Alex Oommen ◽  
Vaisagh Remin
Keyword(s):  
Statistical Analysis ◽  
High Volume ◽  
Thyroid Peroxidase ◽  
Postoperative Hypocalcemia ◽  
Thyroglobulin Antibodies ◽  
Thyroid Peroxidase Antibody ◽  
Thyroglobulin Antibody ◽  
Duration Of Surgery ◽  
Difficulty Scale ◽  
Common Operation

Background: Today, thyroidectomy is a common operation used to treat various thyroid disorders. Nowadays, many high-volume thyroid surgeons are discharging patients on the same day of thyroidectomy. The incidence of complications following thyroidectomy is directly linked to the difficulty of the procedure. So, if we can predict the difficulty of thyroidectomy preoperatively, we can anticipate complications and decide on which patients will require in-patient care.Methods: A thyroidectomy difficulty scale was developed by Schneider and colleagues. This scale was used in our study to classify patients in to difficult thyroidectomy group and non-difficult thyroidectomy group. The association between preoperative variables and difficulty of thyroidectomy was studied.Results: Statistical analysis revealed that there was a significant association between hyperthyroidism and difficult thyroidectomy. Similarly, there was a significant association between positive anti-thyroid peroxidase antibody (which defines Hashimoto’s thyroiditis) and difficult thyroidectomy. Also, there was a significant association between positive anti-thyroglobulin antibody and difficult thyroidectomy. Difficult thyroidectomy was found to have a significant association with postoperative hypocalcemia. Statistical analysis also showed duration of surgery to have a significant association with difficulty of thyroidectomyConclusions: Patients with hyperthyroidism, positive anti-thyroid peroxidase antibodies, positive anti-thyroglobulin antibodies have a high probability of a difficult thyroidectomy, associated with longer operative times and increased complications. This information can improve preoperative risk counseling and lead to more efficient scheduling of the operating room.

Role of the Specialized Pro-resolving Mediator Resolvin D1 in Hashimotoʼs Thyroiditis

2021 ◽  
Author(s):  
Jing Song ◽  
Rongxin Sun ◽  
Yuanyuan Zhang ◽  
Ying Fu ◽  
Dong Zhao
Keyword(s):  
Thyroid Autoimmunity ◽  
Thyroid Stimulating Hormone ◽  
Inflammatory Factors ◽  
Thyroid Peroxidase ◽  
Sensitivity Index ◽  
Resolvin D1 ◽  
Thyroid Peroxidase Antibody ◽  
Thyroglobulin Antibody ◽  
Inflammation Resolution

Abstract Objective Resolvins are produced by the catabolism of polyunsaturated fatty acids (PUFAs) and play vital roles in inflammation resolution. Resolvins have been associated with autoimmune disorders. This study aimed to measure the level of Resolvin D1 (RVD1) in the serum of Hashimoto's thyroiditis (HT) patients and healthy controls (HCs) and to further analyse its correlation with thyroid autoantibodies and inflammatory factors. Methods Sixty-three participants were recruited, namely, 30 untreated HT patients and 33 sex- and age-matched HCs. Serum RVD1 and inflammatory chemokine (MCP-1 and IP-10) levels were measured by ELISA according to the manufacturer’s protocol. Serum total T3 (TT3), TT4, free T3 (FT3), FT4, thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) and thyroid-stimulating hormone (TSH) levels were measured using an electrochemiluminescence immunoassay. Thyroid homeostasis parameters, including the thyroid secretory capacity (SPINA-GT), the total deiodinase activity (SPINA-GD), Jostel’s TSH index (TSHI) and the thyrotroph thyroid hormone sensitivity index (TTSI), were calculated. Results Serum RVD1 levels in HT patients (134.76, 85.35–201.36 pg/mL) were significantly lower than those in HCs (187.64, 131.01–326.85 pg/mL) (P=0.004). As the TPOAb level increased, the RVD1 level showed a decreasing trend (P for trend=0.002). Both multinomial and ordinal logistics analyses revealed that serum RVD1 levels were negatively correlated with TPOAb levels in the adjusted models. Moreover, RVD1 showed a negative correlation with the inflammatory chemokine IP-1 0 (r=–0.276, P=0.034), TSHI (r=–0.269, P=0.036) and TTSI (r=–0.277, P=0.031). Conclusions Thyroid autoimmunity may be associated with low levels of RVD1. Decreased RVD1 levels indicate impaired resolution of inflammation in HT patients.

IRON DEFICIENCY, A RISK FACTOR FOR THYROID AUTOIMMUNITY DURING SECOND TRIMESTER OF PREGNANCY IN CHINA

2020 ◽  
Vol 26 (6) ◽  
pp. 595-603
Author(s):  
Yanan Zhang ◽  
Xinmei Huang ◽  
Zaoping Chen ◽  
Qian Yang ◽  
Xiaoying Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Iron Deficiency ◽  
Thyroid Autoimmunity ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Second Trimester ◽  
Thyroid Peroxidase Antibody ◽  
Thyroglobulin Antibody

Objective: Previous studies have reported an association between iron deficiency (ID) and increased thyroid peroxidase antibody (TPO-Ab) during early pregnancy. The objective of this study was to explore the relationship between ID and thyroid dysfunction, as well as thyroid autoantibodies, during the second trimester of pregnancy. Methods: A total of 1,592 pregnant women (13 to 28 weeks gestation) were enrolled in this cross-sectional study. According to serum ferritin (SF) concentrations, they were divided into ID (SF <20 μg/L) or non-ID (SF ≥20 μg/L) groups. Logistic regression analysis was used to evaluate the association between ID and subclinical hypothyroidism (thyroid-stimulating hormone [TSH] >4.0 mIU/L and free thyroxine [FT4] within the reference range) and thyroid autoimmunity. Results: The prevalence of ID was 23.43% (373/1,592). Compared with the non-ID group, the ID group had lower FT4 levels (13.94 pmol/L [8.91 to 29.82 pmol/L] versus 14.63 pmol/L [8.22 to 47.24 pmol/L]; P<.001]) and higher TSH levels (1.85 mIU/L [0.01 to 7.84 mIU/L] versus 1.69 mIU/L [0.01 to 10.2 mIU/L]; P<.05). Logistic regression analysis confirmed ID as a risk factor for increased thyroglobulin antibody (TG-Ab) (odds ratio 1.974; 95% confidence interval 1.065, 3.657; P<.05), but not for subclinical hypothyroidism or increased TPO-Ab. Conclusion: ID is associated with increased TG-Ab during the second trimester of pregnancy. Abbreviations: BMI = body mass index; CV = coefficient of variation; FT4 = free thyroxine; Hb = hemoglobin; ID = iron deficiency; IDA = iron deficiency anemia; SF = serum ferritin; T3 = triiodothyronine; T4 = thyroxine; TAI = thyroid autoimmunity; TG = thyroglobulin; TG-Ab = thyroglobulin antibody; TPO = thyroid peroxidase; TPO-Ab = thyroid peroxidase antibody; TSH = thyroid-stimulating hormone

scholarly journals A Pilot Study on the Beneficial Effects of the Additional Selenium Supplementation to Methimazole for Treating Patients with Graves? disease

2019 ◽  
Author(s):  
BIN XU ◽  
DI WU ◽  
HONG YING ◽  
YING ZHANG
Keyword(s):  
Protein Expression ◽  
Combination Group ◽  
Thyroid Peroxidase ◽  
Graves Disease ◽  
Mrna Levels ◽  
Thyroid Cells ◽  
Beneficial Effects ◽  
Thyroid Peroxidase Antibody ◽  
Thyroglobulin Antibody

Backgroud/aim: The aim of this study was to assess the effect of a combination use of methimazole (MMI) and selenium (Se) in the treatment of Graves’ disease (GD). Materials and methods: A total of 103 newly-diagnosed hyperthyroidism patients were randomized to MMI and MMI+Se combination group. After treatment for six months, the levels of triiodothyronine (FT3), free thyroxine (FT4), thyrotrophin receptor antibody (TRAb), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb) were observed. Besides, an in vitro culture model of thyroid cells was established and the protein expression and mRNA levels of TRAb, TPOAb and TGAb were determined by western blot and RT-PCR. Results: A significant decrease in the levels of FT3, FT4, TRAb, TPOAb and TGAb were observed in both groups along with a marked increase in TSH levels. Furthermore, the in vitro experiments showed that the protein expression and mRNA levels of TRAb, TPOAb and TGAb decreased significantly. Also, compared to the MMI group, there was a greater improvement of these indices in the MMI+Se group. Conclusion: We suggest that the combined use of MMI and Se could improve the thyroid activity in patients which may provide effective therapy for the treatment of GD in clinical settings. Key words: Graves’ disease; methimazole; selenium; TRAb; TPOAb; TGAb

scholarly journals Restricted thyroglobulin antibody epitope specificities in subjects with type 1 diabetes mellitus

2009 ◽  
Vol 161 (3) ◽  
pp. 489-493 ◽  
Author(s):  
O E Okosieme ◽  
C N Wijeyaratne ◽  
J H Lazarus ◽  
L D K E Premawardhana
Keyword(s):  
Thyroid Peroxidase ◽  
Thyroglobulin Antibodies ◽  
Autoimmune Thyroid ◽  
Thyroglobulin Antibody ◽  
High Prevalence ◽  
Patients At Risk ◽  
Healthy Control ◽  
A Prospective Study ◽  
Design And Methods

ObjectivesFollowing iodisation in Sri Lanka we observed a high prevalence of thyroglobulin antibodies (TgAbs) in type 1 diabetic (T1DM) patients. The clinical significance of these TgAbs is uncertain. We sought to obtain a detailed epitope analysis of TgAbs in T1DM patients recruited from diabetes clinics and to compare these with TgAb epitope specificities in patients with autoimmune thyroid disease (AITD) and healthy individuals in that country.Design and methodsWe used a panel of 10 Tg-MAbs in competitive ELISA reactions in a prospective study of subjects recruited from Colombo, to determine the epitopes recognised by TgAb-positive patients with T1DM (n=58, 34F:24M, median age 16 years), AITD patients (n=42, 33F:9M, median age 37 years) and healthy subjects (n=50, 39F:11M, median age 27 years). The outcomes were a comparison of reactivity with six Tg clusters (I–VI) in these subjects, and the relation of epitope specificity patterns with free thyroxine and TSH.ResultsPatients with T1DM and AITD but not healthy control subjects preferentially recognised the immunodominant clusters, I, III and IV. Patients with these narrow epitope specificities had higher median TSH levels (1.60 vs 1.06;P=0.01), and were more frequently positive for antibodies to thyroid peroxidase than those with broad specificities (52.3 vs 7.1%;P=0.004).ConclusionsThe TgAb epitope specificities in euthyroid Sri Lankans with T1DM are similar to AITD patients. TgAb epitope studies may potentially identify T1DM patients at risk of thyroid dysfunction.

scholarly journals Hyperthyroidism Prevalence in China After Universal Salt Iodization

2021 ◽  
Vol 12 ◽  
Author(s):  
Chuyuan Wang ◽  
Yongze Li ◽  
Di Teng ◽  
Xiaoguang Shi ◽  
Jianming Ba ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mainland China ◽  
Epidemiological Survey ◽  
Thyroid Peroxidase ◽  
Subclinical Hyperthyroidism ◽  
Salt Iodization ◽  
Excessive Iodine ◽  
Thyroid Peroxidase Antibody ◽  
Thyroglobulin Antibody ◽  
Antibody Levels

BackgroundUniversal salt iodization (USI) was implemented in mainland China in 1996. The prevalence of hyperthyroidism and its risk factors now require examination.MethodsData were acquired from a nationwide Thyroid, Iodine, and Diabetes Epidemiological survey (TIDE 2015–2017) of 78,470 subjects from 31 provinces. Iodine status, and thyroid hormones and antibodies were measured. ResultsAfter two decades of USI, the prevalence of overt hyperthyroidism (OH), Graves’ disease (GD), severe subclinical hyperthyroidism (severe SCH), and mild subclinical hyperthyroidism (mild SCH) in mainland China was 0.78%, 0.53%, 0.22%, and 0.22%, respectively. OH and GD prevalence were higher in women than in men (OH: 1.16% vs. 0.64%, P&lt;0.001; GD: 0.65% vs. 0.37%, P&lt;0.001).Prevalence was significantly decreased after 60 years-of-age compared with 30–39 years-of-age (OH:0.61% vs. 0.81%, P&lt;0.001; GD: 0.38% vs. 0.57%, P&lt;0.001).Excessive iodine(EI) and deficient iodine(DI) were both related to increased prevalence of OH (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.68–2.59; OR1.35, 95%CI 1.07–1.72, respectively); however, only deficient iodine was associated with increased prevalence of GD (OR1.67, 95%CI 1.30–2.15). Increased thyroid peroxidase antibody and thyroglobulin antibody levels were significantly associated with prevalence of OH and GD, but not severe SCH and mild SCH. Although hyperthyroidism was more prevalent in women, the association disappeared after adjusting for other factors such as antibody levels.ConclusionOH and GD prevalences in mainland China are stable after two decades of USI. Iodine deficiency, elevated thyroid antibody levels, and middle age are the main risk factors for OH and GD. The severe SCH population, rather than the mild SCH population, shows similar characteristics to the OH population.

scholarly journals Association between Vitiligo and Thyroid Autoimmunity

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Emina Kasumagic-Halilovic ◽  
Asja Prohic ◽  
Begler Begovic ◽  
Nermina Ovcina-Kurtovic
Keyword(s):  
Case Control Study ◽  
Thyroid Autoimmunity ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Thyroid Peroxidase ◽  
Thyroid Autoantibodies ◽  
Thyroid Peroxidase Antibody ◽  
Thyroglobulin Antibody ◽  
Common Skin ◽  
Control Study

Background. Vitiligo is a common skin disorder characterized by macular depigmentation of the skin. The etiopathogenesis of the disease is still unclear, but there is evidence that autoimmunity and endocrine disfunction may be involved.Objective. The aim of this study was to determine whether vitiligo is statistically associated with thyroid autoimmunity.Method. In a prospective case-control study, we compared the frequency of thyroid autoantibodies (thyroglobulin antibody, anti-Tg and thyroid peroxidase antibody, and anti-TPO) in 33 patients with vitiligo and in 33 healthy volunteers. Thyroid autoantibodies and thyroid hormones (thyroxine (T4), triiodothyronine (T3), and thyroid stimulating hormone (TSH) were measured in all subjects.Results. Thyroid functional abnormalities were found in 6 (18.18%) patients. Anti-Tg and anti-TPO were positive in 9 (27.27%) and 8 (24.24%) patients, respectively. In control group, only one subject (3.03%) had abnormalities in thyroid hormonal status, and two subjects had positive thyroid autoantibodies. Compared with the control group, the frequency of both anti-Tg and anti-TPO was significantly higher in those with vitiligo ().Conclusion. This study shows a significant association between vitiligo and thyroid autoimmunity, and that tests to detect thyroid autoantibodies are relevant in patients with vitiligo.

Evidence for acute release of thyroid peroxidase during subtotal thyroidectomy

1991 ◽  
Vol 124 (6) ◽  
pp. 661-665 ◽  
Author(s):  
U. Feldt-Rasmussen ◽  
M. Høier-Madsen ◽  
J. Date ◽  
M. Blichert-Toft
Keyword(s):  
Subtotal Thyroidectomy ◽  
Antithyroid Drugs ◽  
Thyroid Peroxidase ◽  
Specific Method ◽  
Thyroglobulin Antibodies ◽  
Thyroid Peroxidase Antibodies ◽  
Thyroglobulin Antibody ◽  
Thyroglobulin Autoantibodies ◽  
Commercial Method ◽  
Time Of Operation

Abstract. An immediate reduction of thyroglobulin autoantibodies during subtotal thyroidectomy of thyroglobulin antibody positive patients has previously been shown to indicate an acute release of thyroglobulin into the circulation peroperatively. The aim of the present study was to investigate whether thyroid peroxidase was also released by measuring anti-thyroid peroxidase antibodies by a quantitative and antigen specific method both per- and postoperatively in patients positive for anti-thyroid peroxidase antibodies. Twelve anti-thyroid peroxidase positive patients (11 females, 1 male) referred for surgery of toxic goitre were studied. Median age was 43 years (range 24-64) and median goitre size 86 g (25-165). All patients had been pretreated with antithyroid drugs and were euthyroid at the time of operation. Anti-thyroid peroxidase was measured before operation, 1-8 h, 10 days, 1-3 months, and 12 months postoperatively by a commercial method (DYNO-test®, Henning, Berlin). The median anti-thyroid peroxidase level before operation was 1048 kU/l (range 68-10 517 kU/l) and fell during operation to 0.63 (range 0.37-1.28) (p<0.01) of initial concentration without further decrease during the next 1-8 h. The comparative decrease in thyroglobulin antibodies was 0.19 (0-0.88). The anti-thyroid peroxidase level was increasing after 10 days, but did not reach initial level until between 3 and 12 months after surgery. However, in 3 of 10 patients anti-thyroid peroxidase had disappeared after 12 months, all of whom had low levels before operation, whereas anti-thyroid peroxidase was 2-4 times higher than preoperatively in 3 other patients. The present study thus gives evidence for an acute release of thyroid peroxidase into the circulation during thyroid surgery able to decrease anti-thyroid peroxidase activity almost to the same degree as the Tg-induced decrease in Tg-ab.

scholarly journals Lack of association between thyroid autoantibodies and parity in a population study argues against microchimerism as a trigger of thyroid autoimmunity

2006 ◽  
Vol 154 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Inge Bülow Pedersen ◽  
Peter Laurberg ◽  
Nils Knudsen ◽  
Torben Jørgensen ◽  
Hans Perrild ◽  
...  
Keyword(s):  
Population Study ◽  
Hormone Replacement ◽  
Thyroid Autoimmunity ◽  
Thyroid Peroxidase ◽  
Thyroid Autoantibodies ◽  
Thyroid Antibodies ◽  
Previous Pregnancy ◽  
Logistic Regression Models ◽  
Thyroid Peroxidase Antibody ◽  
Thyroglobulin Antibody

Background: Thyroid autoimmunity is more common in females than in males. One possible explanation for this female preponderance may be the effect of oestrogens on the immune system. It has also been suggested that foetal microchimerism involving transfer of foetal cells into maternal tissue during pregnancy may play an important role. Objective: We investigated the association between the presence of circulating thyroid autoantibodies and previous pregnancy, parity and the use of oral contraceptives (OCs) and hormone replacement therapy (HRT) in a population cohort. Methods: We examined 3712 women randomly selected from the general population. Serum was analysed for thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) using assays based on an RIA technique (DYNO test). Data were analysed in logistic regression models to adjust for possible confounders. Women previously treated for thyroid disease or with pregnancy within 1 year prior to the study were excluded from the analyses. Results: In both univariate and multivariate models and whether the presence of TPO-Ab and Tg-Ab was investigated alone or in combination, findings were negative with respect to an association between circulating thyroid antibodies and previous pregnancy, number of pregnancies, parity and previous abortion. There was no association between thyroid autoantibodies and use of OCs. Women aged 60–65 years receiving HRT now or previously had a lower prevalence of Tg-Ab (univariate, P = 0.01; multivariate, P = 0.02). No such association was observed between HRT and TPO-Ab. Conclusion: In this population study there was no association between previous pregnancy, parity and thyroid antibodies, which argues against the role of microchimerism as a trigger of thyroid autoimmunity. Exogenous oestrogens may reduce aspects of autoimmunity.

scholarly journals The relationship between circulating estradiol and thyroid autoimmunity in males

2014 ◽  
Vol 170 (1) ◽  
pp. 63-67 ◽  
Author(s):  
La-or Chailurkit ◽  
Wichai Aekplakorn ◽  
Boonsong Ongphiphadhanakul
Keyword(s):  
Thyroid Autoimmunity ◽  
Serum Levels ◽  
Mean Value ◽  
Thyroid Peroxidase ◽  
Test Results ◽  
Autoimmune Thyroid ◽  
Thyroid Peroxidase Antibody ◽  
Thyroglobulin Antibody ◽  
The Difference ◽  
The Relationship

IntroductionAlthough autoimmune thyroid disease is less common in males, it is unclear whether estrogen contributes to the difference in susceptibility among males.ObjectiveTo examine whether circulating estradiol (E2) is related to thyroid autoimmunity in males.Patients and methodsOne-thousand two-hundred and sixty-three males aged 15–94 years were studied. Serum levels of E2, TSH receptor antibody (TRAb), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), free thyroxine (FT4), and TSH were measured by ELISA.ResultsCirculating E2varied widely in males, ranging 18.4–403.7 pmol/l with a mean value of 136.2±51.7 pmol/l. E2increased with age (r=0.18,P<0.001). No relationship between E2and BMI was found. When comparing the difference in E2according to the test results of TRAb, TPOAb, and TgAb, it was found that E2was significantly higher in subjects with positive TRAb (TRAb positive, E2=170.3±59.8 pmol/l; TRAb negative, E2=134.0±50.6 pmol/l;P<0.001). No difference in E2was demonstrated according to the results of TPOAb or TgAb. Logistic regression analysis showed that E2was a determinant of positive TRAb, independent of age and BMI. There was no relationship between serum E2and TSH or FT4. However, E2was negatively related to TSH (r=−0.45,P<0.01) in subjects whose TSH levels fell below the reference range (0.3–4.2 mIU/l).ConclusionHigher circulating E2is related to thyroid autoimmunity in males as reflected by positive TRAb.

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