scholarly journals Clinical study of thyroid swellings

2021 ◽  
Vol 7 (3) ◽  
pp. 448
Author(s):  
Ashwini S. Rathod ◽  
Girija A. Ghate ◽  
Ammu Korah ◽  
Lakshmi Krishnan ◽  
Ruchir R. Dashora
Keyword(s):  
Thyroid Function ◽  
Clinical Signs ◽  
Neck Region ◽  
Signs And Symptoms ◽  
Thyroid Function Test ◽  
Thyroid Disorders ◽  
Thyroid Function Tests ◽  
Simple Cyst ◽  
Etiological Factors ◽  
Function Tests

<p><strong>Background:</strong> Thyroid swellings are very frequently encountered in ENT practice, ranging from a simple cyst to a malignant tumour. Disorder of structure of thyroid gland, due to various etiological factors, will give rise to swelling in the neck region. Clinical signs and symptoms are inadequate to diagnose thyroid disorders as similar presentations are seen in various thyroid disorders. So, this study of thyroid swellings was done to know different clinical presentations, age and sex distribution, correlation between thyroid swellings and thyroid function tests, analyse various thyroid swellings and etiological factors based on pathological reports.</p><p class="abstract"><strong>Methods:</strong> A prospective study with 50 patients of thyroid swellings was conducted over 2 years, after taking consent from each patient. Patients were clinically examined by inspection, palpation, percussion, auscultation and underwent thyroid function tests. Ultrasonography (USG) and fine needle aspiration cytology (FNAC) was done in all patients.  </p><p class="abstract"><strong>Results:</strong> Total 50 patients of thyroid swellings were studied. Mean age of the patients was 38.92 years with female preponderance (74%). Thyroid swellings were commonly present bilaterally (54%). 82% cases showed euthyroid state. USG revealed that most of the patients had colloid nodule (46%), followed by MNG (26%). Majority of lesions were benign on both USG and FNAC reports. MNG (44%) was reported frequently in the provisional diagnosis, followed by colloid nodule (24%).</p><p class="abstract"><strong>Conclusions:</strong> In all cases of thyroid swellings, detailed clinical history, thorough clinical examination is required. Thyroid function test, USG and FNAC reports help to reach the definitive diagnosis. Histopathological report confirms and gives final diagnosis.</p><p> </p>

scholarly journals The Characteristics of Children with Abnormalities Detected in Thyroid Function Tests, and Distribution of Diagnoses

2020 ◽  
Author(s):  
Elif Çelik ◽  
Ayşe Anık
Keyword(s):  
Thyroid Function ◽  
Thyroid Disease ◽  
Correct Diagnosis ◽  
Thyroid Function Test ◽  
Hashimoto Thyroiditis ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Test Results ◽  
Function Tests ◽  
Function Test

INTRODUCTION: Thyroid function tests are among the most frequently implemented laboratory tests in primary, and secondary healthcare institutions. The aim of the present study was to investigate the demographic and clinical characteristics and final diagnosis of children referred by primary and secondary healthcare institutions with the suspicion of an abnormality in thyroid function test and/or with the initial diagnosis of specific thyroid disease. METHODS: A total of two hundred eighty-nine pediatric patients, aged between 4 and 18 years admitted to the outpatient clinics of Behçet Uz Children’s Health and Diseases Hospital between January 2018 and January 2020, were included in the study. The patient data were obtained retrospectively from the hospital records. RESULTS: A total of 66% of the patients who were included in the study were female with a median age of 12 years (8.7-14.4), while 64% of them were pubertal; and 78% of the cases were referred by secondary healthcare institutions. The most common reason for referral was isolated elevation of thyroid stimulating hormone (TSH). A total of 56% of the patients were asymptomatic at the time of admission, and thyroid function test results of 75% of them were within normal limits. When evaluated according to their final diagnoses, the children were normal/healthy (64%), diagnosed with Hashimoto thyroiditis (30%), nodular thyroid disease (3%), Graves disease (2%) and isolated increase of TSH was related to obesity in 5 patients (1%). DISCUSSION AND CONCLUSION: It is essential to evaluate children with abnormal thyroid function test results with detailed history and physical examination. Besides, the thyroid function tests should be performed with reliable and sensitive methods in standardized laboratories to reach the correct diagnosis in these children.

THYROID FUNCTION TESTS IN ADULTS WITH DOWN'S SYNDROME

1978 ◽  
Vol 88 (1) ◽  
pp. 48-54 ◽  
Author(s):  
S. Korsager ◽  
E. M. Chatham ◽  
H. P. Østergaard Kristensen
Keyword(s):  
Thyroid Function ◽  
Down's Syndrome ◽  
Clinical Signs ◽  
Down’S Syndrome ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Thyroid Status ◽  
Biochemical Tests ◽  
Old Patients ◽  
Function Tests

ABSTRACT Thyroid status was studied in 24 patients above the age of 40 years with Down's syndrome. Three patients had thyroid function tests indicating hypothyroidism. Eight patients had thyroid autoantibodies in serum and 8 patients had a higher than normal level of thyroid stimulating hormone in serum. None of the patients had figures indicating thyrotoxicosis. None of the patients showed any of the clinical signs usually seen in patients with hypothyroidism. It is concluded that biochemical tests indicating hypothyroidism are much more often seen in patients with Down's syndrome than in normal subjects and that thyroid status should be assessed in old patients with this disease.

scholarly journals Rational use of thyroid function test

2019 ◽  
Vol 7 (02) ◽  
Author(s):  
Dr. Yasser Al-Ankoodi
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Clinical Presentation ◽  
Financial Burden ◽  
Signs And Symptoms ◽  
Thyroid Function Test ◽  
Thyroid Disorders ◽  
Continuous Increase ◽  
Rational Use ◽  
Function Test

Thyroid function test (TFT) is one of the frequently asked investigations. There is continuous increase and demand for this test. The reasons for increased number of thyroid testing include the wide list of clinical presentation of thyroid disorders with variable signs and symptoms.  The thyroid gland itself can be affected with different ranges of disorders including auto-antibodies, congenital, genetics and cancers (1,2). In addition, the thyroid disorders can mimic or co-exist with other conditions especially in elderly and children.  This climbing number of tests makes a financial burden to the laboratory. It necessitated extra reagents and consumables, extra manpower and some time extra analyzer.

scholarly journals THYROID FUNCTION IN PREGNANCY: MATERNAL AND FETAL OUTCOMES WITH HYPOTHYROIDISM AND SUBCLINICAL THYROID DYSFUNCTION

2011 ◽  
Vol 22 (3) ◽  
pp. 169-187
Author(s):  
NEIL K VANES ◽  
JOHN H LAZARUS ◽  
SHIAO-Y CHAN
Keyword(s):  
Thyroid Hormones ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Thyroid Disorders ◽  
Thyroid Function Tests ◽  
Fetal Outcomes ◽  
Function Tests ◽  
Maternal Wellbeing ◽  
In Pregnancy

Thyroid hormones are important in the development of the fetus and the placenta as well as in maintaining maternal wellbeing. Thyroid disorders are common in the population as a whole, particularly in women, and therefore are common during pregnancy and the puerperium. Biochemical derangement of thyroid function tests are present in approximately 2.5–5% of pregnant women.

scholarly journals Effects of high iodine containing low osmolar contrast agent (visipaque) on thyroid function tests

2020 ◽  
Vol 4 (5) ◽  
pp. 01-05
Author(s):  
Sorush Niknamian
Keyword(s):  
Contrast Agent ◽  
Thyroid Function ◽  
Thyroid Volume ◽  
Thyroid Function Test ◽  
Iodine Concentration ◽  
Overt Hypothyroidism ◽  
Thyroid Function Tests ◽  
High Iodine ◽  
Function Tests ◽  
Significant Difference

Objective: Investigating high iodine containing low osmolar contrast agent (visipaque) effects on thyroid function tests and thyroid sonography characteristics. Methods: 65 euthyroid cases and 92 controls composed the samples in baseline. Thyroid function tests, Urine Iodine Concentration (UIC) and thyroid sonography were conducted for both groups before and 1 and 3 months after angiography. Serum levels of T4, T3, T3RU, TSH, TPO-Ab and UIC were measured, and hypo/heyperthyroidism prevalence was compared between groups. Results: Mean T3,T4 and TSH changes 1 month after angiography were insignificant in both groups (P:0.61,P:0.4 and P:0.14, P:0.23 in cases and controls for T3 and T4). Medians among cases and controls were 12.8 and 16.75 µg/dl, respectively, at baseline. These values varied to 28.45 and 15.2µg/dl, and 12.95 and 14.2µg/dl 1 month and 3 months after angiography in case and control groups, respectively. UIC increase one month after angiography was significant among cases (P=0.002). TPO-Ab+ were same 3 months after angiography. Thyroid volume changes were significant among cases (P<0.001) and insignificant among controls (P=0.680). No significant difference was seen between cases and controls in overt hypothyroidism, however, a considerable change was seen in thyroid volume and UIC one month after angiography among cases. The hypothyroidism rate among cases was insignificant which may be either related to few cases or short half-life of visipaque (2.1 hour) so that 97% of injected dose was excreted in urine within 24 hours. Conclusion: Thyroid function test is not recommended before angiography in patients without previous thyroid records.

Is It Necessary to Measure Thyroid Hormone Levels in Children Receiving Antiepileptic Drugs?

2018 ◽  
Vol 07 (04) ◽  
pp. 136-141
Author(s):  
Reem A. Abdel Aziz ◽  
Mostafa A. Abu ELela
Keyword(s):  
Antiepileptic Drugs ◽  
Thyroid Function ◽  
Thyroid Function Test ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Thyroid Function Tests ◽  
Healthy Children ◽  
Function Tests ◽  
Serum T3

Purpose This article evaluates the effect of antiepileptic drugs (AEDs) on thyroid function tests in children with epilepsy. Methodology One hundred twenty children were studied, with 40 patients taking older generation AEDs Na valproate (N = 20) and carbamazepine (N = 20), 40 patients taking newer generation AEDs levetiracetam (N = 20) and oxcarbazepine (N = 20), and 40 healthy children as controls. Serum T3, T4, FT4, and thyroid-stimulating hormone (TSH) were measured. Results Patients taking Na valproate had lower T3, T4, and a higher TSH level than controls. Patients taking carbamazepine had the lowest T3, T4, and FT4 serum levels among patients receiving AEDs. Conclusion The thyroid function tests were affected by the use of Na valproate and carbamazepine compared to both the control group and the group taking newer AEDs oxcarbazepine and levetiracetam. In addition, there was no effect of levetiracetam on thyroid function test results.

Radioimmunoassay of free thyroxine in serum: comparison with clinical findings and results of conventional thyroid-function tests.

1980 ◽  
Vol 26 (8) ◽  
pp. 1186-1192 ◽  
Author(s):  
M F Bayer ◽  
I R McDougall
Keyword(s):  
Thyroid Function ◽  
Clinical Status ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Free Thyroxine ◽  
Thyroid Disorders ◽  
Thyroid Function Tests ◽  
Healthy Individuals ◽  
Function Tests ◽  
The Mean

Abstract We have evaluated a radioimmunoassay for free thyroxine (FT4) involving antibody-coated tubes (GammaCoat 125I Free T4RIA; Clinical Assays, Div. of Travenol Labs, Inc.). The coefficient of correlation between FT4 and the FT4 index was 0.98 for all patients with various thyroid disorders, 0.77 for hospitalized patients with miscellaneous diseases, and 0.74 for healthy individuals. FT4 values also agreed well with triiodothyronine or thyrotropin concentrations in these patients and were consistent with each patient's clinical status. Patients with severe nonthyroidal illnesses and abnormal thyroid-function tests, despite clinical euthyroidism, had normal FT4 values. In this group, the mean FT4 was almost identical to that in the controls, although mean thyroxine, triiodothyronine, and FT4 index differed significantly and the correlation between FT4 and FT4 index was poorer (r = 0.66). For most patients, the diagnostic value of FT4 measurements is comparable to that of the FT4 index, and it may be superior in patients with severe nonthyroidal illnesses. The test costs less and saves time as compared to the FT4 index computation, and it can be used routinely with thyrotropin assay for the diagnosis of hypothyroidism or with triiodothyronine assay for the diagnosis of hyperthyroidism.

scholarly journals MON-475 Discrepant Thyroid Function Tests in Adenocarcinoma-Is This a True Thyroid Disorder?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Mohammed Al Tameemi ◽  
Janice L Gilden
Keyword(s):  
Thyroid Function ◽  
Thyroid Function Test ◽  
Amiodarone Therapy ◽  
Thyroid Function Tests ◽  
Thyroid Disorder ◽  
Check Point ◽  
Free T4 ◽  
Function Tests ◽  
Function Test ◽  
Check Point Inhibitors

Abstract Background: Many causes of abnormal thyroid function tests (TFTs) occur that may or may not reflect a true thyroid disorder. The most common include: immune check point inhibitors therapies (ICI) used to treat various types of cancers; biotin supplements, which may interfere with thyroid function test assays; euthyroid sick syndrome; as well as amiodarone therapy for cardiac disorders. Clinical Case: A 67-year old female patient with type 2 diabetes mellitus, taking insulin and oral antihyperglycemic agents, with hyperlipidemia, hypertension and coronary artery disease, who had abnormal TFTs (TSH was 3.7 to 4.9 uIIu/ml; ref range 0.27-4.2 uIU/mL), and Free T4 was 0.92 to 1.06 ng/dL; ref range 0.55-1.6 ng/dl) prior to the diagnosis of metastatic adenocarcinoma of the lungs. She was initially treated with radiation. TFTs were unchanged. Her CEA was noted to be 129.5 (0-3.0 ng/mL). However, following chemotherapy with Tarceva (Erlotinib) 50 mg po daily, the TSH increased to 7.6 uIU/ml with Free T4 of 3.19 ng/dL. She remained clinically euthyroid. A thyroid ultrasound showed 1 -small sub centimeter nodule in each thyroid lobe. The patient later admitted to also taking biotin for an unknown period of time. TSH antibodies and TSI were both negative. Free T4 by dialysis was normal. While still taking Tarceva her TSH was noted to be 2.5 to 3.8 uIU/ml and both Free T4 and Free T3 were elevated and was 6.57 pg/ml;ref range=2.52-4.34 pg/mL). Six months later, the Free T4 decreased to 1.08 ng/dL. Thyroid antibodies and thyroglobulin remain normal. The patient remained clinically euthyroid. Conclusion: It is important to note that several factors can cause abnormal thyroid function tests, such as Immune check point inhibitors therapy, with the exact mechanism for abnormal TFTs unknown, and can also be associated with either Grave’s hyperthyroidism or Hashimoto’s hypothyroidism,as well as other autoimmune endocrine disorders. Biotin, a common supplement, has also been reported to interfere with the thyroid function test assays for free thyroxine (T4), total T4, free triiodothyronine (T3), total T3, TSH, and various cancer markers. However, It is important to clinically evaluate the patient for thyroid disorders, and recognize that therapy may not always be required, when discrepant and fluctuating thyroid function tests are obtained, such as in this patient. References: (1) Holmes EW, Samarasinghe S, Emanuele MA, Meah. Biotin interference in clinical immunoassays: a cause for concern. . Arch Pathol Lab Med. 2017;141:1459-1460. (2) Rossi E, Sgambato, De Chaira G, et al. Thyroid-induced toxicity of check-point inhibitors immunotherapy in the treatment of advance non-small cell lung cancer. J. Endocrinol Diabetes 2016;3:1-10.

scholarly journals HYPERTHYROIDISM

2016 ◽  
Vol 23 (04) ◽  
pp. 401-405
Author(s):  
Muhammad Usman Anjum ◽  
Adil Umar Durrani ◽  
Talib Hussain ◽  
Syed Humayun Shah
Keyword(s):  
Thyroid Function ◽  
Field Studies ◽  
Mean Value ◽  
Endocrine Disorders ◽  
Thyroid Disorders ◽  
Thyroid Function Tests ◽  
Cross Sectional ◽  
Female Ratio ◽  
Function Tests ◽  
Male To Female

Thyroid disorders are one of the common endocrine disorders. Their prevalenceis affected by many factors, especially environmental and nutritional ones. Objectives: Toascertain the seroprevalence of hyperthyroidism in clinically suspected hyperthyroid patients.Design: Descriptive cross-sectional study. Setting: Frontier Medical & Dental College,Abbottabad. Period: January to August, 2015. Methods: One hundred and twenty patientswere included in the study based on inclusion and exclusion criteria. Thyroid function tests(TSH, fT3 & fT4) were performed using enzyme linked immunoassay (ELISA) method. Results:There was preponderance of males in our study with male to female ratio of 1.4:1. Maximumpatients (56.67 %) were between the ages of 21-40 years of age, with mean age of studypopulation to be 32.09±13.01 years. The prevalence of hyperthyroidism was 15% based on theresults of thyroid function tests. There were 11 males and 7 females with male to female ratio of1.57:1 and mean age of hyperthyroid patients was 25.72± 8.27 years. The mean value of TSH,fT3 and fT4 was 0.038±0.025 mIU/L, 7.08±2.19 ng/mL and 25.25±6.30 μg/dL respectively inhyperthyroid patients as compared to 3.15±2.23 mIU/L, 2.05±0.88 ng/mL and 10.69±2.69μg/dL in euthyroid subjects. Conclusion: Thyroid disorders are not very rare among generalpopulation. TFTs provide a reliable way of ascertaining the thyroid function. As this is a hospitalbased study, field studies should be conducted to ascertain the true prevalence of thyroiddisorders in the community.

scholarly journals SUN-504 A Case of T3 Thyrotoxicosis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Isabelle Daneault Peloquin ◽  
Matthieu St-Jean
Keyword(s):  
Thyroid Function ◽  
Thyroid Function Test ◽  
Nutritional Supplement ◽  
Thyroid Function Tests ◽  
Free T4 ◽  
Endocrine Society ◽  
Product Consumption ◽  
Function Tests ◽  
History Of ◽  
Receptor Antibodies

Abstract Clinical vignette ENDOCRINE SOCIETY 2020 Title: A case of T3 thyrotoxicosis induced by a dietary supplement. A 24 yo man consulted for a 2 weeks history of diaphoresis, fatigue, insomnia, palpitations and headache associated with a 20 pounds lost. The patient didn’t have a goiter or any signs of orbitopathy. The results revealed a free T3 level of 45.8 pmol/L upon arrival (normal (N) 3.4- 6.8 pmol/L), free T4 level of 6.4 pmol/L (N 11.0–22.0 pmol/L) and TSH level less than 0.005 mUI/L (N: 0.35 to 3.50 mUI/L). Facing those results, a complete review of the patient medication and natural product consumption was done. The patient revealed that he was using, since a month, a vegetable extracts nutritional supplement that didn’t included iodine. He was asked to stop the nutritional supplement and propranolol 10 mg twice daily was prescribed. Thyroid function tests were done 3 days after. The results demonstrate a fT3 level of 4.6 pmol/L, a fT4 level of 5.6 pmol/L and a TSH that still suppressed. A thyroid scintigraphy was performed 7 days later and showed a homogeneous uptake of 18.5% (N 7.0% – 35.0%). We saw the patient 2 weeks later and we ordered another thyroid function test with TSH receptor antibodies, TPO antibodies and thyroglobulin. The results were the following: fT3 of 5.1 pmol/L, fT4 of 12.1 pmol/L, TSH of 2.31 mUI/L, thyroglobulin of 19.8 ug/L (N: 1.4 – 78) and normal levels of antibodies against TPO and TSH receptors. To confirm the contamination of the nutritional supplement by fT3 we used a plasma pool of normal patients in which we measured thyroid function tests at baseline and after we have added the nutritional supplement powder to reflect the dose suggested by the manufacturer. The results showed that fT3 level increased by 36.5%, fT4 by 11.2% and TSH didn’t changed. The powder was then analyzed by an external laboratory that wasn’t able to demonstrate the presence of fT3 nor fT4. The two diagnostic possibility facing those results were that the powder induced an interference with immunoassay used to measure fT3 and fT4 but not TSH or thyrotoxicosis induced by the nutritional supplement with limitation in the technique that tried to identify fT3 in the powder. Given the presentation of the patient, we are convinced that this case represents a thyrotoxicosis induced by a nutritional supplement. In conclusion, Graves’ disease is responsible for 60–80% of the cases of hyperthyroidism. However, there are few cases reports of thyrotoxicosis induced by nutritional supplement1,2, but some studies demonstrate the presence of thyroid hormone in significant amounts in some commercially available health supplements3. This case highlights the importance of verifying exposition to medications and natural products when confronted to cases of thyrotoxicosis. 1.Regina A et al. MMWR Morb Mortal Wkly Rep. 2016 2. Panikkath R et al. Am J Ther. 2014 3. Kang GY et al. Thyroid. 2013

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