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

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.

2019 ◽  

AbstractObjectiveInvestigating high iodine containing low osmolar contrast agent (visipaque) effects on thyroid function tests and thyroid sonography characteristics.Methods65 euthyroid cases and 92 controls composed the samples in the 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/hyperthyroidism prevalence was compared between groups.ResultsMean T3, T4 and TSH change 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 hours) so that 97% of the injected dose was excreted in urine within 24 hours.ConclusionThyroid function test is not recommended before angiography in patients without previous thyroid records.


Author(s):  
Elif Çelik ◽  
Ayşe Anık

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.


Author(s):  
Ashwini S. Rathod ◽  
Girija A. Ghate ◽  
Ammu Korah ◽  
Lakshmi Krishnan ◽  
Ruchir R. Dashora

<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>


Author(s):  
Iskender Ekinci ◽  
Hande Peynirci

Background: There are limited data about the factors affecting the response time to medical treatment in Graves’ disease (GD) although many studies examined the predictors of the relapse after drug withdrawal. The aim of the current study was to evaluate the time for becoming euthyroid under antithyroid drug (ATD) therapy and the parameters influencing this period in patients diagnosed as GD.Methods: Patients with newly-diagnosed GD and decided to treat with ATD initially between March 2017 and September 2018 were retrieved retrospectively. Sociodemographic features as well as laboratory parameters like thyroid function tests and thyroid-stimulating hormone-receptor antibody (TRab) at the time of diagnosis were recorded.Results: Out of 41 patients, 63.4% (n=26) were female. The mean age was 36.1±11.7 years and 43.9% (n=18) of them were smoking. The time between the initiation of treatment and the duration of becoming euthyroid was 2.4±1.8 months. No significant difference was noted between age, gender, and smoking status and the time to become euthyroid under ATD treatment. This period was significantly positively correlated with levels of free triiodothyronine, free thyroxine, and negatively correlated with thyroid-stimulating hormone. Response to ATD therapy was higher in patients with pre-treatment TRab levels <10 IU/l than TRab ≥10 IU/l (p=0.011).Conclusions: Pretreatment thyroid function tests and TRab levels may be taken into consideration before deciding treatment in patients with newly diagnosed GD. It would be useful to design more comprehensive studies so that this proposal can find a response in clinical practice.


Author(s):  
Maimoona Rasool ◽  
Sarah Maryam ◽  
M. Sohail Anjum Noor ◽  
Mehreen Fatima ◽  
Sultan Ayaz ◽  
...  

Background: Pregnancy has great influence on maternal thyroid gland. It induces significant physiological as well as hormonal changes that alters the maternal thyroid function. Our goal was to determine this pregnancy associated changes in thyroid gland. Objective: To correlate the sonographic findings of maternal thyroid gland with thyroid function tests during pregnancy. Material and methods: 135 pregnant women were recruited in this study, data of TSH, T3 and T4 was obtained and correlated it with the sonographic findings of maternal thyroid gland in each trimester of pregnancy. Results: In the 135 sampled pregnant women, mean thyroid gland volume was 4.08±1.19 cm3. The mean levels of T3, T4 and TSH were v3.37±.44 pmol/L, 14.96±2.49 pmol/L and 1.21±.92 mIU/L respectively. A remarkable correlation between thyroid hormones and thyroid volume was observed. Conclusion: It is concluded that the ultra-sonographic findings is correlated with the thyroid function tests during pregnancy.


2018 ◽  
Vol 07 (04) ◽  
pp. 136-141
Author(s):  
Reem A. Abdel Aziz ◽  
Mostafa A. Abu ELela

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.


2018 ◽  
Vol 1 (2) ◽  
pp. 75-78 ◽  
Author(s):  
Buddhi Bahadur Thapa ◽  
Madhav Tiwari ◽  
Sailesh Gurung ◽  
Man Bahadur Gurung ◽  
Mukunda Kalauni ◽  
...  

Background: Sub-clinical hypothyroidism (SCH), overt hypothyroidism and metabolic syndrome (MetS) are recognized risk factors for atherosclerotic cardiovascular disease and Type 2 diabetes mellitus (DM- II).Thyroid function affects MetS parameters including blood pressure (BP), fasting blood sugar (FBS), serum triglycerides (TG) and high density lipoprotein cholesterol (HDL-C). But the relationship between MetS and thyroid functions is yet to be identified clearly. The present study is to investigate the frequency of MetS in patients of SCH and overt hypothyroidism. Materials and Methods: A hospital based cross–sectional study was conducted at Swastik referral laboratory and research centre. In this study, 50 patients with overt hypothyroidism, 50 patients with SCH and 129 euthyroid controls were enrolled. National Cholesterol Education Program- Adult Treatment Panel III (NCEP-ATP III; 2005) revision criteria were used to diagnose metabolic syndrome. Thyroid function test (TFT: FT3, FT4 and TSH) was done by using chemiluminescence immunoassay (CLIA) and other tests by using a semi-auto analyzer. ANalysis Of VAriance (ANOVA) test was performed using SPSS (version 16.0). Result: There was a significant difference in the mean of the waist circumference (p=0.031), BP systolic (p=0.010), BP diastolic (p<0.001)), FBS (p=0.001), serum HDL-C (p=0.031) and serum TG (p=0.003) between control, subclinical and overt hypothyroidism group (p<0.001). Prevalence of MetS was 25.6 % in euthyroid controls whereas 44.0% in the SCH group and 62.0% in the overt hypothyroid group (p<0.001). Conclusion: Thyroid dysfunction may be responsible for the development of metabolic syndrome.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Mohammed Al Tameemi ◽  
Janice L Gilden

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.


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