scholarly journals “Small Thyroid Gland” in Reproductive Women without Autoimmune Thyroid Disease—Ultrasonographic Evaluation as a Useful Screening Tool for Hypothyroidism

2021 ◽  
Vol 10 (9) ◽  
pp. 1828
Author(s):  
Justyna Milczarek-Banach ◽  
Piotr Miśkiewicz
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Predictive Factor ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Volume ◽  
Childbearing Age ◽  
Cross Sectional ◽  
Autoimmune Thyroid ◽  
Tsh Levels

Proper thyroid function is important for women of childbearing age, as hypothyroidism affects fertility, pregnancy and offspring. The upper reference limit for thyrotropin (TSH) in pregnancy was defined as <2.5 mU/L in the first trimester. Recommendations include either universal screening of TSH before pregnancy, or identifying individuals at “high risk” for thyroid illness. “Small thyroid gland” not associated with autoimmune thyroid disease (AITD) seems to be a reason for hypothyroidism and probably should be included in target case finding procedure before pregnancy. The purpose of this cross-sectional study was to analyze relationships between the thyroid volume and its function, and to determine the thyroid volume as a predictive factor for TSH levels above 2.5 µIU/mL in reproductive women without AITD. We included 151 women without AITD, and aged 18–40. Blood and urine samples were analyzed for parameters of thyroid function. Ultrasound examination of the thyroid was performed. The thyroid volume was negatively correlated with TSH. Women with a thyroid volume in the 1st quartile for the study population presented higher TSH levels versus women in the 4th quartile (p = 0.0132). A thyroid volume cut-off point of 9 mL was the predictive factor for TSH levels above 2.5 µIU/mL (p = 0.0037).

scholarly journals Occupational Exposure to Ionizing Radiation Is Associated with Autoimmune Thyroid Disease

2005 ◽  
Vol 90 (8) ◽  
pp. 4587-4592 ◽  
Author(s):  
Henry Völzke ◽  
André Werner ◽  
Henri Wallaschofski ◽  
Nele Friedrich ◽  
Daniel M. Robinson ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Thyroid Gland ◽  
Ionizing Radiation ◽  
Confidence Interval ◽  
Thyroid Disease ◽  
Odds Ratio ◽  
Autoimmune Thyroid Disease ◽  
Statistical Significance ◽  
Cross Sectional ◽  
Autoimmune Thyroid

Context: The thyroid gland is a potential target organ for radiation-related damage. Objective: The aim of the analysis was to investigate the association between occupational exposure to ionizing radiation and autoimmune thyroid disease (AITD). Design: Our design was the cross-sectional Study of Health in Pomerania. Setting: The setting was the general community. Subjects: Analyses were performed in a population-based sample of 4299 subjects. Among them, 160 persons reported a history of occupational exposure to ionizing radiation. Main Outcome Measure: AITD was defined as the combined presence of hypoechogenicity in thyroid ultrasound and antithyroxiperoxidase antibodies greater than 200 IU/ml. Results: Females with occupational exposure to ionizing radiation had more often AITD than nonexposed females (10.0 vs. 3.4%; P &lt; 0.05). This association persisted after adjustment for relevant confounders (odds ratio, 3.46; 95% confidence interval, 1.16–10.31; P &lt; 0.05). In males, there were too few subjects who fulfilled the criteria of AITD, but the association between the exposure to radiation and hypoechogenicity of the thyroid gland barely missed statistical significance (odds ratio, 2.20; 95% confidence interval, 0.92–5.26; P = 0.08). In both females and males, subjects who reported a length of exposure of more than 5 yr exhibited the highest risk of the endpoints. Conclusions: We conclude that occupational exposure to ionizing radiation is related to the risk of AITD. The usage of thyroid protection shields by radiation workers is strongly recommended.

scholarly journals Association between PCOS and autoimmune thyroid disease: a systematic review and meta-analysis

2018 ◽  
Vol 7 (11) ◽  
pp. 1158-1167 ◽  
Author(s):  
Mírian Romitti ◽  
Vitor C Fabris ◽  
Patricia K Ziegelmann ◽  
Ana Luiza Maia ◽  
Poli Mara Spritzer
Keyword(s):  
Systematic Review ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Reference Group ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Autoimmune Thyroid

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder affecting women of reproductive age. PCOS has been associated with distinct metabolic and cardiovascular diseases and with autoimmune conditions, predominantly autoimmune thyroid disease (AITD). AITD has been reported in 18–40% of PCOS women, depending on PCOS diagnostic criteria and ethnicity. The aim of this systematic review and meta-analysis was to summarize the available evidence regarding the likelihood of women with PCOS also having AITD in comparison to a reference group of non-PCOS women. We systematically searched EMBASE and MEDLINE for non-interventional case control, cross-sectional or cohort studies published until August 2017. The Ottawa–Newcastle Scale was used to assess the methodological quality of studies. Statistical meta-analysis was performed with R. Thirteen studies were selected for the present analysis, including 1210 women diagnosed with PCOS and 987 healthy controls. AITD was observed in 26.03 and 9.72% of PCOS and control groups respectively. A significant association was detected between PCOS and chance of AITD (OR = 3.27, 95% CI 2.32–4.63). Notably, after geographical stratification, the higher risk of AITD in PCOS women persisted for Asians (OR = 4.56, 95% CI 2.47–8.43), Europeans (OR = 3.27, 95% CI 2.07–5.15) and South Americans (OR = 1.86, 95% CI 1.05–3.29). AIDT is a frequent condition in PCOS patients and might affect thyroid function. Thus, screening for thyroid function and thyroid-specific autoantibodies should be considered in patients with PCOS even in the absence of overt symptoms. This systematic review and meta-analysis is registered in PROSPERO under number CRD42017079676.

Ultrasonography of the thyroid gland in pregnancies complicated by autoimmune thyroid disease

1993 ◽  
Vol 21 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Peter Zimmermann ◽  
Teuvo Takala ◽  
Lauri Pöyhönen ◽  
Reijo Punnonen
Keyword(s):  
Thyroid Gland ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Autoimmune Thyroid

A case of watery diarrhoea syndrome due to an adrenal phaeochromocytoma secreting vasoactive intestinal polypeptide with coincidental autoimmune thyroid disease

1987 ◽  
Vol 114 (3) ◽  
pp. 340-344 ◽  
Author(s):  
B. M. Fisher ◽  
G. J. A. MacPhee ◽  
D. L. Davies ◽  
S. G. McPherson ◽  
I. L. Brown ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Psychiatric Symptoms ◽  
Plasma Catecholamines ◽  
Ct Scanning ◽  
Watery Diarrhoea ◽  
Autoimmune Thyroid ◽  
Biochemical Testing ◽  
Well Differentiated

Abstract. A 40 year old woman presented with a 10 year history of watery diarrhoea and an acute quadriparesis. On clinical examination there was severe muscle weakness and a nodule was palpable in the thyroid gland. Biochemical testing revealed a hypokalaemia at 1.6 mmol/l. Plasma levels of VIP were raised at 202 pmol/l. CT scanning demonstrated a mass in the area of the left adrenal gland, and isotope scanning of the thyroid gland showed a 'cold' nodule. The plasma catecholamines and calcitonin were elevated. The patient also presented with psychiatric symptoms, and the relevance of these to her condition has been discussed. At operation a left adrenal tumour was removed. Post-operatively the patient's symptoms disappeared and the plasma hormone levels returned to normal values. Histological examination of the tumour revealed a well differentiated phaeochromocytoma which contained VIP and calcitonin. The thyroid nodule was excised and showed histological features of autoimmune thyroid disease. It is suggested that in all cases of the WDHA syndrome where the tumour is in an extra-pancreatic site patients should be screened for phaeochromocytoma.

Thyroid Function in Patients with Rheumatic Heart Disease

1985 ◽  
Vol 30 (1) ◽  
pp. 23-24
Author(s):  
M. D. Macleod
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Normal Population ◽  
Autoimmune Thyroid ◽  
Cardiology Clinic ◽  
Rheumatic Heart

Thyroid function was assessed in 94 patients with rheumatic heart disease presenting consecutively to a cardiology clinic. Despite previous reports of an association with autoimmune thyroid disease, abnormal thyroid function occurred no more commonly in this group than would be anticipated in a normal population.

scholarly journals Autoimmune Thyroid Disease with Fluctuating Thyroid Function

PLoS Medicine ◽  
2005 ◽  
Vol 2 (5) ◽  
pp. e89 ◽  
Author(s):  
Ali S Alzahrani ◽  
Saleh Aldasouqi ◽  
Suzan Abdel Salam ◽  
Ali Sultan
Keyword(s):  
Thyroid Function ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Autoimmune Thyroid

scholarly journals Familial dysalbuminemic hyperthyroxinemia confounding management of coexistent autoimmune thyroid disease

2020 ◽  
Vol 2020 ◽  
Author(s):  
Serena Khoo ◽  
Greta Lyons ◽  
Andrew Solomon ◽  
Susan Oddy ◽  
David Halsall ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Thyroid Status ◽  
Free T4 ◽  
Autoimmune Thyroid ◽  
Analytical Interference ◽  
Tsh Levels

Summary Familial dysalbuminemic hyperthyroxinemia (FDH) is a cause of discordant thyroid function tests (TFTs), due to interference in free T4 assays, caused by the mutant albumin. The coexistence of thyroid disease and FDH can further complicate diagnosis and potentially result in inappropriate management. We describe a case of both Hashimoto’s thyroiditis and Graves’ disease occurring on a background of FDH. A 42-year-old lady with longstanding autoimmune hypothyroidism was treated with thyroxine but in varying dosage, because TFTs, showing high Free T4 (FT4) and normal TSH levels, were discordant. Discontinuation of thyroxine led to marked TSH rise but with normal FT4 levels. She then developed Graves’ disease and thyroid ophthalmopathy, with markedly elevated FT4 (62.7 pmol/L), suppressed TSH (<0.03 mU/L) and positive anti-TSH receptor antibody levels. However, propylthiouracil treatment even in low dosage (100 mg daily) resulted in profound hypothyroidism (TSH: 138 mU/L; FT4: 4.8 pmol/L), prompting its discontinuation and recommencement of thyroxine. The presence of discordant thyroid hormone measurements from two different methods suggested analytical interference. Elevated circulating total T4 (TT4), (227 nmol/L; NR: 69–141) but normal thyroxine binding globulin (TBG) (19.2 µg/mL; NR: 14.0–31.0) levels, together with increased binding of patient’s serum to radiolabelled T4, suggested FDH, and ALB sequencing confirmed a causal albumin variant (R218H). This case highlights difficulty ascertaining true thyroid status in patients with autoimmune thyroid disease and coexisting FDH. Early recognition of FDH as a cause for discordant TFTs may improve patient management. Learning points: The typical biochemical features of familial dysalbuminemic hyperthyroxinemia (FDH) are (genuinely) raised total and (spuriously) raised free T4 concentrations due to enhanced binding of the mutant albumin to thyroid hormones, with normal TBG and TSH concentrations. Given the high prevalence of autoimmune thyroid disease, it is not surprising that assay interference from coexisting FDH may lead to discordant thyroid function tests confounding diagnosis and resulting in inappropriate therapy. Discrepant thyroid hormone measurements using two different immunoassay methods should alert to the possibility of laboratory analytical interference. The diagnosis of FDH is suspected if there is a similar abnormal familial pattern of TFTs and increased binding of radiolabelled 125I-T4 to the patient’s serum, and can be confirmed by ALB gene sequencing. When autoimmune thyroid disease coexists with FDH, TSH levels are the most reliable biochemical marker of thyroid status. Measurement of FT4 using equilibrium dialysis or ultrafiltration are more reliable but less readily available.

scholarly journals Long term effect of nutrition on thyroid disease

2021 ◽  
Vol 8 (2) ◽  
pp. 922
Author(s):  
Mohammed Salah Hussein ◽  
Lama Samir Asiri ◽  
Sadeem Wadia Asali ◽  
Abdulaziz Mohsin Alawlaqi ◽  
Gadeer Sameer Sibah ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Diseases ◽  
Term Effect ◽  
Feedback Mechanisms ◽  
Nutritional Elements ◽  
Autoimmune Thyroid ◽  
Long Term Effect

Many forms of thyroid diseases have been classified under autoimmune thyroid disease. These include hyperthyroidism or commonly known as Grave’s disease, and hypothyroidism commonly identified as Hashimoto’s thyroiditis. Many nutritional elements have been linked to the function of the thyroid gland as any disturbance in these elements can lead to the development of relevant thyroid diseases. The most important elements include iodine, iron, selenium, zinc, and soy. In this current manuscript, we aimed to discuss the effect of these nutritional elements on the development of thyroid diseases by reviewing relevant studies in the literature. Although it is widely known that iodine is an essential component for the synthesis and release of these hormones, exaggerated intake of iodine can also lead to the development of hypothyroidism by negative feedback mechanisms. Besides, it can also trigger abnormal autoimmune reactions which can lead to the development of AITD. Selenium is another important factor and evidence shows that it has been associated with Grave’s thyroiditis, however, further evidence is needed as recommended by previous investigations. Clinicians should also take care of iron, zinc, and soy levels during management to obtain a better prognosis.

scholarly journals Autoimmune thyroid disease and associated autoimmunity

2005 ◽  
Vol 133 (Suppl. 1) ◽  
pp. 16-24 ◽  
Author(s):  
Snezana Djurica ◽  
Bozo Trbojevic ◽  
Dragoslav Milosevic ◽  
Natasa Markovic
Keyword(s):  
Autoimmune Disease ◽  
Thyroid Gland ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Lymphoid Cells ◽  
Initial Report ◽  
Endocrine Orbitopathy ◽  
Autoimmune Thyroid ◽  
Autoimmune Attack ◽  
Organ Specific

Autoimmune diseases are manifested in a broad spectrum. Classic examples of organ-specific autoimmune disease include Addison?s disease, insulin-dependent type-1 Diabetes mellitus, Grave?s disease (MGB), and Hashimoto thyroiditis (HT). The initial report of this autoimmune thyroid disease (AITD) dates back to Hakira Hashimoto (1912). In HT, as an organ-specific autoimmune disease, massive infiltration of lymphoid cells and parenchyma destruction are a consistent feature. The infiltration appears to be immune-mediated, primarily lymphocytic (T helper, T suppressor cells), NK cells and B cells. The pathological characteristics of AITD include development of the goitre (atrophic form is not so frequent), impaired thyroid gland function (from hyperthyroidism to subclinical and manifested hypothyroidism) and the formation of antithyroidal antibodies against thyroglobulin (AbTg) and the microsomal antigen (Ab TPO). There is a very good correlation between the antibodies against TPO and the histological findings. Morbus Graves Basedow is characterized by autoimmune hyperthyroidism with goitre, and infiltrative orbitopathy. Autoantibodies against the TSH-receptor molecule on the plasma membrane of the thyroid gland follicles cause a nonphysiological activation and an increase of the cellular function. Besides this hyperthyroidal condition, an autoimmune attack against the retrobulbar tissue leading to endocrine orbitopathy, can be noted in about 40% of patients suffering from MGB.

Sign in / Sign up

Export Citation Format

Share Document