Thyroid Gland Disorder Emergencies

2013 ◽  
Vol 24 (3) ◽  
pp. 325-332
Author(s):  
Jessica Hampton
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Pharmacological Treatment ◽  
Thyroid Dysfunction ◽  
Acute Illness ◽  
Thyroid Storm ◽  
Myxedema Coma ◽  
Rapid Action ◽  
The Us ◽  
Careful Assessment

Although thyroid dysfunction will develop in more than 12% of the US population during their lifetimes, true thyroid emergencies are rare. Thyroid storm and myxedema coma are endocrine emergencies resulting from thyroid hormone dysregulation, usually coupled with an acute illness as a precipitant. Careful assessment of risk and rapid action, once danger is identified, are essential for limiting morbidity and mortality related to thyroid storm and myxedema coma. This article reviews which patients are at risk, explains thyroid storm and myxedema coma, and describes pharmacological treatment and supportive cares.

Thyreotoxische Krise und Myxödemkoma

2018 ◽  
Vol 143 (06) ◽  
pp. 397-405 ◽  
Author(s):  
Malte Milkau ◽  
Friedhelm Sayk
Keyword(s):  
Thyroid Dysfunction ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Diagnostic Tools ◽  
Thyroid Storm ◽  
Thyreotoxische Krise ◽  
Myxedema Coma ◽  
Clinical Forms ◽  
Medical Emergencies ◽  
Significant Mortality

AbstractThyroid storm and myxedema coma are the most severe clinical forms of thyroid dysfunction. While both hyper- and hypothyroidsm are common diseases, thyroid storm and myxedema coma are rare. Due to their unspecific signs and symptoms they are often difficult to diagnose. Both disorders are medical emergencies, which still show a significant mortality. The following article summarizes diagnostic tools and treatment options for these disorders

Disorders of iodine excess

2011 ◽  
pp. 403-408
Author(s):  
Shigenobu Nagataki ◽  
Misa Imaizumi ◽  
Noboru Takamura
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Thyroid Dysfunction ◽  
Laminaria Japonica ◽  
Dry Weight ◽  
Developed Countries ◽  
Iodine Intake ◽  
Normal Thyroid ◽  
Excess Iodine ◽  
Normal Thyroid Function

Iodine is an essential substrate for the biosynthesis of thyroid hormone because both thyroxine (T4) and triiodothyronine (T3) contain iodine. An adequate supply of dietary iodine is therefore necessary for the maintenance of normal thyroid function. Dietary iodine intake is increasing in many regions, especially in developed countries, mainly due to iodization of salt or bread, and it is well known that various drugs and foods contain large quantities of iodine (1), e.g. seaweeds, such as konbu (Laminaria japonica), contain 0.3% of iodine dry weight. Furthermore, large doses of iodine are used for prophylaxis against exposure to 131I. Excess iodine, as well as iodine deficiency, can induce thyroid dysfunction. The response of the thyroid gland to excess iodine and disorders due to excess iodine are the main subject of this chapter.

The thyroid gland and disorders of thyroid function

2020 ◽  
pp. 2284-2302
Author(s):  
Anthony P. Weetman ◽  
Kristien Boelaert
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Anterior Pituitary ◽  
Thyroid Dysfunction ◽  
Fetal Brain ◽  
Active Principle ◽  
Receptor Isoforms ◽  
Transcriptional Regulatory ◽  
Thyroid Hormone Levels ◽  
Tsh Levels

The iodine-containing thyroid hormones triiodothyronine (T3) and thyroxine (T4) have diverse effects on metabolism and are essential for normal development, particularly of the fetal brain. The active principle, T3, binds to nuclear receptor isoforms and serves as a transcriptional regulatory factor, thus explaining the protean actions. Thyroid hormone release is regulated by thyrotropin (TSH) from the anterior pituitary, which is itself modulated by the hypothalamic tripeptide, thyrotropin-releasing hormone. A normal TSH level rules out primary thyroid dysfunction, but when TSH levels are abnormal, or when pituitary or hypothalamic abnormalities are possible, it is essential to confirm thyroid status by measuring circulating thyroid hormone levels, which is best achieved by immunoassay of free T3 and free T4. Thyroid-antibody measurement and imaging by scintiscanning are useful in determining the aetiology of thyroid disease when this is not obvious clinically.

scholarly journals Strangulation-Induced Thyrotoxicosis in a Patient with Undiagnosed Underlying Graves’ Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-2
Author(s):  
Theresa Lanham ◽  
Abigayle Sullivan ◽  
Erik Lanham ◽  
Anthony Donato
Keyword(s):  
Thyroid Hormone ◽  
Rare Case ◽  
Thyroid Dysfunction ◽  
Young Female ◽  
Thyroid Storm ◽  
Mechanical Trauma ◽  
Graves Disease ◽  
Life Threatening ◽  
History Of ◽  
One Year

Thyrotoxicosis is a constellation of symptoms including palpitations, tremors, agitation, and heat intolerance, caused by excess thyroid hormone. It can be life-threatening in its most serious form. We present a rare case of thyrotoxicosis provoked by mechanical trauma to the neck via strangulation in a young female with a history of self-resolving postpartum symptoms of hyperthyroidism one year prior, but no formal diagnosis of thyroid dysfunction. Although hyperthyroidism and posttraumatic stress have many similar features, thyroid storm is a life-threatening disorder that needs immediate intervention.

THYROID DYSFUNCTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE: THE STATE OF THE PROBLEM AND THE WAYS OF SOLVING

2018 ◽  
Vol 22 (4) ◽  
pp. 40-49 ◽  
Author(s):  
A. R. Volkova ◽  
O. D. Dygun ◽  
B. G. Lukichev ◽  
S. V. Dora ◽  
O. V. Galkina
Keyword(s):  
Chronic Kidney Disease ◽  
Thyroid Gland ◽  
Kidney Disease ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
The Body ◽  
Type I ◽  
Low T3 ◽  
Iodine Excretion

Disturbance of the thyroid function is often detected in patients with different profiles. A special feature of patients with chronic kidney  disease is the higher incidence of various thyroid function  disturbances, especially hypothyroidism. It is known that in patients  with chronic kidney disease (CKD) iodine excretion from the body is  violated, since normally 90% of iodine is excreted in urine.  Accumulation of high concentrations of inorganic iodine leads to the  formation of the Wolf-Chaikoff effect: suppression of iodine  organization in the thyroid gland and disruption of the thyroid  hormones synthesis. Peripheral metabolism of thyroid hormones is  also disturbed, namely, deiodinase type I activity is suppressed and  peripheral conversion of T4 into T3 is inhibited (so-called low T3  syndrome). Therefore, patients with CKD are often diagnosed with  hypothyroidism, and the origin of hypothyroidism is not always  associated with the outcome of autoimmune thyroiditis. The article  presents an overview of a large number of population studies of  thyroid gland dysfunction in patients with CKD, as well as  experimental data specifying the pathogenetic mechanisms of  thyroid dysfunction in patients with CKD. Therapeutic tactics are still  not regulated. However, in a number of studies, replacement therapy with thyroid hormones in patients with CKD had some advantages.

scholarly journals The thyroid hormone receptor gene (c-erbA alpha) is expressed in advance of thyroid gland maturation during the early embryonic development of Xenopus laevis.

1991 ◽  
Vol 11 (10) ◽  
pp. 5079-5089 ◽  
Author(s):  
D E Banker ◽  
J Bigler ◽  
R N Eisenman
Keyword(s):  
Gene Expression ◽  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Xenopus Laevis ◽  
Hormone Receptor ◽  
Hormone Receptors ◽  
Thyroid Hormone Receptor ◽  
Thyroid Hormone Receptors ◽  
Stages Of Development ◽  
Xenopus Development

The c-erbA proto-oncogene encodes the thyroid hormone receptor, a ligand-dependent transcription factor which plays an important role in vertebrate growth and development. To define the role of the thyroid hormone receptor in developmental processes, we have begun studying c-erbA gene expression during the ontogeny of Xenopus laevis, an organism in which thyroid hormone has well-documented effects on morphogenesis. Using polymerase chain reactions (PCR) as a sensitive assay of specific gene expression, we found that polyadenylated erbA alpha RNA is present in Xenopus cells at early developmental stages, including the fertilized egg, blastula, gastrula, and neurula. By performing erbA alpha-specific PCR on reverse-transcribed RNAs from high-density sucrose gradient fractions prepared from early-stage embryos, we have demonstrated that these erbA transcripts are recruited to polysomes. Therefore, erbA is expressed in Xenopus development prior to the appearance of the thyroid gland anlage in tailbud-stage embryos. This implies that erbA alpha/thyroid hormone receptors may play ligand-independent roles during the early development of X. laevis. Quantitative PCR revealed a greater than 25-fold range in the steady-state levels of polyadenylated erbA alpha RNA across early stages of development, as expressed relative to equimolar amounts of total embryonic RNA. Substantial increases in the levels of erbA alpha RNA were noted at stages well after the onset of zygotic transcription at the mid-blastula transition, with accumulation of erbA alpha transcripts reaching a relative maximum in advance of metamorphosis. We also show that erbA alpha RNAs are expressed unequally across Xenopus neural tube embryos. This differential expression continues through later stages of development, including metamorphosis. This finding suggests that erbA alpha/thyroid hormone receptors may play roles in tissue-specific processes across all of Xenopus development.

THYROID PATHOLOGY IN CHILDREN WITH TYPE 1 DIABETES

Vestnik ◽  
2021 ◽  
pp. 107-111
Author(s):  
С.И. Сабирова ◽  
С.Г. Надырова ◽  
А.Б. Жанзак ◽  
А.Е. Манасбаева ◽  
Ж.Ж. Нургалиева
Keyword(s):  
Type 1 Diabetes ◽  
Thyroid Gland ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Development Indicators ◽  
Clinical Hospital ◽  
Number Of Children ◽  
Thyroid Pathology ◽  
Number Of Patients

Целью научной работы является изучение структуры заболеваний щитовидной железы у больных сахарным диабетом 1 типа. В данной статье мы ретроспективно проанализировали 972 историй болезни больных детей с СД 1 типа, находившихся на стационарном лечении в ДГКБ №2 г. Алматы (Казахстан) в период с 2014 по 2019 гг. Были изучены и оценены показатели физического развития, объективные данные (кожные покровы, ЧСС, АД, пальпация ЩЖ), лабораторно - уровней гормонов ТТГ, свТ4, свТ3, а/т к ТПО, а/т к ТГ в сыворотки крови, инструментально - УЗИ ЩЖ. Всего за 2014-2019 гг. через отделение эндокринологии ДГКБ №2 прошли 972 детей с диагнозом СД 1 типа. Большинство детей (382 человек, 79,9%) имели стаж болезни СД до 5 лет. 88 детей (18,5%) со стажем от 5 до 10 лет, 8 человек (1,7%) страдали СД более 10 лет. СД1 в основном был диагностирован в возрасте 7-12 лет (245-51,3%), меньше всего выявили СД 1 типа у детей до 3 лет (21 - 4,4%). Из общего количества пациентов с СД1 (972) было обследовано на функцию ЩЖ 478 детей (49,2%). Среди них было выявлено 319 детей с дисфункцией ЩЖ, что составляет 66,7%. Так, за 2014 год из 92 детей - 7 (7,6%), обследованных на функцию щитовидной железы, в результате чего было выявлено 6 (85,7%) детей с дисфункцией щитовидной железы. С каждым годом росло количество детей, которых направляли на обследование ЩЖ, так в сравнении с 2014 годом, когда из 92 детей - 7 (7,6%) были обследованы на функцию щитовидной железы, в 2019 году были обследованы уже 222 (92,1%) детей из 241. Симптомы как гиперфункции, так и гипофункции ЩЖ, особенно их субклинические варианты протекают под маской других заболевании и не сразу обнаруживаются, исходя из этого следует сразу обследовать на функцию ЩЖ при поступлении и в дальнейшим их наблюдать в динамике. В ходе исследования дисфункция щитовидной железы диагностирована у 319 (67,7%) пациентов, что должно привлечь внимание не только эндокринологов, но и врачей общей практики, педиатров и настроить их на прицельный поиск этой патологии и своевременную коррекцию гипотиреоза или другой патологии ЩЖ при его наличии The purpose of this research is to study the structure of thyroid diseases in patients with type 1 diabetes. In this article, we retrospectively analyzed 972 case histories of sick children with type 1 diabetes who were treated in the children's city clinical hospital No. 2 in Almaty (Kazakhstan) in the period from 2014 to 2019. Physical development indicators, objective data (skin, heart rate, blood pressure, thyroid palpation), laboratory levels of TSH, thyroxine, triiodothyronine, antibodies to thyroperoxidase, antibodies to thyroglobulin in blood serum, instrumental ultrasound examination of the thyroid gland were studied and evaluated. In total, in 2014-2019, 972 children with a diagnosis of type 1 diabetes mellitus passed through the endocrinology Department of the children's city clinical hospital No. 2.The majority of children (382 people, 79.9%) had a history of diabetes up to 5 years. 88 children (18.5%) with experience from 5 to 10 years, 8 people (1.7%) had diabetes for more than 10 years. Type 1 diabetes was mainly diagnosed at the age of 7-12 years (245-51. 3%), the least detected type 1 diabetes in children under 3 years (21 - 4.4%). Out of the total number of patients with type 1 diabetes (972), 478 children (49.2%) were examined for thyroid function. Among them, 319 children with thyroid dysfunction were identified, which is 66.7%. So, in 2014, out of 92 children, 7 (7.6%) were examined for thyroid function, as a result of which 6 (85.7%) children had thyroid dysfunction. Every year, the number of children referred for thyroid examination increased, so compared to 2014, when out of 92 children - 7 (7.6%) were examined for thyroid function, in 2019, 222 (92.1%) children out of 241 were examined. Symptoms of both hyperfunction and hypofunction of the thyroid gland, especially their subclinical variants, occur under the guise of other diseases and are not immediately detected, so you should immediately investigate the function of the thyroid gland at admission and further observe them in dynamics. During the study, thyroid dysfunction was diagnosed in 319 (67.7%) patients, which should attract the attention of not only endocrinologists, but also General practitioners, pediatricians and set them up for a targeted search for this pathology and timely correction of hypothyroidism or other thyroid pathology if it is present.

Can Thyroid Ultrasonography Predict Substernal Extension or Tracheal Compression in Goiters?

2018 ◽  
Vol 69 (4) ◽  
pp. 422-429
Author(s):  
Hedyeh Ziai ◽  
Nicole L. Lebo ◽  
Ania Z. Kielar ◽  
Michael J. Odell
Keyword(s):  
Thyroid Gland ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Thyroid Volume ◽  
Classification Systems ◽  
Tracheal Compression ◽  
Gland Volume ◽  
The Us ◽  
Thyroid Gland Volume ◽  
Preoperative Ct

Purpose To determine whether an ultrasonography (US)-defined thyroid volume can accurately predict substernal extension or tracheal narrowing. Methods After research ethics approval, we identified patients with thyroid nodules investigated with both US and computed tomography (CT). Reviewers assigned scores for both substernal extension and tracheal compression on CT using pre-established classification systems. Statistical analysis with receiver operating characteristic curve analysis was performed to find the US-determined thyroid volume thresholds that correlated with each substernal extension and tracheal compression. Results This study included 120 patients (mean age 63.4 years; SD ± 15.9; 67% female). Thirty-five patients (29%) had substernal extension. The mean US total thyroid gland volume in patients with and without substernal extension were 92.4 and 37.6 cm3, respectively ( P < .001). 86% of patients with substernal extension had tracheal narrowing vs. 27% of patients without substernal extension ( P < .0001). A cutoff dominant gland volume of ≥37.5 cm3 showed 83% sensitivity and 79% specificity for substernal extension (area under the curve [AUC] = 0.84). A total thyroid gland volume threshold of ≥37.8 cm3 showed 89% sensitivity and 87% specificity for any degree of tracheal narrowing (AUC = 0.90). Conclusions This study suggests that US volumes may be used as a predictor to identify those patients with thyroid enlargement who are most at risk of substernal extension and tracheal compression and who may benefit from preoperative CT imaging for optimal surgical and anesthetic planning.

scholarly journals Thyroid Hormone Deficiency Before the Onset of Hearing Causes Irreversible Damage to Peripheral and Central Auditory Systems

2000 ◽  
Vol 83 (5) ◽  
pp. 3101-3112 ◽  
Author(s):  
Marlies Knipper ◽  
Christoph Zinn ◽  
Hannes Maier ◽  
Mark Praetorius ◽  
Karin Rohbock ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Auditory System ◽  
Critical Time ◽  
Organ Of Corti ◽  
Thyroid Gland Function ◽  
Distortion Product ◽  
Fetal Thyroid ◽  
Gland Function ◽  
Dependent Processes

Both a genetic or acquired neonatal thyroid hormone (TH) deficiency may result in a profound mental disability that is often accompanied by deafness. The existence of various TH-sensitive periods during inner ear development and general success of delayed, corrective TH treatment was investigated by treating pregnant and lactating rats with the goitrogen methimazole (MMI). We observed that for the establishment of normal hearing ability, maternal TH, before fetal thyroid gland function on estrus days 17–18, is obviously not required. Within a crucial time between the onset of fetal thyroid gland function and the onset of hearing at postnatal day 12 ( P12), any postponement in the rise of TH-plasma levels, as can be brought about by treating lactating mothers with MMI, leads to permanent hearing defects of the adult offspring. The severity of hearing defects that were measured in 3- to 9-mo-old offspring could be increased with each additional day of TH deficiency during this critical period. Unexpectedly, the active cochlear process, assayed by distortion product otoacoustic emissions (DPOAE) measurements, and speed of auditory brain stem responses, which both until now were not thought to be controlled by TH, proved to be TH-dependent processes that were damaged by a delay of TH supply within this critical time. In contrast, no significant differences in the gross morphology and innervation of the organ of Corti or myelin gene expression in the auditory system, detected as myelin basic protein (MBP) and proteolipid protein (PLP) mRNA using Northern blot approach, were observed when TH supply was delayed for few days. These classical TH-dependent processes, however, were damaged when TH supply was delayed for several weeks. These surprising results may suggest the existence of different TH-dependent processes in the auditory system: those that respond to corrective TH supply (e.g., innervation and morphogenesis of the organ of Corti) and those that do not, but require T3 activity during a very tight time window (e.g., active cochlear process, central processes).

THE EFFECT OF THYROID HORMONE ON THE RATE OF BOTH NEUROMUSCULAR AND MUSCULAR FAILURE IN ADRENALECTOMIZED MICE MAINTAINED ON SALT

1958 ◽  
Vol 17 (2) ◽  
pp. 134-142 ◽  
Author(s):  
MARY F. LOCKETT ◽  
S. N. GANJU
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Nerve Stimulation ◽  
Early Onset ◽  
Dose Effect ◽  
Muscle Fibres ◽  
Rat Diaphragm ◽  
Direct Stimulation ◽  
Normal Rat ◽  
Stimulation Of

SUMMARY Pretreatment of salt-maintained adrenalectomized mice for 6 days with 3–6 mg dried thyroid gland, or with 0·25 μg of either l-thyroxine or l-triiodothyronine, per mouse per day, delayed the early onset of both neuromuscular and muscular failure which are characteristic of these animals. Dose-effect curves for the action of thyroxine on the myoneural junctions and striped muscle fibres are given. A concentration of 0·05μg l-triiodothyronine/100 ml. bath fluid antagonized potassium reduction of the maximal twitch of the normal rat diaphragm in response to nerve stimulation, but not in response to direct stimulation of the curarized muscle.

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