Anemia normocitica e dosaggio degli ormoni tiroidei

2020 ◽  
Vol 23 (9) ◽  
pp. 228-230
Author(s):  
Elena Ferretti ◽  
Cecilia Maria Pini ◽  
Laura Luti
Keyword(s):  
Bone Marrow ◽  
Thyroid Function ◽  
Hashimoto Thyroiditis ◽  
Dry Skin ◽  
Faecal Impaction ◽  
Specific Antibodies ◽  
The Third ◽  
Normocytic Anaemia ◽  
Ormoni Tiroidei ◽  
Age And Sex

The paper describes the case of an 11-year-old girl presenting with normocytic hyporegenerative anaemia associated with increase of transaminases, CK and LDH. On physical exam skin pallor, mask-like facies and dry skin were observed; weight and height were below the third percentile for age and sex. Abdomen ultrasound (US) was significant for faecal impaction, but excluded an abdominal neoplasia. Lab tests showed persistency of normocytic anaemia while B12 and folate dosage, haemoglobin electrophoresis and DEB test were normal. However, a screening of thyroid function showed an abnormally high TSH and undetectable fT4 and fT3. Dosing of specific antibodies and thyroid US led to diagnosis of Hashimoto thyroiditis. Normocytic anaemia among paediatric patients cannot only be related to medullary aplasia, but also to chronic diseases and endocrinological disorders that should be adequately investigated. If the diagnosis still remains elusive, the execution of a bone marrow is mandatory.

SUBACUTE THYROIDITIS

1960 ◽  
Vol XXXIII (III) ◽  
pp. 457-472 ◽  
Author(s):  
B.-A. Lamberg ◽  
G. Hintze ◽  
R. Jussila ◽  
M. Berlin
Keyword(s):  
Thyroid Function ◽  
Early Phase ◽  
Radioactive Iodine ◽  
Serum Proteins ◽  
Conversion Ratio ◽  
Subacute Thyroiditis ◽  
Synthetic Analogues ◽  
The Third ◽  
Thyroid Uptake ◽  
Iodine Metabolism

ABSTRACT A series of cases of clinically diagnosed subacute thyroiditis comprising 11 patients is reported. Studies on the iodine metabolism, electrophoretic distribution of the serum proteins and the responsiveness to TSH were carried out. The patients were observed for periods up to 16 months from the onset of the disease. In the early phase there was an elevation of the serum PBI in a few cases and hyperthyroid signs in some, accompanied by depressed thyroid uptake of radioactive iodine and a fairly good response to TSH. Later, the thyroid grew hard and the iodine metabolism changed. In several cases there was a marked increase in the conversion ratio and the serum PB131I level. The responses to TSH was variable for different parameters of thyroid function, suggesting a state of »low thyroid reserve« as defined by Jefferies et al. (1956). Hypothyroidism developed in 3 cases; in two of them there was a response to exogenous TSH, in the third no response was seen at this stage of the disease. Cortisone and synthetic analogues seem to be of great benefit in the treatment of the acute symptoms of the disease.

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.

scholarly journals INTRAVENOUS LEVOTHYROXINE DURING HEMODIALYSIS IN A PATIENT WITH HYPOTHYROIDISM AND NON-ADHERENCE TO ORAL MEDICATIONS

2020 ◽  
Vol 6 (5) ◽  
pp. e230-e233
Author(s):  
Dipa Avichal ◽  
Igor Kravets
Keyword(s):  
Renal Disease ◽  
Thyroid Function ◽  
End Stage Renal Disease ◽  
Hashimoto Thyroiditis ◽  
Thyroid Stimulating Hormone ◽  
Psychiatric Medication ◽  
Medication Regimen ◽  
Free T4 ◽  
Stage Renal Disease ◽  
End Stage

Objective: We describe an unusual and challenging clinical scenario: a patient with end-stage renal disease on hemodialysis with severely uncontrolled hypothyroidism and worsening psychosis, who refused both oral and intramuscular levothyroxine, but was successfully treated with intravenous (IV) levothyroxine given on hemodialysis days. Methods: The patient was interviewed and examined on admission and during hospitalization. Thyroid function was assessed through thyroid-stimulating hormone (TSH), thyroxine (T4), free T4, and triiodothyronine (T3) by electrochemiluminescence immunoassay. Thyroid function was measured on admission, before and after each hemodialysis session for 1 week, and monthly thereafter. Results: The patient was a 71-year-old female with schizoaffective disorder, end-stage renal disease on hemodialysis, and uncontrolled Hashimoto thyroiditis due to non-adherence to oral levothyroxine therapy. On admission her TSH was 172.6 mIU/mL, free T4 was 0.59 ng/dL, and total T3 was 52 ng/dL. She presented to the hospital from her nursing home after repeated refusal to go to hemodialysis sessions secondary to worsening psychosis. At the hospital, she agreed to undergo hemodialysis and receive IV medications, but refused oral and intramuscular levothyroxine. After initiation of IV levothyroxine therapy 3 times weekly during hemodialysis, the patient’s thyroid function normalized within 19 weeks (TSH was 2.2 mIU/L, free T4 was 1.3 ng/dL, total T3 was 60 ng/dL). The achievement of the euthyroid status and adjustment of the patient’s psychiatric medication regimen were followed by a resolution of the patient’s psychosis. Conclusion: This case report demonstrates an unusual approach to the successful control of hypothyroidism, namely administration of IV levothyroxine 3 times weekly during hemodialysis sessions when conventional routes of levothyroxine administration could not be used due to the patient’s refusal.

scholarly journals Hashimoto thyroiditis in mother and thyroid function in offspring – a prospective study

2015 ◽  
Vol 14 (3) ◽  
pp. 9-14
Author(s):  
Agnieszka Zubkiewicz-Kucharska ◽  
◽  
Joanna Chrzanowska ◽  
Anna Noczyńska ◽  
◽  
...  
Keyword(s):  
Prospective Study ◽  
Thyroid Function ◽  
Hashimoto Thyroiditis ◽  
A Prospective Study

scholarly journals Quantification of plasma cell dynamics using mathematical modelling

2018 ◽  
Vol 5 (1) ◽  
pp. 170759 ◽  
Author(s):  
Marcel Mohr ◽  
Dirk Hose ◽  
Anja Seckinger ◽  
Anna Marciniak-Czochra
Keyword(s):  
Mathematical Model ◽  
Bone Marrow ◽  
Mathematical Modelling ◽  
Plasma Cells ◽  
Cell Dynamics ◽  
Growth And Survival ◽  
Specific Antibodies ◽  
Health And Disease ◽  
Potential Basis ◽  
The Impact

Plasma cells (PCs) are the main antibody-producing cells in humans. They are long-lived so that specific antibodies against either pathogens or vaccines are produced for decades. PC longevity is attributed to specific areas within the bone marrow micro-environment, the so-called ‘niche’, providing the cells with required growth and survival factors. With antigen encounters, e.g. infection or vaccination, new PCs are generated and home to the bone marrow where they compete with resident PCs for the niche. We propose a parametrized mathematical model describing healthy PC dynamics in the bone marrow. The model accounts for competition for the niche between newly produced PCs owing to vaccination and resident PCs. Mathematical analysis and numerical simulations of the model allow explanation of the recovery of PC homoeostasis after a vaccine-induced perturbation, and the fraction of vaccine-specific PCs inside the niche. The model enables quantification of the niche-related dynamics of PCs, i.e. the duration of PC transition into the niche and the impact of different rates for PC transitions into and out of the niche on the observed cell dynamics. Ultimately, it provides a potential basis for further investigations in health and disease.

scholarly journals Variation of iodine status during pregnancy and its associations with thyroid function in women from Rio de Janeiro, Brazil

2019 ◽  
pp. 1-9 ◽  
Author(s):  
Carolina Martins Corcino ◽  
Tatiana Martins Benvenuto Louro Berbara ◽  
Débora Ayres Saraiva ◽  
Nathalie Anne de Oliveira e Silva de Morais ◽  
Annie Schtscherbyna ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Rio De Janeiro ◽  
Urinary Iodine ◽  
Urinary Iodine Concentration ◽  
Thyroid Antibodies ◽  
Third Trimester ◽  
Iodine Status ◽  
The Third ◽  
Increased Risk

AbstractObjectiveTo assess iodine status and its effects on maternal thyroid function throughout pregnancy.DesignIn the present prospective cohort study, three urinary samples were requested for urinary iodine concentration (UIC) determinations in both the first and third gestational trimesters. Serum thyrotropin (TSH) and free thyroxine (FT4) were analysed in both trimesters and thyroid antibodies were assessed once.SettingRio de Janeiro, Brazil.ParticipantsFirst-trimester pregnant women (n243), of whom 100 were re-evaluated during the third trimester.ResultsIodine sufficiency was found in the studied population (median UIC=216·7 µg/l). The first- and third-trimester median UIC was 221·0 and 208·0 µg/l, respectively. TSH levels (mean (sd)) were higher in the third trimester (1·08 (0·67)v. 1·67 (0·86) mIU/l;P<0·001), while FT4levels decreased significantly (1·18 (0·16)v. 0·88 (0·12) ng/dl;P<0·001), regardless the presence of iodine deficiency (UIC<150 µg/l) or circulating thyroid antibodies. UIC correlated (β; 95% CI) independently and negatively with age (–0·43; –0·71, –0·17) and positively with multiparity (0·15; 0·02, 0·28) and BMI (0·25; 0·00, 0·50). Furthermore, median UIC per pregnant woman tended to correlate positively with TSH (0·07; –0·01, 0·14). Women with median UIC≥250 µg/l and at least one sample ≥500 µg/l throughout pregnancy had a higher risk of subclinical hypothyroidism (OR=6·6; 95% CI 1·2, 37·4).ConclusionsIn this cohort with adequate iodine status during pregnancy, excessive UIC was associated with an increased risk of subclinical hypothyroidism.

scholarly journals Bone marrow fibrosis (pseudo-myelofibrosis) in human kala-azar

2000 ◽  
Vol 33 (4) ◽  
pp. 363-366 ◽  
Author(s):  
Francisco Dário Rocha Filho ◽  
Francisco Valdeci de Almeida Ferreira ◽  
Flávia de Oliveira Mendes ◽  
Fernanda Nogueira Holanda Ferreira ◽  
Alexandre Karbage ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Iliac Crest ◽  
Histological Analysis ◽  
Blood Parameters ◽  
Bone Marrow Fibrosis ◽  
Iliac Crest Biopsy ◽  
The Third ◽  
Kala Azar ◽  
Reticulin Fibers ◽  
Marrow Fibrosis

Thirty cases of human kala-azar were diagnosed by iliac crest biopsy and myeloculture. Histological analysis of 12 patients showed diffuse thickening of reticulin fibers. To the best of our knowledge, this is the third report describing secondary bone marrow fibrosis (myelofibrosis-like) associated with kala-azar. Patients with positive bone marrow fibrosis (pbmf = 12) were compared to patients without detectable bone marrow fibrosis (wbmf = 18). There were no significant differences in clinical and blood parameters following treatment. All patients showed regression of hepatosplenomegaly.Our findings suggest that associated bone marrow fibrosis is transient and did not interfere in the evolution of treated patients.

scholarly journals Bone Marrow Plasma Cells Are a Primary Source of Serum HIV-1–Specific Antibodies in Chronically Infected Individuals

2015 ◽  
Vol 194 (6) ◽  
pp. 2561-2568 ◽  
Author(s):  
Jairo M. Montezuma-Rusca ◽  
Susan Moir ◽  
Lela Kardava ◽  
Clarisa M. Buckner ◽  
Aaron Louie ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Plasma Cells ◽  
Primary Source ◽  
Specific Antibodies ◽  
Bone Marrow Plasma ◽  
Hiv 1

Quantification of T-Cell Progenitors During Ontogeny: Thymus Colonization Depends on Blood Delivery of Progenitors

Blood ◽  
1999 ◽  
Vol 93 (7) ◽  
pp. 2234-2243 ◽  
Author(s):  
D. Dunon ◽  
N. Allioli ◽  
O. Vainio ◽  
C. Ody ◽  
B.A. Imhof
Keyword(s):  
Bone Marrow ◽  
T Cell ◽  
Peripheral Blood ◽  
Blood Circulation ◽  
Hematopoietic Progenitors ◽  
Refractory Periods ◽  
The Third ◽  
T Cell Progenitors ◽  
Intrathymic Injection

Abstract An in vivo thymus reconstitution assay based on intrathymic injection of hematopoietic progenitors into irradiated chicks was used to determine the number of T-cell progenitors in peripheral blood, paraaortic foci, bone marrow (BM), and spleen during ontogeny. This study allowed us to analyze the regulation of thymus colonization occurring in three waves during embryogenesis. It confirmed that progenitors of the first wave of thymus colonization originate from the paraaortic foci, whereas progenitors of the second and the third waves originate from the BM. The analysis of the number of T-cell progenitors indicates that each wave of thymus colonization is correlated with a peak number of T-cell progenitors in peripheral blood, whereas they are almost absent during the periods defined as refractory for colonization. Moreover, injection of T-cell progenitors into the blood circulation showed that they homed into the thymus without delay during the refractory periods. Thus, thymus colonization kinetics depend mainly on the blood delivery of T-cell progenitors during embryogenesis.

Neonate with haemophagocytic lymphohistiocytosis secondary to dengue infection: a case report

2016 ◽  
Vol 47 (3) ◽  
pp. 253-255 ◽  
Author(s):  
MV Krithika ◽  
Prakash Amboiram ◽  
Sneha M Latha ◽  
Binu Ninan ◽  
Febe Renjitha Suman ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Case Report ◽  
Virus Infection ◽  
Dengue Virus ◽  
Dengue Infection ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Dengue Virus Infection ◽  
The Third ◽  
First Case

We report the first case of haemophagocytic lymphohistiocytosis (HLH) in a neonate secondary to primary Dengue virus infection. This neonate presented in the third week of life with fever, shock and hepatosplenomegaly and was diagnosed to have Dengue infection by serology and HLH was confirmed on bone marrow.

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