Association between thyroid-stimulating hormone (TSH) and proteinuria in relation to thyroid cyst in a euthyroid general population

Background High normal levels of thyroid-stimulating hormone (TSH) have been reported to be associated with chronic kidney disease (CKD) among euthyroid individuals. However, there has been only limited research on the association between TSH and proteinuria, a major risk factor for the progression of renal disease. Methods A cross-sectional study of 1595 euthyroid individuals was conducted. All participants were within the normal range for free triiodothyronine (T3), free thyroxine (T4), and TSH. Analyses were stratified by thyroid cyst status to test the hypothesis that the absence of thyroid cysts, an indicator of latent thyroid damage, is associated with declining ability to synthesis thyroid hormone. Results For participants with thyroid cysts, a significant inverse association between TSH and proteinuria was observed (adjusted odds ratio (95% confidence intervals) of log-transformed TSH for proteinuria 0.40 (0.18, 0.89)). In participants without thyroid cysts, a significant positive association between those two factors was observed (2.06 (1.09, 3.90)). Conclusions Among euthyroid individuals in the general population, being in the normal range of TSH was found to have an ambivalent association with proteinuria. Thyroid cyst status could be an effect modifier for those associations.

Case Report: Giant Thyroid Cyst with Critical Airway Compresion

Thyroid nodules with cystic component are common and the vast majority of them do not cause symptoms. Their neck location, close to airway and vascular structures, makes them a potentially life-threating condition if they become bigger or suffer from an acute haemorrhage. In this case report we expose the case of a twenty-two year old man who went to our emergency service suffering from odynophagia and neck swelling. He was diagnosed with giant thyroid cyst and critical tracheal compression. Initially, in order to relieve symptoms, we carried out two ultrasound-guided aspirations; later, as final treatment, the patient underwent thyroid lobectomy. He progressed successfully without postoperative complications. In our experience, surgery is an effective and definitive treatment to consider in cases for big thyroid cyst in young patients.

711 Atypical Presentation of a Ruptured Thyroid Cyst

Introduction Thyroid cysts are a common finding with the bulk of cases being benign and approximately only 5% being malignant. The majority of these cysts are managed conservatively in the absence of malignancy or compressive symptoms. Case presentation A middle-aged female patient presented with sudden onset anterior neck bruising but minimal specific symptomatology. On examination, the patient had bruising around the anterior neck and chest wall. CT and MRI scanning of the neck revealed the bruising was attributed to a ruptured thyroid cyst. On follow up, an ultrasound guided fine-needle aspirate revealed the histology to be inflammatory follicular thyroid tissue. D iscussion The case demonstrated a rare presentation, given the lack of trauma in her history nor the presence of more sinister conditions as demonstrated by the fine-needle aspirate. Normally hemorrhage of thyroid cysts are due to trauma or abnormal thyroid vasculature. There are a few previous case reports of similar presentations where ruptured thyroid cysts led to life-threatening airway compromise requiring intubation. Early recognition of these thyroid cyst complications is crucial. Conclusion Neck and anterior chest wall hematoma can be a sign of thyroid cyst rupture/hemorrhage. It is important to recognize this sign to prevent life-threatening airway compromise.

Associations between thyroid-stimulating hormone and hypertension according to thyroid cyst status in the general population: a cross-sectional study

Background The absence of thyroid cysts may indicate latent thyroid damage, as demonstrated in our previous study. However, the association between the absence of thyroid cysts and latent functional damage of the thyroid is unknown. At low thyroid hormone productivity, which may be associated with latent functional damage of the thyroid, the association between thyroid-stimulating hormone (TSH) and hypertension might be enhanced. Therefore, we evaluated the association between TSH level and hypertension stratified by thyroid cyst status. Methods We conducted a cross-sectional study of 1724 euthyroid Japanese individuals aged 40–74 years who participated in an annual health checkup in 2014. Results In the study population, 564 and 686 participants had thyroid cysts and hypertension, respectively. A significant positive association was observed between TSH and hypertension in subjects without a thyroid cyst but not in subjects with thyroid cysts. There was a significant positive association between hypertension and TSH in subjects without a thyroid cyst (odds ratio [OR] 1.27; 95% confidence intervals [CI] 1.01, 1.61) but not in subjects with thyroid cysts (OR 0.79; CI 0.57, 1.09) in the model fully adjusted for known confounding factors. The correlation between the TSH and free triiodothyronine (fee T3) levels (simple correlation coefficient [r] = − 0.13, p < 0.01) was stronger in the subjects without thyroid cysts than in those with thyroid cysts (r = − 0.03, p = 0.525). Conclusions TSH is positively associated with hypertension only in individuals without thyroid cysts. The correlation between the TSH and free T3 levels was stronger in the subjects without thyroid cysts than in those with thyroid cysts. Therefore, the absence of thyroid cysts could be related to the association between TSH level and hypertension, possibly by indicating that the subjects without thyroid cysts had limited thyroid hormone reserves. Therefore, the absence of thyroid cysts could indicate the latent functional damage of the thyroid.

Unintentional puncture of thyroid cyst during insertion of dialysis catheter

Central venous catheter (CVC) for hemodialysis are frequently implanted to the internal jugular vein. Thyroid cysts are commonly shown in ultrasound examination and their recognition should not pose a problem. Herby we present an uncommon case of the thyroid cyst unintended puncture, during an attempt of CVC insertion. No further clinical consequences were observed. For all practitioners, involved in interventional nephrology, such complication may be of the utmost importance.

Right thyroid lobed cyst in a middle-aged woman: A case report

Background: Thyroidal ultrasound has been used to detect neck lesions and nodules for decades. However, cystic thyroid disease is rare with few reported series. Different consensus exists concerning availability of medical treatment and the limited role of surgical management. Case presentation: We present a 31-year-old female with obvious neck swelling and dysphagia. Ultrasound diagnosed a suspected colloidal thyroid cyst in the right lobe. The hypoechoic cystic mass measures 3.2 cm x 3.6 cm on frozen sonogram, with evidence of bilateral (cervical) lymphadenopathy. Thyroid cystic nodule viewed via sonar corresponds to detected mass finding on observation and palpitation. Researchers have recently standardized Thyroid-Imaging- Reporting and Data System (TIRADS), mostly in the United States. Conclusion: If Fine Needle Aspiration (FNA) and hormone therapy fail, cysts larger than >2.8cm may require surgical intervention, especially when there is a danger of great-vessel compression.

Efficacy of ethanol ablation for treatment of benign cystic thyroid nodules: the first hospital-based study in Vietnam

Background: In Vietnam, surgery or aspiration is preferred to treat thyroid cysts however each of them still have limitations. Purposes of this study were to evaluate the efficacy and safety of ethanol ablation in treating thyroid cysts and determine factors that predict the outcome of treatment. Methods: This prospective study was approved by the Ethics Committee of the Institutional Review Board of Family hospital and written informed consent for procedures was obtained. From May 2018 to March 2019, 23 patients who underwent treatment for thyroid cysts by EA were enrolled in this study and were followed up for 1 month at Family hospital. The primary endpoint was efficient after one month as the volume reduction ratio was ≥ 50%. Secondary endpoints were improvements in symptoms, cosmetic scores, and safety. Multiple logistic regression analysis was used. Results: In the finding, from May 2018 to March 2019, only 17 patients who matched inclusion criteria were included in the analyst, including 7 purely thyroid cysts, and 10 predominantly cystic nodules. Mean volume decreased significantly from 5.21 ± 3.37 ml to 2.35 ± 2.52 ml in corresponding to 52.87% of volume reduction with p < 0.05. Ethanol ablation (EA) success rate was 52.90% after 1 month. Symptoms and cosmetic scores were improved significantly. The thyroid function was constant. No adverse events occurred. Purely thyroid cyst was a predictive factor contributing to the success of EA. Conclusion: EA seems likely to be a safe and an efficient therapy for patients who had purely or predominantly cystic thyroid nodules.