Diffuse Alopecia and Thyroid Atrophy in Sheep

Thyroid dysfunction substantially affects the quality of life due to its association with various disorders in different organs. A low intake of selenium and zinc can predispose to thyroid alterations, resulting in hypothyroidism. A deficiency of selenium and zinc causes direct and indirect skin lesions, both by the action of free radicals on the skin and by thyroid dysfunction. The aim of this study was to describe natural cases of diffuse alopecia and thyroid abnormalities in sheep with selenium and zinc deficiency. Five adult sheep presented marked and diffuse alopecia, and the residual hairs were dry and brittle. The skin was thick and crusty, with marked peeling. The triiodothyronine (T3) and thyroxine (T4) serum concentrations were below reference values for the species. Zinc and Se concentrations were low in both the serum and liver. During necropsy, cachexia associated with serous fat atrophy was observed, and the thyroid glands showed marked atrophy. Microscopically, the thyroid presented multifocal to coalescent atrophy, with atrophied and dilated follicles, macrophage infiltration, and the presence of fibrous connective tissue. The skin revealed hyperkeratosis and edema. It is concluded that thyroid atrophy, alopecia, and hyperkeratosis are associated with low serum and liver concentrations of zinc and selenium in sheep.

Update on Neonatal Isolated Hyperthyrotropinemia: A Systematic Review

The purpose of this paper was to systematically summarize the published literature on neonatal isolated hyperthyrotropinemia (HTT), with a focus on prevalence, L-T4 management, re-evaluation of thyroid function during infancy or childhood, etiology including genetic variation, thyroid imaging tests, and developmental outcome. Electronic and manual searches were conducted for relevant publications, and a total of 46 articles were included in this systematic review. The overall prevalence of neonatal HTT was estimated at 0.06%. The occurrence of abnormal imaging tests was found to be higher in the persistent than in the transient condition. A continuous spectrum of thyroid impairment severity can occur because of genetic factors, environmental factors, or a combination of the two. Excessive or insufficient iodine levels were found in 46% and 16% of infants, respectively. Thirty-five different genetic variants have been found in three genes in 37 patients with neonatal HTT of different ethnic backgrounds extracted from studies with variable design. In general, genetic variants reported in the TSHR gene, the most auspicious candidate gene for HTT, may explain the phenotype of the patients. Many practitioners elect to treat infants with HTT to prevent any possible adverse developmental effects. Most patients with thyroid abnormalities and/or carrying monoallelic or biallelic genetic variants have received L-T4 treatment. For all those neonates on treatment with L-T4, it is essential to ensure follow-up until 2 or 3 years of age and to conduct medically supervised trial-off therapy when warranted. TSH levels were found to be elevated following cessation of therapy in 44% of children. Withdrawal of treatment was judged as unsuccessful, and medication was restarted, in 78% of cases. Finally, data extracted from nine studies showed that none of the 94 included patients proved to have a poor developmental outcome (0/94). Among subjects presenting with normal cognitive performance, 82% of cases have received L-T4 therapy. Until now, the precise neurodevelopmental risks posed by mild disease remain uncertain.

An Old Disease with a New Twist: CNS and Thyroid Sarcoidosis Presenting as Subacute Dementia

Neurosarcoidosis and thyroid abnormalities are reversible causes of dementia in the elderly. We present a case of a patient with rapidly progressive dementia due to neurosarcoidosis and sarcoid involvement of the thyroid improved by corticosteroids and Methimazole.

A Cross-Sectional Study of Thyroid Dysfunction in Patients Suffering from Liver Cirrhosis in a Tertiary Care Hospital in Bengaluru, India

BACKGROUND Thyroid abnormalities are seen in most of the patients suffering from liver cirrhosis. Cirrhosis of the liver is the major cause of morbidity and mortality worldwide. Cirrhosis plays a vital role in the thyroid hormone metabolism and thyroid hormone circulation by producing thyroid binding globulin. Hence, it is seen that the thyroid dysfunction is associated with the severity of liver disease. We wanted to study the changes in the levels of thyroid hormones in patients suffering from alcoholic liver cirrhosis. METHODS In this cross-sectional study, 50 patients who were admitted to the IP department and ICU of General Medicine Department of Akash Hospital, Devanahalli, for symptoms of cirrhosis of liver were evaluated for their thyroid profile along with other relevant investigations. RESULTS Among the 50 patients studied, 43 were male and 7 were female. 17 patients had an increase in their thyroid stimulating hormone (TSH). These patients also had a significant association with various LFT parameters such as indirect bilirubin, AST, ALT, APS, and GGT. These 17 patients who had increase in TSH also had associated hepatic complications such as - jaundice (41 %), hepatic encephalopathy (35.29 %), bleeding varices (29.4 %), and portal hypertension (82.35 %). CONCLUSIONS Thyroid abnormalities are not uncommon in patients with cirrhosis. Hypothyroidism is the most common abnormality that was detected. Rate of complications is also high in patients with elevated levels of TSH. A fair amount of suspicion is required for detecting thyroid abnormalities in patients suffering from cirrhosis. KEYWORDS Cirrhosis, Thyroid Hormone, Hypothyroidism, Hyperthyroidism, Thyroiditis

Sonographic Abnormalities of Thyroid Gland in Post-Menopausal Women with and without Hormone Replacement Therapy

Background: Thyroid dysfunction is common especially in women over the age of 50 years. The prevalence of thyroid abnormalities is more in postmenopausal women using hormone replacement therapy. The prevalence of biochemical (or subclinical) hypothyroidism in women increases steadily with age, rising from 10% to 20% in the postmenopausal. The study results clearly indicate an increase in the activities of TSH among the older-aged post-menopausal women. Objective: To compare the sonographic findings of thyroid gland in post-menopausal women with and without hormone replacement therapy. Material and Method: A review of scientific literature concerning the correlation of Sonographic abnormalities of thyroid gland in post-menopausal women with and without hormone replacement therapy was done. Different platforms including medical journals, books and online resources(e.g., PubMed, Google Scholar & Medline) were explored to find the relevant data using the mesh Terms: Thyroid gland, postmenopausal women, Hormone Replacement Therapy etc. The main focus was given to the latest data published in the last 10 years.

Sonographic Abnormalities of Thyroid Gland in Post-Menopausal Women with and without Hormone Replacement Therapy

Background: Thyroid dysfunction is common especially in women over the age of 50 years. The prevalence of thyroid abnormalities is more in postmenopausal women using hormone replacement therapy. The prevalence of biochemical (or subclinical) hypothyroidism in women increases steadily with age, rising from 10% to 20% in the postmenopausal. The study results clearly indicate an increase in the activities of TSH among the older-aged post-menopausal women. Objective: To compare the sonographic findings of thyroid gland in post-menopausal women with and without hormone replacement therapy. Material and Method: A review of scientific literature concerning the correlation of Sonographic abnormalities of thyroid gland in post-menopausal women with and without hormone replacement therapy was done. Different platforms including medical journals, books and online resources(e.g., PubMed, Google Scholar & Medline) were explored to find the relevant data using the mesh Terms: Thyroid gland, postmenopausal women, Hormone Replacement Therapy etc. The main focus was given to the latest data published in the last 10 years.

Thyroid function analysis in COVID-19: A retrospective study from a single center

Background and objective Coronavirus disease 2019 (COVID-19) is an on-going epidemic with a multitude of long-ranging effects on the physiological balance of the human body. It can cause several effects on thyroid functions as well. We aimed to assess the lasting sequelae of COVID-19 on thyroid hormone and the clinical course of the disease as a result. Methods Out of 76 patients, 48 patients of COVID-19 positive and 28 patients of COVID-19 negative polymerase chain reaction (PCR) were assessed for thyroid functions, IL-6, and Procalcitonin between moderate, severe, and critical pneumonia on HRCT. Results Seventy-five percent of patients with COVID-19 had thyroid abnormalities and higher IL-6 levels (76.10 ± 82.35 vs. 6.99 ± 3.99, 95% CI 52.18–100.01, P-value <0.01). Logistic regression analysis suggested TT3 (P-value 0.01), IL-6 (P-value <0.01), and Procalcitonin (P-value 0.03) as independent risk factors for COVID-19. ROC curve demonstrated IL-6 as the most sensitive marker (P-value <0.01), and TT3, and Procalcitonin as the predictor for COVID-19 disease. Conclusion This pilot study from Pakistan demonstrates that changes in serum TSH and TT3 levels may be important manifestations of the courses of COVID-19 pneumonia.