SARS-CoV-2 detection in primary thyroid sarcoma: coincidence or interaction?

Introduction Thyroid dysfunctions associated with SARS-CoV-2 are emerging in scientific literature. During the second COVID-19 epidemic spread, we evaluated a patient with the suspect of subacute thyroiditis. Methods and results Specimen from fine-needle aspiration of a hypoechoic undefined area was analyzed for cytology and for SARS-CoV-2 detection. SARS-CoV-2 was retrieved by real-time polymerase chain reaction on the cytologic sample, which was then cultured on Vero E6 cells and demonstrated to be cytopathic. Whole-genome sequence was deposited. Histological exam diagnosed a rare case of primary thyroid sarcoma with diffuse and strong expression of mouse double minute 2 homolog (MDM2) oncoprotein. Ultrastructural examination confirmed, in several neoplastic cells, the presence of viral particles in cytoplasmic vacuoles. Conclusions In our hypothesis, SARS-CoV-2 and sarcoma coexistence could represent a synergistic interplay, ultimately favoring both viral persistence and tumor proliferation: the overexpression of MDM2 in tumor cells might have generated a favorable immunological niche for SARS-CoV-2 localization and, in turn, SARS-CoV-2 could have favored tumor growth by inducing MDM2-mediated p53 downregulation. Functional studies are needed to confirm this suggestive pathway.

Subclinical Hypothyroidism as the Most Common Thyroid Dysfunction Status in Children With Down’s Syndrome

IntroductionThyroid dysfunctions are one of the most common abnormalities coexisting in children with Down’s syndrome (DS) and have been reported in up to 54% of cases.Aim of the StudyThe purposes of this retrospective study were to investigate the course of subclinical hypothyroidism in children with DS, to evaluate the thyroid function of these subjects in relation to the risk of developing overt thyroid disease and autoimmunity, and to identify clinical and biochemical characteristics of patients prescribed L-T4 therapy in children and adolescents with DS and SH.Material and MethodsThe records of DS patients referred to the Endocrinology Outpatient Clinic between 2010 and 2015 for screening of thyroid function were observed till the end of 2019 June and analyzed retrospectively. The children diagnosed with congenital hypothyroidism, acute lymphoblastic leukemia, and seizures and treated with drugs that may have interfered with thyroid function like lithium, antiepileptic, or iodinated drugs and glucocorticoids were excluded from the study.ResultsThe data of 77 DS patients were collected, evaluated, and analyzed. The study group consisted of 73 patients (32 girls and 41 boys with the mean age at baseline of 3.0 ± 4.5 years). A total of 63/73 (87%) children were diagnosed with SH. The 16/63 (25.4%) patients were followed-up without the treatment (group SH-T0), and therapy with levothyroxine (L-T4) was introduced in 47/63 (74.6%) SH children with a mean dosage of 1.8 ± 1.0 μg/kg/day (group SH-T1). Thyroxine supplementation did not improve growth expressed as ΔhSDS (0.1 ± 1.3, ranged −2.1 to 3.8 in SH-T0 vs. 0.0 ± 0.7, ranged −1.7 to 1.4 in SH-T1, p = 0.96) and ΔBMI Z-score (0.3 ± 0.9, ranged −0.9 to 2.6 in SH-T0 vs. 0.3 ± 1.1, ranged −2.1 to 2.9 in SH-T1, p = 0.65). Positive anti-TPO and anti-TG antibodies were detected in 7/63 (11.1%) DS cases.ConclusionsSH is the most frequent presentation of thyroid gland dysfunction in DS children. A small percentage of patients develop an overt hypothyroidism, particularly in females with mostly positive titer of antithyroid autoantibodies.

Unmasking of Gitelman Syndrome during Pregnancy in an Adolescent with Thyrotoxic Crisis

Background. Gitelman syndrome (GS) is an inherited salt-losing renal tubulopathy characterized by hypokalemic metabolic alkalosis with hypomagnesemia and hypocalciuria. Patients can be asymptomatic until late adolescence or adulthood, and hence may be discovered incidentally during presentation with other illnesses. GS has been described in association with thyroid disorders and should be considered in patients with hyperthyroidism and persistent hypokalemia, especially in those with associated hypomagnesemia and hypocalciuria. Case summary. In this report, we describe an 18-year-old female who presented with hyperemesis gravidarum and thyrotoxicosis, and was incidentally found to have GS, confirmed by the sequence analysis of SLC12A3. Conclusions. Thyroid dysfunctions, such as hypothyroidism, thyrotoxicosis, and thyroid nodules, may develop during pregnancy. A structural homology between the beta-human chorionic gonadotropin and thyroid stimulating hormone molecules, as well as their receptors is probably the basis for the transient thyrotoxicosis crisis during pregnancy. Since hyperemesis in pregnancy can also lead to hypokalemia and alkalosis, a high index of suspicion for GS during pregnancy is required for timely diagnosis and management.

Prevalence of thyroid dysfunction and its relationship with the lipid profile in patients in hospital from Encarnación

Thyroid dysfunctions are a cause of morbidity and disability worldwide. Little information has been found on the prevalence of thyroid dysfunctions in Paraguay, so this study provides data on their presentation. The objective was to determine the prevalence of thyroid dysfunction and its relationship with the lipid profile in adult outpatients attending the laboratory of the Regional Hospital of Encarnación, during January-November 2016. A descriptive cross-sectional study was performed, based on the review of 250 medical records, 84 % of whom were women; the median age was 39 (35-47) years in men and 36 (32-43) years in women. Thirty percent were hypothyroid and 3 % hyperthyroid; the most frequent thyroid dysfunction was subclinical hypothyroidism with 19 %. Highly significant differences were found for total cholesterol, LDL, VLDL and thyrotrophin between hypothyroid vs euthyroid, with the former having more atherogenic profiles. Logistic regression was used to assess the contribution of dyslipidaemia, finding a significant association with hypothyroidism (OR=3.24(1.81-5.81), p<0.001). Thirty-three percent of this population sample, 1 in 3 individuals, had thyroid dysfunction. These could be managed appropriately and further complications could be avoided.

Prevalence of thyroid dysfunctions in a large, unselected population in Duhok city, Iraqi Kurdistan: A cross-sectional study

Objective: To determine the prevalence of thyroid-stimulating hormone (TSH) alterations and different types of thyroid dysfunctions in both sexes with no age limitations from variety of sources in Duhok province. Patients and Methods: In this retrospective cross-sectional study, we screened 25040 suspicious cases of thyroid diseases in a year (2019), retrieving the data from the computer of three clinical laboratories in the Duhok City; following exclusion of 470 cases, 24568 cases were included to categorize the different types of thyroid dysfunctions. Results: The prevalence of TSH alteration was 25.03%, 20.55% of them had a high concentration being statistically higher in females, while only 4.48% was low TSH with equal prevalence among both sexes. Out of 24568 patients, the prevalence of subclinical hypothyroidism was 94.85%, followed by 2.20%, 1.20%, 0.78%, 0.67%, and 0.31% for each of subclinical hyperthyroidism, primary hypothyroidism, central hyperthyroidism, central hypothyroidism, and primary hyperthyroidism respectively. Conclusions: The studied population had high prevalence of high TSH level (20.55%), being more prevalent in female than in male. Our survey revealed that the distribution of thyroid disorders was vary among different age groups with highest prevalence of subclinical hypothyroidism in all age groups (94.85%); Also, we concluded that middle & advanced ages, and females were more susceptible to thyroid disorders.

A STUDY TO EVALUATE THE THYROID FUNCTION IN SERO POSITIVE RHEUMATOID ARTHRITIS

Background: The thyroid dysfunction in rheumatoid arthritis is well-known but unfortunately there are only few studies available in our country to assess the thyroid function in RA patients. Methods: It was a Hospital based observational, descriptive study . Upgraded department of General Medicine, SMS Medical College and AttachedHospitals, (Jaipur). Results: Maximum patients 208(80.00%) are euthyroid followed by 28(10.77%) are overt - hypothyroidism, 22(8.46%) subclinical hypothyroidism and 2 patients (0.77%) are subclinical hyperthyroidism patients Conclusion: Prevalence of thyroid dysfunctions in rheumatoid arthritis is high and associated with thyroid autoimmunity and suggested that allrheumatoid arthritis patients should go for thyroid functions. Hence, it is advisable to screen the patients of rheumatoid arthritis for thyroid dysfunction so that early identification and treatment can provide a healthier life ahead. Keywords: NAFLD, TSH, T3, T4.

Frequency and factors associated with thyroid dysfunctions: An analytical cross-sectional study from a tertiary care center in Kabul, Afghanistan

Introduction/Objective Endocrinopathies are a commonly occurring entity, particularly those of the thyroid gland, however there is lack of scientific literature from Afghanistan, a country with very limited health care facilities and resources. This is the first study aimed to describe the frequency of occurrence and factor associated with thyroid dysfunction in Afghan population. The aim of this study is to estimate the frequency and to identify factors associated with thyroid dysfunction among individuals coming to a tertiary care facility in Kabul, Afghanistan. Methods/Case Report A cross-sectional study was conducted from July to Sep 2018 at the Department of Clinical Pathology, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan. Blood samples were obtained, serum TSH levels were analyzed, and the patients were divided into three diagnostic categories according to their serum TSH concentrations: 1) Hypothyroidism 2) Hyperthyroidism 3) normal. Results (if a Case Study enter NA) A total of 127 individuals were included in the final analysis. Majority study participants (77%) were females. A large number of the participants (92%) did not have family history of thyroid dysfunction. (74%) participants in the study had normal TSH levels classified as normal thyroid function, (14%) had lower TSH levels and (12%) higher TSH levels (Table 1) classified as hyper and hypothyroid respectively. Conclusion The findings of the current study showed a high frequency of thyroid dysfunctions from a single center. Further large scale studies are needed to find out the prevalence and document this entity for better health outcomes in the country.

Study of Calcium, Magnesium and Phosphorus Levels among Hypothyroid Patients in Trichy, Tamil Nadu

BACKGROUND Mineral metabolism is frequently disturbed in thyroid dysfunctions. Among thyroid dysfunctions, hypothyroidism is one of the most common form resulting from the deficiency of thyroid hormones. Studies done on serum calcium, phosphorus and magnesium in hypothyroid patients earlier have conflicting results. Hence the present study has been undertaken to study the levels of serum calcium, phosphorus, and magnesium among hypothyroid patients and analyse their correlation with thyroid stimulating hormone (TSH). METHODS The case control study was conducted in the Department of Biochemistry in Trichy SRM Medical College Hospital and Research Centre for a period of 6 months from 2017 January to July 2017. The study was undertaken involving 50 hypothyroid cases and 50 healthy volunteers as controls after proper ethical clearance and informed consent of all the study subjects. Serum calcium, phosphorus and magnesium were measured along with tri-iodothyronine (FT3), tetra-iodothyronine (FT4) and TSH among all study subjects. Statistical analysis of data was done using statistical package for social sciences (SPSS) software. RESULTS The mean value of serum total calcium and total magnesium was lower among hypothyroid cases and phosphorus value was increased as compared to controls. (P < 0.001) Statistically significant negative correlation was observed between serum calcium, magnesium and TSH among hypothyroid cases. Statistically significant positive correlation was observed between serum phosphorus and TSH among hypothyroid cases. CONCLUSIONS Among hypothyroid patients the values of serum calcium, magnesium and phosphorus is significantly altered. Thyroid disorders have an important role in bone and mineral metabolism. Thus, monitoring of these minerals among hypothyroid patients in regular follow up may effectively improve the clinical manifestations in them. Hence, monitoring of mineral status of the hypothyroid patients on follow-up will be of benefit to the patients. KEYWORDS Hypothyroidism, Calcium, Phosphorus, Magnesium, Minerals