Treatment of patients with Graves' disease and the appropriate extent of thyroidectomy

Publication date: Available online 31 August 2019Source: Best Practice &Research Clinical Endocrinology &MetabolismAuthor(s): Iuliana D. Bobanga, Christopher R. McHenryGraves' disease is an autoimmune disorder caused by thyroid stimulating auto-antibodies directed against the thyrotropin receptor on thyroid follicular cells. It is the most common cause of hyperthyroidism and is associated with cardiovascular, ophthalmologic and other systemic manifestations. Three treatment options are available for Graves' disease: anti-thyroid drugs, radioactive iodine and thyroidectomy. While thyroidectomy is the least common option used for treatment of Graves' disease, it is preferentially indicated for patients with a large goiter causing compressive symptoms, suspicious or malignant thyroid nodules or significant ophthalmopathy. The best operation for Graves' disease has been a matter of debate. The standard operation was a subtotal thyroidectomy for much of the twentieth century, however, over the past 20 years total thyroidectomy has been increasingly performed. Herein, we provide a historical perspective and review the current literature, including randomized controlled trials, systematic reviews and meta-analyses and conclude that total thyroidectomy is the preferred option for the surgical treatment of Graves' disease, with a nearly 0% recurrence rate, predictable postoperative hypothyroidism and a low complication rate comparable to subtotal thyroidectomy when performed b...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research

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Authors: Abdulla J, Abubaker F, Saber FA Abstract OBJECTIVE: Since thyroid dysfunction is a common disorder and affecting all populations regardless of iodine status, a comprehensive evaluation of thyroid dysfunction in Bahrain is essential to draw a national strategy, increase public awareness, and recognize the role of ethnicity. METHODS: Following the approval of the Research Ethics Committee, the study was initiated by collecting laboratory and patient's data that have performed thyroid function tests (TFTs) during January 2018 till January 2019 at the Royal Services of Bahrain Defense Force (BDF) Military ...
Source: Neuroendocrinology Letters - Category: Endocrinology Tags: Neuro Endocrinol Lett Source Type: research
AbstractPurposePrevious studies have demonstrated handwriting changes in patients with overt hyperthyroidism due to Graves ’ disease. The aim of the present study was to investigate handwriting features in patients affected by overt autoimmune hypothyroidism.MethodsThirty subjects – 24 females and 6 males, mean and median age of 50.15 ± 16.8 years and 52.5 years, respectively – with overt hypothyroidism (OH) related to Hashimoto’s thyroiditis (Group 1), and 30 age- and sex-matched euthyroid individuals (Group 2) were recruited to write a “standard text”.Group 1 patie...
Source: Endocrine - Category: Endocrinology Source Type: research
AbstractA complex relationship exists between thyroid and liver in health and disease. Liver plays an essential physiological role in thyroid hormone activation and inactivation, transport, and metabolism. Conversely, thyroid hormones affect activities of hepatocytes and hepatic metabolism. Serum liver enzyme abnormalities observed in hypothyroidism may be related to impaired lipid metabolism, hepatic steatosis or hypothyroidism-induced myopathy. Severe hypothyroidism may have biochemical and clinical features, such as hyperammonemia and ascites, mimicking those of liver failure. Liver function tests are frequently abnorma...
Source: Journal of Endocrinological Investigation - Category: Endocrinology Source Type: research
Discussion Myasthenia gravis (MG) is a problem of the neuromuscular junction which causes muscle weakness. It can occur in all ages and have a range of symptoms from mild localized disease to mortality-threatening respiratory failure. MG occurs in 1.7-30 cases/million, with a prevalence of 77.7 cases/million. Pediatric patients comprise 10-15% of all patients with MG. In various Asian populations, the juvenile MG can be up to 50% of all of the MG cases. Fluctuations in muscle weakness is a hallmark of the disease. As a reminder, “[i]n normal synaptic transmission in the neuromuscular junction, the axon is depolarize...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Authors: Khoury T, Kadah A, Mari A, Sbeit W, Drori A, Mahamid M Abstract BACKGROUND: Autoimmune hepatitis (AIH) may be associated with other autoimmune diseases. Autoantibodies are common in AIH suggesting their potential role in the pathogenesis of the disease. Among these autoantibodies, thyroid autoantibodies have been reported in patients with chronic hepatitis, with greater prevalence in patients with chronic hepatitis C infection. OBJECTIVES: To assess the prevalence of thyroid dysfunction among patients with AIH. METHODS: In this case-control, retrospective study, we examined patients diagnosed with ...
Source: The Israel Medical Association Journal - Category: General Medicine Tags: Isr Med Assoc J Source Type: research
Publication date: Available online 4 February 2020Source: Best Practice &Research Clinical Endocrinology &MetabolismAuthor(s): Alessandro Antonelli, Silvia Martina Ferrari, Francesca Ragusa, Giusy Elia, Sabrina Rosaria Paparo, Ilaria Ruffilli, Armando Patrizio, Claudia Giusti, Debora Gonnella, Alfonso Cristaudo, Rudy Foddis, Yehuda Shoenfeld, Poupak FallahiAbstractGraves' disease (GD) is the most common cause of hyperthyroidism in developed Countries. It is more common between 30-60 years; 5-10 times more frequent in women. The genetic predisposition accounts for 79% of the risk for GD, while environmental factors ...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research
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Source: Medicina Clinica - Category: General Medicine Tags: Med Clin (Barc) Source Type: research
Abstract Previous years, the incidence of autoimmune thyroid diseases has increased worldwide. The presence of many pollutants in the environment suspected to be thyroid disruptors may have contributed to the observed increase. Unfortunately, the results from epidemiological studies assessing the association between pollution and thyroid disorders remain inconsistent, maybe due to a nearly complete neglect of the mixture effect. The blood levels of 12 brominated flame retardants, 3 polychlorinated biphenyls, 16 organochlorine pesticides, 7 perfluoroalkyl substances and 16 phenolic organohalogens were measured in 3...
Source: Environmental Research - Category: Environmental Health Authors: Tags: Environ Res Source Type: research
AbstractGraves ’ orbitopathy (GO) is the most common cause of orbital tissue inflammation, accounting for ~ 60% of all orbital inflammatory conditions in the population aged 21–60 years, and for ~ 40% in the population aged >  60 year. GO is observed in 25–30% of patients with Graves’ hyperthyroidism and more rarely in association with hypothyroid autoimmune thyroiditis. In addition, a small proportion of GO patients (1–2%) do not have a clinically overt thyroid dysfunction. Clinically, GO is characterized by pr optosis, inflammation invol...
Source: Journal of Endocrinological Investigation - Category: Endocrinology Source Type: research
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Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
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