New Impact for the Journal
Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - July 5, 2019 Category: Endocrinology Source Type: research

2019 European Thyroid Association Guidelines on the Management of Thyroid Dysfunction following Immune Reconstitution Therapy
Thyroid dysfunction (TD) frequently occurs as an autoimmune complication of immune reconstitution therapy (IRT), especially in individuals with multiple sclerosis treated with alemtuzumab, a pan-lymphocyte depleting drug with subsequent recovery of immune cell numbers. Less frequently, TD is triggered by highly active antiretroviral therapy (HAART) in patients infected with human immunodeficiency virus (HIV), or patients undergoing bone-marrow/hematopoietic-stem-cell transplantation (BMT/HSCT). In both alemtuzumab-induced TD and HIV/HAART patients, the commonest disorder is Graves ’ disease (GD), followed by hypothyr...
Source: European Thyroid Journal - July 4, 2019 Category: Endocrinology Source Type: research

Risk of Thyroid Cancer in 1,504 Patients Referred for Thyroid Surgery with Assumed Benign Histology
Conclusions: The risk of malignancy of 7.6% and 6.8% was high, considering that patients with malignant FNA, suspicious FNA, or clinical findings indicating malignancy were excluded, and 2.2% of these malignancies were stages T2 –4. In cases with solitary solid tumour on ultrasound, the risk of malignancy should not be ignored, even with benign FNA.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - June 26, 2019 Category: Endocrinology Source Type: research

Performance of ATA Risk Stratification Systems, Response to Therapy, and Outcome in an Indian Cohort of Differentiated Thyroid Carcinoma Patients: A Retrospective Study
Conclusion: This study found that both ATA RSS-2009 and ATA RTR-2015 are reliable in predicting outcome in DTC patients after initial treatment. However, the response to initial therapy at 1 year predicted outcome more accurately than the initial risk status.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - June 26, 2019 Category: Endocrinology Source Type: research

A Case of Unilateral Dermopathy Possibly Related to Graves ’ Disease
Discussion: The observation of a patient with a monolateral dermopathy somehow reports to the Kriss ’ hypothesis, especially in view of the patient’s habit of sleeping on the same side as dermopathy was present. Of course, this does not represent a proof that the Kriss’ hypothesis is correct, but it carries an element in favour of it. The fact that GO was bilateral is somehow against it, but does not exclude this possibility.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - June 11, 2019 Category: Endocrinology Source Type: research

Orbital Radioiodine Uptake on Scintigraphy in a Patient with Thyroid Cancer
Discussion: Ocular and orbital metastases from thyroid cancer, as well as some non-neoplastic disorders or contamination, are possible causes for131I uptake in the orbital region in scintigraphy. Conjunctival inclusion cyst is a condition associated with incidental131I uptake that had not been reported before and should be ruled out as a non-metastatic cause of orbital radioiodine uptake in patients with PTC.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - May 23, 2019 Category: Endocrinology Source Type: research

The Colorful Diversity of Thyroid Hormone Metabolites
Since the discovery of L-thyroxine, the main secretory product of the thyroid gland, and its major metabolite T3, which exerts the majority of thyroid hormone action via ligand-dependent modulation of the function of T3 receptors in nuclei, mitochondria, and other subcellular compartments, various other T4-derived endogenous metabolites have been identified in blood and tissues of humans, animals, and early protochordates. This review addresses major historical milestones and experimental findings resulting in the discovery of the key enzymes of thyroid hormone metabolism, the three selenoprotein deiodinases, as well as th...
Source: European Thyroid Journal - May 21, 2019 Category: Endocrinology Source Type: research

In Memoriam – Prof. Dr. Georg Hennemann, Internist (1932–2018)
Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - May 17, 2019 Category: Endocrinology Source Type: research

Prevalence of Undiagnosed Hypothyroidism in Europe: A Systematic Review and Meta-Analysis
Conclusions: The current evidence suggests that a considerable proportion of the European population has hypothyroidism, particularly subclinical hypothyroidism, which is undiagnosed. This issue deserves further investigation because of possible deleterious consequences for public health.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - May 17, 2019 Category: Endocrinology Source Type: research

Sex-Dependent Association between Weight Change and Thyroid Dysfunction: Population-Level Analysis Using the Korean National Health and Nutrition Examination Survey
Conclusions: This study highlights the necessity of performing thyroid function testing in women who complain of weight loss, but such testing may be less vital in women with weight gain or men with any changes in weight.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - May 14, 2019 Category: Endocrinology Source Type: research

The Role of Calcitonin in Predicting the Extent of Surgery in Medullary Thyroid Carcinoma: A Nationwide Population-Based Study in Norway
Conclusions: Basal calcitonin cannot predict the need for prophylactic lateral lymph node dissection in patients with MTC. Further prospective, randomized studies are warranted.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - May 5, 2019 Category: Endocrinology Source Type: research

The Use of the Iodine-Rich Drug Amiodarone in the Rapid Preoperative Preparation for Thyroidectomy because of Persistent Hyperthyroidism
Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - April 15, 2019 Category: Endocrinology Source Type: research

CA19-9 as a Predictor of Worse Clinical Outcome in Medullary Thyroid Carcinoma
Conclusion: CA19-9 might have a role as a prognostic factor in addition to calcitonin and carcinoembryonic antigen in metastatic MTC.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - April 3, 2019 Category: Endocrinology Source Type: research

Thyroid Volume Assessment in 3 –14 Year-Old Spanish Children from an Iodine-Replete Area
Conclusions: This work proposes reference ultrasound-determined Tvols for 3 –14-year-old children living in Madrid.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - April 3, 2019 Category: Endocrinology Source Type: research

Detecting True Change in the Hospital Anxiety and Depression Scale, SF-36, and Hypothyroid Score when Monitoring Patients with Subclinical Hypothyroidism
Conclusion: Score differences of almost 100% and higher were required to support a true change in mood (HADS) and hypothyroid symptom scores in untreated SCH patients. For quality of life a true change was detected at a 20% difference in SF-36 scores. The hypothyroid score and HADS questionnaire do not seem useful for the evaluation of individuals.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - March 31, 2019 Category: Endocrinology Source Type: research

In Memoriam: Leslie J. De Groot, 1928 –2018
Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - March 31, 2019 Category: Endocrinology Source Type: research

Insulin Sensitivity and Beta-Cell Function in Graves ’ Disease and Their Changes with the Carbimazole-Induced Euthyroid State
Conclusions: Abnormal glucose tolerance is a significant metabolic consequence in patients with Graves ’ disease. Decreased beta-cell function was observed among those with abnormal glucose tolerance and it improved during follow-up. In a proportion of patients, abnormal glucose tolerance persisted after 3 months, emphasizing the need for continued follow-up.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - March 14, 2019 Category: Endocrinology Source Type: research

Tyrosine Kinase Inhibitor Therapy in Locally Advanced Differentiated Thyroid Cancer: A Case Report
A 73-year-old female presenting with haemoptysis and dyspnoea was found to have a locally advanced left thyroid mass and vocal cord palsy. A CT scan of the neck and thorax and endoscopy demonstrated invasion into the tracheal lumen. Histopathology of the intraluminal tracheal mass confirmed a papillary thyroid cancer (PTC). The tumour was deemed unresectable due to local extent and patient comorbidities. TKI therapy with lenvatinib was used for 14 months. On serial scanning, a marked reduction in tumour volume from 31 × 59 × 32 mm to 17 × 28 × 22 mm was noted. This subsequently allowed a successful ...
Source: European Thyroid Journal - January 17, 2019 Category: Endocrinology Source Type: research

Effect of Adequate Thyroid Hormone Replacement on the Hypothalamo-Pituitary-Gonadal Axis in Premenopausal Women with Primary Hypothyroidism
Conclusion: Hypothyroidism is associated with a reversible partial suppression of the hypothalamo-pituitary-gonadal axis in premenopausal women, demonstrated by lower E2 along with a mild elevation of PRL. Treatment of hypothyroidism improves the level of estrogen and lowers the level of PRL.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - January 13, 2019 Category: Endocrinology Source Type: research

The Effect of Radioiodine Treatment on TRAb, Anti-TPO, and Anti-TG in Graves ’ Disease
Conclusions: Treatment with radioiodine elicits an increase in thyroid antibodies, but not in all GD patients. The proportion of responders varied and was affected by age, resulting in a stronger immune response at younger age. However, there were no additional effects of smoking.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - January 3, 2019 Category: Endocrinology Source Type: research

Previous Live Births and Induced Abortions May Precede Later Development of Graves ’ Hyperthyroidism
Conclusions: Childbirths and induced abortions may be followed by development of Graves ’ hyperthyroidism after the post-partum period. This was not the case for the non-autoimmune subtypes of hyperthyroidism.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - December 14, 2018 Category: Endocrinology Source Type: research

Bone Metastases from Thyroid Carcinoma of Follicular Origin: A Single Institutional Experience
Discussion: The high frequency of patients with SRE was notable. The follicular variant of papillary thyroid cancer was the variant most commonly associated with BM, reflecting a more similar behavior to follicular carcinoma than the classic variant.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - December 14, 2018 Category: Endocrinology Source Type: research

A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Graves ’ Hyperthyroidism and Graves’ Orbitopathy
Conclusions: In Graves ’ hyperthyroidism without GO, 38.2% of ETA (European Thyroid Association) members recommend Se supplementation. Conversely, Se is recommended by the majority of respondents in GO, both in patients with mild and moderate to severe ocular involvement. This clinical practice is partially in disagreem ent with current European treatment guidelines that recommend Se as a 6-month treatment in mild GO only.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - December 14, 2018 Category: Endocrinology Source Type: research

Less than 2% of the Low- and Intermediate-Risk Differentiated Thyroid Cancers Show Distant Metastases at Post-Ablation Whole-Body Scan
Conclusions: The ptWBS diagnostic role was clinically relevant for the therapeutic strategies of our patients only in 1.1% of the cases. The cost-effectiveness of performing RRA and ptWBS in all LR and IR patients to find 1 –2% of the cases with distant metastases remains controversial.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - December 14, 2018 Category: Endocrinology Source Type: research

Unique Case of a Large Indolent Medullary Thyroid Carcinoma: Time to Reconsider the Medullary Thyroid Adenoma Entity?
Conclusions: Further studies are needed to clarify the characteristics of MTC and better predict its behavior at diagnosis.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - December 6, 2018 Category: Endocrinology Source Type: research

Calcitonin Screening in Nodular Thyroid Disease: Is There a Definitive Answer?
Conclusions: Hypercalcitoninemia was found in 4.6% of NTD patients. Ctn levels ≥100 pg/mL were associated with a greater CMT risk than values between 10 and 100 pg/mL, reinforcing results from other groups. The need for an adequate interpretation of results as well as an appropriate selection of patients to surgery stresses the importance of endocrinologists requesting and i nterpreting results.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - December 5, 2018 Category: Endocrinology Source Type: research

The Malignancy Risk Assessment of Cytologically Indeterminate Thyroid Nodules Improves Markedly by Using a Predictive Model
Conclusions: The nomogram developed in our study accurately predicts the malignancy risk of thyroid nodules with indeterminate cytology by using clinical, cytological, and ultrasonographic features.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - November 29, 2018 Category: Endocrinology Source Type: research

Primary versus Tertiary Care Follow-Up of Low-Risk Differentiated Thyroid Cancer: Real-World Comparison of Outcomes and Costs for Patients and Health Care Systems
Conclusion: Our study shows that extended follow-up of low-risk TC patients is perfectly feasible in primary care and provides significant economic benefit for the healthcare system.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - November 22, 2018 Category: Endocrinology Source Type: research

Evaluation of Diagnostic Utility of Immunohistochemistry Markers of TROP-2 and HBME-1 in the Diagnosis of Thyroid Carcinoma
Conclusion: IHC panel consisting of TROP-2 and HBME-1 can be used in equivocal follicular patterned lesions for the diagnosis of thyroid carcinomas.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - November 22, 2018 Category: Endocrinology Source Type: research

Author Index Vol. 7, 2018
Eur Thyroid J 2018;7:327 –328 (Source: European Thyroid Journal)
Source: European Thyroid Journal - November 21, 2018 Category: Endocrinology Source Type: research

Subject Index Vol. 7, 2018
Eur Thyroid J 2018;7:329 –330 (Source: European Thyroid Journal)
Source: European Thyroid Journal - November 21, 2018 Category: Endocrinology Source Type: research

Contents Vol. 7, 2018
Eur Thyroid J 2018;7:I –VI (Source: European Thyroid Journal)
Source: European Thyroid Journal - November 21, 2018 Category: Endocrinology Source Type: research

Repeat Ultrasonography in the First Years after Therapy with Radioiodine Is Not Necessary in Most Patients with Papillary Thyroid Carcinoma when Postoperative Ultrasonography Is Negative: A Reduction of Costs and False-Positives
Conclusion: The results suggest that low- or intermediate-risk patients with PTC without persistent disease after thyroidectomy (including negative postoperative US and RxWBS) do not require repeat US examination in the first two years after treatment with RAI. In the following years until the fifth year, US can be restricted to patients with Tg ≥1 ng/mL.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - November 16, 2018 Category: Endocrinology Source Type: research

Trends in Diagnostics, Surgical Treatment, and Prognostic Factors for Outcomes in Medullary Thyroid Carcinoma in Norway: A Nationwide Population-Based Study
Conclusions: Preoperative diagnostics have improved over time with increased therapeutic control. A low ratio of metastatic and dissected lymph nodes predicts better outcomes in patients with metastatic lymph nodes.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - November 8, 2018 Category: Endocrinology Source Type: research

TRH Neurons and Thyroid Hormone Coordinate the Hypothalamic Response to Cold
Thyroid hormone (TH) plays a key role in regulating body temperature in mammals. Cold exposure stimulates the hypothalamus-pituitary-thyroid (HPT) axis at the hypothalamic level by activating hypophysiotropic thyrotropin-releasing hormone (TRH)-producing neurons, ultimately resulting in increased plasma TH concentrations. Importantly, the local TH metabolism within various cold-responsive organs enables tissue-specific action of TH on heat production and adaption to cold independently of the circulating TH levels. In addition to these neuroendocrine effects, TRH neurons in the hypothalamus also have neural connections with...
Source: European Thyroid Journal - October 31, 2018 Category: Endocrinology Source Type: research

The Impact of Esophageal Compression on Goiter Symptoms before and after Thyroid Surgery
Conclusions: In patients with goiter, thyroidectomy leads to substantial improvements in esophageal anatomy, as assessed by MRI, and this correlates with improved swallowing symptoms. This information is valuable in qualifying the dialogue with goiter patients, before deciding on the mode of therapy. Clinicaltrials.gov (NCT03072654).Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - October 17, 2018 Category: Endocrinology Source Type: research

A Case of Oculocutaneous Albinism in a Patient with Hashimoto ’s Thyroiditis
Discussion: In the majority of cases, OCA in Caucasians is caused by mutations in the tyrosinase gene. The tyrosinase peptide is normally expressed on the surface of melanocytes, although recent studies have shown its presence in thyroid follicular epithelial cells of patients with Hashimoto ’s thyroiditis. Therefore, although the mechanism is unclear, the present case report may suggest a pathogenetic link between OCA and Hashimoto’s thyroiditis.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - October 16, 2018 Category: Endocrinology Source Type: research

Differentiated Thyroid Cancer: How Do Current Practice Guidelines Affect Management?
Conclusions: Management of DTC at our institution closely adheres to contemporary clinical practice guidelines. The finding of more aggressive management in those requiring a personalised decision-making approach highlights the requirement for improved risk stratification in this cohort to ratio ­nalise management strategies.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - October 5, 2018 Category: Endocrinology Source Type: research

European Thyroid Association (ETA) and Thyroid Federation International (TFI) Joint Position Statement on the Interchangeability of Levothyroxine Products in EU Countries
Several European countries have seen major health issues after a switch from one levothyroxine brand to another, as well as following the introduction of several levothyroxine formulation changes. While the relationship between these health issues and brand or formulation changes merits further investigation, the current position statement on behalf of both health-care providers and patients summarizes recent events in several European countries and provides a number of recommendations to limit the burden for patients, so as to prevent increased health-care consumption and health-care expenses in this context.Eur Thyroid J...
Source: European Thyroid Journal - October 5, 2018 Category: Endocrinology Source Type: research

The Impact of Zoledronic Acid and Radioactive Iodine Therapy on Morbi-Mortality of Patients with Bone Metastases of Thyroid Cancer Derived from Follicular Cells
Conclusion: ZA can successfully diminish the chance of having new SRE and possibly affect OS in DTC patients with bone metastases. The positive impact of RAI adjuvant treatment on OS is directly associated with RAI uptake.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - October 5, 2018 Category: Endocrinology Source Type: research

Hypofractionated Radiotherapy for Anaplastic Thyroid Carcinoma: 15 Years of Experience in a Single Institution
Conclusions: Multivariate analysis showed that an EQD2≥50 Gy resulted in better OS, and hypofractionated radiotherapy decreased the rate of mortality from local recurrence.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - October 5, 2018 Category: Endocrinology Source Type: research

Association between Thyroid-Stimulating Hormone Levels and Non-Alcoholic Fatty Liver Disease Is Not Independent from Metabolic Syndrome Criteria
Conclusions: Although the TSH variability within the reference range is associated with NAFLD in univariable models, once adjusted for metabolic syndrome factors no significant association is noted.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - September 2, 2018 Category: Endocrinology Source Type: research

Poorly Differentiated Thyroid Carcinoma Patients with Detectable Thyroglobulin Levels after Initial Treatment Show an Increase in Mortality and Disease Recurrence
Conclusions: Our results suggest that detectable Tg levels after surgery and RAI in a subset of PDTC patients appear to predict a higher rate of death and recurrence.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - August 21, 2018 Category: Endocrinology Source Type: research

41st Annual Meeting of the European Thyroid Association
Eur Thyroid J 2018;7(suppl 1):I –IV (Source: European Thyroid Journal)
Source: European Thyroid Journal - August 16, 2018 Category: Endocrinology Source Type: research

Anti VEGF-TKI Treatment and New Renal Adverse Events Not Reported in Phase III Trials
In conclusion, these 2 c ases argue for increased awareness for the possibility of renal failure as a consequence of anti-VEFG treatment. Predisposing conditions like known mild chronic renal insufficiency with only mild proteinuria and with atherosclerosis or precipitating co-medications like zoledronate infusion need to b e accounted for to prevent these severe AEs.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - August 16, 2018 Category: Endocrinology Source Type: research

How Do We Improve the Impact of Iodine Deficiency Disorders Prevention in Europe and Beyond?
Conclusions: EUthyroid has taken steps towards achieving a euthyroid Europe. Our challenge is to inspire a greater sense of urgency in both policymakers and the wider public to address this remediable deficit caused by IDD.Eur Thyroid J 2018;7:1 –8 (Source: European Thyroid Journal)
Source: European Thyroid Journal - July 31, 2018 Category: Endocrinology Source Type: research

A 2018 Italian and Romanian Survey on Subclinical Hypothyroidism in Pregnancy
Conclusions: Respondents globally appeared well informed about the management of thyroid autoimmunity and subclinical hypothyroidism in pregnancy. A more aggressive attitude in implementing iodine supplementation would be desirable. Most endocrinologists were convinced about an evident association between mild thyroid impairment and adverse outcomes in pregnancy, thus using a TSH value of 2.5 mIU/L as the threshold for diagnosing hypothyroidism and starting levothyroxine in pregnant women.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - July 26, 2018 Category: Endocrinology Source Type: research

2018 European Thyroid Association Guideline for the Management of Graves ’ Hyperthyroidism
Graves ’ disease (GD) is a systemic autoimmune disorder characterized by the infiltration of thyroid antigen-specific T cells into thyroid-stimulating hormone receptor (TSH-R)-expressing tissues. Stimulatory autoantibodies (Ab) in GD activate the TSH-R leading to thyroid hyperplasia and unregulated thyro id hormone production and secretion. Diagnosis of GD is straightforward in a patient with biochemically confirmed thyrotoxicosis, positive TSH-R-Ab, a hypervascular and hypoechoic thyroid gland (ultrasound), and associated orbitopathy. In GD, measurement of TSH-R-Ab is recommended for an accurate di agnosis/different...
Source: European Thyroid Journal - July 25, 2018 Category: Endocrinology Source Type: research

Study of Deiodinase Type 2 Polymorphisms in Graves ’ Disease and Ophthalmopathy in a Swedish Population
Conclusions: Rs225011 in DIO2 was weakly associated with GD. The mechanism behind this association requires further study. None of the investigated common SNPs in DIO2 was significantly associated with GO, fT3, fT4, TRAb, or TPOAb in GD patients.Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - July 20, 2018 Category: Endocrinology Source Type: research

Reflections on the Management of Graves ’ Hyperthyroidism
Eur Thyroid J (Source: European Thyroid Journal)
Source: European Thyroid Journal - July 19, 2018 Category: Endocrinology Source Type: research