Teprotumumab: a disease modifying treatment for graves ’ orbitopathy
ConclusionsThe results from these two large clinical trials have shown teprotumumab to have remarkable effects on multiple clinical outcomes in GO, particularly in its ability to reverse proptosis. It may herald a new era in the treatment of thyroid eye disease and could offer an alternative to surgery and its associated complications. Additional studies will continue to shape the treatment of GO and define the role of teprotumumab within the treatment paradigm. (Source: Thyroid Research)
Source: Thyroid Research - July 4, 2020 Category: Endocrinology Source Type: research

Antithyroid drugs and birth defects
AbstractAntithyroid drugs (ATDs) are preferred for the treatment of hyperthyroidism caused by Graves ’ disease in pregnant women. The drugs have been a recognized treatment for decades, and a general risk of side effects is known. For the use of ATDs in pregnancy, a concern about teratogenic side effects has been brought forward since the 1970s. In more recent years, a number of large observation al studies have added new evidence and quantified the risk of birth defects associated with different types of ATDs. The findings that both Methimazole (MMI) and Propylthiouracil (PTU) are associated with birth defects have ...
Source: Thyroid Research - June 27, 2020 Category: Endocrinology Source Type: research

Elevated serum TSH concentrations are associated with higher BMI Z-scores in southern Iranian children and adolescents
ConclusionBMI Z-score and elevated TSH levels are positively correlated however studies should be performed on establishing the causality. (Source: Thyroid Research)
Source: Thyroid Research - June 13, 2020 Category: Endocrinology Source Type: research

Macrofollicular variant of papillary thyroid carcinoma with metastasis to femur
ConclusionsOur case supports the view that, on rare ocassions, MFV-PTC may show a more aggressive biological behavior than expected. The synchronous or asynchronous presence of one or more bone lesions, should raise the suspicion of metastasis. Given the suspicion, it is necessary to take a biopsy to confirm histologically. Only a careful analysis of the architectural and cytological characteristics of goiter or hyperplastic nodules will allow to recognize this rare variety of carcinoma. (Source: Thyroid Research)
Source: Thyroid Research - June 13, 2020 Category: Endocrinology Source Type: research

Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic
ConclusionThyroid cancer has a higher prevalence in Yemen than in other middle eastern countries. Our study also reports a higher rate of follicular thyroid cancer than that in other published data, which has to be confirmed by further studies. The malignancy and premalignant diagnosis rate was ~ 50% in our patients who underwent surgery. Many centers in Yemen still do not perform FNA before thyroid surgery. It is important that other centers in the country start emphasizing the need for FNA before surgery. This will decrease the number of unnecessary surgeries and associated complications. (Source: Thyroid Research)
Source: Thyroid Research - June 6, 2020 Category: Endocrinology Source Type: research

Nice guideline on thyroid disease: where does it take us with liothyronine?
AbstractThe new NICE guidelines on thyroid disease and its management do not recommend the routine use of liothyronine, but do not completely rule it out either. Guidelines from the British and European Thyroid Associations are open to a “trial of liothyronine” on an individual basis.Some patients do not feel well on L-thyroxine despite a serum TSH in the reference range. Key issues to consider in such patients include establishing whether the patient had established hypothyroidism initially, and whether the L-thyroxine has been titrated carefully enough, possibly using small increments, to achieve a careful ba...
Source: Thyroid Research - May 23, 2020 Category: Endocrinology Source Type: research

The effectiveness of cognitive- behavioral therapy on quality of life in women with hypothyroidism in the reproductive age: a randomized controlled trial
This study aimed to evaluate the effect of cognitive- behavioral therapy (CBT) on the quality of life in women with hypothyroidism.Methods96 women with hypothyroidism randomly allocated into two groups: CBT group (n = 48) and control group (n = 48). Women in the CBT group were classified into four sub-groups of 12, and each sub-group received eight sessions of counseling (each session lasting 90 min). We collected data using a demographic questionnaire and the 36-Item Short Form Health Survey (SF 36) for measuring the quality of life. We used the independent t-test, chi-square test and AN...
Source: Thyroid Research - May 20, 2020 Category: Endocrinology Source Type: research

Adequate timing and constant supervision are the keys for successful implementation of levothyroxine or levothyroxine/paracetamol absorption test
ConclusionsAdequate patient supervision and frequent sampling (e.g. every 30  min for 210 min) is the key for successful implementation of LT4 absorption test. Paracetamol coadministration appears superfluous in such cases. (Source: Thyroid Research)
Source: Thyroid Research - May 18, 2020 Category: Endocrinology Source Type: research

Time-dependent changes in FT4 and FT3 levels measured using mass spectrometry after an acute ingestion of excess levothyroxine in a case with hypothyroidism
ConclusionIt was helpful to clarify the time dependent changes in free thyroid hormone levels by ultrafiltration LC-MS/MS in discussing the clinical course in this case. Though mass spectrometry has a disadvantage in speed for routine laboratory use, its accurate measurement, particularly of levels exceeding the measurable range of the immunoassay, provides valuable information for more appropriate management of extreme thyrotoxicosis. (Source: Thyroid Research)
Source: Thyroid Research - May 1, 2020 Category: Endocrinology Source Type: research

Should radioiodine now be first line treatment for Graves ’ disease?
ConclusionsEarly radioiodine treatment will potentially reduce mortality and should be offered to patients with severe disease. However, thionamides are still suitable for patients with milder disease, contraindications to radioiodine, or individuals who choose to avoid permanent hypothyroidism. Ultimately, a patient individualised approach that prioritises early and  sustained control of hyperthyroidism will improve long-term outcomes regardless of the therapy modality used. (Source: Thyroid Research)
Source: Thyroid Research - March 9, 2020 Category: Endocrinology Source Type: research

Falsely undetectable TSH in a euthyroid patient
ConclusionIf the result of TSH level revealed very low or undetectable through one specific method, it should not be considered necessarily as a symptom of hyperthyroidism. It is to be requested to measure by the other methods with other devices too. (Source: Thyroid Research)
Source: Thyroid Research - January 30, 2020 Category: Endocrinology Source Type: research

Cross-sectional and prospective study on anti-M üllerian hormone changes in a cohort of pre-menopausal women with a history of differentiated thyroid cancer
ConclusionsAMH can be considered a reliable index of ovarian reserve in women with DTC. Chronological age is the main factor influencing AMH levels in both DTC patients and controls. After age-related stratification, AMH levels are similar in women with DTC treated with RAI and those treated with surgery alone. (Source: Thyroid Research)
Source: Thyroid Research - January 10, 2020 Category: Endocrinology Source Type: research

Life-threatening complications of high doses of intravenous methylprednisolone for treatment of Graves ’ orbitopathy
ConclusionsAn individualized safe and effective dose of intravenous methylprednisolone should be established for each patient with GO based on the vascular risk factors, comorbidities, and concomitant drugs. According to the European Group on Graves ’ Orbitopathy (EUGOGO) guidelines, cumulative doses of intravenous methylprednisolone should not exceed 8 g. (Source: Thyroid Research)
Source: Thyroid Research - December 23, 2019 Category: Endocrinology Source Type: research

Pre-sternal thyroid swellings: a case of rare aberrant site recurrence and review of literature
ConclusionPre-sternal region masses of thyroid origin are very rare. A proper work up, suspicion for thyroid mass and array of tests will be required to come to a provisional diagnosis. Since the masses reported in literature were primarily malignant, any such mass may be treated on lines of malignancy with radical surgery. (Source: Thyroid Research)
Source: Thyroid Research - November 21, 2019 Category: Endocrinology Source Type: research

Meeting Abstracts from the 67 th Annual British Thyroid Association Meeting
(Source: Thyroid Research)
Source: Thyroid Research - November 19, 2019 Category: Endocrinology Source Type: research

The surgical management of locally advanced well-differentiated thyroid carcinoma: changes over the years according to the AJCC 8th edition Cancer Staging Manual
ConclusionsWe discuss the changes introduced by the 8th edition AJCC Cancer Staging Manual, in terms of the diagnostic and surgical management of extra thyroid extension, in patients affected by papillary and follicular thyroid cancer. (Source: Thyroid Research)
Source: Thyroid Research - October 27, 2019 Category: Endocrinology Source Type: research

Association of thyroid hormones with resting energy expenditure and complement C3 in normal weight high body fat women
This study aims to examine the relationship between adiposity, thyroid hormone levels and immunity by comparing resting energy expenditure (REE), serum thyroid hormone levels and complement C3 in normal-weight high body fat (normal weight obesity) women and normal-weight normal body fat women.MethodsIn this case-control study, 40 women with normal body weight (BMI
Source: Thyroid Research - October 25, 2019 Category: Endocrinology Source Type: research

Painless destructive thyroiditis in a patient with resistance to thyroid hormone: a case report
We report a case of painless thyroiditis in a patient with RTH that was misdiagnosed as Graves ’ disease because of TSH-suppressed thyrotoxicosis.Case presentationA sixteen-year-old boy consulted a local general physician for fatigue. He had a goiter, and biochemical analysis showed TSH  
Source: Thyroid Research - October 25, 2019 Category: Endocrinology Source Type: research

Genomic test ends a long diagnostic odyssey in a patient with resistance to thyroid hormones
ConclusionsThyroid hormone resistance continues to be an un(der)- and misdiagnosed thyroid condition whose management is particularly challenging when associated with autoimmune thyroid disease. Whole exome sequencing has the potential to identifyTHRB pathogenic variants as incidental findings. Reporting such secondary findings from genomic testing may be particularly important in the context of the rarity of the condition and the potential clinical consequences of misdiagnosis and mistreatment. (Source: Thyroid Research)
Source: Thyroid Research - July 15, 2019 Category: Endocrinology Source Type: research

Association of antithyroglobulin antibody with iodine nutrition and thyroid dysfunction in Nepalese children
This study was conducted to investigate iodine nutrition, thyroid function and thyroid autoimmunity in the Nepalese children, and explore the association of thyroidal autoimmunity with iodine nutrition and thyroid dysfunction.MethodsFive schools from Udayapur district of eastern Nepal were selected for the study. A total of 213 school children aged 6 –12 years were enrolled, and anthropometric data, urine samples and blood samples were collected. Urinary iodine concentration (UIC), free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), and antithyroglobulin antibody (TgAb) was me...
Source: Thyroid Research - July 9, 2019 Category: Endocrinology Source Type: research

Levothyroxine before conception in women with thyroid antibodies: a step forward in the management of thyroid disease in pregnancy
AbstractStudies suggesting an association between thyroid autoimmunity and pregnancy-related adverse outcomes, particularly miscarriage and preterm delivery, date to nineties. The postulated causes for these associations were attributed to a direct or indirect effect of autoimmunity and/or to a mild thyroid impairment.Since then, small trials and several meta-analyses confirmed a detrimental effect of thyroid autoimmunity and suggested that patients with thyroid autoimmunity who wish to conceive or are pregnant might benefit from levothyroxine treatment to decrease the rate of miscarriage and preterm delivery.A recently pu...
Source: Thyroid Research - June 20, 2019 Category: Endocrinology Source Type: research

Semi-quantitative assessment of diffuse hepatic uptake seen in I-131 scans – an indicator of functioning thyroid tissue and disease burden in differentiated thyroid cancer
ConclusionHTR has good correlation with functional status of tumor cells, while it has weak correlation to therapeutic dose of I-131 administered and serum Tg. Increased HTR predicts significant disease burden in the form of distant bone and lung metastasis and may potentially be used as a second prognostic factor apart from serum Tg. (Source: Thyroid Research)
Source: Thyroid Research - April 25, 2019 Category: Endocrinology Source Type: research

Normalization of thyroid function tests among thyrotoxicosis patients attending a University Hospital in North-West Ethiopia
ConclusionThough PTU is not the preferred antithyroid agent in the management of thyrotoxicosis, all patients used PTU for the management of hyperthyroidism. All TFTs were normalized in only less than one-third of the participants. Resolution of symptoms took longer period of time than expected. (Source: Thyroid Research)
Source: Thyroid Research - March 23, 2019 Category: Endocrinology Source Type: research

Hypothyroidism in the older population
ConclusionsCurrent evidence suggests that threshold for treating mild subclinical hypothyroidism in older people should be high. It is reasonable to aim for a higher TSH target in treated older hypothyroid patients as their thyroid hormone requirements may be lower. In addition, age-appropriate TSH reference ranges should be considered in the diagnostic pathway of identifying individuals at risk of developing hypothyroidism. Appropriately designed and powered randomised controlled trials are required to confirm risk/benefit of treatment of subclinical hypothyroidism in older people. Until the results of such RCTs are avail...
Source: Thyroid Research - February 8, 2019 Category: Endocrinology Source Type: research

Mucin in benign thyroid nodules: treatment related change or not?
(Source: Thyroid Research)
Source: Thyroid Research - January 11, 2019 Category: Endocrinology Source Type: research

Thyroid malignancy among patients with thyroid nodules in the United Arab Emirates: a five-year retrospective tertiary Centre analysis
ConclusionWe report a higher prevalence of thyroid malignancy among patients with thyroid nodules relative to that reported in other parts of the world. The rate of thyroid malignancy was higher in patients of Far-East Asian and Caucasian ethnic background. (Source: Thyroid Research)
Source: Thyroid Research - November 30, 2018 Category: Endocrinology Source Type: research

Rapid detection of papillary thyroid carcinoma by fluorescence imaging using a γ-glutamyltranspeptidase-specific probe: a pilot study
ConclusionsAll PTC samples were detected by fluorescence imaging with gGlu-HMRG. Thus, fluorescence imaging with gGlu-HMRG is a rapid, simple, and powerful detection tool for PTC. (Source: Thyroid Research)
Source: Thyroid Research - November 21, 2018 Category: Endocrinology Source Type: research

Calcitonin measurement in fine-needle aspirate washout fluid by electrochemiluminescence immunoassay for thyroid tumors
AbstractPurposeFor the differential diagnosis of medullary thyroid carcinoma (MTC) on thyroid nodules, ultrasound-guided fine-needle aspiration cytology is a useful and safe procedure, but its diagnostic accuracy is not high enough. As an ancillary method to accurately diagnose MTC, the calcitonin in fine-needle aspirate washout fluid (FNA-Ct) is used. However, no data are available about cut-off values of FNA-Ct using the currently available electrochemiluminescence immunoassay (ECLIA).MethodsWe investigated 180 thyroid nodules in 141 patients. After smearing, the syringe and needle used for the FNA were rinsed with norma...
Source: Thyroid Research - October 30, 2018 Category: Endocrinology Source Type: research

Correlation between anti-thyroid peroxidase antibody levels and diffuse thyroid uptake of 18 F-fluorodeoxyglucose in Hashimoto ’s thyroiditis: a retrospective study
In this study, we evaluated the factors associated with diffuse uptake by comparing Hashimoto’s thyroiditis patients with or without diffuse uptake in the thyroid.MethodsA retrospective study was conducted of 18 patients with Hashimoto ’s thyroiditis who underwent blood tests, thyroid ultrasonography, and FDG-PET during the period from 2014 to 2015. The patients were divided into two groups: one with diffuse thyroid uptake (group 1,n = 13) and one without diffuse thyroid uptake (group 2,n = 5). Clinical and laboratory parameters, including maximum standardized uptake in the thyroid (...
Source: Thyroid Research - October 16, 2018 Category: Endocrinology Source Type: research

Synergistic inhibition of MEK/ERK and BRAF V600E with PD98059 and PLX4032 induces sodium/iodide symporter (NIS) expression and radioiodine uptake in BRAF mutated papillary thyroid cancer cells
ConclusionSimultaneously suppressing BRAF V600E and p-ERK restored NIS expression and increase Iodide uptake in PTC cells, which was associated the inhibition of p-ERK expression. The results warrants clinical trials to confirm. (Source: Thyroid Research)
Source: Thyroid Research - October 11, 2018 Category: Endocrinology Source Type: research

Hyperthyroidism in a complete molar pregnancy with a mature cystic ovarian teratoma
ConclusionThis case presents the rare occurrence of a complete hydatidiform mole causing hyperthyroidism and an associated finding of a mature cystic teratoma. It also highlights the importance of monitoring b-hCG levels following a complete molar pregnancy due to an increased risk of choriocarcinoma. (Source: Thyroid Research)
Source: Thyroid Research - August 10, 2018 Category: Endocrinology Source Type: research

A rare malignant thyroid carcinosarcoma with aggressive behavior and DICER1 gene mutation: a case report with literature review
ConclusionTo our knowledge, the E1705K point mutation within theDICER1 gene is the first reported mutation in carcinosarcoma of the thyroid. A comprehensive review of the relevant literature is also included for discussion. (Source: Thyroid Research)
Source: Thyroid Research - July 31, 2018 Category: Endocrinology Source Type: research

The largest reported papillary thyroid carcinoma arising in struma ovarii and metastasis to opposite ovary: case report and review of literature
ConclusionsAmong the different surgeries for MSO, TAH  + BSO appears to have the best clinical outcome. However, unilateral salpingo-oopherectomy/ unilateral oophorectomy and bilateral salpingo-oopherectomy also seem effective. Ovarian cystectomy alone seems associated with higher recurrence. There remains no consensus on the associations between M SO tumor size and potential extent of metastasis, and about the management of thyroid gland. However, surveillance and thyroid gland work up to detect concurrent thyroid cancer are recommended. (Source: Thyroid Research)
Source: Thyroid Research - July 24, 2018 Category: Endocrinology Source Type: research

Effect of perchlorate and thiocyanate exposure on thyroid function of pregnant women from South-West England: a cohort study
AbstractBackgroundIodine is important for thyroid hormone synthesis, and iodine deficiency in pregnancy may impair fetal neurological development. As perchlorate and thiocyanate inhibit sodium-iodide symporter reducing the transport of iodine from circulation into the thyroid follicular cells, environmental exposure to these substances in pregnancy may impair maternal thyroid hormone synthesis. We aimed to explore the impact of perchlorate and thiocyanate exposure on thyroid status in a cohort of pregnant mothers from South West England.MethodsUrine samples were obtained from 308 women participating in a study of breech pr...
Source: Thyroid Research - July 6, 2018 Category: Endocrinology Source Type: research

‘Does levothyroxine improve pregnancy outcomes in euthyroid women with thyroid autoimmunity undergoing assisted reproductive technology?’
AbstractEvidence on the treatment of euthyroid infertile women and thyroid autoimmunity with thyroid hormone is scare, and therefore the recent study by Wang et al. is a welcome addition to it. Based on their results, thyroid hormone seems not to be indicated to decrease the miscarriage rate in that particular group of infertile women. This comment is meant to put the study results into perspective with the available evidence and the current guidelines, and to highlight its strengths and weaknesses. (Source: Thyroid Research)
Source: Thyroid Research - May 30, 2018 Category: Endocrinology Source Type: research

Characteristics and natural course of hypoechoic thyroid lesions diagnosed as possible thyroid lymphomas by fine needle aspiration cytology
AbstractBackgroundThere is little information regarding the natural course of hypoechoic thyroid lesions that are probable or possible thyroid lymphoma based on fine needle aspiration cytology (FNAC) results.MethodsSixty-five patients who were diagnosed as probable or possible thyroid lymphoma by ultrasonography (US) and FNAC were investigated. Forty-three patients with strong suspicion underwent thyroid surgery for the diagnosis at our hospital, and 22 patients were followed up with periodic US examination. Thyroid lymphoma was definitely diagnosed in 41 out of 43 patients who underwent thyroid surgery, and such patients ...
Source: Thyroid Research - May 30, 2018 Category: Endocrinology Source Type: research

‘Does levothyroxine improve pregnancy outcomes in euthyroid women with thyroid autoimmunity undergoing assisted reproductive technology?’
AbstractEvidence on the treatment of euthyroid infertile women and thyroid autoimmunity with thyroid hormone is scare, and therefore the recent study by Wang et al. is a welcome addition to it. Based on their results, thyroid hormone seems not to be indicated to decrease the miscarriage rate in that particular group of infertile women. This comment is meant to put the study results into perspective with the available evidence and the current guidelines, and to highlight its strengths and weaknesses. (Source: Thyroid Research)
Source: Thyroid Research - May 30, 2018 Category: Endocrinology Source Type: research

Characteristics and natural course of hypoechoic thyroid lesions diagnosed as possible thyroid lymphomas by fine needle aspiration cytology
AbstractBackgroundThere is little information regarding the natural course of hypoechoic thyroid lesions that are probable or possible thyroid lymphoma based on fine needle aspiration cytology (FNAC) results.MethodsSixty-five patients who were diagnosed as probable or possible thyroid lymphoma by ultrasonography (US) and FNAC were investigated. Forty-three patients with strong suspicion underwent thyroid surgery for the diagnosis at our hospital, and 22 patients were followed up with periodic US examination. Thyroid lymphoma was definitely diagnosed in 41 out of 43 patients who underwent thyroid surgery, and such patients ...
Source: Thyroid Research - May 30, 2018 Category: Endocrinology Source Type: research

Thyroid hormones increase stomach goblet cell numbers and mucin expression during indomethacin induced ulcer healing in Wistar rats
AbstractBackgroundGastric ulcers are mucosal discontinuities that may extend into the mucosa, submucosa or even deeper. They result from an imbalance between mucosal aggressors and protective mechanisms that include the mucus bicarbonate layer. Thyroid hormones have been shown to accelerate gastric ulcer healing in part by increasing the adherent mucus levels. However, the effects of thyroid hormones on goblet cell numbers and expression of neutral and acidic mucins during ulcer healing have not been investigated.MethodsThirty six adult male Wistar rats were randomly divided into six groups each with six animals. Group 1 (...
Source: Thyroid Research - May 25, 2018 Category: Endocrinology Source Type: research

The upper limit for TSH during pregnancy: why we should stop using fixed limits of 2.5 or 3.0  mU/l
AbstractPhysiological changes necessitate the use of pregnancy-specific reference ranges for TSH and FT4 to diagnose thyroid dysfunction during pregnancy. Although many centers use fixed upper limits for TSH of 2.5 or 3.0  mU/L, this comment describeds new data which indicate that such cut-offs are too low and may lead to overdiagnosis or even overtreatment. The new guidelines of the American Thyroid Association have considerably changed recommendations regarding thyroid function reference ranges in pregnancy accord ingly. Also a stepwise approach to interpreting these guidelines is discussed as well as the relevant r...
Source: Thyroid Research - May 21, 2018 Category: Endocrinology Source Type: research

Acute suppurative thyroiditis caused by thyroid papillary carcinoma in the right thyroid lobe of a healthy woman
ConclusionsThis report represents a rare case of AST associated with PTC on the right side of thyroid gland, found in a healthy adult woman. The reason why AST coincided with malignant thyroid tumor is unclear. We have to take it into our account that malignant tumor may exist in the background when AST is identified on the right side of thyroid gland with a healthy subject. (Source: Thyroid Research)
Source: Thyroid Research - May 15, 2018 Category: Endocrinology Source Type: research

Ultrasound criteria for risk stratification of thyroid nodules in the previously iodine deficient area of Austria - a single centre, retrospective analysis
AbstractBackgroundWe aimed to study the validity of six published ultrasound criteria for risk stratification of thyroid nodules in the former severely iodine deficient population of Austria.MethodsRetrospective, single centre, observer blinded study design. All patients with a history of thyroidectomy due to nodules seen in the centre between 2004 and 2014 with preoperative in-house sonography and documented postoperative histology were analyzed (n = 195). A board of five experienced thyroidologists evaluated the images of 45 papillary carcinomas, 8 follicular carcinomas, and 142 benign nodules regarding the f...
Source: Thyroid Research - May 9, 2018 Category: Endocrinology Source Type: research