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Acta Endocrinologica (Bucharest,... 2023Sarcopenia is a syndrome, considered one of the main risk factors for morbidity and mortality among adults. Thyrotoxicosis may contribute to its development.
BACKGROUND
Sarcopenia is a syndrome, considered one of the main risk factors for morbidity and mortality among adults. Thyrotoxicosis may contribute to its development.
AIM
To assess the physical well-being among women with thyrotoxicosis and to determine the risk of sarcopenia among them; 13 women over 40 years of age with thyrotoxicosis took part in this study.
MATERIALS AND METHODS
Grip strength was used to assess muscle strength. Appendicular skeletal muscle mass, adjusted for body size was used to asses muscle quantity. Physical performance was measured by gait speed test. We divided women in groups: group A - patients with newly diagnosed thyrotoxicosis and group B - patients who had started treatment.
RESULTS
The values of muscle strength, muscle mass and gait speed were lower in group A compared to group B. Three of the patients in group A were diagnosed with severe sarcopenia. Thus the frequency of sarcopenia was 50% in this group. None of the women in group B met the criteria for sarcopenia.Despite the small number of women in this study, we can conclude that untreated thyrotoxicosis is a risk factor for decreased muscle strength, quantity and physical performance and could cause secondary sarcopenia.
PubMed: 37908874
DOI: 10.4183/aeb.2023.269 -
JCEM Case Reports Jul 2023Lithium is not commonly used to treat thyrotoxicosis, and there are few reports in the literature of its use as initial therapy in thyrotoxicosis. We describe the case...
Lithium is not commonly used to treat thyrotoxicosis, and there are few reports in the literature of its use as initial therapy in thyrotoxicosis. We describe the case of a patient with Graves thyrotoxicosis and ophthalmopathy, on a background of autoimmune neutropenia, treated successfully with relatively long-term lithium monotherapy. Lithium was used at a lower dose and longer duration than previously reported on, to good effect. We demonstrate that lithium is an important and useful option for those who are unable to tolerate thionamide therapy.
PubMed: 37908984
DOI: 10.1210/jcemcr/luad094 -
Experimental and Therapeutic Medicine Jul 2021In patients who were not previously diagnosed with any thyroid conditions, the scenario of COVID-19-related anomalies of the hypothalamus-pituitary-thyroid axes may... (Review)
Review
In patients who were not previously diagnosed with any thyroid conditions, the scenario of COVID-19-related anomalies of the hypothalamus-pituitary-thyroid axes may include either: A process of central thyroid stimulating hormone (TSH) disturbances via virus-related hypophysitis; an atypical type of subacute thyroiditis which is connected to the virus spread or to excessive cytokine production including a destructive process with irreversible damage of the gland or low T3 (triiodothyronine) syndrome (so called non-thyroid illness syndrome) which is not specifically related to the COVID-19 infection, but which is associated with a very severe illness status. Our objective here was to briefly review thyroid changes due to the COVID-19 infection. Ongoing assessment of the effects of the COVID-19 pandemic will reveal more information on coronavirus-induced thyroid conditions. Routine thyroid assays performed in patients with severe infection/at acute phase of COVID-19 are encouraged in order to detect thyrotoxicosis. After recovery, thyroid function should be assessed to identify potential hypothyroidism. There remain unanswered questions related to the prognostic value of interleukin-6 in infected patients, especially in cases with cytokine storm, and the necessity of thyroid hormone replacement in subjects with hypophysitis-related central hypothyroidism.
PubMed: 34035853
DOI: 10.3892/etm.2021.10188 -
Anaesthesia Reports 2021Thyroid storm is a rare manifestation of severe thyrotoxicosis, and presentation with coma is highly atypical. A 32-year-old woman, previously euthyroid, presented in a...
Thyroid storm is a rare manifestation of severe thyrotoxicosis, and presentation with coma is highly atypical. A 32-year-old woman, previously euthyroid, presented in a comatose state with tachycardia, hypertension and pyrexia. The patient's trachea was intubated in the community and she was subsequently admitted to the intensive care unit with a working diagnosis of meningoencephalitis. Although hypertension was present initially, subsequent hypotension necessitated a noradrenaline infusion. The patient remained persistently tachycardic and pyrexial. Initial laboratory investigations, including examination of cerebrospinal fluid, did not identify a specific diagnosis. Subsequently, raised thyroxine and triiodothyronine levels alongside undetectable thyroid-stimulating hormone confirmed the diagnosis of thyroid storm. Following treatment for thyrotoxicosis, the patient made a full recovery and was discharged from the intensive care unit after three days. This case highlights the importance of considering thyroid disease in critically ill patients presenting with non-specific symptoms.
PubMed: 34806018
DOI: 10.1002/anr3.12134 -
Frontiers in Endocrinology 2023Moyamoya disease (MMD), also known as abnormal cerebral vascular network disease, is characterized by progressive occlusion or stenosis of the internal carotid and... (Review)
Review
Moyamoya disease (MMD), also known as abnormal cerebral vascular network disease, is characterized by progressive occlusion or stenosis of the internal carotid and cerebral arteries, as well as the formation of an abnormal cerebral vascular network. It can occur anywhere in the world but is most common in China, Japan, and the Republic of Korea. In recent years, there have been increasing reports on the coexistence of thyroid diseases and MMD, but the mechanism of their coexistence is still unclear. For this article, we used keywords such as "moyamoya disease", "thyroid", "Grave disease", "thyrotoxicosis", and "thyroid autoimmune antibodies" to search for 52 articles that met the requirements in medical databases such as PubMed and Web of Science. This article also reviews the research on the role of thyroid hormone, the mechanism of immune antibodies, the possible correlation between thyroid diseases and MMD disease genes, and the treatment methods, and discusses the possible relationship between MMD and thyroid diseases to provide a reference for the pathogenesis and treatment of MMD with thyroid diseases.
Topics: Humans; Moyamoya Disease; Thyroid Diseases; Thyrotoxicosis; Japan
PubMed: 37900127
DOI: 10.3389/fendo.2023.1233567 -
Frontiers in Immunology 2022The problem of aging is mainly the increase of age-related diseases, and elderly patients have longer hospitalization and worse prognosis. Poorer nutritional status and...
The problem of aging is mainly the increase of age-related diseases, and elderly patients have longer hospitalization and worse prognosis. Poorer nutritional status and immunosenescence may be predisposing and severe factors. The mechanism of the high incidence of diseases and poor prognosis behind aging is complex. Finding suitable aging models is of great significance to find strategies to prevent aging related events. In this study, the relationship between thyrotoxicosis and aging was investigated in mice. The results of routine blood tests and flow cytometry showed that immunosenescence occurred in thyrotoxicosis mice, which was characterized by a significant decrease in neutrophils, lymphocytes, CD4+/CD8+ and CD4+IFN-γ+ lymphocytes. Biochemical examination results showed that there were hypocholesterolemia, hypolipoproteinemia, and hyperlipidemia in thyrotoxicosis mice. Serum proteomics analysis showed that the downregulation of complement and coagulation proteins was another manifestation of declined immunity. Moreover, proteomics analysis showed that many downregulated proteins were related to homeostasis, mainly transport proteins. Their downregulation led to the disturbance of osmotic pressure, ion homeostasis, vitamin utilization, lipid transport, hyaluronic acid processing, and pH maintenance. Serum metabolomics analysis provided more detailed evidence of homeostasis disturbance, especially lipid metabolism disorder, including the downregulation of cholesterol, vitamin D, bile acids, docosanoids, and the upregulation of glucocorticoids, triglycerides, sphingolipids, and free fatty acids. The upregulated lipid metabolites were related to lipotoxicity, which might be one cause of immunosenescence and many aging related syndromes. This study provides evidence for the aging model of thyrotoxicosis mice, which can be used for exploring anti-aging drugs and strategies.
Topics: Aged; Aging; Animals; Humans; Immunosenescence; Lipids; Malnutrition; Mice; Thyrotoxicosis
PubMed: 35720307
DOI: 10.3389/fimmu.2022.864929 -
BMJ Paediatrics Open Nov 2022Thyrotoxicosis due to hyperthyroidism is a serious disorder in childhood often presenting to general paediatricians with a range of clinical manifestations. The... (Review)
Review
Thyrotoxicosis due to hyperthyroidism is a serious disorder in childhood often presenting to general paediatricians with a range of clinical manifestations. The commonest cause is Graves' disease, an autoimmune disorder resulting from thyrotropin receptor stimulation by autoantibodies. Early recognition and accurate interpretation of investigations are essential to achieve and maintain a euthyroid state. This will not only optimise growth, development and transition from childhood to young adult life but also avoid the potentially severe and life-threatening complications of acute thyrotoxicosis. In this review, we have focussed on the general paediatrician's perspective of the presentation and management of thyrotoxicosis and the need to network with specialist paediatric endocrine centres to optimise patient care. We have discussed nuances of therapy, side effects and long-term outcomes, while recognising that limited remission rates in this age group often necessitate more definitive management. While carbimazole is usually used as first-line medical therapy, we have provided useful information to guide paediatricians in the discussion of individualised safe and effective treatment plans for both short-term and long-term management.
Topics: Young Adult; Humans; Child; Adolescent; Antithyroid Agents; Thyrotoxicosis; Graves Disease; Hyperthyroidism; Carbimazole
PubMed: 36645751
DOI: 10.1136/bmjpo-2022-001582 -
Journal of Endocrinological... May 2022To describe a case series of thyrotoxicosis likely triggered by SARS-CoV-2 vaccination and to warn physicians about this potential correlation. To report clinical,...
AIM
To describe a case series of thyrotoxicosis likely triggered by SARS-CoV-2 vaccination and to warn physicians about this potential correlation. To report clinical, laboratory and imaging findings and provide further information that goes in line with the underlying mechanisms.
METHODS
Single-center case series based on all the information collected in the hospital medical records, as well as the temporal sequence between the onset of symptoms and COVID-19 vaccination.
RESULTS
We report 8 cases with thyrotoxicosis after SARS-CoV-2 vaccination. 4 cases of Graves' disease (GD), 2 cases of subacute painful thyroiditis (SAT), 1 case of concurrent GD and SAT and 1 case of atypical subacute thyroiditis. Five patients received BNT162b2 mRNA vaccine, 3 patients 1273 mRNA vaccine. The onset of symptoms following vaccination ranged from 10 to 14 days in six of eight patients and from 7 to 8 weeks in two patients.
CONCLUSIONS
Several hypotheses have been proposed to explain the potential correlation between SARS-CoV-2 vaccination and thyrotoxicosis, including immune system hyper-stimulation, molecular mimicry and Autoimmune/Autoinflammatory Syndrome Induced by Adjuvants (ASIA). We should pay greater attention to thyroid disorders in patients receiving vaccine against SARS-CoV-2.
Topics: BNT162 Vaccine; COVID-19; COVID-19 Vaccines; Graves Disease; Humans; SARS-CoV-2; Thyroiditis, Subacute; Thyrotoxicosis; Vaccination; Vaccines, Synthetic; mRNA Vaccines
PubMed: 35015288
DOI: 10.1007/s40618-022-01739-0 -
Cureus Apr 2022Hyperthyroidism directly affects the cardiovascular system, altering the heart's normal function and leading to high cardiovascular mortality. Excess thyroid hormones... (Review)
Review
Hyperthyroidism directly affects the cardiovascular system, altering the heart's normal function and leading to high cardiovascular mortality. Excess thyroid hormones are associated with significantly increased risk and prevalence of cardiac arrhythmias, particularly atrial fibrillation (AF). This article reviewed the hemodynamic changes and the risk of cardiac arrhythmias, including atrial and ventricular arrhythmias associated with hyperthyroidism. It has also discussed the multi-level pathophysiology of thyrotoxic AF, sinus tachycardia, and different treatment modalities such as anti-thyroid drugs, beta-blockers, and the role of cardioversion and catheter ablation. This article has explored different studies that have concluded that AF and sinus tachycardia are the most common arrhythmias associated with thyrotoxicosis.
PubMed: 35619859
DOI: 10.7759/cureus.24378 -
Cureus Apr 2023Thyrotoxicosis, an endocrine disorder characterized by elevated serum thyroid hormone levels of tri-iodothyronine (T3) and/or thyroxine (T4), can impact cardiovascular... (Review)
Review
Thyrotoxicosis, an endocrine disorder characterized by elevated serum thyroid hormone levels of tri-iodothyronine (T3) and/or thyroxine (T4), can impact cardiovascular health in several ways. The cardiovascular system is often severely targeted by the thyrotoxic state, and the term "Cardio-thyrotoxic syndrome" has been proposed to encompass the various cardiovascular disease states resulting from thyrotoxicosis. In this review, we discuss various cardiovascular disorders resulting from the effects of thyrotoxicosis. It is important to keep a high index of suspicion for thyroid disorder in the setting of new atrial fibrillation, heart failure, and tachycardia-induced cardiomyopathy. Management of cardio-thyrotoxicosis involves control of heart rate and blood pressure and treatment of acute cardiovascular complications. Thyroid-specific therapy to achieve a euthyroid state will not only improve but even potentially reverse cardiovascular abnormalities.
PubMed: 37200647
DOI: 10.7759/cureus.37659