-
Lancet (London, England) Jun 2024
Topics: Humans; Female; Thyrotoxicosis; Ethiodized Oil; Adhesives; Adult; Iodine; Pelvic Pain
PubMed: 38908880
DOI: 10.1016/S0140-6736(24)01135-8 -
Medicine Jun 2024The link between celiac disease (CeD) and thyroid dysfunction has been investigated. However, it is uncertain if CeD is causally linked to thyroid dysfunction. A...
The link between celiac disease (CeD) and thyroid dysfunction has been investigated. However, it is uncertain if CeD is causally linked to thyroid dysfunction. A 2-sample Mendelian randomization study was conducted to ascertain the causal connection between CeD and thyroid dysfunction. Using data from the FinnGen Consortium, a 2-sample Mendelian randomization study was conducted to look at the connection between thyroid dysfunction and CeD. Another replication of the data from the UK Biobank was subsequently performed to confirm our findings. Furthermore, a sequence of sensitivity analyses was performed. The inverse variance weighting technique demonstrates that genetically determined CeD is substantially linked with hypothyroidism, thyrotoxicosis, Graves' disease, and free thyroxine. However, no significant associations were found between CeD and thyroid-stimulating hormone or thyroiditis. Moreover, we achieve the same results in duplicate datasets, which increases the reliability of our findings. This study suggests that CeD and thyroid dysfunction are linked, and it gives theoretical support and new ways of thinking about how to diagnose and treat both conditions.
Topics: Humans; Mendelian Randomization Analysis; Celiac Disease; Thyroid Diseases; Hypothyroidism; Thyrotropin
PubMed: 38905357
DOI: 10.1097/MD.0000000000038474 -
Expert Review of Endocrinology &... Jul 2024Molecular imaging of thyroid and parathyroid diseases has changed in recent years due to the introduction of new radiopharmaceuticals and new imaging techniques.... (Review)
Review
INTRODUCTION
Molecular imaging of thyroid and parathyroid diseases has changed in recent years due to the introduction of new radiopharmaceuticals and new imaging techniques. Accordingly, we provided an clinicians-oriented overview of such techniques and their indications.
AREAS COVERED
A review of the literature was performed in the PubMed, Web of Science, and Scopus without time or language restrictions through the use of one or more fitting search criteria and terms as well as through screening of references in relevant selected papers. Literature up to and including December 2023 was included. Screening of titles/abstracts and removal of duplicates was performed and the full texts of the remaining potentially relevant articles were retrieved and reviewed.
EXPERT OPINION
Thyroid and parathyroid scintigraphy remains integral in patients with thyrotoxicosis, thyroid nodules, differentiated thyroid cancer and, respectively, hyperparathyroidism. In the last years positron-emission tomography with different tracers emerged as a more accurate alternative in evaluating indeterminate thyroid nodules [F-fluorodeoxyglucose (FDG)], differentiated thyroid cancer [I-iodide, F-tetrafluoroborate, F-FDG] and hyperparathyroidism [18F-fluorocholine]. Other PET tracers are useful in evaluating relapsing/advanced forms of medullary thyroid cancer (F-FDOPA) and selecting patients with advanced follicular and medullary thyroid cancers for theranostic treatments (Ga/Ga-somatostatin analogues).
Topics: Humans; Molecular Imaging; Parathyroid Diseases; Thyroid Diseases; Radiopharmaceuticals; Positron-Emission Tomography
PubMed: 38899737
DOI: 10.1080/17446651.2024.2365776 -
Journal of Clinical Medicine May 2024Coronary artery vasospasm plays a crucial role in the prevalence of unstable angina. Despite common misdiagnosis, there is limited evidence on this topic. Here, we...
Coronary artery vasospasm plays a crucial role in the prevalence of unstable angina. Despite common misdiagnosis, there is limited evidence on this topic. Here, we present a rare case of unstable vasospastic angina in a female with severe thyrotoxicosis. : A 62-year-old female patient was admitted to the cardiac intensive care unit due to crushing chest pain at rest. The patient exhibited ischemic changes on the ECG with a normal troponin I level. Recurrent chest pain prompted urgent coronary angiography, revealing generalized vasospasm of all coronary artery branches including the left main coronary artery. Intracoronary nitroglycerin injection partially alleviated the vasospasm; however, there was a persistent stenosis in the left main artery. Subsequent intravascular ultrasound demonstrated an anatomically normal left main artery. Post-procedure, laboratory tests revealed undetectable levels of thyroid-stimulating hormone and thyroid hormones above the detectable level. The patient was initiated on methimazole and discharged symptom-free, expecting a good prognosis under conservative management. : Clinically significant coronary vasospasm triggered by thyrotoxicosis remains a rarity in clinical practice, often posing diagnostic challenges. This case emphasizes the significance of intracoronary nitroglycerin and intravascular ultrasound in discerning the etiology of coronary lesions seen on angiography. We advocate for these techniques to optimize invasive coronary artery diagnostics, enabling the selection of the appropriate treatment strategies and improving long-term prognosis.
PubMed: 38892840
DOI: 10.3390/jcm13113130 -
Medicine Jun 2024Graves' disease is a prevalent thyroid disorder and is the primary cause of hyperthyroidism. Significant progress has been made in understanding the epidemiology,...
BACKGROUND
Graves' disease is a prevalent thyroid disorder and is the primary cause of hyperthyroidism. Significant progress has been made in understanding the epidemiology, pathogenesis, diagnosis, treatment, and prognosis of this disease. However, bibliometric analyses on Graves' disease are lacking. We aimed to comprehensively summarize the research, progression, and focal points of Graves' disease through data mining and integrated analysis of the existing literature.
METHODS
We retrieved relevant literature on Graves' disease from 2003 to 2023 from the Web of Science database. We performed bibliometric analysis using CiteSpace and the R package Bibliometrix.
RESULTS
We identified 10,901 publications from 132 countries, with a steady rise in the number of publications over the past 5 years. The US leads in publication volume, with the University of California System being the primary contributing institution. The journal Thyroid had the highest publication output, while the Journal of Clinical Endocrinology and Metabolism was the most frequently cited. These publications involved 2305 authors, with Antonelli Alessandro and Smith Terry being the most prolific. The most frequently cited articles were the "2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis" and the "Thyroid Association/European Group on Graves' orbitopathy guidelines for the management of Graves' orbitopathy." Analysis of the bursts of cited references, keywords, and their clustering revealed that research on Graves' disease predominantly centers on clinical management, thyroid-stimulating hormone receptors, thyroid hormones, autoimmunity and inflammation, Graves' ophthalmopathy, thyroid nodules, and thyroid cancer.
CONCLUSION
This is the first comprehensive bibliometric study to summarize progress and trends in Graves' disease research. These results highlight recent research hotspots and promising directions, thereby providing a valuable reference for other scholars.
Topics: Bibliometrics; Humans; Graves Disease; Biomedical Research; Global Health
PubMed: 38875401
DOI: 10.1097/MD.0000000000037963 -
Acta Clinica Belgica Jun 2024: Thyrotoxic periodic paralysis (TPP) is a type of hypokalemic periodic paralysis that is caused by an underlying thyrotoxicosis. It is a rare cause of hypokalemia due...
: Thyrotoxic periodic paralysis (TPP) is a type of hypokalemic periodic paralysis that is caused by an underlying thyrotoxicosis. It is a rare cause of hypokalemia due to intracellular potassium shift, causing acute muscle weakness.: We present a case of a 19-year-old male of Thai descent with acute proximal symmetric lower limb weakness. The combination of these symptoms with profound hypokalemia, rapid recovery after normalization of serum potassium, and evidence of hyperthyroidism led to the diagnosis of thyrotoxic periodic paralysis, in this case due to an underlying Graves' disease.: Clinicians should consider the diagnosis of TPP when a patient presents with the triad of acute paresis, profound hypokalemia and hyperthyroidism.
PubMed: 38869234
DOI: 10.1080/17843286.2024.2365491 -
Medicine Jun 2024Hyperthyroidism is increased synthesis and secretion of thyroid hormones by the thyroid gland resulting in thyrotoxicosis. The modality of therapy for hyperthyroidism...
Hyperthyroidism is increased synthesis and secretion of thyroid hormones by the thyroid gland resulting in thyrotoxicosis. The modality of therapy for hyperthyroidism includes anti-thyroid drugs, radioiodine and surgery. Anti-thyroid drugs are the only available therapy for hyperthyroid patients in developing world as radioiodine is inaccessible and surgical set up does not exist as required. The aim of this study was to determine the magnitude and predictors of uncontrolled hyperthyroidism among hyperthyroid patients after prolonged anti-thyroid drug use. An institutional-based cross sectional study was conducted at the University of Gondar hospital, Northwest Ethiopia, between April 1, 2022 and October 31, 2022. A consecutive sampling method was used to recruit 317 study subjects. Data were collected through a pre-designed questionnaire. Patients were interviewed to obtain socio-demographic data and relevant medical information. Laboratory analyses were done based on the follow up protocol. Data were entered into EPI Info version 4.6.0.0 (EPI Info, Atlanta) and analyzed in STATA version 14 (Stata Corp LP, Texas, USA). Binary logistic regression model was used to identify variables associated with uncontrolled hyperthyroidism among hyperthyroid patients. P value < .05 was used to declare significant association. A total of 317 patients with hyperthyroidism were included in the study. The median age of the study subjects was 45 years (IQR 36-55 years). Most (95%) of the study participants were females. Toxic multi-nodular goiter was the most common cause of hyperthyroidism (92%), followed by toxic adenoma (5%) and Graves' disease (2%). On multivariate binary logistic regression, large goiter size (AOR: 3.163, 95% CI [1.333-7.506]), severe disease (AOR: 2.275, 95% CI [1.060-4.880]), infrequent iodinated salt intake (AOR: 3.668, 95% CI [1.245-10.802]), and poor adherence to anti-thyroid drug (AOR:15.724, 95% CI [5.542-44.610]) were statistically significant with uncontrolled hyperthyroidism at 12 months of anti-thyroid drug intake. A quarter of patients with hyperthyroidism didn't achieve euthyroid state after 12 months of anti-thyroid drug use. The identified predictors for non-euthyroid state were large goiter size, severe disease, infrequent iodinated salt intake, and poor adherence to anti-thyroid drug.
Topics: Humans; Female; Ethiopia; Male; Hyperthyroidism; Cross-Sectional Studies; Middle Aged; Antithyroid Agents; Adult
PubMed: 38847659
DOI: 10.1097/MD.0000000000038201 -
Cureus May 2024Ectopic thyroid tissue is very rare, but the coexistence of ectopic and eutopic thyroid glands is even more rare. The recognition of this diagnosis is important in...
Ectopic thyroid tissue is very rare, but the coexistence of ectopic and eutopic thyroid glands is even more rare. The recognition of this diagnosis is important in patients who are being treated for thyrotoxicosis, but it is also crucial to exclude other associated serious disease conditions. In this article, we report three different cases that showed ectopic thyroid tissue with the coexisting presence of an eutopic thyroid gland. All three cases showed different outcomes. The recognition of this condition is of great importance because it alerts the referring physicians to this rare, yet possible occurrence and the potential pathological conditions associated with it. The first case showed how imaging could help outline even small ectopic thyroid tissue outside of the neck region even in cases where histopathological confirmation is difficult. The second case was very rare as thyroid carcinoma originated in ectopic thyroid tissue. In the last case, the initial imaging was misleading as it mimicked greatly ectopic thyroid tissue, and only detailed history and careful inspection of the images could lead to the correct interpretation of the findings.
PubMed: 38846237
DOI: 10.7759/cureus.59834 -
Thyroid : Official Journal of the... Jun 2024Introduction Thyroid hormone transporters are essential for thyroid hormones to enter target cells. Monocarboxylate transporter MCT8 is a key transporter and expressed...
Introduction Thyroid hormone transporters are essential for thyroid hormones to enter target cells. Monocarboxylate transporter MCT8 is a key transporter and expressed at the blood-brain barrier, in neural cells and many other tissues. Patients with MCT8 deficiency have severe neurodevelopmental delays due to cerebral hypothyroidism and chronic sequelae of peripheral thyrotoxicosis. The T3 analog 3,3,5-triiodothyroacetic acid (TRIAC) rescued neurodevelopmental features in animal models mimicking MCT8 deficiency and improved key metabolic features in patients with MCT8 deficiency. However, the identity of the transporter(s) that facilitate TRIAC transport are unknown. Here, we screened candidate transporters that are expressed at the human blood-brain barrier and/or brain-cerebrospinal fluid barrier and known thyroid hormone transporters for TRIAC transport. Materials and methods Plasma membrane expression was determined by cell surface biotinylation assays. Intracellular accumulation of 1 nM TRIAC was assessed in COS-1 cells expressing candidate transporters in Dulbecco's phosphate buffered saline (DPBS)/0.1% glucose or Dulbecco's modified Eagle's medium (DMEM) with or without 0.1% bovine serum albumin (BSA). Expression of Slc22a8 was determined by fluorescent in situ hybridization (FISH) in brain sections from wild-type and Mct8/Oatp1c1 knock-out mice at postnatal day 12, 21 and 120. Results Fifty-nine plasma membrane transporters were selected for screening of TRIAC accumulation (n=40 based on expression at the human blood-brain barrier and/or brain-cerebrospinal fluid barrier and having small organic molecules as substrates; n=19 known thyroid hormone transporters). Screening of the selected transporter panel showed that 18 transporters facilitated significant intracellular accumulation of TRIAC in DPBS/0.1% glucose or DMEM in the absence of BSA. In the presence of BSA, substantial transport was noted for SLCO1B1 and SLC22A8 (in DPBS/0.1% glucose and DMEM) and SLC10A1, SLC22A6 and SLC22A24 (in DMEM). The zebrafish and mouse orthologues of these transporters similarly facilitated intracellular accumulation of TRIAC. Highest Slc22a8 mRNA expression was detected in mouse brain capillary endothelial cells and choroid plexus epithelial cells at early postnatal time points, but wasreduced at P120. Conclusions Human SLC10A1, SLCO1B1, SLC22A6, SLC22A8 and SLC22A24 as well as their mouse and zebrafish orthologues are efficient TRIAC transporters. These findings contribute to the understanding of TRIAC treatment in patients with MCT8 deficiency and animal models thereof.
PubMed: 38836423
DOI: 10.1089/thy.2023.0467 -
BMJ Case Reports Jun 2024We report a case where the patient may have developed Graves' disease after COVID-19 infection, and where the COVID-19 vaccination may have exacerbated the condition,...
We report a case where the patient may have developed Graves' disease after COVID-19 infection, and where the COVID-19 vaccination may have exacerbated the condition, inducing the onset of a thyroid storm. Although any association between the vaccine and the onset of thyroid disease is impossible to demonstrate through a single case, the antecedent COVID-19 infection and COVID-19 messenger ribonucleic acid vaccination may have synergistically contributed to the development of Graves' disease followed by thyroid storm.
Topics: Female; Humans; COVID-19; COVID-19 Vaccines; Graves Disease; SARS-CoV-2; Thyroid Crisis; Vaccination; Child
PubMed: 38834307
DOI: 10.1136/bcr-2024-259796