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Thyroid: Official Journal of the American Thyroid Association

Marina A Michalaki, Apostolos G Vagenakis, Kostas B Markou
We have read with great interest the recently published paper by Livadas et al in which, authors have found that 60.8% of patients on long-term levothyroxine (LT4) replacement therapy, in whom the diagnosis of hypothyroidism is not well established, remained euthyroid 6-8 weeks post discontinuation of LT4. We have concerns about the short period of re-evaluation of these patients. From one hand, in euthyroid subjects withdrawal of LT4 therapy is a cause of transient hypothyroidism and from the other in hyperthyroid patients the phenomenon of hysteresis in the hypothalamus-pituitary-thyroid (HPT) axis could observe...
May 16, 2019: Thyroid: Official Journal of the American Thyroid Association
Elena Izkhakov, Nachum Vaisman, Sophie Barnes, Micha Barchana, Naftali Stern, Lital Keinan-Boker
BACKGROUND: Thyroid hormones heavily impact energy expenditure, body mass, and body composition. Their role in the state of exogenous subclinical hyperthyroidism in differentiated thyroid carcinoma (DTC) patients, however, is less well-defined. The first aim of this study was to assess changes in body weight, body composition, resting energy expenditure (REE), respiratory quotient (RQ), and metabolic parameters in female DTC patients, starting from the phase of a euthyroid state prior to total thyroidectomy through the subsequent year following thyroid-stimulating hormone (TSH) suppression...
May 15, 2019: Thyroid: Official Journal of the American Thyroid Association
Julieta Fernandez-Ruocco, Monica Gallego, Ainhoa Rodriguez-de-Yurre, Julian Zayas-Arrabal, Leyre Echeazarra, Amaia Alquiza, Victor Fernandez-Lopez, Juan Manuel Rodriguez-Robledo, Oscar Brito, Marisa Sepulveda, Natália F Oshiyama, Martin Vila Petroff, Rosana Aldama Bassani, Emiliano Horácio Medei, Oscar Casis
BACKGROUND: Hypothyroidism (HT), the most common endocrine disease, induces cardiac electrical remodeling that creates a substrate for ventricular arrhythmias. Recent studies report that high thyroid stimulating hormone (TSH) levels are related to cardiac electrical abnormalities and increased mortality rates. The aim of the present work was to investigate the direct effects of TSH on the heart and its possible causative role in the increased incidence of arrhythmia in HT. METHODS: We created and characterized a new rat model of central HT (low TSH levels) together with the classical propylthiouracyl-induced primary HT model (high TSH levels)...
May 14, 2019: Thyroid: Official Journal of the American Thyroid Association
Ioannis Legakis, Dimitrios Adamopoulos, Ioannis Stamatiou, Alexandros Gryparis, George P Chrousos
BACKGROUND: A longitudinal study was conducted in full-term healthy infants who were born between 2015 and 2017 in Athens, Greece, in order to elucidate the evolution of thyroid-stimulating hormone (TSH) and other thyroidal parameter levels by sex, from their day of birth until 2 years old. Other thyroidal parameters that were taken into account include anti-thyroid peroxidase (TPO-Ab) and anti-thyroglobulin (TG-Ab) antibodies, total and free triiodothyronine (T3, FT3), along with total and free thyroxine (T4, FT4)...
May 14, 2019: Thyroid: Official Journal of the American Thyroid Association
So Young Han, Soo Hyun Choi, Jeon-Soo Shin, Eun Jig Lee, Seung-Han Han, Jin Sook Yoon
BACKGROUND: High-mobility group box 1 (HMGB1) has been implicated in the pathogenesis of inflammatory autoimmune diseases. We investigated the influence and mechanisms of HMGB1 in Graves' orbitopathy (GO). METHODS: HMGB1 and its receptors (receptor for advanced glycation end products (RAGE), Toll-like receptor (TLR) 2, and TLR4 mRNA levels were evaluated by real-time polymerase chain reaction (qPCR) in GO and non-GO orbital tissues. The mRNA expressions of HMGB1 and its receptors were evaluated in primary cultured orbital fibroblasts from six GO patients and five healthy control subjects under IL-1β or TNF-α stimulation using qPCR...
April 11, 2019: Thyroid: Official Journal of the American Thyroid Association
Anne R Cappola, Akshay S Desai, Marco Medici, Lawton S Cooper, Debra Egan, George Sopko, Glenn I Fishman, Steven Goldman, David S Cooper, Samia Mora, Peter J Kudenchuk, Anthony N Hollenberg, Cheryl L McDonald, Paul W Ladenson
Thyroid hormones have long been known to have a range of effects on the cardiovascular system. However, significant knowledge gaps exist concerning the precise molecular and biochemical mechanisms governing these effects and the optimal strategies for management of abnormalities in thyroid function in patients with and without preexisting cardiovascular disease. In September 2017, The National Heart, Lung, and Blood Institute convened a Working Group with the goal of developing priorities for future scientific research relating thyroid dysfunction to the progression of cardiovascular disease...
May 13, 2019: Thyroid: Official Journal of the American Thyroid Association
Geum Joon Cho, So-Youn Kim, Hoi Chang Lee, Kyu-Min Lee, Sung Won Han, Min-Jeong Oh, Teresa K Woodruff
Background: It is unclear whether a history of thyroid cancer is associated with an increased risk of adverse pregnancy outcomes in subsequent pregnancies. This study aimed to evaluate the risk of adverse obstetric outcomes and the abnormal growth of offspring in women with a history of thyroid cancer. Methods: This retrospective observational study used nationwide data from between 2006 and 2014 to compare pregnancy outcomes of women with a history of thyroid cancer and those with no such history. Cases of thyroid cancer were identified using ICD-10 codes...
May 9, 2019: Thyroid: Official Journal of the American Thyroid Association
Yasemin Ucal, Fatma Tokat, Mete Duren, Umit Ince, Aysel Ozpinar
INTRODUCTION: The lack of papillary structures and faint and/or unclear core features of follicular variant of papillary thyroid carcinoma (FV-PTC) may hamper the definitive fine needle aspiration biopsy (FNAB) based diagnosis. Recently, the nomenclature of noninvasive encapsulated FV-PTC was revised to "noninvasive follicular thyroid neoplasms with papillary-like nuclear features" (NIFTP). However it remains inconclusive whether or not the peptide patterns differ between NIFTP and encapsulated FV-PTC...
May 8, 2019: Thyroid: Official Journal of the American Thyroid Association
Naoki Edo, Kyojiro Kawakami, Yasunori Fujita, Koji Morita, Kenji Uno, Kazuhisa Tsukamoto, Hiroyuki Onose, Toshio Ishikawa, Masafumi Ito
BACKGROUND: Exosomes or small extracellular vesicles secreted from cells are nanovesicles with a diameter of 40-150 nm, which play a number of roles in both physiological and pathological processes. In Graves' disease (GD), autoantibodies bind to thyrotropin receptor (TSHR) on the surface of thyroid follicular epithelial cells and stimulate thyroid growth and thyroid hormone synthesis and secretion via cAMP production. In the present study, we aimed to confirm the existence of TSHR in exosomes secreted from thyroid cells and to define the role of TSHR exosomes in GD...
May 7, 2019: Thyroid: Official Journal of the American Thyroid Association
Xinyi Cao, Lin Dang, Xiangqian Zheng, Yi Lu, Yumei Lu, Rongjie Ji, Tianye Zhang, Xianhui Ruan, Jingtai Zhi, Xiukun Hou, Xianfu Yi, Mulin Jun Li, Tingyu Gu, Ming Gao, Lirong Zhang, Yupeng Chen
Background: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive malignancies, with no effective treatment currently available. The molecular mechanisms of ATC carcinogenesis remain poorly understood. The objective of this study was to investigate the mechanisms and functions of super-enhancer (SE)-driven oncogenic transcriptional addiction in the progression of ATC and identify new drug targets for ATC treatments. Methods: High-throughput chemical screening was performed to identify new drugs inhibiting ATC cell growth...
May 3, 2019: Thyroid: Official Journal of the American Thyroid Association
Gilbert H Daniels, Peter A Kopp
May 2, 2019: Thyroid: Official Journal of the American Thyroid Association
Catherine Peters, Adeline K Nicholas, Erik Schoenmakers, Greta Lyons, Shirley Langham, Eva G Serra, Neil J Sebire, Marina Muzza, Laura Fugazzola, Nadia Schoenmakers
Background The aetiology, course and most appropriate management of borderline congenital hypothyroidism (CH) are poorly defined, such that the optimal threshold for diagnosis with bloodspot screening TSH (bsTSH) measurement remains controversial. Dual oxidase 2 (DUOX2) mutations may initially cause borderline elevation of bsTSH, which later evolves into significant hypothyroidism on venous blood measurement. We hypothesized that mutations in both DUOX2 and its accessory protein DUOXA2 may occur frequently even in patients with borderline bsTSH elevation, such that higher diagnostic thresholds in bsTSH screening may fail to detect such cases, with consequent risk of undiagnosed neonatal hypothyroidism of sufficient magnitude to require thyroxine therapy...
May 2, 2019: Thyroid: Official Journal of the American Thyroid Association
Tim Korevaar, Megan R Haymart
May 2, 2019: Thyroid: Official Journal of the American Thyroid Association
Wenwu Dong, Kiyomi Horiuchi, Hiroki Tokumitsu, Akiko Sakamoto, Eiichiro Noguchi, Yoshinori Ueda, Takahiro Okamoto
BACKGROUND: Little is known about annual hazard rates of cancer mortality and recurrence for papillary thyroid cancer (PTC). In this study we investigated the time-varying pattern of cancer death and recurrence from PTC and independent prognostic factors for cause specific mortality (CSM) and recurrence of PTC. METHODS: This retrospective chart review enrolled 466 patients diagnosed with PTC who underwent curative initial surgery between April 1981 and December 1991 with a median follow-up of 18...
May 1, 2019: Thyroid: Official Journal of the American Thyroid Association
MinJi Jeon, Yu-Mi Lee, Tae-Yon Sung, Minkyu Han, Yong-Wook Shin, Won Gu Kim, Tae Yong Kim, Ki-Wook Chung, YoungKee Shong, Won Bae Kim
BACKGROUND: Active surveillance (AS) is recommended as an alternative to immediate surgery in patients with papillary thyroid microcarcinoma (PTMC), but the impact of AS on quality of life (QoL) has not been reported. The aim of this study was to compare QoL parameters in patients with PTMC under AS versus those who underwent lobectomy (LB). METHODS: In this cross-sectional study, patients with PTMC were prospectively enrolled between June 2016 and October 2017...
April 30, 2019: Thyroid: Official Journal of the American Thyroid Association
Gabrielle Dufort, Stéphanie Larrivée-Vanier, Dardye Eugène, Xavier De Deken, Britta Seebauer, Karl Heinimann, Sébastien Lévesque, Serge Gravel, Gabor Szinnai, Guy van Vliet, Johnny Deladoëy
We describe six patients with bi-allelic DUOX2 variants and widely variable phenotypes. Patient 1 is an infant with a compressive hypothyroid goiter causing respiratory distress, which was promptly alleviated by levothyroxine. He was a compound heterozygote for DUOX2 variants, including a novel deletion of 540 base pairs. Patients 2 and 3 are siblings with the same compound heterozygous mutations of DUOX2, yet one had overt hypothyroidism at 14 months and the other lifelong euthyroidism. Patient 4 is a compound heterozygote and has mild persistent congenital hypothyroidism; his sister (patient 5) only had borderline TSH at newborn screening, consistent with homozygous DUOX2 variants with mild impact on enzyme activity; their euthyroid mother (patient 6) has the same DUOX2 mutations as her son...
April 27, 2019: Thyroid: Official Journal of the American Thyroid Association
Bin Zhang, Jie Tian, Shufang Pei, Yubing Chen, Xin He, Yuhao Dong, Lu Zhang, Xiaokai Mo, Wenhui Huang, Shuzhen Cong, Shuixing Zhang
Background: Ultrasound (US) examination is helpful in the differential diagnosis of thyroid nodules (malignant vs. benign), but its accuracy relies heavily on examiner experience. Therefore, the aim of this study was to develop a less subjective diagnostic model aided by machine learning. Methods: A total of 2064 thyroid nodules (2032 patients, 695 male; M age  = 45.25 ± 13.49 years) met all of the following inclusion criteria: (i) hemi- or total thyroidectomy, (ii) maximum nodule diameter 2.5 cm, (iii) examination by conventional US and real-time elastography within one month before surgery, and (iv) no previous thyroid surgery or percutaneous thermotherapy...
April 27, 2019: Thyroid: Official Journal of the American Thyroid Association
Hye In Kim, Jiyeon Hyeon, So Young Park, Hyeon Seon Ahn, Kyunga Kim, Ji Min Han, Ji Cheol Bae, Jung Hee Shin, Jee Soo Kim, Sun Wook Kim, Jae Hoon Chung, Tae Hyuk Kim, Young Lyun Oh
BACKGROUND: The current American Thyroid Association (ATA) risk stratification system for papillary thyroid carcinoma (PTC) incorporates the number and size of positive lymph nodes (LNs), but places less weight on extranodal extension (ENE). We investigated how to incorporate ENE into the current system to predict recurrence better in PTC N1 patients. METHODS: A total of 369 N1 PTC patients without distant metastasis were enrolled. We identified the combination of number of positive LNs and LNs with ENE that had the highest C-index in multivariable Cox proportional hazard models...
April 26, 2019: Thyroid: Official Journal of the American Thyroid Association
Syed Morshed, Risheng Ma, Rauf Latif, Terry F Davies
BACKGROUND: Graves' disease (GD) is associated with TSH receptor (TSHR) antibodies of variable bioactivity. Recently we have characterized antibodies that bind to the cleavage region of the TSHR ectodomain (C-TSHR-Ab) and demonstrated their ability to induce thyroid cell apoptosis in vitro via excessive cell stress involving multiple organelles . METHODS: To investigate the in vivo effects of C-TSHR-Ab, we first developed a murine monoclonal antibody (mAb) directed against residues 337 to 356 of the TSHR cleavage region and then injected into mice...
April 26, 2019: Thyroid: Official Journal of the American Thyroid Association
Di Wu, Cristiane Jeyce Gomes Lima, Shari L Moreau, Kanchan Kulkarni, Alexander Zeymo, Kenneth D Burman, Leonard Wartofsky, Douglas Van Nostrand
BACKGROUND: The objective of this study was to evaluate the overall survival (OS) of 131I treatments alone and when combined with non-131I treatments in patients with bone metastases (BM) secondary to differentiated thyroid cancer (DTC). METHODS: This was a retrospective study of patients who were evaluated between 2001-2018 at MedStar Washington Hospital Center and had differentiated thyroid cancer (DTC), bone metastases (BM) and at least one 131I treatment after the diagnosis of BM...
April 24, 2019: Thyroid: Official Journal of the American Thyroid Association
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