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Hashimoto’s thyroiditis

Christian Trummer, Verena Schwetz, Felix Aberer, Marlene Pandis, Elisabeth Lerchbaum, Stefan Pilz
Objective<br>A conversion from Hashimoto's thyroiditis (HT) to Graves' disease (GD) and vice versa leads to diagnostic and therapeutic challenges.<br> Clinical Presentation and Intervention<br>A 30-year old woman presented with overt hyperthyroidism and negative thyroid-stimulating hormone receptor antibodies (TRAbs). Since hashitoxicosis was assumed, the patient was treated with propranolol. Within the next few weeks, the patient developed severe overt hypothyroidism, leading to treatment with levothyroxine...
March 22, 2019: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Mario Rotondi, Andrea Carbone, Francesca Coperchini, Rodolfo Fonte, Luca Chiovato
IgG4-related disease (IgG4-RD) is fibro-inflammatory, immune-mediated, systemic disease, recognized as a defined clinical condition only in 2001. The prevalence of IgG4-RD is 6/100,000 but it is likely to be underestimated due to insufficient awareness of the disease. The diagnostic approach is complex because of the heterogeneity of clinical presentation and because of rather variable diagnostic criteria. Indeed, high concentrations of IgG4 in tissue and serum are not a reliable diagnostic marker. The spectrum of IgG4-RD also includes well-known thyroid diseases including Riedel's thyroiditis, Hashimoto's thyroiditis and its fibrotic variant, Graves' disease and Graves' orbitopathy...
March 1, 2019: European Journal of Endocrinology
Hyung Jin Hahn, Sang Gyu Kwak, Dong-Kyu Kim, Jong-Yeup Kim
Ménière disease (MD), an idiopathic disorder of sensorineural hearing loss and vertigo, shares many similarities with two common skin conditions, atopic dermatitis (AD) and vitiligo. Recent studies have suggested that MD may be related to or triggered by autoimmune conditions, notably Hashimoto thyroiditis and alopecia areata. These evidences led to the authors contemplating the possibility of immunological bridge between MD and the two skin conditions. The authors have tested this hypothesis with population-based cohort from the National Health Insurance Service Database of Korea...
March 13, 2019: Scientific Reports
Erisa Alia, Eric J Feit, Jacob Oren Levitt
Pretibial myxedema or thyroid dermopathy constitutes dermal deposition of mucin, primarily hyaluronic acid and chondroitin sulfate. It is a manifestation of autoimmune thyroiditis, seen more in Graves disease than in Hashimoto thyroiditis. The time delay from treatment of hyperthyroidism to appearance of localized myxedema varies from one month to 16 years (mean 5.13 years). Despite a variety of therapeutic options, failure and relapse rates are high. Therapeutic options reported in the literature include compression, topical and intralesional corticosteroids, oral pentoxifylline, octreotide, rituximab, plasmapheresis, and high-dose intravenous immunoglobulin...
February 15, 2019: Dermatology Online Journal
Hamiyet Yilmaz Yasar, Mustafa Demirpence, Ayfer Colak, Leman Yurdakul, Merve Zeytinli, Hakan Turkon, Ferhat Ekinci, Aybike Günaslan, Erdem Yasar
OBJECTIVE: In this study, we aimed to evaluate serum irisin and apelin levels in patients with subclinical hypothyroidism (SCH) when they were subclinical hypothyroid and become euthyroid after levothyroxine therapy and association of these adipokines with markers of atherosclerosis such as serum homocysteine levels and carotid intima-media thickness (IMT). SUBJECTS AND METHODS: The study included 160 patients with newly diagnosed subclinical hypothyroidism due to Hashimoto's thyroiditis and 86 euthyroid healty subjects...
February 2019: Archives of Endocrinology and Metabolism
Giuseppe Crisafulli, Tommaso Aversa, Giuseppina Zirilli, Giovanni Battista Pajno, Domenico Corica, Filippo De Luca, Malgorzata Wasniewska
Aim of this mini review was to analyze the main variables which should be taken into account when the decision regarding a possible treatment with L-T4 has to be considered for a child with subclinical hypothyroidism (SH). The indications of periodical monitoring and vigilance have been also discussed. It was inferred that therapy should be recommended for children with underlying Hashimoto's thyroiditis and progressive deterioration of thyroid status over time, particularly in the cases with goiter and hypothyroid symptoms and in those with associated Turner syndrome or Down's syndrome and/or other autoimmune diseases...
2019: Frontiers in Endocrinology
Ivar Guldvog, Laurens Cornelus Reitsma, Lene Johnsen, Andromeda Lauzike, Charlotte Gibbs, Eivind Carlsen, Tone Hoel Lende, Jon Kristian Narvestad, Roald Omdal, Jan Terje Kvaløy, Geir Hoff, Tomm Bernklev, Håvard Søiland
Background: Hashimoto disease is a chronic autoimmune thyroiditis. Despite adequate hormone substitution, some patients have persistent symptoms that may be the result of immunologic pathophysiology. Objective: To determine whether thyroidectomy improves symptoms in patients with Hashimoto thyroiditis who still have symptoms despite having normal thyroid gland function while receiving medical therapy. Design: Randomized trial. (ClinicalTrials...
March 12, 2019: Annals of Internal Medicine
Mehmet Sedat Durmaz, Nesibe Akyürek, Turgay Kara, Fatih Ateş, Bora Özbakir, Funda Gökgöz Durmaz, Seda Soğukpinar Karaağaç, Mehmet Öztürk
The study aimed to investigate the effectiveness of the vascularization index (VI) obtained using superb microvascular imaging (SMI) technique in the diagnosis of Hashimoto thyroiditis (HT). The thyroid glands of 80 patients with HT and 107 healthy, asymptomatic participants were examined using SMI. The thyroid parenchyma echogenicity was evaluated, and the thyroid gland volume was measured. Vascularization index measurements were performed by manually drawing the contours of the thyroid parenchyma using the free region of interest with color 2-dimensional SMI VI mode...
March 6, 2019: Ultrasound Quarterly
Kazuhiro Ueda, Atsushi Kiyota, Mariko Tsuchida, Mikako Okazaki, Nobuaki Ozaki
Myxedema coma is a rare endocrine emergency resulting from the decompensation of severe hypothyroidism, which is associated with a high mortality rate. It is characterized by the deterioration of mental status, hypothermia, hypotension, hyponatremia, and hypoventilation. Early disease diagnosis and advancements in intensive supportive care have reduced the mortality rate. Besides intensive supportive care, appropriate management of the underlying thyroid hormone deficiency is essential. However, as the disease is rare and unrecognized, evidence-based treatment of myxedema has not yet been established in many countries...
March 8, 2019: Endocrine Journal
Robert Krysiak, Karolina Kowalcze, Bogusław Okopień
BACKGROUND: Both exogenous vitamin D and selenium reduce thyroid antibody titers. The aim of the study was to investigate whether the impact of vitamin D on thyroid autoimmunity is affected by selenium intake. METHODS: The study included 47 euthyroid women with Hashimoto's thyroiditis and low vitamin D status, 23 of whom had been treated with selenomethionine (200 μg daily) for at least 12 months before the beginning of the study. During the study, all patients were treated with vitamin D preparations (4000 IU daily)...
December 14, 2018: Pharmacological Reports: PR
Domenico Santoro, Gianluca Di Bella, Antonio Toscano, Olimpia Musumeci, Michele Buemi, Giorgina Barbara Piccoli
Pregnancy is a challenge in the life of a woman with chronic kidney disease (CKD), but also represents an occasion for physicians to make or reconsider diagnosis of kidney disease. Counselling is particularly challenging in cases in which a genetic disease with a heterogeneous and unpredictable phenotype is discovered in pregnancy. The case reported regards a young woman with Stage-4 CKD, in which "Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes" (MELAS syndrome), was diagnosed during an unplanned pregnancy...
March 4, 2019: Journal of Clinical Medicine
Giorgio Radetti, Sandro Loche, Valeria D'Antonio, Mariacarolina Salerno, Chiara Guzzetti, Tommaso Aversa, Alessandra Cassio, Marco Cappa, Roberto Gastaldi, Filippo Deluca, Maria Cristina Vigone, Giulia Maria Tronconi, Andrea Corrias
It is unclear whether patients with Hashimoto thyroiditis (HT) are predisposed to develop thyroid nodules and/or thyroid cancer. The objective of our study was therefore to assess the prevalence of thyroid nodules and/or cancer in patients with HT and to look for possible prognostic factors. A retrospective survey of 904 children/adolescents with HT (709 females, 195 males) regularly followed in nine Italian centers of pediatric endocrinology was performed. Median period of follow-up was 4.5 years (1.2 to 12...
March 1, 2019: Journal of the Endocrine Society
Xuan Wang, Xiaoqing Shao, Xinhao Liu, Qiu Qin, Jian Xu, Jin An Zhang
OBJECTIVE: Hashimoto's Thyroiditis (HT) is an autoimmune disease, characterized by chronic inflammation of the thyroid gland with unknown etiologies. Recently, interlukin-33/ST2 (IL-33/ST2) pathway has been revealed its participation in the process of several autoimmune diseases. In this study, the role of IL-33/ST2 pathway in the development of HT is investigated. METHODS: The levels of plasma IL-33, sST2 and the frequency of circulating CD4+ST2L+T cells in 30 HT patients and 20 healthy controls were determined by enzyme-linked immunosorbent assay (ELISA) and flow cytometry respectively...
February 26, 2019: Endocrine, Metabolic & Immune Disorders Drug Targets
Robert Krysiak, Witold Szkróbka, Bogusław Okopień
BACKGROUND: Both selenium and vitamin D were found to reduce thyroid antibody titers in women with Hashimoto's thyroiditis. METHODS: The study enrolled 37 young drug-naïve euthyroid men with autoimmune thyroiditis, who were treated for 6 months with either exogenous vitamin D (group A, n = 20) or selenomethionine (group B, n = 17). Serum titers of thyroid peroxidase and thyroglobulin antibodies, serum levels of thyrotropin and free thyroid hormones, serum levels of 25-hydroxyvitamin D, as well Jostel's thyrotropin, the SPINA-GT and the SPINA-GD indices were determined at the beginning and at the end of the study...
October 24, 2018: Pharmacological Reports: PR
Takahiro Nojiri, Makoto Kurano, Osamu Araki, Kazuki Nakawatari, Masako Nishikawa, Satoshi Shimamoto, Koji Igarashi, Kuniyuki Kano, Junken Aoki, Shinji Kihara, Masami Murakami, Yutaka Yatomi
Graves' Disease is a representative autoimmune thyroid disease that presents with hyperthyroidism. Emerging evidence has shown the involvement of lysophosphatidic acid (LPA) and its producing enzyme, autotaxin (ATX), in the pathogenesis of various diseases; among them, the involvement of the ATX/LPA axis in some immunological disturbances has been proposed. In this study, we investigated the association between serum ATX levels and Graves' disease. We measured the levels of serum total ATX and ATX isoforms (classical ATX and novel ATX) in patients with untreated Graves' disease, Graves' disease treated with anti-thyroid drugs, patients with subacute thyroiditis, silent thyroiditis, Plummer's disease, or Hashimoto's thyroiditis, and patients who had undergone a total thyroidectomy, as well as normal subjects...
February 27, 2019: Endocrine Journal
Tatjana Zake, Sandra Skuja, Ieva Kalere, Ilze Konrade, Valerija Groma
T helper (Th) 17 cells and interleukin (IL)-17 play a significant role in the pathogenesis of autoimmune thyroid disease (AITD). However, it has recently become clear that Th17 cells are more heterogeneous and exhibit two different phenotypes, whereas IL-23 and IL-1β are crucial for the generation of pathogenic Th17 lymphocytes. We aimed to investigate the association between IL-17 and Th17-promoting cytokines in AITD by studying the immunoexpression patterns of IL-17, IL-23, and IL-1β in thyroid tissue. Following thyroidectomy, 29 patients with AITD (21 cases of Hashimoto's thyroiditis (HT) and 8 cases of Graves' disease (GD)) and 18 patients with colloid goiter, as controls, were enrolled in this study, and immunohistochemistry was performed...
February 27, 2019: Endocrine Journal
Jasna Todorović, Marko Dinčić, Jelena Nešović Ostojić, Ivan Zaletel, Srdjan Lopičić, Duško Dundjerović, Svetislav Tatić, Sanjin Kovačević, Ivan Paunović, Nela Puškaš, Ljiljana Marković
Previous evidence suggested that lymphocytic thyroiditis (LT) was a variant of Hashimoto's thyroiditis (HT), thus the aim of the current study is to quantify structural changes in histological specimens taken from HT and LT patients. A total of 600 images containing a single lymphocyte nucleus (300 nuclei per group) were obtained from 20 patients with HT and LT. In order to quantify changes in the nuclear architecture of investigated lymphocytes, the fractal dimension (FD) and some gray-level co-occurrence matrix texture parameters (angular second moment, inverse difference moment, contrast, entropy, and correlation) were calculated for each nucleus...
February 28, 2019: Microscopy and Microanalysis
Shiao Li Oei, Anja Thronicke, Matthias Kröz, Harald Matthes, Friedemann Schad
BACKGROUND: Viscum album L (VA, mistletoe) extracts are commonly used in integrative oncology. Here the clinical safety profile of additional VA-treatments to standard care in cancer patients with preexisting autoimmune diseases was analyzed. METHODS: In this observational cohort study medical data and recorded adverse events (AEs) of treated patients were retrieved from the Network Oncology registry and a safety analysis was performed. RESULTS: A total of 106 patients (median age 63 years) treated with add-on VA-extracts were analyzed...
January 2019: Integrative Cancer Therapies
Giovanni de Gennaro, Paolo Vitti, Michele Marinò
Background: Oculocutaneous albinism (OCA) is a heterogeneous autosomal recessive disorder characterized by reduced or absent melanin synthesis. Its prevalence is approximately one in 17,000 individuals worldwide. OCA causes a complete or partial absence of pigment in the skin, hair, and eyes. Reduction of melanin in the eyes results in reduced visual acuity, photophobia, and nystagmus. To our knowledge, the coexistence of albinism and thyroid autoimmune diseases has not been reported...
January 2019: European Thyroid Journal
Tristan Struja, Andreas Eckart, Alexander Kutz, Peter Neyer, Marius Kraenzlin, Beat Mueller, Christian Meier, Luca Bernasconi, Philipp Schuetz
Early diagnosis of thyroid disorders is key to further treatment. We assessed the ability of a high-throughput proton NMR metabolomic profile to distinguish disease type amongst of Graves' disease (n=87), Hashimoto's thyroiditis (n=17), toxic goiter (n=11), and autoimmune thyroiditis [i. e., subacute thyroiditis (n=4), postpartum thyroiditis (n=1)]. This observational study was conducted investigating patients presenting with a thyroid disorder at a Swiss hospital endocrine referral center and an associated endocrine outpatient clinic...
February 21, 2019: Hormone and Metabolic Research
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