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At least 397 records · Page 22Linked to original sources
PubMed1981

Auditory brain stem responses in thyroid dysfunction.

A characteristic pattern of ABR was observed in hyper-and hypofunction of the thyroid gland. The most conspicuous change took place in the BSCT. Its value correlated well with the level of serum T4. Dynamic changes of ABR pattern were recorded during the development of myxedema and on return to an euthyroid state. This preliminary study suggests that examinations of ABR may serve as a tool in the overall assessment of thyroid status.

Adolescent↗
PubMed1996

Thyroid dysfunction in HIV-infected children: is L-thyroxine therapy beneficial?

PURPOSE: To assess thyroid function in symptomatic HIV-infected infants and children with failure to thrive and to evaluate clinical response in patients with hyperthyrotropinemia to levothyroxine. METHODS: We evaluated 11 children (mean age: 1.5 years; males = 5, females = 6) with HIV infection and failure to thrive (weight and height > 2 SD below the mean) for presence of hypothyroidism. Thyroid-stimulating hormone (TSH) and thyroxine (T4) were measured. Four children with high basal TSH and one child with a normal basal TSH underwent the Thyrotropin-releasing hormone (TRH) stimulation test as well. Four children received treatment with L-thyroxine. RESULTS: Eight of the 11 children had high basal TSH levels. All patients had normal or increased T4 values. The TRH stimulation test showed an exaggerated response in all four patients with high basal TSH values and a normal response in one patient with normal basal THS values. All four patients who received treatment with L-thyroxine showed normalization of the TSH. Increased growth velocity was noted in 3 of 4 patients. The fourth patient died within two weeks following initiation of therapy for overwhelming candida sepsis. The autopsy of this patient showed atrophy of the thyroid gland. Two of the four patients with high TSH levels, who did not receive L-thyroxine, died; the other two did not show any improvement in their height z scores. Two patients with a high TSH also had high thyroid-binding hormone (TBG) levels. Both patients with the high TBG died within 2 to 3 months of the study. CONCLUSIONS: Hypothyroidism as indicated by elevated basal TSH and abnormal TRH response was common in the HIV-infected children in this study and may have contributed to failure of growth in these children. Replacement therapy resulted in correction of abnormal TSH and improvement of height z scores during the period of observation. The significance of these findings needs to be confirmed in a larger prospective study.

Child, Preschool↗
PubMed1990

Thyroid dysfunction following bone marrow transplantation: long-term follow-up of 80 pediatric patients.

Thyroid function was evaluated in children surviving disease-free for 2 years or more following bone marrow transplantation (BMT) for severe aplastic anemia (27 patients), acute non-lymphoblastic leukemia (28 patients), and acute lymphoblastic leukemia (25 patients). Pre-BMT conditioning consisted of high dose chemotherapy and total lymphoid irradiation with 750 cGy for patients with severe aplastic anemia, and for patients with leukemia, high dose chemotherapy and single dose total body irradiation with 750-850 cGy (33 patients) or fractionated total body irradiation with 1320 cGy (20 patients). Compensated hypothyroidism (elevated thyroid stimulating hormone (TSH) with a normal thyroxine index) occurred in 20/80 patients with a median time of onset of 12.3 months post-BMT (range 4-30). No patients developed primary hypothyroidism (elevated thyroid stimulating hormone with low thyroxine index). In seven patients, compensated hypothyroidism was transient with TSH returning to normal at a median of 60 months post-BMT (range 11-75). Six patients with compensated hypothyroidism received thyroid hormone replacement therapy. Time to development of compensated hypothyroidism was associated (p = 0.03) with underlying disease and radiation (11 of 27 patients with severe aplastic anemia + total lymphoid irradiation versus nine of 53 patients with leukemia + total body irradiation). In aplastic anemia patients, but not patients with leukemia, the incidence of thyroid hypofunction 5 years post-transplant was significantly higher (p less than 0.001) in those receiving methotrexate alone (82%) as prophylaxis for graft-versus-host disease compared with those receiving a regimen of methotrexate, antithymocyte globulin and prednisone (16%).

Adolescent↗
PubMed1988

Evaluation of a new strategy for detection of thyroid dysfunction in the routine laboratory.

We assessed the use of a new strategy for detecting thyroid disorders, utilizing a sensitive assay for concentrations of thyrotropin (TSH) and free thyroid hormone in serum as follow-up tests. Of 1279 patients who were not on thyroxin (T4) replacement treatment, 82% could be classified as euthyroid and would require no further tests. In patients who were on T4 replacement, 41% fell into the euthyroid category and would require no further tests. Using this strategy to replace our existing strategy of free thyroxin as a "first-line" test would reduce the proportion of patients who would require one or more follow-up tests from 49% to 24%.

Evaluation Studies as Topic↗
PubMed1997

Interferon-associated thyroid dysfunction in anti-D-related chronic hepatitis C.

To assess the frequency and nature of thyroid abnormality in association with interferon (IFN) therapy alone and in combination with ribavirin, 19 patients receiving IFN therapy for hepatitis C virus (HCV)-induced liver disease had thyroid function tests assessed on a monthly basis. Group I (n = 9) patients received 5 million U of IFN s.c. daily for 2 weeks, followed by 3 million U three times per week for 6 months. Group II (n = 10) patients received 3 million U IFN s.c. three times per week together with ribavirin 400 mg twice daily orally for 6 months. Five of 19 patients (26.3%) developed thyroid abnormalities, 3 (33.3%) in group I and 2 (20%) in group II. Three patients developed thyroid function tests consistent with hyperactivity, and 2 of these normalized on cessation of IFN therapy. One patient continued on IFN but remained clinically euthyroid with antithyroid treatment. Two patients developed thyroiditis and required thyroid supplementation. (One of the 2 had pretreatment antimicrosomal thyroid antibodies and a positive family history of thyroid disease.) Of the 3 patients with HCV type 1b, 1 had pretreatment thyroid antibodies, and all 3 had antibodies during IFN therapy. Neither of the 2 patients with genotype 3 had pre-IFN or post-IFN thyroid antibodies. Patients on IFN therapy need regular thyroid function testing. The frequency of abnormal thyroid tests may be dose related. HCV genotype may influence the development of thyroid antibodies.

Antiviral Agents↗
PubMed2006

[Uncertainties about the benefit of treatment in subclinical thyroid dysfunction].

The Leiden 85-plus study in the oldest old has observed (a) no relationship between thyroid function and symptoms of depression, cognitive impairment or disabilities in daily life, and (b) increased mortality in subjects with TSH < 0.3 mU/l as well as longer survival in subjects with TSH > 4.8 mU/l. Subclinical hyperthyroidism probably warrants more proactive treatment as other studies have also shown increased mortality to accompany a low TSH, although no randomised trials have been done to prove that early intervention prevents atrial fibrillation or prolongs life. The benefits of treatment for subclinical hypothyroidism at a very advanced age are uncertain, but treatment might well be beneficial in middle-aged subjects as some studies report an increased risk of cardiovascular morbidity and mortality. In all cases, however, it is recommended that underlying thyroid disease be demonstrated before treatment is started.

Aged, 80 and over↗
PubMed1987

Significance of thyroid dysfunction in human cardiac allograft procurement.

Twenty-two potential cardiac allograft donors had evaluation of thyroid function performed just prior to cardiectomy. Despite statistically significant abnormal thyroid function, no correlation to graft function or failure was observable. Multiple myocardial microinfarcts, undetected at the time of donor selection were detected in two hearts that were abandoned prior to transplantation and possibly another heart that failed as an allograft in a heart-lung transplant recipient.

Adolescent↗
PubMed1992

Adrenal and thyroid dysfunctions in experimental Trypanosoma congolense infection in cattle.

Severe pathological changes were observed in the adrenal and thyroid glands of Zebu (Bos indicus) heifers infected with Trypanosoma congolense. In the adrenal glands, severe inflammatory changes characterised by mononuclear cellular infiltration in the subcapsular areas, zona glomerulosa, zona fasciculata and zona reticularis were observed. In addition, there were hyperaemia, haemorrhage and hyperplasia resulting in increased adrenal weight in the two heifers slaughtered on Days 50 and 70 post-infection (p.i.). In the medullary areas of these two heifers, there was only mononuclear cellular infiltration. In the two heifers slaughtered on Day 113, localised mononuclear cellular infiltration was observed in addition to cortical cell depletion and fibrosis, resulting in reduced adrenal weight when compared with the controls. In the thyroid glands of the infected heifers, gross enlargement of the follicles filled with pale staining colloids were observed in association with squamous metaplasia of the follicular epithelium and fibroplasia. Serum cortisol concentrations showed an appreciable but non-significant increase (P less than 0.05) between Weeks 2 and 6 p.i. in the infected heifers (5.6 +/- 0.86 ng ml-1 vs. 4.4 +/- 0.34 ng ml-1) when compared with the uninfected controls or the pre-infection level. Thereafter, cortisol levels declined though non-significantly throughout the rest of the study. However, there was a steady increase towards normal levels from Week 12 p.i. until the end of the experiment. Changes in the basal serum concentrations of thyroxine (T4) were also measured weekly. There was a progressive decrease in the levels of T4 from the third until the 11th week p.i., when the decrease became significant (P less than 0.05) and remained so until the 16th week when the experiment ended.

Adrenal Glands↗
PubMed2006

Prematurity may be a risk factor for thyroid dysfunction in childhood.

CONTEXT: Children born prematurely and/or small for gestational age (SGA) frequently show disturbances in thyroid function. OBJECTIVE: The objective of the study was to determine the role played either by size or gestational age on subsequent thyroid function. DESIGN AND SETTING: This cross-sectional study was conducted at a tertiary referral hospital. PATIENTS: A total of 117 children, 88 of whom were SGA (mean age 7.8 +/- 2.5 yr) and 29 appropriate for gestational age (AGA) (mean age 8.1 +/- 1.9 yr), were selected for the study. MAIN OUTCOME MEASURES: We evaluated TSH, free T(4), free T(3), urinary iodine, and antithyroid antibodies, and all patients underwent a thyroid ultrasound. Insulin sensitivity was assessed with the quantitative insulin sensitivity check index. RESULTS: TSH and free T3 were not significantly different in the two groups, whereas free T4 was higher in the AGA group (P < 0.005). Interestingly, four AGA (13.8%) and 17 SGA (19.3%) patients had TSH levels above the upper limit of normality. Thyroid volume was normal and thyroid autoimmunity was excluded. Urinary iodine was also similar in the two groups (115 +/- 66 vs. 143 +/- 87); however, in both groups there were some children [15 AGA (51%) and 13 SGA (14.7%) (P < 0.001)] with a mild to moderate iodine deficiency. By multiple regression analysis, gestational age was found to be the only determinant of TSH serum levels. Insulin sensitivity was the same in both groups of children and similar to controls. CONCLUSIONS: Some children born prematurely, independently from their birth size, frequently have disturbances of the hypothalamus-pituitary-thyroid axis later in life.

Body Mass Index↗