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PubMed1997

Molecular epidemiology of autoimmune thyroid disease.

This paper presents preliminary data regarding the prevalence and risk factors for autoimmune thyroid disease in IDDM probands ascertained from the Children's Hospital of Pittsburgh IDDM Registry for 1950-1965 (n = 669). Living IDDM probands who participated in the 1990 follow-up survey (n = 380) were recruited for the Familial Autoimmune and Diabetes Study. Siblings and parents were also invited to participate. To date, 255 IDDM probands and 597 parents and siblings have been evaluated. The diagnosis of autoimmune thyroid disease was based on a clinical evaluation, medical history, and laboratory determinations. Graves disease was rare in this cohort (n = 5). However, Hashimoto's thyroiditis was common among women. Prevalence rates ranged from 54% for IDDM women age < 40 years to 75% for those > 50 years. Corresponding age-specific estimates for female relatives were 22% and 44%, respectively. Approximately one-half of the Hashimoto's individuals were euthyroid; they were more likely to have other autoantibodies and a positive family history than those who were hypothyroid or had no thyroid disease. Genetic analyses revealed a 2-fold increase in DQA1*0501-DQB1*0201 among the Hashimoto's compared to the non-Hashimoto's haplotypes. These findings suggested that Hashimoto's thyroiditis was common in IDDM families, which may be due, in part, to common disease susceptibility genes.

Adolescent↗
PubMed1976

[Geriatric change of thyroid function and thyroid diseases (author's transl)].

The geriatric changes of thyroid function in healthy individuals are relatively low; therefore it is not necessary to take it into consideration for routine diagnostic work. Thyroid diseases show an increase with age and also a change of the clinical picture. Therefore, and because of being superimposed by symptoms of simulatneous second disease, it is necessary to start with the specific diagnostic earlier than in younger patients.

Adult↗
PubMed1988

[Fine-needle aspiration biopsy in the diagnosis of thyroid diseases].

On 105 patients with thyroid gland diseases thin needle aspiration biopsy was performed. The cytologic examinations proved to be of great importance for the diagnosis of thyroiditis and thyroid cancer. When lymphoid cells were found immunocytochemical examination was made additionally. It allows the differentiation of the subacute thyroiditis from the chronic and recurrent thyroiditis. The thin needle aspiration biopsy is practically a harmless manipulation. The great frequency of the asymptomatic chronic thyroiditis and of thyroid gland cancer supports the recommendation of a wider application of the method in all patients with thyroid gland diseases.

Biopsy, Needle↗
PubMed1997

Treatment of thyroid disease in pregnancy.

With appropriate therapy, complications related to thyroid disease in pregnancy can be minimized. Although the diagnosis of thyroid endocrinopathy may be difficult in pregnancy, few therapies are contra-indicated. Because medications may cross the placenta, however, clinicians need always to be mindful of potential fetal effects and should work to use the minimal dose necessary to achieve maternal euthyroidism. Thyroid function tests, in particular free T4 and TSH, remain good measures of thyroid function and therapy in pregnancy.

Adult↗
PubMed1982

Diplopia in autoimmune thyroid disease.

Diplopia without obvious exophthalmos, caused by infiltrative endocrine ophthalmopathy, developed in 12 patients with clinical and laboratory confirmation of autoimmune thyroid disease. In eight patients, the diplopia alone prompted medical attention, which led to the diagnosis of autoimmune thyroid disease. A hypotropia secondary to restrictive tightening of the inferior rectus muscle, producing vertical diplopia, was the most common manifestation of the disorder. The ocular muscle imbalance in autoimmune thyroid disease is caused by mechanical orbital restriction of the extraocular muscle, not by an innervational defect. Evidence of orbital restriction of the eye muscles can establish the diagnosis, regardless of the patient's thyroid function.

Adult↗
PubMed2000

[Serum cortisol level variations in thyroid diseases].

This work studies the thyroid disorders impact on adrenals glands by measuring total cortisol. Radioimmunoassays of thyroid hormones and cortisol were performed in 108 subjects, aged 20-52 years, with thyroid diseases. Our results show low cortisol values (80.35 nmol/L) in 4.77% of hyperthyroids, high values in 3.57% of hyperthyroids (1348.18 nmol/L) and 12.5% of hypothyroids (969.05 nmol/L). In hyperthyroidism, thyroid hormone stimulates the secretion of 11 ceto metabolites biologically inactive, unable to slow pituitary activity, inducing an increased production of endogene cortisol. Excessive catabolism can lead to the exhausting of overstimulated adrenal glands, and therefore to a decreased cortisol. In hypothyroidism, high cortisol results of increase cortisol half life and decrease of metabolic clearance. Control mechanisms often allow normal cortisol values. These alterations in functional activity of adrenal glands, seen in nearly 10% of these subjects, sometimes command a specific attitude in diagnosis and therapy.

Adrenal Glands↗
PubMed1991

[Evaluation of immunological tests in thyroid diseases].

We evaluated immunological tests for autoimmune thyroid diseases. Although both humoral and cellular immunity are correlated to the onset and pathophysiological progression of these diseases, the major tests employed in daily clinic belong to the former. We measured the anti-TSH receptor antibody (TRAb, TBII), circulating immune complex (CIC), thyroid growth stimulating immunoglobulin (TGSI) and interleukin-2 (IL2) levels in patients with Graves' disease (GD) and chronic thyroiditis (CT). The normal range of TRAb in 190 healthy controls was from -10.9 to +10.3% calculated from the mean +/- 2SD. Sixty eight out of 78 untreated cases of GD (87.2%) showed a higher TRAb than the upper normal level (positive), 92 out of 131 cases of GD under treatment (70.2%) were positive and only 5 out of 57 cases of treated GD (8.8%) were positive. Three neonates out of 12 GD mothers had a positive TRAb and one of them developed neonatal GD. Nine out of the 45 CT (20%) had positive TRAb, but about half were euthyroid and goitrous. In untreated GD, CIC was distributed widely from the normal range to high levels. CIC showed a significantly negative correlation with TRAb. TGSI correlated with goiter size and CIC in GD revealed autologous inhibition on TGSI. Three cases showed markedly decreased levels of TRAb which was found to be due to anti-TSH antibodies. Production of IL2 in GD was impaired, but it was improved by treatment of GD.(ABSTRACT TRUNCATED AT 250 WORDS)

Autoantibodies↗
PubMedDate not supplied

Development of autoimmune thyroid diseases during long-term treatment of hematological malignancies with alpha-interferons.

In recent years recombinant alpha-interferons (alpha-IFNs) have been widely used in the treatment of several hematological malignancies. Prolonged courses of IFN have been shown to induce autoantibodies and to support the exacerbation or even the development of autoimmune diseases. In this report we describe the development of symptomatic autoimmune thyroid diseases in 4 (7.4%) out of 54 patients in chronic treatment with recombinant alpha-IFNs in our department. Two patients developed a disease resembling Hashimoto's thyroiditis after 17 and 49 months of continuous IFN treatment, while the other two developed a typical Graves' disease after 41 and 52 months of therapy. The mechanism by which IFN induces autoimmune thyroid diseases, the choice of searching for anti-thyroid autoantibodies before starting long-term IFN treatment, the option of discontinuing IFN therapy in the presence of overt thyroid diseases, and the management of these diseases are discussed.

Autoimmune Diseases↗
PubMed1988

IgA class antibodies against Yersinia enterocolitica O:3 in patients with thyroid disease.

IgM, IgG and IgA class serum antibodies against Yersinia enterocolitica O:3 and O:9 and Yersinia pseudotuberculosis 1a and 3 in 41 patients with thyroid disease and 50 healthy control persons were measured by enzyme-linked immunosorbent assay (ELISA). Concentrations of antibody levels against Yersinia enterocolitica O:9 and Yercinia pseudotuberculosis 1a and 3 did not differ significantly between the patients and controls. The median value of IgA class antibody Yersinia enterocolitica O:3 was 7.5 relative units (EIU, percentage of the reference serum) in the patients with thyroid disease and 0.7 EIU in the controls (P less than 0.01; Mann-Whitney's U-test), whereas IgM and IgG class antibodies did not show this difference. IgA class serum antibodies were especially high in patients with autoimmune thyroid diseases. These findings and two case reports support the concept that there may be a causal relationship between infections with Yersinia enterocolitica O:3 and autoimmune thyroid diseases.

Adolescent↗
PubMed2001

Production of 8-OHdG and cytochrome c by cultured human mononuclear cells in patients with autoimmune thyroid disease.

Since oxidative stress is related to autoimmune thyroid disease, we studied the production of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and cytochrome c by culture of mononuclear cells from patients with Graves' disease and Hashimoto's thyroiditis. In patients with untreated Graves' disease, 8-OHdG and cytochrome c levels in culture supernatant of mononuclear cells were significantly higher than those of healthy control subjects, while the cytochrome c levels were significantly higher in patients with untreated Graves' disease and Hashimoto's thyroiditis than those of control subjects. Significant correlations between 8-OHdG and FT4, and cytochrome c were found. These results indicated that thyroid function has a potent influence on oxidative stress.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed2001

[Screening for thyroid disease. Occurrence of hypothyroidism and hyperthyroidism in patients admitted to a geriatric department].

INTRODUCTION: The aim of this study was to evaluate whether screening of all geriatric patients for thyroid disorders should be recommended and to assess the prevalence of thyroid dysfunction in a geriatric population. MATERIAL AND METHODS: From 1 April 1997 to 31 March 1998, all patients above 60 years of age admitted to the ward of geriatric medicine at Copenhagen University Hospital, Glostrup were screened for thyroid disease with a sensitive TSH assay. RESULTS: Of 480 patients with no former history of thyroid disease, three (0.6%) were found to have hypothyroidism (elevated TSH and free T4 below normal) and started treatment with Eltroxin. Twenty-three patients (4.8%) had elevated TSH with normal values of T3 and free T4 (subclinical hypothyroidism). Forty-nine patients (10.2%) had TSH values below normal with normal T3 and free T4 (subclinical hyperthyroidism). Four patients (0.8%) had TSH values below normal and elevated T3 and/or free T4 and isotope uptake studies showed multinodular goitre. None of these patients was treated. Of the 34 patients (6.2%) with known thyroid dysfunction ten patients had their treatment adjusted and two patients started treatment. DISCUSSION: We found that less than 1% of the patients had an unrecognised thyroid disease that required treatment. The total prevalence of thyroid dysfunction was 7.2%. One third of the patients with a known thyroid disease needed their treatment adjusted. We would not recommend screening for thyroid dysfunction of all geriatric patients, but we would advocate better monitoring of patients already in treatment.

Aged↗
PubMedDate not supplied

[Autotransfusion in patients undergoing surgery for thyroid diseases].

Autotransfusions were performed in 80 patients operated upon for thyroid diseases at the Department of Surgery, Institute of Haematology in Warsaw. For autotransfusions patients were selected in good general condition and with haematological indices in the range accepted for blood donors. Planning of autotransfusion is purposeful only in these cases of thyroid disease in which the necessity of blood transfusion can be predicted in advance (e.g. Graves-Basedov-disease, retrosternal goitre, mediastinal goitre). The transfused volume may cover completely or partly the intraoperative blood loss. Autotransfusion protects the patients against possible isoimmunization which may develop after transfusion of blood from donors. Protection of patients against possible immunization is a problem of considerable value. It is important particularly in young subjects, especially young women who may become mothers. Operations connected with blood loss up to 500 ml do not require supplementary transfusions. Intraoperative blood loss in the range from 500 to 1000 ml requires supplementation. The risk of posttransfusion complications is lowest when autotransfusion is done.

Blood Transfusion, Autologous↗
PubMed1990

[The significance of serum fructosamine measurement in patients with thyroid diseases].

Serum fructosamine was measured in patients with Graves' disease and primary hypothyroidism. Fructosamine levels and fructosamine per albumin ratio were significantly lower in patients with Graves' disease than in normal subjects, while they were significantly higher in patients with primary hypothyroidism. Fructosamine levels were normalized by treatment in the euthyroid state in patients with Graves' disease. Along with the normalization of thyroid stimulating hormone levels, fructosamine levels returned to the normal range in patients with primary hypothyroidism with treatment. There were significant correlations between fructosamine levels and free triiodothyronine levels, free thyroxine levels, thyroid stimulating hormone levels, hemoglobin A1C levels, albumin levels, and creatine phosphokinase levels. We concluded that it was useful to measure serum fructosamine as an indicator of peripheral metabolic function in patients with thyroid diseases.

Creatine Kinase↗
PubMed1998

[Latent thyroid diseases in obesity].

We have investigated 2672 obese subjects (2324 females and 348 males); of these, the following two groups were considered: obese subjects with or without thyroid disease. Subjects were stratified according to age, sex, and BMI. The prevalence of thyroid disease was correlated to age, sex and BMI increased body weight. Our data showed that 22% of patients affected by essential obesity and not resident in area of iodine deficiency is affected by thyroid diseases which are not diagnosed (18%). In the obese subjects, presence of goiter is more frequent than in the normal weight subjects and affects mainly adult males. Chronic thyroiditis is typical of females (9:1 female:male ratio) with no difference between normo and overweight subjects. Prevalence of single nodule in the obese is similar to the normal weight subjects, it is more frequent in adults and in subjects with medium size obesity. However, occurrence of carcinoma (8%) in single nodules appears higher in the overweight (5-6%) as compared to the normal weight subjects.

Adenocarcinoma, Follicular↗
PubMed1987

Recombinant DNA technology in the study of autoimmune thyroid disease.

Molecular biology techniques are now beginning to be applied to the study of autoimmune thyroid disease. This review provides a background to the molecular biology techniques used, summarizes the limited data presently available in the area of autoimmune thyroid disease, and describes the potential future application of these techniques for further understanding of autoimmune thyroid disease.

Autoantigens↗
PubMed1982

Effectiveness of analysis of free thyroxin concentration in serum for diagnosis of covert thyroid disease.

The indirect indices of free-thyroxin concentration (fT4) are of limited effectiveness in diagnosing covert (mild) thyroid disease. We compared measurements of fT4 and of normalized T4 (NT4, the effective thyroxin ratio) in a group of patients being treated for thyroid disease, most of whom were clinically euthyroid. Although fT4 values correlated well with NT4, many of the patients (34% in one of the comparisons) had fT4 and NT4 values that gave different indications of thyroid status. A review of the patients' treatment and other biochemical indications revealed that measurements of fT4 were more effective in detecting mild disturbances of thyrometabolic status than were assays for NT4, total T4, total triiodothyronine, or thyrotropin. This study suggests that direct fT4 assays are particularly useful in diagnosing covert thyroid disease.

Humans↗