Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “thyroid dysfunction”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,081 records · Page 60Linked to original sources
PubMed2003

Improvement of iodine deficiency after iodine supplementation in schoolchildren of Azerbaijan was accompanied by hypo and hyperthyrotropinemia and increased title of thyroid autoantibodies.

OBJECTIVE: In the mountainous areas of Azerbaijan the schoolchildren suffer from severe Iodine Deficiency (ID) with median Urinary iodine excretion (UIE) 36 mcg/l and prevalence of goiter 99% (estimated by US). In a population of 293,000 schoolchildren aged 8-14 y.o. we administered capsules containing 190 mg of iodized oil (Lipiodol-Guerbet, Cedex, France) twice yearly in 6 months apart (total 380 mg). The aim of the present study was to evaluate the efficacy, the benefits, as well as the possible side-effects in a follow-up period of 6 and 12 months after the initial administration of iodized oil. METHODS: Six and 12 months after the initial administration of iodide, two representative samples of 391 and 326 children respectively were examined. The evaluation included: estimation of goiter by US, determination of UIE and serum measurements of T3, T4, TSH, Tg, autoantibodies against thyroid peroxidase (anti-TPO) and thyroglobulin (anti-Tg). RESULTS: There was an improvement in median UIE which increased from 36 mcg/l to 68 and 81 mcg/l after 6 and 12 months of treatment respectively. The prevalence of goiter decreased from 99% to 54% and 26% respectively. Tg was decreased at 6 and 12 months from the first administration, whereas TSH remained unchanged at 6 months and decreased at 12 months when compared to the latter value. Hypothyroidism was detected in 7% of children after iodide administration both at 6 and 12 months, but overt hypothyroidism was observed only in 0.5% at 12 months. Subclinical hyperthyroidism was detected in 2% and 6% after iodide administration both at 6 and 12 months. There was a significant increase in the title of thyroid auto antibodies in 6 months which was retained and increased in 12 months. There was no relation between the appearance of thyroid dysfunction and the positive thyroid auto antibodies. CONCLUSION: The dose of 190 mg iodide administered twice yearly, improved iodine deficiency and endemic goiter in schoolchildren. The increase of UIE resulted from iodide administration, was accompanied by an increased title of thyroid auto-antibodies and an increased prevalence of hyper- and hypothyrotropinemia apparently of no autoimmune etiology.

Adolescent↗
PubMed1997

[Quantitative salivary gland scintigraphy--a recommended examination prior to and after radioiodine therapy].

AIM: The aim of this study was to evaluate possible deterioration of salivary gland function due to radioiodine therapy with low activities using standardized quantitative salivary gland scintigraphy (qSZ). In addition, the prevalence of sialopathies was estimated in patients with thyroid dysfunction. METHODS: Prior to routine thyroid scintigraphy qSZ was performed after i.v. injection of 36-126 MBq 99mTc-pertechnetate, and both uptake and excretion fraction were calculated as a measure of parenchymal function and saliva excretion, respectively 312 healthy patients served as reference for a normal data base. 144 patients underwent qSZ prior to and 3 months after radioiodine therapy. Results of qSZ in another 674 thyroid patients were evaluated for determining the prevalence of salivary gland dysfunction. RESULTS: Normal uptake was 0.45 +/- 0.14% and 0.39 +/- 0.12%, and normal excretion fraction amounted to 49.5 +/- 10.6% and 39.1 +/- 9.2% in parotid and submandibular glands, respectively. Despite salivary gland stimulation with ascorbic acid during radioiodine therapy a significant activity-related functional impairment of 14-90% could be measured after application of 0.4-24 GBq of 131I. Prevalence of pretreatment sialopathies was 77/674 = 11.4% in single glands, and there was a global salivary gland functional impairment in 52/674 = 7.7%. CONCLUSION: Together with thyroid scintigraphy qSZ is an easy to perform examination without additional radiation burden. It can be recommended in all patients prior to and after radioiodine therapy both in order to quantify and to document possible parenchymal impairment induced even by low activities of 131I.

Adolescent↗
PubMed1998

Effect of population-based interventions on laboratory utilization: a time-series analysis.

CONTEXT: Previous studies have identified methods of decreasing laboratory utilization. However, most were hospital-based, relatively small, single-centered, or of limited duration. OBJECTIVE: To determine the effect of 3 population-based interventions (physician guidelines, laboratory requisition form modification, and changes to funding policy) on laboratory utilization in Ontario. DESIGN: Interventional time-series analysis in which data analysis was based on all claims made to the Ontario Health Insurance Program between July 1, 1991, and April 1997 for laboratory tests affected by the interventions. SETTING: All clinical laboratories (not based in hospitals) in Ontario. INTERVENTIONS: Physician guidelines, modification of laboratory requisition form, and changes in funding policy for the use of the erythrocyte sedimentation rate test (ESR), microscopic urinalysis, tests for renal function, iron stores, serum urea, and serum iron determinations, and tests for thyroid dysfunction (total thyroxine and thyroid-stimulating hormone [TSH]). MAIN OUTCOME MEASURES: Change from 1991 to 1997 in utilization rates of ESR, microscopic urinalysis, serum urea and iron determinations, and tests for total thyroxine and TSH. RESULTS: Age- and sex-standardized rates for laboratory tests unaffected by the interventions were stable during the study period. Utilization of ESR and urea determination decreased by 58% (P<.001) and 57% (P<.001), respectively, after they were removed from the requisition form and guidelines discouraging their use were disseminated. Rates for urinalyses without microscopy increased by 1700% (P<.001), while microscopic urinalysis decreased by 14% (P<.001), after a policy change eliminated microscopic urinalysis from routine urinalysis. Rates of iron determination declined by 80% (P<.001) and ferritin rates increased by 34% (P= .05) when policy changes eliminated iron testing when ordered with ferritin and guidelines advocating ferritin alone for investigating iron deficiency were disseminated. Utilization of total thyroxine testing declined by 96% (P = .02) when the provincial health plan stopped its funding. When TSH was removed from the laboratory requisition form, a 12% decline (P= .03) in its use was observed. Through April 1997, these interventions saved more than 625000 tests or $210400. CONCLUSIONS: The combination of guideline dissemination, laboratory requisition form modification, and changes to funding policy was associated with significant reductions in laboratory utilization.

Clinical Laboratory Techniques↗
PubMed1998

Post-liver transplantation myocardial dysfunction.

Patients with end-stage liver disease usually show a hyperdynamic circulatory state. It has previously been reported that patients who develop myocardial depression in the early post-liver transplantation period are more prone to organ failure and death. We reviewed the records of 754 adult patients undergoing liver transplantation at our institution and identified 7 patients who initially showed hyperdynamic circulation, but then developed reversible dilated cardiomyopathy in the early posttransplantation period. All identifiable causes of cardiac dysfunction, such as myocardial ischemia, thyroid dysfunction, and electrolyte imbalances, were excluded. Left ventricular ejection fraction decreased from a preoperative median baseline of 60% to 20% (P = .02), with four-chamber dilatation on echocardiogram. All these patients required supportive care, including mechanical ventilation, afterload reduction, inotropic support, and monitoring in the intensive care unit. Cardiac function subsequently improved in all patients, with ejection fraction increasing to a median of 50%. All patients were discharged from the hospital. At a median follow-up of 15 months, there was no recurrence of heart failure. The increased peripheral resistance seen after successful liver transplantation may be an important causative factor.

Adolescent↗
PubMed2002

A new equation especially developed for predicting resting metabolic rate in the elderly for easy use in practice.

BACKGROUND: Equations published in the literature for predicting resting metabolic rate (RMR) in older individuals were exclusively derived from studies with small samples of this age group. AIM: of the present investigation was therefore to compare the measured RMR of a relatively large group of older females and males with values for RMR calculated from the most commonly used WHO [1] equations. Furthermore, on the basis of the data collected by our study group a new equation for calculating RMR in the elderly was to be developed. Variables used in this equation should be easily and exactly determinable in practice. SUBJECTS AND METHODS: RMR was measured by indirect calorimetry after an overnight fast in a sample of 179 female (age 67.8 +/- 5.7 y, BMI 26.4 +/- 3.7 kg/m(2)) and 107 male (age 66.9 +/- 5.1 y, BMI 26.3 +/- 3.1 kg/m(2)) participants in the longitudinal study on nutrition and health status in an aging population of Giessen, Germany. The subjects were at least 60 years old, did not suffer from thyroid dysfunction, and were not taking thyroid hormones. Stepwise multiple linear regression analysis was used to estimate the best predictors of RMR. RESULTS: In females there was no significant difference between our measured RMR (5504 +/- 653 kJ/d) and RMR predicted with the WHO [1] equation (5458 +/- 440 kJ/d), whereas in males measured RMR (6831 +/- 779 kJ/d) was significantly higher than calculated RMR (6490 +/- 550 kJ/d). Results of regression analysis, considering body weight, body height, age, and sex, showed that RMR is best calculated by the following equation: RMR [kJ/d]= 3169 + 50.0 x body weight [kg] - 15.3 x age [y] + 746 x sex [female = 0, male = 1]. The variables of this equation accounted for 74 % (R(2)) of the variance in RMR and predicted RMR within +/- 486 kJ/d (SEE). CONCLUSION: On the basis of the data determined in a large group of older individuals, we offer a new equation for calculating RMR in the elderly that is both easy and accurate for use in practice.

Age Factors↗
PubMed1987

Screening of thyroid function in the hospitalized aged.

When a thyroid test was made on all the patients coming to a geriatric department of a hospital, markedly more new cases of hypothyroidism (17 as against 2), and also somewhat more new cases of hyperthyroidism (34 as against 21) were found than when the thyroid test was used only on clinical suspicion of thyroid dysfunction. The authors consider a thyroid test (T4?) worth taking systematically in all aged patients admitted to hospital.

Aged↗
PubMed1994

Diagnosis of Candida thyroiditis by fine needle aspiration.

Infective thyroiditis is an uncommon condition, and fungal infection of the thyroid gland is rare. We present a case of Candida thyroiditis in a patient with leukaemia and review the three previous reports of this entity in the world's literature. We conclude that Candida thyroiditis should be considered in immunosuppressed patients with known infection who develop fever and neck pain, that gallium scanning may help localise the infection to the thyroid gland; that fine needle aspiration is a useful diagnostic test, and that thyroid dysfunction is common with Candida thyroiditis.

Adult↗
PubMedDate not supplied

[Autoimmune thyroiditis in children and adolescents: clinical and laboratory findings in 34 patients].

Autoimmune thyroiditis (AT) is the most common cause of nonendemic thyromegaly and acquired hypothyroidism in childhood and adolescence. Outgoing from an increasing number of newly diagnosed patients during the last years we performed a retrospective analysis including 34 patients treated between 1989 and 1998. Clinical data, laboratory and sonographical findings are described. Cases were ascertained by palpable thyroid enlargement or clinical signs of thyroid dysfunction and positive autoantibodies against thyroid tissue. Frequency of AT diagnosis has threefold increased since 1995 in our department. Age at diagnosis was 5.4 to 16.3 years (median 11.3). Palpable thyromegaly was present in 29 (85%) of our patients. Three patients had myxedema without goiter. Symptoms had been present for a period between 6 weeks and 7.5 years: median in all patients 6 months, median in hypothyroid patients 9 months. At time of diagnosis 15 patients suffered from hypothyroidism, 3 from hyperthyroidism and 7 patients showed normal levels of thyroid hormones. In 9 patients we found an isolated elevation of thyrotropin. 12 patients were prepubertal (Tanner I), 15 patients were pubertal (Tanner II-IV). 5 patients showed a dissociation of pubertal maturation. Ultrasound of thyroid gland showed an inhomogeneous and hypoechoic pattern in 32 patients. 30 patients were treated with thyroxine. Patients with persistent hyperthyroidism were treated with carbimazol. During the follow-up period enlargement of the thyroid gland decreased in one third of the patients. Thyromegaly caused by autoimmune thyroiditis gets an increasing importance. The high degree of obviously hypothyroid patients at the time of diagnosis reflects a delay of diagnosis. Early recognition and treatment of the disease should be achieved for a preventive care of hypothyroidism.

Adolescent↗
PubMed2026

A novel deep intronic EIF2AK3 variant disrupts splicing and causes Wolcott-Rallison syndrome.

AIM: Deep intronic variants can disrupt splicing and cause monogenic disease but are missed by routine genetic testing. This study assessed the contribution of deep intronic variants to Wolcott-Rallison syndrome (WRS), a recessive disorder characterized by early-onset diabetes and progressive multisystem disease caused by loss-of-function EIF2AK3 variants. METHODS: We investigated a cohort of 116 individuals referred to the Exeter Genomics Laboratory for genetic testing who had diabetes diagnosed at &#x2264;2&#x2009;years and at least one additional feature consistent with WRS: hepatic dysfunction, skeletal abnormalities or developmental delay. No genetic cause had been identified after testing all known early-onset diabetes genes. We screened genome-sequencing data for rare homozygous intronic EIF2AK3 variants. Candidate variants predicted to affect splicing by SpliceAI were assessed using a minigene exon-trapping assay. RESULTS: We identified two rare homozygous intronic EIF2AK3 variants in two siblings. Only one variant, c.1651-180G>T, was predicted to disrupt splicing in silico. The two children, born to consanguineous parents, were diagnosed with early-onset diabetes (diagnosed at 1&#x2009;year and 21&#x2009;weeks), hepatic dysfunction, skeletal abnormalities, developmental delay, thyroid dysfunction, hip dysplasia and gait abnormalities. The minigene assay showed that c.1651-180G>T creates a cryptic donor splice site within intron 9, resulting in inclusion of a 79-nucleotide pseudoexon, causing a frameshift and premature stop codon. Using this evidence, the variant was reclassified as likely pathogenic according to ACMG/ACGS guidelines. CONCLUSIONS: We report the first deep intronic EIF2AK3 variant causing WRS, highlighting the need to consider systematic intronic analysis in unresolved cases.

EIF2AK3↗
PubMed1993

A long-term follow-up study of patients with non-toxic diffuse goitre in Japan.

OBJECTIVE: Although non-toxic diffuse goitre is a common disorder, little is known of the clinical course of patients. We therefore decided to investigate the long-term clinical outcome of patients with non-toxic diffuse goitre. DESIGN: A retrospective study. PATIENTS: Of 850 patients with non-toxic diffuse goitre who met our criteria and were seen in our thyroid clinic between 1977 and 1985, 108 who had been followed for from 5 to 14 years (mean 8 years) were entered in this study. All patients fulfilled our criteria having soft diffuse goitres, normal serum TSH and T4 concentrations, and undetectable antithyroglobulin and antithyroid microsomal antibodies. MEASUREMENTS: A family history of thyroid disease was obtained and the occurrence of Graves' ophthalmopathy was noted. Serum TSH and T4 concentrations, and antithyroglobulin and antithyroid microsomal antibodies were measured during the follow-up period. Thyroidal radioactive iodine uptake (RAIU), serum free T4 and free T3 concentrations, and TSH binding inhibitory immunoglobulin (TBII) activities were determined in all patients who were subsequently found to have abnormal serum TSH or T4 concentrations or signs of Graves' ophthalmopathy. RESULTS: Thirty-six of the 108 patients (33%) had a family history of autoimmune thyroid disease. Elevated serum T4 or free T4 concentrations and depressed serum TSH concentrations were found in six patients during the follow-up period. Hyperthyroid Graves' disease was diagnosed in four of the six patients, subacute thyroiditis in one, and transient post-partum thyrotoxicosis in one. Hypothyroidism was found in one patient who was diagnosed as having transient post-partum hypothyroidism. Euthyroid Graves' disease was diagnosed in one patient. Furthermore, six of these eight patients had a family history of autoimmune thyroid disease in first-degree relatives. CONCLUSION: During a prolonged follow-up period of patients with non-toxic diffuse goitre, Graves' disease was found in five of 108 patients (four hyperthyroid Graves' and one euthyroid Graves'), post-partum thyroid dysfunction in two, and subacute thyroiditis in one. Six of these eight patients had a family history of autoimmune thyroid disease in first-degree relatives. Long-term follow-up is necessary for patients with non-toxic diffuse goitre, especially those who have a family history of autoimmune thyroid disease.

Adolescent↗
PubMed2002

Controversies in radioiodine therapy: relation to ophthalmopathy, the possible radioprotective effect of antithyroid drugs, and use in large goitres.

In routine use for more than 50 years, radioiodine ((131)I) is generally considered safe and devoid of major side effects. Therefore, it is surprising that relatively many aspects of radioiodine therapy are controversial, as illustrated by recent international questionnaire studies. Our review aims at highlighting three of these areas - namely, the influence of (131)I on the course of Graves' ophthalmopathy, the possible radioprotective effects of antithyroid drugs, and the use of (131)I in large goitres. (131)I therapy carries a small (but definite) risk of causing progression of Graves' ophthalmopathy. Identification of risk factors (thyroid dysfunction, high level of thyroid-stimulating hormone (TSH) receptor antibodies, cigarette smoking) allows the identification of patients at risk and the institution of concomitant glucocorticoid treatment, thereby hindering progression of eye disease. On the basis, largely, of retrospective data, it appears that carbimazole (or methimazole), if stopped 3-5 days before treatment, does not influence the outcome of (131)I therapy. Simultaneous thyrostatic medication most probably reduces the efficacy of (131)I, as does restarting it within 7 days. Propylthiouracil seems to have a more prolonged radioprotective effect than carbimazole. Surgery is the treatment of first choice in patients with a large goitre. However, in the case of patient ineligibility or preference, (131)I therapy may be an option. The treatment has a favourable effect on tracheal compression and inspiratory capacity, but the reduction in thyroid volume is only 30-40%. Inpatient treatment, necessitated by the large doses, makes the treatment cumbersome. Controversy related to radioiodine therapy is mainly based on the lack of adequate prospective randomised studies comparing efficacy, side effects, cost and patient satisfaction.

Antithyroid Agents↗
PubMedDate not supplied

[Thyroiditis and pregnancy].

Authors develop the concept of immunity tolerance and its importance in thyroiditis occurrence and evolution during pregnancy as well post-partum pathology. They also refer the mechanisms that can induce to change the immunity response during pregnancy involving maternal, placental and fetal cytochemistry. It is also proposed a constant and precocious screening of the thyroid dysfunction in pregnant woman with thyroid antibodies, because their positivity prevalence is extremely high as far as the associated risk of abortion.

Abortion, Spontaneous↗