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At least 1,261 records · Page 70Linked to original sources
PubMed1984

Circulating immunoglobulin E (IgE) antibodies to L-thyroxine in a euthyroid patient with multinodular goiter and allergic rhinitis.

A 30-yr-old woman with allergic rhinitis and multinodular goiter developed atopic manifestations on different desiccated thyroid extract treatment. Urticaria was observed when the patient was on L-T4 treatment; no atopy was experienced during L-T3 regimen. Serum total immunoglobulin E (IgE) concentration was 390 +/- 7kU/liter (mean +/- SD) prior to any treatment and rose to 850 +/- 7.5 kU/liter when the patient developed urticaria, but declined to baseline figures while she was on L-T3. Intracutaneous testing was positive for desiccated pork thyroid powder, L-T4 and D-T4, but negative for L-T3, DIT and L-tyrosine. Immunoradioligand analyses of mixtures of patient's serum or precipitated immunoglobulin fraction and of 125I-T4 or of 125I-T3 revealed binding of radiolabeled thyroxine to the patient's serum IgE, in turn bound to anti-human-IgE serum covalently coupled to paper discs. This binding was completely inhibited by the preincubation of immunoglobulin fraction with excess unlabeled L-T4 and D-T4, but not with excess nonradioactive L-T3, thus proving the specificity of the binding. Preadsorption experiments performed with desiccated pork thyroid powder solution mixed with the patient's immunoglobulin fraction suggested binding of some unknown component(s) of desiccated thyroid which was apparently not thyroglobulin. This study provides evidence of IgE antibodies to L-T4 cross reacting with D-T4 and capable of binding 125I-T4 in serum. It also suggests a model for the detection of circulating IgE antibodies to thyroid hormones.

Adult↗
PubMed1992

Large parathyroid functioning carcinoma (1,200 g) presenting as a substernal goiter.

Parathyroid carcinoma is a rare tumor responsible for 0.5-5% of primary hyperparathyroidism. It is usually small (not more than 27 g) and the precise diagnosis of malignancy is made when local or distant metastases are found. We describe a case of a 37 yr old male presenting with a substernal goiter and no specific symptoms except hypertension. This mass had cysts and calcifications and it was in the anterior upper mediastinum. The patient had severe hypercalcemia (Ca greater than 14 mg/dl), high PTH levels and mild renal failure. Bone scanning showed signs of hyperparathyroidism. The patient was subjected to total thyroidectomy and removal of the mass en block. The tumor was circumscribed lobulated and mostly cystic. It weighed 1,200 g (380 g after evacuation of cysts) and measured 12 x 9 x 4.5 cm. Histologic examination showed a highly differentiated adenocarcinoma of parathyroid with metastasis in a regional lymph node. Almost 4 years later the patient is alive and well without hypercalcemia and without evidence of distant metastases.

Adenocarcinoma↗
PubMed1993

Association of multinodular goiter with breast carcinoma: Cowden's disease.

Cowden's Disease or multiple hamartoma syndrome is an autosomal dominant genodermatosis associated with abnormalities of the breast, thyroid gland, gastrointestinal tract and genitourinary system. A large percentage of these patients have goiters or other thyroid abnormalities. Physicians should consider the diagnosis of Cowden's disease in patients presenting with thyroid disease and skin lesions such as papules or skin tags and if present these subjects should be screened for other malignancies associated with this disease.

Adult↗
PubMed1990

Acromegaly, multinodular goiter and silent polyostotic fibrous dysplasia. A variant of the McCune-Albright syndrome.

A 36-year-old woman is reported with a possible variant of the McCune-Albright syndrome. The triad was incomplete because of the absence of skin pigmentation and since the sexual precocity was not evident. The presence of a pituitary mass and the secretory dynamics of growth hormone and prolactin were suggestive of a mammosomatotroph cell adenoma. A toxic multinodular goiter was also associated, but unique was the spontaneous normalization of the thyroid function. Unusual was the silent evolution of the polyostotic fibrous dysplasia, which was only fortuitously discovered during magnetic resonance imaging of the pituitary region. Treatment of the acromegaly with the long-acting somatostatin analogue octreotide resulted in an important inhibition of the GH secretion and in a reduction of the volume of the pituitary adenoma.

Acromegaly↗
PubMed1989

Qualitative and quantitative defects of thyroglobulin resulting in congenital goiter. Absence of gross gene deletion of coding sequences in the TG gene structure.

Seven subjects belonging to three families (ME, MA, MO), with congenital goiter and various degrees of thyroid hypofunction, were investigated from the standpoints of clinical, biochemical, and molecular biology. In two of these families (ME, MA), 6 individuals had low serum levels of Tg-related antigens with a minor increase after bovine TSH (bTSH) stimulation. A large proportion of the tracer was incorporated into serum albumin, and Tg antigens in the thyroid extracts were barely detectable by RIA. (0.19 mg/g tissue; normal, 70-90 mg/g). Gel filtration (CL6B Sepharose gel) showed absence of a normal Tg peak, and SDS agarose gel electrophoresis indicated complete absence of Tg dimer and monomer. Immunoelectrophoresis confirmed the absence of Tg-related antigens. Thus, in these patients a quantitative defect of Tg gene expression was characterized. By contrast, in the MO family a high basal serum concentration of immunoreactive Tg was present, with an exaggerated response to bTSH. Thyroid extracts revealed elevated TPO activity and normal levels of Tg-related antigens. Tg was also eluted in the gel filtration columns with the same mobility as standard 19S Tg. Immunoelectrophoresis against rabbit and human Tg was abnormal, with two precipitin arcs being detected. The Tg molecule after hydrolysis yielded only DIT and MIT, with poor formation of iodothyronines. Microscopic studies revealed a pronounced lack of colloid in the follicular lumina, and overdistended endoplasmic reticulum cisternae.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Thyroid autoregulation. Inhibition of goiter growth and of cyclic AMP formation in rat thyroid by iodinated derivatives of arachidonic acid.

Thyroid autoregulation has been related to intraglandular content of an unknown putative iodocompund. Data from different laboratories have shown that the thyroid is capable of producing different iodolipids, including iodinated derivatives of arachidonic acid; such as 5-hydroxy-6-iodo-8, 11, 14-eicosatrienoic-delta-lactone (IL-delta). Previous results from our laboratory showed that a semi-purified preparation of iodinated arachidonic acid exerts an inhibitory action in vitro on calf thyroid. In the present studies three purified iodinated derivatives of arachidonic acid were synthesized: IL-delta; 14-iodo-15-hydroxy-5, 8, 11-eicosatrienoic acid (I-OH-A) and its corresponding omega-lactone (IL-omega). Their action on MMI-induced goiter was studied in rats. Administration of MMI to rats during 10 days increased thyroid weight by 124%. This effect was significantly inhibited by the simultaneous injection of 5 micrograms/day of I-OH-A (57% inhibition of MMI action), IL-W (39%), IL-delta (33%) and T3 (95%), while arachidonic acid was without action. No inhibition was found with 1.25 micrograms/day Kl, a dose equivalent to that which could be originated from total dehalogenation of the iodocompounds. These results support the idea that these iodocompounds have an intrinsic biologic activity and that there is a correlation between action and chemical structure. Serum TSH was increased around 15-20 fold after MMI administration. Chronic or acute injection of I-OH-A failed to alter TSH levels, indicating that this iodocompound exerts its action directly on the gland, without altering TSH concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Seasonal variation of stable intrathyroidal iodine in nontoxic goiter disclosed by x-ray fluorescence.

The intrathyroidal stable iodine (ITI) determined in 776 patients chosen at random. Ninety % of these patients presented with nontoxic goiter. Curve-filtering analysis techniques showed a seasonal variation in ITI: an acrophase was found in April/May, a nadir in September/October. The possible relationship of this seasonal variation with the intake of iodine or alimentary antithyroid substances are discussed, as well as possible relationship with variation in chronic TSH stimulation related to ambient temperature.

Fluorescence↗
PubMed1984

HLA antigens in Greek patients with thyrotoxicosis (Graves' disease and toxic nodular goiter).

HLA-A and B-antigens were tested by a standard microlymphocytotoxicity technique in 126 controls and 225 thyrotoxic patients of Greek origin [173 with Graves' disease and 52 with toxic nodular goiter (TNG)]. We found: i) an increased frequency of HLA-B8 (21.4% versus 7.1%) and a decreased frequency of HLA-B12 (2.9% versus 18.2%) in Graves' disease when compared with controls; ii) no differences in the distribution of HLA-A, -B antigens in TNG, when compared with either controls or Graves' disease. These findings suggest that the associations between HLA-A, -B antigens and Graves' disease in Greek patients are similar to those reported in other caucasians. The absence of any correlation between HLA-A, -B and TNG provides additional laboratory evidence that TNG and Graves' disease represent different entities.

Adult↗
PubMed2004

Neonatal goiter with congenital thyroid dysfunction in two infants diagnosed by MRI.

It is essential to diagnose thyroid dysfunction at an early stage because congenital hypothyroidism (CH) represents one of the most common preventable causes of delayed physical and psychological development, including mental retardation. US evaluates the shape of the thyroid gland. CT and scintigraphic examinations demonstrate iodine metabolism of the thyroid, but there is associated radiation exposure. We encountered two cases of congenital goiter, in which MRI was very helpful in confirming thyroid dysfunction and was very useful in making an accurate diagnosis.

Diagnosis, Differential↗
PubMed2005

Comparison of surgical techniques for treatment of benign toxic multinodular goiter.

Controversy remains regarding the best surgical approach for toxic multinodular goiter (MNG). The aim of this study was to evaluate the results of various thyroid operations for managing toxic MNG. A group of 100 patients with toxic MNG were divided into three groups and managed with total thyroidectomy (TT; group I, n-17), near-total thyroidectomy (NTT; group II, n = 48), or bilateral subtotal thyroidectomy (BST; group III, n = 35). Patients were compared with regard to age, gender, surgical operations, complications, thyroid hormone status, duration of hospitalization, and the reoperation rate for incidentally found thyroid carcinomas. There were 14 men (14%) and 86 women (86%) with a mean age of 47.03 +/- 13.56 years (range 19-77 years). After the operation two patients had a hematoma, and one patient had a seroma. Four patients had unilateral vocal cord paralysis, and one had permanent paralysis. Moreover, 18 patients had transient and 2 patients permanent hypocalcemia. There was no significant difference between the groups regarding complications (p < 0.05). Permanent hypothyroidism was achieved in all patients in group I and 44 patients (92%) in group II, whereas in group III only 10 (29%) patients had hypothyroidism. Conversely, hyperthyroidism, both subclinical and clinical, was noted only in group III (12 patients, 34%) during follow-up. We think that TT and NTT are safe, effective approaches in the treatment of toxic MNG, preventing recurrence of thyrotoxicosis and reoperation for incidentally found thyroid cancers. The complication rates for TT and NTT were similar to that for BST. Hence these operation should be considered for patients referred for surgical treatment of toxic MNG.

Adult↗
PubMed2002

Multinodular goiter: surgical management and histopathological findings.

The purpose of this study was to assess histopathological findings after a bilateral near-total thyroidectomy (residual thyroid tissue about 4 to 5 g) for multinodular goiter (MNG). The 270 patients included 238 women and 32 men with a mean age of 52 years (range: 19-82 years) who had MNG involving the entire gland and had undergone a primary bilateral surgical procedure between 1993-1998. There was no intra- or postoperative mortality. Indications for the MNG surgery were suspected malignancy (7.7%), thyrotoxicosis (27.7%), pressure on cervical structures with tracheal deviation (38%), significant cosmetic deformity in young female patients (6.6%) and intrathoracic extension of the MNG (19.6%). Grave's disease was not included in our study. The surgical specimen weight ranged from 60 to 560 g (average 120 g). Final pathological findings were benign in 237 patients (87.8%) and malignant in 33 patients (12.2%). Nineteen patients were diagnosed with macroscopic (ten patients) or microscopic (nine patients) types of papillary carcinoma: there were two patients with the follicular variant of papillary carcinoma, three with lymphoma and Hashimoto's thyroiditis, three with medullar carcinoma, three with anaplastic carcinoma, two with follicular carcinoma and one with Hurthle cell carcinoma. A true total completion thyroidectomy was performed only for the medullary carcinoma patients and for four of the "high-risk" papillary carcinoma patients. Permanent (>12 months) unilateral recurrent paralysis occurred in four patients (1.4%), permanent (>12 months) hypoparathyroidism in ten patients (3.7%) and hypertrophic or keloid scar in 14 patients (5.1%). Our results suggest that near total thyroidectomy with minimal residual tissue is a versatile surgical procedure for various histopathological features in MNG patients. Low rates of postoperative complications were observed.

Adult↗
PubMed2004

Accuracy of preoperative pinhole subtraction single photon emission computed tomography for patients with primary and recurrent hyperparathyroidism in an endemic goiter area.

PURPOSE: Bilateral parathyroid exploration is still the standard therapeutic procedure for primary and recurrent hyperparathyroidism (HPTH). Since a unilateral surgical strategy that reduces surgical complications should not increase the risk of missing enlarged parathyroid glands, reliable preoperative imaging is the first requirement for this approach. This study was conducted to assess the accuracy of preoperative (99m)TcO(4)-(201)T1 pinhole subtraction single photon emission computed tomography (SPECT) compared with sonography. METHODS: The study population consisted of 15 patients with primary (n = 13) or recurrent (n = 2) HPTH who underwent preoperative (99m)TcO(4)-(201)T1 pinhole subtraction SPECT. Preoperative sonography was also done in 14 of these patients. RESULTS: (99m)TcO(4)-(201)T1 pinhole subtraction SPECT was significantly more accurate than sonography. It had an overall accuracy of 80% in detection of enlarged parathyroid glands. The accuracy of localization increased to 92.3% in patients with solitary adenomas, and to 100% in those with solitary adenomas and no previous parathyroid exploration. CONCLUSIONS: The high accuracy of preoperative localization with (99m)TcO(4)-(201)T1 pinhole subtraction SPECT in patients with primary and recurrent HPTH allows for an imaging-guided unilateral operative strategy in most patients, even those with concomitant nodular goiters. This may reduce the risk of surgical complications and expand the use of minimally invasive techniques in parathyroid surgery.

Adenoma↗
PubMed1988

Sequential changes in serum thyroglobulin, triiodothyronine, and thyroxine following partial thyroidectomy for nontoxic nodular goiter.

The sequential changes in serum thyroglobulin (Tg), thyroxine (T4), free thyroxine (FT4), triiodothyronine (T3) and thyrotropin (TSH) were evaluated in ten patients on whom partial thyroidectomy for nontoxic nodular goiter had been performed. These changes were compared with those in ten patients who underwent upper abdominal surgery (cholecystectomy) under similar anesthesia, and whose calorie and fluid intake was similar until at least 48 hours after surgery. In agreement with previous reports, marked elevations in serum Tg that reached peak concentration (660 to 1350 ng/mL) at one or two hours after the thyroid incision (mean +/- SD; 787 +/- 304.0 ng/mL and 839 +/- 345.7 ng/mL, respectively) were observed. On the other hand, the significant but minimal increases in serum T4 and FT4 were observed at 24 hours (P less than .001 and P less than .001, respectively), 48 hours (P less than .01 and P less than .001, respectively), and 72 hours (P less than .01 and P less than .01, respectively) after the thyroid incision compared with the level just prior to the thyroid incision. Similarly, serum T3 also increased significantly at 6 to 168 hours after the thyroid incision (P less than .01, P less than .05, P less than .05, P less than .05, and P less than .05, respectively). These increases in serum T4, FT4 and T3 were not observed in the cholecystectomy patients. The mean serum TSH levels at 24 to 72 hours after thyroid incision and those at 6 to 48 hours after the abdominal incision were significantly decreased compared with those before thyroid and abdominal incision, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Depression and anxiety in an 85-year-old woman with a toxic nodular goiter.

Depression is commonly encountered in medical settings and often may be a symptom of an underlying medical illness. This case report illustrates the disabling symptoms of anxiety and depression that can accompany a toxic nodular goiter, and underscores the importance of both accurate psychiatric diagnosis and appropriate medical evaluation in the assessment of psychiatric disorders in the elderly.

Aged↗
PubMed1995

Translocation (5;19)(q13;q13) in a multinodular thyroid goiter.

We describe the cytogenetics of a multinodular thyroid goiter where 90% of the analyzed cells showed a diploid karyotype with a balanced translocation between chromosomes 5 and 19: 46,XX,t(5;19)(q13;q13). This translocation has been previously described in cases of thyroid adenoma. Our case is the first report of this anomaly in nodular hyperplasia. We discuss its putative role in the neoplastic transformation of thyroid lesions.

Adult↗
PubMed1987

Changes of the blood lymphocyte population following 131I treatment for nodular goiter.

The blood lymphocyte population was examined in 34 patients who were treated with 131I for toxic or atoxic nodular goiter. The patients received one to three doses of 300-550 MBq of 131I administered at 1 week intervals. Lymphocyte counts were significantly reduced both 1 and 6 weeks after treatment. This reduction was accompanied by a changed composition of the lymphocyte population. The frequency of lymphocytes expressing membrane receptors for C'3 (EAC-rosette forming) was significantly reduced 1 and 6 weeks after 131I-administration. At 6 weeks there was a slight but statistically significant increase of the frequency of T-cells as identified by Leu 1 monoclonal antibodies. This was largely caused by an increased proportion of helper/induced T-cells as identified by Leu 3a monoclonals. 131I-treatment also reduced the capacity of lymphocytes to secrete immunoglobulins (Ig) upon PWM-stimulation. The most pronounced effect was observed for IgM. Secretion of IgG and IgA were less reduced. Mitogenic stimulations of lymphocytes with PHA and ConA were not significantly changed. We conclude that these changes observed, with the exception of mitogen reactivity, are essentially similar to those occurring after external radiation therapy for cancer. We speculate that blood lymphocytes passing through the continuously irradiated gland are damaged mainly by emitted beta-particles.

Adult↗
PubMed2004

Inferior laryngeal paraganglioma presenting as plunging goiter.

Paragangliomas are uncommon slow-growing neuroendocrine tumors that may arise from the extra-adrenal paraganglia. Paragangliomas of the inferior and superior laryngeal paraganglia are known as laryngeal paraganglioma. Inferior laryngeal paraganglioma, which is also called subglottic paraganglioma, is very seldomly observed. To our knowledge only 24 patients with subglottic paraganglioma have been found. We present a 77-year-old male patient who has been previously followed-up for cervical goiter, which has a progressive enlargement into the mediastinum, causing severe tracheal obstruction. The tumor was completely and easily resected via median sternotomy with collar incision and finally diagnosed as inferior laryngeal paraganglioma. The present case is the first subglottic laryngeal paraganglioma descending into the visceral compartment of the mediastinum in the literature.

Aged↗