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PubMed2000

Deletion of NKX2.1 gene encoding thyroid transcription factor-1 in two siblings with hypothyroidism and respiratory failure.

Thyroid transcription factor-1 encoded by the NKX2.1 gene is a candidate regulator of thyroid and lung morphogenesis and function in humans. We report 2 female siblings with congenital thyroid dysfunction and recurrent acute respiratory distress carrying a heterozygous deletion of chromosome 14q12-13.3, resulting in haploinsufficiency for the NKX2.1 gene. This observation further supports a physiologic role for thyroid transcription factor-1 in early human thyroid and pulmonary function.

Chromosomes, Human, Pair 14↗
PubMed2000

[Physiopathological implications of thyroid function in premature infants].

The last two decades have been characterized by a remarkable improvement of the methods used for the determination of thyroid hormones concentration as well as by mass screening of congenital hypothyroidism. This has resulted in an expanded knowledge on the development of the hypothalamus-hypophysis-thyroid function in the fetus and in newborn. The paper presents the latest advancements in this field. The following thyroid dysfunction syndromes in premature infants are discussed: transient hypothyroxinemia, transient primary hypothyroidism, transient idiopathic hyperthyrotropinemia, low T3 - syndrome. All these conditions should be taken into consideration while determining the thyroid function in premature infants, particularly while screening newborns with congenital hypothyroidism.

English Abstract↗
PubMed2003

[Subclinical hyperthyroidism: not necessarily a thyroid disorder].

Three women, aged 16, 70 and 72 years, were seen in our outpatients' clinics with a decreased TSH value. In two of them, thyroid dysfunction was not the cause of the low TSH activity. In patient A, the cause was diminished food intake and in patient B, who was also known with nodular thyroid disease, the cause was the use of glucocorticoids. Only patient C had subclinical hyperthyroidism due to goitre with concomitant atrial fibrillation. She was recommended for treatment with 131I. Patients A and B recovered spontaneously. Subclinical hyperthyroidism is being increasingly encountered due to the availability of sensitive assays for measuring TSH activity and the increased frequency with which general practitioners test thyroid function. However, in about 55% of cases suppressed TSH values normalise spontaneously. This means that it is important to establish if thyroid disease is truly present. The treatment of subclinical hyperthyroidism should be initiated on the basis of individual data.

Adolescent↗
PubMed1981

[Pseudohypoparathyroidism with hypothyroidism (author's transl)].

This is a report about three children suffering from pseudo-hypoparathyroidism type I and moderate primary hypothyroidism. The thyroid dysfunction was characterised by slightly low plasma thyroxine and high basal TSH showing an increased response to TRH. T3 and rT3 were within normal limits, the size of the thyroid glands and also bone age were normal. The plasma concentrations of T4 and TSH and the response of TSH to TRH were no different during hypocalcemia from those obtained in normocalcemia during vitamin D treatment. Thyroxine treatment could normalize T4 and TSH. Moderate hypothyroidism is frequently present in pseudohypoparathyroidism. It has to be assumed that the same genetical defect of the second messenger, already proved to exist in the kidneys of patients with pseudohypoparathyroidism may also exist in the thyroid gland.

Adolescent↗
PubMed1997

Influences of thyroid diseases in diabetic pregnant women.

Thyroid disorders are particularly frequent in women and, second to diabetes mellitus, are the most common endocrine diseases during pregnancy. An association between insulin-dependent diabetes mellitus and thyroid autoimmunity has long been recognized. Management of thyroid diseases in pregnancy is different than in non pregnant women, due to physiological changes of thyroid hormone economy in the childbearing period. Thyroid dysfunction may affect carbohydrate metabolism and worsen glucose control in diabetic patients. On the other hand, poorly compensated diabetes mellitus may cause alteration in the production and metabolism of thyroid hormones. Pregnant women with insulin-dependent diabetes mellitus have an increased risk of developing post partum thyroiditis. These observations have lead to the recommendation that thyroid function should be checked in diabetic women during pregnancy and in the post partum.

Adult↗
PubMed1980

Experimental hypothalamic dysfunction in dogs.

The authors demonstrate an experimental model in dogs developed in order to study endocrine disorders as a result of suprasellar space occupying lesion. Fogarty balloon catheters were inserted in dogs below the optic chiasm and filled with contrast medium. The study of thyroid function shows that initially reversible hypothalamic hypothyroidism develops and that in a second stage most animals develop chronic thyroid dysfunction which is irreversible even after careful removal of the experimental tumor. The clinical symptoms correlate with these findings. Morphological examinations prove the fact that the hypothalamic disorders are due to disturbances of the blood-brain-barrier in the hypothalamus following hypothalamic compression and decompression.

Animals↗
PubMed1988

Deficient nocturnal surge of TSH secretion during sleep and sleep deprivation in rapid-cycling bipolar illness.

Rapid-cycling bipolar patients have a high prevalence of hypothyroidism, and this disturbance in their hypothalamic-pituitary-thyroid (HPT) function may provide a model for understanding the less severe thyroid dysfunction present in other forms of affective disorder. For these reasons, we investigated HPT function in eight rapid-cycling bipolar patients and eight normal controls by measuring plasma levels of thyroid-stimulating hormone (TSH) and cortisol every 30 min during a baseline 24-h period and during an additional night of sleep deprivation. Thyrotropin-releasing hormone (TRH) (500 micrograms) challenge tests were also performed in the patients. Controls exhibited a significant circadian variation in TSH with a nocturnal rise that was augmented by sleep deprivation. In the rapid cyclers, the nocturnal rise in TSH was absent, and sleep deprivation failed to raise their TSH levels significantly compared with baseline. Low nocturnal TSH levels were associated with blunted TSH responses to TRH infusions; due to the relatively brief sampling interval used in the TRH challenge tests, however, these results do not reliably discriminate between hypothalamic and pituitary dysfunction as an etiology for low nocturnal TSH levels. Additional studies are needed to determine the precise nature of the HPT disturbance in rapid-cycling patients.

Adult↗
PubMed2003

Role of thyroid hormones in human and laboratory animal reproductive health.

The highly conserved nature of the thyroid gland and the thyroid system among mammalian species suggests it is critical to species survival. Studies show the thyroid system plays a critical role in the development of several organ systems, including the reproductive tract. Despite its highly conserved nature, the thyroid system can have widely different effects on reproduction and reproductive tract development in different species. The present review focuses on assessing the role of thyroid hormones in human reproduction and reproductive tract development and comparing it to the role of thyroid hormones in laboratory animal reproduction and reproductive tract development. The review also assesses the effects of thyroid dysfunction on reproductive tract development and function in humans and laboratory animals. Consideration of such information is important in designing, conducting, and interpreting studies to assess the potential effects of thyroid toxicants on reproduction and development.

Animals↗
PubMed2002

Toxicology review and risk assessment of resorcinol: thyroid effects.

Resorcinol administered at high doses to rodents can disrupt thyroid hormone synthesis and can produce goitrogenic effects. These effects were not seen in a 2-year bioassay at doses of up to 520 mg/kg/day. There are species-specific differences in synthesis, binding, and transport of thyroid hormone that complicate interpretation of goitrogenesis in rodents. Clinical case reports from patients undergoing resorcinol therapy for dermatological indications reveal thyroid side effects when copious amounts of resorcinol-containing ointments are applied to integrity-compromised skin for months to years. Effect levels were greater than 34 mg/kg/day. Occupational epidemiology studies provide no evidence that exposure to resorcinol at levels greater than found in the general environment causes thyroid dysfunction. Studies investigating the relationship between endemic goiter and exposure to "phenolics," including resorcinol, in drinking water do not fulfill accepted scientific criteria for establishing resorcinol as a cause of thyroid disease. Those reports neither quantify exposure levels nor demonstrate dose-response relationships or rule out confounding by the multiple other chemicals present in water supplies, by bacterial contamination of water, or by nutritional factors. A risk assessment comparing potential worst-case exposures to resorcinol through its use in dermatological preparations supports the conclusion that under real-world conditions, human exposures to resorcinol are not expected to cause adverse effects on thyroid function.

Administration, Cutaneous↗
PubMed2004

The insulin-like growth axis in patients with autoimmune thyrotoxicosis: effect of antithyroid drug treatment.

OBJECTIVE: Hyperthyroidism is associated with altered growth hormone (GH) secretion. Many patients with thyroid dysfunction experience several poorly described complications such as symptoms and signs also seen in patients with growth hormone deficiency (GHD). We have therefore prospectively evaluated a possible relationship between the thyroid function, body composition, leptin levels and insulin-like growth factor (IGF) related peptides in patients with Graves' disease. DESIGN, PATIENTS, AND MEASUREMENTS: In a prospective group of 24 fasting female patients with Graves' disease (mean age (CI 95%): 40 years (33-47)), we measured serum thyroxine, triiodothyronine, thyrotropine (TSH), TSH receptor antibodies, anti-thyroid peroxidase, leptin, body composition, body mass index (BMI) and IGF-related peptides at diagnosis and after 12 months of treatment with thiamazol (ATD). RESULTS: In thyrotoxic patients IGF-I plus IGF-II correlated positively with IGFBP-3 at baseline (r = 0.90, p < 0.1 x 10(16)) and after 12 months follow-up (r = 0.87, p < 0.1 x 10(-16)). In the thyrotoxic state total IGF-I, IGF-II, IGF binding protein 3 (IGFBP-3) and acid-labile subunit (ALS) but not free IGF-I decreased significantly from 223 microg/L (189-260) (mean (CI 95%), 877 microg/L (801-953), 4165 microg/L (3772-4577) and 22 mg/L (18-26)) to 198 microg/L (172-226), 788 microg/L (711-865), 3431 microg/L (3135-3741) and 19 mg/L (16-26) (p <0.006), respectively, after 12 months of ATD despite an increase in BMI from 22 (21-23) to 23 kg/m(2) (22-25) (p < 0.0004) but no significant changes in leptin. CONCLUSIONS: The complex IGF systems seemed intact in thyrotoxic patients but change in body composition and the regulation of leptin and insulin secretion during treatment of autoimmune thyroid disease influence IGF-related peptides leaving the patient in a state somewhat similar to partial GHD, but the mechanism behind these alterations remains unclear.

Adult↗
PubMed1998

[Thyroid function and difficult to manage asthma].

Hyperthyroidism can cause asthma to worsen, such that analysis of thyroid function has been recommended when the course of asthma is unfavorable. The aim of this study was to determine whether systematic analysis of thyroid function is useful for all patients with difficult-to-manage asthma. For prospective study, we enrolled 48 asthmatics whose condition had deteriorated due to no known cause. All patients were studied as follows: a) all were assessed for thyrotropin (TSH) levels and, if alterations were detected, we ordered analysis of free thyroxin (FT4), and b) case histories were taken to rule out the existence of active thyroid disease. Nine patients (19%) were suspected of thyroid disease. TSH levels were abnormal in only 5 (10%) patients in this group (low in four and high in one). Hyperthyroidism was confirmed in only 3 patients (6%) after high FT4 levels were detected. Although the frequency of hyperthyroidism in the sample studied is higher than that described for the general population, the systematic investigation of thyroid dysfunction in all patients with difficult-to-manage asthma does not appear justified given that disease could be demonstrated in only some of those who were clinically suspected of thyroid disease.

Adult↗
PubMed2001

Low TSH requirement and goiter in transgenic mice overexpressing IGF-I and IGF-Ir receptor in the thyroid gland.

Through the cAMP signaling pathway, TSH stimulates thyroid follicular cell proliferation, differentiation, and function. Although the autocrine production of IGF-I in the thyroid gland suggests an important physiological function for this factor in these processes, the exact role of the IGF-I/IGF-I receptor system in vivo remains unclear. Although the mitogenic action of TSH requires the presence of IGF-I or insulin in primary culture of dog and human thyroid cells, IGF-I has an effect equal to and independent of the effect of TSH on cell proliferation in rat thyroid cell lines and may even be the main growth regulator in this case. To investigate the in vivo function of the IGF-I/IGF-I receptor system, transgenic mice overexpressing human IGF-I, IGF-I receptor, or both in the thyroid were generated. Adult transgenic mice did not present external signs of thyroid dysfunction, but mice overexpressing both transgenes had significantly increased gland weight and follicular lumen area. A decreased TSH level together with a slightly increased serum T(4) concentration and increased thyroidal iodine uptake were also observed, suggesting that IGF-I and IGF-I receptor stimulate thyroid function to some extent in vivo.

Animals↗
PubMed2003

Chronic daily ethanol and withdrawal: 5. Diurnal effects on plasma thyroid hormone levels.

We previously demonstrated that chronic daily ethanol consumption and daily withdrawal by male rats in a modified ethanol liquid diet paradigm produced (a) chronically increased adrenal glucocorticoid activity; (b) decreased plasma testosterone; (c) decreased forebrain proopiomelanocortin gene expression; and (d) corresponding alterations in plasma leptin levels-all of which are consistent with reported changes during alcohol abuse and alcoholism. Each of these systems interact with hypothalamo-pituitary-thyroid (HPT) regulation, and links between chronic alcohol abuse and thyroid dysfunction have been suggested by both human and rat studies. Accordingly, we have begun to investigate potential HPT mediation of, or response to, alterations in these systems by investigating plasma thyroid hormone levels in the same chronic daily ethanol/ withdrawal paradigm. Chronic daily episodes of ethanol consumption and withdrawal by male Sprague- Dawley rats decreased plasma levels of free (non-protein- bound) triiodothyronine (T3) (p < 0.01) and free thyroxine (T4) (p < 0.05) in the morning but not in the afternoon, relative to both ad libitum-fed and pair-fed controls (n = 9/treatment). Plasma total T4 levels were likewise suppressed (p < 0.01) in the morning, whereas total T3 levels were increased (p < 0.05) in the afternoon. These changes eliminated normal diurnal patterns (higher in the morning) of plasma free T3, free T4, and total T3 concentrations. Three weeks after cessation of ethanol consumption, morning plasma levels of free and total T3 and T4, as well as plasma thyroid-stimulating hormone (TSH), were all not significantly changed by the prior ethanol consumption or pair-feeding. These results reveal that plasma thyroid hormone concentrations are suppressed in a time of day dependent manner by chronic daily ethanol consumption and daily withdrawal in this model of chronic ethanol abuse. During subsequent long-term "abstinence," these thyroid hormones returned to control levels. These results are consistent with evidence that thyroid function is commonly diminished in alcoholism, with variable reports of recovery during abstinence. Further investigations with this rat model of daily ethanol consumption and daily withdrawal will help resolve interactions and roles of the HPT axis in alcohol abuse.

Alcoholism↗
PubMed2006

Prevalence of goitre and autoimmune thyroiditis in schoolchildren in Delhi, India, after two decades of salt iodisation.

Delhi lies in the sub-Himalayan plains and the existence of iodine deficiency is well established. Iodised salt was introduced in Delhi nearly two decades ago. The aim of the present study was to determine the status of iodine nutrition in school-aged children and the prevalence of autoimmune thyroiditis. A total of 4,320 schoolchildren (2,218 [51.3%] boys) aged 10-16 years were studied. Goitre was detected in 396 children, an overall goitre prevalence of 9.2%. Of the 396 children with goitre, 112 (28.3%) had evidence of autoimmune thyroiditis (AIT). The median urinary iodine (UI) excretion in the study population as a whole was 14.6 microg/dl. The median UI in the group of children with goiter was 13.3 microg/dl, whereas UI in children with goiter and evidence of AIT was 16.6 microg/dl (p <0.01). Of the 112 children with AIT, 77 (68.7%) were euthyroid, 23 (20.5%) had subclinical hypothyroidism, eight (7.2%) had hypothyroidism and the remaining four (3.6%) had hyperthyroidism. UI was high in goitrous children with AIT, and in children with thyroid dysfunction. Further studies are needed to clarify whether the higher UI in goitrous children with AIT is causally related to AIT or is due to the inability of the diseased thyroid to trap available iodine efficiently.

Adolescent↗
PubMed2001

Effect of eicosapentaenoic acid ethyl ester on hypothyroid function.

Thyroid hormones affect reactions in almost all pathways of lipid metabolism. It has been reported that plasma free fatty acid (FFA) concentration in hypothyroidism is generally within the normal range. In this study, however, we show that plasma FFA concentration in some hypothyroid patients is higher than the normal range. Symptoms of thyroid dysfunction in these individuals were less severe than those of patients with lower plasma FFA concentrations. From these findings we hypothesized that the change in FFA concentration must correlate with thyroid function. Using an animal model, we then examined the effect of highly purified eicosapentaenoic acid ethyl ester (EPA-E), a n-3 polyunsaturated fatty acid derived from fish oil, on thyroid function in 1-methyl-2-imidazolethiol (MMI)-induced hypothyroid rats. Oral administration of EPA-E inhibited reduction of thyroid hormone levels and the change of thyroid follicles in MMI-induced hypothyroid rats. These findings suggest that FFA may affect thyroid functions and EPA-E may prevent MMI-induced hypothyroidism.

Animals↗
PubMed2005

Thyroid function in treatment-resistant schizophrenia patients treated with quetiapine, risperidone, or fluphenazine.

BACKGROUND: Thyroid dysfunction is relatively common in patients with schizophrenia, possibly related to a genetic linkage of the disorders and to antipsychotic treatment. Quetiapine has been implicated as causing some degree of thyroid function changes, yet it remains unclear as to what extent or why these changes may occur. Furthermore, the need for thyroid function monitoring in patients taking this medication is not definitive. METHOD: Thyroid function was assessed in 38 adult DSM-IV-diagnosed schizophrenia patients after 6 weeks of prospective, double-blind, randomized treatment with quetiapine (400 mg/day), risperidone (4 mg/day), or fluphenazine (12.5 mg/day). Data were collected from 1997 to 2002. RESULTS: At baseline, the percentages of randomized patients with abnormal values were 18% (4/22) for serum T(3) resin uptake, 13% (4/30) for thyroid-stimulating hormone (TSH), and 9% (2/22) for total serum thyroxine (TT(4)), representing fairly widespread thyroid abnormalities independent of treatment group. Little change was noted in thyroid function during the 6 weeks of treatment, except for a significant decrease in TT(4) values for those taking quetiapine (p = .01). Clinically, however, no patients demonstrated any signs or symptoms of hypothyroidism during the study, nor were any significant changes in the free thyroxine index or TSH levels noted. CONCLUSIONS: It is expected that TT(4) levels will decrease during quetiapine treatment, and this may possibly be related to competitive metabolism of thyroid hormones and quetiapine by UDP-glucuronosyltransferase. Routine monitoring of thyroid function in quetiapine-treated patients without a history of thyroid disease is not recommended.

Adult↗
PubMed1985

Thyroid disease in pregnancy.

The recognition of thyroid dysfunction in pregnancy is important, since, untreated, it may cause maternal and fetal morbidity and mortality. In this article, the author reviews the relationship of maternal and fetal-placental thyroid function, the interpretation of thyroid tests during gestation, and the management of common thyroid problems that may complicate pregnancy.

Adult↗
PubMed2006

Pulsed tissue Doppler identifies subclinical myocardial biventricular dysfunction in active acromegaly.

OBJECTIVE: The aim of this study was to assess the role of pulsed tissue Doppler (TD) to identify left (LV) and right ventricular (RV) myocardial regional involvement in acromegaly. PATIENTS AND MEASUREMENTS: Thirty active acromegaly patients, free of diabetes mellitus, thyroid dysfunction, valvular and coronary heart disease, clinically overt heart failure, and 30 sex- and age-matched healthy controls underwent standard Doppler echocardiography and pulsed TD, by placing the sample volume at the level of basal posterior septum, LV lateral mitral annulus and RV lateral tricuspid annulus. Myocardial systolic (S(m)) and diastolic velocities (E(m)/A(m) ratio) and time-intervals of relaxation (RT(m)), precontraction (PCT(m)) and contraction (CT(m)) and the PCT(m)/CT(m) ratio were measured at each level. RESULTS: The two groups had similar heart rate, whereas acromegaly patients had higher body mass index, systolic and diastolic blood pressure, LV mass and impaired Doppler indexes of LV and RV diastolic function, without any difference in the global systolic function. At TD, acromegaly patients showed significantly delayed RT(m) and PCT(m,) reduced E(m)/A(m), S(m) and increased PCT(m)/CT(m) of posterior septum, mitral annulus and tricuspid annulus in comparison with controls. By separate multilinear regression analyses, after adjusting for body mass index, heart rate, diastolic blood pressure and LV mass index, age was the main independent determinant of tissue Doppler diastolic but not of systolic indexes. CONCLUSIONS: In active acromegaly, pulsed TD confirms LV and RV diastolic abnormalities detectable by standard Doppler, additionally identifying subclinical biventricular impairment of systolic function.

Acromegaly↗