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PubMed1989

Evaluation of metabolic status in amiodarone-induced thyroid disorders: plasma coenzyme Q10 determination.

In previous works we have demonstrated that Coenzyme Q10 (CoQ10) levels have a significant inverse correlation with thyroid hormone concentration in patients with spontaneous hyper- or hypothyroidism. In order to verify whether this correlation is maintained in patients on long-term amiodarone therapy, in whom thyroid metabolism is altered by the iodine contained in the drug, we have studied 30 patients with thyroid dysfunction induced by chronic amiodarone treatment. We have distinguished four groups of patients: group A (n = 8): patients with true hyperthyroidism induced by drug administration; group B (n = 11): patients with mild hyperthyroid symptoms, but isolated thyroxine increase or dissociation between different indexes of thyroid function; group C (n = 5): patients with normal thyroid hormone levels, but increased TSH levels; group D (n = 6): patients who appeared really clinically euthyroid, with normal thyroid hormone levels and normal TSH response to TRH. In group A patients, plasma CoQ10 levels averaged 0.49 +/- 0.03 micrograms/ml, significantly lower than those in normal subjects and similar to those observed in spontaneous hyperthyroid patients. In group B patients, CoQ10 levels were in the normal range (0.88 +/- 0.10 microgram/ml). In group C patients, CoQ10 levels were lower than those in normal subjects and similar to those of group A patients (0.49 +/- 0.04 microgram/ml); they differed, in regards to CoQ10 values, in comparison with spontaneous primary hypothyroid patients, who had very high levels of plasma CoQ10. Finally, in group D patients, CoQ10 levels were in the normal range (0.77 +/- 0.04 microgram/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2002

Thyroid hormone-dependent development of mouse cerebellar Purkinje cells in vitro.

Using a well-defined medium with insulin, transferrin and selenium but without serum and albumin, we quantitatively determined the effect of thyroid hormones on the development of Purkinje cells in mouse cerebellar monolayer cultures. Addition of a thyroid hormone, T3 or T4, to the serum-free medium resulted in a highly elaborate dendritic development of Purkinje cells. The cultured Purkinje cells in the presence of T4 even showed similarities in shape and in synapse formation to normal Purkinje cells in vivo. Such effect of T4 on the dendritic arborization of Purkinje cells was dose dependent and significantly sensitive to a low dose of T4 even at 50 pM. The effect of T4 was confirmed by an inhibition experiment using amiodarone, which was reported to induce thyroid dysfunction. Furthermore, T4 affected not only Purkinje cell development but also the shape of other neural cells such as small interneurons (mainly granule cells) and astrocytes in cerebellar cultures. T4 induced development of both interneurons and astrocytes having long processes. These results indicate that thyroid hormones play a pivotal role in the development of mouse Purkinje cell dendrites acting on Purkinje cells directly and/or indirectly via the close interaction with interneurons and astrocytes.

Animals↗
PubMed2004

[Subclinical thyroid disease: subclinical hypothyroidism and hyperthyroidism].

Subclinical hypothyroidism (SHT) and subclinical hyperthyroidism (SCH) are defined as normal serum free T4 and T3 levels associated with elevated (SHT) or subnormal (SCH) serum TSH levels, respectively. Symptoms and signs of thyroid dysfunction are scarce. The prevalence is low. In SHT, total cholesterol and LDL-C are modestly elevated and levothyroxine may influence the lipids levels. There is decreased cardiac contractility and increased peripheral vascular resistance that improve with treatment. SCH is associated with atrial fibrillation, increased cardiac contractility and left ventricular mass, diastolic and systolic dysfunction that can be reversed with beta-adrenergic antagonists. Bone density is reduced in SCH. Depression, panic disorders and alterations in cognitive testing are frequent in SHT. Treatment of SHT is recommended for serum TSH levels greater than 8 mU/L and presence of thyroid antibodies. Endogenous SCH should be treated for serum TSH levels less than 0.1 mU/L, in the presence of symptoms and in elderly patents.

Humans↗
PubMed2006

Central hypothyroidism and hypophysitis during treatment of chronic hepatitis C with pegylated interferon alpha and ribavirin.

Thyroid dysfunction is a known complication of interferon treatment in patients with hepatitis C virus (HCV) infection. Other uncommon endocrine complications have been reported during the treatment of viral hepatitis with IFN-alpha, such as hypopituitarism. A 54-year-old female patient with chronic hepatitis C began treatment with pegylated (PEG)-IFN-alpha 2a 180 mug/week plus ribavirin 1,000 mg/day. At week 20 of treatment, her routine laboratory control showed low levels of thyroid-stimulating hormone (TSH) and free serum thyroxine. This was confirmed at week 24, and other laboratory values showed low levels of adrenocorticotrophic hormone (ACTH). A T1-weighted magnetic resonance imaging scan demonstrated high intensity of the anterior pituitary gland and enhancement after intravenous administration of gadolinium. Hypophysitis with hypothalamic-pituitary dysfunction and secondary or central hypothyroidism was diagnosed on the basis of the clinical features, endocrinological assessment, immunological markers and imaging studies. Twenty-four weeks after stopping treatment, HCV RNA was negative by polymerase chain reaction and alanine aminotransferase values were below the upper limits of normal, and ACTH and thyroid values remained within the reference values. This is the first report of central hypothyroidism and hypophysitis during treatment with PEG-IFN-alpha plus ribavirin, and may be included in the potential list of side effects of the combination treatment.

Antiviral Agents↗
PubMed2006

Thyroid hormone and heart failure.

Thyroid hormone metabolic disarray has been identified as a risk factor for the progression of heart disease and the development of heart failure (HF). Both hyper- and hypothyroidism have been associated with a failing myocardium. Poor cardiac contractility and low cardiac output due to hyperthyroidism is a rare occurrence and is mostly seen in patients with preexisting heart disease. Referred to as a "rate related" phenomenon, hyperthyroid-induced sustained sinus tachycardia or atrial fibrillation may further reduce ventricular contractility. Increasingly, the hypothyroid state, and in particular a low triiodothyronine level, has been associated with a reduced cardiac performance and poor prognosis in HF, even in the presence of normal thyroid-stimulating hormone levels. Low thyroid hormone levels alter cardiac gene expression and increase systemic vascular resistance, both resulting in a reduction of cardiac contractility and cardiac output. This review summarizes current data on thyroid dysfunction and HF as well as the emerging implications of the "low triiodothyronine state."

Amiodarone↗
PubMed1995

Cognitive function, thyroid status and postpartum depression.

Impairment of cognitive function can occur with thyroid disorder and also with depression. Since depression occurs in conjunction with postpartum autoimmune thyroiditis, the question arises as to whether any impairment of cognitive function in postpartum women is related to change in thyroid status or to depressed mood. A total of 242 women (110 thyroid antibody-positive and 132 antibody-negative) were assessed at 8, 12, 20 and 28 weeks postpartum in the outpatients of a district general hospital. Thyroid antibody levels (antimicrosomal and antithyroglobulin) were monitored at monthly intervals, together with plasma T3, T4 and thyroid-stimulating hormone. The main outcome measures were Research Diagnostic Criteria for depression, the 17-item Hamilton Depression Rating Scale and the Edinburgh Postnatal Depression Scale, together with reaction time and digit span. Subjects with postnatal depression showed detectable cognitive impairment independent of thyroid antibody status and actual thyroid dysfunction.

Antibodies↗
PubMed1995

Role of complement in the pathogenesis of postpartum thyroiditis: relationship between complement activation and disease presentation and progression.

The aim of this study was to assess whether the presentation and progression of autoimmune postpartum thyroiditis (PPT) was related to the degree of thyroid peroxidase autoantibody (TPO-ab)-mediated activation of the complement cascade. One hundred and forty-eight thyroid autoantibody-positive women have been followed during their postpartum year. Seventy-five women remained euthyroid during this time whilst the remaining 73 showed one or more episodes of thyroid dysfunction. Fourteen women showed hyperthyroid PPT, 23 showed a biphasic PPT and the remaining 36 showed hypothyroid PPT. Hyperthyroid PPT was always transient but 29 of the 59 women with hypothyroidism remained hypothyroid or still required thyroxine replacement therapy at the conclusion of the study. Thyroid autoantibodies were measured by enzyme-linked immunosorbent assay (ELISA), free triiodothyronine and free thyroxine by the Amerlex M methods and thyrotrophin by the Amerlite TSH (monoclonal) assay. Complement component C3b, immobilized as a result of classical complement pathway activation in the presence of TPO/TPO-ab complexes in vitro, was measured by ELISA. Bioactive TPO-ab were calculated as the product of the C3 index and TPO-ab level. Basal levels of complement C3 activation were seen in the euthyroid TPO-ab-positive women (C3 index 0.06 at delivery rising to 0.36 at 12 months postpartum; bioactive TPO-ab activity 0.4 kIU/l at delivery rising to 10.4 kIU/l at 12 months' postpartum (N = 75). These parameters were elevated progressively as the severity of the clinical syndrome increased. In 14 hyperthyroid PPT women the C3 index was 0.47 at 8 months' postpartum (bioactive TPO-ab activity = 20 kIU/I; p vs euthyroid group, NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Autoantibodies↗
PubMed2003

[Hypothyroidism and the heart].

The cardiovascular system is sensitive to the action of thyroid hormones, and thyroid dysfunction causes a wide spectrum of cardiovascular changes. The effect of overt hypothyroidism on the cardiovascular system has long been recognised. Nowadays, the clinical presentation of cardiovascular symptoms related to hypothyroidism is only rarely observed due to early diagnosis of hypothyroidism by easily available thyroid-stimulating hormone assays. Overt hypothyroidism causes changes in such parameters of cardiovascular function as heart rate, left ventricular systolic and diastolic function, blood, arterial pressure and systemic vascular resistance. During the last years, there has been increasing evidence that subclinical hypothyroidism may also impair the cardiovascular system. This review discusses the effect of hypothyroidism on the cardiovascular system.

Cardiovascular Physiological Phenomena↗
PubMedDate not supplied

[Multinodular diving goiters: 100 cases in Morocco].

OBJECTIVE: To assess 100 cases of multinodular diving goiters, the authors review the literature to compare the epidemiology, clinical pictures, additional required work-up, treatments, complications, and sequelae. METHOD: Records of 100 cases of multinodular diving goiters were collected in the surgical department of the Military Hospital of Marrakesh in Morocco from 1991 through 2004. They accounted for 6% of all goiters. The sex ratio was clearly female, and the mean age 50 years. The clinical symptoms of diving goiters involves mainly signs of compression, with dyspnea seen in 50% of cases. Thyroid dysfunction was found in only 25% of our patients. A diagnosis of diving goiter must be suspected when there are signs of mediastinal compression and a palpable cervical goiter, as seen in all our patients. The diagnosis can often be confirmed with thoracic radiography and thyroid scintigraphy. Treatment is mainly surgical and depends on disease course. Cervicotomy was performed in 97% of our patients and was sufficient to extract even most voluminous goiters and those deepest in the mediastinum. RESULTS: Immediate operative results were satisfactory. More long-term results were also generally satisfactory, except for 4 cases of recurrent paralysis and 5 cases of hypoparathyroidism. Both have been reported by several authors. CONCLUSION: Surgical management of multinodular diving goiters is necessary. In general, cervicotomy is sufficient, and the results generally satisfactory, except some complications and neoplasms.

Adult↗
PubMed1988

[Disorders of thyroid function as a consequence of severe craniocerebral injury].

In 32 patients with acute severe head trauma (SHT) the venous plasma levels of thyroid and thyrotrophic (TTH) hormones were studied and the functional state of the hypothalamus-hypophysis-thyroid system assessed. TTH hypersecretion and steady thyroid hypofunction are regular responses of the thyroid endocrine complex to SHT. Pathogenic mechanisms of the adenohypophyseal and thyroid dysfunctions in acute SHT are discussed and the need in their correction suggested.

Acute Disease↗
PubMed1986

Palpebral asymmetry and hyperthyroidism. Two cases in connection with Graves' disease.

The causes of eyelid retraction or ptosis are numerous. Eye changes associated with thyroid dysfunctions are frequent, and diagnosis is not difficult in patients who are thyrotoxic. In euthyroid patients more difficulty may be encountered, especially if the disorder is asymmetric. The cases are described of two patients with ptosis and eyelid retraction on the other side, who suffered from thyroid disorder.

Blepharoptosis↗
PubMed2000

Thyroid hormones and treatment of obesity.

Thyroid hormones have important thermogenic function. Nevertheless, thyroid dysfunctions are often associated with minor changes in body weight and fat mass. On the other hand, both overfeeding and fasting have important effects on iodothyronine metabolism and regulation of deiodinase activity. Although under debate, there are clinical and theoretical reasons to administer low-dose thyroid hormones (T3) in selected obese patients. This short review deals with both pathophysiological and clinical aspects of thyroid hormone used in the therapy of obesity.

Body Temperature Regulation↗
PubMed2004

How valuable is screening for thyroid disease in patients with carpal tunnel syndrome?

BACKGROUND: It has been suggested that many patients with carpal tunnel syndrome have associated thyroid or other metabolic diseases. METHODS: 206 patients with clinical features suggestive of carpal tunnel syndrome (CTS), including those with known underlying cause of CTS, were screened for thyroid dysfunction. Nerve conduction studies were compatible with a diagnosis of CTS in 136 patients (CTS group). RESULTS: We diagnosed only 2 new cases of hypothyroidism (1.5% of patients in the CTS group) and none with hyperthyroidism. CONCLUSIONS: Thus routine screening of patients with isolated CTS for thyroid function abnormality does not appear to be worthwhile.

Journal Article↗
PubMed1993

Elevated plasma levels of VWF:Ag in hyperthyroidism are mediated through beta-adrenergic receptors.

Thyroid dysfunction influences the levels of Von Willebrand factor (VWF:Ag). Plasma VWF:Ag levels in 35 hyperthyroid patients were significantly elevated, which had a positive correlation with both T3 (Triiodothyronine) and T4 (Thyroxine) levels. A follow-up study of seven hyperthyroid patients undergoing anti-thyroid therapy showed that the elevated VWF:Ag levels returned to normal range with the normalization of thyroid function. On the other hand, after administration of 160 mg/day of propranolol, a specific blocker of beta-adrenergic receptors, to five hyperthyroid patients for twenty-eight days, plasma VWF:Ag levels returned to normal range, while T3, T4 levels remained high without significant alteration. These results demonstrated that the elevation of plasma VWF:Ag by thyroid hormone is mediated through beta-adrenergic receptors, which may be useful to further understand the physiological and pathological roles of thyroid hormone in the regulation of VWF:Ag levels.

Adult↗
PubMed2003

[Thyroid function in pregnant women with pregnancy induced hypertension].

OBJECTIVE: The aim of this study is to investigate thyroid's function in pregnant women with pregnancy induced hypertension. MATERIALS AND METHODS: 42 pregnant women with PIH diagnosed after 20 weeks of gestation (between 22-30 hbd) were hospitalized in Department of Obstetrics and Gynecology of Mother and Child Institute in Warsaw. This group consisted 20 multiparous and 22 primiparous. We measured thyroid hormone levels: TSH, fT4, fT3 and TBG. RESULTS: In 8 pregnant women (5 primiparous and 3 multiparous) thyroid function was normal (normal level of TSH, fT3, fT4) and middle blood pressure in term of beginning of the study was 155/100 mmHg. 34 pregnant women (19 primiparous and 15 multiparous) had abnormal thyroid function. 3 (1 primiparous and 2 multiparous) pregnant women of this group had subclinical hyperthyroidism (middle blood pressure in the beginning of the study was 155/105) and 31 (21 primiparous and 10 multiparous) had fT4 and fT3 levels lower then normal range with normal TBG levels. In this group only one patient TSH level was higher then 5 mlU/l, which allows to recognize overt hypothyroidism. In other cases the results indicate the subclinical hypothyroidism. The middle blood pressure was 140/95 mmHg. CONCLUSION: 1. Thyroid dysfunction in pregnant women was concluded in 78.2% of tested group. 2. Subclinical hypothyroidism was concluded the most frequent in the tested group. 3. The middle blood pressure at the term of beginning of the study was the lowest in pregnant women with hypothyroidism. 4. The thyroid function tests should be performed in all pregnant women with PIH.

Adult↗
PubMed1975

Thyroid hormones and thyrotropin in amniotic fluid.

Thyroid hormone and thyrotropin concentrations in amniotic fluid were studied by radioimmunoassays during pregnancy. The mean thyroxine concentration was 398 ng per 100 ml at 15 to 19 and 440 ng per 100 ml at 36 to 42 weeks. Although 3,3',5-tri-iodothyronine was undetectable (less than 25 ng per 100 ml), 3,3',5'-tri-iodothyronine levels were very high (range, 132 to 605 ng per 100 ml) at 15 to 30 weeks, but decreased substantially (range, 54 to 130 ng per 100 ml) thereafter. Thyrotropin was undetectable. The mean thyroxine and 3,3',5-tri-iodothyronine levels in amniotic fluid were much lower and the mean 3,3'5'-tri-iodothyronine much higher than the corresponding values in maternal serum at both 15 to 19 and 36 to 42 weeks of pregnancy. Measuring thyroid hormones in amniotic fluid, especially 3,3',5'-tri-iodothyronine, may aid in the diagnosis of fetal thyroid dysfunction and in identification of pregnancies of less than 30 weeks' gestation.

Amniotic Fluid↗
PubMed1996

Apolipoprotein B metabolism in primary and secondary hyperlipidaemias.

Important advances in our understanding of apolipoprotein B100 metabolism have been made in the last year. Here we review a diverse group of studies designed to examine the underlying metabolic defects in primary hyperlipidaemia or to define the impact of diseases such as diabetes nephrotic syndrome and thyroid dysfunction on the metabolism of apoB-containing lipoproteins.

Apolipoproteins↗
PubMed2000

Thyroiditis induced by interferon in dialysis.

We describe a dialysis patient who acquired acute Hepatitis C infection. Her primary renal disease was systemic lupus erythromatosis. She was having goitre but clinically euthyroid and her thyroid function test was normal. To avoid long term complications of Hepatitis C we elected to treat her with Interferon 3 million units subcutaneously 3 times a week. During treatment she developed some transient side effects initially which subsided but later she felt pressure symptoms around her neck. When we checked her TSH and thyroid antibodies these were elevated. Though this could be related to HCV, rarely, but we think the thyroid change is mostly related to Interferon. Some possible explanation of the effect of Interferon on thyroid have been reviewed and we think patients getting such drugs should be under close monitoring to avoid permanent thyroid dysfunction.

Acute Disease↗