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PubMed1993

Altered muscle sympathetic nerve activity in hyperthyroidism and hypothyroidism.

To determine whether sympathetic nerve activity is altered in hyperthyroidism and hypothyroidism we microneurographically measured muscle sympathetic nerve activity in patients with these thyroid dysfunctions and compared the results with those of normal controls. Patients with hyperthyroidism tended to have less muscle sympathetic nerve activity than normal controls, and patients with hypothyroidism had significantly greater muscle sympathetic nerve activity than normal controls (P < 0.05). In all subjects, there was a significantly negative-correlation between the serum concentration of free triiodothyronine or free thyroxine and muscle sympathetic nerve activity, and there was a significantly positive correlation between the serum concentration of thyroid-stimulating hormone and the muscle sympathetic nerve activity. These results suggest an inverse relationship between thyroid function and sympathetic nerve activity.

Adult↗
PubMed1992

Thyroid function 10-18 years after mantle field irradiation for Hodgkin's disease.

Thyroid function was measured in 81 patients who had been curatively irradiated on a mantle field for Hodgkin's disease 10-18 years ago. 47 patients (58%) had elevated levels of thyroid stimulating hormone, indicating hypofunction of the thyroid gland, compared with 4.6% of controls (hospital visitors) matched for age and sex. The mean free thyroxine index (FTI) was significantly lower in patients than in controls, but all FTI values were still normal. Age at the time of irradiation, sex, time since irradiation and administration of chemotherapy were not significant factors in the development of thyroid dysfunction. A life-long awareness of the possibility of insidiously developing myxedema in these patients is strongly advocated.

Adult↗
PubMed2003

[Clinical and radiological features and clinical course of orbital myositis].

Orbital myositis is idiopathic inflammation of the extraocular muscles in the absence of thyroid orbitopathy and often is included under broad description pseudotumor. We report here a series of three cases. Data from literature, combined with our own results yield a distinguishing pattern of orbital myositis suggesting that the term "orbital pseudotumor" is no longer a useful concept. The diagnostic criteria purposed here are: acute orbital pain exacerbated on eye movement; enlargement of one or more extraocular muscles with the respect of other orbital structures on muscle CT scan; absence of clinical and biological thyroid dysfunction: absence of signs of anterior uveitis or scleritis or visual decrease; rapid response to immunomodulator treatment.

Adult↗
PubMed1990

How common is postpartum thyroiditis? A methodologic overview of the literature.

The incidence of postpartum thyroiditis (PPT) in the general population has been reported to range from 1.9% to 16.7%, depending on the study. To determine whether bias may have played a role in the generation of these widely varying estimates, a set of methodologic criteria were applied to the published original research dealing with the epidemiology of PPT. The articles that passed these methodologic filters reported a narrow range of incidences of PPT, varying between 3.7% and 5.9%. Reanalysis of these articles confirmed that thyrotoxicosis occurred more frequently in the first 3 months post partum than did hypothyroidism, and that a positive antimicrosomal antibody titer was strongly associated with postpartum thyroid dysfunction (odds ratio, 86.6; 95% confidence interval, 45.9 to 163.2). This article suggests that PPT is a common condition that occurs in the postpartum period. The best estimate of the incidence of PPT in an unselected cohort of postpartum women is 4.9%.

Autoantibodies↗
PubMed1994

Prevalence of abnormal thyrotropin concentrations measured by a sensitive assay in patients with type 2 diabetes mellitus.

The utilisation of assays for TSH with improved sensitivity has revealed that abnormal TSH results are frequently observed in patients with nonthyroidal illnesses, such as trauma, renal diseases, liver diseases or sepsis. The aim of this study was to investigate the prevalence of abnormal TSH concentrations, using a sensitive immunometric assay, in patients with type 2 (non-insulin-dependent) diabetes mellitus. The study population consisted of 290 type 2 diabetics, 159 females and 131 males aged 40 to 93 years (mean 60.6 +/- 11.9 years), hospitalised because of poor diabetic control or recent-onset diabetes (mean HbA1c value = 9.6 +/- 2.2%). All patients with TSH values outside the normal range (0.45 to 3.66 mlU/l) had FT4 assay and thyroid microsomal autoantibody assay performed on the same specimen of serum. Abnormal TSH concentrations were detected in 91 patients (31.4%). Subclinical hypothyroidism (high TSH, normal FT4) was most common (48.3%), followed by subclinical hyperthyroidism (low TSH, normal FT4) (24.2%) and by definite hypothyroidism (high TSH, low FT4) (23.1%). Definite hyperthyroidism (low TSH, raised FT4) was found in 4 patients (4.4%). None of the patients with low TSH values had increased FT3 concentrations. The prevalence of abnormal thyroid function test results was significantly higher in the female than in the male patients (40.9% vs. 19.8%, p < 0.0005) and in the insulin-treated patients than in those receiving oral hypoglycaemic agents (OHA) (37.3% vs. 23.1%, p < 0.02). Thirty patients with abnormal thyroid function test results (33.0%) had evidence of thyroid autoimmunity (titre of thyroid microsomal autoantibodies > 250 IU/l). Five thyroid microsomal antibody-negative patients had non-autoimmune thyroid diseases, 7 had nonthyroidal illnesses other than diabetes mellitus and 4 were receiving drugs known to affect the hypothalamic-pituitary-thyroid axis. Twenty-seven thyroid microsomal auto-antibody-negative patients with abnormal TSH values (17 with subclinical hypothyroidism and 10 with subclinical hyperthyroidism), who were not receiving drugs known to affect TSH secretion and were free of diseases other than diabetes mellitus, were retested after two months of adequate treatment of diabetes with OHA or insulin. TSH concentrations decreased in all but one patient with initial subclinical hypothyroidism and increased in all patients with initial subclinical hyperthyroidism. These changes were coupled with a significant fall of glycated haemoglobin values. In view of the transient changes in TSH secretion, we suggest that the diagnosis of thyroid dysfunction in type 2 diabetics should be delayed until improvement of the metabolic status.

Adult↗
PubMed1995

Primary hypothyroidism as a consequence of 131-I-metaiodobenzylguanidine treatment for children with neuroblastoma.

BACKGROUND: 131-I-metaiodobenzylguanidine is a radioiodinated compound selectively concentrated by cells of neuroectodermal origin, including neuroblastoma cells, for this reason it may represent a promising treatment modality for neuroblastoma in childhood. Although a potential side effect of 131-I-MIBG administration is thyroid dysfunction, relatively few data are reported about this issue. METHODS: A series of 14 long term surviving patients with neuroblastoma who had been treated with 131-I-MIBG courses ranging from 2.5 to 5.5 gigabecquerels after surgical and conventional pharmacologic therapy is reported. RESULTS: Twelve patients developed primary hypothyroidism that was clinically overt in 8 patients and compensated in 4 patients within 6-12 months of completion of 131-I-MIBG administration. Only in two patients was thyroid function spared. Significant correlations between the cumulative dose of 131-I-MIBG and the degree of thyroid failure were not found. CONCLUSIONS: Primary hypothyroidism appears to be a common side effect in children with neuroblastoma treated with 131-I-MIBG. This finding suggests that methods to preserve thyroid function other than oral administration of iodide should be sought.

3-Iodobenzylguanidine↗
PubMed2000

Coexistent insulin dependent diabetes mellitus and hyperthyroidism in a patient with Down's syndrome.

The prevalence of thyroid disease is increased in Down's syndrome. Compared with adults, thyroid dysfunction in children with Down's syndrome is less frequently reported. Insulin dependent diabetes mellitus is also uncommon in Down's syndrome children. Coexistent insulin dependent diabetes mellitus and hyperthyroidism in Down's syndrome was only reported once previously in literature. We report an 8-year-old girl with Down's syndrome that had polyuria, polydipsia, abdominal pain and urinary incontinence one and half a month prior to admission. Physical examination revealed typical face of Mongolism and tachycardia. Thyroid glands were not palpable. Laboratory data revealed diabetic ketoacidosis with plasma glucose: 860 mg/dl. She had thyroid hyperfunction with TSH: < 0.1 microU/ml, T3: 219.7 ng/dl, T4: 15 micrograms/dl. Thyroid autoimmune antibodies were also increased. There was markedly increased radiotracer uptake in the bilateral thyroid glands in Tc-99 thyroid scan. We suggest that Down's syndrome children with insulin dependent diabetes mellitus should be evaluated carefully for thyroid function and autoimmune disease.

Child↗
PubMed1984

Gastrointestinal transit in thyroid disease.

Diarrhea and malabsorption are common manifestations of hyperthyroidism, whereas constipation or obstipation frequently occur in hypothyroidism. Abnormalities of gastrointestinal motility have been proposed as the primary cause of these complaints, but documentation has been conflicting and largely limited to observations of the transit time of a barium meal. We studied gastrointestinal transit time in fasting patients with thyroid dysfunction using the pulmonary excretion of H2 after the ingestion of a nonabsorbable carbohydrate, lactulose, as an indicator of the rate of transit to the colon. Mean transit time of 10 hyperthyroid patients (29 +/- 4.0 min) was significantly less than that of 42 healthy controls (72 +/- 3.7 min, p less than 0.001), and of 6 hyperthyroid patients when they became hypothyroid after treatment (80 +/- 11.0 min, p less than 0.05). Transit time decreased significantly when hypothyroid patients were given thyroid replacement (p less than 0.01). These findings support the hypothesis that abnormal gut motility may be the primary cause of the diarrhea and malabsorption of hyperthyroidism, and the constipation and obstipation commonly seen in hypothyroidism.

Adult↗
PubMed2003

Effect of hypothyroidism on hormone profiles in virgin, pregnant and lactating rats, and on lactation.

Thyroid dysfunctions can produce reproductive problems. Untreated maternal hypothyroidism has serious consequences on development of offspring, resulting in stunted growth and mental retardation. The effects of propylthiouracyl-induced hypothyroidism (0.1 g l(-1) in drinking water starting 8 days before mating, or given to virgin rats for 30 or 50 days) on the serum profiles of hormones related to reproduction and mammary function (prolactin, growth hormone (GH), progesterone, corticosterone, oestradiol, insulin-like growth factor I (IGF-I), thyroid-stimulating hormone (TSH), triiodothyronine and tetraiodothyronine), and on mammary function in virgin, pregnant and lactating rats, were investigated. Propylthiouracyl treatment severely decreased circulating triiodothyronine and tetraiodothyronine concentrations, and increased serum TSH concentrations. Virgin rats showed prolonged periods of vaginal dioestrus, increased circulating progesterone concentrations and afternoon peaks of prolactin concentration, which are indicative of prolactin-induced pseudopregnancy. Propylthiouracyl-treated virgin rats had mammary development comparable to that of midpregnancy, and half of these rats had increased mammary casein and lactose concentrations. Serum prolactin concentrations were decreased on the afternoon of day 5 of pregnancy, increased during late pregnancy (days 15-21) and were normal during lactation. Circulating GH concentrations decreased on days 15-21 of pregnancy, whereas progesterone concentrations increased during late pregnancy and early lactation. Circulating oestradiol (measured in late pregnancy and in virgin rats), IGF-I and corticosterone concentrations were decreased. Although assessment of mammary histology showed no differences in extent of development, casein content was increased in propylthiouracyl-treated rats on day 21 of pregnancy; litter growth was severely reduced and at day 20 of age the pups were hypothyroid, with decreased GH serum concentrations. An acute suckling experiment was performed on days 10-12 of lactation to determine whether some impairment in mammary function or the suckling reflex might account for these differences. After an 8 h separation of mothers from their litters and 30 min of suckling, circulating prolactin values were not affected by propylthiouracyl treatment, but serum oxytocin concentration and milk excretion were reduced. In conclusion, hypothyroidism induces various alterations in the hormone profiles of virgin and pregnant rats, and induces pseudopregnancies and mammary development in virgin rats. These alterations do not appear to have an overt impact on the outcome of pregnancy and on mammary function during lactation, with the exception of the milk ejection reflex, which may account at least partially for the reduced litter growth.

Animals↗
PubMed1996

[Natural history of dysthyroidism during interferon treatment of chronic hepatitis C].

Thyroid dysfunction developed in 35 patients among a series of 300 (190 men and 110 women) treated with alpha-interferon (35/300 = 12%. No relationship was observed between the type of alpha-interferon, the dose, or hepatic response, but there were more women (24/35). Antithyroid antibody levels were frequently elevated before treatment (8/35, 23%). Hypothyroidism developed in 27 patients, 7 with clinical hypothyroidism, 10 with moderate hypothyroidism and 5 with elevated TSH only. Patients with severe symptoms and highly elevated thyroid antibodies were more prone to develop sustained or irreversible hypothyroidism (10 patients). Twelve patients recovered a normal thyroid function within a few months, but antibody levels fell more slowly. Primary hyperthyroidism of variable severity appeared in 13 patients. In 8 patients, normal thyroid function was recovered within a few weeks but thyroid antibodies remained high for at least one year. In 5 others spontaneous hypothyroidism occurred within a few weeks ("biphasic" hypothyroidism). Direct toxicity appears to be less probable than an autoimmune mechanism; elevated antithyroid antibodies were observed in only 20 patients (57%). In clinical practice, TSH levels should be regularly monitored during and after alpha-interferon therapy.

Adult↗
PubMed1980

Thyroid function studies. Test strategies and interpretation of results.

Biochemical tests for detection of thyroid dysfunction in persons without underlying systemic illness are highly effective. In fact, one or more of the following tests are sufficiently diagnostic to allow initiation of appropriate treatment: thyroxine (T4), free T4 index (FT4-I), thyrotropin (TSH), and triiodothyronine (T3). Only rarely is it necessary to measure free T4 concentration or perform a thyrotropin-releasing hormone (TRH) stimulation test. Patients with underlying illnesses, on the other hand, frequently exhibit unexpectedly abnormal test results depsite euthyroidism. Thus, if clinically feasible, thyroid function testing should be postponed in such patients.

Humans↗
PubMed2001

Biochemical investigation of foetal and neonatal thyroid function using the ACS-180SE analyser: clinical application.

Despite sonographic detection of foetal goitre, uncertainty persists in the initial diagnosis of thyrotoxicosis and hypothyroidism. The aim of this study was to establish foetal and neonatal iodothyronine and thyrotrophin reference values for the ACS-180SE analyser. From 22 to 36 weeks of gestation, median foetal serum free thyroxine (FT4) levels increased from 6.0 pmol/L to 143 pmol/L, while free tri-iodothyronine (FT3) levels increased from 0.7 pmol/L to 1.9 pmol/L and mean thyrotrophin (TSH) levels remained stable (10.2 +/- 3.8mU/L; n = 33). At birth, concentrations were independent of gender and gestational age. Among the 10 cases of sonographically detected foetal goitre, serum TSH and FT4 were measured in five, showing hypothyroidism (3/5) or hyperthyroidism (2/5). Cord blood TSH levels reflected the efficacy of prenatal therapy. Measurement of foetal FT4 and TSH can be used to confirm foetal thyroid dysfunction, whereas treatment efficacy can be assessed sonographically and confirmed by measurement of TSH assay at birth.

Female↗
PubMedDate not supplied

[Cytogenetic changes in peripheral blood lymphocytes in people with impaired thyroid status].

Increased counts of cells with chromosome aberrations were revealed in peripheral blood lymphocytes of subjects with thyroid dysfunction: 5.5 +/- 0.6% in hypothyrosis, 9.0 +/- 1.8% in hyperthyroidism, and 2.5 +/- 0.1% in controls (20 donors). The aberrations are mainly presented by paired and solitary fragments, rarely by chromatid translocations; in two patients with hyperthyroidism dicentrics were detected. Distribution of aberration types varied. In hypothyrosis chromosome aberrations were two times more incident than chromatid ones. In hyperthyroidism chromosome and chromatid aberrations were approximately equally incident. These results may be used to explain the causes of unfavorable outcomes of pregnancy in patients with thyroid diseases.

Cell Cycle↗
PubMed1981

Thyroid abnormalities associated with treatment of malignant lymphoma.

The effects on the thyroid of radiation therapy to the neck and/or chemotherapy were investigated in 54 Hodgkin's and 72 non-Hodgkin's lymphoma patients. These patients had received radiation therapy with doses ranging from 2000 to 4000 rad (median 3600 rad) to the cervical or mantle fields and/or multiple-agent chemotherapy following usual staging procedures. Palpable abnormalities of the thyroid were found in 15 patients. The patients with irradiation to the neck had a higher incidence of hypothyroidism than those patients treated with chemotherapy alone (31/74 vs. 8/52, P less than 0.001 for TSH and 10/74 vs. 1/52, P less than 0.025 for T4). A higher frequency of elevated serum TSH levels and antithyroid antibodies were also observed in patients receiving radiation therapy alone to the neck than in those receiving both radiation therapy and chemotherapy (19/33 vs. 12/41, P less than 0.025 for TSH and 16/33 vs. 7/41, p less than 0.01 for antibodies), suggesting that chemotherapy agents may reduce the thyroid dysfunction induced by irradiation. There was no difference in prevalence of elevated TSH levels following irradiation to the neck between patients in whom lymphangiogram was or was not performed (21/51 vs. 10/23).

Adult↗
PubMed1989

Effects of sex, thyro-parathyroidectomy, and light regime on levels and circadian rhythms of wheel-running in rats.

Intact and thyro-parathyroidectomized (TPX) Sprague-Dawley rats of both sexes were observed for 24 days under a 12:12 light:dark cycle (Entrainment), followed by 20 days in constant dim red light (Free-Run). Circadian periods and levels of wheel-running activity were examined. Intact females and TPX males were significantly more active and had significantly shorter free-running circadian periods than intact males, and the effects of TPX in females were different from those in males. Circadian periods in TPX females were slightly, but not significantly, shorter than in intact females, and activity levels in TPX females were nonsignificantly depressed relative to intact females. It was also found that day versus night activity levels differed more in TPX animals than in intact animals, especially during entrainment, suggesting that TPXs may be more sensitive to some effects of light. A number of possible explanations for the effects of TPX are considered, including changes in thyroid and calcitonin levels, interactions with gonadal hormones, and possible developmental effects of thyroid hormones on the circadian system. It is also possible that rhythm changes are secondary to alterations in activity levels. Human manic depressives reportedly have an unusually high incidence of thyroid, parathyroid, and calcium regulation abnormalities, display shortened circadian sleep-wake rhythms and abnormal levels of activity, and may also be hypersensitive to some effects of light; in addition, depression predominates in women, whereas mania predominates in men. The present results suggest that thyroid dysfunction could be partially responsible for the some of these abnormalities, and for sex differences in the manifestations of these disorders.

Animals↗
PubMed2002

Treatment of acromegaly improves myocardial abnormalities.

BACKGROUND: Treatment for acromegaly decreases left ventricular (LV) mass, but it is not clear whether diastolic dysfunction is also reversible. With Doppler echocardiography, before and after effective therapy, we assessed the LV morphology and function of patients with acromegaly who were free of complications. METHODS: In 15 patients with active acromegaly (age range, 33.4 +/- 9.3 years), we compared LV Doppler echocardiographic indices, before and after transsphenoidal surgery or radiotherapy or before and after both procedures, noting a significant drop in plasma levels of growth hormone (<2.0 ng/mL after oral glucose tolerance testing). Patients did not have arterial hypertension, diabetes mellitus, thyroid dysfunction, or coronary artery disease. Occasionally, in this series, patients had no symptoms of heart failure, and patients who underwent treatment with somatostatin analog drugs were not included because they did not have a significant hormonal drop. The follow-up period after hormonal control was 2.7 +/- 1.7 years. We also studied 15 healthy control subjects matched for age, sex, and body surface area. RESULTS: Patients with acromegaly compared with healthy control subjects had increased LV mass index, relative wall thickness, and deteriorated diastolic function. After therapy, most of the abnormalities improved: LV mass index (104 +/- 21 g/m(2) x 87 +/- 21 g/m(2); P <.01), LV relative wall thickness (0.40 +/- 0.06 x 0.35 +/- 0.04; P <.01), proto/telediastolic transmitral peak flow velocity ratio (1.17 +/- 0.33 x 1.49 +/- 0.34; P <.001), and isovolumetric relaxation period (126 +/- 18 ms x 113 +/- 13 ms; P <.05). CONCLUSION: Treatment of acromegaly in patients without clinical heart failure improves both LV morphology and diastolic function. Avoidance of progression to more advanced forms of acromegalic cardiomyopathy should be possible.

Acromegaly↗
PubMed1997

Clinical significance of thyrotropin-binding inhibitor immunoglobulin levels in newborns and their mothers.

We investigated whether determination of thyrotropin-binding inhibitor immunoglobulin (TBII) indices in newborns with hyperthyrotropinemia on neonatal screening, or those born to mothers with autoimmune thyroid diseases, and their mothers could predict the newborns' thyroid status. We selected 195 babies born between 1988 and 1996. TBII indices in the sera of these newborns and their mothers were tested at some time from Day 1 to Day 30 after birth, and followed up after that. The subjects were divided into four groups according to the TBII index. Group 1 consisted of 17 pairs of mothers and newborns who both had serum TBII indices greater than or equal to 15%, including four transiently hyperthyroid and 13 transiently hypothyroid newborns. Group 2 comprised 166 pairs who both had a TBII index less than 15%, including one euthyroid and 165 hypothyroid newborns. Eight of the 165 warranted permanent thyroxine therapy due to athyreosis or ectopic thyroid gland. Group 3 consisted of one pair in which the newborn's serum TBII index was 15% or higher but the mother's was less than 15%: the newborn was transiently hypothyroid. Group 4 comprised 11 pairs in which the newborns' serum TBII indices were greater than or equal to 15% but the mothers' were less than 15%. These 11 newborns were all transiently hypothyroid and nine of them warranted transient thyroxine replacement therapy. The results suggest that the long-term outcome of newborns is good when TBII indices are at least 15% in the mother and child because their thyroid dysfunction seems to be related to the transient presence of the transplacental TBII from the mother. When TBII indices in both mother and child are less than 15%, the newborns warrant further investigation due to the likelihood of permanent hypothyroidism.

Autoantibodies↗
PubMed2005

Oxidants, antioxidants in physical exercise and relation to thyroid function.

Intensive muscular exercise promotes the production of reactive oxygen species (ROS) in the working muscles and can impair athletic performance, particularly in conjunction with inadequate recovery. Mammals are protected against oxygen toxicity by a system of ROS scavengers composed of enzymatic and non-enzymatic components. Although antioxidant supplementation has recently been considered as a means to diminish or prevent damage from ROS, the specific antioxidant requirements of athletes are not known. Since thyroid function is essential for athletic performance, thyroid control should be undertaken in cases where there is any sign of thyroid dysfunction "of unknown etiology". Hyperthyroidism and hypothyroidism have been associated with increased production of ROS as well as related inflammatory response and myopathy. There is evidence that antioxidant supplementation combined with antithyroid treatment with methimazole could be useful in decreasing the oxidative stress.

Animals↗