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At least 19 recordsLinked to original sources
PubMed1976

[The hypophyseal TSH reserve in surgical patients with bland goiter and recurrent goiter].

Serum-T4, -T3, FTI, basal TSH and TRH-induced TSH response were measured in 80 patients with simple nontoxic goiter and in 24 patients with nontoxic recurrent goiter in a surgical unit. 55 of the 80 patients with simple goiter and 11 patients with recurrent goiter had normal individual TSH values. Mean FTI and serum T3 were not statistically different from age and sex related normal values, except serum-T3, which was above normal in elderly goiter patients. The incidence of elevated TSH reserve (preclinical hypothyroidism) was significantly higher (p less than 0.0005) in recurrent than in simple goiter (10 of 24 vs. 8 of 80 patients). Simple goiter aptients with preclinical hypothyroidism had a lower-than-normal mean serum T4 level, whereas mean serum T4 and T3 concentrations were higher than normal in preclinically hypothyroid recurrent goiter patients. In these subjects raised TSH values and goitrogenesis possibly may be related to lower sensitivity of the pituitary to thyroid hormones. 17 simple goiter patients and 3 recurrent goiter patients with normal circulating serum T4 and T3 levels showed no response to TSH to TRH. This suprising finding is related to preclinical hyperthyroidism on the basis of autonomously functioning thyroid compartments. In 12 tested patients TRH responsiveness recovered following goiter resection. The mean T3 response to TRH in goiter patients with normal or elevated TSH reserve was subnormal. This indicates that thyroid reserve is potentially decreased even in goiter patients whose thyroid function was, on the evidence of normal TSH values, actually appropriate.

Adult↗
PubMed1986

Goiter size and thyroid function in an endemic goiter area in northern Italy.

Thyroid function was studied in a large number of subjects residing in Varsi, a town in the province of Parma, Italy. In this area, endemic goiter associated with moderate iodine deficiency [59 +/- 3 (+/- SE) microgram iodine/g creatinine], as defined by WHO criteria, affects 65% of the population. Serum T4, T3, thyroglobulin (Tg), and TSH concentrations were measured by RIA in 1218 subjects. The TSH response to TRH was determined in 108 subjects selected randomly from the groups with different grades of goiter. No significant change in serum T4 concentrations was found in subjects with different grades of goiter. Serum T3 concentrations were higher in subjects with the larger goiters. Serum Tg concentration progressively increased, and serum TSH progressively decreased with increasing goiter size. The TSH response to TRH was diminished in subjects with larger goiters. The findings of decreasing serum TSH concentrations and blunted TSH responses to TRH as goiter size increased suggest the possibility of autonomous thyroid function in the larger goiters in subjects residing in this area of moderate iodine deficiency.

Adolescent↗
PubMed1987

Effect of therapy on the serum thyroglobulin concentration in patients with toxic diffuse goiter, toxic nodular goiter and toxic adenoma.

Serum thyroglobulin (S-Tg) was measured in 104 patients with thyrotoxicosis, 59 of whom had toxic diffuse goiter (Graves' disease), in 30 with toxic nodular goiter and in 15 with toxic adenoma. Before treatment, most patients had increased S-Tg concentrations, regardless of what type of thyrotoxicosis they had. After therapy the course of the S-Tg varied, two major patterns being observed: the S-Tg concentration increased in some patients but decreased in others, although no relationship could be found between these patterns and the outcome of therapy, the presence or absence of thyroglobulin antibodies (Tg-ab) or changes in the Tg-ab titer. However, the median pretreatment concentrations of S-Tg were significantly higher in patients with toxic nodular goiter and toxic adenoma than in those with toxic diffuse goiter (p less than 0.001 and p less than 0.05, respectively), but did not differ significantly between patients with toxic nodular goiter and toxic adenoma. The lowest posttreatment S-Tg concentrations were found after surgery, irrespective of type of thyrotoxicosis. The median pretreatment and posttreatment S-Tg concentrations in patients with toxic diffuse goiter who relapsed, did not differ from those patients in remission. This was also true of patients with toxic nodular goiter. In both groups, however, there was a tendency towards higher pretreatment S-Tg values in patients who subsequently relapsed. Serial determinations of S-Tg, on the other hand, are of limited value in predicting the risk of recurrence, independent of which type of thyrotoxicosis is involved.

Adolescent↗
PubMed1986

Increased serum thyroglobulin concentrations and impaired thyrotropin response to thyrotropin-releasing hormone in euthyroid subjects with endemic goiter in Sicily: their relation to goiter size and nodularity.

Serum thyroglobulin (Tg), T4, T3, FT4, FT3, TSH concentrations and TSH response to iv TRH (delta TSH) were measured in 56 consecutive patients with (multi) nodular goiter from a severely iodine-deficient endemic goiter area in Northeastern Sicily and in 11 non goitrous euthyroid individuals living in the same area. Serum Tg concentrations were sharply increased in goitrous subjects (453 +/- 476 ng/ml) and related to thyroid size and the presence of nodules (chi 2 = 43.5, p less than 0.0005). Serum TSH levels measured in goitrous patients (2.1 +/- 0.9 microU/ml) were significantly lower than those measured in nongoitrous iodine deficient subjects (3.1 +/- 0.9 microU/ml, p less than 0.001) and decreased with increasing goiter size and nodularity (chi 2 = 27.3, p less than 0.05). A similar pattern was shown by the analysis of the delta TSH (chi 2 = 43.1, p less than 0.0005). These results suggest that at least a part of the largest and multinodular goiters become autonomously functioning with duration and growing in size. In 13 goitrous patients with absent or impaired response to TRH, a significant direct relation was apparent between log-Tg and goiter size and nodularity (r = 0.64) with an inverse relationship between serum FT3 and delta TSH (r = 0.73). A computed program analysis based on the combination of different independent variables (x) including age, thyroid size and nodularity, serum TSH, log-Tg and FT3, indicated the existence of a significant negative relationship between these variables and the TSH response to TRH (r = 0.75, p = 0).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Serum thyroglobulin is elevated in patients with heterogeneous goiter during radioiodide scintigraphy, but normal in those with homogeneous goiter].

Serum thyroglobulin (Tg) levels were determined in 98 biologically euthyroid patients with a diffuse or nodular goiter, and compared to values observed in 33 control subjects. Based on the results of clinical examination and thyroid scanning with radioiodine, patients were divided into 3 groups: group 1 with homogeneous diffuse goiters, group 2 with heterogeneous diffuse goiters without palpable nodules, and group 3 with solitary hypofunctioning nodules. The control group had a mean Tg of 37 +/- 15 micrograms/l. Group 1 (n = 32) had a mean Tg of 46 +/- 28 micrograms/l; six (19%) had an elevated Tg level (level greater than 74 micrograms/l). Group 2 (n = 30) had a mean Tg of 133 +/- 134 micrograms/l; fourteen (47%) had an elevated Tg level. Group 3 (n = 36) had a mean Tg of 188 +/- 191 micrograms/l; twenty (56%) had an elevated Tg level. The comparison of Tg between patient groups, and between patients groups and the control group, showed a significantly higher value in the groups of hypofunctioning nodules and heterogeneous diffuse goiters. It is concluded that the elevated serum Tg level in patients with a diffuse or nodular simple goiter is commonly associated with heterogeneity of the thyroid scan.

Adolescent↗
PubMed1986

Standard dose 131I therapy for toxic multinodular goiter in an endemic goiter region.

1. The effect of the standard 15 mCi dose of 131I on the thyroid function of 25 patients from an endemic goiter region with toxic multinodular goiter of different sizes was determined. 2. The patients were followed for 1 to 5 years and 7 months (mean: 2 years and 10 months). Eighteen patients were treated with the antithyroid drugs propylthiouracil or methimazole before 131I and seven only received 131I. 3. All but three patients achieved euthyroidism after a single dose of 131I. Two patients in the antithyroid treatment group became hypothyroid 2 months and 2 years after the isotope therapy, respectively. Pretreatment with antithyroid drugs did not significantly modify the effectiveness of 131I treatment. 4. This simplified dose regimen of 131I was effective in the treatment of hyperthyroidism caused by multinodular goiter in an endemic region, and the efficacy was independent of the size of the goiter.

Adult↗
PubMed1987

Management of goiter and thyroid nodules in an area of endemic goiter.

This article discusses the diagnostic and therapeutic measures we have used during the past five years to treat 861 patients from an edemic goiter area with various thyroid disorders. The similarities and differences between these patients, with nontoxic goiter, toxic goiter, and thyroid cancer, were compared with those seen in patients with thyroid problems who live in iodine-rich areas.

Disease Reservoirs↗
PubMedDate not supplied

[Physiological basis of goiter transformation of the thyroid gland and the pathogenesis of euthyroid goiter].

Endemic goiter disease develops as a result of iodine insufficiency in the environment, that induces advancing reproduction of thyrocytes realized by endomitosis. Eventually goiter-transformed gland ceases responding to the lack of iodine in the environment, that is due to the destruction of thyrocyte ++thyroreceptors. It should be taken into account that goiter disease depends upon the female sexual hormones.

Cell Division↗
PubMed1976

[Single weekly doses of 1 mg 1-thyroxine for the treatment of mild goiter and for the prevention of recurrence after goiter surgery].

The possibility of using weekly single doses of 1 mg l-thyroxine for treatment of euthyroid goiters and for prophylaxis against recurrence after thyroidectomies was studied in a series of 37 patients. The treatment was continued over a period of about 3 months. Before therapy and during therapy T 4, T 3 und ETR values were determined, and TSH in plasma was assayed under TRH stimulation. 131I-24 hour-uptakes and thyroid weight were followed, together with scintigraphic studies. X-ray films of the trachea were done prior to and after therapy, and eventual side effects of the prescribed therapy were noted. Results show a significant rise in T 4 and ETR values, which however, remained in the normal range. T 3 levels did not change. 131I uptake figures were kept as low as 18 per cent of the given dose and the TSH response to TRH was markedly decreased. Non toxic goiters showed a slight decrease in weight, while thyroid remnants after thyroidectomy did not increase in size. In some patients subjective symptoms improved considerably under the given therapy. 4 of our patients showed transient signs of thyrotoxicosis factitia during the first 1 to 2 days after taking 1 mg of l-thyroxine, so that a modification of the treatment--2X500 mcg/week--might be advisable. The overall effect of this form of treatment is considered as about equivalent to others forms of thyroid hormone therapy.

Goiter↗
PubMed1976

[Secretion of TSH and stimulation-ability of the hypophysis after long-term suppression therapy in euthyroid nodular goiter and residual thyroid gland after subtotal resection of goiter].

In 51 patients, 33 with euthyroid goiter and 18 after subtotal thyroidectomy, plasma concentrations of T4, T3, and TSH before and after stimulation with TRF were determined under long term suppression with thyroid hormone and 1,2, and 4 weeks after stopping it. Even after complete suppression (delta TSH less than 0, 5 muU/ml) resumption of TSH secretion occurred within 4 weeks in all but two. A significantly higher increase of TSH and somewhat lower thyroid-hormone concentrations turned out in operated patients. An excessive decrease of T3 (and T4) concentrations within the 1st (and 2nd) week after therapy, dependent on the degree of previous TSH suppression, could be due to transitory thyrotropic insufficiency.

Goiter, Nodular↗