Syndrome of persisting thyroid stimulating immunoglobulins and growth promotion of goiter combined with low thyroxine and high triiodothyronine serum levels in drug treated Graves’ disease

1983 ◽  
Vol 6 (5) ◽  
pp. 389-394 ◽  
Author(s):  
K. W. Wenzel ◽  
J. R. Lente
Keyword(s):  
Growth Promotion ◽  
Serum Levels ◽  
Graves Disease ◽  
Thyroid Stimulating Immunoglobulins

Thyroid Stimulating Immunoglobulins: Measurement and Clinical use

1985 ◽  
Vol 69 (2) ◽  
pp. 113-121 ◽  
Author(s):  
C. A. Ollis ◽  
S. Tomlinson ◽  
D. S. Munro
Keyword(s):  
Thyroid Hormones ◽  
Elevated Serum ◽  
Serum Levels ◽  
The Other ◽  
Graves Disease ◽  
Clinical Use ◽  
Hormone Production ◽  
Skin Changes ◽  
Thyroid Stimulating Immunoglobulins ◽  
Eye Involvement

Graves’ disease is the commonest form of hyperthyroidism in which excessive production of thyroid hormones by the hyperplastic overactive thyroid gland produces elevated serum levels of the thyroid hormones tri-iodothyronine (T3) and thyroxine (T4). Many of the manifestations of Graves’ disease, increased basal metabolic rate, increased heart rate, heat intolerance, sweating and nervousness, can be attributed to the peripheral actions of the excess thyroid hormones. The pathogenesis of many of the other dramatic features of Graves’ disease, such as the eye involvement or localized skin changes, is not fully understood, but circulating immunoglobulins with thyroid stimulating activity are almost certainly linked to excess thyroid hormone production and thereby cause the hyperthyroidism.

scholarly journals Fetal Tachycardia Treated Successfully with Maternally Administered Propylthiouracil

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Barbara V. Parilla ◽  
Farhan Hanif ◽  
Keren Hasbani ◽  
Thomas Iannucci
Keyword(s):  
Normal Sinus Rhythm ◽  
Clinical Signs ◽  
Serum Levels ◽  
Graves Disease ◽  
Transplacental Passage ◽  
Normal Sinus ◽  
Thyroid Stimulating Immunoglobulins ◽  
History Of ◽  
Maternal Thyroid ◽  
Fetal Tachycardia

Background. Fetal tachycardia may result from the transplacental passage of thyroid stimulating immunoglobulins in a patient with hypothyroidism secondary to ablation of Graves’ disease.Case. A 32-year-old woman, gravida 4, para 2, and abortus 1, with hypothyroidism and a history of Graves’ disease, presented at 23 6/7 weeks of gestation with a persistent fetal tachycardia. The treatment of the fetal tachycardia with maternally administered digoxin and Sotalol was unsuccessful. Maternal thyroid stimulating immunoglobulins were elevated, and treatment with maternally administered propylthiouracil (PTU) resulted in a normal sinus rhythm for the remainder of the pregnancy. An induction of labor was performed at 37 weeks. Four to five days after delivery, the neonate exhibited clinical signs of hyperthyroidism necessitating treatment.Conclusion. Fetal tachycardia resulting from the transplacental passage of thyroid stimulating immunoglobulins can be successfully treated with maternally administered PTU. The neonate needs to be followed up closely as clinical signs of hyperthyroidism may occur as thyroid stimulating immunoglobulins continue to circulate in the neonate, while the serum levels of PTU decline.

The Effect of Immunosuppression on Selected Antioxidant Parameters in Patients with Graves’ Disease with Active Thyroid-Associated Orbitopathy

2020 ◽  
Author(s):  
Magdalena Londzin-Olesik ◽  
Beata Kos-Kudla ◽  
Jacek Karpe ◽  
Aleksandra Nowak ◽  
Mariusz Nowak
Keyword(s):  
Oxidative Stress ◽  
Clinical Symptoms ◽  
Immunosuppressive Treatment ◽  
Serum Vitamin ◽  
Serum Levels ◽  
Paraoxonase 1 ◽  
Control Group ◽  
Graves Disease ◽  
Methylprednisolone Treatment ◽  
Antioxidant Parameters

Abstract Background and Study Aims Thyroid-associated orbitopathy, the most common extrathyroidal manifestation of Graves’ disease, is an autoimmune inflammation of orbital soft tissue. We report the study assessing the effect of immunosuppressive treatment with methylprednisolone on selected antioxidant parameters in patients with Graves’ disease with active thyroid-associated orbitopathy. Patients and Methods Activity and serum levels of selected antioxidant parameters as well as lipid peroxidation products were determined in a group of 56 patients with active thyroid-associated orbitopathy at three time-points: at baseline, after the discontinuation of intravenous methylprednisolone treatment and at 3 months after the discontinuation of additional oral methylprednisolone treatment. A control group consisted of 20 healthy age- and sex-matched volunteers. Results We found an increased activity of superoxide dismutase and glutathione peroxidase and increased serum levels of uric acid, malondialdehyde and conjugated dienes, as well as a reduced activity of paraoxonase-1 and reduced serum vitamin C level in the study group at baseline. Systemic intravenous and oral methylprednisolone therapy led to normalization of activity and concentration of the most studied parameters. Conclusion Results of our study confirmed that oxidative stress is one of the factors involved in the pathogenesis of thyroid-associated orbitopathy and the methyloprednisolone treatment is effective in reducing both clinical symptoms and oxidative stress in patients with this disease.

scholarly journals Prognostic Value ofTc99m-Pertechnetate Thyroid Scintigraphy in Radioiodine Therapy in a Cohort of Chinese Graves’ Disease Patients: A Pilot Clinical Study

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Haifeng Hou ◽  
Shu Hu ◽  
Rong Fan ◽  
Wen Sun ◽  
Xiaofei Zhang ◽  
...  
Keyword(s):  
Single Dose ◽  
Prognostic Value ◽  
Low Dose ◽  
Radioiodine Therapy ◽  
Treatment Success ◽  
Serum Levels ◽  
Graves Disease ◽  
Thyroid Scintigraphy ◽  
Thyroid Mass ◽  
Pilot Clinical Study

Objectives. This study is to assess the prognostic value ofTc99m-pertechnetate thyroid scintigraphy for predicting the outcomes of fixed low dose of radioiodine therapy (RIT) in a cohort of Chinese Graves’ disease (GD) patients.Materials and Methods. This is a retrospective study of GD patients who received RIT with a single dose of radioiodine (5 mCi). All the patients receivedTc99m-pertechnetate thyroid scintigraphy prior to RIT. Thyroid mass,Tc99m-pertechnetate uptake, gender, age at diagnosis, duration of the disease, ophthalmopathy, and serum levels of FT4, FT3, TT4, and TT3 prior to RIT were analyzed as potential interference factors for outcomes of RIT.Results. One hundred and eighteen GD patients who completed RIT were followed up for 12 months. The outcomes (euthyroidism, hypothyroidism, and hyperthyroidism) were found to be significantly associated with thyroid mass andTc99m-pertechnetate uptake. Patients with thyroid mass ≤ 40.1 g orTc99m-pertechnetate uptake ≤ 15.2% had higher treatment success.Conclusions. A fixed low dose of 5 mCi radioiodine seems to be practical and effective for the treatment of Chinese GD patients with thyroid mass ≤ 40.1 g andTc99m-pertechnetate uptake ≤ 15.2%. This study demonstratesTc99m-pertechnetate thyroid scintigraphy is an important prognostic factor for predicting the outcomes of RIT.

scholarly journals MASSIVE THYMIC HYPERPLASIA SECONDARY TO GRAVES DISEASE

2020 ◽  
Vol 6 (3) ◽  
pp. e144-e146
Author(s):  
WingYee Wan ◽  
Jeffrey A. Colburn
Keyword(s):  
Computed Tomography ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Thymic Hyperplasia ◽  
Anterior Mediastinal Mass ◽  
Graves Disease ◽  
Presenting Symptoms ◽  
Thyroid Stimulating Immunoglobulins ◽  
Computed Tomography Angiogram ◽  
Stimulating Hormone

Objective: Graves disease (GD) has a well-known association with thymic hyperplasia, which is seen histo-logically in up to 38% of patients with GD. However, there have only been approximately 100 documented cases of Graves-associated massive thymic hyperplasia. Potential mechanisms of thymic pathology are reviewed. Methods: A 24-year-old female presented to the emergency department with dyspnea, palpitations, tachycardia, anxiety, and weight loss. She was evaluated for hyperthyroidism using labs (thyroid-stimulating hormone, free thyroxine, thyroid-stimulating immunoglobulins) and imaging (radioactive iodine uptake [RAIU] scan), leading to treatment with radioiodine. A computed tomography angiogram of the chest was also performed to evaluate for pulmonary embolism given the patient's presenting symptoms. Results: Our patient was found to have undetectable thyroid-stimulating hormone, elevated free thyroxine (2.9 ng/dL), and elevated thyroid-stimulating immunoglobulins (399%). Diagnosis of GD was confirmed on RAIU scan. The computed tomography chest angiogram demonstrated a significant anterior mediastinal mass (7.9 × 6.9 × 6.3 cm). Treatment with radioiodine led to reduction of the mass by 76% in volume. Conclusion: While the patient's thyroid labs and RAIU scan were consistent with GD, the presence of massive thymic hyperplasia was atypical. However, the resolution of thymic hyperplasia after radioiodine therapy, without the use of thymectomy, was similar to other reported cases.

A comparison of porcine and human thyroid tissue in the assay of thyroid stimulating immunoglobulins

1986 ◽  
Vol 113 (3) ◽  
pp. 335-339
Author(s):  
S. de Rave ◽  
H. M.J. Goldschmidt ◽  
Y. T.J. Somers-Pijnenburg ◽  
B. Bravenboer ◽  
J. H. M. Lockefeer
Keyword(s):  
Medical Treatment ◽  
Thyroid Tissue ◽  
Human Thyroid ◽  
Graves Disease ◽  
Clinical Use ◽  
Human Thyroid Tissue ◽  
Thyroid Stimulating Immunoglobulins ◽  
Camp Generation

Abstract. The central role of Thyroid Stimulating Immunoglobulins (TSI) in the pathogenesis of the hyperthyroidism of Graves' disease has become generally accepted and a wide variety of assays for the detection of these antibodies has been developed. The dependence on the availability of human thyroid tissue makes most of these assays unsuitable for routine clinical use, a problem circumvented by the use of nonhuman thyroid tissue in some TSI assays. We therefore compared porcine and human thyroid tissue in a TSI assay based on in vitro cAMP generation. No major differences in within and between run variation were found and, with some notable exceptions, a reasonable correlation could be demonstrated between the results in both assays (R = 0.89, P < 0.001). However, the sensitivity of the porcine TSI assay is only 60% of the estimated sensitivity of the human TSI assay. In spite of the practical advantages this porcine TSI assay, and possibly also other TSI assays using non-human thyroid tissue, cannot totally replace human TSI assays. The value of these assays in predicting the outcome of medical treatment of Graves' disease remains to be established.

Serum levels of interleukin 6 and tumor necrosis factor-α in hyperthyroid patients before and after propylthiouracil treatment

1995 ◽  
Vol 132 (6) ◽  
pp. 668-672 ◽  
Author(s):  
Ismail Çelik ◽  
Sema Akalin ◽  
Tomris Erbaş
Keyword(s):  
Tumor Necrosis Factor ◽  
Interleukin 6 ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Serum Levels ◽  
Graves Disease ◽  
Tnf Α ◽  
Factor Α ◽  
Hyperthyroid Patients ◽  
Necrosis Factor

Çelik I, Akalin S, Erbaş T. Serum levels of interleukin 6 and tumor necrosis factor-α in hyperthyroid patients before and after propylthiouracil treatment. Eur J Endocrinol 1995;132:668–72. ISSN 0804–4643 Contrary to the usual inhibitory role of tumor necrosis factor-α (TNF-α) thyroid metabolism, it also has specific stimulatory effects in autoimmune thyroid disorders, including induction of HLA class II antigen-presenting cell—T cell interaction. Despite high intrathyroidal concentrations, various studies were not able to demonstrate high serum levels of TNF-α in patients with Graves' disease. To investigate this discrepancy we determined TNF-α and interleukin 6 (IL-6) levels in 25 hyperthyroid patients who responded to propylthiouracil treatment (16 with Graves' disease and nine with toxic multinodular goiter) and compared them with the levels found in euthyroid patients with simple diffuse goiter (n = 15) and normal healthy controls (n = 15). Median IL-6 levels were high in both Graves' disease and toxic multinodular goiter patients before propylthiouracil treatment (23 and 26.5 pg/ml, respectively). After restoring euthyroidism there was a statistically significant decline to near-normal levels (3 and 10 pg/ml, respectively). On the other hand, median serum TNF-α levels were high only in Graves' disease patients (20 pg/ml) and could not be normalized with antithyroid medication (20 pg/ml) compared to that of controls (5 pg/ml). Tumor necrosis factor-α, but not IL-6, was found to be high in the sera of Graves' disease patients when euthyroid, which may be due to an ongoing antigen–antibody interaction, a feature of autoimmune attack. It remains to be determined whether the degree of TNF-α and/or IL-6 elevation will be a predictor of disease recurrence. Ismail Çelik, Section of Oncology, Dept. of Medicine, Hacettepe University Institute of Oncology, Ankara 06100, Turkey

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