scholarly journals Primary Thyroid Disorders in Patients with Endogenous Hypercortisolism: An Observational Study

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Eda Demir Onal ◽  
Muhammed Sacikara ◽  
Fatma Saglam ◽  
Reyhan Ersoy ◽  
Bekir Cakir

Cushing’s syndrome (CS) may alter the performance of the hypothalamic-hypophyseal-thyroid axis. We searched for a relationship between hypercortisolism and primary thyroid disorders. The medical records of 40 patients with CS were retrospectively examined. Thyroid ultrasonography (USG), basal thyroid function test results (TFT), and antithyroglobulin and antithyroperoxidase antibodies were analyzed. In 80 control subjects, matched by age and gender with CS patients, thyroid USG, TFTs, and autoantibody panel were obtained. Among the CS patients, 17 had nodular goiter, versus 24 controls (42.5% versus 30%,P>0.05). Among the twenty-five patients with an available TFT and autoantibody panel—before and after surgical curative treatment—autoantibody positivity was detected in 2 (8%) patients before and 3 (12%) after surgery (P=0.48). Regarding TFT results, 1 (2.5%) patient had subclinical hyperthyroidism and 1 (2.5%) had subclinical hypothyroidism, whereas 1 (2.5%) control had hyperthyroidism. In total, 21 (52.5%) patients and 32 (40%) controls had≥1 of the features of thyroid disorder, including goiter, positive thyroid autoantibody, and thyroid function abnormality; the difference was not significant (P>0.05). The prevalence of primary thyroid disorders is not significantly increased in patients with CS.

Author(s):  
Bharati Das ◽  
Puspanjali Khuntia

Background: Thyroid disorders are well known entity in pregnancy. Both mother and baby have to suffer from the consequences.  Lot of works has been done and many guidelines too came out over the years but what is actual understanding of the disease process by the mothers about themselves and for their babies especially in developing country like India remained uncovered. This has been analysed in present study.Methods: It is a prospective observational study done in the post-partum programmed department of SCB medical college and hospital, a tertiary care center in eastern part of India for 3 years period. Thyroid dysfunction of the mothers and new born screening of thyroid function of their babies has been assessed.Results: During this period total no of the babies along with their mothers were evaluated were 3762. Total no of thyroid disorders detected in 85 (2.25%) of mothers, among which hypothyroidism in 79 (2.09%) and hyperthyroidism in 6 (0.16%) were found. From total 85 cases, 79 (93%) mothers were hypothyroid   and 6 (7%) were hyperthyroid. Among the hypothyroid mothers 32 (40.5%) were diagnosed before present pregnancy and (59.5%) were diagnosed during pregnancy. In the babies of hypothyroid mother, new born screening for thyroid function was done only in 14 (17.7%) cases between 5-10 days.Conclusions: Thyroid screening should be done in pregnancy as universal screening instead of high-risk cases. Documentation and interdepartmental coordination are very much essential in thyroid disorders for further decision by the physician for necessity of continuation of treatment and thyroid function test in the post-partum period for the mothers and its long-term consequences. It also guides the neonatologist or pediatrician doing thyroid function test of their babies. Ideally All newborns should be screened for congenital hypothyroidism as a part of new born screening (NBS) programmed. Effective communication with the mother and the family is very much essential for monitoring and treatment of both mother and the baby.


2014 ◽  
Vol 58 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Eda Demir Onal ◽  
Fatma Saglam ◽  
Muhammed Sacikara ◽  
Reyhan Ersoy ◽  
Bekir Cakir

Objective : To establish whether there is a relationship between hyperprolactinemia and primary thyroid disorders, focusing on patients with autoimmune features. Materials and methods : The medical records of 100 patients with hyperprolactinemia (HPRL) were retrospectively examined. Records of thyroid ultrasonography (USG), basal serum levels of thyroid stimulating hormone, circulating free thyroxine, free triiodothyronine, antithyroglobulin (anti-Tg), and antithyroperoxidase (anti-TPO) antibodies were analyzed. In 100 control subjects, matched by age and gender with HPRL patients, thyroid USG, thyroid function tests (TFTs), and autoantibody panel were obtained. Results : The median PRL in patients was 93 ng/mL (range: 37-470). Twenty-five patients (25%) and 22 controls (22%) had positive anti-Tg and/or anti-TPO titers (P = 0.739). The median serum PRL was 98 (37-470) ng/mL in patients with positive thyroid autoantibodies, and 92 (40-470) ng/mL in patients who were negative (P = 0.975). Among the individuals with autoantibody positivity TFTs abnormalities were more frequent in HPRL patients (60%, out of 25 patients, 14 with subclinical hypothyroidism and one with hyperthyroidism) than in controls (9.1%, out of 22 patients, 2 with subclinical hyperthyroidism) (P < 0.001). Twenty-seven patients with HPRL and 31 controls had goiter (27 vs. 31%, P = 0.437). Forty-six patients (46%) and 50 (50%) controls had one or more of the features of thyroid disorder, which were goiter, positive thyroid autoantibody, and thyroid function abnormality (P = 0.888). Conclusion : HPRL may be associated with more severe thyroid dysfunction in patients with thyroid autoimmunity.


2021 ◽  
pp. 80-82
Author(s):  
Dipti Debbarma ◽  
Shipra Singh ◽  
Debarshi Jana ◽  
Chittaranjan Dutta

INTRODUCTION: The Thyroid gland is unique among the endocrine glands. It is the largest of all the endocrine glands and it is supercial in location. It is the only gland which is easily approachable to direct physical, cytological and histopathological examination. The thyroid gland is affected by a variety of pathological lesions that are manifested by various morphologies including developmental, inammatory, hyperplastic and neoplastic pathology which are quiet common in the clinical practice. AIM OFTHE STUDY:In this study, we aimed to assess the cytological ndings of palpable thyroid nodules in conjunction with thyroid hormonal prole of the patient. To study the incidence in relevance to age, sex in various categories of thyroid lesions. MATERIALS & METHODS: Study Design: Institutional based Cross-sectional Study. Duration of study: January 2019 to August 2020. Source of data: Patients presenting to the OPD and admitted in the In-patient ward at Darbhanga Medical College, Bihar. Place of study: Department of Pathology, Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Sample Size: 60 patients of enlarged thyroid gland. RESULTS & OBSERVATIONS: We found that the 53.3% Patients are in euthyroid state. Nodular goitre is the most common nding. In the present study among 60 patients, Nodular goiter accounts for 83.3 % of all cases; 41.7% of them were in euthyroid state, 21.7 % in hypothyroid state , 8.3 % in subclinical hypothyroid and remaining 11.7 % in hyperthyroid state . SUMMARY AND CONCLUSION: FNAC together with thyroid function test (TFT) analysis leads to early and accurate diagnosis of various thyroid diseases and reduces surgical intervention. The study showed that FNAcytologic diagnosis cannot be used to predict thyroid function using total serum T4, T3 and TSH concentrations. Measurement of TSH, free T4, and free T3 would be preferable


Author(s):  
Skand Shekhar ◽  
Raven McGlotten ◽  
Sunyoung Auh ◽  
Kristina I Rother ◽  
Lynnette K Nieman

Abstract Background We do not fully understand how hypercortisolism causes central hypothyroidism or what factors influence recovery of the hypothalamic-pituitary-thyroid axis. We evaluated thyroid function during and after cure of Cushing’s syndrome (CS). Methods We performed a retrospective cohort study of adult patients with CS seen from 2005 – 2018 (cohort 1, c1, n=68) or 1985 – 1994 (cohort 2, c2, n=55) at a clinical research center. Urine (UFC) and diurnal serum cortisol (F: ~8AM and ~midnight (PM)), morning triiodothyronine (T3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) (c1) or hourly TSH from 1500-1900h (day) and 2400-04000h (night) (c2), were measured before and after curative surgery. Results While hypercortisolemic, 53% of c1 had central hypothyroidism (low/low normal fT4 + unelevated TSH). Of those followed long-term, 31% and 44% had initially subnormal FT4 and T3, respectively, which normalized 6—12 months after cure. Hypogonadism was more frequent in hypothyroid (69%) compared to euthyroid (13%) patients. Duration of symptoms, AM and PM F, ACTH, and UFC were inversely related to TSH, FT4 and/or T3 levels (r -0.24 to -0.52, P &lt;0.0001 to 0.02). In c2, the nocturnal surge of TSH (mIU/L) was subnormal before (day 1.00±0.04 vs night 1.08±0.05, p=0.3) and normal at a mean of 8 months after cure (day 1.30±0.14 vs night 2.17±0.27, p=0.01). UFC &gt;1000 μg /day was an independent adverse prognostic marker of time to thyroid hormone recovery. Conclusions Abnormal thyroid function, likely mediated by subnormal nocturnal TSH, is prevalent in Cushing’s syndrome and is reversible after cure.


2018 ◽  
Vol 19 (2) ◽  
pp. 98
Author(s):  
Mohammad Saifur Rahman ◽  
Sadia Sultana ◽  
Ayesha Nazneen

<p><strong>Objectives:  </strong>Thyroid disorders are commonly observed in pregnancy. Thyroid hormones play an important role in embryogenesis and fetal development. The fetus is completely dependent on the mother for thyroid hormone in first trimester. About 10% of all pregnant women can be affected by thyroid disorders during pregnancy. Thyroid function abnormalities in pregnancy are a challenge for the concerned physicians.  The objective of this study was to assess the maternal thyroid function in first trimester of pregnancy.</p><p><strong>Patients and Methods: </strong>A descriptive cross sectional study was carried out at the Combined Military Hospital (CMH), Dhaka over a period of one year from January 2013 to December 2013 to see the serum FT<sub>3</sub>, FT<sub>4</sub>, TSH, thyroid antibodies level and common thyroid disorders in pregnancy. A total of 138 pregnant women in their first trimester (up to 12 weeks) of pregnancy with an age range of 18-35 years were enrolled in this study. Pregnant women with known thyroid disorder and on treatment and pregnancy more than three months were excluded. Measurement of serum FT<sub>3</sub>, FT<sub>4</sub>, TSH, Anti TPO-Ab and Anti TG-Ab were done in each patient at the time of enrolment. Ultrasonography of each patient was done for confirmation of pregnancy and correlation of gestational age.</p><p><strong>Results:  </strong>Among 138 pregnant women, subclinical hypothyroidism was detected in 10 (7.2%) patients and subclinical hyperthyroidism was detected in 3 (2.2%) patients. Mean difference of the investigation findings were not statistically significant among primi and multi gravida. TPO-Ab and TG-Ab difference were statistically significant between two age groups.</p><p><strong>Conclusion: </strong>Subclinical thyroid disorders are fairly high among pregnant women. Correct diagnosis in early pregnancy and prompt treatment will bring an excellent prognosis for both mother and offspring.</p><p>Bangladesh J. Nuclear Med. 19(2): 98-102, July 2016</p>


2019 ◽  
Vol 3 (1) ◽  
pp. 3-9
Author(s):  
Saurav Piya ◽  
Jeena Gurung ◽  
Anadi Khatri

Introduction: Thyroid Eye Disease (TED) is an organ-specific autoimmune inflammatory incapacitating eye disorder usually associated with Graves’ disease affecting the orbit. Objectives: To determine thyroid function status in patients with thyroid-associated Ophthalmopathy. Methods: This is a hospital-based cross-sectional study of sixty three clinically diagnosed new cases of thyroid-associated ophthalmopathy done at Nepal Eye Hospital, Kathmandu from February 2012 to January 2013. Detailed history, systemic & ocular examination with special emphasis on evaluation of extraocular movement, lid signs, exophthalmos with Hertel's exophthalmometer was done. Thyroid function test and endocrine consultation were also done in all cases. Results: There were an equal distribution of TED with hyperthyroid (34.95%) and euthyroid status (34.95%). The most common presentation of both euthyroid and hypothyroid patient was tremor (13.4%) and palpitation (13.45%). The most common symptom of TED was foreign body sensation (54 %) but in TED with euthyroid and hypothyroid status, redness (22.2 %) and diminution of vision (20.6 %) were more frequent symptoms respectively. The most common presenting sign was Von Graefe’s sign (69 %). Among TED with hyperthyroid and hypothyroid status, Dalrymple's sign (29.3%) and Mobius sign (17.4%) were most common respectively. Conclusion: Thyroid-associated ophthalmopathy is an important health concern among patients with a thyroid disorder. TED with hyperthyroid states present more severely than hypothyroid and euthyroid states. As TED occurred with a high prevalence in all thyroid states, a close collaboration between endocrinologists and ophthalmologists along with timely referrals of patients with any eye complaint is mandated.


2018 ◽  
Vol 9 ◽  
pp. 41
Author(s):  
Leo Saputra ◽  
Farisza Gita ◽  
Ratna Sari Dewi

Objective: To find out the difference in the plaque index scores of FPD users before and after using a 12.5% VCO mouthwash.Methods: The plaque index measurement of an abutment tooth was taken on 40 subjects with FPD in both test and control groups. Subjects used a 12.5% VCO mouthwash or aquades twice a day for 4 days after brushing their teeth. Statistical analysis of the measurement result of the plaque index scores before and after using the coconut oil mouthwash was done using the Wilcoxon test.Results: There is a statistically significant difference in the plaque index scores of FPD users before and after using the 12.5% VCO mouthwash with a statistically significant decrease in plaque index scores among restoration margin locations and tooth brushing habits, but not among age and gender groups.Conclusion: Using a 12.5% VCO mouthwash may decrease the plaque index of fixed prosthetic denture users.


Author(s):  
Dr. Yasser Al-Ankoodi

Thyroid function test (TFT) is one of the frequently asked investigations. There is continuous increase and demand for this test. The reasons for increased number of thyroid testing include the wide list of clinical presentation of thyroid disorders with variable signs and symptoms.  The thyroid gland itself can be affected with different ranges of disorders including auto-antibodies, congenital, genetics and cancers (1,2). In addition, the thyroid disorders can mimic or co-exist with other conditions especially in elderly and children.  This climbing number of tests makes a financial burden to the laboratory. It necessitated extra reagents and consumables, extra manpower and some time extra analyzer.


Author(s):  
Ashwini S. Rathod ◽  
Girija A. Ghate ◽  
Ammu Korah ◽  
Lakshmi Krishnan ◽  
Ruchir R. Dashora

<p><strong>Background:</strong> Thyroid swellings are very frequently encountered in ENT practice, ranging from a simple cyst to a malignant tumour. Disorder of structure of thyroid gland, due to various etiological factors, will give rise to swelling in the neck region. Clinical signs and symptoms are inadequate to diagnose thyroid disorders as similar presentations are seen in various thyroid disorders. So, this study of thyroid swellings was done to know different clinical presentations, age and sex distribution, correlation between thyroid swellings and thyroid function tests, analyse various thyroid swellings and etiological factors based on pathological reports.</p><p class="abstract"><strong>Methods:</strong> A prospective study with 50 patients of thyroid swellings was conducted over 2 years, after taking consent from each patient. Patients were clinically examined by inspection, palpation, percussion, auscultation and underwent thyroid function tests. Ultrasonography (USG) and fine needle aspiration cytology (FNAC) was done in all patients.  </p><p class="abstract"><strong>Results:</strong> Total 50 patients of thyroid swellings were studied. Mean age of the patients was 38.92 years with female preponderance (74%). Thyroid swellings were commonly present bilaterally (54%). 82% cases showed euthyroid state. USG revealed that most of the patients had colloid nodule (46%), followed by MNG (26%). Majority of lesions were benign on both USG and FNAC reports. MNG (44%) was reported frequently in the provisional diagnosis, followed by colloid nodule (24%).</p><p class="abstract"><strong>Conclusions:</strong> In all cases of thyroid swellings, detailed clinical history, thorough clinical examination is required. Thyroid function test, USG and FNAC reports help to reach the definitive diagnosis. Histopathological report confirms and gives final diagnosis.</p><p> </p>


Author(s):  
Carla Maia

Focusing on the relational dimension of some selected works, this essay proposes to consider the subject matter as films with women rather than films of women. The main effort is to understand something that takes place in-between spaces – before and after the camera, but also between viewer and film – and critically reflect on the aesthetic, ethical and political potential that a cinema marked by different women’s perspectives can bring to light. The author concludes that instead of reflecting a certain proximity between women, most films by contemporary female documentarists in Brazil, are suffering from the impact of the difference in social station between the director and the women being filmed.


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