scholarly journals Autoimmune Thyroid Disease and Psoriasis Vulgaris after COVID-19 in a Male Teenager

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Nadia K. Qureshi ◽  
Sanjay K. Bansal
Keyword(s):  
Family History ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Psoriasis Vulgaris ◽  
Thyroid Diseases ◽  
Graves Disease ◽  
Healthy Male ◽  
Autoimmune Thyroid

COVID-19 is implicated in triggering autoimmune, dermatologic, and thyroid diseases. We present a first known case of development of Graves’ disease and psoriasis vulgaris in a previously healthy male teenager without any family history, diagnosed after COVID-19 infection. Evaluation of “long COVID syndrome” should include thorough history and thyroid evaluation.

Development of Autoimmune Thyroid Disease in Multiple Sclerosis Patients Post-Alemtuzumab Improves Treatment Response

2020 ◽  
Vol 105 (9) ◽  
pp. e3392-e3399 ◽  
Author(s):  
Alina Sovetkina ◽  
Rans Nadir ◽  
Antonio Scalfari ◽  
Francesca Tona ◽  
Kevin Murphy ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Graves Disease ◽  
Autoimmune Thyroid ◽  
Tertiary Referral Center ◽  
T2 Lesions ◽  
Relapsing Remitting ◽  
Edss Score ◽  
Multiple Sclerosis Patients

Abstract Context Alemtuzumab is an anti-CD52 monoclonal antibody used in the treatment of relapsing-remitting multiple sclerosis (MS). Between 20% and 40% of alemtuzumab-treated MS patients develop autoimmune thyroid disease (AITD) as a side effect. Objective The objective of this work is to determine whether MS disease progression following alemtuzumab treatment differs in patients who develop AITD compared to those who do not. Design, Setting, and Patients A retrospective analysis of 126 patients with relapsing-remitting MS receiving alemtuzumab from 2012 to 2017 was conducted at a tertiary referral center. Main Outcome Measures Thyroid status, new relapses, Expanded Disability Status Scale (EDSS) score change, and disability progression following alemtuzumab were evaluated. Results Twenty-six percent (33 out of 126, 25 female, 8 male) of alemtuzumab-treated patients developed AITD, 55% of which was Graves disease. EDSS score following alemtuzumab was reduced in patients who developed AITD compared to those who did not (median [interquartile range]; AITD: –0.25 [–1 to 0.5] vs non-AITD: 0 [1-0]. P = .007]. Multivariable regression analysis confirmed that the development of AITD was independently associated with EDSS score improvement (P = .011). Moreover, AITD patients had higher relapse-free survival following alemtuzumab (P = .023). There was no difference in the number of new focal T2 lesions and contrast-enhancing magnetic resonance imaging lesions developed following alemtuzumab between the 2 groups. Conclusion Graves disease was the most common form of AITD developed by MS patients following alemtuzumab. This study suggests that MS patients who develop AITD may have an improved response to alemtuzumab, as measured by reduced disability and lower relapse rate.

scholarly journals A Case of Thyrotoxicosis due to Simultaneous Occurrence of Subacute Thyroiditis and Graves’ Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Kazunori Kageyama ◽  
Noriko Kinoshita ◽  
Makoto Daimon
Keyword(s):  
Thyroid Hormones ◽  
Thyroid Disease ◽  
Rare Case ◽  
Autoimmune Thyroid Disease ◽  
Subacute Thyroiditis ◽  
Simultaneous Occurrence ◽  
Graves Disease ◽  
Inflammatory Disorder ◽  
Autoimmune Thyroid ◽  
Prompt Diagnosis

Subacute thyroiditis is an inflammatory disorder of the thyroid. Graves’ disease is an autoimmune thyroid disease in which thyroid hormones are overproduced. Here we present a rare case of thyrotoxicosis due to the simultaneous occurrence of both diseases. Prompt diagnosis and therapy are required to prevent complications in patients with thyrotoxicosis.

scholarly journals Co-existent ocular myasthenia gravis and Graves’ disease in a 5 year old

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Olivia Watson ◽  
Michelle Jack ◽  
Helen Young
Keyword(s):  
Myasthenia Gravis ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Clinical Presentation ◽  
Graves Disease ◽  
Autoimmune Thyroid ◽  
Ocular Myasthenia ◽  
Ocular Myasthenia Gravis ◽  
The Relationship ◽  
Symptom Recurrence

Myasthenia gravis and Graves’ disease are known to co-exist in adults, yet there have only been a small number of paediatric cases reported. We report a 5 year old female who was diagnosed with ocular myasthenia gravis after presenting with unilateral ptosis and subsequently found also to have Graves’ disease. She was treated successfully with pyridostigmine, corticosteroids and carbimazole without symptom recurrence or progression to generalised myasthenia gravis. The aetiology of the coexistence is not fully understood, nor is the relationship between the two disorders’ presentation and treatment. We discuss the variation in clinical presentation of myasthenia gravis between populations and when associated with autoimmune thyroid disease, potential HLA-related genetic susceptibility and the varying approaches to treatment of the co-existent disorders.

scholarly journals Familial dysalbuminemic hyperthyroxinemia confounding management of coexistent autoimmune thyroid disease

2020 ◽  
Vol 2020 ◽  
Author(s):  
Serena Khoo ◽  
Greta Lyons ◽  
Andrew Solomon ◽  
Susan Oddy ◽  
David Halsall ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Thyroid Status ◽  
Free T4 ◽  
Autoimmune Thyroid ◽  
Analytical Interference ◽  
Tsh Levels

Summary Familial dysalbuminemic hyperthyroxinemia (FDH) is a cause of discordant thyroid function tests (TFTs), due to interference in free T4 assays, caused by the mutant albumin. The coexistence of thyroid disease and FDH can further complicate diagnosis and potentially result in inappropriate management. We describe a case of both Hashimoto’s thyroiditis and Graves’ disease occurring on a background of FDH. A 42-year-old lady with longstanding autoimmune hypothyroidism was treated with thyroxine but in varying dosage, because TFTs, showing high Free T4 (FT4) and normal TSH levels, were discordant. Discontinuation of thyroxine led to marked TSH rise but with normal FT4 levels. She then developed Graves’ disease and thyroid ophthalmopathy, with markedly elevated FT4 (62.7 pmol/L), suppressed TSH (<0.03 mU/L) and positive anti-TSH receptor antibody levels. However, propylthiouracil treatment even in low dosage (100 mg daily) resulted in profound hypothyroidism (TSH: 138 mU/L; FT4: 4.8 pmol/L), prompting its discontinuation and recommencement of thyroxine. The presence of discordant thyroid hormone measurements from two different methods suggested analytical interference. Elevated circulating total T4 (TT4), (227 nmol/L; NR: 69–141) but normal thyroxine binding globulin (TBG) (19.2 µg/mL; NR: 14.0–31.0) levels, together with increased binding of patient’s serum to radiolabelled T4, suggested FDH, and ALB sequencing confirmed a causal albumin variant (R218H). This case highlights difficulty ascertaining true thyroid status in patients with autoimmune thyroid disease and coexisting FDH. Early recognition of FDH as a cause for discordant TFTs may improve patient management. Learning points: The typical biochemical features of familial dysalbuminemic hyperthyroxinemia (FDH) are (genuinely) raised total and (spuriously) raised free T4 concentrations due to enhanced binding of the mutant albumin to thyroid hormones, with normal TBG and TSH concentrations. Given the high prevalence of autoimmune thyroid disease, it is not surprising that assay interference from coexisting FDH may lead to discordant thyroid function tests confounding diagnosis and resulting in inappropriate therapy. Discrepant thyroid hormone measurements using two different immunoassay methods should alert to the possibility of laboratory analytical interference. The diagnosis of FDH is suspected if there is a similar abnormal familial pattern of TFTs and increased binding of radiolabelled 125I-T4 to the patient’s serum, and can be confirmed by ALB gene sequencing. When autoimmune thyroid disease coexists with FDH, TSH levels are the most reliable biochemical marker of thyroid status. Measurement of FT4 using equilibrium dialysis or ultrafiltration are more reliable but less readily available.

scholarly journals Long term effect of nutrition on thyroid disease

2021 ◽  
Vol 8 (2) ◽  
pp. 922
Author(s):  
Mohammed Salah Hussein ◽  
Lama Samir Asiri ◽  
Sadeem Wadia Asali ◽  
Abdulaziz Mohsin Alawlaqi ◽  
Gadeer Sameer Sibah ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Diseases ◽  
Term Effect ◽  
Feedback Mechanisms ◽  
Nutritional Elements ◽  
Autoimmune Thyroid ◽  
Long Term Effect

Many forms of thyroid diseases have been classified under autoimmune thyroid disease. These include hyperthyroidism or commonly known as Grave’s disease, and hypothyroidism commonly identified as Hashimoto’s thyroiditis. Many nutritional elements have been linked to the function of the thyroid gland as any disturbance in these elements can lead to the development of relevant thyroid diseases. The most important elements include iodine, iron, selenium, zinc, and soy. In this current manuscript, we aimed to discuss the effect of these nutritional elements on the development of thyroid diseases by reviewing relevant studies in the literature. Although it is widely known that iodine is an essential component for the synthesis and release of these hormones, exaggerated intake of iodine can also lead to the development of hypothyroidism by negative feedback mechanisms. Besides, it can also trigger abnormal autoimmune reactions which can lead to the development of AITD. Selenium is another important factor and evidence shows that it has been associated with Grave’s thyroiditis, however, further evidence is needed as recommended by previous investigations. Clinicians should also take care of iron, zinc, and soy levels during management to obtain a better prognosis.

scholarly journals The Role of Medical Staff in Shaping the Nutrition Habits in Patients with Autoimmunization Thyroid Diseases in Poland.

2021 ◽  
Author(s):  
Ewa Czubek ◽  
Piotr Romaniuk ◽  
Klaudia Alcer ◽  
Mirjana Varjacic
Keyword(s):  
Thyroid Disease ◽  
Medical Staff ◽  
Autoimmune Thyroid Disease ◽  
Eating Behaviour ◽  
Medical Personnel ◽  
Well Being ◽  
Thyroid Diseases ◽  
Autoimmune Thyroid Diseases ◽  
Autoimmune Thyroid

Abstract Background: Autoimmune thyroid diseases are the most common diseases in humans. Their pathogenesis is complex. Patients are searching for ways of coping with them condition, including diet modifications. The aim of this study was to assess the role of medical personnel in shaping eating habits in patients with autoimmune thyroid disease based on experiences declared by patients. Methods: There were 208 people that took part in the study, of which 205 were qualified for final analysis. The results showed that patients most often choose online sources, while medical personnel rank second as the source of information on dietary recommendations.Results: People with thyroid disease are statistically more likely to use dietitian advice than people without thyroid disease. The highest percentage of respondents decided to modify their nutrition due to their own initiative. In addition, patients with autoimmune thyroid disease are statistically more likely to consider changing their diet to improve their well-being. The connection between the source of advice and modification of eating behaviour was also noted.Conclusion: Thanks to the joint effort of medical staff, patients can receive reliable knowledge about their disease, treatment and nutrition adapted to their needs.Trial registration: approved by the Bioethics Committee of Medical University of Silesia in Katowice (opinion no.: PCN/0022/KB1/80/2).

TSH RECEPTOR ANTIBODIES: RELEVANCE & UTILITY

2020 ◽  
Vol 26 (1) ◽  
pp. 97-106 ◽  
Author(s):  
George J. Kahaly ◽  
Tanja Diana ◽  
Paul D. Olivo
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Hashimoto Thyroiditis ◽  
Rapid Diagnosis ◽  
Tsh Receptor ◽  
Graves Disease ◽  
Thyrotropin Receptor ◽  
Blocking Antibody ◽  
Autoimmune Thyroid

Objective: Antibodies (Abs) to the thyrotropin (TSH) receptor (TSH-R) play an important role in the pathogenesis of autoimmune thyroid disease (AITD). We define the complex terminology that has arisen to describe TSH-R-Abs, review the mechanisms of action of the various types of TSH-R-Abs, and discuss significant advances that have been made in the development of clinically useful TSH-RAb assays. Methods: Literature review and discussion. Results: TSH-R-Abs may mimic or block the action of TSH or be functionally neutral. Stimulating TSH-R-Abs are specific biomarkers for Graves disease (GD) and responsible for many of its clinical manifestations. TSH-R-Abs may also be found in patients with Hashimoto thyroiditis in whom they may contribute to the hypothyroidism of the disease. Measurement of TSH-R-Abs in general, and functional Abs in particular, is recommended for the rapid diagnosis of GD, differential diagnosis and management of patients with AITD, especially during pregnancy, and in AITD patients with extrathyroidal manifestations such as orbitopathy. Measurement of TSH-R-Abs can be done with either immunoassays that detect specific binding of Abs to the TSH-R or cell-based bioassays that also provide information on their functional activity and potency. Application of molecular cloning techniques has led to significant advances in methodology that have enabled the development of clinically useful bioassays. When ordering TSH-R-Ab, clinicians should be aware of the different tests available and how to interpret results based on which assay is performed. The availability of an international standard and continued improvement in bioassays will help promote their routine performance by clinical laboratories and provide the most clinically useful TSH-R-Ab results. Conclusion: Measurement of TSH-R-Abs in general, and functional (especially stimulating) Abs in particular, is recommended for the rapid diagnosis, differential diagnosis, and management of patients with Graves hyperthyroidism, related thyroid eye disease, during pregnancy, as well as in Hashimoto thyroiditis patients with extra-thyroidal manifestations and/or thyroid-binding inhibiting immunoglobulin positivity. Abbreviations: Ab = antibody; AITD = autoimmune thyroid disease; ATD = antithyroid drug; cAMP = cyclic adenosine 3′,5′-monophosphate; ELISA = enzyme-linked immunosorbent assay; GD = Graves disease; GO = Graves orbitopathy; HT = Hashimoto thyroiditis; MAb = monoclonal antibody; TBAb = thyrotropin receptor blocking antibody; TBII = thyroid-binding inhibiting immunoglobulin; TSAb = thyrotropin receptor–stimulating antibody; TSB-Ab or TRBAb = thyrotropin receptor–stimulating blocking antibody; TSH = thyrotropin; TSH-R = thyrotropin receptor

Echographic diagnosis of pretibial myxedema in patients with autoimmune thyroid disease

1994 ◽  
Vol 131 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Mario Salvi ◽  
Flavia De Chiara ◽  
Eliana Gardini ◽  
Roberta Minelli ◽  
Lina Bianconi ◽  
...  
Keyword(s):  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Subcutaneous Tissue ◽  
Normal Subjects ◽  
Graves Disease ◽  
Skin Thickness ◽  
Autoimmune Thyroid ◽  
Tissue Sections ◽  
Pretibial Myxedema ◽  
Ultrasound Scanner

Salvi M, De Chiara F, Gardini E, Minelli R, Bianconi L, Alinovi A, Ricci R, Neri F, Tosi C, Roti E. Echographic diagnosis of pretibial myxedema in patients with autoimmune thyroid disease. Eur J Endocrinol 1994;131:113–19. ISSN 0804–4643 In the present study we have evaluated the use of pretibial ultrasound for the diagnosis of pretibial myxedema (PTM). We studied 76 patients, 58 with Graves' disease, 13 with Hashimoto's thyroiditis and five with idiopathic hypothyroidism. Thirty-two normal subjects were also studied as controls. Sixty-four patients had associated ophthalmopathy. The ultrasound scanner was equipped with 10-and 13-MHz probes. Punch biopsies were carried out in 11 patients and tissue sections examined on a light microscope. On clinical examination 21 patients (28%) had suspected PTM. By ultrasound, we measured the thickness of dermis and subcutaneous tissue (Dl) and that including only deeper dermis (D2) in normal subjects to define the echographic parameters of normal pretibial skin. We then found increased skin thickness in 25 patients (33%), with mean Dl and D2 values significantly higher than those measured in controls (p < 0.00001). The echographic study was positive in 20 patients with ophthalmopathy (31%). Ultrasound showed increased skin thickness in 16 of 21 patients (76%) with clinically suspected PTM. Histopathological findings confirmed the presence of PTM in all the patients who underwent pretibial skin biopsy. We believe that the measurement of pretibial skin thickness by ultrasound may be useful for revealing the presence of PTM. Mario Salvi, Cattedra di Endocrinologia, Università di Parma, Via Gramsci 14-43100 Parma, Italy

scholarly journals The Spectrum of Autoimmune Thyroid Disease in the Short to Medium Term Following Interferon-αTherapy for Chronic Hepatitis C

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Huy A. Tran ◽  
Glenn E. M. Reeves
Keyword(s):  
Hepatitis C ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Interferon Therapy ◽  
Pegylated Interferon ◽  
Thyroid Diseases ◽  
Hepatitis C Infection ◽  
Medium Term ◽  
Autoimmune Thyroid Diseases ◽  
Autoimmune Thyroid

Autoimmune thyroid diseases are common manifestations of hepatitis C infection, exacerbated by interferon-based treatment. However, the occurrence and pattern of thyroid disease in the short/medium term following the completion of IFN-based therapy is relatively unknown and there are very few previous reports regarding the specific spectrum of autoimmune thyroid disease that may follow such therapy. We hereby report 3 cases which demonstrate the range of thyroid diseases that may occur following interferon therapy. The hypothesis advanced is that in the pathogenesis of these conditions there must be both triggering and sustaining mechanisms as thyroid diseases occur well outside the immediate effect window of pegylated interferon. This paper suggests the need to continue thyroid surveillance in IFN-treated HCV patients following the completion of therapy, perhaps for the first 6 months.

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