Association of Thyroid Hypofunction with Clinical Outcomes after Microvascular Decompression for Hemifacial Spasm

2021 ◽  
pp. 1-7
Author(s):  
Jeong-A Lee ◽  
Doo-Sik Kong ◽  
Seunghoon Lee ◽  
Sang-Ku Park ◽  
Kwan Park
Keyword(s):  
Thyroid Hormone ◽  
Clinical Outcomes ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Thyroid Dysfunction ◽  
Hormone Replacement ◽  
Clinical Manifestations ◽  
Postoperative Outcomes ◽  
Improvement Rate ◽  
Thyroid Hormone Replacement Therapy

<b><i>Introduction:</i></b> Data regarding the association between thyroid dysfunction and hemifacial spasm (HFS) are limited. We conducted a single-center, retrospective study to investigate the predictive value of thyroid dysfunction in patients with HFS after microvascular decompression (MVD). <b><i>Methods:</i></b> Between July 2004 and January 2015, 156 patients who were tested for thyroid hormones after MVD for HFS were enrolled in the present study. We assessed their detailed history, clinical manifestations, serum thyroid hormone levels, and surgical outcomes. The patients were classified into low and high groups based on thyroid hormone concentrations, and clinical outcomes were evaluated in each group. <b><i>Results:</i></b> In a total of 156 patients with a median follow-up period of 40.9 months, the improvement rate was 87.8%. The patients were classified into low (76, 48.7%) or high (80, 51.3%) groups based on serum thyroxine (T4) levels. There was a difference between the 2 groups in terms of postoperative outcomes following MVD (<i>p</i> = 0.020). There were no differences in the outcomes according to serum tri-iodothyronine (T3) levels as well as other factors associated with the outcomes. <b><i>Conclusions:</i></b> We found that decreased serum T4 levels are associated with poor postoperative outcomes among patients with HFS. Further studies are needed to examine the clinical benefit of thyroid hormone replacement therapy for patients with suboptimal T4 concentrations as well as active thyroid hormone screening for patients with HFS.

scholarly journals MON-499 Nivolumab-Induced Hypothyroidism Is Irreversible in Most Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jee Hee Yoon ◽  
Ji Yong Park ◽  
A Ram Hong ◽  
Hee Kyung Kim ◽  
Ho-Cheol Kang
Keyword(s):  
Hormone Replacement Therapy ◽  
Thyroid Hormone ◽  
Replacement Therapy ◽  
Cancer Patients ◽  
Thyroid Dysfunction ◽  
Clinical Course ◽  
Hormone Replacement ◽  
Thyroid Function Tests ◽  
Thyroid Hormone Replacement ◽  
Thyroid Hormone Replacement Therapy

Abstract Background Thyroid dysfunction caused by the immune checkpoint inhibitor (ICPI) is common, however mild dysthyroidism could occur easily in cancer patients due to other causes. The aim of this study was to investigate the incidence and clinical course of ICPI-induced hypothyroidism requiring thyroid hormone replacement. Patients and methods We analyzed baseline and follow up thyroid function tests of cancer patients treated with nivolumab between March 2016 and March 2019 at Chonnam University Hwasun Hospital retrospectively. Results Among 265 cancer patients treated with nivolumab therapy, six patients were excluded from the study because they were on thyroid hormone replacement therapy before starting nivolumab therapy. Twenty-one patients (8.1%) newly developed thyroid dysfunction during nivolumab therapy and sixteen patients (6.2%) required thyroid hormone replacement therapy due to drug-induced hypothyroidism. Cancer diagnoses included lung cancer (n=7), renal cell carcinoma (n=4), malignant melanoma (n=2), hepatocellular carcinoma (n=2), and esophageal cancer (n=1). Six patients (37.5%) showed thyrotoxic phase prior to overt hypothyroidism and the others (n=10, 62.5%) revealed hypothyroidism without thyrotoxic phase. Most ICPI-induced hypothyroidism was irreversible, only one patient was able to discontinue thyroid hormone replacement after quitting nivolumab therapy. Conclusion A significant number of patients treated with nivolumab developed ICPI-induced hypothyroidism requiring thyroid hormone replacement and its clinical course was irreversible in most patients.

Lithium treatment and thyroid dysfunction – data from an inpatient psychiatric department

2016 ◽  
Vol 33 (S1) ◽  
pp. S545-S545
Author(s):  
M. Lázaro ◽  
A. Mota ◽  
A. Moreira ◽  
R. Alves ◽  
M.A. Nobre
Keyword(s):  
Thyroid Dysfunction ◽  
Lithium Treatment ◽  
Hormone Replacement ◽  
Thyroid Hormone Replacement ◽  
High Prevalence ◽  
Thyroid Hormone Replacement Therapy ◽  
Competing Interest ◽  
Psychiatric Department ◽  
Term Monitoring

IntroductionLithium is among the most effective therapies for bipolar disorder. Lithium treatment may cause hypothyroidism, goiter or to a lesser extent hyperthyroidism, since it can affect several aspects of thyroid functioning. The prevalence of lithium-associated hypothyroidism varies extensively between studies, reaching up to 47%, and affecting more females than males (5:1).ObjectiveDetermine the prevalence of thyroid dysfunction in an acute inpatient psychiatric department dedicated to affective disorders and its association with lithium therapy.AimsTo review the relation between lithium treatment and thyroid dysfunction.MethodsObservational, descriptive and retrospective study with clinical and laboratorial data concerning all inpatient episodes of 2015 in our Psychiatric Department. A non-systematic literature search was performed in PubMed.ResultsThe present study documented a high prevalence of thyroid dysfunction, particularly in women. Most cases were due to either hypothyroidism or subclinical hypothyroidism. Patients treated with lithium were more often under thyroid hormone replacement therapy (levothyroxine).ConclusionsThe evidence that lithium treatment is associated with hypothyroidism is well established and this condition is easily treatable with levothyroxine. This study highlights the importance of baseline screening of thyroid function and regular long-term monitoring in patients treated with lithium.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The Effects of Amiodarone on Thyroid Function in Pediatric and Young Adult Patients

2019 ◽  
Vol 104 (11) ◽  
pp. 5540-5546 ◽  
Author(s):  
Brett Barrett ◽  
Colin P Hawkes ◽  
Amber Isaza ◽  
Andrew J Bauer
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Thyroid Hormone ◽  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Adult Population ◽  
Hormone Replacement ◽  
Common Adverse Effect ◽  
Children And Young Adults

Abstract Context Amiodarone is used in patients with arrhythmias, but thyroid dysfunction [amiodarone-induced thyrotoxicosis (AIT) or amiodarone-induced hypothyroidism (AIH)] is a common adverse effect. As the onset of AIT and AIH has not been studied in children, the timing of dysfunction and long-term monitoring are not known in this population. Objective To describe the incidence and timing of amiodarone-induced thyroid dysfunction in children and adolescents, with a secondary aim to identify risk factors for amiodarone-induced thyroid dysfunction, and to identify variance in thyroid hormone surveillance and treatment. Design Retrospective review of thyroid dysfunction in children and young adults treated with amiodarone between 2007 and 2018. Setting Children’s Hospital of Philadelphia. Patients Children and young adults treated with amiodarone. Main Outcome Measures Prevalence of amiodarone-induced thyroid dysfunction. Results Of 484 patients, 190 had thyroid-function testing; 17.3% were found to have subclinical hypothyroidism, and 13.7% testing developed hypothyroidism. Hyperthyroidism occurred in 2.1%. In patients with subclinical hypothyroidism, 63% returned to normal thyroid function without thyroid hormone replacement. Only 26% of patients with hypothyroidism had spontaneous normalization of thyroid function. Twenty-five percent of AIT patients had spontaneous normalization of thyroid function. Conclusions This study looks at a pediatric and young-adult population in an effort to describe the natural history of amiodarone-induced thyroid dysfunction. Based on our data, we recommend that a complete thyroid-function panel be obtained within the first week and then at weekly intervals for the first 5 weeks after initiation. The majority of thyroid dysfunction was noted within the first 35 days of treatment.

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