LONG-ACTING THYROID STIMULATOR (LATS) IN TOXIC NODULAR GOITRE, TOXIC ADENOMA AND GRAVES' DISEASE

1969 ◽  
Vol 62 (2) ◽  
pp. 199-209 ◽  
Author(s):  
B.-A. Lamberg ◽  
A. Gordin ◽  
M. Viherkoski ◽  
G. Kvist
Keyword(s):  
Present Series ◽  
Surrounding Tissue ◽  
Graves Disease ◽  
List Type ◽  
Multinodular Goitre ◽  
Toxic Adenoma ◽  
Nodular Goitre ◽  
Group 2 ◽  
Long Acting ◽  
Toxic Nodular Goitre

ABSTRACT The long-acting thyroid stimulator (LATS) was determined by means of the McKenzie assay in 68 patients with hyperthyroidism. The patients were classified into the following groups: Group 1. Graves' disease (diffuse goitre with hyperthyroidism with or without exophthalmos). Of the 35 patients tested 25 (71 %) were LATS-positive. Group 2. Graves' disease with nodular goitre (nodular goitre with hyperthyroidism and with exophthalmos). The present series includes only 4 such patients, although this combination is by no means uncommon in Finland. Two of the patients were LATS-positive. It has been suggested that these patients represent Graves' disease superimposed upon endemic nodular goitre. Group 3. Toxic nodular goitre. The present series comprises 23 patients with toxic multinodular goitre, of whom 10 (44%) were LATS-positive. In view of the findings on thyroid palpation, on thyroid scintigraphy, the presence or absence of LATS in the blood and some other criteria, these patients can be divided into two categories, (a) one with Graves' disease superimposed upon nodular goitre of endemic origin (see group 2) and (b) the other with classical multinodular goitre. Analysis of the scintigrams showed that in some patients (with either exophthalmos or LATS in the blood and nodular goitre = Graves' disease + nodular goitre) it was not the nodules that were activated but the paranodular tissue, a finding which gave a scintigram typical of patients with classical Graves' disease. In some LATS-positive cases, however, some nodules were also activated to the same extent. The difference between these scintigrams and those typical of classical multinodular goitre is particularly stressed since in Finland »toxic nodular goitre« is the prevailing type of hyperthyroidism. Group 4. Single toxic adenoma. Two patients out of 6 were LATS-positive. This is in contrast to the findings of other authors according to which LATS has never been found in patients with toxic adenoma. A hypothesis is put forward that in these patients subclinical Graves' disease (LATS in the blood) coincided with a primarily autonomous, hyperactive but not necessarily toxic single thyroid adenoma, which was more susceptible to the stimulating activity of LATS than the surrounding tissue.

scholarly journals Incidence of hyperthyroidism in Stockholm, Sweden, 2003–2005.

2008 ◽  
Vol 158 (6) ◽  
pp. 823-827 ◽  
Author(s):  
Mirna Abraham-Nordling ◽  
Ove Törring ◽  
Mikael Lantz ◽  
Bengt Hallengren ◽  
Hans Ohrling ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Adult Population ◽  
Graves Disease ◽  
Multinodular Goitre ◽  
Stockholm County ◽  
Toxic Adenoma ◽  
Nodular Goitre ◽  
Total Incidence ◽  
First Time ◽  
Toxic Nodular Goitre

ObjectivesTo investigate the incidence of hyperthyroidism in Stockholm County, in those patients who were diagnosed with hyperthyroidism for the first time during the years 2003–2005.DesignAll new cases of hyperthyroidism ≥18 years of age were prospectively registered to calculate the total incidence of hyperthyroidism, as well as the incidence of the subgroups: Graves' disease (GD), toxic multinodular goitre and solitary toxic adenoma (STA). Eight specialized units/hospitals in Stockholm County participated in the registration. The participating physicians were all specialists in medical endocrinology, oncology, nuclear medicine or surgery.ResultsDuring a 3-year period, 1431 new patients of hyperthyroidism were diagnosed in a well-defined adult population (>18 years of age) of in average 1 457 036 inhabitants. This corresponds to a mean annual incidence of hyperthyroidism of 32.7/100 000. The incidence of GD was 24.5/100 000 per year, toxic nodular goitre was 3.3/100 000 per year and STA was 4.9/100 000 per year.ConclusionsThe total incidence of hyperthyroidism in Stockholm County was found to be 32.7/100 000 per year, of which 75% had GD. There were a higher percentage of smokers among the patients with hyperthyroidism compared with the overall population in Stockholm, but no difference in the frequency of smoking between patients with GD and toxic nodular goitre.

FURTHER STUDIES ON THE RATE OF DISAPPEARANCE OF LABELLED THYROXINE FROM THE INTRAVASCULAR COMPARTMENT OF MAN, WITH REFERENCE TO THE ROLE OF THYROXINE BINDING PROTEINS

1967 ◽  
Vol 55 (3) ◽  
pp. 497-521 ◽  
Author(s):  
Brian R. Webster ◽  
Amy Britton ◽  
Robert Volpé ◽  
Calvin Ezrin
Keyword(s):  
Binding Sites ◽  
Radioactive Iodine ◽  
Binding Capacity ◽  
Normal Subjects ◽  
Graves Disease ◽  
List Type ◽  
Half Time ◽  
Nodular Goitre ◽  
Toxic Nodular Goitre

ABSTRACT The disappearance of an intravenously injected tracer dose of 131I-labelled L-thyroxine from the circulation has been followed for 70 minutes. We have confirmed that the most significant separation between euthyroid subjects and patients with hyperthyroidism or myxoedema is given by the single exponential slope of the regression of blood radioactivity occurring between 20 and 50 minutes after T4* injection. This slope is referred to as the acute T4* half-time. When there is no alteration in total TBG the acute T4* half-time is closely related to the plasma BEI concentration. Increase in the latter due to Graves' disease, toxic nodular goitre, or exogenous administration of thyroxine or desiccated thyroid, results in a comparable acceleration in the acute T4* half-time compared to the value in euthyroid control subjects. Conversely patients with a low BEI due to primary or radioactive iodine induced myxoedema all have a significantly slow acute T4* half-time compared to normal subjects. There was no specific abnormality in the handling of thyroxine by patients with Graves' disease in contrast to the earlier findings of Lennon et al. (1961). Hypermetabolism per se does not affect the acute T4* half-time. The administration of pharmacological doses of triiodothyronine, unlike similar doses of thyroxine, failed to affect the acute T4* half-time. The acute T4* half-time is consistently related in an inverse manner to the concentration of unsaturated thyroxine-binding sites in association with TBG. These data show no such correlation between TBPA binding and the acute T4 half-time. Synthetic oestrogen, by increasing the unsaturated thyroxine-binding capacity of TBG, produces a profound slowing of the acute T4* halftime.

Type of operation for toxic adenoma, toxic multinodular goitre and Graves’ Disease

2015 ◽  
Vol 87 (1) ◽  
pp. 34-37 ◽  
Author(s):  
S. Lanitis ◽  
K. Karkoulias ◽  
G. Sourtse ◽  
V. Ganis
Keyword(s):  
Graves Disease ◽  
Multinodular Goitre ◽  
Toxic Adenoma

scholarly journals The influence of non-radioactive iodine (127I) on the outcome of radioiodine (131I) therapy in patients with Graves’ disease and toxic nodular goitre

2011 ◽  
Vol 14 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Franciszek Rogowski ◽  
Saeid Abdelrazek ◽  
Piotr Szumowski ◽  
Anna Zonenberg ◽  
Adam Parfienczyk ◽  
...  
Keyword(s):  
Radioactive Iodine ◽  
131I Therapy ◽  
Graves Disease ◽  
Nodular Goitre ◽  
Toxic Nodular Goitre

scholarly journals The usefulness of conventional and echo colour Doppler sonography in the differential diagnosis of toxic multinodular goitres

2000 ◽  
pp. 339-346 ◽  
Author(s):  
F Boi ◽  
M Loy ◽  
M Piga ◽  
A Serra ◽  
F Atzeni ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Autoimmunity ◽  
Peak Systolic Velocity ◽  
Normal Subjects ◽  
Graves Disease ◽  
Multinodular Goitre ◽  
Toxic Adenoma ◽  
Radionuclide Distribution ◽  
Group A ◽  
Group B

OBJECTIVE: To assess the potential role of conventional sonography and colour flow Doppler (CFD) sonography (CFDS) in the differential diagnosis of toxic multinodular goitres. SUBJECTS AND METHODS: We investigated 55 patients with untreated hyperthyroidism (24 with typical toxic diffuse goitre of Graves' disease (Group A); 26 with multinodular goitre (Group B); and five with single toxic adenoma (Group C); 22 euthyroid subjects (12 with non-toxic multinodular goitre (Group D) and ten normal subjects (Group E)) were included as controls. In all cases free thyroxine, free tri-iodothyronine, TSH, TSH receptor antibodies (TRAb), anti-thyroperoxidase antibody, anti-thyroglobulin antibodies and anti-thyroid microsomal antibodies were determined and a [(99m)Tc]pertechnetate thyroid scan was performed. RESULTS: Patients with toxic multinodular goitre displayed two different CFDS patterns: 18 patients (Group B-1) had nodules with normal vascularity surrounded by diffuse parenchymal hypoechogenicity with markedly increased CFD signal and maximal peak systolic velocity (PSV) (a pattern similar to Group A patients with Graves' disease); eight patients (Group B-2) had increased intra- and perinodular CFD signal and PSV with normal extranodular vascularity (a pattern similar to that found in Group C patients with single toxic adenoma). Patients of Group B-1 showed a proportion of clinically evident thyroid ophthalmopathy, positive TRAb and other thyroid autoantibodies similar to that observed in Group A patients, while no evidence of thyroid autoimmunity was found in Group B-2. Sixteen out of 18 (89%) patients from Group B-1 displayed a scintiscan pattern of diffuse uneven radionuclide distribution, while seven out of eight (87.5%) of those from Group B-2 had localized uptake in multiple discrete nodules. Taken together, these data strongly suggest that Group B-1 mostly represents patients with the multinodular variant of Graves' disease, while Group B-2 represents patients with non-autoimmune toxic multinodular goitre. CONCLUSIONS: This study shows that combined conventional sonography and CFDS may easily distinguish nodular variants of Graves' disease from non-autoimmune forms of toxic multinodular goitre and confirms the clinical usefulness of this technique in the first-line evaluation of hyperthyroid patients.

Antithyroid drugs as a factor influencing the outcome of radioiodine therapy in Graves' disease and toxic nodular goitre?

2001 ◽  
Vol 28 (9) ◽  
pp. 1360-1364 ◽  
Author(s):  
C. Körber ◽  
P. Schneider ◽  
N. Körber-Hafner ◽  
H. Hänscheid ◽  
C. Reiners
Keyword(s):  
Radioiodine Therapy ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Nodular Goitre ◽  
Toxic Nodular Goitre

Kinetics of the iodide trapping mechanism in normal and pathological human thyroid slices

1983 ◽  
Vol 103 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Bernardo Ernesto Gluzman ◽  
Hugo Niepomniszcze
Keyword(s):  
Human Thyroid ◽  
Toxic Adenoma ◽  
Nodular Goitre ◽  
Iodide Transport ◽  
Trapping Mechanism ◽  
Normal Human ◽  
Kinetics Of ◽  
And Diffusion ◽  
Toxic Nodular Goitre ◽  
Maximal Capacity

Abstract. Kinetics of the iodide trapping mechanism in thyroid slices was studied in human and animal tissues. Slices were incubated with several medium iodide concentrations, ranging from 5 × 10−6 m to 2 × 10−4 m, in order to calculate in the steady state the following kinetic parameters of the iodide transport: Km, maximal capacity (C) and diffusion factor (D). Results indicated that the Km was similar in magnitude (10−5 m) in all cases where trapping activity was present, while maximal capacity (C) values showed significant differences between those pathologies in which trapping activity was hyperstimulated (dishormonogenetic goitre, Graves' disease, toxic adenoma) and those where thyroid tissues presented focal or total alterations on its structure (non-toxic nodular goitre, Hashimoto's thyroiditis, thyroid cancer) or where thyroid tissues were not sufficiently stimulated by TSH (extranodular tissue of toxic adenoma). 'Warm' nodules were not significantly different from normal human thyroid. These results suggest that the scattered trapping values observed in the different thyroid pathologies correspond to quantitative differences between them rather than to qualitative alterations in the thyroid iodide pump.

Appearance of thyroid stimulating antibody and Graves' disease after radioiodine therapy for toxic nodular goitre

1994 ◽  
Vol 40 (6) ◽  
pp. 803-806 ◽  
Author(s):  
Luca Chiovato ◽  
Ferruccio Santini ◽  
Paolo Vitti ◽  
Giovanna Bendinelli ◽  
Aldo Pinchera
Keyword(s):  
Radioiodine Therapy ◽  
Graves Disease ◽  
Nodular Goitre ◽  
Thyroid Stimulating Antibody ◽  
Toxic Nodular Goitre
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