Responses to TRH, T3 suppression tests and histological findings by needle biopsy in patients with simple goitre in Japan

1982 ◽  
Vol 100 (2) ◽  
pp. 231-236 ◽  
Author(s):  
Osamu Fukino ◽  
Hajime Tamai ◽  
Mitsuharu Kumai ◽  
Noriyuki Ohsako ◽  
Kanji Kuma ◽  
...  
Keyword(s):  
Needle Biopsy ◽  
Biopsy Specimen ◽  
Lymphocytic Infiltration ◽  
Antithyroid Antibody ◽  
Histological Findings ◽  
Trh Test ◽  
Chronic Thyroiditis ◽  
Abnormal Response ◽  
Suppression Test ◽  
Hyperplastic Change

Abstract. Studies were performed in 120 patients with simple goitre, defined as relatively soft diffuse goitre. All were clinically and biochemically euthyroid and their antithyroid antibodies were negative. The TRH test was performed in 115, and a T3 suppression test was performed in 99 after the TRH test, while satisfactory biopsies of the thyroid were obtained in 37. The results showed that 28 of the 115 cases (24%) had an abnormal response to TRH; 8 (7%) were hyporesponders and 20 (17%) were hyperresponders. The T3 suppression test showed that 3 of 99 cases (3%) were non-suppressible. As determined by histological examination of the needle biopsy specimen, 17 of the 37 cases (46%) had normal follicles without lymphocytic infiltration, 10 (27%) had diffuse chronic thyroiditis, 5 (14%) had focal thyroiditis and 4 (11%) had diffuse epithelial hyperplastic change, and 1 (3%) had an adenomatous goitre. It is suggested that simple goitre defined as above includes various thyroid diseases and that the results of TRH tests, antithyroid antibody estimations and histological findings do not correlate in many patients.

A study of thyroid function after subtotal thyroidectomy for Graves' disease: particularly on TRH tests, T3 suppression tests and antithyroid antibodies in euthyroid patients

1983 ◽  
Vol 103 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Osamu Fukino ◽  
Hajime Tamai ◽  
Shinichi Fujii ◽  
Noriyuki Ohsako ◽  
Sunao Matsubayashi ◽  
...  
Keyword(s):  
Elevated Serum ◽  
Subtotal Thyroidectomy ◽  
Graves Disease ◽  
Trh Test ◽  
Antithyroid Antibodies ◽  
Abnormal Response ◽  
Suppression Test ◽  
Recurrent Hyperthyroidism ◽  
Serum Tsh

Abstract. Of 305 patients who underwent subtotal thyroidectomy for Graves' disease between 1969 and 1975, recurrent hyperthyroidism was found in 31 (10.2%) and hypothyroidism in 18 (5.9%). The remaining 256 patients were clinically euthyroid, but an elevated serum TSH level was found in 104 (34.1%) and an elevated serum T3 level in 19 (6.28%). In 57 of 133 clinically and biochemically euthyroid patients, a TRH test, T3 suppression test and measurement of antithyroid antibodies were performed. Twenty-nine of the 57 patients (50.9%) showed an abnormal response to TRH. Eight of these (14.0%) showed an impaired or absent response. The T3 suppression test showed that 15 of the 57 patients (26.3%) were non-suppressible. Positive antithyroid antibodies, especially antimicrosomal antibodies, were more frequent in non-suppressible and TRH-non-responsive patients than in suppressible and TRH-responsive patients. It is suggested that after operation for Graves' disease: 1) only half of the clinically euthyroid patients were biochemically euthyroid, 2) of the clinically and biochemically euthyroid patients, there were many with abnormalities in TRH responsiveness and T3 suppressibility, and 3) thyroid functional status is unstable and long careful follow-up is important after operation for Graves' disease.

EUTHYROID GOITERS IN CHILDREN: CORRELATION OF NEEDLE BIOPSY WITH OTHER CLINICAL AND LABORATORY FINDINGS IN CHRONIC LYMPHOCYTIC THYROIDITIS AND SIMPLE GOITER

PEDIATRICS ◽  
1969 ◽  
Vol 44 (5) ◽  
pp. 695-708
Author(s):  
Shun M. Ling ◽  
Solomon A. Kaplan ◽  
Jordan J. Weitzman ◽  
George B. Reed ◽  
Gertrude Costin ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Needle Biopsy ◽  
Biopsy Specimen ◽  
Disease Process ◽  
Chronic Lymphocytic Thyroiditis ◽  
Red Cell ◽  
Thyroid Antibodies ◽  
Thyroid Extract ◽  
Laboratory Findings ◽  
Lymphocytic Thyroiditis

All children with euthyroid goiters examined over a period of 3 years underwent study of thyroid function, needle biopsy, and measurement of thyroid antibodies. Sixty-six of 71 children studied had satisfactory biopsies of the thyroid. Of these, 43 (65%) had chronic lymphocytic thyroiditis and 23 (35%) had simple goiter as determined by histologic examination of the biopsy specimen. Elevated titers of anti-thyroid antibodies were found in 50% of the patients with thyroiditis by the tanned red cell method and in 63% by the indirect Coons method. Neither antibody was present in significant quantity in 20% of the patients. Abnormal levels of antibody were rarely detected in children with histologic evidence of simple goiter. Treatment with thyroid extract has little effect on the progression of the disease process to fibrosis and atrophy. Such treatment may be necessary to anticipate the development of hypothyroidism or for replacement if thyroid function is already diminished. There is no evidence that simple goiter is associated with hypothyroidism, and treatment of this disease with thyroid preparations is necessary only for cosmetic purposes. Needle biopsy is the most useful means for making a distinction between thyroiditis and simple goiter.

Dexamethasone Suppression Test in Depression and other Psychiatric Illness

1983 ◽  
Vol 142 (5) ◽  
pp. 498-504 ◽  
Author(s):  
A. Coppen ◽  
M. Abou-Saleh ◽  
P. Milln ◽  
M. Metcalfe ◽  
J. Harwood ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Affective Disorders ◽  
Psychiatric Illness ◽  
Dexamethasone Suppression Test ◽  
Major Depressive ◽  
Abnormal Response ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Normal Controls

SummaryThe prevalence of an abnormal response to the dexamethasone suppression test (DST) was examined in 119 in-patients suffering from a major depressive disorder and in 79 normal controls. Only 11 per cent of controls showed an abnormal DST as against 70 per cent of depressed patients. The specificity of the DST was examined by testing patients with other psychiatric disorders. Abnormal responses were found in one-fifth of a sample of schizophrenics, over one-quarter of abstinent alcoholics, two-fifths of neurotics (including neurotic depressives) and almost half of senile dements. Abnormal DST was also found in 33 per cent of patients receiving prophylactic lithium for recurrent affective disorders.

scholarly journals Troglitazone Induces CYP3A4 Activity Leading to Falsely Abnormal Dexamethasone Suppression Test

2003 ◽  
Vol 88 (7) ◽  
pp. 3113-3116 ◽  
Author(s):  
Eleni V. Dimaraki ◽  
Craig A. Jaffe
Keyword(s):  
Breath Test ◽  
Plasma Corticosterone ◽  
Dexamethasone Suppression Test ◽  
Screening Tests ◽  
Cyp3a4 Activity ◽  
Abnormal Response ◽  
Before And After ◽  
Erythromycin Breath Test ◽  
Suppression Test ◽  
Dexamethasone Suppression

After evaluating a patient who appeared to have a falsely abnormal response to the dexamethasone suppression test while taking troglitazone, we examined the effects of troglitazone on the activity of hepatic CYP3A4 and the screening tests for Cushing’s syndrome. We studied five healthy women and three healthy men, aged 25 ± 2 yr, before and after treatment with troglitazone (600 mg daily) for 28 d. Baseline 0800 h cortisol and corticosterone were similar before and after troglitazone treatment. Before troglitazone treatment, all subjects suppressed 0800 h cortisol below 1.8 μg/dl (mean, 0.66 ± 0.08 μg/dl) during the 1-mg overnight dexamethasone suppression test (DST), whereas during troglitazone treatment none of the subjects suppressed 0800 h cortisol below 1.8 μg/dl (mean, 9.0 ± 1.8 μg/dl). Serum dexamethasone levels decreased by 66 ± 4%, and the erythromycin breath test measurements increased by 27 ± 8%, indicating increased CYP3A4 activity during troglitazone treatment. The hydrocortisone suppression test (HST) was performed by administering 50 mg hydrocortisone at 2300 h. Using the criterion of suppression of 0800 h plasma corticosterone by more than 50%, the specificity of the HST was 100% both before and after troglitazone treatment. In conclusion, troglitazone induced the activity of CYP3A4 leading to falsely abnormal DST. HST is a useful alternative to the DST in patients taking medications that increase the activity of CYP3A4.

Dexamethasone suppression test and TRH test in endogenous depression

1983 ◽  
Vol 67 (4) ◽  
pp. 258-264 ◽  
Author(s):  
H. Aggernses ◽  
C. Kirkegaard ◽  
I. Krog-Meyer ◽  
B. Kijne ◽  
J. K. Larsen ◽  
...  
Keyword(s):  
Endogenous Depression ◽  
Dexamethasone Suppression Test ◽  
Trh Test ◽  
Suppression Test ◽  
Dexamethasone Suppression

Renal cell carcinoma sub-typing by histopathology and fluorescence in situ hybridization on a needle-biopsy specimen

2007 ◽  
Vol 99 (2) ◽  
pp. 290-295 ◽  
Author(s):  
Daniel A. Barocas ◽  
Susan Mathew ◽  
Joseph J. DelPizzo ◽  
E. Darracott Vaughan ◽  
R. Ernest Sosa ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
In Situ Hybridization ◽  
Fluorescence In Situ Hybridization ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Needle Biopsy ◽  
Biopsy Specimen

Clinical Significance of Endogenously Labelled Thyroid Hormones in the Diagnosis of Thyroidal Autonomy

1983 ◽  
Vol 22 (04) ◽  
pp. 212-216
Author(s):  
H. Kutzim ◽  
W. Waters
Keyword(s):  
Healthy Subjects ◽  
Diagnostic Error ◽  
Control Group ◽  
Trh Test ◽  
Clinical Value ◽  
Thyroid Glands ◽  
Suppression Test ◽  
Group 5 ◽  
Hyperthyroid Patients

The clinical value of the determination of 123I concentration in serum 48 hrs after tracer administration (123I)48 is investigated with special regard to thyroidal autonomy. Serum radioiodine concentration, thyroid radioiodide uptake at 4 and at 48 hrs were measured in 74 healthy subjects and patients with simple goiter, in 36 patients with thyroidal autonomy (diagnosis by thyroid suppression test), and in 20 hyperthyroid patients. 83% of the patients with elevated radioiodine concentration belonged to the group of thyroidal autonomy. The product of radioiodine concentration and thyroid radioiodide uptake is a much better parameter. 95% of the patients in which this product was elevated, belonged to the autonomy group (5 % diagnostic error). Also in the control group the diagnostic error was 5 %. The combination of (123I)48 with the result of the TRH-test is very useful in excluding thyroidal autonomy, if (l23I)48 is normal and the TRHtest is positive (100% of the patients have regulated thyroid glands). 94% of the patients having elevated (123I)48 and a negative TRH-test belonged to the group of thyroidal autonomy. A very useful combination for the diagnosis of borderline hyperthyroidism is the determination of the product of (123I)48 and the uptake48 together with the pulse rate or fine tremor of the fingers (or TRH-test). The results suggest that the determination of (123I)48 is a very good parameter of thyroidal autonomy beside the thyroid suppression test. It may be used alone for the diagnosis of thyroidal autonomy if the suppression test is contraindicated. In the diagnosis of borderline hyperthyroidism its determination makes the suppression test unnecessary in many instances.

scholarly journals Effective and less invasive diagnostic strategy for gastrointestinal GVHD

2018 ◽  
Vol 06 (03) ◽  
pp. E281-E291 ◽  
Author(s):  
Katsuya Endo ◽  
Fumiyoshi Fujishima ◽  
Masatake Kuroha ◽  
Rintaro Moroi ◽  
Motoyuki Onodera ◽  
...  
Keyword(s):  
Sigmoid Colon ◽  
Graft Versus Host Disease ◽  
Cell Apoptosis ◽  
Biopsy Specimen ◽  
Orange Peel ◽  
Diagnostic Strategy ◽  
Histological Findings ◽  
Detection Rates ◽  
Graft Versus Host ◽  
Mucosal Defect

Abstract Background and study aims Rectosigmoidoscopy with biopsy has been regarded to be a useful procedure to diagnose gastrointestinal graft-versus-host disease (GVHD). However, little is known about the specific colonoscopic features of gastrointestinal GVHD. In this study, we focused on the 4 unique colonoscopic findings – orange peel appearance, spotty redness, small mucosal sloughing, and diffuse mucosal defect – which are possible specific findings of gastrointestinal GVHD. We aimed to estimate the usefulness of these four unique colonoscopic findings in the rectosigmoid portion to diagnose gastrointestinal GVHD. Patients and methods Seventy patients who were histologically diagnosed with gastrointestinal GVHD at our institute were retrospectively enrolled. Colonoscopic findings were reviewed, focusing on the four characteristic findings. The percentage of the positive cases for the characteristic findings was calculated. The final scoping portion and the number of cases showing any of the four characteristic findings in the rectosigmoid portion were also evaluated. The relationships between biopsy sites and the histological findings were also evaluated. Results Orange peel appearance was observed in 66 cases (94.3 %). Spotty redness was observed in 45 cases (64.3 %). Small mucosal sloughing was observed in 49 cases (70.0 %). Diffuse mucosal defect was observed in six cases (8.6 %). The number of cases that were concurrently positive for one, two, and three findings were 16 (20.8 %), 20 (26.0 %), and 34 (48.6 %), respectively. Fifty-eight cases (82.9 %) were investigated up to the rectosigmoid portion, and 12 (17.1 %) were investigated beyond the sigmoid colon. All of the cases showed at least 1 of the 4 characteristics in the rectosigmoid portion. The percentage of crypt apoptosis in the biopsy specimen from orange peel appearance, spotty redness, small mucosal sloughing, and diffuse mucosal defect were 87.5 %, 83.3 %, 87.2 %, and 88.9 %, respectively. Conclusion Orange peel appearance, spotty redness, small mucosal sloughing, and diffuse mucosal defect are the characteristic colonoscopic findings useful for diagnosis of gastrointestinal GVHD. These findings are frequently observed in the rectosigmoid portion. The histological detection rates for crypt cell apoptosis from these findings are high. Identifying the four characteristic findings on rectosigmoidoscopy and taking biopsies from these areas could be essential for the diagnostic strategy for gastrointestinal GVHD.

Papillary Carcinoma of the Thyroid Occurring as Multiple Vascular Tumors

1982 ◽  
Vol 90 (4) ◽  
pp. 497-500
Author(s):  
Mark Bassett ◽  
Charles W. Cummings ◽  
Daniel W. Kozie
Keyword(s):  
Papillary Carcinoma ◽  
Surgical Therapy ◽  
Needle Biopsy ◽  
Biopsy Specimen ◽  
Correct Diagnosis ◽  
Vascular Tumors ◽  
Tumor Vascularity ◽  
Tumor Involvement

A case of advanced papillary carcinoma in a 16-year-old boy is presented. While this case is typical of the indolent and locally invasive character of papillary carcinoma, it is remarkable for the extent of tumor involvement appearing as reactive lymphadenopathy. The pronounced tumor vascularity and the similarity of the needle biopsy specimen to chemodectoma both conflicted with the initial diagnostic impression. The correct diagnosis was confirmed only with definitive surgical therapy.

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