China
Africa
Explore chapters and articles related to this topic
Evaluation and Investigation of Thyroid Disease
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Thyroid antibodies are found in around 10% of the healthy, euthyroid population. Thyroid peroxidase (TPO) antibody immunoassays are usually used in isolation for diagnosis of autoimmune thyroid disease, including overt hypothyroidism and Hashimoto's thyroiditis.
An anxious insomniac
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Apart from in an emergency (as in this case), thyroidectomy should only be performed on patients who are euthyroid. Drug treatment should be stopped before surgery. A course of potassium iodide reduces the vascularity of the thyroid.
Thyroidectomy
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Patients with thyroid nodules present euthryoid in the majority of cases. The occasional hyperfunctioning nodule that presents with a low TSH, and is “hot” on radioactive iodine scan requires a lobectomy according to the American Thyroid Association (ATA) guidelines. These patients should be made euthyroid prior to lobectomy with methimazole and possibly a beta blocker. Prior to surgery for suspected cancer, US to look at lateral neck nodes and fine-needle aspiration biopsy with a thyroglobulin wash of abnormal neck nodes helps determine the extent of surgery. Positive lateral neck nodes require the addition of a modified radical neck dissection to the total thyroidectomy and central neck lymph node dissection. The US can also be useful to look at the carotid–subclavian junction on the right. If the junction is abnormal, there is a higher likelihood of discovering a non-recurrent recurrent laryngeal nerve.
Insights into the possible impact of COVID-19 on the endocrine system
Published in Archives of Physiology and Biochemistry, 2023
Adel Abdel-Moneim, Ahmed Hosni
A study performed during the 2003 SARS-outbreak recorded lower levels of serum T3 and tetraiodothyronine (T4) in patients with SARS compared with controls (Wang et al.2003). In addition, intensive care cases of SARS with sick-euthyroid syndrome seemed to have a lower thyroid weight related to decreasing follicular thyroid size along with colloid depletion (De Jongh et al.2001). Multiple pathways have been proposed for the progression of sick-euthyroid syndrome, including changes in iodothyronine deiodinases and TSH secretion, thyroid hormone binding to plasma protein, thyroid hormone delivery in peripheral tissues, and thyroid hormone inhibitory effects (DeGroot 2000). Moreover, Sun et al. (2005) identified follicular cell dystrophy, deformation, and decrease levels of thyroglobulin in four patients with SARS who died. Furthermore, autopsy investigations of five patients with SARS showed considerable degradation of the thyroid follicular and parafollicular cells with significant numbers of cells undergoing apoptosis (Wei et al. 2007). Destruction of the thyroid follicular cells can be manifested by low T3 and T4 levels.
Low awareness and under-diagnosis of hypothyroidism
Published in Current Medical Research and Opinion, 2022
Ulrike Gottwald-Hostalek, Barbara Schulte
People with hypothyroidism present typically with a range of relatively nonspecific symptoms, such as, fatigue, feeling cold, weight gain, constipation, low mood, slowed cognition, muscle aches/cramps, weakness, muscle cramps, dry skin, brittle hair and nails, diminished libido, carpal tunnel syndrome, or dysmenorrhea20. Some of these symptoms are more prevalent in people with overt or subclinical hypothyroidism, compared with euthyroid subjects; however, the symptoms are found commonly in hypothyroid and euthyroid populations, and their presence or absence is not a reliable predictor of thyroid status2,21. The symptoms reminiscent of hypothyroidism are similar to those of advancing age22, and persist in some individuals even after optimization of the TSH level with levothyroxine23. Inevitably, many people will persevere with these nonspecific symptoms, perhaps attributing them to other causes, without discussing them with a healthcare professional. This may be especially true for subclinical hypothyroidism, where the severity of thyroid-related symptoms is likely to be lower than in an individual with overt clinical hypothyroidism.2
Thyroid eye disease presenting with superior rectus/levator complex enlargement
Published in Orbit, 2020
Yao Wang, Pradeep Mettu, Talmage Broadbent, Phillip Radke, Kevin Firl, J. Banks Shepherd, Steven M. Couch, Angeline Nguyen, Amanda D. Henderson, Timothy McCulley, Collin M. McClelland, Ali Mokhtarzadeh, Michael S. Lee, James A. Garrity, Andrew R. Harrison
We identified TED patients presenting with enlarged superior rectus/levator complex enlargement at four academic institutions. The clinical presentation of these patients differed from that of the previously-described cohort of all TED patients from Olmsted County, Minnesota.1 Of our nineteen study patients, 63.2% had hyperthyroidism, compared to 90% in the incidence cohort, and 26.3% were euthyroid, compared to 6% in the incidence cohort. All of our patients presented with exophthalmos compared to 62% in the incidence cohort. 63% of our patients presented with upper eyelid retraction, versus 71% in the incidence cohort. Only 17% of patients in the incidence cohort suffered from diplopia, versus 63% in our TED population (all but two had vertical misalignment). Even though a quarter of our patients were euthyroid, it is important to note that average TSI was elevated at 3.7 and TRAb was 2.5IU/L. Although TSI initially was normal in one patient (Figure 1), it was elevated several months later upon recheck. This finding suggests there is a lag time to positive seroconversion, and consideration should be given to rechecking antibody titers if they are initially normal.