Form Of Thyroid Dysfunction Research Articles

Thyroid dysfunction in pregnancy - a retrospective observational analysis of a Maltese cohort

BackgroundThyroid dysfunction is known to adversely affect pregnancy. This studyevaluates the prevalence of thyroid disorders and explores their associationwith pregnancy complications/comorbidities and modes of delivery in the Maltesepregnant population over a ten year period.DesignA population based observational study.MethodWe analysed data from the National Obstetrics Information Service of theDepartment of Health Informations and Research (NOIS) for all births deliveredin Malta between 2006 and 2016. Cases identified and recorded by NOIS to have had some form of thyroiddysfunction during pregnancy were confirmed by cross-referencing with laboratory results found in patients’medical records and/or iSOFT® database system. Using the Statistical Packagefor the Social sciences (SPSS®) demographic data, pastobstetric and medical history and obstetric outcomes were analysed forpregnancies with thyroid dysfunction and compared to data pertaining to pregnancies in euthyroid patients, that is those with no recorded thyroid dysfunction on NOIS. Chi square/Fisher'sexact test were used to compare categorical variables while ANOVA/Mann-WhitneyU test was used to compare continuous variables. Statistical significance wasdefined by a two-sided p value <0.05.ResultsData was available for 46,283 women (mean [SD] age = 29.2 [5.4] years).587 pregnancies (1.3%) suffered from thyroid dysfunction. Of these, 67.3% werehypothyroid, 3.2% had hyperthyroidism, 28.3% had isolated hypothyroxinaemia(IHT) while 1.2% had a history of thyroid carcinoma. Patients with IHT andhypothyroidism were older than euthyroid patients (p < 0.001). IHT and hypothyroid patients had astatistically significant higher body mass index (BMI) than euthyroid women(p=0.001 for hypothyroid women, p = 0.035 for IHT). Hypothyroid and IHT women were more likely to have had aprevious lower segment caesarean section (p=0.043, and 0.006respectively). Type 1 diabetes and gestational diabetes p = 0.012) were more common associatedcomorbidities in hypothyroid pregnancies. Offspring of patients with IHT had ahigher birth weight than those born to euthyroid patients (p=0.009). Patients with hyperthyroidism were found to havea significantly increased risk of early preterm delivery before 34 weeks ofgestation and were also more likely to have suspected intrauterine growthrestriction and low mean birth weight. We report no significantdifferences in past history of obstetric loss, antenatal complications, mode ofdelivery, gestational age at delivery and postpartum haemorrhage rates acrossthyroid categories.ConclusionsAvailable evidence suggests that thyroid dysfunction is more likely in thesetting of older age, and higher body mass index. Moreover, it impacts on neonatalbirth weight, rates of early preterm delivery and intrauterine growthrestriction.

COMPARATIVE STUDY OF SERUM ELECTROLYTES IN PATIENTS HAVING THYROID DYSFUNCTIONS WITH THE EUTHYROIDS IN A TERTIARY HOSPITAL IN NEPAL

Background: Thyroid hormone influences almost all metabolisms in the body and maintains body homeostasis. Since electrolytes homeostasis is also maintained by the thyroid hormone, we conducted this study to access the level of serum electrolytes in the presence of thyroid dysfunction. Methods: This was a cross-sectional study including 120 patients with any form of thyroid dysfunction and 120 euthyroids conducted in the department of biochemistry and medicine at Dhulikhel Hospital, Kavre, Nepal for six months (May-October 2021). Ethical clearance was taken from the Institutional Review committee- KUSMS. Venous blood was collected and serum free T3, free T4, TSH, sodium and potassium were measured. Data were analysed in Statistical Package for Social Sciences (SPSS Inc., Chicago, USA) version 16.0. Independent t-test, Man Whitney U test, one way ANOVA with ad hoc Dunnet t test and Spearman correlation were performed. Results: The mean level of sodium in subclinical hypothyroid, overt hypothyroid, euthyroid, subclinical hyperthyroid and overt hyperthyroid were 140.72±2.38, 141.24 ±4.60, 141.04±2.35, 141.89±3.38 and145.44±2.74, respectively. There was negative statistically significant correlation of the level of Na with TSH (rs=-0.144, p&lt;0.05) and positive with fT3(rs=0.241, p&lt;0.01). Conclusions: The level of serum sodium increased with the increase in the level of TSH and decreased with the increase in the level of fT3 in our population.

Assessment and treatment of thyroid disorders in pregnancy and the postpartum period.

Thyroid disorders are prevalent in pregnant women. Furthermore, thyroid hormone has a critical role in fetal development and thyroid dysfunction can adversely affect obstetric outcomes. Thus, the appropriate management of hyperthyroidism, most commonly caused by Graves disease, and hypothyroidism, which in iodine sufficient regions is most commonly caused by Hashimoto thyroiditis, in pregnancy is important for the health of both pregnant women and their offspring. Gestational transient thyrotoxicosis can also occur during pregnancy and should be differentiated from Graves disease. Effects of thyroid autoimmunity and subclinicalhypothyroidism in pregnancy remain controversial. Iodine deficiency is the leading cause of hypothyroidism worldwide. Despite global efforts to eradicate iodine deficiency disorders, pregnant women remain at risk of iodine deficiency due to increased iodine requirements during gestation. The incidence of thyroid cancer is increasing worldwide, including in young adults. Assuch, the diagnosis of thyroid nodules or thyroid cancer during pregnancy is becoming more frequent. The evaluation and management of thyroid nodules and thyroid cancer in pregnancy posea particular challenge. Postpartum thyroiditis can occur up to 1 year after delivery and must bedifferentiated from other forms of thyroid dysfunction, as treatment differs. This Review provides current evidence and recommendations for the evaluation and management of thyroid disorders in pregnancy and in the postpartum period.

Association between Thyroid Dysfunction and Intensive Care Unit-Acquired Weakness: A Case-Control Study.

Background Thyroid disorders may decrease the threshold for developing myopathy. Nonthyroidal illness syndrome (NTIS) is a common form of thyroid dysfunction in critically ill patients who are prone to the development of intensive care unit-acquired weakness (ICUAW). We therefore tested the hypothesis that patients with abnormalities in thyroid function are at a higher risk of developing ICUAW. Methods We assessed blood samples from patients admitted to the ICU for ≥7 days for thyroid functions. Patients were classified into 4 categories (euthyroid, hyperthyroid, hypothyroid, and NTIS). Patients were then evaluated daily for ICUAW development. Patients with ICUAW were considered as cases, whereas patients who did not develop ICUAW served as controls. We compared demographic and clinical variables, such as APACHE II score; length of ICU stay; free T3 (FT3), free T4, and thyroid-stimulating hormone levels; incidence of the four categories of thyroid function; and other risk factors for ICUAW. Logistic regression was used to determine independent risk factors for ICUAW. Results This case-control study included 114 patients: 57 cases (ICUAW) and 57 controls. FT3 levels were significantly lower in the cases (2.13 ± 0.96 mU/L) than in controls (2.69 ± 1.07 mU/L; P=0.004). There were no significant differences between cases and controls regarding the incidence of all categories of thyroid function. In univariate analysis, five independent variables had P < 0.25 (sepsis, vasopressors, mechanical ventilation duration, NTIS, and FT3 levels). Among these variables, multiple regression showed that only FT3 level (CI = 0.157–0.82, P=0.015) was an independent risk factor. Conclusion The study revealed an inverse association between ICUAW incidence and FT3 levels.

Vitamin D dosage

Despite its historical name, vitamin D is not a vitamin at all but a hormone that, when activated, is a metabolically active steroid fat-soluble hormone that acts on cellular receptors. Vitamin D hormone is synthesized endogenously and then metabolized in the body, provi-ding that there are the necessary precursors and some factors — the effects of ultraviolet light on the skin. At the same time, vitamins themselves are nutrients, co-factors of biochemical reactions that are not synthesized in the body and cannot interact with receptors, consumed with food, so the hormone D is not a vitamin. Disputes about its use and dosage continue throughout the study period of vitamin D hormone. Most reputable experts in Europe and the USA support the need to replenish and maintain a normal level of vitamin D, believing it to be completely safe and useful. In 2011, the US Endocrine Society issued clinical practice guidelines for vitamin D, indicating that the desired serum concentration of 25(OH)D is &gt; 75 nmol/l (&gt; 30 ng/ml) to achieve the maximum effect of this vitamin on calcium metabolism, bone, and muscle metabolism. According to them, for a consistent increase in serum 25(OH)D above 75 nmol/l (30 ng/ml), adults may require at least 1,500-2,000 IU/day of additional vitamin D, at least 1,000 IU/day in children and adolescents. The most common form of thyroid dysfunction is secondary hyperparathyroidism, which develops due to vitamin D defect/deficiency (80–90 %). Non-optimal serum concentrations of 25(OH)D lead to secondary hyperparathyroidism, potentially leading to decreased bone mineralization and, ultimately, to an increased risk of osteopenia, osteoporosis and fractures, cardiac arrhythmia, and increased blood pressure. Vitamin D is most commonly used at a star-ting dose of 5,000 IU daily for 2–3 months, then transferring patients to maintenance doses of 2,000–4,000 IU/day daily that are consi-dered safe. However, it should be noted that some patients will need constant administration of 5,000 IU of vitamin D per day for a long time (years) to maintain the target optimal level of 25(OH)D in the blood, especially in patients with normocalcemic forms of secondary hyperparathyroidism.

Thyroid Function, Urinary Iodine, and Thyroid Antibody Status Among the Tribal Population of Kashmir Valley: Data From Endemic Zone of a Sub-Himalayan Region.

Background: There are scarce data on the prevalence of thyroid disorders and urinary iodine status among tribal populations of India, with no reported data from Kashmir valley.Objectives: To estimate the prevalence of thyroid disorders and evaluate urinary iodine concentration (UIC) and thyroid autoantibody status among Gujjar and Bakerwal tribes of Kashmir valley.Methods: This cross-sectional study recruited tribal subjects using multistage cluster sampling from 5 out of 22 districts of Jammu and Kashmir (J&K). Using a predesigned questionnaire, the details of past or current medical history and drug intake, including thyroid hormone medication etc. were recorded after obtaining an informed consent. Examination included anthropometry (height, weight, waist circumference), blood pressure measurement, and relevant general physical examination focusing on goiter palpation, while as laboratory assessment included estimation of serum thyroid hormone levels, antithyroid peroxidase antibody (anti-TPO Ab), and urinary iodine concentration.Results: A total of 763 subjects (56.4% women and 43.6% men) with a mean(±SD) age of 39.46 (±17.51) ranging from 10 to 85 years and mean(±SD) body mass index (BMI) of 21.28 (±4.16) kg/m2 were studied. Goiter was detected in 6.8%, while 33.2% subjects had some form of thyroid dysfunction (including 24.1% subclinical and 6.8% overt hypothyroidism). Subclinical and overt hyperthyroidism were observed in 1.3 and 0.9% of cases, respectively. Anti-TPO Ab was elevated in 13.6%, while the median [interquartile range (IQR)] for UIC was 154.50 (135) μg/L [156.13 (134) μg/L in men and 147.26 (136) μg/L in women]. A negative correlation was observed between UIC and anti-TPO Ab (r = −0.087, P = <0.05).Conclusion: These novel data on iodine and thyroid status among a tribal population of India generally inhabiting in remote sub-Himalayan belts demonstrate high prevalence of subclinical hypothyroidism (SCH) with persistent iodine deficiency. These preliminary data may warrant large well-designed studies to carry out comprehensive assessment of the problem in this high-risk and marginalized population.

Thyroid hormones profile of patients with type 2 diabetes mellitus in Kano, Nigeria

Diabetes mellitus (DM) and thyroid disease are the two most common endocrine disorders in the general population. Several Studies have shown that thyroid dysfunction is common in patients with DM, and thyroid dysfunction have been found to have a considerable impact on the glycaemic control and often increases the risk of development of long-term complications in patients with diabetes mellitus. This study determined the prevalence of thyroid dysfunction in patients with type 2 DM in Kano, North-Western Nigeria. The study was a descriptive cross-sectional study conducted on 250 participants made up of 130 patients with type 2 DM and 120 apparently healthy non-diabetic controls. Questionnaires were used to collect information on bio data, medical history, duration of diagnosis of diabetes and type of treatment. Also, blood samples of the participants were collected and analyzed for fasting plasma glucose, fT3, fT4, and TSH. The results were interpreted using American Thyroid Associations’ criteria and the data was analyzed using the statistical software package, STATA version 20. Two hundred and thirty-four (93.6%) of the participants were euthyroid while sixteen (6.4%) were found to have various forms of thyroid dysfunction. The prevalence of thyroid dysfunction was 10% and 2.5% among type 2 diabetics and controls respectively. Among the type 2 DM patients with thyroid dysfunction, 38.5% had hypothyroidism. Thyroid dysfunction was found to be commoner among type 2 DM patients than non-diabetic individuals with hypothyroidism being the commonest disorder.

Status of Thyroid Hormone Parameters in Hypertensive Disorders of Pregnancy

Introduction: Hypertensive disorders of pregnancy (HDP) are the most common complications observed during pregnancy and are a leading cause of maternal and perinatal morbidity and mortality. Thyroid hormone abnormalities are prevalent in females of reproductive age group. However, the relation between thyroid hormones and hypertensive pregnant women remains unclear. This study aims to assess the status of thyroid hormone abnormalities in patients with HDP.&#x0D; Materials and Methods: This is a case-control study conducted for one year in Karnali Province Hospital and Deuti Hospital, Surkhet, Nepal. Thirty hypertensive patients with singleton pregnancies in the third trimester were taken as case and 30 healthy normotensive singleton pregnant women as control and their thyroid hormone parameters were compared. Statistical analysis was done using SPSS version 21.&#x0D; Results: The mean gestational age of recruited study subjects and control were 37.00 ± 3.04 weeks and 35.70±3.83 weeks (p&gt;0.05). The mean value of TSH was significantly higher (p&lt;0.05) in hypertensive subjects (4.19±2.95) μIU/L when compared with the control (2.67±1.71) μIU/L. There was no significant difference when the serum level of FT3 and FT4 were compared between hypertensive and normotensive pregnant women (p&gt;0.05). Subclinical hypothyroidism was found in 16.66% of hypertensive subjects.&#x0D; Conclusions: HDP is associated with thyroid hormone abnormalities. An increase in TSH levels with normal FT3 and FT4 levels were found to be the most common form of thyroid dysfunction during pregnancy.

Cardiac remodeling hypertensive patients with different forms of thyroid dysfunction

Objective . To analyze the changes in the structural and functional characteristics of the heart, clinical severity of heart failure (HF) and the levels of N-terminal fragment of the brain natriuretic peptide (NT-proBNP) in patients with arterial hypertension (HTN) and various forms of the thyroid dysfunction (TD). Design and methods. The total of 101 HTN patients were included in the study: 40 with hypothyroidism; 39 — with hyperthyroidism, 22 — without any TD. Control group consisted of 20 persons without any cardiovascular pathology and TD. Basic structural and functional parameters of the heart, serum levels of NT-proBNP were studied. Results . In patients with TD, HF was revealed significantly more often than in the group of AH without TD. There with patients with hypothyroidism had higher, HF functional class compared to the group of hyperthyroidism. In the group of HTN with hypothyroidism left ventricular (LV) hypertrophy and decrease of E/A ratio were observed, whereas patients with HTN and hyperthyroidism were characterized by LV dilatation and by a significant increase of serum NTproBNP level. Conclusions. In HTN patients with hyperthyroidism cardiac remodeling is characterized by the prevalence of LV dilatation, whereas in hypothyroidism LV hypertrophy with LV diastolic dysfunction dominate. Hyperthyroidism is also associated with increased NT-proBNP serum levels.

Thyroid peroxidase antibody levels among human immunodeficiency virus infected patients in Kano, North-Western Nigeria

Autoimmunity plays a role in the development of thyroid dysfunction in human immunodeficiency virus (HIV) infected patients. This study assessed the serum levels of thyroid peroxidise antibody (TPO-Ab) in relation to the various forms of thyroid dysfunction in HIV patients in Kano. Free tri-iodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH) and TPO-Ab were measured using Chemiluminescent immunoassay(CLIA) on the serum of 70 HIV sero-positive patients on Highly Active Antiretroviral Therapy (HAART, as Group I), 70 HAART naïve HIV sero-positive patients (Group II) and 70 apparently healthy HIV negative controls (Group III). The prevalence of thyroid dysfunctions were 55.7%, 42.9% and 2.8% among groups I, II and III respectively. TPO-Ab was elevated in 1 (1.43%) HIV positive patient on HAART, Group I, that also had subclinical hyperthyroidism. Four participants (5.7%) among group III were found to have elevated anti-TPO levels. Thyroid dysfunction was more common among HIV-positive than HIV-negative participants. Thyroid dysfunction among HIV patients was mainly non-autoimmune in origin. However, thyroid autoimmunity appears to play a little role in the development of hyperthyroidism in HIV patients.

Thyroid Stimulating Hormone Level at Diagnosis as a Predictor of Persistent Subclinical Hypothyroidism in Children with Down Syndrome

To evaluate subclinical hypothyroidism in a cohort of children with Down syndrome and identify a TSH level at the time of diagnosis to predict persistent hypothyroidism. 192 children (age <3 years) with Down syndrome, registered in the Genetic Clinic of a referral tertiary care Hospital from 2010 to 2015 were evaluated with thyroid function test at initial visits and subsequently based on standard protocol. Children with subclinical hypothyroidism were evaluated at 3 years of age after discontinuation of thyroxine for 3 months. 47 (24.5%) children had elevated TSH and among them 43 (91.5%) had subclinical hypothyroidism. Among the subclinical hypothyroidism group, 25 (73.5%) had transient hypothyroidism and 9 (26.5%) persistent hypothyroidism. Initial TSH level at the time of diagnosis was higher in persistent hypothyroidism group as compared to transient group (P= 0.003). The best cut-off level for prediction of persistent hypothyroidism for initial TSH level was 11.6 mIU/L. Subclinical hypothyroidism, especially transient, is the commonest form of thyroid dysfunction in children with Down syndrome. The initial TSH level may help to predict the possibility of persistence of hypothyroidism.

Thyroid Storm and Myxedema Coma

Thyroid storm and myxedema coma are the most severe clinical forms of thyroid dysfunction. While both hyper- and hypothyroidsm are common diseases, thyroid storm and myxedema coma are rare. Due to their unspecific signs and symptoms they are often difficult to diagnose. Both disorders are medical emergencies, which still show a significant mortality. The following article summarizes diagnostic tools and treatment options for these disorders.

Association of Thyroid Dysfunction with Mood Disorders in an OPD setting

Background and Objectives: Thyroid dysfunction is common among patients with mood disorders. The main purpose of this study is to estimate the prevalence of thyroid dysfunction among patients with various types of mood disorders. Materials and Methods: The study compromised of 50 patients meeting the inclusion and exclusion criteria selected by simple random sampling technique who attended the psychiatry OPD at B P Koirala Institute Of Health Sciences Dharan, Nepal. These patients were classified into different types of mood disorders according to ICD-10 DCR Criteria. Nineteen patients (38%) were diagnosed BPAD, fourteen patients ( 28%) as Depressive Disorder and the rest as single episode mania , Recurrent depressive disorder and dysthymia. Results: Out Of a total 50 cases, Fifteen Patients(30%) were found to have some form of thyroid dysfunction , the most common being subclinical hypothyroidism seen in 22% and the rest 8% with overt hypo/hyperthyroidism cases. This data is clearly /significant higher than the general population. However, there was no significant association found between socio-demographic variables and mood disorders with thyroid dysfunction. Conclusions: This study shows that thyroid dysfunction is common among patients with mood disorders though larger studies in the community setting are required for further evaluation. DOI: http://dx.doi.org/10.3126/jpan.v3i1.11348 J Psychiatrists’ Association of Nepal Vol .3, No.1, 2014: 23-28

Risk Factors for Thyroid Dysfunction among Type 2 Diabetic Patients in a Highly Diabetes Mellitus Prevalent Society

Diabetes and thyroid dysfunction found to exist simultaneously. In this regard, the present study looked into the prevalence of different forms of thyroid dysfunction and their risk factors among Type 2 diabetic Saudi patients. Methodology. A cross-sectional retrospective randomized hospital-based study of 411 Type 2 diabetic Saudi patients of >25 years of age was conducted to test the prevalence of different types of thyroid dysfunction and their risk factors. Results. The prevalence of different types of thyroid dysfunction is 28.5%, of which 25.3% had hypothyroidism, where 15.3%, 9.5%, and 0.5% are clinical, subclinical, and overt hypothyroidism, respectively. The prevalence of hyperthyroidism is 3.2%, of which subclinical cases accounted for 2.7% and overt hyperthyroidism accounted for 0.5%. Risk factors for thyroid dysfunction among Saudi Type 2 diabetic patients are family history of thyroid disease, female gender, and duration of diabetes of >10 years, while the risk was not significant in patients with history of goiter and patients aged >60 years. Smoking and parity show a nonsignificant reduced risk. Conclusion. Thyroid dysfunction is highly prevalent among Saudi Type 2 diabetic patients, and the most significant risk factors are family history of thyroid disease, female gender, and >10 years duration of diabetes.

Prevalence of Thyroid Hormone Dysfunction among Female Patients, Attending A Multispeciality Hospital In Manipur

Introduction: Thyroid disease is a chronic non-communicable disease affecting women more than male . About 20 million Americans have some form of thyroid dysfunction, mostly women and about forty million individuals suffering in India. Objective of this study is the prevalence of thyroid hormone dysfunction in female patients as hypo or hyperthyroidism in the Dept of biochemistry, RIMS, Imphal. Materials and methods: This cross-sectional study was conducted in the Deptt. of Biochemistry, RIMS, Imphal in collaboration with Deptt. of Medicine on 824 female patients from January 2010 to December 2012.Thyroid function test were assayed by the ELISA method. Results and observations: In this study, out of 824 female patients enrolled, 491 patients are below 40 yrs and 333 patients are above 40 yrs. The present study shows that prevalence of hypothyroidism and hyperthyroidism in females are 19.1% and 13.7% respectively and also shows that prevalence of hypothyroidism is more common in females of hilly areas (23.8%) compared to valley or plain areas (16.2%). Conclusion: Hypothyroidism is the most common thyroid dysfunction in the female population of Manipur so screening is needed above 40 yrs of female and for people of hilly areas of Manipur. KeyWords; female patients, hypothyroidism, hilly areas, T3, T4, TSH.

Heart disease in patients with thyroid dysfunction: hyperthyroidism, hypothyroidism and beyond

The thyroid and the cardiovascular system are closely related, both in physiological and pathological conditions. The adverse consequences on the heart of overt thyroid disease are well-known and even subclinical forms of both hyperthyroidism and hypothyroidism are associated with increased cardiovascular mortality. In recent years, attention has shifted towards milder forms of thyroid disease, such as the so-called "low T3 syndrome", which is characterized by an isolated reduction in circulating levels of the biologically active form of thyroid hormone, triiodothyronine (T3). Furthermore, variations of T3 within the physiological range have been linked to coronary artery disease, one of the leading causes of morbidity and mortality worldwide. The present manuscript provides an overview of thyroid physiology and pathophysiology, with a particular focus on cardiovascular disease in patients with milder forms of thyroid dysfunction.

Phosphorous magnetic resonance spectroscopy-based skeletal muscle bioenergetic studies in subclinical hypothyroidism.

Subclinical hypothyroidism (sHT) is considered to be a milder form of thyroid dysfunction. Few earlier studies have reported neuromuscular symptoms as well as impaired muscle metabolism in sHT patients. In this study we report our findings on muscle bioenergetics in sHT patients using phosphorous magnetic resonance spectroscopy (31P MRS) and look upon the possibility to use 31P MRS technique as a clinical marker for monitoring muscle function in subclinical thyroid dysfunction. Seventeen normal subjects, 15 patients with sHT, and 9 patients with hypothyroidism performed plantar flexion exercise while lying supine in 1.5 T magnetic resonance scanner using custom built exercise device. MR Spectroscopy measurements of inorganic phosphate (Pi), phosphocreatine (PCr), and ATP of the calf muscle were taken during rest, at the end of exercise and in the recovery phase. PCr recovery rate constant (kPCr) and oxidative capacity were calculated by monoexponential fit of PCr vs time (t) at the beginning of recovery. We observed that changes in some of the phosphometabolites (increased phosphodiester levels and Pi concentration) in sHT patients which were similar to those detected in patients with hypothyroidism. However, our results do not demonstrate impaired muscle oxidative metabolism in sHT patients based upon PCr dynamics as observed in hypothyroid patients. 31P MRS-based PCr recovery rate could be used as a marker for monitoring muscle oxidative metabolism in sub clinical thyroid dysfunction.

Thymic Hyperplasia Presenting as Anterior Mediastinal Mass in 2 Patients With Graves Disease

Thymic Hyperplasia Presenting as Anterior Mediastinal Mass in 2 Patients With Graves Disease

Thyroid dysfunction in phobic patients

Of 295 patients treated for phobic disorders, 27 (9.2%) reported having had some form of thyroid dysfunction (14 cases of hyperthyroidism, 13 of hypothyroidism). This far exceeds the expectation of thyroid problems in the general population. No relationship was detected between the kind of thyroid disorder or the time of its onset and the kind of phobia diagnosed (agoraphobia, mixed phobia, simple phobia). In a slight majority of cases, the reported onset of thyroid disorder preceded the diagnosis of phobia.

PLASMA TSH AND PROLACTIN IN VARIOUS FORMS OF HYPOTHYROIDISM

Previous studies showed that thyrotropin releasing factor (TRF) stimulates thyrotropin (TSH) and prolactin (PRL) secretion. We compared plasma TSH and PRL in various forms of thyroid dysfunction. Plasma TSH and PRL were measured in 32 normal short children, in 19 patients with untreated primary hypothyroidism (PHT), none of whom had galactorrhea (age range: 11 wks-lU yrs), in 18 patients with idiopathic hypopituitarism (IHP) with TSH deficiency and in 14 children with hypopituitarism with a mass lesion (HPML).In PHT, irrespective of etiology, plasma TSH levels were all strikingly elevated, the response to TRF was augmented, and prolactin levels were significantly higher than in normal children, in idiopathic hypopituitarism and in hypopituitarism with a mass lesion. Eight of 19 patients with PHT had PRL levels markedly above the upper range of normal. The elevated levels fell to normal with treatment. These data suggest that the elevated plasma prolactin levels may be a consequence of increased TRF secretion or an increased sensitivity of the pituitary to TRF.