Frequency Of Thyroid Dysfunction Research Articles

Gender-driven thyroid dysfunction in systemic lupus erythematosus patients: Clinical significance of an overlooked association and global stance

Aim of the workThis study aimed to determine the association of thyroid dysfunction in systemic lupus erythematosus (SLE) patients. Patients and methodsOut of a cohort including 312 adult SLE patients those with thyroid dysfunction (n = 53) were further evaluated. The medical history, clinical examination, laboratory investigations and medications received were recorded. The SLICC damage index (SLICC-DI) was assessed. ResultsThyroid dysfunction formed 17 % of the patients and their mean age was 39.5 ± 11.5 years and disease duration 5.6 ± 3.3 years were comparable to those without thyroid disorder, however female gender was predominantly higher (F:M 52:1 vs 6.2:1, p < 0.0001). The frequency of thyroid dysfunction was alike in Saudi (16 %) and non-Saudi (17.9 %) patients (p = 0.66). The majority of cases (96.2 %) had hypothyroidism, one with autoimmune thyroiditis, while only 2 (3.8 %) had hyperthyroidism. There was a significantly increased frequency of associated neuropsychiatric manifestations (64.2 % vs 45.2 %;p = 0.012), and hematological involvement (32.1 % vs 14.3 %; p = 0.011) and less complement (C4) consumption (15.1 % vs 23.6 %; p = 0.048) in those with thyroid dysfunction compared to those without. The frequency of anti-double stranded deoxyribonucleic acid (anti-dsDNA) positivity tended to be higher (71.7 % vs 66.8 %) and its titre significantly lower (316.3 ± 319.8 IU/ml vs 461.3 ± 459.1; p = 0.013). The SLICC-DI and mortality rate were comparable between groups. Only the presence of proteinuria inversely significantly correlated with the level of T4 (r = -0.31, p = 0.007). ConclusionThyroid dysfunction forms a notable percentage of SLE patients with a prominent female gender propensity. The significant relation of thyroid disorders to neuropsychiatric manifestations, hematological involvement, C4 consumption and anti-dsDNA deserves recognition.

Type 2 amiodarone-induced thyrotoxicosis: prevalence, time and predictors of development

BACKGROUND: Amiodarone takes a leading position in arrhythmological practice in the prevention and relief of various cardiac arrhythmias. Type 2 amiodarone-induced thyrotoxicosis is a frequent side effect of the drug. It is the most complex type of thyroid dysfunction both in terms of the severity of clinical manifestations, and in terms of understanding the mechanisms of pathogenesis, possibility of differential diagnosis and providing effective treatment. Due to the increasing life expectancy of the population, corresponding increase in the frequency of cardiac arrhythmias, the problem does not lose its relevance. Identification of predictors, assessment and prediction of the individual risk of developing this thyroid pathology is a necessity in daily clinical practice for making a reasonable decision when prescribing the drug, determining the algorithm for further dynamic monitoring of the patient.AIM: To evaluate the structure of amiodarone-induced thyroid dysfunction, prevalence, time and predictors of development type 2 amiodarone-induced thyrotoxicosis in a prospective cohort study. MATERIALS AND METHODS: The study involved 124 patients without thyroid dysfunction who received amiodarone therapy for the first time. Evaluation of the functional state of the thyroid gland was performed initially, after prescribing the drug for the first 3 months 1 time per month, in the future – every 3 months. The follow-up period averaged 12-24 months. The end of the observation occurred with the development of amiodaron-induced thyroid dysfunction or patient's refusal to further participate in the study. For the differential diagnosis of the type of amiodarone-induced thyrotoxicosis, the level of anti-TSH receptor antibodies and thyroid scintigraphy with technetium pertechnetate were determined. The type and frequency of thyroid dysfunction, time and predictors of development type 2 amiodarone-induced thyrotoxicosis were evaluated.RESULTS: The structure of amiodarone-induced thyroid dysfunction was represented by hypothyroidism in 19,3% (n=24), type 1 thyrotoxicosis in 1,6% (n=2), type 2 thyrotoxicosis in 23,4% (n=29). The median time of its development was 92,0 [69,0;116,0] weeks; the average period of common survival – 150,2±12,6 weeks (95% CI: 125,5–175,0), median – 144±21,7 weeks (95% CI: 101,4–186,6). The main predictors of type 2 amiodarone-induced thyrotoxicosis were: age (OR=0,931; 95% CI: 0,895–0,968; p&lt;0.001), BMI (OR=0,859; 95% CI: 0,762–0,967; p=0,012), time from the start of amiodarone therapy (OR=1,023; 95% CI: 1,008–1,038; p=0,003). Age ≤60 years was associated with increased risk of the dysfunction by 2.4 times (OR=2,352; 95% CI: 1,053–5,253; p=0,037), BMI≤26,6 kg/m2 – 2,3 times (OR=2,301; 95% CI: 1,025–5,165; p=0,043). CONCLUSION: The results allow to personalized estimate the risk of type 2 amiodarone-induced thyrotoxicosis and determine the patient's management tactic.

Frequency of Thyroid Dysfunction in Diabetic Patients

Thyroid hormones are involved in the control of insulin secretion, beta-cell function/multiplication, liver glucose synthesis, output and peripheral utilization. Thyroid dysfunction identification and correction help in glycemic control. Objective: To know the frequency of thyroid dysfunction in diabetic patients. Methods: This descriptive cross-sectional study was done in the Medical-C Department, Ayub Teaching Hospital Abbottabad from July 2018 to August 2019. Total 150 diabetic patients were enrolled by using non-probability consective sampling. Patients were labelled as diabetics on the basis of diabetes history, anti-diabetic medications use, high blood glucose (&gt;200mg/dl) on presentation or on previous high blood sugar reading or a high HbA1c value. Fresh venous blood sample was sent for thyroid function tests (T3, T4 and TSH). Thyroid dysfunction in our study was defined as patient having Thyroid Stimulating Hormone (TSH) value above or below the normal range. Data of patients were collected on study pro forma and was analyzed using statistical program SPSS version-20.0 Results: There were 67 (44.66%) male and 83 (55.33%) female patients. The mean age was 51.83 ± 14.52 years. Thyroid dysfunction was detected in 37 (24.66%) study participants. Out of 67 male patients, 11 (16.41%) had thyroid dysfunction and out of 83 female patients, 26 (31.32%) had thyroid dysfunction. Subclinical hypothyroidism was present in 4 (2.7%), 5 (3.3%) had hypothyroidism, 20 (13.3%) had subclinical hyperthyroidism and 8 (5.3%) had hyperthyroidism. Conclusion: This study suggests that a significant portion of diabetic patients suffer from thyroid dysfunction.

Türkiye'de Tip-2 diyabetli hastalarda patofizyolojik değişikliklerin tiroid disfonksiyonu ve nodüler guatr gelişimi üzerine etkileri

Objective: The prevalence of thyroid dysfunction is higher in patients with diabetes, and its diagnosis could cause better diabetes management. The purpose of the present study is to examine the impact of pathophysiological changes in patients with Type-2 diabetes on the frequency of thyroid dysfunction, thyroid autoimmunity, thyroid nodule, and thyroid cancer in Turkey. &#x0D; Methods: The study was conducted on a total of 3.276 patients with Type-2 diabetes who underwent thyroid tests and thyroid ultrasonography (US). The demographic characteristics, biochemical and hormonal values, thyroid US reports, and histopathology reports were collected from the patient's electronic records. &#x0D; Results: Thyroid autoimmunity positive TPOab 15.9% (n = 524) and/or positive TGab 9.9% (n = 327), the rate of positivity of both antibodies (TPOab + TGab) in the same patient, and total thyroid autoimmunity was found to be 32.57% (n=1067) in Type-2 diabetic patients. Thyroid dysfunction was detected in 18.3% (n = 602) of these patients. The distribution of thyroid dysfunction was 9.09% (n = 298) subclinical hypothyroidism, 4.1% (n = 135) clinical hypothyroidism, 3.1% (n = 102) subclinical hyperthyroidism, 2.0% (n = 67) clinical hyperthyroidism. Also, 67.9% (n = 2225) thyroid nodules, and 5% (n = 164) thyroid cancer were detected. &#x0D; Conclusion: Thyroid dysfunction was found to have increased in patients with Type-2 diabetes at significant levels.

A case-control study to assess the association of Alopecia areata with thyroid dysfunction and thyroid Autoimmunity.

Several previous studies have suggested a positive association between Alopecia Areata and thyroid disorders. However, there is a paucity of such studies in our country. Our study aimed to know the frequency of thyroid dysfunction and thyroid autoimmunity in patients reporting to Dermatology Outdoors with Alopecia Areata (AA) and to compare it with normal controls. This was a Case-Control study conducted at the Dermatology outpatient of a tertiary care hospital in Pakistan. 102 patients with AA and 102 age and sex-matched controls were enrolled. The age of onset of the disease, the involved sites and the presence of other associated diseases were noted. Venous blood samples were taken from patients and controls for Thyroid function tests and Anti- Thyroid peroxidase antibodies (Anti-TPO Ab). The data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. The mean age of onset of the disease was 30.37±12.53. 91.2% of patients had the classic patch type of AA. The most commonly involved site was Scalp. Associated diseases were found in eight (7.8%) patients. Thyroid dysfunction was found in two patients and none of the Controls. Both the patients had Subclinical thyroid disease. The p-value was 0.157, which was not statistically significant. Thyroid autoimmunity (raised Anti-TPO Ab titre) was detected in five (4.90%) patients and none of the Controls. The p-value was 0.024, which was statistically significant. AA is significantly associated with Thyroid autoimmunity but there is no significant association between AA and clinical or subclinical thyroid disease.

Preterm yenidoğanlarda gebelik yaşına göre küçük olmak ile tiroid fonksiyon testleri arasındaki ilişki

Purpose: The aim of this study was to evaluate the relationship between thyroid hormone levels and clinical outcomes in preterm, small for gestational age (SGA) infants.&#x0D; Materials and Methods: The premature newborns (gestational age of ≤30 weeks) were divided into two groups as SGA and non-SGA. Thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels, the frequency of congenital hypothyroidism (CH), demographic and clinical characteristics, morbidity and mortality rate were compared between the groups.&#x0D; Results: A total of 430 premature newborns, 72 in the SGA group and 358 in the non-SGA group were included. The frequency of CH, morbidity, demographic and clinical characteristics were similar between two groups. The mortality rate was higher in SGA (36.1%) than in non-SGA group (13.6%). Serum fT4 level was lower in SGA group (1.04±0.30 ng/dl) compared to the non-SGA group (1.24±0.33 ng/dl). The serum TSH level was higher in SGA group (9.91 ± 5.6 uIU/L) than in non-SGA group (6.6 ± 5.2 uIU/L).&#x0D; Conclusion: The frequency of thyroid dysfunction was higher in preterm SGA infants compared to non-SGA, which was due to transiently high TSH and low fT4 concentrations. Therefore, thyroid function tests should be monitored periodically in preterm and SGA infants.

METABOLIC SYNDROME AND THYROID DYSFUNCTION IN PATIENTS WITH ACROMEGALY IN SULAIMANI

Background &#x0D; Acromegaly is a chronic endocrinology disorder caused by the over-production of growth hormone (GH) predominantly by a pituitary adenoma. Acromegaly is associated with metabolic changes and thyroid dysfunction (ThD) in the body. However, the frequency of metabolic syndrome (MtS) in acromegaly patients is unknown, and studies assessing the frequency of different ThD types in acromegaly cases were few.&#x0D; Objectives &#x0D; To analyze the frequencies of MtS and ThD in patients with acromegaly in comparison to controls in Sulaimani city, to find the frequencies of MtS and ThDs in active cases compared to inactive cases in acromegaly patients, and to assess the relationship between the cumulative exposure to Insulin-like Growth Factor 1 (IGF-1) with ThD and MtS in acromegaly.&#x0D; Patients and Methods&#x0D; In this case-control study, 82 subjects were enrolled, which included 22 patients with acromegaly who visited the Sulaimani endocrinology center from August 2021 to February 2022 and 60 control subjects. The mean age of cases was 47.55 [11.50] years, with 7 (31.8%) male and 15 (68.2%) female. Thyroid function test, clinical, and biochemical parameters of MtS were measured in both groups in addition to IGF1. Chi-square test, Student T-test, and ANOVA were used in data analysis. Correlation between quantitative variables determined by Pearson correlation, with a P-value ≤ 0.05, is significant&#x0D; Results&#x0D; Out of 22 patients with acromegaly, 68.2% were euthyroid, 9.1% had primary hypothyroidism, 18.2% had central hypothyroidism, and 4.5% had hyperthyroidism, which is significantly higher than the control group (p-value =0.002). MtS frequency is 68.18% in cases, significantly higher than control, p-value=0.011. Most MtS and ThD parameters were significantly higher in acromegaly patients than in controls, P-value &lt; 0.001. No significant correlation between the last IGF1 and other parameters existed except free T3, which has a significant negative correlation with IGF1, P &lt; 0.05. &#x0D; Conclusion&#x0D; In acromegaly, the frequency of MtS is high (68.18%), and the frequency of ThD is 31.8%. Both MtS and ThDs are more common in patients compared to controls. No significant relationship exists between disease activity and the presence of MtS or ThD. Because both MtS and ThDs increase the metabolic markers, consequently increasing cardiovascular disease (CVD) morbidity and mortality in cases.

Thyroid Dysfunction During Combined Pegylated Interferon Alpha and Ribavirin Therapy in Patients of Chronic Hepatitis C-Virus Infection

Objective: To determine frequency of thyroid dysfunction among patients of chronic hepatitis C receiving combined pegylated interferon alpha and ribavirin therapy.&#x0D; Study Design: Cross sectional study.&#x0D; Place and Duration of Study: Department of Medicine, Military Hospital Rawalpindi, from Jan to Jul 2017.&#x0D; Methodology: One hundred and twenty patients, aged 18–60 years from both genders, with established hepatitis C were included; while the patients with decompensated liver disease, previous antiviral treatment, pre-existing thyroid, autoimmune or severe cardiopulmonary disease and on immuno-suppressants or steroids were excluded. After formal informed consent, they were prescribed 24 weeks pegylated interferon alpha-2 (3 million units subcutaneously thrice weekly) and oral ribavirin (1000–1200 mg daily) therapy. After 12 weeks, serum thyroid stimulating hormone, free thyroxine and triiodothyronine levels were determined by chemiluminescence technique.&#x0D; Results: Out of 120 patients, 100 (83.33%) were males and 20 (16.67%) were females with male to female ratio of 5:1. Mean thyroid stimulating hormone levels at baseline and 12 weeks were 2.86 ± 1.03uiu/ml and 2.16 ± 0.79 uiu/ml respectively. Mean triiodothyronine levels at baseline and 12 weeks were 3.27 ± 1.31pg/ml and 2.69 ± 1.01 pg/ml respectively. Mean thyroxine levels at baseline and 12 weeks were 1.26 ± 0.38 pg/ml and 1.07 ± 0.53 pg/ml respectively. Frequency of thyroid dysfunction was found in 40 (33.33%) patients.&#x0D; Conclusion: Frequency of thyroid dysfunction among hepatitis C patients receiving combined pegylated interferon alpha and ribavirin therapy is quite high.

Epidemiologic Profile of Thyroid Disorders in a Tertiary Care Hospital, a Five Years Analysis

Background: Thyroid disorders are commonly encountered endocrine ailments in clinical practice.Objective: To determine the trends and frequency of thyroid disorders in patients presented for thyroid dysfunction at the department of Pathology Benazir Bhutto hospital RawalpindiStudy Design: Cross-sectional retrospective study. Materials and Methods: Patients who underwent thyroid function tests were enrolled in the study Thyroid function tests were performed on a fully automated Chemistry Analyzer. Graph Pad Prism version 7 and SPSS version 25 were used for statistical analysis of the data.Results: Out of 2856 patients, 81.9% were females and 18.1% were males. The mean age of the participants was 38.12 ± 14.51 years and the median was 35(13-96). Overall, 1951 (68.3%) of the subjects were euthyroid, 343(12.0%) had subclinical hyperthyroidism, 200 (7.0%) had subclinical hypothyroidism, 192(6.7%) had overt hyperthyroidism and 168 (5.9%) had overt hypothyroidism. Females have a significantly high percentage of thyroid disorders as compared to males(χ2 =0.976 p =0.027). The major age group 798(27.9 %) tested for thyroid dysfunction suspicion was 24 to 33 years followed by 34-43 (22.9%).Conclusions: The thyroid dysfunction prevalence was higher in females than males. An upward trend in the frequency of thyroid dysfunction was observed with increasing age. Subclinical hyperthyroidism was the commonest abnormality observed. A steep rise in subclinical hyperthyroidism may be attributed to the high intake of iodized salt.

Frequency and factors associated with thyroid dysfunctions: An analytical cross-sectional study from a tertiary care center in Kabul, Afghanistan

Abstract Introduction/Objective Endocrinopathies are a commonly occurring entity, particularly those of the thyroid gland, however there is lack of scientific literature from Afghanistan, a country with very limited health care facilities and resources. This is the first study aimed to describe the frequency of occurrence and factor associated with thyroid dysfunction in Afghan population. The aim of this study is to estimate the frequency and to identify factors associated with thyroid dysfunction among individuals coming to a tertiary care facility in Kabul, Afghanistan. Methods/Case Report A cross-sectional study was conducted from July to Sep 2018 at the Department of Clinical Pathology, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan. Blood samples were obtained, serum TSH levels were analyzed, and the patients were divided into three diagnostic categories according to their serum TSH concentrations: 1) Hypothyroidism 2) Hyperthyroidism 3) normal. Results (if a Case Study enter NA) A total of 127 individuals were included in the final analysis. Majority study participants (77%) were females. A large number of the participants (92%) did not have family history of thyroid dysfunction. (74%) participants in the study had normal TSH levels classified as normal thyroid function, (14%) had lower TSH levels and (12%) higher TSH levels (Table 1) classified as hyper and hypothyroid respectively. Conclusion The findings of the current study showed a high frequency of thyroid dysfunctions from a single center. Further large scale studies are needed to find out the prevalence and document this entity for better health outcomes in the country.

Frequency of Thyroid Dysfunction in Type 2 Diabetes Patients

Thyroid problems are more common in people with type 2 diabetes. They have microvascular problems as a result of hypothyroidism. Patients with diabetes and hypothyroidism have a higher risk of cardiovascular disease. Diabetic individuals who are screened for thyroid dysfunction will be able to receive early therapy for hypothyroidism. The goal of this study was to determine the extent of thyroid dysfunction in people with type 2 diabetes and the relationship between thyroid dysfunction and diabetic complications. This study is to be conducted at a tertiary care hospital in Chennai for a period of 1 year 200 patients were selected 100 were diabetics and 100 were controls (non-diabetic). 24 patients out of 100 subjects were detected to have thyroid dysfunction. 17 patients were detected to have SCH, 6 had primary hypothyroidism and I had primary hyperthyroidism. No case of subclinical hyperthyroidism was detected. TSH values were significantly higher in diabetics. Thyroid dysfunction especially SCH was prevalent in diabetics. There was a poor glycemic control in diabetics with thyroid dysfunction.

Evaluation of the frequency and patterns of thyroid dysfunction in patients with metabolic syndrome

BackgroundMetabolic syndrome (MetS) and thyroid dysfunction have a degree of close association, and each of them affects the other. Due to the associated cardiovascular events, MetS has increased morbidity and mortality. The study tried to detect the frequency of thyroid function in patients with MetS. This is a case control study that recruited 100 patients with MetS and 100 healthy control subjects.ResultsPatients with MetS had significantly higher body mass index and waist circumference. Also, frequency of thyroid dysfunction was significantly higher in MetS group (32% vs. 9%; P<0.001). The most frequent form of thyroid dysfunction was subclinical hypothyroidism: 21% of the MetS group and 6% of the control group. Out of the studied patients with MetS, 13 (13%) patients had three criteria, 55 (55%) patients had four criteria, and 32 (32%) patients had five criteria for MetS.ConclusionPatients with MetS are vulnerable to develop thyroid dysfunction mainly subclinical hypothyroidism. So, it is recommended to perform regular screening for those patients as regard thyroid dysfunction.

Thyroid Function and Thyroglobulin Level in Iodine-Deficient Children of Eastern Nepal

Iodine deficiency during childhood affects physical and mental development. Iodine deficiency or excess both can negatively impact thyroid function. We conducted this study to assess iodine nutrition and thyroid function in children with insufficient urinary iodine concentration. A community-based cross-sectional study was conducted among the selected schools of Udayapur district. Urinary iodine concentration (UIC) was measured in 1012 school children (6-14 years). Based on UIC data, 83 blood samples were collected to measure serum thyroglobulin (Tg), thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4). UIC was measured by ammonium persulfate digestion method, and Tg, TSH, fT4, and fT3 were measured using ELISA kits. The median UIE was 236 µg/L, and 11.1% of the children had insufficient UIC. The mean fT3, fT4, and TSH in children with insufficient UIC were 2.55±0.43 pg/mL, 0.96±0.28 ng/dL, and 3.60±1.44 mIU/L respectively. Among children with low UIC levels, the median Tg was 17.5 ng/mL. Overt hypothyroidism was seen in 6%, and subclinical hypothyroidism in 3.6%. The children had sufficient iodine nutrition, and the frequency of thyroid dysfunction was low among the children with insufficient UIC.

Frequency of Thyroid Dysfunction and Congenital Heart Defects in Subjects with Down Syndrome

ABSTRACT:&#x0D; Background: Down syndrome (DS) is the most common chromosomal abnormality with prevalence of 1 in 700-1500 live births. Its manifestations may include congenital heart defects(CHD), thyroid dysfunctions, hematopoietic disorders, early-onset Alzheimer disease, gastrointestinal disorders, neuromuscular weakness, hearing and visual problems, characteristic facial and physical features. The prevalence of thyroid disorders and congenital heart diseases are higher in DS patients than in general population.&#x0D; Objective:To explore the frequency, and types of congenital heart defects (CHD) and Thyroid disorders in children with Down syndrome (DS) in the children hospital and the institute of child health (CHICH) Multan.&#x0D; Study design: Descriptive cross sectional&#x0D; Setting: Outpatient department (OPD) of CHICH Multan&#x0D; Method:A total of 158 down syndrome (DS) patients of 0 to 15 years of age, of both genders were included in this study from October 2019 to October 2020. DS was diagnosed by specific clinical features and karyotyping. Age, sex and mother’s age was noted. Blood samples of all the patients were sent for karyotyping and serum T4 and Thyroid stimulation hormone (TSH). For patients more than 36 months, blood samples were also sent for Antithyroglobulin and antithyroid peroxidase antibodies. Echocardiography of all the patients was done. Data was collected and analyzed by using SPSS version 16.0.&#x0D; Results:Out of 158 DS children most presented below 6months of age, with male to female ratio of 1:1.4. Mostly mothers were between 20 to 40 years of age. Karyotyping revealed non disjunction in 97% of cases. Cardiac abnormalities were found in 48% of DS children. Most common Type was VSD (10.9%), Thyroid abnormalities were detected in 24% of DS patients, subclinical hypothyroidism (13.9%) was most common.&#x0D; Conclusion: CHD and Thyroid disorders must be ruled out in all DS patients,to start early management.&#x0D; Keywords: Down syndrome, Congenital heart disease, hypothyroidism.

Prevalence of Thyroid Dysfunction in Chronic Hepatitis C Patients on Interferon Therapy

Objective: to record the prevalence of thyroid dysfunction in chronic HCV cases receiving interferon therapy Methodology: A total of 100 patients with a diagnosis of chronic Hepatitis C between 35-70 years of either sex with normal Thyroid function test at the time of commencement of therapy were included. This trial was conducted during the period 2021-22 at Services Hospital Lahore. Interferon alfa 3 million units were administered to patients three times per week, along with oral ribavirin 1000 mg or 1200 mg every day (depending on their weight) for 24 weeks. During therapy, these individuals had clinical evaluations every 2, 4, and 6 months. The presence and severity of adverse events were evaluated at each visit, along with standard laboratory tests. TSH levels were used to assess patients for thyroid illness every 2, 4, and 6 months. Results: Mean age was calculated as 48.57+11.35 years, 52(52%) were male and 48(48%) were females, frequency of thyroid dysfunction in Chronic HCV cases receiving interferon therapy was recorded in 19(19%) of the cases. Conclusion: The incidence of thyroid dysfunction in individuals taking interferon treatment for chronic hepatitis C infection is not very high. However, we recommend that those who are currently receiving treatment for chronic hepatitis C should be evaluated for thyroid dysfunction. Keywords: Chronic Hepatitis C infection, Interferon therapy, Thyroid Dysfunction,

FREQUENCY OF THYROID DYSFUNCTION IN CHRONIC KIDNEY DISEASE PATIENTS

Objectives: To determine the frequency of thyroid dysfunction in chronic kidney disease patients.&#x0D; Methods: It was a Cross-sectional Study at department of Medicine, Bahawal Victoria Hospital, Bahawalpur. Duration of the study was from 20th October 2018 to 19th April 2019. 72 patients with chronic kidney disease, 20 to 60 years of age and of both genders were included. Patients with known thyroid disorders or taking medication that can affect thyroid function (dopamine antagonists, antiepileptic, oral contraceptives, lithium, and glucocorticoids) were excluded. Venous blood sample was taken and sent to the laboratory for thyroid function tests.&#x0D; Results: Age of the patients included in this study was from 20 to 60 year and mean age was 41.97 ± 9.76 years. Most of them 42 (58.33%) were between 41 to 60 years of age. Out of 72 patients, 44 (61.11%) were male and 28 (38.89%) were female with male to female ratio of 1.6:1. Mean duration of disease in our study was 5.71 ± 2.50 years .Mean BMI was 27.75 ± 3.01 kg/m2.Thyroid dysfunction was present in 23 (31.94%) patients of chronic kidney disease.&#x0D; Conclusion: Thyroid dysfunction is frequently found in chronic kidney disease patients.

Routine Measurement of Thyroid Stimulating Hormone in Patients Presenting With Third-Degree Atrioventricular Block: Do We Really Need It?

BackgroundHypothyroidism can be a cause of sinus bradycardia. However, thyroid laboratory evaluation is often performed routinely in patients with complete heart block (CHB) though there is little data to support this practice. This study aimed to assess the frequency of thyroid dysfunction in patients presenting with CHB without clinical features of hypothyroidism.MethodologyAll patients referred for permanent pacemaker implantation for CHB were included in this cross-sectional study. Patients with known thyroid disorder or clinical features of thyroid disorder were excluded. Demographic, electrocardiography (EKG), and routine thyroid stimulating hormone (TSH) screening results were recorded.ResultsA total of 102 patients with complete atrioventricular (AV) block were enrolled in the study of which 50.0% (51) were male. The mean age was 61.09 ± 11.74. Co-morbidities included diabetes mellitus 44.1% (45), smoking 36.3% (37), and hypertension 55.9% (57). Mean EKG atrial rate was 82.97 ± 31.31 mmHg with a mean ventricular escape rate of 36.17 ± 5.93. Permanent pacemakers were implanted in all of the patients. Only one patient had an abnormal TSH.ConclusionsWe found a very low prevalence of thyroid dysfunction among patients without clinical features of thyroid dysfunction presenting with third-degree AV block. This calls for cautious prescription of thyroid testing in clinically euthyroid patients.

Thyroid profile in patients of thalassemia with multiple blood transfusions and high serum ferritin: a cross-sectional study

Introduction: Beta-thalassemia major patients undergo regular blood transfusion resulting ingrowth faltering and various endocrine problems including thyroid dysfunction due to iron overloadin the body. This study was conducted to determine the frequency of thyroid dysfunction in childrenpresenting with Beta-thalassemia major on regular blood transfusions. Materials and methods:Sixty children were included with proven beta-thalassemia major who reported to the Department ofPediatrics, VIMS, and RC, Bangalore. Inclusion criteria: 1.Children 4 to 18 years age group .2.Thechild received transfusions for more than 2 years. 3.Children with serum ferritin level &gt;700.Results: In this study, four patients(6.8%) had overt hypothyroidism, eight patients(13.6%) hadsubclinical hypothyroidism and 47 patients(79.7%) had euthyroid status. There was a positivecorrelation between Ferritin and T4, TSH levels. i.e., with an increase in Ferritin level, there was anincrease in T4, TSH levels, and vice versa. However, the correlation was significant with TSH. Therewas a significant negative correlation between Ferritin and T3 levels. i.e with an increase in Ferritinlevel, there was a decrease in T3 levels and vice versa. Conclusion: Thyroid dysfunction can exist inthalassemia patients on multiple transfusions and chelation therapy with high serum ferritin levels.Detection of hypothyroidism is important as inexpensive oral replacement therapy is readilyavailable. Hence regular screening of beta-thalassemia major patients for Serum T3, Serum T4,Serum TSH for early detection and timely treatment could improve the life expectancy and quality oflife of these patients.

Frequency of Thyroid Dysfunction in Healthy Pregnant Women

Objective: To investigate the frequency of thyroid dysfunction in healthy women during pregnancy. Study Design: Descriptive cross sectional study. Place and Duration of Study: Department of Gynecology and Obstetrics Unit 1, Nishtar Hospital, Multan from 6-1-2016 to 6-7-2016. Methodology: It was a descriptive cross-sectional study done in Department of Gynecology and Obstetrics Unit 1 Nishtar Hospital and included 451 pregnant women. The participants who were found to have some abnormality in TSH were further evaluated for levels of T3 and T4. The outcome variable that is frequency of thyroid dysfunction was recorded by researcher on Performa. All the data was analyzed by using SPSS-23. Results: The Mean age of the study participants was 27.87±4.76 years. The Mean parity was 2.88±0.99 and Mean gravidity was 3.96±0.95. Most of expecting ladies307 (68.1%) were at parity of 1–4. The Mean Value of gestational age of participants was 20.25±4.30 weeks with minimum of 13 weeks and maximum of about 26 weeks. 90 (20.0%) cases were found to be Euthyroid. There were 94 (20.8 %) cases of subclinical hypothyroidism and 54 (12.0%) cases of subclinical hyperthyroidism. Conclusion: The frequency of thyroid problems is alarmingly high according to results of our study. Subclinical hypothyroidism was found to have marked association with increasing age of mother, high parity of mother, and gestational age.

Frequency of thyroid dysfunction in pediatric patients with congenital heart disease exposed to iodinated contrast media- a long-term observational study.

Background The thyroid gland of patients with congenital heart disease may be exposed to large doses of iodine from various sources. We assessed the thyroid response after iodine exposure during conventional angiography in cardiac catheterization and angiographic computer tomography in childhood. Methods Retrospective mid- to long-term follow-up of 104 individuals (24% neonates, 51% infants, 25% children) with a median age and body weight of 104days [0-8 years] and 5.3kg [1.6-20]. Serum levels of thyroid-stimulating hormone, free triiodthyronine and free thyroxine were evaluated at baseline and after excess iodine. We also assessed risk factors that may affect thyroid dysfunction. Results Baseline thyroidal levels were within normal range in all patients. The mean cumulative iodinate contrast load was 6.6±1.6mL/kg. In fact, 75% had experienced more than one event involving iodine exposure, whose median frequency was three times per patient [1-12]. During the median three years follow-up period [0.5-10], the incidence of thyroid dysfunction was 15.4% (n=16). Those patients developed acquired hypothyroidism (transient n=14, long-lasting n=2 [both died]) with 10 of them requiring temporary replacement therapy for transient thyroid dysfunction, while four patients recovered spontaneously. 88 individuals (84.6%) remained euthyroid. Repeated cardiac interventions, use of drugs that interfere with the thyroid and treatment in the intensive care unit at the index date were strong predictors for acquired thyroid dysfunction. Conclusions The incidence of acquired hypothyroidism after iodine excess was 15.4%. However, most patients developed only transient hypothyroidism. Systemic iodine exposure seems to be clinically and metabolically well tolerated during long-term follow-up.