Hashimoto's Thyroditis Research Articles

Correlation of Stool Lactobacillus acidophilus and Leaky Gut Syndrome in Patients with Hashimoto Thyroditis

Abstract Background Hashimoto thyroiditis (HT) is the most common autoimmune disease worldwide, characterized by chronic inflammation and circulating autoantibodies against thyroid peroxidase and thyroglobulin. Patients require hormone replacement with oral levothyroxine, and if untreated, they can develop serious adverse health effects and ultimately death. There is a lot of evidence that the intestinal dysbiosis, bacterial overgrowth, and increased intestinal permeability favor the HT development, and a thyroid–gut axis has been proposed, which seems to impact our entire metabolism. Aim of the Work To Study the Correlation of stool lactobacillus acidophilus and leaky gut syndrome in patients with hashimoto thyroditis. Patients and Methods This was a case control study that was conducted on 60 Egyptian patients that was divided into 2 groups, Group 1 that included 30 patients with Hashimoto s thyroiditis first diagnosed or on therapy and Group 2 that included 30 healthy subjects as a control and it was conducted at Ain Shams University hospital outpatient Endocrinology Clinic throughout 6 months. Results There was no statistically significant difference between two groups regarding Gender and Age, and there was highly statistically significant difference found between two groups regarding BMI. There was no statistically significant difference found between two groups regarding FT3, and there was highly statistically significant difference found between two groups regarding FT4 and TSH. There was highly statistically significant difference found between two groups regarding Anti tpo, Zonulin and Lactobacillus PCR. There was non statistically significant difference found between two groups regarding Gender, Age and BMI. No statistically significant difference was found between two groups regarding FT3, FT4 and TSH. There was highly statistically significant difference found between two groups regarding Anti tpo, and there was no statistically significant difference found between two groups regarding Zonulin. Conclusion There are alterations in the micro biota and intestinal permeability in Brazilian patients with HT. In addition, we suggest that diet might have played an important role in modulating the gut micro biota in patients with HT. These findings could help understand the HT development and progression, while.

Risk Factors for Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis.

Purpose: To explore the risk factors that may predict the lymph node metastasis potential of these lesions and new prevention strategies in papillary thyroid carcinoma patients.Materials and Methods: In total, 9,369 papillary thyroid carcinoma patients with 37.17% lymph node metastasis were analyzed (Revman 5.3 software) in this study. The PubMed and Embase databases were used for searching works systematically that were published through to January 22, 2020.Results: Several factors were related to the increased risk of lymph node metastasis in patients with papillary thyroid carcinoma: age <45 years (pooled OR = 1.52, 95% CI = 1.14–2.01, p <0.00001); gender = male (pooled OR = 1.68, 95% CI = 1.51–1.87, p <0.00001); multifocality (pooled OR = 2.05, 95% CI = 1.45–2.89, p <0.0001); tumor size ≥1.0 cm (pooled OR = 3.53, 95% CI = 2.62–4.76, p <0.00001); tumor location at the upper pole 1/3 (pooled OR =1.46, 95% CI = 1.04–2.04, p = 0.03); capsular invasion + (pooled OR = 3.48, 95% CI = 1.69–7.54, p = 0.002); and extrathyroidal extension + (pooled OR = 2.03, 95% CI= 1.78–2.31, p <0.00001). However, tumor bilaterality (pooled OR = 0.85, 95% CI = 0.54–1.34, p = 0.49) and Hashimoto's thyroditis (pooled OR = 1.08, 95% CI = 0.79–1.49, p = 0.62) showed no correlation with lymph node metastasis in papillary thyroid carcinoma patients.Conclusion: The systematic review and meta-analysis defined several significant risk factors of lymph node metastasis in papillary thyroid cancer patients: age (<45 years), gender (male), multifocality, tumor size (>1 cm), tumor location (1/3 upper), capsular invasion, and extra thyroidal extension. Bilateral tumors and Hashimoto's thyroiditis were unrelated to lymph node metastasis in patients with papillary thyroid cancer.

Expression of miRNA-146b-5p in patients with thyroid cancer in combination with Hashimoto's disease and its clinical significance.

The expression level of microRNA (miRNA)-146b in patients with thyroid carcinoma (TC) in combination with Hashimoto's thyroditis (HT) was evaluated to analyze the clinical significance. Eighty-seven patients who underwent thyroid surgery in The Third Affiliated Hospital of Southern Medical University from March 2010 to February 2013 were enrolled. Of the patients, 37 were diagnosed with TC (group A), and 50 were diagnosed with TC in combination with HT (group B). Forty patients were diagnosed with HT (group C). The expression levels of miRNA-146b-5p in cancer tissue and paracancerous tissue of patients in the two groups were measured by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Correlation between the miRNA-146b-5p levels and the clinicopathological characteristics of patients with combined TC and HT were evaluated. According to the expression of miRNA-146b-5p, patients in group B were separated into the high and low expression groups to observe the five-year cancer recurrence rate. There was no significant difference in miRNA-146b-5p expression between the papillary carcinoma group, the follicular carcinoma group and the medullary carcinoma group (P>0.05). The miRNA-146b-5p expression in the lesion tissue of group B was significantly higher than that of groups A and C, while the miRNA-146b-5p expression in the lesion tissue of group A was significantly higher than that of group C (P<0.05), and the lesion tissue of the three groups was higher than that of the corresponding parastatal tissue (P<0.05). The miRNA-146b-5p expression level was associated with tumor size, lymph node metastasis and TNM stage (P<0.05), while not associated with sex, age, lesion multiplicity, smoking history, diabetes history and pathological type in group B (P>0.05). The non-recurrence rate of group B high expression subgroup was lower than that of group B low expression subgroup (P=0.045). High expression of miRNA-146b-5p was found in the cancer tissues of patients with combined TC and HT. The expression level of miRNA-146b-5p was associated with tumor size, lymph node metastasis and TNM stage. It is a potential prognostic indicator for patients with combined TC and HT.

Association of GSTT1 and GSTM1 gene polymorphisms with susceptibility to autoimmune diseases: A preliminary study

Autoimmune diseases (ADs) are chronic conditions initiated by the loss of immunological tolerance to self-antigens. The aim of this study was to detrmine how polymorphisms of glutathione S-transferases T1 and M1 (GSTT1 and GSTM1) genes influences on the occurrence of two autoimmune diseases: multiple sclerosis (MS) and Hashimoto's thyroditis (HT). A multiplex polymerase chain reaction (PCR) was used to detect the deletions in GSTT1 and GSTM1 genes. Our results showed that patients with ADs had significantly higher (p 0.05). This study suggests the potential role of GSTM1 deletion on ADs susceptibility, but on the other hand this study should be repeated in other patients with the same or similar diagnosis of ADs.

Clinico-pathological features of papillary thyroid cancer coexistent with Hashimoto's thyroiditis

Former studies suggest the frequent coexistence of Hashimoto's thyreoditis with papillary thyroid cancer, frequently featured by multifocal carcinogenesis but lower clinical stages compared to thyroid cancers lacking thyroiditis. We examined the clinico-pathological correlations between Hashimoto's thyroditis and papillary thyroid cancer in our region in the North-Eastern part of Hungary. We included a total of 230 patients with papillary thyroid cancer who underwent thyroid surgery at the Surgical Department of the University of Debrecen. Patients' sex, age, multifocality of thyroid cancer and clinical stage were evaluated. Cases included 40 patients (17.4%) with (4 male, 36 female) and 190 (82.6%) patients without HT (44 male, 146 female). Hashimoto's thyroiditis related thyroid cancer was almost exclusively associated with the papillary histological type. Multifocality of papillary cancer was significantly more frequent with coexisting Hashimoto's thyroiditis (16/40; 40.0%) compared to cases uninvolved (45/190; 23.7%; p = 0.034). In contrast, lymph node metastasis was significantly less frequent among patients with Hashimoto's thyroiditis (4 pN1 [36.4%]; 7 pN0 [63.6%]) then without it (34 pN1 [82.9%]; 7 pN0 [17.1%]; p = 0.002). Higher frequency and multifocality of papillary thyroid cancer might be the consequence of preexisting Hashimoto's thyroiditis to be considered as a preneoplastic stimulus supporting carcinogenesis, though the exact pathomechanism of this correlation is not clear yet. Orv. Hetil., 2017, 158(5), 178-182.

Immunoreactions for P53 isoforms are associated with ultrastructural proliferative profiles in benign thyroid nodules.

P53 isoforms originate from the alternative initiation of P53 gene translation through usage of an internal promoter located in intron 4. All P53 isoforms are spliced in intron 9 and may modulate cell proliferation and cell fate outcome in response to DNA damage. To examine immunoexpression of P53 isoforms in benign proliferative lesions occurring in multinodular thyroids and to assess the ultrastructural phenotype of P53 distribution in the thyrocytes of those lesions by electron microscopy. By immunohistochemistry and transmission electron microscopy (TEM), we evaluated 38 multinodular thyroids containing a total of 102 benign lesions: 38 nodular goiters (NG; colloid=20, parenchymatous=18), 52 follicular adenomas (FA) and 12 Hashimoto's thyroditis (HT). FA were classified into 10 normo-follicular, 9 macro-follicular, 28 micro-follicular and 5 solid variants. Immunoreaction for P53 isoforms was observed in approximately 50% of all lesions, except macrofollicular variant FA (33%). At TEM analysis, immunoreactive NG, FA and TH lesions showed signs of proliferation by simultaneous appearance of dispersed chromatin, increased amounts of cytoplasmic organelles and dilation of the rough endoplasmic reticulum. TEM signs of apoptosis and proliferation were also detected in FA, but with different rates compared to NG. The immunohistochemical expression of P53 isoforms in NG, FA and HT suggests their role in the development of these lesions. Ultrastructural findings support the hypothesis that P53 immunoexpression correlates with reactive proliferative changes in thyrocytes.

HASIMOTO'S THYROIDITIS A REVIEW

Hashimoto thyroditis is an organ specific autoim-mune disorder. Initially described Hakaru Hash-imotoa century ago is now the most common cause of hypothyroidism in iodine sufficient are-as of the world. But still the pathogenesis is not fully understood. With higher incidence among female population HT develops as a result of in-teraction between the genetic factors and envi-ronmental factors in susceptible individuals. HT is associated with other autoimmune disorders. Now many variants of HT have been identified: classical form, fibrous variant, IgG4 variant, juve-nile form, hashitoxicosis and silent thyroiditis (sporadic or postpartum). All variants of HT are characterized by lympho-cytic infiltration, distruction and atropy of thy-roid gland ultimately thyroid failure though each entity has specific other features. Clinically HT can also present as euthyroid or even hyperthy-roid state with or without goiter. Diagnosis is based on the clinical features, demonstration of antibodies against thyroid antigen, sonography and cytological findings. Treatment is mainly sup-plementing Levothyroixin for correction of hypo-thyroidism. Surgery is reserved for patients with large goiter causing mechanical compression of cervical structures, painful HT and suspicion of malignancy.

Cytomorphological Aspects of Hashimoto's Thyroiditis: Our Experience at a Tertiary Center

INTRODUCTIONHashimoto’s thyroiditis is the most common form of acquired hypothyroidism. Fine needle aspiration cytology is one important tool in diagnosing Hashimoto’s thyroditis, along with clinical, biochemical, immunological and ultrasonographical modalities. The present study examines cytological aspects of Hashimoto’s thyroiditis along with their correlation with clinical, biochemical and immunological findings, whenever available.MATERIALS AND METHODSThis is a retrospective study of 50 cases of Hashimoto’s thyroiditis. Cytological findings were reviewed and correlated with clinical, biochemical and immunological findings whenever available.RESULTSThe majority of the patients were middle-aged females, with a female to male ratio of 6.14:1. Most patients presented with diffuse thyromegaly (68%) and/or hypothyroidism (56.09%).The antibody profile was available in 22% of patients. Of these, anti-thyroid peroxidase antibodies were raised in 81.81% of patients and anti-thyroglobulin antibodies were raised in 63.63% of patients.In the present study, high lymphoid to epithelial cell ratio was seen in 78% of cases, and 74% of cases showed Hurthle cell change. Follicular atypia was seen in 36% of cases. Lymphoid follicle formation was seen in seen in 54% of cases.Follicular cell infiltration by lymphocytes, eosinophils and neutrophils was seen in 72%, 48% and 26% of cases, respectively. Plasma cells were seen in 18% of cases.CONCLUSIONThyroid function tests and immunological tests cannot diagnose all cases of Hashimoto’s thyroiditis. Fine needle aspiration cytology continues to be a diagnostic tool of significance in diagnosing Hashimoto’s thyroiditis. The presence of inflammatory cells, particularly lymphocytes and eosinophils, was detected in a significant proportion of cases.

Psychotic Symptoms in a Patient with Hashimoto's Thyroditis

Psychotic Symptoms in a Patient with Hashimoto's Thyroditis

Medullary thyroid carcinoma in a patient with Hashimoto's thyroiditis diagnosed by calcitonin washout from a thyroid nodule

Serum calcitonin is a tumor marker used in the diagnosis and follow-up of medullary thyroid carcinoma. Calcitonin washout evaluation is a new method used for suspicious thyroid nodules and lymph nodes. Limited clinical data are present about the efficacy of this method. A 61-year-old female patient with known Hashimoto's thyroditis and an 8-mm hypoechoic nodule was presented with one previously benign fine-needle aspiration cytology (FNAC). On referral to our department, she had a moderately high-serum calcitonin level, and we repeated the FNAC that was reported as nondiagnostic. We performed FNAC for the third time together with calcitonin washout evaluation from the thyroid nodule. The FNAC was again nondiagnostic, but the calcitonin washout level from the thyroid nodule was 152.569 pg/mL. Total thyroidectomy was performed, and the diagnosis was confirmed as medullary thyroid carcinoma. Calcitonin washout evaluation may be a useful method in the differential diagnosis of patients with thyroid nodules having moderately high-serum calcitonin levels.

Regulation of interleukin-6 release by human thyrocytes

Autoimmune thyroiditis is characterized by lymphocytic accumulation within the thyroid which may be the result, in part, of immunomodulatory cytokine secretion by thyrocytes. We have tested human thyroid cell cultures (n = 9) for interleukin-6 (IL-6) release using two bioassays. IL-6 was detected in all culture supernatants under basal conditions and was increased by gamma-interferon, tumour necrosis factor and TSH in a dose-dependent manner. The bioactivity was confirmed as IL-6 by immunoblotting experiments and could not be accounted for by contamination of the thyroid cell cultures with fibroblasts, lymphocytes or monocytes. Circulating IL-6 levels were not raised in patients with Graves' hyperthyroidism. Exogenous recombinant IL-6 reduced cyclic AMP production in response to TSH when added to thyroid cell cultures. Since IL-6 plays a major role in B cell differentiation and T cell activation, release of IL-6 by thyrocytes may increase the intrathyroidal autoimmune response in Graves' disease and Hashimoto's thyroditis. Our results also suggest that IL-6 may modulate thyroid cell function.

慢性甲状せん炎（橋本病）を合併したルポイド肝炎の１男性例

慢性甲状腺炎(橋本病)を合併したルポイド肝炎で極めて稀な男性例を報告する.症例は50歳男性で,全身倦怠感を主訴に入院.び慢性甲状腺腫と肝腫大をみとめ,主要検査成績ではGOT43, GPT59,総コレステロール107mg/dl,コリンエステラーゼ0.2ΔpH,アルブミン3.3g/dl,γ-グロブリン3.1g/dl,免疫学的には,RA, LE細胞,抗核抗体陽性で抗甲状腺抗体も高力価を示した.肝生検像では,lymphoid follicleの形成がみられ小葉改築傾向を伴う慢性活動性肝炎像を,甲状腺生検像では典型的な橋本病の像を呈し,肝病変の成立には甲状腺病変と同じく自己免疫的な機序が考えられた.更に本例はアルコール多飲者でプレドニソロン投与にも拘らず病勢は進行し,肝生検像でも一貫してアルコールによると思われる組織像がみられ,アルコールが直接あるいは間接的にextrinsic trigger factorとして働いた可能性も考えられる.

Thyrotropin suppression by 3,5-dimethyl-3'-isopropyl-L-thyronine in man.

The thyromimetic activity of 3,5-dimethyl-3'-isopropyl-L-thyronine (DIMIT), a nonhalogenated thyroid analog, was studied in adult men using suppression of TRH-induced TSH release to assess this activity. In nine men, aged 30-58 yr, the TSH increment after 500 microgram TRH iv was compared to the TSH response to TRH 24 h after oral administration of 1 mg DIMIT. Eight euthyroid subjects had normal baseline TSH levels of 1.5 +/- 0.2 (SE) microunit/ml that fell significantly to 0.7 +/- 0.2 microunit/ml 24 h after DIMIT (P less than 0.005). Their TSH increments after TRH fell from 15.3 +/- 2.8 to 6.7 +/- 1.6 microunit/ml 24 h after DIMIT (P less than 0.001). One subject with probable Hashimoto's thyroditis had an elevated TSH of 18 microunit/ml, with an exaggerated TSH response to TRH of 72 microunit/ml. His basal TSH fell to 7.6 and his TSH increment fell to 14.3 microunit/ml 24 h after DIMIT. The suppression of TSH was relatively prolonged. In four subjects, the TSH response to TRH was still blunted from 5-12 days after DIMIT. In one subject, the TSH increment returned to normal 15 days after DIMIT. DIMIT had no significant effect on PRL secretion. There was no evidence of toxicity in patients receiving DIMIT. DIMIT has effective thyromimetic activity in man, as shown by its significant and prolonged suppression of TSH secretion.