Prevalence Of Thyroid Abnormalities Research Articles

The Prevalence of Thyroid Abnormalities in Patients With Chronic Kidney Disease: A Cross-Sectional Study at a Tertiary Care Hospital.

Background and objective Chronic kidney disease (CKD) is a clinical syndrome characterized by the irreversible loss of kidney function. It is a widespread condition affecting populations worldwide. The kidneys play a crucial role in the metabolism, breakdown, and elimination of thyroid hormone and thyroid-stimulating hormone (TSH). Consequently, thyroid dysfunction can occur as an endocrine manifestation in CKD patients. Previous studies investigating thyroid abnormalities and the severity of CKD have yielded diverse outcomes. In light of this, this study aimed to determine the prevalence of thyroid dysfunction in CKD patients and explore the association between different thyroid dysfunctions and markers of kidney function. Methods A total of 140 CKD patients who met the inclusion criteria were recruited, and their demographic details and routine investigations were recorded. Blood samples were collected for kidney function tests and thyroid function tests. The primary outcome measures included markers of kidney function [urea, creatinine, and estimated glomerular filtration rate (e-GFR)] and thyroid profile [TSH, free thyroxine (FT4), and free triiodothyronine (FT3)]. Mean and standard deviation (SD) were calculated for continuous variables, while frequencies were calculated for categorical data. Fisher's exact test was employed to evaluate the association between two categorical variables, and p-values below 0.05 were considered statistically significant. Results The mean (± SD) urea, creatinine, and e-GFR were found to be 139 (± 81.1) mg/dL, 5.33 (± 4.1) mg/dL, and 20.1 (± 15) ml/min/1.73 m2, respectively. Of note,133 (95%) patients had elevated urea levels, with the majority (n = 109, 77.8%) having urea levels between 40 and 199 mg/dL; 70 (50%) patients had creatinine levels less than 4 mg/dL, and 107 (76.4%) had e-GFR of less than 30 ml/min/1.73 m2. The mean (± SD) TSH, FT4, and FT3 levels were found to be 6.64 (± 11.2) mIU/ml, 13.6 (± 4.54) pmol/L, and 2.65 (± 1.89) pmol/L, respectively. It was observed that 18 (12.9%, 95% CI: 8.29-19.4%) of the CKD patients had hypothyroidism and 21 (15%, 95% CI: 10.02-21.8%) had subclinical hypothyroidism (SCH), while only two (1.4%, 95% CI: 0.39-5.05%) and five (3.6%, 95% CI: 1.5-8.08%) had hyperthyroidism and subclinical hyperthyroidism, respectively. Thirty-nine (27.9%, 95% CI: 21.1-35.8%) patients had low FT4 levels, whereas a considerable majority (n = 123, 87.9%, 95% CI: 81.41-92.28%) of the patients suffering from CKD were found to have low FT3 levels. The associations of urea levels with SCH, low FT4, and FT3 status were found to be statistically significant with p-values of 0.002, 0.033, and <0.001, respectively. The association between e-GFR and low FT3 status was also statistically significant, with a p-value of 0.014. Conclusion Nine out of 10 patients with CKD were discovered to have low FT3 levels, whereas one in four patients had low FT4 levels. The study participants also exhibited a significant presence of SCH and hypothyroidism, with prevalence rates of 15% and 12.9%, respectively. Urea levels and e-GFR, indicating the severity of CKD, showed a significant association with the presence of various thyroid abnormalities. Hypothyroidism in CKD patients can complicate disease progression, impact mortality rates, and affect overall quality of life. Therefore, routine screening for thyroid abnormalities should be conducted in all CKD patients.

Sonographic Abnormalities of Thyroid Gland in Post-Menopausal Women with and without Hormone Replacement Therapy

Background: Thyroid dysfunction is common especially in women over the age of 50 years. The prevalence of thyroid abnormalities is more in postmenopausal women using hormone replacement therapy. The prevalence of biochemical (or subclinical) hypothyroidism in women increases steadily with age, rising from 10% to 20% in the postmenopausal. The study results clearly indicate an increase in the activities of TSH among the older-aged post-menopausal women. Objective: To compare the sonographic findings of thyroid gland in post-menopausal women with and without hormone replacement therapy. Material and Method: A review of scientific literature concerning the correlation of Sonographic abnormalities of thyroid gland in post-menopausal women with and without hormone replacement therapy was done. Different platforms including medical journals, books and online resources(e.g., PubMed, Google Scholar &amp; Medline) were explored to find the relevant data using the mesh Terms: Thyroid gland, postmenopausal women, Hormone Replacement Therapy etc. The main focus was given to the latest data published in the last 10 years.

Human immunodeficiency virus, diabetes mellitus and thyroid abnormalities: Should we be screening?

BackgroundDiabetes mellitus (DM) and human immunodeficiency virus (HIV) are associated with thyroid abnormalities. Scarce literature exists on the prevalence of thyroid abnormalities in people living with HIV (PLWH) and DM (PLWHD). Guidelines vary regarding thyroid-stimulating hormone (TSH) screening in PLWH and/or DM.ObjectivesThis study describes thyroid abnormalities in PLWHD and HIV-uninfected people living with DM (PLWD).MethodThis was a cross-sectional analysis of demographic, clinical and biochemical data including TSH results of first-visit patients to the Edendale Hospital diabetes clinic between January 2016 and December 2017.ResultsA total of 915 patients were enrolled: 165 PLWHD and 750 PLWD. Overall prevalence of thyroid disorders in PLWD was 8.53% (64/750). The occurrence of ‘total’ thyroid disorders and of ‘subclinical-hypothyroidism’ (SCH) was higher in PLWHD than PLWD (23.03% vs. 8.53% and 20.61% vs. 4%, p < 0.001; respectively). People living with HIV and diabetes with thyroid disorders had lower CD4 counts than PLWHD without thyroid disorders (376.08 ± 333.30 vs. 509 ± 341.7 cells/mm3; p = 0.004). Subclinical-hypothyroidism was more common in patients on antiretroviral therapy [ART] (27/136 [19.85%] vs. 4/27 [14.81%], p < 0.001). A significant number of PLWHD acquired HIV before the onset of DM (107/165 [64.85%] vs. 58/165 [35.15%], p < 0.001). Patients on ART were more likely to develop DM, OR 2.66 (95% CI 1.11–6.38).ConclusionOur study showed an increased prevalence of thyroid disorders (especially SCH) in PLWD and a higher prevalence in PLWHD. Young, overweight, female PLWHD were at risk of SCH. People living with HIV and DM on ART demonstrated an increased prevalence of thyroid dysfunction and poor lipaemic control. The introduction of combined communicable–non-communicable disease clinics might provide an integrated patient screening option.

Prevalence of thyroid abnormalities in HIV/AIDS persons and correlation with CD4 count, HAART drug and duration of illness

Background: Human immunodeficiency virus (HIV) infection is characterized by decrease in CD4 cell count and immunodeficiency, leading to opportunistic infections (OIs) and tumors. Objective of this study was to find out any association between thyroid function abnormality and CD4 count, duration of disease and ART drugs.Methods: Among 300 HIV/AIDS Persons attending ART centre, M.Y. Hospital, or attending general OPD, or admitted as in patients Dept. of Medicine, MGM Medical College and M.Y. Hospital, Indore, India.Results: Amongst 300 HIV patients,62 (20.66%) had thyroid dysfunction, most common being subclinical hypothyroidism (24/300, 8.0%) followed by sick euthyroid (17/300, 5.6%) and subclinical hyperthyroidism (13/300, 4.3%). Overt hypothyroidism was present in 5 of 300 (1.66%) patients and overt hyperthyroidism was present in 3 of 300 (1.0%) patients. 25 of 152 (16.44%) and 37 of 148 (25%) male and female HIV patients had thyroid function abnormality. Thyroid dysfunction was significantly more observed in old HIV patients (42/150, 28.0%) than in newly diagnosed HIV patient’s group (20/150, 13.33%).Conclusions: This prevalence being fairly high, it can be suggested that all retro positive patients, recently diagnosed and on treatment also may be subjected for routine thyroid function testing.

1745-P: High Prevalence of Thyroid Abnormalities in Patients with Congenital Generalized Lipodystrophy

Background: It is related that thyroid appears can be affected by insulin resistance (IR). Early and severe IR is a characteristic of Congenital Generalized Lipodystrophy (CGL), characterized by near to total absence of subcutaneous adipose tissue. There are few studies about thyroid abnormalities in CGL. Aim: To describe thyroid structure and function in patients with CGL and correlate with HOMA-IR. Methods: The patients were submitted to a medical interview, physical examination, thyroid ultrasonography and biochemical, lipid profile and thyroid hormones evaluation. Results: Twenty-three patients with a CGL were included, median age was 13.3 years (3.6 to 38.7), 15 (65%) were younger than 19 years, 14/23 (60.8%) were women and 14 (60.8%) patients had diabetes. All patients had low leptin levels, low HDL cholesterol and 18/23 (78,2%) had hypertriglyceridemia (316.55-1052mg/dL). The prevalence of thyroid hormonal dysfunction was 17.4% (4/23): subclinical (1/23) and clinical hypothyroidism (1/23), subclinical (1/23) and clinical hyperthyroidism (1/23). TSH level was 1.27 uUI/mL (0.48 - 6.71), fT4, 1.06 ng/dL (0.82 - 1.92) and T3, 1.27 ng/dL (0, 69 - 1.76). Antithyroperoxidase (ATPO) and anti-titreoglobulin (ATG) antibodies were positive in 4% (1/23) and in 17.3% (4/23). There was a negative correlation between HOMA-IR and fT4 (r= 0.036). The thyroid volume was 4.3 cm³ (1.04 - 60.4), it was altered in 19% of the patients: 33% had nodules and another 33%, parenchyma heterogenicity. There was a positive correlation between HOMA-IR and volume (r= 0.035). A case of thyroid carcinoma was diagnosed in an 8 years-old girl. Conclusion: The prevalence of thyroid abnormalities was higher than in population data, especially in a young population. IR correlated positively with thyroid volume and negatively with T4l levels. This study did not show correlation between IR and autoimmunity. These data support that thyroid may be directly influenced by the high levels of insulin present in CGL. Disclosure V.O. Fernandes: None. G.D. Lima: None. A.D. Montenegro: None. A.B. Carvalho: None. G.M. Rodrigues: None. I.P. Melo: None. L.V. Martins: None. L.A. Batista: None. L. Aguiar: None. R.M. Montenegro: None.

Thyroid dysfunction and immune checkpoint inhibitor outcomes.

e15103 Background: Immune checkpoint inhibitors (ICI) frequently cause thyroid dysfunction. We performed a longitudinal analysis of thyroid function tests in a large, single-center cohort of patients with multiple cancer types receiving ICI. Methods: We performed a retrospective medical records review of consecutive patients treated with ICI from 1/1/2005 to 12/31/2018. We collected demographic and clinical data, including serial thyroid function tests. We compared overall survival between patients with normal and abnormal thyroid stimulating hormone (TSH) at baseline and after ICI initiation using Kaplan-Meier curves, log-rank tests, and multivariate Cox proportional hazards model. Results: A total of 910 patients were included: 63% male, 82% white, median age 67. The most common cancer types were lung (26%), kidney (18%), and melanoma (17%). ICI types were anti-PD1/L1 (78%), anti-CTLA-4 (7%), and combination ICI (15%). Normal baseline TSH and abnormal post-treatment TSH was associated with longer overall survival (median survival 26 months) compared to all other TSH permutations (median survival &lt; 10 months) ( P&lt; 0.001). This finding persisted after multivariate Cox regression adjustment for age, gender and cancer type (P &lt; 0. 001), and also after sensitivity analysis censoring patients who died within 2 months after starting ICI. Conversely, abnormal TSH at baseline was associated with lower overall survival (median 8 months) compared to normal TSH at baseline (median 18 months) ( P&lt; 0.001), which also persisted in multivariate analysis ( P&lt; 0.001). Kidney and head and neck cancers (71% and 69%) were associated with increased development of thyroid dysfunction compared to melanoma, lung and other urological cancers (52%, 50% and 35%) ( P&lt; 0.01). Conclusions: Although abnormal thyroid function after ICI initiation was associated with improved overall survival, pre-treatment thyroid abnormalities were associated with worse overall survival. Given the prevalence of thyroid abnormalities in the general population, further research into these observations is warranted.

Long-term thyroid disorders in pediatric survivors of hematopoietic stem cell transplantation after chemotherapy-only conditioning.

Thyroid dysfunction (TD) was usually described in hematopoietic stem cell transplantation (HSCT) recipients who were given total body irradiation (TBI) in the conditioning regimen. Because previous studies have reported discrepant results regarding the presence of long-term thyroid complications in HSCT survivors following chemotherapy-only conditioning, we investigated the frequency of thyroid abnormalities in a series of children treated with HSCT for different disorders without TBI as part of the conditioning protocol. We compared thyroid-stimulating hormone, free thyroxine, total triiodothyronine (TT3), anti-peroxidase (TPO Ab) and anti-thyroglobulin antibodies and thyroid volume z-score in 28 HSCT survivors and 16 healthy subjects matched for age and sex. HSCT recipients had a higher frequency of TD and thyroid complications in total, including TD and euthyroid Hashimoto thyroiditis, compared to the control group. Patients transplanted for Hodgkin lymphoma (HL) were more likely to develop a thyroid complication compared to patients with non-malignant hematologic diseases and leukemia patients. BEAM (carmustine, etoposide, citarabin and melphalan) conditioning compared to busulfan (Bu) and fludarabine (Flu)-based regimens and autologous compared to allogenic grafting were associated with a higher prevalence of TD in our study. HSCT survivors had higher mean serum TT3 levels. A multivariate analysis revealed that autologous (auto)-HSCT recipients had higher mean serum titers of TPO Ab compared to allogenic (allo)-HSCT recipients and controls and the mean thyroid volume z-score was significantly higher in controls compared to auto-/allo-HSCT survivors. We identified a 35.7% prevalence of thyroid abnormalities, emphasizing the need for a long-term surveillance of thyroid function and morphology even in this group of patients who were not exposed to TBI.

Thyroid lesions in patients with acromegaly - case-control study and update to the meta-analysis.

Acromegaly results from oversecretion of growth hormone and subsequently insulin growth factor-1. According to some authors, the disease can cause increased prevalence of nodular goitre and thyroid cancer (TC). However, the number of studies comparing acromegalic patients with control groups is low. We aimed to assess the prevalence of thyroid lesions in patients with acromegaly in comparison to an age- and sex-matched control group and to update the meta-analysis previously performed in our department by the same authors. We searched medical documentation of patients with acromegaly treated in our department between 2003 and 2013. The prevalence of thyroid abnormalities was compared with the group of patients with hormonally inactive adrenal incidentalomas. To perform the meta-analytic part of the paper we also searched ten databases to find relevant papers. Two hundred and five patients with acromegaly and 184 patients with incidentalomas were included. Any thyroid lesions were present in 77.6% of patients with acromegaly vs. 63.0% with incidentalomas (p = 0.002), multinodular goitre - 66.8% vs. 47.8% (p = 0.0002), and TC- 5.4% vs. 2.7% (p = 0.21) respectively. For thyroid lesions the pooled odds ratio (OR) was 3.1 (95% confidence interval [CI] 1.8-5.5), and for TCs the OR was 4.5 (95% CI 1.9-10.3). According to our results thyroid lesions were significantly more common in patients with acromegaly; in case of TC the difference was not significant. The updated meta-analysis showed significantly increased prevalence of both disorders. In conclusion, systematic thyroid examination should be an important part of follow-up in case of acromegalic patients. (Endokrynol Pol 2017; 68 (1): 2-6).

Prevalence of Thyroid Abnormalities in Thai Patients with Vitiligo.

Background Vitiligo is an acquired hypopigmentary disorder. The prevalence of vitiligo is 0.1–2% worldwide. Numerous autoimmune diseases are associated with vitiligo, including autoimmune thyroid diseases. The prevalence of thyroid abnormalities is up to 34% in vitiligo patients depending on ethnicities. Objective This study aims to investigate thyroid abnormalities in Thai patients with vitiligo. Methods Medical records of vitiligo patients attending outpatient dermatology clinic at a university-based hospital from 2012 to 2016 were retrospectively reviewed. Data regarding vitiligo, clinical features, and autoimmune thyroid laboratory results were retrieved and analyzed. Results Among 325 vitiligo patients identified, anti-thyroid peroxidase and anti-thyroglobulin were positive in 90 (27.7%) and 63 patients (19.4%), respectively. Positive thyroid antibody was associated with female gender (p < 0.001) and vitiliginous hand lesions (p < 0.02). Out of 197 patients with complete thyroid function test, the prevalence of autoimmune thyroid diseases (AITD) is 12.7%. Female, nonsegmental type, higher affected area, and the presence of leukotrichia are significantly associated with AITD in vitiligo patients. Conclusions Prevalence of positive thyroid antibodies and AITD in Thai patients with vitiligo is compatible with previous studies around the world. Screening for AITD with thyroid antibodies and serum TSH is essential for vitiligo patients.

FUNCŢIA TIROIDIANĂ LA COPIII HIPOACUZICI IMPLANTAŢI COHLEAR

Congenital hypothyroidism may be associated with hearing loss. However, the prevalence of thyroid abnormalities in children with severe hearing loss is not clearly evaluated. The authors assessed the thyroid function in 30 children with profound sensorineural bilateral hearing loss, with cochlear implant, to determine if there is any association between congenital hearing loss and hypothyroidism. Serum levels of TSH and free thyroxine were normal in the study group. None had Pendred syndrome. We present a literature review on the association between hearing loss and thyroid abnormalities and the importance of testing hearing in children with congenital hypothyroidism.

Prevalence of thyroid abnormalities among psoriatic patients

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Very high prevalence of ultrasound thyroid scan abnormalities in healthy volunteers in Modena, Italy.

Italy is characterized by high prevalence of goiter. To date, only limited data about the prevalence of goiter in the Italian adult population are available. To investigate the prevalence of thyroid ultrasound abnormalities in adults unaware of any thyroid disease and evaluate the rate of differentiated thyroid cancer (DTC) obtained by this intervention. Ultrasound (US) thyroid scan was performed in adult volunteers recruited by advertisement in Modena, Italy. One hundred and thirty-five women and 66 men (no.= 201), unaware of any thyroid disease (mean age of 46 ± 10.7 yr) underwent their first thyroid US scan. US thyroid abnormalities were found in 101 subjects (50.3%): 91 nodular goiters (45.2%) and 13 US-thyroiditis (6.5%) associated with positive auto-antibodies in 11 of them. Seventeen subjects (18%) with nodules underwent US-fine needle aspiration biopsy with the following cytological class (C) outcome: 14 patients C2 (82%), 1 patient C3 (6%), 2 patients had C4 (12%), the latter received histological confirmation. The prevalence of thyroid abnormalities is very high in subjects unaware of any thyroid disease. DTC was found in 1% of subjects and in 2% of those affected by nodular goiter. Compared to the detection rate of the well-established screening programs for breast (0.45%) and colorectal (0.27%) cancer, the prevalence of DTC seems to be much higher. Thyroid US screening could allow the detection of DTC in asymptomatic subjects and this diagnosis often includes DTC at an advanced stage. Thus, US screening not necessarily results in the over-diagnosis of clinically not relevant thyroid diseases.

Subclinical hypothyroidism and its association with lupus nephritis: a case control study in a large cohort of Chinese systemic lupus erythematosus patients

The aim of this study was to evaluate the prevalence of thyroid diseases in Chinese systemic lupus erythematosus (SLE) patients and the relevance of subclinical hypothyroidism (SCH) with lupus nephritis (LN). A large cohort of 1006 SLE patients was retrospectively analyzed. The prevalence of autoimmune thyroid disease was 2.78%, clinical hypothyroidism 1.69%, subclinical hypothyroidism 10.04%, central hypothyroidism 1.29%, hyperthyroidism 1.19%, euthyroid sick syndrome (ESS) 9.54%, and nodules 1.09%, respectively. Compared with the prevalence of thyroid abnormalities in the general Chinese population (0.91-6.05%), SCH was much higher (10.04%) in this study. In addition, SCH was more frequent in patients with LN (13.4%) than those without LN (7.3%, p = 0.001). Case control study was performed to explore the relative risk factors of SCH. In multiple logistic regression models, 24 h urine protein and estimated glomerular filtration rate (eGFR) were retained as independent correlates of SCH after adjusting for demographic variables, risk factors, and other potential confounders. The results of the present study suggest that SCH is a common complication in SLE patients, and closely related with LN.

Thyroid abnormalities in patients treated with lenalidomide for hematological malignancies: Results of a retrospective case review

Lenalidomide is an antiangiogenic drug associated with hypothyroidism. We describe a case-series of lenalidomide use in hematological cancers and the prevalence of thyroid abnormalities. We reviewed medical records of patients treated with lenalidomide at a single center form 2005 to 2010 and extracted demographic, clinical, and laboratory data. Of 170 patients with confirmed lenalidomide use (age 64.9 ± 15 years), 148 were treated for multiple myeloma and 6% had thyroid abnormalities attributable only to lenalidomide. In patients with a previous diagnosis of thyroid dysfunction, the addition of lenalidomide therapy was associated with a higher incidence of subsequent TFTF abnormality (17%) as compared to patients with no previous diagnosis of thyroid dysfunction (6%) (P=0.0001). Many patients (44%) with pre-existing disease and a change in thyroid function before or while on lenalidomide had no further follow-up of their thyroid abnormalities, Of 20 patients who did not undergo any thyroid function testing either before starting or while on lenalidomide for a median of 9.4 months (± 6.5), 35% developed new symptoms compatible with hypothyroidism, including worsened fating, constipation or cold intolerance. Symptoms of thyroid dysfunction overlap with side effects of lenalidomide. Thyroid hormone levels are not regularly evaluated in patients on lenalidomide. While on this treatment, thyroid abnormalities can occur in patients with no previous diagnoses and in patients with pre-existing abnormalities. Because symptoms of thyroid dysfunction could be alleviated by appropriate treatment, thyroid function should be evaluated during the course of lenalidomide to improve patients quality of life.

The prevalence of thyroid disorders among sexual and violent offenders and their co-occurrence with psychological symptoms.

The prevalence of thyroid abnormalities among 831 sexual, violent, and non-violent non-sex offenders was found to be greater than found in the general population. Thyroid abnormalities were most common among violent offenders and among sex offenders who victimized children. Thyroid disorders were associated with psychotic diagnoses, delusions, mania, suicidal thoughts, and showed a trend to more suicide attempts. These disorders were undiagnosed in 49.1% of the cases prior to the present clinical assessment. Of these, 59.3% faced their first criminal charges, and the undiagnosed thyroid abnormalities may be important in the offenders' treatment and may be possible legal mitigating factors in some offenses. Results indicate that a routine endocrine evaluation with blood tests would be a valuable addition to the assessment of violent and sexual offenders.

Alta prevalencia de disfunción tiroidea en pacientes psiquiátricos hospitalizados

Thyroid dysfunction is frecuent in psychiatric outpatients and in the general Chilean population but there is no information about the prevalence of thyroid diseases in Chilean psychiatric inpatients. To retrospectively assess the frequency of thyroidal diseases in psychiatric inpatients. Clinical charts and thyroid assessment of 241 psychiatric inpatients (147 women, mean age 33+/-16 years) attended in a University Psychiatric Clinic, were reviewed. Psychiatric diagnosis at discharge was made according to DSM IV criteria and endocrine diagnosis was made based on international criteria. Forty nine patients (20.7%) had thyroid abnormalities. Forty four patients had hypothyroidism (18.3%) and five had hyperthyroidism (2.35%). No specific associations were found between gender or psychiatric diagnosis and endocrine abnormalities. In this sample, the prevalence of thyroid abnormalities was similar to other reports in psychiatric inpatiens and higher than in the general population in Chile.

Diagnostic evaluation of women experiencing repeated in vitro fertilization failure

Objective The aim of the study was to propose a set of tests to clarify the diagnosis of repeated implantation failure in patients undergoing in vitro fertilization (IVF). Study design Fifty-nine patients with at least two unsuccessful IVF attempts were included in the study. Blood samples were evaluated for the presence of underlying thyroid abnormalities, antiphospholipid antibodies (aPL), increased levels of natural killer cells (NK), inherited thrombophilia and mouse embryo assay factor (MEA-f). The same tests were performed on 20 normal fertile control patients. Results Seventy-six percent of IVF patients showed at least one abnormal result. This incidence was higher with respect to that found among control patients (45%). The prevalence of thyroid abnormalities, aPL and increased NK level was higher in IVF patients whereas no differences were observed in terms of prevalence of inherited thrombophilias and MEA-f. Conclusions A better understanding of reproductive failure mechanisms should allow an effective diagnostic flow chart and a focused therapeutic option for patients experiencing repeated IVF failure. With this objective in mind, our data provide two important results: thyroid abnormalities, aPL and increased NK levels are more prevalent in women experiencing IVF failure. No evidence was found for an association between inherited thrombophilia and MEA-f and failure to achieve pregnancy after IVF.

Prevalence of Thyroid Abnormalities in Indigent Ambulatory Systolic Heart Failure Patient

PURPOSE: Hyperthyroidism or hypothyroidism may contribute to the development of systolic heart failure (SHF) or may contribute to the exacerbation of existing SFH. Current guidelines recommend a screening thyroid stimulating hormone (TSH) with the initial evaluation do the SHF patient. However the cost effectiveness of this practice is currently unknown as the prevalence of thyroid disease is associated with SHF has not been well described.

Summary of the cytological diagnosis of childhood thyroid diseases around Chernobyl

A combination of ultrasonography and fine-needle aspiration biopsy was performed in the screening project on children around Chernobyl. The aspirated materials from 446 cases were analyzed cytologically. The ultrasonographical screening revealed a 2.9% prevalence of thyroid abnormalities. Fine-needle aspiration biopsy (FNA), conducted in 446 cases, revealed the following diseases: papillary carcinoma, 7.2%; follicular neoplasm, 10.3%; adenomatous goiter, 22.4%; chronic thyroiditis, 26.2%; and cyst, 22.9%. We evaluated the detail of findings of papillary carcinoma. Intranuclear inclusion and nuclear grooving were encountered in 75% and 85%, respectively. Psammoma body was encountered in about 50% of the cases. Nuclear atypism as defined by pleomorphism and the ratio of nucleus to cytoplasm were relatively conspicuous. The cytological characteristics of pediatric papillary carcinoma revealed diagnostic findings almost the same as those in adult cases, with the noteworthy exception of high prevalence of psammoma body, which seems to be specific to the Chernobyl cases. We also analyzed 47 cases of chronic thyroiditis diagnosed by fine-needle aspiration biopsy. Prominent epithelial hyperplasia was encountered in 23.4%, and Askinazy cell metaplasia was present in 55.3%. The presence of epithelial changes suggests that thyroiditis has existed for a long time or that thyroid follicles are destructed heavily in children. In this viewpoint, the Chernobyl cases are classified into auto-immune thyroiditis or Hashimato thyroiditis. This study suggests that childhood thyroid diseases, including both neoplasms and immunological disorders, are considered to be an ideal follow-up disease for monitoring the late effect of radioactive fallout.

Serum Tg--a sensitive marker of thyroid abnormalities and iodine deficiency in epidemiological studies.

Serum Tg is widely used in the control of thyroid cancer but also in the diagnosis of certain other thyroid diseases. Serum Tg may be useful in the characterization of the iodine status of a population, but little is known about determinants of serum Tg levels. We examined a random selection of 4,649 subjects from 2 regions in Denmark with different iodine status. Thyroid volume and structure were determined with ultrasonography, and thyroid function tests and Tg analysis were performed. The factor with the closest association with serum Tg levels was thyroid volume at ultrasonography (P < 0.001). Also thyroid nodularity (P < 0.001) and iodine excretion (P < 0.001) had close associations to serum Tg, even after adjusting for the influence of the other parameters. Thyroid dysfunction had a less pronounced but still highly significant association with serum Tg (P < 0.001), but no relation was found to serum TSH in general. The association with age seemed to rely on differences in the prevalence of thyroid abnormalities, and men had lower Tg levels than women of the same age. There was a marked difference in serum Tg between the two regions with slightly different iodine excretion also after adjusting for the other factors. In conclusion, serum Tg reflects thyroid abnormalities and thyroid function and is a sensitive marker of iodine deficiency in a population.