Thyroid Disease Research Articles

Vitiligo Cases in the Out-Patient Department in a Tertiary Care Hospital

Background: The prevalence of vitiligo has been reported to range from 0.1% to 8% worldwide. It has a low mortality rate but a high morbidity cost because of its psychological and social effects. Type-1 diabetes mellitus, autoimmune thyroid disease and other autoimmune illnesses have been linked to this condition. This study was performed to assess the occurence of vitiligo among males and females and the epidemiological status of vitiligo in a tertiary Hospital of Dhaka, Bangladesh. Materials and methods: A cross-sectional survey was conducted among 3,212 adults (1,429 males and 1,783 females) in a community of Dhaka between October 2022 and May 2023 at OPD of Delta Medical College. Face-to face interviews were conducted at the OPD of Delta Medical College for each participant and all respondents had their skin examined by dermatologists. The risks of comorbidities associated with vitiligo were evaluated. Results: In this particular research project, most vitiligo patients were between the ages of 13 and 60 years. According to this research, the average age of vitiligo patients was 35.5 years. Here, the proportion rate for this is 2.74%. The ratio of male participants to female participants in this research was M:F = 1:1.51. Only 88 out of the 24 cases were stable, whereas around 64 were unstable. The focused kind of vitiligo was shown to be the most prevalent form of the condition in this particular research. Conclusion: Vitiligo was most common among individuals in Dhaka in their middle 30s and the incidence of the condition rise with age. In adult patients, vitiligo was connected with higher risks of alopecia areata, hypothyroidism, diabetes mellitus and atopic dermatitis. IAHS Medical Journal Vol 7(1), June 2024; 17-21

Abstract 4136480: A Rare Cause of a Classic Presentation of NSTEMI: Case of 39-Year-Old Female with Hypothyroidism Induced Myocarditis

Background: Myocarditis is a cause of non-ischemic cardiomyopathy (NICM) and troponin elevation. There are many causes including uncontrolled thyroid disorder (TD). A thorough history, cardiac MRI (cMRI) followed by an endomyocardial biopsy (EMB) is necessary for diagnosis. This case illustrates a classic presentation of NSTEMI with a rare cause of myocarditis due to uncontrolled hypothyroidism. Description of Case: A 39-year-old female with history of congenital hypothyroidism and tobacco use disorder presented to the Emergency Department with sudden onset of unprovoked sub-sternal chest pain. She stated she had stopped taking her levothyroxine years ago due to side effects such as abdominal discomfort. On admission, work up included high sensitivity troponin (Hs-cTn), EKG, urine drug screen (UDS), and thyroid panel. There was no evidence of ischemic changes on EKG, Hs-cTn was 3600 (normal: 3-54) which up-trended to 43,742, and UDS was negative. She was placed on appropriate medical therapy for NSTEMI and taken for urgent coronary angiography wbich showed normal epicardial arteries. A transthoracic echocardiogram (TTE) was unremarkable with a normal ejection fraction (EF). However, she continued to complain of chest discomfort and palpitations. Her vital signs remained stable but her thyroid panel revealed a TSH of 127 (normal: 0.27-4.2), T4 of 0.18 (normal: 0.92 – 1.6) and T3 of 1.0 (normal: 2.3-4.2). Inflammatory markers were also elevated. A cMRI was obtained revealing gadolinium enhancement in the anterior septal wall with extension into the subepicardium of the inferior wall suggestive of possible myocarditis. An EMB was performed to elucidate etiology. Pathology results were only remarkable for edema but newly reduced EF of 30-35% was noted on TTE at time of biopsy. Endocrinology was consulted for untreated hypothyroidism and patient was initiated on levothyroxine leading to improvement of her symptoms. Discussion: Our patient's history and work up were consistent with myocarditis induced by severe hypothyroidism. TD is a rare cause of reversible NICM and symptoms improve once TD is controlled. While there are several cases reported on hyperthyroidism associated myocarditis, there are only a few cases of myocarditis associated with uncontrolled hypothyroidism. Clinicians should maintain a broad differential to ensure a thorough work up in a patient presenting with NSTEMI, and a thyroid panel should be included especially if myocarditis is suspected.

Hereditary alpha tryptasemia: elevated tryptase, female sex, thyroid disorders, and anaphylaxis

IntroductionThe clinical significance of elevated baseline serum tryptase (BST) in the absence of mast cell disorders or allergic reactions has long been unclear. Recently, a genetic variation of the TPSAB1 gene, which among others encodes for alpha tryptase, has been reported and named hereditary alpha tryptasemia (HaT). HaT has been linked to various manifestations, including severe allergic reactions. However, clinical studies are limited. In this study, we aimed to determine HaT prevalence and characterize its clinical manifestations in patients at a specialized allergy center.MethodsFrom January 2022 to December 2023, patients with elevated BST at least once were screened for HaT at the outpatient clinic. A control group included patients with a history of anaphylaxis undergoing specific Hymenoptera immunotherapy. TPSAB1 copy numbers, BST levels, and clinical parameters were assessed and analyzed.ResultsOf 47 patients with elevated BST (≥11.4 µg/L), 93% showed increased TPSAB1 copy numbers. Individuals diagnosed with HaT displayed a BST range between 12.3 and 28.4 µg/L, with 84.1% associated with TPSAB1 duplication and 15.9% with triplication. HaT predominated in women (86.4%) and was associated with thyroid disease (27.3%). Over half had a history of anaphylaxis (54.5%), which was mainly low-grade.DiscussionIn patients with elevated BST but no mastocytosis, the most likely cause of elevated BST was an increase in the copy number of the TPSAB1 gene. A heightened risk of anaphylaxis should be considered. Further research is needed to explore the predominance of women and the emerging link with thyroid disease.

Dietary Habits, Nutritional Knowledge, and Their Impact on Thyroid Health in Women: A Cross-Sectional Study

Background: The thyroid gland plays a crucial role in regulating metabolism and various bodily functions through hormone production. Women are particularly susceptible to thyroid disorders such as hypothyroidism and Hashimoto’s disease, with associated symptoms affecting overall well-being. Prior research has inadequately addressed the influence of dietary habits and nutritional knowledge on thyroid health, especially in women. Objective: This study aimed to evaluate the dietary habits and nutritional awareness of women aged 18–45 with diagnosed thyroid disorders, emphasizing the effects of education level on knowledge and dietary practices. Material and Methods: A cross-sectional survey was conducted with 297 women diagnosed with thyroid conditions. The survey assessed demographics, comorbidities, hydration habits, and knowledge about nutrient intake critical for thyroid health. Chi-square tests, ANOVA, and correlation analyses were performed to evaluate associations. Results: Hypothyroidism and Hashimoto’s disease were most prevalent among younger women (18–25 years). A significant association was observed between higher education and knowledge of protein and carbohydrate roles in managing thyroid health (p < 0.01). Women with higher educational backgrounds more frequently used healthier cooking methods and were more informed about beneficial nutrients, including vitamin D and omega-3. A chi-square test indicated that low water intake was significantly associated with comorbid conditions, including insulin resistance and cardiovascular disease (p < 0.01). Conclusions: Significant gaps remain in dietary knowledge, particularly concerning protein intake and nutrient–drug interactions, indicating a need for targeted dietary education. Women with higher education demonstrated greater dietary awareness, emphasizing the importance of tailored educational interventions to enhance thyroid disorder management.

Longitudinal assessment of thyroid function in dogs with hypoadrenocorticism: Clinical outcomes and prevalence of autoantibodies

AbstractBackgroundKnowledge about primary hypoadrenocorticism coexisting with immune‐mediated thyroiditis (Schmidt's syndrome) in dogs is limited.ObjectiveTo evaluate thyroid function in dogs with naturally occurring hypoadrenocorticism before and during treatment.AnimalsSixty‐six client‐owned dogs.MethodsMeasurement of canine thyroid stimulating hormone (cTSH), total thyroxine (T4), free thyroxine, and autoantibodies against thyroglobulin, T4, and total triiodothyronine.ResultsThirty‐eight dogs were assessed before and 28 during treatment. Follow‐up data were available for 24/38 and 17/28 dogs, with median follow‐up duration of 3.8 years (range, <1.0‐8.8 years) and 4 years (range, 1.1 weeks to 10.5 years), respectively. Canine thyroid stimulating hormone was above the reference range at the time of diagnosis of hypoadrenocorticism in 10 of 38 dogs but decreased into the reference range in 7 for which follow‐up data was available. Hypothyroidism was confirmed in 5 dogs at a median age of 11 years (range, 7‐15 years). In 4 dogs, the condition was diagnosed after a median treatment duration of 5.75 years (range, 2.6‐10 years), while in 1 dog, the diagnosis was made concurrently. One dog had detectable thyroid autoantibodies.Conclusions and Clinical RelevanceHypothyroidism occurs as a rare concurrent condition in dogs with hypoadrenocorticism, potentially at any phase of treatment. Close monitoring of cTSH levels in these dogs could be beneficial, as early changes might indicate the onset of hypothyroidism. The low prevalence of detectable thyroid autoantibodies suggests that nonimmune mechanisms might contribute to thyroid dysfunction.

Real-world analysis of the incidence and risk factors of pneumonitis in non-small cell lung cancer patients treated with combined thoracic radiotherapy and immunotherapy

Abstract Objectives Combining radiotherapy with immune checkpoint inhibitor (ICI) treatment has emerged as an important therapeutic regimen. However, this combined treatment may increase the risk of pneumonitis. The aim of this study is to analyze the incidence and risk factors for pneumonitis in non-small cell lung cancer (NSCLC) patients receiving combined thoracic radiotherapy and ICI (RT + ICI) treatment in the real-world clinical setting, offering a reference and guidance for clinical physicians. Methods This study identified 447 patients with pathologically confirmed NSCLC at West China Hospital of Sichuan University from 2016 to 2021. Clinical characteristics, treatment regimens, immune-related adverse events (irAEs), and hematological data were collected and analyzed. Results Patients receiving combined RT + ICI treatment had a higher risk of developing pneumonitis than those receiving ICI treatment alone (26.9 vs. 6.7 %, p<0.001). The multivariate logistic analysis identified the following independent risk factors for pneumonitis in patients undergoing combined RT + ICI treatment: history of lung disease (p=0.032), first-line ICI treatment (p=0.001), anti-PD-L1 instead of anti-PD-1 treatment (p=0.035), and the development of immunotherapy-related thyroid dysfunction (p=0.019). The independent risk factors were incorporated into a nomogram to predict the incidence of pneumonitis. The area under the receiver operating characteristic curve is 0.727, suggesting an acceptable predictive efficacy. Conclusions Compared to ICI monotherapy, NSCLC patients receiving the combination of thoracic radiotherapy and ICI treatment are at higher risk of developing pneumonitis. The nomogram holds promise for facilitating the risk assessment and early identification of pneumonitis in NSCLC patients receiving combined RT + ICI treatment.

Predicting thyroid involvement in primary Sjögren’s syndrome: development and validation of a predictive nomogram

IntroductionPatients with Primary Sjögren’s syndrome (pSS) are at a higher risk of thyroid disorders than the general population. This retrospective analysis of 202 patients with pSS was conducted to uncover risk factors associated with thyroid involvement and to create a predictive model for this condition.MethodsWe analyzed 202 patients with pSS from Guang’anmen Hospital, China Academy of Chinese Medical Sciences, with 105 cases of thyroid involvement and 97 without. The Least Absolute Shrinkage and Selection Operator method was used to identify key variables for our risk model. These variables were then subjected to multivariate logistic regression to develop the model. The accuracy of the model was assessed through the C-index, receiver operating characteristic curves, calibration plots, and decision curve analysis, with internal validation via bootstrapping.ResultsHigh-sensitivity C-reactive protein (HCRP), pulmonary disease, pharyngeal dryness, forgetfulness, night sweats, hyperuricemia, nasal dryness, anxiety, Ro52, and aspartate aminotransferase (AST) were incorporated into the nomogram. The model showed robust discrimination and calibration abilities. Decision curve analysis indicated the clinical utility of our nomogram in intervening on the probability thresholds of thyroid disease.ConclusionBy integrating HCRP, pulmonary disease, pharyngeal dryness, forgetfulness, night sweats, hyperuricemia, nasal dryness, anxiety, Ro52, and AST, our thyroid risk nomogram can predict the risk of thyroid involvement in patients with pSS, aiding in more informed treatment strategies.

A comparison of comorbidities and their risk factors prevalence across rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis with focus on cardiovascular diseases: data from a single center real-world cohort

AbstractManagement of comorbidities is essential to a patient-centered approach to the treatment of chronic inflammatory arthritis. The aim of this study was to compare the prevalence of comorbidities and their risk factors in rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) in a single center outpatient cohort. This cross-sectional study included adult patients diagnosed with RA, PsA, and axSpA from a single rheumatology outpatient center. Comorbidities were documented by physicians, and patients were categorized into two age groups, younger (< 45 years) and older (≥ 45 years), with age- and gender-based comparisons. Disease activity, comorbidities, and cardiovascular (CV) risk factors were analyzed using chi-squared tests for categorical variables and independent samples t-tests for continuous variables, with p values < 0.05 considered statistically significant. Comorbidities were registered by physicians using GoTreatIt® Rheuma software. Among 508 RA, 267 PsA, and 285 axSpA patients, the four most common comorbidities were hypertension (36.4%, 25.1%, and 19.7%, respectively), dyslipidemia (19.5%, 15.4%, 14.7% respectively), obesity (16.9%, 22.5%, 14% respectively) and thyroid disease (21.5%, 13.9%, 11.2% respectively). Other comorbidities differed among the diseases and included osteoporosis, osteoarthritis, diabetes mellitus, arrhythmia, and asthma in RA, diabetes mellitus, depression and asthma in PsA, osteoporosis and serious infection in axSpA. RA patients, compared to axSpA had a higher prevalence of coronary artery disease (4.1% vs. 0.7%, p = 0.006), arrhythmia (6.9% vs. 2.5%, p = 0.008) and major adverse cardiac events (2.6% vs. 0.4%, p = 0.024) compared to axSpA. Osteoporosis was more frequent in RA (19.1%) and axSpA (8.4%) than in PsA (2.3%; p < 0.001) and was frequently diagnosed in patients aged < 45. Depression prevalence was surprisingly low (1.6%, 5.2%, and 1.8%, respectively). RA patients had the highest multimorbidity rate, with 26.6% reporting three or more comorbidities, compared to 16.8% in PsA and 10.6% in axSpA (p < 0.001). Health status was poorest in RA and worse in women compared to men for all diseases. RA, PsA, and axSpA share the same four most common comorbidities: hypertension, dyslipidemia, obesity, and thyroid disease but have different prevalence of other disorders and CV risk factors, indicating the need for an individual screening and prevention approach. The possible unrecognition of depression should be evaluated.

Subclinical hypothyroidism as an independent predictor of cardiovascular prognosis in left ventricular thrombus patients

Abstract Objectives Left ventricular thrombus (LVT) is associated with an increased risk of adverse cardiovascular events, and thyroid hormones are known to affect the cardiovascular system in various ways. However, subclinical thyroid dysfunction still deserves to be emphasized, and its impact on the prognosis of patients with LVT is rare but needs to be investigated. Methods We used retrospective data from patients diagnosed with LVT at Fuwai Hospital over the past 10 years to assess the relationship between thyroid functional status and prognosis of LVT using multivariate Cox proportional hazards models, and validated the improved predictive effect of including thyroid function in the prognostic assessment of LVT using receiver operating characteristic (ROC) curves. Results Subclinical hypothyroidism was significantly associated with a higher incidence of major adverse cardiovascular and cerebrovascular events (MACCEs) (HR 1.774, 95% CI: 1.053-2.989; p = 0.031) and cardiovascular death (HR 1.986, 95%CI: 1.110-3.553; p = 0.021) in LVT patients, whereas no significant correlation was observed in the subclinical hyperthyroidism group. In addition, including thyroid function in the prognostic consideration of LVT patients would contribute to the predictive effect of MACCEs (AUC for 1 year: 0.715; AUC for 2 years: 0.745; AUC for 3 years: 0.684). Conclusion Subclinical hypothyroidism can be used as an independent predictor of MACCEs in patients with LVT, and there is a clinical value in using subclinical hypothyroidism as an important factor suggesting a poor prognosis in patients with LVT.

TMET-26. TARGETING TRANSSULFURATION VIA SUPPRESSION OF THYROID HORMONE SIGNALING: A WINDOW OF OPPORTUNITY TRIAL OF METHIMAZOLE IN PATIENTS WITH PROGRESSIVE WHO GRADE 4 GLIOMAS (NCT05607407)

Abstract BACKGROUND Gaseous hydrogen sulfide (H2S), a by-product of cysteine metabolism, inhibits cancer cell behavior and growth in glioblastoma (GBM) models. H2S production capacity (HPC) is decreased in human GBM specimens compared to non-tumor controls. Thus, boosting HPC is a novel strategy for GBM treatment. Suppression of thyroid hormone signaling increases endogenous production of H2S. Hypothesis: hypothyroidism induced by methimazole will enhance the efficacy of chemotherapy in WHO grade 4 gliomas by increasing HPC within the tumor. Goal: proof of concept that methimazole, by reducing thyroid hormone signaling, can increase HPC in patients with WHO grade 4 gliomas (G4G). METHODS This window of opportunity trial evaluates safety, HPC in plasma and tumor, and efficacy of methimazole + chemotherapy in patients with progressive G4G. MAIN OBJECTIVE 10% increase in HPC and a 1.5-fold increase in peripheral blood sulfhydration signaling. Patients planned for a clinically-indicated resection receive pre-op (5-7 days) and post-op methimazole with the addition of investigator’s choice of chemotherapy 1 month after starting post op methimazole. Patients receive methimazole + chemotherapy until progression. Pre- and post-op plasma and resected tumor tissue are assayed for HPC and proteins relevant to H2S production. Key eligibility: progressive G4G for whom a clinically-indicated resection is planned; normal thyroid function with no history of thyroid dysfunction. Patients may have received unlimited prior regimens including bevacizumab. RESULTS To date 12 patients (8 male) median age 56 years enrolled, 3 of whom are in pre-op phase. Relative to age/sex matched control, post-methimazole plasma at all time points tested but not tumor HPC increased (minimum increase 56%, p 0.041). No grade 3-5 toxicities or significant changes in thyroid function tests. PFS6 0 for first 6 patients. CONCLUSIONS Induction of subclinical hypothyroidism is feasible and safe in recurrent GBM with significant increases in plasma but not tumor HPC. The protocol is being modified to increase methimazole doses and allow earlier addition (10 days) of post-op chemotherapy.

Anhedonia is associated with a specific depression profile and poor antidepressant response

Abstract Background Anhedonic features within major depressive disorder (MDD) have been associated with worse course and outcome and may predict non-response to treatment. However a detailed clinical profile of anhedonia in MDD is still lacking. Materials and Methods One thousand two hundred ninety-four patients with MDD were selected from the cross-sectional European multicenter Group for the Study of Resistant Depression (GSRD) study. Anhedonia was assessed through the Montgomery-Åsberg Depression Rating Scale anhedonia item “inability to feel”. Clinical and demographic features were then analyzed. Results The presence of anhedonia related to a distinct demographical (living alone) and clinical profile (thyroid diseases, diabetes, suicide risk, high number of previous depressive episodes, more severe MDD and more frequent inpatients status). Furthermore, anhedonia was associated with non-response to treatment and treatment resistance, even after adjusting for confounding variables. Conclusion Our findings support the role of anhedonia as a modulating feature of MDD, being associated with a more severe depression profile. Moreover, anhedonic features are independent predictors of poor treatment response.

Analysis of risk factors for autoimmune thyroid disease based on blood indicators and urinary iodine concentrations

ObjectiveThe aim of this study was to elucidate the relationships between thyroid hormones, lifestyle factors, biochemical markers, and autoimmune thyroid disease (AITD), thereby identifying the factors influencing the development of these diseases.MethodsThe study encompassed 517 patients with AITD and 549 patients with non-autoimmune thyroid disease. Demographic and clinical data were collected, and various laboratory indicators, including urinary iodine and thyroid hormones, were measured and compared between the groups. Lasso regression was employed to select the independent variables, while logistic regression analysis determined the factors associated with the development of AITD.ResultsThe prevalence of drinking alcohol history, median urinary iodine, and TSH concentrations proved significantly greater in the AITD group compared to the control group, while FT3 levels demonstrated lower values within the AITD group (p<0.05). Furthermore, there was a significant difference in the distribution of iodine nutrition status between the two groups (p<0.05). Both univariate and multivariate logistic regression analyses revealed significant associations among excessive iodine intake, drinking alcohol history, TSH, FT3, and the development of AITD.ConclusionsExcessive iodine intake and drinking alcohol history are implicated in an augmented risk of developing AITD. The prevention of AITD may necessitate the regular monitoring of TSH and FT3 concentrations.

FREQUENCY OF INFECTIOUS AND NON-INFECTIOUS DISEASES DURING THE WAR IN UKRAINE BASED ON SOME PRIMARY MEDICAL CARE UNITS' DATA IN THE CHERNIVTSI REGION

Aim – to investigate the impact of the war in Ukraine and COVID-19 on the frequency of infectious (COVID-19, tuberculosis) and non-infectious diseases (hypertension (AH), diabetes mellitus (DM), obesity, thyroid pathology, chronic kidney disease (CKD)) according to data from primary health care units in Chernivtsi region..Material and methods. The statistical reports of Communal Non-commercial Enterprises (CNEs) "Kitsman Center of Primary Medical Care" of the Kitsman District Council and "City Polyclinic No. 1" of the Chernivtsi City Council for the years 2019-2023 with the number of observed population subject to medical care - 36,508 and 58,500, respectively, were analyzed.Results. During the COVID-19 pandemic (2021-2022), a surge in the incidence of tuberculosis was observed in separate communities, with an almost 7% increase per 100,000 residents in the Chernivtsi region as a whole (in 2022-2023), caused, in our opinion, by the war and an increased population migration. During the period of the COVID-19 pandemic and with the beginning of the full-scale invasion of the russian federation on the territory of Ukraine, a strict trend in the incidence of DM increase (mainly non-insulin-dependent) was established. The frequency of obesity in women increased as well by 17.5%, while in men, on the contrary, it decreased – by 17.42%. The frequency of diffuse goiter in the structure of thyroid diseases decreased by 3%, with a slight elevation in autoimmune thyroiditis.Conclusion. An obvious dependence of changes in the incidence of CKD and hypertension in linkage with the COVID-19 pandemic and the war in Ukraine was not established in the analyzed communities.

25-year experience of surgical treatment of thyroid diseases in a multidisciplinary hospital

BACKGROUND: Every year there is an increase in the number of patients with thyroid diseases, thus improving surgical treatment methods with decreased traumatic effect and postoperative complications, remains relevant. AIM: To summarize the results of 25-year work of the team (surgeons and endocrinologists) of specialists from the multidisciplinary hospital of Saint Petersburg and the departments of the North-Western State medical university named after I.I. Mechnikov on the diagnosis and treatment of patients with surgical pathology of the thyroid gland. MATERIALS AND METHODS: The results of surgical treatment of 3977 patients with thyroid diseases operated accoding to the traditional Kocher approach, asymmetric “floating” mini-approach and video-assisted mini-approach were analyzed. RESULTS: In the analyzed time period, a rapid increase in the number of minimally invasive techniques for surgical operations on the thyroid gland is characteristic, which are used for nodular euthyroid goiter, multi-nodular euthyroid goiter and toxic thyroid adenoma. With the help of traditional approach, surgical intervention was performed mainly for diffuse toxic goiter and multinodular toxic goiter. The introduction of new techniques and approaches in the provision of medical care to patients with surgical diseases of the thyroid gland can significantly improve the results of treatment. CONCLUSIONS: 25-year experience of the endocrinological center of the Elizabethan Hospital demonstrates that collaboration of departments and doctors of a multidisciplinary hospital allows to introduce new approaches to treating surgical thyroid diseases and improve its results without increasing the number of postoperative complications.

Thyroid hormones in female and male reproduction with special reference to dogs and cats

Thyroid hormones have an important function in numerous physiological processes in humans and animals, including the regulation of metabolism, growth and development of individual and reproductive function. The thyroid hormones, triiodothyronine (T3) and thyroxine (T4), have a direct effect on the reproductive organs and an indirect effect in interaction with other hormones. Thyroid hormones influence the reproductive system by regulating metabolism and tissue development of the ovaries, uterus and placenta. Changes in the serum concentrations of T3 and T4 lead to disturbances in overall body function. Thyroid dysfunction, including hypothyroidism and hyperthyroidism, can lead to significant reproductive problems. The aim of this review was to describe the functions of thyroid hormones and the effects of hypothyroidism and hyperthyroidism on the animal reproductive system. Hypothyroidism is often caused by autoimmune diseases such as lymphocytic thyroiditis, and is associated with later puberty, reduced fertility and abnormalities in reproductive organ development. Hypothyroidism can lead to a prolonged interval, absent cycles, silent oestrus cycles, prolonged oestrus bleeding, and a lack of libido, with the occurrence of infertility, miscarriages, stillbirths and mummified foetuses. In males, hypothyroidism leads to a decrease in libido, semen quality, ejaculate volume, testicular atrophy, hypospermia and azoospermia. Hyperthyroidism, on the other hand, is usually the result of thyroid cancer, which produces excessive amounts of thyroid hormones. Increased concentrations of thyroid hormones lead to disturbances in the physiological balance of reproductive hormones, irregular oestrus cycles, anovulation and reduced fertility, as well as a decrease in the weight of the ovaries and the number of healthy follicles, with a simultaneous increase in the number of atretting follicles. The effects of hyperthyroidism on male fertility include disorders of spermatogenesis, changes in sex hormone levels and changes in sperm quality, such as hypospermia, oligozoospermia, asthenozoospermia and teratozoospermia. It is important to diagnose and treat thyroid disorders in time in order to prevent negative effects on fertility and reproduction in animals.

Perinatal Risk Factors in Single-suture Craniosynostosis: A Systematic Review and Meta-analysis.

To our knowledge, there has not been a review article summarizing the current evidence with regard to perinatal risk factors, and our aim is to perform a systematic review and meta-analysis of the evidence of perinatal risk factors in single suture craniosynostosis to inform our practice and identify any need for further research in this area. Our target population was pediatric single-suture craniosynostosis patients, and the intervention was perinatal risk factors. The comparison group was an age and sex-matched control group without craniosynostosis and the outcome we investigated was presence of single suture craniosynostosis. The literature search was done using OVID MEDLINE, Pubmed, and Embase databases from 1946 to 2023. A PRISMA flowchart was created, and statistical analysis was performed using RevMan pooled odds ratios, and 95% CIs were used to combine results from individual studies. Our initial search identified 625 abstracts and these were narrowed down to 16 articles, which were included in the final selection for the review. Out of these, 13 were used for the quantitative meta-analysis. Our meta-analysis showed a possible association between craniosynostosis and the following perinatal risk factors; presence of maternal thyroid disease, maternal age greater than 29, paternal age greater than 29, maternal smoking, gestational age above 37 weeks, and maternal underweight (BMI<18.5). Further prospective studies are warranted to investigate definite associations. The next step is to set up a multicenter prospective study among a craniofacial unit network.

Association of HLA class II genes with autoimmune thyroid diseases in children with type 1 diabetes

Association of HLA class II genes with autoimmune thyroid diseases in children with type 1 diabetes

Polycystic Ovary Morphology, Subclinical Hypothyroidism, and the Cutoff Value of Thyroid-Stimulating Hormone, a Population-Based Study.

Although numerous studies have explored the link between polycystic ovary syndrome (PCOS) and thyroid dysfunction, the relationship between polycystic ovary morphology (PCOM) and thyroid issues remains unclear. This study aimed to examine the association between PCOM and subclinical hypothyroidism (SCH) as well as the threshold for thyroid-stimulating hormone (TSH). Data were drawn from the Iranian PCOS prevalence study and the Khuzestan PCOS prevalence study. Eligible participants were divided into two groups: those with PCOM (n = 120) and a control group (n = 630). A logistic regression model was employed to assess the impact of PCOM on SCH, with odds ratios and 95% confidence intervals calculated. Additionally, a quantile regression model was used to evaluate the effect of PCOS on TSH levels. The results indicated no significant association between PCOM and SCH (adjusted OR: 1.38, 95% CI: 0.80-2.37; p = 0.243). Furthermore, after adjusting for confounding factors such as age, body mass index (BMI), and number of pregnancies, no significant differences were found in TSH levels between the PCOM and control groups. The prevalence of SCH and the TSH threshold were similar in both groups. Further comprehensive population-based studies with detailed thyroid evaluations are recommended.

Clinicopathological and molecular markers for the identification of Hashimoto’s thyroiditis as a possible predisposing and prognostic factor of papillary thyroid carcinoma

Background: The papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, while Hashimoto’s thyroiditis (HT) is the most common inflam¬matory thyroid disease. The coincidental coexistence or the possible predisposing, protective or aggravating role of HT in the development of PTC have been repeatedly examined. Aim: The aim of the present study was to eval¬uate histopathological and clinical data obtained from pa¬tients with HT, PTC, and PTC+HT so as to investigate the possible association of HT with PTC. Methodology: The study’s cohort consisted of 114 patients (67 PTC, 29 PTC+HT, and 18 HT patients). A full record of their clini¬copathological and clinical laboratory data was followed by extensive statistical analysis in order to reveal possi¬ble correlations between the existence of each disease and various clinicopathological parameters. The study was conducted from 2019 to 2023 at the Hippokration General Hospital of Athens (Greece). Results: A signifi¬cant increase in the levels of thyroid-stimulating hormone (TSH; p=0.031), anti-thyroglobulin antibodies (Anti-Tg; p&lt;0.001), and anti-thyroid peroxidase antibodies (Anti-TPO; p&lt;0.001) was observed in the PTC+HT group. These patients also have smaller tumors (p=0.015) and a younger age of disease onset (p&lt;0.001), while the ma¬jority of PTC+HT patients were women (p=0.023) and had infiltrated lymph nodes (p=0.002). Furthermore, the majority of patients with infiltration of the capsule be¬longed to the PTC+HT group (57.1%; p=0.032). Conclu¬sion: PTC+HT represents a less aggressive clinical state, as good prognostic markers of PTC correlate with the presence of HT. In PTC+HT patients, the PTC tends to have early onset age and the primary tumor is often small, while the majority of PTC+HT patients are women.

Theranostics Nuclear Medicine in Prostate Cancer

Theranostic Nuclear Medicine is based on the idea of combining the same molecule (or drug) with different radioisotopes for both diagnosis and treatment, a concept that emerged in the early 1940s with the use of radioactive iodine for thyroid diseases. Theranostic Nuclear Medicine has since expanded to diseases of higher incidence, such as prostate cancer, with several imaging methods used to assess the extent of the disease and the corresponding radiopharmaceuticals used for treatment. For example, by detecting osteoblastic metastases by bone scintigraphy, corresponding radiopharmaceuticals with therapeutic properties can be administered to eliminate or reduce pain associated with metastases and/or determine overall survival gain. The purpose of this review is to discuss the role of Theranostic Nuclear Medicine in prostate cancer, addressing the main diagnostic imaging studies with their corresponding treatments in the Theranostic model.