Thyroid Disorders In Patients Research Articles

The role of autoimmune thyroid disorders in patients with alopecia areata

Objective: The aim of this study was to investigate the association of thyroid autoimmunity with alopecia areata (AA) by examining thyroid stimulating hormone (TSH) and thyroid autoantibody levels. In addition, to compare the epidemiologic data obtained with the data of our country. Methods: Our study was organized as a cross-sectional, retrospective study. The study was performed on patients between the ages of 2-65 years who were admitted to our outpatient clinic between 01.01.2008 and 31.12.2011, who were clinically or histopathological diagnosed with AA, examined for etiology and thyroid autoantibodies were requested. Patients under two years of age and over 65 years of age, patients with no thyroid autoantibodies and pregnant patients were excluded. Results were expressed as mean±standard deviation and median values. Mann-Whitney U test was used to compare TSH, anti-TG antibody (Anti-TG) and anti-TPO (Anti-TPO) antibody values in the variables of nail involvement, psychiatry, comorbidity and family history. Spearman correlation analysis was used to examine the relationships between age and disease duration and TSH, Anti-TPO and Anti-TG variables. Results: In our study, 65 (42.8%) of 152 patients were female and 87 (57.2%) were male. The ages of the patients ranged between 2-65 years and the mean age was 26.5±14.6 years. The mean age of females was 27.5±14.4 and 25.7±14.9 in males. Elevated thyroid autoantibodies were found in a total of 29 patients, 21 of whom were female and 8 of whom were male. Of these 29 patients, 10 had hypothyroidism, 2 had chronic thyroiditis and 3 had toxic multinodular goiter. 14 patients did not return after the examination at the internal medicine outpatient clinic, so the diagnosis of thyroid disease could not be reached. The mean TSH, Anti-TG and Anti-TPO values were 2.27±1.57, 29.2±99 and 71.5±2.2, respectively. When these values were analyzed separately as men and women, they were found to be 2.6±2.02, 41.8±1.23 and 134±2.8 in women and 1.99±1.03, 19.8±75.6 and 24.5±1.32 in men. There was a significant difference between men and women in terms of Anti-TG and Anti-TPO values (p=0.011 and p=0.001, respectively). A significant correlation was found between disease duration and Anti-TPO positivity (p=0.045); however, a similar relationship was not found between disease duration and Anti-TG positivity (p=0.34). Conclusions: As a result of this study, although there was a significant correlation between anti-TPO and duration of AA, the association between thyroid autoimmunity and AA was not found to be statistically significant. This may be due to the fact that humoral autoimmunity plays a role in thyroid autoimmunity and primarily cellular autoimmunity plays a role in AA. In addition, the epidemiologic data of our study were similar to the data of studies conducted in our country.

Proinflammatory cytokine shift and changes in lymphocyte activation markers in patients with autoimmune thyroiditis and reproductive dysfunction

The article is devoted to the problem of autoimmune thyroiditis (AIT), a disease of the thyroid gland, which is quite common in women and ranks first in the structure of causрm es of irregular periods, infertility, and miscarriage. The clinical characteristics and analysis of indicators of thyroid status, cytokine profile, and lymphocyte activation markers in 80 patients with autoimmune thyroiditis and reproductive dysfunction are presented. The obрm tained results indicate various thyroid disorders in patients with AIT, in particular, the levels of TPO and ATG antibodies were increased by 98 and 39 times, respectively, relative to the control; the level of IL-1ѓА was 10 times higher, IL-6.16 times higher, the concentration of TNF-ѓї.. more than 13 times higher, and the level of IL-18 was 1.9 times lower in patients with AIT compared with the values obtained in the patients with impaired reproductive funcрm tion without thyroid pathology. The research results prove the undeniable pathogenetic role of cytokines and lymphocyte activation markers in the development of the AIT inflammatory process.

Frequency of thyroid disorders in patients with menstrual irregularities presenting to the OPD in tertiary care hospital.

Objective: To determine the frequency of thyroid disorders in patients with menstrual irregularities presenting to the OPD in tertiary care hospital. Study Design: Cross Sectional study. Setting: Department of Outpatients Obstetrics & Gynaecology, Ward 8, Jinnah Postgraduate Medical Center, Karachi, Pakistan. Period: July 30, 2021 to January 29, 2022. Methods: All patients who met the inclusion criteria and visited JPMC, Karachi were enrolled in the study. After providing a thorough explanation of the procedure, risks, and benefits of the study, informed consent was obtained. The study involved conducting detailed history and examination, as well as recommending relevant laboratory investigations such as thyroid and ultrasound pelvic/TVS profiles. Results: 150 women of thyroid disorders in patients with menstrual irregularities were included with mean age was 33.72±7.62 years, mean height was 1.69±0.07 meter, mean weight was 76.60±12.70 kg, mean BMI was 26.78±4.13 kg/m2, mean parity was 2.84±2.05 and mean duration of menstrual irregularity was 0.82±0.07 days. Positive family history of thyroid disorder was found to be in 15 (10.0%). Positive history of thyroid surgery was noted in 26 (17.3%) patients. Thyroid disorder was noted in 57 (38.0%) cases. In distribution for type of thyroid disorder, subclinical hypothyroidism was noted in 37 (64.9%), 9 (15.8%) overt hypothyroidism, 11 (19.3%) subclinical hyperthyroidism while overt hyperthyroidism was noted in 0 (0.0%). In distribution of menstrual complain, amenorrhea was noted in 3 (5.3%), 3 (5.3%) oligomenorrhea, 7 (12.3%) metrorrhagia, 32 (56.1%) menorrhagia while polymenorrhea were noted in 12 (21.1%) cases. Conclusion: It is to be concluded that thyroid disorder is frequently observed in patients experiencing menstrual irregularities, as indicated by the study. However, further research is required to validate these finding.

Assessment of Thyroid Disorders in Patients with Inflammatory Bowel Diseases

Assessment of Thyroid Disorders in Patients with Inflammatory Bowel Diseases

Association between Alopecia Areata and Thyroid Disorders

Background & Objective: Alopecia areata (AA) is an autoimmune disorder characterized by patches ofnon-scarring alopecia affecting the scalp and body hair. Previous epidemiological studies suggest a potentialpositive association between alopecia areata (AA) and several autoimmune diseases, including autoimmunethyroid disorders. The present study was therefore undertaken to determine the association between AA andthyroid disorder. Methods: This cross-sectional case-control study was carried out in the Department of Physiology, Dhaka Medical College, Dhaka over a period of 1 year from July 2021 to June 2022. A total of 40 clinically diagnosed patients of AA (case) of both sexes with age ≥18 years were taken from the Outpatient Department of Dermatology and Venereology, Dhaka Medical College Hospital (DMCH), Dhaka. An equal number (n = 40) of age-matched (withcases) apparently healthy subjects were taken as controls for comparison. In order to assess thyroid functionstatus, five variables were measured. These were free tri-iodothyronine (FT3), free thyroxine (FT4), thyroidstimulating hormone (TSH), thyroglobulin antibody (TgAb), and thyroid peroxidase antibody (TPOAb or TmAb).Thyroid disorders were evaluated in terms of hypothyroidism, subclinical hypothyroidism, hyperthyroidism, subclinical hyperthyroidism, etc. Result: In the present study, the baseline demographic and clinical characteristics were almost similar between cases and controls. The male-to-female ratio of AA patients was 1:1. The mean age was 29.9 ± 10.5 years for thecase group and 29.9 ± 10.4 years for the control group. Most of the patients with AA had mild disease (45%)followed by moderate (42.5%) and severe (12.5%) diseases. The study demonstrated the prevalence of thyroiddys function to be significantly higher in the case group (20%) than that in the control group (5%) with a risk of developing thyroid disorder in patients with AA being 4.7(95% CI = 0.9 – 23.9) times higher than that in the control group (p = 0.043). There were significant differences between cases and controls in terms of levels of TSH,FT3 and FT4. The present study demonstrated a significant difference between cases (AA patients) and controlswith respect to thyroid auto-antibodies (Tg-Ab, TPO-Ab) as well. Tg-Ab and TPO-Ab were also found positive in 12euthyroid alopecia areata patients. Conclusion: The prevalence of thyroid disorders is comparatively high in alopecia areata patients as opposed to healthy individuals of similar age and sex. The serum levels of TSH, TPO-Ab and Tg-Ab are significantly elevated, and the levels of free T3 and free T4 are significantly dropped in patients of alopecia areata compared to theirhealthy counterparts. However, Tg-Ab and TPO-Ab may be present in euthyroid alopecia areata patients. Ibrahim Card Med J 2022;12(2):15-20

Patterns and outcomes of late onset thyroid disturbances after COVID-19 vaccination: A report of 75 cases.

Isolated cases of subacute thyroiditis exist in the early period of COVID-19 vaccination, largely after mRNA vaccines. Here we report late onset thyroid disturbances and persistent health issues in patients of thyroid disorders after COVID-19 vaccination. Seventy-five patients with post COVID-19 vaccination thyroid disturbances were identified. Among these, 41 had flare of underlying thyroid illness, majority occurring at a median time lag of 28.4 weeks since 2nd dose. Thirty-one cases of new onset hypothyroidism and three of new onset hyperthyroidism were reported, with a median time lag respectively of 17.2 and 22.6 weeks since 2nd dose. Most cases occurred after ChAdOx1-nCoV-19, which was the commonest vaccine employed in mass roll out in India. Significant improvement was observed in majority, after a median follow up of 22-26 weeks. New onset health issues persisting for ≥4 weeks were reported in 37.3% and were common in individuals with history of COVID-19 before vaccine. New onset metabolic, musculoskeletal, and reproductive disorders were the common health complaints. Active monitoring is warranted for late onset adverse events after COVID-19 vaccines of all types. Larger studies with involvement of unvaccinated individuals are required to understand the incidence and causality of late onset thyroid disturbances after COVID-19 vaccines.

Prevalence of Thyroid Eye Disease Among Thyroid Disorder Patients

Aim: To assess the prevalence of Thyroid Eye Disease among thyroid disorder patients. Introduction: Thyroid Eye Disease (TED) is a debilitating autoimmune disorder seen in hyperthyroid, hypothyroid and euthyroid patients. The global prevalence of TED is estimated to be 16 per 100,000 women and 2.9 per 100,000 men in the general population. Common symptoms include dry eyes, eyelid retraction, excessive watering, conjunctival redness and swelling, retro-orbital pain and blurred vision. This study aims to assess the prevalence of TED among dysthyroid patients attending Saveetha Medical College and Hospital, Chennai. Methodolody: The purpose of this study is to find the prevalence of TED among dysthyroid patients attending Saveetha Medical College and Hospital, Chennai during the months of July and August. A detailed history of each patient was taken after which a series of tests were conducted to identify and classify the severity of TED. This was done using NOSPECS (no signs, only signs, soft tissue involvement, proptosis, extraocular muscle involvement, corneal involvement, sight loss) classification. Schirmers test was performed to assess the prevalence of dry eyes among TED patients. Result: 122 patients consisting of 87 females and 35 males were included in this study. 43% (53 patients) were found to have Thyroid Eye Disease. There was no significant difference in prevalence between male and female subjects (43.6% and 42.8% respectively). The presence of TED was far greater in hyperthyroid than in hypothyroid patients. 44 out of 53 patients with TED were hyperthyroid (83%), 7 were hypothyroid (13.2%), and 2 patients were euthyroid (3.7%) . Schirmers test conducted on each patient revealed that 12% of the TED patients suffered from dry eyes. NCT test conducted to find the intraocular pressure in TED patients revealed no significant results. Conclusion: The high prevalence of TED seen in dysthyroid patients in this study calls for increased awareness regarding ocular manifestations in thyroid disorders. Patients should be encouraged to undergo regular checkups to ensure normal functioning of eyes and to prevent progression of the disease.

Autoimmune thyroid status in subclinical thyroid disorders in patients attending a tertiary care center in Nepal: a hospital-based cross-sectional study

BackgroundThyroid dysfunction is the leading endocrine disorder worldwide. Iodine deficiency disorders, which were once the major etiology of thyroid dysfunctions, now have been succeeded by autoimmune thyroid diseases with the rise in aberrant salt ionization protocols. This study endeavors to access the level of thyroid autoantibodies viz. anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (TGA), and anti-thyroid stimulating hormone receptor (TRAb) in individuals with subnormal thyroid profiles.MethodsThis hospital-based cross-sectional study was conducted at the Department of Clinical Biochemistry, Tribhuvan University for a period of six months. Using non-probability (purposive) sampling method, a total of 60 patients were enrolled with subnormal thyroid profiles to include the population who have not yet started medication. Thyroid hormones (free T3, free T4, TSH) and thyroid antibodies (anti-TPO, TGA, and TRAb) were measured. For non-parametric data, Chi-square test and Kruskal-Wallis test were used. Spearman’s correlation was done to determine the association between variables.ResultsOut of 60 participants, the majority of the population between 25 and 44 years were diagnosed with thyroid dysfunction with female preponderance. Among all, 40% (n = 24) had subclinical hyperthyroid states while, 60% (n = 36) had subclinical hypothyroid states, and 75% (n = 45) of the total exhibited positive thyroid antibodies. In subclinical hypothyroid patients with TSH above 10 µIU/ml, anti TPO (58.5%) and TGA (66.7%) positivity were highly prevalent. On the other hand, TRAb was exclusively positive in hyperthyroid condition (50% among the group) which is by far the first of its kind reported in Nepal.ConclusionThe rise in autoimmune thyroid disease among the Nepalese population infers that addressing iodine deficiency simply through salt iodinization may not be adequate to deal with the rising burden of thyroid disorders, especially in iodine-depleted areas. Also, the increasing prevalence of thyroid autoantibodies positivity in subclinical hypothyroidism in the Nepalese population accounts for the arduous screening and monitoring of autoimmune thyroid disorders in Nepal.

Spectrum of Thyroid Disorders in Patients with Type-2 Diabetes Mellitus.

Diabetes mellitus and thyroid disorders are the two most common endocrine disorders and they mutually affect each other. There are very few researches from Nepal that have evaluated the association of type-2 diabetes mellitus and thyroid dysfunction. The main objective of this study was to evaluate the prevalence and spectrum of thyroid dysfunctions among type-2 diabetes mellitus patients. This was cross-sectional study conducted among 204 type-2 diabetes mellitus patients visiting the internal medicine department of a tertiary center located in Kathmandu, Nepal. The prevalence of thyroid disorders in patients with type-2 diabetes mellitus was 27.94%. Subclinical hypothyroidism, which occurred in 14.71% of patients, was the most common thyroid disorder. The longer duration of diabetes, more than ten years, was associated with the increased thyroid disorders (p=0.025). The poor glycemic control, HbA1c ≥ 7%, was associated with significantly increased prevalence of thyroid dysfunction in type-2 diabetes mellitus patients (p=0.002). Female patients had higher prevalence of thyroid disorders than males, but this association was not statistically significant. The higher prevalence of thyroid disorders among patients with type-2 diabetes mellitus highlights the importance of screening type-2 diabetes mellitus patients for the presence of thyroid disorders.

A STUDY ON THE PREVALENCE OF THYROID DYSFUNCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN A TERTIARY CENTRE IN A TRIBAL POPULATION OF EASTERN INDIA

Objective: Diabetes is the most common endocrine disorder and is the leading cause of death worldwide. Thyroid dysfunction is another common endocrine disorder frequently encountered in clinical practice worldwide, second only to diabetes. The present study was undertaken with the following aims and objectives: To know the prevalence of thyroid dysfunction in type 2 diabetes mellitus and the spectrum of thyroid dysfunction in type 2 diabetes mellitus. Methods: Type 2 diabetes mellitus patients, as per World Health Organisation criteria, without pre-existing thyroid disease attending the Medicine Outpatient Department or admitted to the Department of Medicine from June 2019 to May 2020 were taken as cases. Patients with type 2 DM aged>15 y were included in our study. Patients below 15 y of age, pregnant or lactating women, patients suffering from malignancy and tuberculosis, hepatic dysfunction, renal dysfunction, and those on drugs known to affect thyroid function (steroid, oral contraceptive pills, beta-blockers, and amiodarone), and patients who had proven pre-existing thyroid dysfunction were excluded from the study. Results: In our study, thyroid dysfunction was present in 14.69% of patients among 320 patients with diabetes. Thyroid dysfunction was present in 7.73% of males and 23.74% of females with diabetes. Out of 47 diabetic patients who had thyroid dysfunction, 76.60% had glycosylated haemoglobin (HbA1C)>7. Conclusion: There was a higher prevalence of thyroid disorders in patients with type 2 diabetes. This finding was more common in female diabetics. Subclinical hypothyroidism was the most frequent thyroid disorder found among diabetics.

STUDY AND CORRELATION OF ANTI THYROID PEROXIDASE ANTIBODY AND ULTRASONOGRAPHY FINDINGS OF THYROID IN PATIENTS OF THYROID DISEASES

Aim: To determine Anti thyroid peroxidase antibody and ultrasonography features of thyroid gland in thyroid disorder patients and study their correlation. Design: This is an observational, cross sectional study and techniques used are clinical and non-invasive. Method: Thyroid function tests, Anti-thyroid peroxidase (Anti-TPO)antibody and ultrasonography neck were performed in 150 patients .Eligible participants were adults of age group 15-70 years with deranged thyroid function tests . Pregnant patients and patients already on thyroid medications were excluded from the study The participants were classified as overt , subclinical hypothyroid or overt, subclinical hyperthyroid. Anti thyroid peroxidase antibody and ultrasonography neck findings obtained were analyzed and correlated using statistical methods. Statistical Analysis: Frequency and percentage were calculated and test of significance such as Chi square test, T test were used. Correlation was assessed using Spearmans correlation coefficient p=<0.05 is considered significant. Result: From January 2020 to August 2021, 150 patients participated in the study in which 50%(n=75) patients were found to be subclinical hypothyroid, 21.3%(n=32) were overt hypothyroid, 21.3% (n=32) were overt hyperthyroid , 6% (n=09) were subclinical hyperthyroid and 1.3%(n=2) were euthyroid with thyroid swelling. 51.3%(n=77) patients had diffuse thyroid disease on ultrasonography neck, normal gland in 19.3%(n=29) patients, thyroiditis in 11.3%(n=17) patients ,Multinodular goiter in 10.6%(n=16) patients, nodule in 6%(n=09) and atrophic gland in 1.34%(n=02) patients. Anti thyroid peroxidase was positive in 62%(n=93) patients. Among patients with diffuse hypoechogenecity on ultrasonography 85%(n=80) patients had positive Anti-TPO antibody with p value 0.05. Conclusion: Maximum number of patients with thyroid diseases had a positive Anti thyroid peroxidase antibody that suggests autoimmunity as a major etiology of thyroid disease.Among patients with diffuse hypogenecity on USG,85%(n=80)patients had positive Anti-TPO antibody with statistical significance(p 0.05). Ultrasonography neck is non invasive ,safe and cost effective method to ascertain the cause of thyroid disease and has a major role in predicting prognosis of the disease. Abbreviations: Anti thyroid peroxidase antibody-Anti-TPO antibody Ultrasonography-USG.

Study on Autoimmune Thyroid Disorders in Chronic Spontaneous Urticaria at a Tertiary Care Central Rural Hospital in India.

Background Chronic spontaneous urticaria (CSU) is a medical condition characterized by the persistence of urticaria for more than six weeks, primarily caused by mast cell activation. Autoimmune thyroid diseases (AITDs) are the most common cause of dysfunction of the thyroid gland, and they are influenced by both genetic and environmental factors. Mast cell mediators have a significant role in the pathogenesis of CSU through two main pathways: the derangement of intracellular signaling pathways in mast cells and basophils and the production of autoantibodies against these cells. This study aimed to explore the association between AITDs and CSU by examining clinical features and measuring thyroid hormones and anti-thyroid peroxidase (anti-TPO) antibodies in patients. Aim and objectives The primary aims of this study are to investigate the prevalence and clinical characteristics of autoimmune thyroid disorders in patients with chronic spontaneous urticaria. The specific objectives are to evaluate the triiodothyronine (T3), tetraiodothyronine (T4), thyroid-stimulating hormone (TSH), and anti-thyroid peroxidase (anti-TPO) antibody levels in patients and controls and to explore the correlations between these parameters and the development and severity of chronic spontaneous urticaria. Material and method The present study was an observational investigation that enrolled 40 patients, consisting of 20 cases and 20 controls. The inclusion criteria involved patients of both sexes, aged above 18 years, who had chronic spontaneous urticaria and agreed to participate in the study with informed consent. Patients with other skin conditions lacking abnormal thyroid etiopathogenesis were also included. Exclusion criteria included patients with major systemic disease, uncontrolled medical or surgical illness, renal or hepatic disorders, and pregnant or lactating females. Patients with chronic spontaneous urticaria underwent a comprehensive clinical evaluation, and their urticaria severity was scored using an established scoring system. Blood samples were collected from both cases and controls for measuring T3, T4, TSH, and anti-TPO antibody levels. The anti-TPO antibody was processed using the enzyme-linked immunosorbent assay (ELISA) method. The autoimmune thyroid disease was screened by monitoring T3, T4, TSH, and anti-TPO antibody levels. Results There were significant variations observed in thyroid-stimulating hormone and anti-thyroperoxidase antibody levels. Among the cases analyzed, 40% demonstrated an urticaria severity score of one, while 25% reported a duration exceeding eight weeks. Additionally, 25% of patients experienced severe pruritus and intense wheals. Conclusions This research has discovered a robust association between serum anti-TPOantibodies and the occurrence of chronic spontaneous urticaria. To mitigate the potential for chronic spontaneous urticaria to lead to long-term morbidity, it is imperative to consider testing for serum anti-TPO antibodies in conjunction with primary thyroid markers, including T3, T4, and TSH.

Analysis of clinical characteristics of thyroid disorders in patients with chronic hepatitis B treated with pegylated-interferon alpha

BackgroundThyroid disorders (TD) is a common complication of pegylated-interferon alpha (Peg-IFNα) therapy. Few studies have investigated the relationship between TD and the efficacy of interferon therapy for chronic hepatitis B (CHB). Therefore, we analyzed the clinical characteristics of TD in patients with CHB treated with Peg-IFNα, and evaluated the correlation between TD and Peg-IFNα treatment efficacy.MethodsIn this retrospective study, the clinical data of 146 patients with CHB receiving Peg-IFNα therapy were collected and analyzed.ResultsDuring the course of Peg-IFNα therapy, positive conversion of thyroid autoantibodies and TD occurred in 7.3% (85/1158) and 8.8% (105/1187) patients, respectively, and was diagnosed more often in women. The most common thyroid disorder was hyperthyroidism (53.3%), followed by subclinical hypothyroidism (34.3%). We found that thyroid function returned to normal in 78.7% of patients with CHB, and thyroid antibody levels returned to the negative range in approximately 50% of patients after interferon treatment cessation. Only 25% of patients with clinical TD required treatment. Compared with patients with hypothyroidism/subclinical hypothyroidism, patients with hyperthyroidism/subclinical hyperthyroidism showed greater reduction and seroclearance of hepatitis B surface antigen (HBsAg) levels.ConclusionsTD are not an absolute contraindication for interferon therapy; however, patients should be monitored closely during interferon therapy. In pursuit of functional cure, a balance between efficacy and safety must be achieved.

Évaluation prospective des dysthyroïdies radio-induites après irradiation mammaire et sus-claviculaire

PurposeThe thyroid is an endocrine gland playing a major role in metabolism and development by the secretion of T4 and T3 thyroid hormones. Due to its anatomical position, it is often included in the target volume for the irradiation of certain tumours and thus receives significant doses (10 to 80Gy). The treatment of breast cancer requires in most cases a breast irradiation associated or not with a lymph node irradiation. The aim of our study was to investigate prospectively the frequency of thyroid disorders in patients with breast cancer treated by radiation, with or without irradiation of the supra- and subclavicular lymph nodes. Material and methodsThis prospective multicentre study (institut Godinot, institut de cancérologie Strasbourg Europe and institut de cancérologie de Lorraine) concerned adult patients with non-metastatic breast carcinoma treated by adjuvant irradiation. They were included in a non-randomized way between February 2013 and June 2015 and divided into two groups according to treatment: (i) breast radiotherapy associated with irradiation of the supra- and subclavicular lymph nodes (group 1), or (ii) breast irradiation alone (group 2). The dose – volume histogram of the thyroid was systematically edited by the physics department. Each patient had a consultation with an endocrinologist at the beginning of the treatment and was monitored by blood analyses including TSH, T4L, antithyroglobulin and antiperoxidase antibodies every 6 months until the 60th month after the end of radiotherapy. Data were described by numbers and percentages for qualitative variables; by means, medians, standard deviation and ranges for quantitative variables. Statistical associations were tested by Chi2, Fisher's, Student's, or analysis of variance tests depending on the conditions of application. Survival analyses were performed by log rank tests and Cox models. ResultsThis study initially included 500 patients, 245 in group 1 and 252 in group 2 (three patients were later excluded for false inclusion). Thyroid abnormalities occurred in 76 patients, representing an incidence of 15.3%. The mean time of the first occurrence of thyroid disorders was 24.3 months. It was more frequent in group 1 with a prevalence of 19.2% against 11.5% in group 2 (P=0.01745). A maximal radiation dose delivered to the thyroid gland greater than 20Gy (odds ratio [OR]: 1.82; P=0.018) or 30Gy (OR: 1.89; P=0.013) was significantly associated with a higher incidence of thyroid disorders, as was a mean dose greater than 30Gy (OR: 5.69; P=0.049). A percentage of thyroid volume receiving 30Gy (V30) greater than 50% (P=0.006) or greater than 62.5% (P=0.021) was significantly associated with an increased incidence of thyroid disorder and more precisely, hypothyroidism (P=0.0007). In multivariate analysis, no factor associated with the occurrence of thyroid disorder was identified. However, in the subgroup analysis concerning group 1 (receiving supraclavicular irradiation), a maximal radiation dose greater than 30Gy appeared to be a risk factor for the occurrence of thyroid disorders (P=0.040). ConclusionThyroid disorder, and in particular hypothyroidism, may be a late side effect of locoregional breast radiotherapy. Patients receiving this treatment should have a biological monitoring of thyroid function.

Diagnosis and Treatment of Nonfunctioning Pituitary Adenomas with Thyroid Disorders.

Patients with nonfunctioning pituitary adenoma (NFPA) can present with different types of thyroid disorders, which are easily misdiagnosed or missed and can even result in serious clinical consequences. This study was to summarize the different types of thyroid disorders in patients with NFPA with the aim of providing references for the diagnosis and treatment of such patients. The data of pituitary adenoma (PA) patients who underwent surgical treatment at Xuanwu Hospital, Capital Medical University, from 2017 to 2021 were retrospectively analyzed, and NFPA patients with preoperative thyroid disorders were screened out to analyze their imaging, endocrine, treatment, and prognosis data. Also, thyroid disorders were classified to summarize diagnostic methods and treatment principles for different types of thyroid disorders. A total of 399 NFPA patients were included in this study, of which 67 (16.8%) had thyroid disorders before surgery. Fifty-four patients had (13.5%) central hypothyroidism (CH) caused by NFPA and were treated with levothyroxine (L-T4) supplementation before and after operation. Eleven patients (2.8%) had primary hypothyroidism and were treated with L-T4 during the perioperative period, and long-term treatment of primary hypothyroidism was provided after surgery. Two NFPA patients (0.5%) were combined with primary hyperthyroidism and treated with medication for primary hyperthyroidism after tumor resection. Thyroid disorders are relatively common in patients with NFPA, but are difficult to be diagnosed due to their different types. CH is the most common type of thyroid disorder, which requires aggressive L-T4 supplementation during the preoperative period. The primary disease of the thyroid gland is easily missed when NFPA is combined with primary hypothyroidism or primary hyperthyroidism, and the thyroid function test results require to be analyzed carefully for continued treatment for thyroid disease after resection of the NFPA.

Thyroid disorders in psychiatric patients: a descriptive study in a psychiatric hospital

IntroductionThyroid disorders can present with psychiatric symptons similar to depression, and, at the same time, certain treatments, like litio, can cause changes in thyroid function. Given, therefore, the importance for the treatment and care of patients, the study of thyroid function is one of the parametres that should be requested in patients with psychiatric pathology.ObjectivesTo study the frequency of thyroid disorders in patients who where admitted to a psychiatric short stay unit.MethodsRetrospective descriptive observational study is carried out in the acute stay unit of a psychiatric hospital. As a sample, all patients admitted to the unit over a period of three months. During admission, their sociodemographic data, the treatment they receive and their diagnosis are recorded. Secondly, blood test are performed whith differents parameters, including TSH values.ResultsIn the total sample of 172 patients, 8 of them have TSH abnormalities. 7 of them, all women, present hypothyroidism values.A single male patient presented values of hyperthryroidism.ConclusionsAccording to the present study, 4,6% of the patients present alterations at the TSH at admission, although except in one case, the values were not markedly altered.The thyroid study at admission allows detecting cases of altered TSH that are amenable to treatment and monitoring.Disclosure of InterestNone Declared

Is Glucose-6-Phosphate Dehydrogenase Deficiency a Risk Factor for Autoimmune Thyroid Disease? A Retrospective Case-Control Study.

The risk of developing thyroid disorders (TDs) in subjects with inherited glucose-6-phosphate dehydrogenase (G6PD) deficiency is unknown. The aim of this study was to explore the association between autoimmune (AITD) and G6PD deficiency in Northern Sardinia, in a population with a high frequency of these two conditions. In this retrospective single-center case-control study, demographic and clinical data were collected from patients examined in a tertiary referral Gastroenterology Section of a teaching hospital. In 8894 subjects examined (64.7% females), 1218 patients were diagnosed with TDs; more specifically, 767 were diagnosed with AITD and 451 were not (non-AITD). Overall, G6PD deficiency was more prevalent in TD patients compared with patients without TD (controls) (16.7% vs. 11.2%; p < 0.0001). Multivariable logistic regression analysis (after adjusting for age, sex, excess weight and smoking habits), confirmed a higher risk of AITD among G6PD deficient patients with an odds ratio (OR) of 1.36 and 95% confidence interval (CI) of 1.11-1.6, female patients (OR 1.33, 95% CI 1.07-1.65) and overweight patients (OR 1.22, 95% CI 1.03-1.44). The risk of AITD is increased in carriers of G6PD deficiency. A careful assessment of thyroid function is advisable in patients with inherited G6PD defects.

Long-Term Lithium Therapy and Thyroid Disorders in Bipolar Disorder: A Historical Cohort Study.

Lithium has been a cornerstone treatment for bipolar disorder (BD). Despite descriptions in the literature regarding associations between long-term lithium therapy (LTLT) and development of a thyroid disorder (overt/subclinical hypo/hyperthyroidism, thyroid nodule, and goiter) in BD, factors such as time to onset of thyroid abnormalities and impact on clinical outcomes in the course of illness have not been fully characterized. In this study we aimed to compare clinical characteristics of adult BD patients with and without thyroid disorders who were on LTLT. We aimed to identify the incidence of thyroid disorders in patients with BD on LTLT and response to lithium between patients with and without thyroid disorders in BD. The Cox proportional model was used to find the median time to the development of a thyroid disorder. Our results showed that up to 32% of patients with BD on LTLT developed a thyroid disorder, of which 79% developed hypothyroidism, which was corrected with thyroid hormone replacement. We did not find significant differences in lithium response between patients with or without thyroid disorders in BD. Findings from this study suggest that patients with BD and comorbid thyroid disorders when adequately treated have a response to lithium similar to patients with BD and no thyroid disorders.

A cross-sectional study to know the prevalence of thyroid dysfunction in systemic lupus erythematosus

Background: Systemic lupus erythematosus (SLE) is a persistent autoimmune disease, the pathogenesis of which remains elusive. Autoimmune factors may be a cause of SLE and thyroid dysfunction. Many studies have revealed that the prevalence of thyroid disorder is higher in SLE patients than in the general population. SLE is a multisystem and hypothyroidism is an organ specific autoimmune disorder and can occur successively or simultaneously. Aims and Objectives: The aim of the study was to study the prevalence of thyroid disorder in patients with SLE. Materials and Methods: Patients admitted with definite clinical features of SLE and Antinuclear Antibodies positive, in medicine ward and healthy blood donors are taken as control. Sample was tested by fully automated analyzer. Results: Subclinical hypothyroidism was found in 24% of study group and 8% of control group which is statistically significant. Central and secondary hyperthyroidism was found in 10% of study group and 12% of control group but it was statistically insignificant. Several studies have documented an association between SLE and other autoimmune diseases such as Sjogren’s syndrome, autoimmune hemolytic anemia, and antiphospholipid syndrome. Subclinical hypothyroidism was higher than another thyroid dysfunction such as primary, central, and subclinical hypothyroidism was found to be higher in frequency, probably depicting the slow destructive process which is pathognomic of autoimmune thyroiditis. Conclusion: Subclinical hypothyroidism was more prevalent in SLE than that of overt hypothyroidism as compared with general population.

Prevalence of thyroid disorder in patients with systemic lupus erythematosus and patients with lupus nephritis

Prevalence of thyroid disorder in patients with systemic lupus erythematosus and patients with lupus nephritis