Thyroid Involvement Research Articles

Renal and Testicular Agenesis in a Patient With Darier’s Disease

Darier's disease is a familial disorder of the skin that has been associated with corneal, bone, pulmonary, and urogenital abnormalities. This report describes a novel urogenital anomaly, namely renal and testicular agenesis, in a patient with Darier's disease. Detailed study of the kindred demonstrated an autosomal dominant pattern of inheritance for Darier's disease and also revealed the presence of autoimmune thyroiditis in several family members. Thyroid involvement ranged from isolated goiter to hypothyroidism. Tissue typing for HLA-A, B, C, and DR antigens did not reveal a specific haplotype common to all the carriers of the cutaneous or thyroid disorder. It is concluded that patients with Darier's disease should be carefully evaluated for the occurrence of systemic diseases, especially urogenital abnormalities and thyroid disorders.

Renal and testicular agenesis in a patient with darier's disease

Darier's disease is a familial disorder of the skin that has been associated with corneal, bone, pulmonary, and urogenital abnormalities. This report describes a novel urogenital anomaly, namely renal and testicular agenesis, in a patient with Darier's disease. Detailed study of the kindred demonstrated an autosomal dominant pattern of inheritance for Darier's disease and also revealed the presence of autoimmune thyroiditis in several family members. Thyroid involvement ranged from isolated goiter to hypothyroidism. Tissue typing for HLA-A, B, C, and DR antigens did not reveal a specific haplotype common to all the carriers of the cutaneous or thyroid disorder. It is concluded that patients with Darler's disease should be carefully evaluated for the occurrence of systemic diseases, especially urogenital abnormalities and thyroid disorders.

Thyroid involvement in Addison's disease: value of a TSH stimulation test

Thyroid involvement in Addison's disease: value of a TSH stimulation test

Small cell undifferentiated carcinoma of the larynx: Report of two patients and review of 13 additional cases

Two patients with small cell undifferentiated carcinoma of the larynx (SCUCL) are described and 13 additional well-documented cases are reviewed. SCUCL affects middle-aged and elderly smokers and has a 2:1 male predominance. Half the patients presented with cervical metastases, an additional 43% developed regional metastases, and 71% ultimately had distant metastases. Thyroid gland involvement occurred in 29% of cases. Ten of fourteen patients had died of their neoplasms (mean survival, 7.8 months). One was living with unresectable tumor. Three were clinically disease-free, 30, 15, and six months, respectively, after diagnosis. Following initial therapy, six patients had recurrent or persistent local tumor or regional metastases. None of them received both total laryngectomy and ipsilateral cervical lymphadenectomy. Four of the six patients had radiation, suggesting that radiotherapy was not always effective in the control of local or regional disease when used in lieu of more extensive surgery. Three patients received chemotherapy, in addition to other modes of treatment, and their mean survival compared favorably with the overall group. The tumor from one of the patients contained a squamous component, and, ultrastructurally, both neoplasms had squamous and neuroendocrine features.

Thyroid abnormalities in patients with myotonic dystrophy.

Myotonic dystrophy (MD) is a systemic genetic disorder predominantly affecting musculature. Although endocrine disturbances have been described, data relating to thyroid gland involvement are sparse and conflicting. To further investigate this aspect, twenty MD patients and twenty age-and sex-matched controls were studied. All were clinically euthyroid and there were no significant differences between circulating levels (mean +/- SD) of T4 (101 . 5 +/- 28.2 v. 103 . 8 +/- 27 . 7 nmol/l), T3 (1 . 86 +/- 0 . 57 v. 2 . 15 +/- 0 . 47 nmol/l), rT3 (0 . 39 +/- 0 . 14 v. 0 . 42 +/- 0 . 09) nmol/l) or TSH (2 . 6 +/- 0 . 5 v. 2 . 4 +/- 0 . 8 mu/l) or between T3 resin uptakes (97 +/- 8 v. 98 +/- 11%). TSH responses following TRH stimulation were significantly less in the MD patients (323 +/- 141 v. 529 +/- 240%; P less than 0.0025). The mean maximum TSH levels achieved were 6 . 7 +/- 3 . 6 mu/l (MD) and 17 . 1 +/- 7 . 2 mu/l (controls); P less than 0.005. Two patients had multinodular goitres (MNG) and one a single thyroid nodule. Thyroid scans were normal except for patchy uptake in the two MNG patients. There was no abnormal incidence of circulating thyroid microsomal or thyroglobulin antibodies, and thyrotrophin binding inhibitory immunoglobulin levels were normal in four patients. It is concluded that in MD: 1 palpable thyroid gland abnormalities occur with increased frequency, 15% (three/twenty) in the present study and 20% (twenty/102 case reports) from a review of the literature; 2 TSH responses to TRH are significantly reduced; 3 circulating thyroid hormone levels are usually normal.

Involvement of thyroid gland in the development of migratory disposition in the redheaded bunting, Emberiza bruniceps

In the redheaded bunting Emberiza bruniceps, thyroidectomy inhibited premigratory fattening and nocturnal restlessness—two characteristics of avian migration—observed in caged birds during the premigratory period (March/April). Thyroxine (T 4) and triiodothyronine (T 3) administration in thyroidectomized birds stimulated locomotor activity and restored the loss in body weight. Annual variations in circulating thyroid hormone concentrations revealed a significant rise in T 3 T 4 ratio prior to spring migration in both years studied. This increase in circulating T 3 T 4 ratio may be associated with the development of migratory disposition in this bird. There was no increase in circulating T 3 T 4 ratio prior to autumnal migration, however, plasma T 4 increased significantly. Different thyroidal mechanisms are most likely involved in spring and fall migratory periods. While T 3 remained low throughout, apart from the characteristic spring rise, high T 4 levels in E. bruniceps were associated with periods of reproduction and molting, the latter coinciding partly with autumnal migration.

Effect of food or water deprivation on circulating levels of pituitary, thyroid and adrenal hormones and on glucose and electrolyte concentrations in domestic ducks (Anas platyrhynchos)

In the natural environment, birds may frequently experience periods of starvation or dehydration, as a result of restrictions in food or water availability, temperature extremes, ecological competition and some migratory, sexual and nesting behaviour. In this paper the involvement of pituitary (growth hormone and luteinizing hormone), thyroid (thyroxine and triiodothyronine) and adrenal (corticosterone) hormones in the birds homeostatic response to these stresses has been investigated in ducks (Anas platyrhynchos) deprived of food or water for up to 36 h and in ducks additionally stressed by prior adaptation to hyper‐osmotic drinking water and/or acutely orally loaded with crude North Sea oil. Variations in the peripheral plasma concentration of these hormones during food or water deprivation have also been correlated with stress induced alterations in body and organ weights and with accompanying changes in circulating sodium, potassium and glucose levels; their physiological roles during stress are discussed.

In vitro T-lymphocyte proliferative response to mouse thyroglobulin in experimental autoimmune thyroiditis

The in vitro lymphocyte proliferative response to mouse thyroglobulin (MTg) was studied in good and poor responder mice in relationship to in vivo antibody formation and thyroid infiltration. CBA( H-2 k ) and BALB/c( H-2 d ) mice were immunized in the hind footpads with MTg incorporated into complete Freund's adjuvant (CFA). At weekly intervals up to 28 days, groups of mice were sacrificed. Their popliteal lymph nodes were cultured in vitro for proliferative response to MTg and their antibody levels and thyroid involvement determined. In good responder CBA mice, the proliferative responses to MTg were strongest on Days 8 to 14, where they were 9- to 14-fold over control levels, depending on the day of harvest. The response declined to 2- to 4-fold over background on Days 21 to 28, although high antibody levels were present throughout this period. The proliferative response was abrogated by anti-Thy-1 treatment, indicating its dependence on T cells. In poor responder BALB/c mice, no significant proliferative responses to MTg were observed at any time, although the animals displayed moderate levels of MTg antibody. The responses to PPD, in contrast, were similar in both strains, usually being 4- to 7-fold above background. Thyroid infiltration, like the proliferative response to MTg, was observed only in CBA mice. Thus lymphocyte proliferation at 8 to 14 days represents a reliable, early in vitro correlate of autoimmune thyroiditis induced with CFA as adjuvant.

Thyrotoxicosis due to Metastatic Involvement of the Thyroid-Reply

Dr Shimaoka correctly notes that metastatic cancer may cause hyperthyroidism with low radioactive iodine uptake. However, this is rare and seldom a diagnostic problem. The patients usually have widespread disease and do not survive long. 1 The radioactive iodine uptake is low because discharged thyroid hormone suppresses pituitary thyroid-stimulating hormone (TSH) release. After parenteral TSH administration, the image will demonstrate the size and sites of uninvolved areas of thyroid tissue, findings quite dissimilar to those of subacute thyroiditis. Unfortunately, Dr Shimaoka did not perform this study. 2 Also, his patient's return to normal thyroid status contrasts sharply with the persistent thyroid involvement characteristic of metastatic cancer. Perhaps a remarkable recovery is possible with lymphoma, but I agree with Dr Shimaoka that the thyroid findings he reported are identical to those seen with spontaneously resolving silent subacute thyroiditis (or silent chronic thyroiditis, as some readers may prefer). This patient might have

Adrenal infarction: An unusual complication of Wegner's granulomatosis

The case of a patient with Wegner's granulomatosis who died with haemorrhagic adrenal infarction is described. Thyroid involvement, another feature not previously reported in this disease, was also noted.

Acute Megakaryocytic Leukemia

A 52-year-old man had aregenerative anemia unresponsive to pyridoxine hydrochloride. Acute leukemia developed, and he died four months after diagnosis. At autopsy he had acute megakaryocytic leukemia with involvement of bone marrow, liver, spleen, adrenals, kidneys, and thyroid. Chromosomal analysis revealed absence of both diploid and Ph1 chromosomes. A mode of 45 chromosomes and aneuploidy were present. This is similar to the only other case with chromosomal studies. Of the 15 acceptable documented cases, eight were men and seven were women. Their age varied from 28 to 76 (mean, 55) years. Only two were less than 40 years of age. Most had pancytopenia, and all were dead within six months of diagnosis.

Thyroidal trophic influence on skeletal muscle myosin.

CROSS-INNERVATION experiments have convincingly demonstrated the importance of the nerve in determining the differential properties of skeletal muscle myosin. The role of hormones in deciding the phenotypic character of muscle myosin has received considerably less attention than that of the neural factors. Recent studies have shown that short-term alterations in thyroid status results in significant changes in cardiac muscle myosin1–4. In contrast, some of those investigations also used skeletal muscle, but no apparent effects on skeletal muscle myosin were detected2,4. But the greater half-life of skeletal muscle myosin would require a longer time than cardiac myosin to manifest these changes5. We have studied the effects of longer term hypothyroidism and hyperthyroidism on skeletal muscle myosin. We report here that alterations in thyroid status influence the quality of skeletal muscle myosin. Our observations suggest possible thyroidal involvement, along with or through neural trophic factors, in determining the phenotypic properties of skeletal muscle myosin.

Topical Steroid Depression of the Hypothalamic-Pituitary-Adrenal Axis in Psoriasis vulgaris

Significant suppression of the hypothalamic-pituitary-adrenal axis has been found in patients hospitalized with psoriasis vulgaris and receiving topical fluorinated steroid therapy. Depression of thyroid function and involvement of autoimmune processes is also suggested by the data.

Serum changes in rabbits experimentally infected with Trypanosoma gambiense.

Total serum lipids, cholesterol, and protein bound iodine levels became strikingly altered during the course of Trypanosoma gambiense infection in rabbits. Serum lipid and cholesterol values increased progressively with time, attaining a 3- to 4-fold increase over control values nearing the terminal stage of infection. Electrophoresis of serum lipids revealed increased beta and pre-beta lipoprotein and the appearance of a chylomicron band. Serum protein bound iodine values were decreased in infected rabbits, indicating possible thyroid involvement. Despite widespread tissue necrosis, no changes in serum lactic dehydrognase activity or isozyme patterns were observed.

HODGKIN'S DISEASE OF THE THYROID

A case of 68 years old Japanese male was reported who was clinically diagnosed senile psychopathy and was found visceral Hodgkin's disease by autopsy. The disease involved thyroid, right kidney, spleen and lymph nodes.The brain showed no macroscopic and microscopic changes except simple atrophy.Generally, diffuse involvement of thyroid was rare condition.In this case, severe degree of diffuse fibrosis with scattered Hodgkin's cells was seen in the thyroid.It was suggested that senile psychopathy could be related to the diffuse involvement of Hodgkin's disease of the thyroid.

Medullary carcinoma of the thyroid gland. A clinicopathologic study of 40 cases.

The clinical records and pathologic material of 40 patients with histologically proven medullary carcinoma of the thyroid seen at Memorial-Sloan Kettering Cancer Center from 1949-71 were reviewed and analyzed. Patients were 20-75 years old with an average of 47.4 years. There was a 21/19 male to female ratio. A neck mass was the most common presenting sign. Only 3 patients had a family history of thyroid carcinoma; none presented with pheochromocytoma or multiple mucosal neuromas. The histologic appearance of the primary lesions showed a variation in cellular morphology as well as pattern of growth. This variability was not only evident within the primary lesion but in the metastatic sites as well. Many observers are unwilling to diagnose medullary carcinoma in the absence of amyloid deposition and are unaware of the variability in the histologic appearance of this tumor. In those patients having a radical neck dissection as part of the initial therapy or at a later date there was a 66.7% 10-year survival while in the patients not having a radical neck dissection the 10-year survival rate was slightly less than 43%. Several of the cases had multifocal thyroid involvement and 75% had proven cervical lymph node metastases. Therefore it is felt that treatment should include at least a total thyroid lobectomy in conjunction with radical neck dissection. (Authors modified)

Thyroid involvement in systemic sarcoidosis

children between the ages of 6 and 9 years. The use of anticancer drugs, radiation, and corticosteroids favors the inception and perpetuation of infestation. Dissemination of strongyloidiasis in the patients reported by Rogers and Nelson 1 and Viola 2 was probably due to altered immunologic mechanisms. At least one complication of parasitic infestation, intestinal malabsorption with steatorrhea, apparently may be precipitated by the administration of corticosteroids2 Eosinophilia was not a helpful indicator of parasitic infestation in these patients. Thirty-one of 32 patients presented with eosinophilia, but parasitic disease was proved in only 9. Fernbach and associates 7 found eosinophilia of up to 49 per cent in a group of leukemic patients receiving cyclophosphamide. All 32 patients included in this study were receiving, or had recently received, this agent. The experience of this study indicates that parasitic infestation can be treated successfully in children with malignant disease without apparent toxicity or sequelae.

Temperature tolerance and thyroid activity of the white perch Roccus (=Morone) americanus

The seasonaliy of temperature tolerance using thiourea‐treated, normal and thyroxine treated white perch was determined after laboratory acclimation and LD50 values calculated by normit analysis. Treatment effects, reflected in slight shifts in LD50 values were evident. However, these did not fit a consistent pattern of thyroidal involvement in temperature tolerance.When specimens of known thyroidal functional state were used in tolerance tests, results, similar to the seasonal tolerance tests, were obtained. Thus, although the white perch has a functioning thyroid capable of forming radiohormone and this capability was experimentally varied in these tests, no tolerance shifts were noted.Data obtained in tolerance testing were statistically adjusted to partition out variation due to differences in acclimation temperatures (season) and to test for treatment (thyroidal functional state) effects. Treatment difference was not significant while that due to season was significant (P<0.01). Thyroidal functional state was thus unrelated to tolerance.

Thyroid involvement in juvenile amaurotic family idiocy (Batten's disease).

Abstract Large amounts of lipofuscin were found in the thyroids of seven cases of Batten's disease (late infantile amaurotic idiocy), and none in controls, including examples of other storage disorders. Since this lesion was found only in Batten's disease, detailed studies of thyroid function might provide some clue about the metabolic defect which causes it.

Aspects of Thyroid Histology in Black-Billed Magpies

INVESTIGATIONS of seasonal changes in thyroid histology in wild birds have shown that increases in activity occur in the period preceding and during the annual molt (Davis and Davis, 1954; Assenmacher, 1958; Voitkevich, 1966) and in response to low temperature (Wilson and Farner, 1960; Kendeigh and Wallin, 1966). Involvement of the avian thyroid in migration and reproduction has also been suggested (Hohn, 1961). Although Phillips and van Tienhoven (1962) collated changes in thyroid activity with events within the breeding season in female Pintails (Anas acuta), information of this type is not available for other species. Few studies have considered sex differences in thyroid metabolism. This paper reports observations of seasonal variations in thyroid histology in a nonmigratory population of Black-billed Magpies (Pica pica hudsonia) near Laramie, Wyoming. Special attention was accorded (1) changes in thyroid activity in connection with major events in the breeding season, and (2) differences in thyroid dynamics as related to sex and age.