Articles

Total T4 rise in pregnancy: a relook?

Total T4 (TT4) measurement is preferred to free T4 (FT4) especially in last part of pregnancy. Guidelines by American Thyroid Association, European Thyroid Association and Endocrine Society state that TT4 incr...

Authors: Subhodip Pramanik, Pradip Mukhopadhyay and Sujoy Ghosh

Kinetic analysis of the growth rate of sporadic and hereditary medullary thyroid carcinoma: comparing the postoperative calcitonin-doubling rate with the hypothetical preoperative tumor volume-doubling rate

Our previous kinetic analyses of changes in the tumor volume (TV) of papillary thyroid microcarcinomas during active surveillance revealed that the tumors’ growth varied over time from rather rapid growth to s...

Authors: Minoru Kihara, Akira Miyauchi, Hiroo Masuoka, Takuya Higashiyama, Yasuhiro Ito and Akihiro Miya

Teprotumumab: a disease modifying treatment for graves’ orbitopathy

On 21st January 2020, the FDA approved Tepezza (teprotumumab-trbw) for the treatment of active Graves’ orbitopathy (GO) in adults. This approval was based on positive results from two multinational randomised ...

Authors: Michelle Ting and Daniel G. Ezra

Antithyroid drugs and birth defects

Antithyroid drugs (ATDs) are preferred for the treatment of hyperthyroidism caused by Graves’ disease in pregnant women. The drugs have been a recognized treatment for decades, and a general risk of side effec...

Authors: Stine Linding Andersen and Stig Andersen

Macrofollicular variant of papillary thyroid carcinoma with metastasis to femur

Macrofollicular variant of papillary thyroid carcinoma (MFV-PTC) is a rare subtype with histological features and an indolent clinical course that can be confused with nodular goiter or follicular adenoma. How...

Authors: Fernando Candanedo-Gonzalez, Diana Rodriguez-Orihuela and Julian Arista-Nasr

Elevated serum TSH concentrations are associated with higher BMI Z-scores in southern Iranian children and adolescents

Subclinical hypothyroidism is defined as elevated TSH levels while T4 or FT4 levels are normal. Elevated TSH levels are linked with obesity in adults. In a recent meta-analysis in Iran, 6.1% of children below ...

Authors: Ashkan Habib, Mohadeseh Molayemat and Asadollah Habib

Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic

The prevalence of thyroid cancer is increasing worldwide. No previous data are available on the prevalence of thyroid cancer in Yemen. We performed this study to determine the prevalence of thyroid cancer amon...

Authors: Butheinah A. Al-Sharafi, Jamila A. AlSanabani, Ibraheem M. Alboany and Amani M. Shamsher

Nice guideline on thyroid disease: where does it take us with liothyronine?

The new NICE guidelines on thyroid disease and its management do not recommend the routine use of liothyronine, but do not completely rule it out either. Guidelines from the British and European Thyroid Associ...

Authors: Graham P. Leese

The effectiveness of cognitive- behavioral therapy on quality of life in women with hypothyroidism in the reproductive age: a randomized controlled trial

Worldwide, hypothyroidism affects 3.7% of the population, and is associated with impaired quality of life. This study aimed to evaluate the effect of cognitive- behavioral therapy (CBT) on the quality of life ...

Authors: Sohaila Rezaei, Parvin Abedi, Elham Maraghi, Najmeh Hamid and Homaira Rashidi

Adequate timing and constant supervision are the keys for successful implementation of levothyroxine or levothyroxine/paracetamol absorption test

Levothyroxine (LT₄) pseudomalabsorption due to medication non-adherence results in significant costs for Health Service. High dose LT₄ or LT₄/paracetamol absorption test is used in such cases. Hence, establishmen...

Authors: Krzysztof C. Lewandowski, Katarzyna Dąbrowska, Magdalena Basińska-Lewandowska, Marek Bolanowski, Marek Ruchała and Andrzej Lewiński

Time-dependent changes in FT4 and FT3 levels measured using mass spectrometry after an acute ingestion of excess levothyroxine in a case with hypothyroidism

Thyrotoxicosis is common disorder among endocrine dysfunctions. It is not rare that the free thyroid hormone level exceeds the measurement range of immunoassay. Such extreme high concentration of free thyroid ...

Authors: Yuko Ito, Satoru Suzuki, Yoshiko Matsumoto, Chiyo Ohkouchi, Satoshi Suzuki, Manabu Iwadate, Sanae Midorikawa, Susumu Yokoya, Shinichi Suzuki and Hiroki Shimura

Should radioiodine now be first line treatment for Graves’ disease?

Radioiodine represents a cost-effective treatment option for Graves’ disease. In the UK, it is traditionally reserved for patients who relapse after initial thionamide therapy. In a change from current practic...

Authors: Onyebuchi E. Okosieme, Peter N. Taylor and Colin M. Dayan

Falsely undetectable TSH in a euthyroid patient

Measuring thyroid hormone levels is essential and helpful in the diagnosis of thyroid diseases.

Authors: Monireh Rahimkhani, Kiana Kazemian and Rashid Ramezani Daryasari

Cross-sectional and prospective study on anti-Müllerian hormone changes in a cohort of pre-menopausal women with a history of differentiated thyroid cancer

Anti-Müllerian hormone (AMH) decreases acutely after post-surgical radioactive iodine (RAI) ablation in females with differentiated thyroid cancer (DTC).

Authors: Miranda Mittica, Andrea Dotto, Martina Comina, Marsida Teliti, Eleonora Monti and Massimo Giusti

Life-threatening complications of high doses of intravenous methylprednisolone for treatment of Graves’ orbitopathy

Treatment of moderate to severe Graves’ orbitopathy (GO) is based mainly on intravenous pulses of methylprednisolone. High doses of methylprednisolone can exert several adverse effects, some of which might be ...

Authors: Dorota Walasik-Szemplińska, Grzegorz Kamiński and Iwona Sudoł-Szopińska

Pre-sternal thyroid swellings: a case of rare aberrant site recurrence and review of literature

Thyroid swellings enlarge caudally into the mediastinum behind the sternum. Pre-sternal swelling of thyroid origin is very rare. We present our case of pre-sternal thyroid swelling which was albeit a surprisin...

Authors: Lovenish Bains, Sushant Bhatia, Rohit Kaushik, Sudhir Kumar Jain, Chandra Bhushan Singh, Shramana Mandal and Daljit Kaur

Meeting Abstracts from the 67^th Annual British Thyroid Association Meeting

Authors:

The surgical management of locally advanced well-differentiated thyroid carcinoma: changes over the years according to the AJCC 8th edition Cancer Staging Manual

Well-differentiated thyroid carcinoma is defined as locally advanced in the presence of an extra thyroid extension, e.g., when the surrounding structures such as the trachea, larynx, esophagus and main blood v...

Authors: Alessio Metere, Valerio Aceti and Laura Giacomelli

Association of thyroid hormones with resting energy expenditure and complement C3 in normal weight high body fat women

A high body fat percentage has a specific effect on activation of the hypothalamic-pituitary-thyroid axis. On the other hand, a slight change in thyroid hormones can affect metabolism and body composition as w...

Authors: Maryam Karkhaneh, Mostafa Qorbani, Asal Ataie-Jafari, Mohamad Reza Mohajeri-Tehrani, Hamid Asayesh and Saeed Hosseini

Painless destructive thyroiditis in a patient with resistance to thyroid hormone: a case report

Resistance to thyroid hormone (RTH) usually features a syndrome of inappropriate secretion of thyroid-stimulating hormone (SITSH) without suppression of the typical high thyroid hormone levels. However, some p...

Authors: Tomoko Nagamine, Jaeduk Yoshimura Noh, Naoya Emoto, Takahito Kogai, Akira Hishinuma, Fumitaka Okajima and Hitoshi Sugihara

Genomic test ends a long diagnostic odyssey in a patient with resistance to thyroid hormones

Resistance to thyroid hormones is a very rare condition, which is often misdiagnosed and mistreated. The cases where there is a concomitant autoimmune thyroid disorder are ultra-rare and particularly challengi...

Authors: Todor Arsov, Chengmei Xie, Nan Shen, Dan Andrews, Carola G. Vinuesa and Olivija Vaskova

Association of antithyroglobulin antibody with iodine nutrition and thyroid dysfunction in Nepalese children

Aberrant iodine intake and thyroid autoimmunity affect thyroid function. Deficiencies of iodine including thyroid disorders have serious impact on child physical and mental development. This study was conducte...

Authors: Binaya Tamang, Saroj Khatiwada, Basanta Gelal, Shrijana Shrestha, Kishun Deo Mehta, Nirmal Baral, Gauri Shankar Shah and Madhab Lamsal

Levothyroxine before conception in women with thyroid antibodies: a step forward in the management of thyroid disease in pregnancy

Studies suggesting an association between thyroid autoimmunity and pregnancy-related adverse outcomes, particularly miscarriage and preterm delivery, date to nineties. The postulated causes for these associati...

Authors: Roberto Negro

Semi-quantitative assessment of diffuse hepatic uptake seen in I-131 scans – an indicator of functioning thyroid tissue and disease burden in differentiated thyroid cancer

To semi-quantitatively analyze liver uptake of I-131 in diagnostic and post-therapy scans by calculating hepatic to thigh ratios (HTR) and evaluate its clinical significance in management of differentiated thy...

Authors: Prasanta K. Pradhan, Suruchi Jain, Madhusudhanan Ponnuswamy, Amitabh Arya and Manish Ora

Normalization of thyroid function tests among thyrotoxicosis patients attending a University Hospital in North-West Ethiopia

Thyrotoxicosis is a clinical state that results from inappropriately high thyroid hormone action in tissues. Although it is one of the common endocrine disorders, there is scarcity of data on the management of...

Authors: Eyob Alemayehu Gebreyohannes, Emneteab Mesfin Ayele, Soliana Alemayehu Tesfaye and Mohammed Assen Seid

Hypothyroidism in the older population

Both overt hypothyroidism as well as minor elevations of serum thyrotropin (TSH) levels associated with thyroid hormones within their respective reference ranges (termed subclinical hypothyroidism) are relativ...

Authors: Owain Leng and Salman Razvi

Mucin in benign thyroid nodules: treatment related change or not?

Authors: Adriana Handra-Luca

Thyroid malignancy among patients with thyroid nodules in the United Arab Emirates: a five-year retrospective tertiary Centre analysis

Thyroid malignancy constitutes the sixth common cancer type in the United Arab Emirates (UAE). There are no epidemiological data outlining the prevalence of cancer in thyroid nodules, nor previous analysis of ...

Authors: Eiman Alseddeeqi, Raqwana Baharoon, Rawia Mohamed, Jenan Ghaith, Abeer Al-Helali and Luai A. Ahmed

Rapid detection of papillary thyroid carcinoma by fluorescence imaging using a γ-glutamyltranspeptidase-specific probe: a pilot study

Nodular lesions of the thyroid gland, including papillary thyroid carcinoma (PTC), may be difficult to diagnose by imaging, such as in ultrasonic echo testing, or by needle biopsy. Definitive diagnosis is made...

Authors: Rumi Hino, Naoko Inoshita, Toyoki Yoshimoto, Makiko Ogawa, Daishu Miura, Ryoko Watanabe, Kenta Watanabe, Mako Kamiya and Yasteru Urano

Calcitonin measurement in fine-needle aspirate washout fluid by electrochemiluminescence immunoassay for thyroid tumors

For the differential diagnosis of medullary thyroid carcinoma (MTC) on thyroid nodules, ultrasound-guided fine-needle aspiration cytology is a useful and safe procedure, but its diagnostic accuracy is not high...

Authors: Minoru Kihara, Mitsuyoshi Hirokawa, Takumi Kudo, Toshitetsu Hayashi, Masatoshi Yamamoto, Hiroo Masuoka, Takuya Higashiyama, Mitsuhiro Fukushima, Yasuhiro Ito, Akihiro Miya and Akira Miyauchi

Correlation between anti-thyroid peroxidase antibody levels and diffuse thyroid uptake of ¹⁸F-fluorodeoxyglucose in Hashimoto’s thyroiditis: a retrospective study

On ¹⁸F-fluorodeoxyglucose (FDG)-positron emission tomography (PET), diffuse uptake in the thyroid gland is often observed in patients with Hashimoto’s thyroiditis. In this study, we evaluated the factors associat...

Authors: Naoki Edo, Koji Morita, Miki Sakamoto, Tatsuro Kaminaga, Hiromi Edo, Erina Okamura, Masumi Ogawa, Kazuhisa Tsukamoto, Hiroko Okinaga and Toshio Ishikawa

Synergistic inhibition of MEK/ERK and BRAF V600E with PD98059 and PLX4032 induces sodium/iodide symporter (NIS) expression and radioiodine uptake in BRAF mutated papillary thyroid cancer cells

The activating mutation BRAF^V600E is a frequent genetic event in papillary thyroid carcinomas (PTC). Mutation BRAF^V600E is associated with the loss of a sodium/iodine symporter (NIS), and subsequent radioiodide-r...

Authors: Honglai Zhang and Dong Chen

Hyperthyroidism in a complete molar pregnancy with a mature cystic ovarian teratoma

The hallmark of gestational trophoblastic disease is the production of human chorionic gonadotropin (hCG) due to the hyperproliferation of extraembryonic trophoblast cells. Previous studies show hCG has thyrot...

Authors: Bryce C. Simes, Alozie A. Mbanaso, Carlos A. Zapata and Chukwuma M. Okoroji

A rare malignant thyroid carcinosarcoma with aggressive behavior and DICER1 gene mutation: a case report with literature review

Malignant biphasic tumor also known as carcinosarcoma is an uncommon neoplasm that is composed of both malignant epithelial and mesenchymal components. Most reported cases of carcinosarcoma affect the female g...

Authors: Jing Yang, Carmen Sarita-Reyes, David Kindelberger and Qing Zhao

The largest reported papillary thyroid carcinoma arising in struma ovarii and metastasis to opposite ovary: case report and review of literature

Malignant struma ovarii (MSO) is a very rare, germ cell tumor of the ovary, histologically identical to differentiated thyroid cancers. Struma ovarii (SO) is difficult to diagnose on clinical basis or imaging ...

Authors: Mohamed S. Al Hassan, Tamer Saafan, Walid El Ansari, Afaf A. Al Ansari, Mahmoud A. Zirie, Hanan Farghaly and Abdelrahman Abdelaal

Effect of perchlorate and thiocyanate exposure on thyroid function of pregnant women from South-West England: a cohort study

Iodine is important for thyroid hormone synthesis, and iodine deficiency in pregnancy may impair fetal neurological development. As perchlorate and thiocyanate inhibit sodium-iodide symporter reducing the tran...

Authors: Bridget A. Knight, Beverley M. Shields, Xuemei He, Elizabeth N. Pearce, Lewis E. Braverman, Rachel Sturley and Bijay Vaidya

Characteristics and natural course of hypoechoic thyroid lesions diagnosed as possible thyroid lymphomas by fine needle aspiration cytology

There is little information regarding the natural course of hypoechoic thyroid lesions that are probable or possible thyroid lymphoma based on fine needle aspiration cytology (FNAC) results.

Authors: Tomoe Nakao, Mitsushige Nishikawa, Mako Hisakado, Toshihiko Kasahara, Takumi Kudo, Eijun Nishihara, Mitsuru Ito, Shuji Fukata, Hirotoshi Nakamura, Mitsuyoshi Hirokawa and Akira Miyauchi

‘Does levothyroxine improve pregnancy outcomes in euthyroid women with thyroid autoimmunity undergoing assisted reproductive technology?’

Evidence on the treatment of euthyroid infertile women and thyroid autoimmunity with thyroid hormone is scare, and therefore the recent study by Wang et al. is a welcome addition to it. Based on their results,...

Authors: Kris Poppe, Flora Veltri and Candice Autin

Thyroid hormones increase stomach goblet cell numbers and mucin expression during indomethacin induced ulcer healing in Wistar rats

Gastric ulcers are mucosal discontinuities that may extend into the mucosa, submucosa or even deeper. They result from an imbalance between mucosal aggressors and protective mechanisms that include the mucus b...

Authors: Jackline Namulema, Miriam Nansunga, Charles Drago Kato, Muhammudu Kalange and Samuel Babafemi Olaleye

The upper limit for TSH during pregnancy: why we should stop using fixed limits of 2.5 or 3.0 mU/l

Physiological changes necessitate the use of pregnancy-specific reference ranges for TSH and FT4 to diagnose thyroid dysfunction during pregnancy. Although many centers use fixed upper limits for TSH of 2.5 or...

Authors: Tim I. M. Korevaar

Acute suppurative thyroiditis caused by thyroid papillary carcinoma in the right thyroid lobe of a healthy woman

The thyroid gland is resistant to microbial infection, because of its organ characteristics such as encapsulation, iodine content, and rich blood supply. Therefore, acute suppurative thyroiditis (AST), as a ba...

Authors: Hazuki Otani, Masakazu Notsu, Sayo Koike, Miwa Morita, Masahiro Yamamoto, Mika Yamauchi, Takahumi Fuchiwaki, Ichiro Morikura, Noriaki Aoi, Hideyuki Kawauchi, Teruaki Iwabashi, Asuka Araki, Noriyoshi Ishikawa, Riruke Maruyama and Toshitsugu Sugimoto

Ultrasound criteria for risk stratification of thyroid nodules in the previously iodine deficient area of Austria - a single centre, retrospective analysis

We aimed to study the validity of six published ultrasound criteria for risk stratification of thyroid nodules in the former severely iodine deficient population of Austria.

Authors: Christina Tugendsam, Veronika Petz, Wolfgang Buchinger, Brigitta Schmoll-Hauer, Iris Pia Schenk, Karin Rudolph, Michael Krebs and Georg Zettinig

Role of the T and B lymphocytes in pathogenesis of autoimmune thyroid diseases

Autoimmune thyroid disorders (AITD) broadly include Graves’ disease and Hashimoto’s thyroiditis which are the most common causes of thyroid gland dysfunctions. These disorders develop due to complex interactio...

Authors: Marta Rydzewska, Michał Jaromin, Izabela Elżbieta Pasierowska, Karlina Stożek and Artur Bossowski

Management of hypothyroidism with combination thyroxine (T4) and triiodothyronine (T3) hormone replacement in clinical practice: a review of suggested guidance

Whilst trials of combination levothyroxine/liothyronine therapy versus levothyroxine monotherapy for thyroid hormone replacement have not shown any superiority, there remains a small subset of patients who do ...

Authors: Colin Dayan and Vijay Panicker

Papillary thyroid cancer recurrence 43 Years following Total Thyroidectomy and radioactive iodine ablation: a case report

Recurrent papillary thyroid carcinoma (PTC) beyond the first two decades of definitive treatment (i.e. total thyroidectomy and radioactive iodine ablation) is a rare occurrence.

Authors: Yaw Amoako-Tuffour, M. Elise Graham, Martin Bullock, Matthew H. Rigby, Jonathan Trites, S. Mark Taylor and Robert D. Hart

Hyalinizing trabecular tumor of the thyroid gland and its significant diagnostic issue

Hyalinizing trabecular tumors (HTT) are rare follicular cell-derived tumors of the thyroid gland that are infrequently reported in otolaryngology literature. We present here an interesting case of HTT which pr...

Authors: Dustin J. Jones, Christopher R. Kieliszak, Sanjay S. Patel and Christopher R. Selinsky

A retrospective review of the multidisciplinary management of medullary thyroid cancer: eligibility for systemic therapy

Medullary thyroid carcinoma (MTC) accounts for 1-2% of all thyroid cancers. The clinical course of metastatic disease can be indolent. Our aim was to characterize the natural history of disease to evaluate the...

Authors: Georgia Geller, Janessa Laskin, Winson Y. Cheung and Cheryl Ho

Meeting abstracts from the 65th British Thyroid Association Annual Meeting

Authors:

Comparative frequency of four different types of pregnancy-associated thyrotoxicosis in a single thyroid centre

Pregnancy and delivery markedly influence thyroid function. However, the comparative prevalence of gestational thyrotoxicosis (GT), new onset of Graves’ disease during pregnancy (GD during pregnancy), postpart...

Authors: Akane Ide, Nobuyuki Amino, Takumi Kudo, Waka Yoshioka, Mako Hisakado, Eijun Nishihara, Mitsuru Ito, Shuji Fukata, Hirotoshi Nakamura and Akira Miyauchi

Malignant Struma ovarii in a 30-year old nulliparous patient

Struma ovarii is a rare monodermal germ cell tumor where the ovary is comprised of at least half thyroid tissue. This phenomenon may indicate an embryological origin.

Authors: J. Colin Boyd, Blair A. Williams, Matthew H. Rigby, Katharina Kieser, Saul Offman, Hemlata Shirsat, Jonathan R. B. Trites, S. Mark Taylor and Robert D. Hart