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1.
BMJ Case Rep ; 15(9)2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-36130820

RESUMO

A woman in her mid-20s who was clinically euthyroid presented with an ostium secondum atrial septal defect for closure. Preoperatively, heart rate ranged from 80 to 110 beats per minute. On the day of surgery, heart rate was 120 beats per minute, which settled after induction. During ultrasound guided central line access, a thyroid swelling was noticed. 20-30 min after commencement of the surgery, heart rate increased up to 130 beats per minute. Since other causes of tachycardia was ruled out, an intraoperative blood sample for thyroid function test was sent. Esmolol was kept ready in case the swelling turned out to be hyperfunctioning thyroid nodule. Post bypass, the patient again developed tachycardia. The thyroid function test showed elevated T3, T4 and a mildly elevated TSH (Thyroid stimulating hormone) value, consistent with an extrathyroid source. The patient is on long-term follow-up under an endocrinologist. Postoperatively, she is again euthyroid and heart rates have settled to less than 100 beats per minute.


Assuntos
Anestésicos , Comunicação Interatrial , Hipertireoidismo , Feminino , Comunicação Interatrial/cirurgia , Humanos , Hipertireoidismo/cirurgia , Taquicardia , Tireotropina
2.
Sci Rep ; 12(1): 15745, 2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-36130976

RESUMO

The present study was carried out, for the first time, to evaluate the association of rs2268458 polymorphism, biochemical and environmental factors on hypothyroid and hyperthyroid disorders in thyroid patients and healthy individuals in Yazd province, Iran. In this study, blood samples were collected from a total of 100 cases, including 60 hypothyroid, 20 hyperthyroid and 20 normal individuals. DNA was extracted from blood samples and the rs2268458 single nucleotide intronic polymorphism was evaluated using Restriction Fragment Length Polymorphism PCR (RFLP-PCR). The results have shown that 59 individuals were homozygote (TT), 40 cases were heterozygote (TC) and one homozygote (CC) case. Of 59 TT homozygote cases, 25 cases were hypothyroid females and 7 hypothyroid male patients. While, heterozygote TC group consisted of 20 hypothyroid females and 7 hypothyroid male cases. Furthermore, only 1 (CC) homozygote male hypothyroid patient was observed in this study. The hyperthyroid population consisted of 7 (TT) homozygote hyperthyroid female cases, 8 (TC) heterozygote hyperthyroid female cases, 3 (TT) homozygote hyperthyroid male cases and 2 (TC) heterozygote hyperthyroid male cases. According to our study, heterozygote cases (TC) showed less severe symptoms, while homozygote cases (TT) showed no serious symptoms and the (CC) homozygote case showed severe thyroid abnormalities. So, it can be concluded that the TSHR-related rs2268458 polymorphism is associated with hypothyroidism and hyperthyroidism in the male and female populations of Yazd Province, Iran and C allele can be a risk factor for some physio-biochemical and hormonal imbalance in the thyroid disorder patients.


Assuntos
Hipertireoidismo , Hipotireoidismo , Doenças da Glândula Tireoide , Feminino , Humanos , Hipertireoidismo/genética , Hipotireoidismo/genética , Masculino , Nucleotídeos , Polimorfismo de Nucleotídeo Único
3.
PLoS One ; 17(9): e0273724, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36054093

RESUMO

OBJECTIVE: The commonly held association of hyperthyroidism with sinus tachycardia and widened pulse pressure (PP) has not been reassessed in decades despite patients with hyperthyroidism in current practice not always present with these signs. The study objective was to assess prevalence and variability of sinus tachycardia and widened PP in present day among individuals with different degrees of hyperthyroidism. METHODS: Data was collected retrospectively from 248 adult patients in an outpatient setting with biochemical evidence of hyperthyroidism, recorded heart rate (HR) and blood pressure (BP) who were not treated with medications that can influence these parameters. RESULTS: Mean age was 42.0 ± 14.2 years with 66.9% being female. Median free thyroxine (fT4) level was 3.49 (IQR 2.42-4.58) ng/dL and thyroid stimulating hormone (TSH) 0.02 (IQR 0.01-0.03) mIU/L. Tachycardia, defined as HR >100 bpm, was present in 28.2%. In the lowest and highest fT4 quartiles, tachycardia was present in 16.4% and 38.7% respectively. Using logistic regression, tachycardia was associated with higher fT4 and diastolic BP. More lenient outcome of tachycardia with HR >90 bpm was seen in 47.2%. Widened PP, defined as >50 mmHg, was observed in 64.1% of patients and correlated with higher fT4 and BP. CONCLUSIONS: Tachycardia is not a common feature of hyperthyroidism today. The relatively infrequent finding of tachycardia in this study compared to older studies may reflect differences in the way medicine is practiced today. The increased ordering of thyroid function tests most likely unmasked cases of mild or asymptomatic thyrotoxicosis. A widened PP was a more prevalent clinical finding in this study.


Assuntos
Hipertireoidismo , Tiroxina , Adulto , Feminino , Humanos , Hipertireoidismo/complicações , Hipertireoidismo/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taquicardia/complicações , Taquicardia Sinusal/epidemiologia , Taquicardia Sinusal/etiologia , Tireotropina
4.
Transl Psychiatry ; 12(1): 362, 2022 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064836

RESUMO

Hyperthyroidism and clinical depression are common, and there is preliminary evidence of substantial comorbidity. The extent of the association in the general population, however, has not yet been estimated meta-analytically. Therefore we conducted this systematic review and meta-analysis (registered in PROSPERO: CRD42020164791). Until May 2020, Medline (via PubMed), PsycINFO, and Embase databases were systematically searched for studies on the association of hyperthyroidism and clinical depression, without language or date restrictions. Two reviewers independently selected epidemiological studies providing laboratory or ICD-based diagnoses of hyperthyroidism and diagnoses of depression according to operationalized criteria (e.g. DSM) or to cut-offs in established rating scales. All data, including study quality based on the Newcastle-Ottawa Scale, were independently extracted by two authors. Odds ratios for the association of clinical depression and hyperthyroidism were calculated in a DerSimonian-Laird random-effects meta-analysis. Out of 3372 papers screened we selected 15 studies on 239 608 subjects, with 61% women and a mean age of 50. Relative to euthyroid individuals, patients with hyperthyroidism had a higher chance of being diagnosed with clinical depression: OR 1.67 ([95% CI: 1.49; 1.87], I2: 6%; prediction interval: 1.40 to 1.99), a result supported in a number of sensitivity and subgroup analyses. The OR was slightly less pronounced for subclinical as opposed to overt hyperthyroidism (1.36 [1.06; 1.74] vs. 1.70 [1.49; 1.93]). This comorbidity calls for clinical awareness and its reasons need investigation and may include neurobiological mechanisms, common genetic vulnerability and a generally heightened risk for clinical depression in patients with chronic somatic disorders.


Assuntos
Transtorno Depressivo Maior , Hipertireoidismo , Comorbidade , Depressão/diagnóstico , Depressão/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Hipertireoidismo/diagnóstico , Hipertireoidismo/epidemiologia , Masculino , Pessoa de Meia-Idade
7.
Wiad Lek ; 75(8 pt 2): 1960-1964, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36129078

RESUMO

OBJECTIVE: The aim: Investigate structural changes in the tissues of the periodontal complex under the condition of experimental lipopolysaccharide periodontitis combined with hyper¬thyroidism. PATIENTS AND METHODS: Materials and methods: The studies were performed on adult white male rats, which simulated periodontitis combined with hyperthyroidism. Periodontal tissues were subjected to morphological examination on the 22nd day of the experiment. Collection of material for microscopic examinations was performed according to the generally accepted method; histological specimens were studied using a light optical microscope. RESULTS: Results: Morphological studies of the components of the periodontal complex of experimental animals with experimental periodontitis established the reorganization of its structural elements. Damage to the epithelium in the area of attachment of the circular ligament and erosive-ulcerative changes of the gums led to a deepening of the gingival sulcus with the formation of a deep periodontal pocket. Intense hyperkeratosis was observed in the area of the bottom of the periodontal pocket. In the own plate of the mucous membrane of the gums - significant edema, collagen fibers were disorganized, defragmented. There were pronounced destructive-degenerative and inflammatory changes of the epithelial and own plates of all areas of the gums and periodontium, damage to the nuclei and cytoplasm of keratinocytes, fibroblasts, and leukocytes. CONCLUSION: Conclusions: Experimental periodontitis combined with hyperthyroidism is accompanied by pronounced signs of destructive and inflammatory changes in the soft and dense tissues of the periodontal complex, as well as disruption of stromal-vascular interactions, which progress from reversible to irreversible disruption of periodontal connective tissue.


Assuntos
Hipertireoidismo , Periodontite , Animais , Colágeno , Hipertireoidismo/complicações , Lipopolissacarídeos , Masculino , Bolsa Periodontal , Periodontite/complicações , Ratos
10.
Int J Mol Sci ; 23(17)2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36077557

RESUMO

This study investigated the peripheral blood lymphocytes (PBL) response to a dose of γ-rays in patients treated with radioiodine (I-131) for hyperthyroidism vs. healthy controls, to gain information about the individual lymphocytes' radio-sensitivity. Blood samples were taken from 18 patients and 10 healthy donors. Phosphorylated histone variant H2AX (γ-H2AX) and micronuclei (MN) induction were used to determine the change in PBL radio-sensitivity and the correlations between the two types of damage. The two assays showed large inter-individual variability in PBL background damage and in radio-sensitivity (patients vs. healthy donors). In particular, they showed an increased radio-sensitivity in 36% and 33% of patients, decrease in 36% and 44%, respectively. There was a scarce correlation between the two assays and no dependence on age or gender. A significant association was found between high radio-sensitivity conditions and induced hypothyroidism. PBL radio-sensitivity in the patient group was not significantly affected by treatment with I-131, whereas there were significant changes inter-individually. The association found between clinical response and PBL radio-sensitivity suggests that the latter could be used in view of the development of personalized treatments.


Assuntos
Hipertireoidismo , Radioisótopos do Iodo , Relação Dose-Resposta à Radiação , Humanos , Hipertireoidismo/radioterapia , Radioisótopos do Iodo/uso terapêutico , Linfócitos , Testes para Micronúcleos , Tolerância a Radiação
11.
J Am Assoc Nurse Pract ; 34(9): 1098-1102, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36083321

RESUMO

ABSTRACT: Hyperthyroidism in the elderly population is often associated with atypical, blunted, or nonspecific signs and symptoms, also known as apathetic hyperthyroidism (AH). The absence of the classical hyperkinetic clinical presentation can be confused with the normal aging process, or other diseases, and often leads to misdiagnosis, delayed treatment, and negative outcomes for elderly patients. We provide a case study of an elderly patient to illustrate the atypical presentation of AH. The vignette also highlights a diagnostic and treatment approach based on geriatric medicine fundamentals and evidence-based research. We then review the multiple factors and pathogenetic mechanisms contributing to endocrine disruptors and the paucity of hyperadrenergic signs and symptoms in the elderly with hyperthyroidism. Additionally, the article contrasts the symptomatology and diagnostic profile between primary hyperthyroidism and AH. Finally, we provide an evidence-based, patient-centered approach to manage AH in the elderly population. We recommend that nurse practitioners cultivate illness script inclusive of atypical presentations to guide their clinical decision making. Psychomotor retardation with or without cardiovascular symptoms warrant a high degree of suspicion and the initiation of laboratory studies, including thyroid functions to confirm or rule out hyperthyroidism.


Assuntos
Cardiopatias , Hipertireoidismo , Idoso , Cognição , Humanos , Hipertireoidismo/complicações , Hipertireoidismo/diagnóstico , Hipertireoidismo/tratamento farmacológico , Pacientes
12.
BMC Endocr Disord ; 22(1): 199, 2022 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-35945543

RESUMO

BACKGROUND: Graves' disease (GD) and papillary thyroid cancer (PTC) can be concomitant. The existence of a link between these entities has long been investigated, but a clear correlation hasn't been established. We report a case of GD resistant to medical treatment in which surgery revealed unsuspected PTC and we aim to study the prevalence of PTC in Graves' disease, its clinical characteristics and review of the literature. CASE PRESENTATION: Report of a 32 yo man who presented with weight loss and was found to be biochemically hyperthyroid. Antibodies were positive. Incremental doses of methimazole provided no improvement in thyroid tests. Hypervascularity and a spongiform nodule were noted on ultrasound. Thyroid uptake and scan showed 70.2% uptake. Thyroidectomy was performed due to inadequate therapeutic response. Pathology revealed PTC with extrathyroidal extension and positive lymph nodes. A retrospective review (2000-2021) and literature review of PTC in GD was performed. Clinical data were reviewed. Statistical analysis was calculated to identify correlations. 243 GD patients had total thyroidectomy at an academic center, 50 (20%) had PTC, 14% were microcarcinomas. 76% of cases were less than 55yo, 82% female, 78% stage 1, PTC diagnosis was incidental in 48%, hyperthyroidism was difficult to treat in 10% and only 2% had recurrence of PTC. There was no correlation between demographic or clinical data. CONCLUSIONS: Evidence is controversial with some studies showing GD does not affect PTC prognosis. PTC may not be well recognized in GD, pre-operative assessment should consider risk of cancer.


Assuntos
Doença de Graves , Hipertireoidismo , Neoplasias da Glândula Tireoide , Feminino , Doença de Graves/complicações , Doença de Graves/patologia , Doença de Graves/cirurgia , Humanos , Hipertireoidismo/complicações , Masculino , Estudos Retrospectivos , Câncer Papilífero da Tireoide/complicações , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
13.
Int. j. cardiovasc. sci. (Impr.) ; 35(4): 459-464, July-Aug. 2022. tab
Artigo em Inglês | LILACS | ID: biblio-1385263

RESUMO

Abstract Background: Hyperthyroidism (Hy) is an endocrine disorder, in which the thyroid hormones markedly alter the cardiac function. Increased myocardial contractility and cardiac output, improvement in diastolic relaxation, changes in electrical activity, increments in ventricular mass, and arrhythmias have been reported. However, the influences of thyroid hormones upon molecular mechanisms of cardiac functions have not yet been fully understood. Objectives: To evaluate changes in cardiac contractile parameters and the Na+/Ca2+ exchanger (NCX) function in induced hyperthyroid rats. Methods: Hy was induced by intraperitoneal injections of T3 (15 μg/100 g) for 10 days. Contractile parameters and NCX function were evaluated in the isolated papillary muscle. Data normality was confirmed by the Shapiro-Wilk test. The comparison between groups was performed through an unpaired Student's t-test. Results are expressed as mean ± SD. The accepted significance level was p < 0.05. Results: Our data revealed, in the Hy group, an increase of 30.98% in the maximum speed of diastolic relaxation (-284.64 ± 70.70 vs. -217.31 ± 40.30 mN/mm2/sec (p = 0.027)) and a boost of 149% in the NCX function in late phase of relaxation (20.17 ± 7.90 vs. 50.22 ± 11.94 minutes (p = 0.002)), with no changes in the maximum twitch force (p = 0.605) or maximum speed of systolic contraction (p = 0.208) when compared to the control. Conclusion: The improvement in relaxation parameters is hypothetically attributed to an increase in Sarco-Endoplasmic Reticulum Ca2+ATPase isoform 2 (SERCA2) expression and an increased calcium flow through L-type channels that boosted the NCX function.


Assuntos
Animais , Masculino , Ratos , Músculos Papilares/fisiologia , Trocador de Sódio e Cálcio/fisiologia , Hipertireoidismo/complicações , Hormônios Tireóideos , Estudos de Intervenção , Ratos Wistar
15.
BMC Endocr Disord ; 22(1): 200, 2022 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-35945539

RESUMO

BACKGROUND: The coexistence of primary hyperparathyroidism (PHPT) and giant toxic nodular goiter is very rare. Moreover, PHPT could be easily overlooked because hyperthyroidism may also lead to hypercalcemia. A 99mTc-MIBI scan of the parathyroid glands is often negative when they are concomitant. CASE PRESENTATION: Here, we report a rare case of the coexistence of giant toxic nodular goiter and PHPT that had been ignored for many years but was successfully treated with an ultrasound-guided parathyroid adenoma microwave ablation (MWA). CONCLUSION: Reoperation for PHPT carries an increased risk of cure failure and complications. Thermal ablation has been proven effective in inactivating hyperfunctioning parathyroid lesions and in normalizing both serum parathyroid hormone (PTH) and calcium.


Assuntos
Bócio Nodular , Hiperparatireoidismo Primário , Hipertireoidismo , Neoplasias das Paratireoides , Bócio Nodular/complicações , Bócio Nodular/cirurgia , Humanos , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/diagnóstico , Hipertireoidismo/complicações , Hormônio Paratireóideo , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/cirurgia , Tecnécio Tc 99m Sestamibi
16.
BMJ Case Rep ; 15(8)2022 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-35985738

RESUMO

Hypercalcaemia in patients with hyperthyroidism is usually asymptomatic. It occurs due to increased bone turnover and demineralisation. There are only a few case reports where symptomatic hypercalcaemia was the presenting complaint of hyperthyroidism. An Asian man in his 40s presented to us with intractable vomiting for the last 6 months which was not controlled despite multiple antiemetic medications. On routine biochemistry performed at our institute, he was found to have hypercalcaemia and concomitant hyperthyroidism. Classical symptoms suggestive of hyperthyroidism were not present in our patient thus delaying the diagnosis. His symptoms resolved after the correction of hypercalcaemia. Hypercalcaemia did not recur after achieving an euthyroid status on treatment with carbimazole. Other common and more sinister causes for hypercalcaemia like malignancy were ruled out. This case highlights that symptomatic hypercalcaemia could be the initial presentation of hyperthyroidism and amelioration of hyperthyroidism corrects the hypercalcaemia.


Assuntos
Doença de Graves , Hipercalcemia , Hipertireoidismo , Antitireóideos/uso terapêutico , Carbimazol/uso terapêutico , Doença de Graves/complicações , Doença de Graves/diagnóstico , Doença de Graves/tratamento farmacológico , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/tratamento farmacológico , Hipercalcemia/etiologia , Hipertireoidismo/complicações , Hipertireoidismo/diagnóstico , Hipertireoidismo/tratamento farmacológico , Masculino
17.
BMC Endocr Disord ; 22(1): 218, 2022 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-36045442

RESUMO

BACKGROUND: The rapid and accurate detection of thyroid-stimulating hormone (TSH) receptor antibodies has always been an urgent need for the clinical diagnosis and management of Graves' disease (GD). We aimed to evaluate the use of an automated thyroid-stimulating immunoglobulin (TSI) bridge immunoassay in the diagnosis of GD and to analyze the relationship between TSI and the degree of hyperthyroidism. METHODS: A total of 227 new-onset GD patients, 29 Hashimoto thyroiditis, 43 non-autoimmune thyroid diseases and 37 euthyroid controls were consecutively recruited. All participants accepted the measurement of their serum thyroid function and thyroid-associated antibodies, including TSI being measured by an Immulite 2000 bridge immunoassay and TSH receptor autoantibodies (TRAb) being measured by a third-generation Roche electrochemiluminescence immunoassay. The quantitative consistency between the TSI and TRAb detection methods was analyzed by using Passing-Bablok regression and Bland-Altman plots. The diagnostic performance for GD was assessed by receiver operating characteristic (ROC) curve analysis. RESULTS: Among 227 GD patients (174 females and 53 males, with a mean age of 39 years), the quantitative TSI was positively correlated with TRAb (r = 0.8099). According to the cut-off values proposed by the manufacturers (TSI: 0.55 IU/L, TRAb: 1.75 IU/L), the positive rates of TSI and TRAb in new-onset GD patients were 96.92% and 95.15%, respectively. Both TSI and TRAb levels positively correlated with FT4 levels (TSI: r = 0.243, TRAb: r = 0.317; all P < 0.001) and FT3 levels (TSI: r = 0.288, TRAb: r = 0.360; all P < 0.001) in new-onset GD patients. The ROC analysis showed that the optimal TSI cut-off value was 0.577 IU/L for GD diagnosis in this Chinese population, with a sensitivity of 96.92% and a specificity of 97.25%, respectively. The optimal TRAb cut-off value of was 1.38 IU/L, with a sensitivity of 96.92% and a specificity of 99.08%. There were no significant differences between the cut-off values obtained through the ROC analysis and those provided by the manufacturer for both TSI and TRAb when calculating their sensitivity and specificity in diagnosing GD. Among the 8 newly diagnosed GD cases with discordant qualitative antibody results, TSI was more likely than TRAb to match the clinical diagnosis of GD (6 TSI-positive vs. 2 TRAb-positive patients). CONCLUSION: The automated TSI bridge immunoassay was positively correlated with thyroxine levels in new-onset GD patients and was more likely to be consistent with the clinical diagnosis of GD than with that of TRAb. The positive Immulite 2000 TSI cut-off value of 0.577 IU/L for GD diagnosis in the Chinese population were close to the value recommended by the manufacturer.


Assuntos
Doença de Graves , Hipertireoidismo , Adulto , Autoanticorpos , Feminino , Humanos , Imunoensaio/métodos , Imunoglobulinas Glândula Tireoide-Estimulantes , Masculino , Receptores da Tireotropina
18.
Adv Pediatr ; 69(1): 219-229, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35985711

RESUMO

Typical symptoms which should lead to suspicion of hyperthyroidism are unintentional weight loss, tachycardia, and palpitations, heat intolerance, and hyperactivity. It is diagnosed by suppressed thyroid-stimulating hormone (TSH) with elevated thyroid hormone (TH) levels. Graves' disease (GD) due to antibodies stimulating the TSH receptor is the leading cause, and first-line treatment is with methimazole (MMI). Emerging data suggest MMI treatment, up to 8 years is effective and safe in improving the rate of remission. Radioactive iodine (RAI) and thyroidectomy offer definitive treatment and induce permanent hypothyroidism. Thyroid storm is a life-threatening condition with systemic decompensation and hyperpyrexia. Neonates of mothers with current or past GD are at risk for neonatal hyperthyroidism (NH). Appropriate identification and follow-up of at-risk neonates will reduce complications.


Assuntos
Doença de Graves , Hipertireoidismo , Neoplasias da Glândula Tireoide , Criança , Doença de Graves/complicações , Doença de Graves/diagnóstico , Doença de Graves/terapia , Humanos , Hipertireoidismo/diagnóstico , Hipertireoidismo/epidemiologia , Hipertireoidismo/terapia , Recém-Nascido , Radioisótopos do Iodo/uso terapêutico , Metimazol/uso terapêutico
19.
BMJ Case Rep ; 15(8)2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922086

RESUMO

Hyperthyroidism has been recognised as the cause of secondary pulmonary hypertension (PH). However, several studies have reported that most PH cases due to hyperthyroidism are asymptomatic and not severe. Here, we report the case of a woman in her 30s with symptomatic and severe PH due to hyperthyroidism. She presented with a 2-month history of dyspnoea on exertion, palpitation and lower-extremity oedema. Echocardiography showed severe PH with estimated pulmonary arterial systolic pressure (ePASP) of 62 mm Hg. The diagnostic work-up showed severe PH due to hyperthyroidism. After treatment for hyperthyroidism, improvement of thyroid function contributed to a decrease in ePASP to 30 mm Hg. Similar to the present case, PH due to hyperthyroidism generally improves with the treatment of hyperthyroidism. Therefore, we must not overlook hyperthyroidism as a cause of PH and diagnose and start treatment for PH-causing hyperthyroidism at an early stage.


Assuntos
Hipertensão Pulmonar , Hipertireoidismo , Ecocardiografia , Feminino , Humanos , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/etiologia , Hipertireoidismo/complicações , Hipertireoidismo/diagnóstico , Artéria Pulmonar
20.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 30(4): 1244-1247, 2022 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-35981392

RESUMO

OBJECTIVE: To investigate the clinical characteristics, etiology, therapy and outcome of hyperthyroidism after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS: The clinical data of 7 patients who experienced hyperthyroidism were retrospectively analyzed in our hospital. RESULTS: These 7 patients (5 males, 2 females) suffered hyperthyroidism after HSCT. All patients did not apply the pretreatment regimen containing total body irradiation (TBI). The median age was 25 years old, only one child. Six patients underwent haploidentical HSCT except one patient after unrelated HSCT. The median time of hyperthyroidism occurrence was 20 months. Two patients experienced chronic graft versus host disease (GVHD) when hyperthyroidism occurred and were treated successfully with glucocorticoid, however one patient suffered hypothyroidism 3 months later and needed long-term oral levothyroxine maintenance. One patient developed hypothyroidism post treatment of 131I. The other four patients were treated with methimazole and all of them showed normal thyroid function except one patient suffered from hypothyroidism 1 year later and needed long-term oral levothyroxine maintenance. CONCLUSION: Hyperthyroidism is a rare complication after HSCT but may affect healthy and lead to lower quality of life. Routine thyroid function monitoring should be recommended after HSCT. Treatment of hyperthyroidism should be given according to the pathogeny.


Assuntos
Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Hipertireoidismo , Hipotireoidismo , Adulto , Criança , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Hipertireoidismo/complicações , Hipotireoidismo/complicações , Masculino , Qualidade de Vida , Estudos Retrospectivos , Tiroxina/uso terapêutico , Condicionamento Pré-Transplante/efeitos adversos
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