Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 380
Filtrar
1.
J Med Case Rep ; 15(1): 108, 2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33653380

RESUMO

BACKGROUND: Hypothyroidism is diagnosed on the basis of laboratory tests because of the lack of specificity of the typical clinical manifestations. There is conflicting evidence on screening for hypothyroidism. CASE PRESENTATION: We report a case of an apparently healthy 19-year-old Kuwaiti woman referred to our clinic with an incidental finding of extremely high thyroid-stimulating hormone (TSH), tested at the patient's insistence as she had a strong family history of hypothyroidism. Despite no stated complaints, the patient presented typical symptoms and signs of hypothyroidism on evaluation. Thyroid function testing was repeated by using different assays, with similar results; ultrasound imaging of the thyroid showed a typical picture of thyroiditis. Treatment with levothyroxine alleviated symptoms and the patient later became biochemically euthyroid on treatment. CONCLUSION: There is controversy regarding screening asymptomatic individuals for hypothyroidism; therefore, it is important to maintain a high index of suspicion when presented with mild signs and symptoms of hypothyroidism especially with certain ethnic groups, as they may be free of the classical symptoms of disease.


Assuntos
Hipotireoidismo/diagnóstico , Tireoidite Autoimune/diagnóstico , Alopecia/fisiopatologia , Apetite , Autoanticorpos/imunologia , Constipação Intestinal/fisiopatologia , Depressão/fisiopatologia , Fadiga/fisiopatologia , Feminino , Humanos , Hipotireoidismo/sangue , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/fisiopatologia , Achados Incidentais , Iodeto Peroxidase/imunologia , Menorragia/fisiopatologia , Índice de Gravidade de Doença , Glândula Tireoide/diagnóstico por imagem , Tireoidite Autoimune/sangue , Tireoidite Autoimune/imunologia , Tireoidite Autoimune/fisiopatologia , Tireotropina/sangue , Tiroxina/sangue , Tiroxina/uso terapêutico , Ultrassonografia , Ganho de Peso , Adulto Jovem
2.
Front Immunol ; 12: 574967, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33679732

RESUMO

Vitamin D is one of the most important nutrients required by the human body. It is a steroid hormone that plays an important role in regulating calcium and phosphorus metabolism, and bone health. Epidemiological studies have revealed a close correlation between vitamin D and many common chronic diseases. Additionally, vitamin D has recently been shown to act as an immunomodulatory hormone, and, accordingly, vitamin D deficiency was uncovered as a risk factor for autoimmune thyroid diseases, although the underlying mechanisms are still unknown. It is therefore necessary to disclose the role and mechanism of action of vitamin D in the occurrence and development of autoimmune thyroid diseases. This knowledge will help design intervention and early treatment strategies for patients with autoimmune thyroid diseases who present with low levels of vitamin D.


Assuntos
Doença de Hashimoto/metabolismo , Fatores Imunológicos/metabolismo , Tireoidite Autoimune/metabolismo , Deficiência de Vitamina D/metabolismo , Vitamina D/metabolismo , Doença de Hashimoto/fisiopatologia , Doença de Hashimoto/prevenção & controle , Humanos , Fatores Imunológicos/uso terapêutico , Receptores de Calcitriol/metabolismo , Fatores de Risco , Testes de Função Tireóidea , Tireoidite Autoimune/fisiopatologia , Tireoidite Autoimune/prevenção & controle , Vitamina D/sangue , Vitamina D/uso terapêutico , Deficiência de Vitamina D/prevenção & controle , Vitaminas/sangue , Vitaminas/metabolismo , Vitaminas/uso terapêutico
4.
Endocr J ; 68(2): 129-136, 2021 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-33473054

RESUMO

We have reviewed the available literature on thyroid diseases and coronavirus disease 2019 (COVID-19), and data from the previous coronavirus pandemic, the severe acute respiratory syndrome (SARS) epidemic. We learned that both SARS and COVID-19 patients had thyroid abnormalities. In the limited number of SARS cases, where it was examined, decreased serum T3, T4 and TSH levels were detected. In a study of survivors of SARS approximately 7% of the patients had hypothyroidism. In the previous evaluation evidence was found that pituitary function was also affected in SARS. Others suggested a hypothalamic-pituitary-adrenal axis dysfunction. One result published recently indicates that a primary injury to the thyroid gland itself may play a key role in the pathogenesis of thyroid disorders in COVID-19 patients, too. Subacute thyroiditis, autoimmune thyroiditis and an atypical form of thyroiditis are complications of COVID-19. Thyroid hormone dysfunction affects the outcome by increasing mortality in critical illnesses like acute respiratory distress syndrome, which is a leading complication in COVID-19. Angiotensin-converting enzyme 2 is a membrane-bound enzyme, which is also expressed in the thyroid gland and the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) uses it for docking, entering as well as replication. Based on the available results obtained in the SARS-CoV-2 pandemic, beside others, we suggest that it is necessary to monitor thyroid hormones in COVID-19.


Assuntos
COVID-19/fisiopatologia , Doença de Graves/fisiopatologia , Hipotireoidismo/fisiopatologia , Síndrome do Desconforto Respiratório/fisiopatologia , Tireoidite/fisiopatologia , Enzima de Conversão de Angiotensina 2/metabolismo , COVID-19/complicações , COVID-19/metabolismo , Doença de Graves/etiologia , Doença de Graves/metabolismo , Humanos , Hipotireoidismo/etiologia , Hipotireoidismo/metabolismo , Mortalidade , Prognóstico , Receptores de Coronavírus/metabolismo , Síndrome do Desconforto Respiratório/etiologia , Síndrome do Desconforto Respiratório/metabolismo , SARS-CoV-2/metabolismo , Síndrome Respiratória Aguda Grave/complicações , Síndrome Respiratória Aguda Grave/metabolismo , Síndrome Respiratória Aguda Grave/fisiopatologia , Glândula Tireoide/metabolismo , Tireoidite/etiologia , Tireoidite/metabolismo , Tireoidite Autoimune/etiologia , Tireoidite Autoimune/metabolismo , Tireoidite Autoimune/fisiopatologia , Tireoidite Subaguda/etiologia , Tireoidite Subaguda/metabolismo , Tireoidite Subaguda/fisiopatologia , Tireotropina/metabolismo , Tiroxina/metabolismo , Tri-Iodotironina/metabolismo
5.
Artigo em Inglês | MEDLINE | ID: mdl-32582023

RESUMO

Background: Autoimmune thyroiditis (AIT) is the most common cause of acquired hypothyroidism in children. The natural outcome of AIT in childhood has been reported previously however follow-up duration is generally short and results variable. Objectives: To characterize clinical and biochemical findings at presentation of AIT, evaluate long-term outcomes and assess which factors at presentation predict evolution over time. Study cohort: 201 children under 18 years of age at presentation (82% female) were enrolled. Subjects were divided into five subgroups according to thyroid stimulating hormone (TSH) level at referral. Results: Mean follow-up was 8.1 years (range 0-29 years). At presentation, 34% of patients had overt hypothyroidism, 32% subclinical hypothyroidism (SCH), 16% compensated hypothyroidism, 14% were euthyroid, and 3.7% had Hashitoxicosis. Children with overt hypothyroidism were younger (10.6 vs. 13.2 years) and had higher thyroid peroxidase antibody titers. At the time of the study, levothyroxine (LT4) therapy was required in 26% of children who were euthyroid at presentation, 56% of SCH patients, 83-84% of those with TSH above 10 mIU/L, and 57% of those with Hashitoxicosis. Over the years, 16% of children presenting with overt hypothyroidism stopped therapy. Free T4 at presentation was the only predictor of outcome over time. Conclusions: Our findings suggest that only 26% children who were euthyroid at presentation developed hypothyroidism, whereas over 50% of those with SCH went on to require treatment. Of those presenting with overt hypothyroidism, 16% recovered with time. The only predictive parameter for LT4 therapy at the end of the study was free T4 levels at presentation. Long-term follow-up is required to determine ongoing therapy needs and screen for additional autoimmune diseases.


Assuntos
Biomarcadores/análise , Hipotireoidismo/fisiopatologia , Glândula Tireoide/fisiopatologia , Tireoidite Autoimune/fisiopatologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Hipotireoidismo/tratamento farmacológico , Masculino , Prognóstico , Estudos Retrospectivos , Testes de Função Tireóidea , Glândula Tireoide/efeitos dos fármacos , Hormônios Tireóideos/análise , Tireoidite Autoimune/tratamento farmacológico , Tiroxina/uso terapêutico , Adulto Jovem
6.
Medicina (Kaunas) ; 56(6)2020 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-32466561

RESUMO

Background and objectives: The aim of the study was to assess the correlation of autoimmune thyroid diseases (AITD) in patients with diabetes mellitus type 1 (DM1) with the occurrence of diabetic retinopathy (DR). Materials and Methods: The inclusion criteria for the study were: type 1 diabetes diagnosed on the basis of WHO criteria lasting at least a year, presence of AITD for at least a year, and age over 18 years. The control group consisted of patients without diagnosed AITD (DM1noAITD), selected according to age, BMI and DM1 duration. Anthropometric parameters, metabolic risk factors such as glycated hemoglobin (HbA1c), lipids and blood pressure, thyroid status and the presence of DR were assessed. Results: The study involved 200 patients with type 1 diabetes aged 36 ± 12 years, 70 men and 130 women. Patients from the study group (DM1AITD) had significantly lower creatinine concentration, significantly lower systolic blood pressure (SBP), glycated hemoglobin (HbA1c) percentage and triglyceride (TG) concentration, and higher high-density lipoprotein (HDL-cholesterol) concentration than the control group (DM1noAITD). There was a significantly lower chance of non-proliferative diabetic retinopathy (NPDR) among DM1AITD than in the control group. Conclusions: Patients with DM1 and AITD were metabolically better balanced, as evidenced by a significantly lower SBP, percentage of HbA1c and TG, as well as significantly higher HDL-cholesterol in this group. Patients with DM1 and AITD were significantly less likely to have NPDR than the control group.


Assuntos
Diabetes Mellitus Tipo 1/complicações , Retinopatia Diabética/diagnóstico , Fatores de Proteção , Tireoidite Autoimune/fisiopatologia , Adulto , Colesterol/análise , Colesterol/sangue , Creatinina/análise , Creatinina/sangue , Estudos Transversais , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/epidemiologia , Retinopatia Diabética/sangue , Retinopatia Diabética/epidemiologia , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Polônia/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Tireoidite Autoimune/sangue , Tireoidite Autoimune/epidemiologia
7.
Cancer Sci ; 111(5): 1468-1477, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32086984

RESUMO

Immune-related adverse events (irAEs) are often seen during immune-checkpoint inhibitor (ICI) treatment of various malignancies. Endocrine irAEs including thyroid dysfunctions are the most common irAEs, but their biomarkers remain unclear. In order to identify individuals who are susceptible to thyroid irAE for earlier diagnosis and appropriate follow-up, the current study is aimed to investigate biomarkers of thyroid irAE. Herein, patients with advanced malignant diseases who received ICIs treatment were prospectively studied. Clinical and laboratory examination, thyroid function, and autoantibodies were evaluated at baseline, and every 4 wk after first treatment with ICIs. Cytokines/chemokines were measured at baseline and at 4 wk. In vivo effects of ICIs on experimental autoimmune thyroiditis were evaluated. Twenty-six patients with malignant diseases who received ICIs treatment were enrolled in the study. Patients were divided into two groups: those who developed thyroid irAE, and those without irAEs. Comparing the two groups, early increase (≤4 wk) in serum thyroglobulin (Tg) levels and thyroid autoantibodies was seen in thyroid irAE (P < .05). Notably, higher levels of serum IL-1ß, IL-2, and GM-CSF at baseline, and early decrease of IL-8, G-CSF, and MCP-1 were significantly associated in the development of thyroid irAE (P < .05). In vivo effects of anti-PD-1 antibody on deterioration of mice experimental thyroiditis were seen. In conclusion, early change in Tg, thyroid autoimmunity, and cytokine levels might indicate development of thyroid irAE. Pre-existing thyroid autoimmunity might be involved with the development of thyroid irAE. Potential application of these factors as surrogate biomarkers for tumor therapy was indicated.


Assuntos
Autoanticorpos/sangue , Citocinas/sangue , Fatores Imunológicos/efeitos adversos , Tireoglobulina/sangue , Doenças da Glândula Tireoide/induzido quimicamente , Doenças da Glândula Tireoide/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Animais , Biomarcadores/sangue , Modelos Animais de Doenças , Feminino , Humanos , Imunoterapia/efeitos adversos , Masculino , Camundongos , Pessoa de Meia-Idade , Neoplasias/terapia , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Estudos Prospectivos , Tireoglobulina/imunologia , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/patologia , Glândula Tireoide/efeitos dos fármacos , Glândula Tireoide/patologia , Glândula Tireoide/fisiopatologia , Tireoidite Autoimune/patologia , Tireoidite Autoimune/fisiopatologia
8.
Clin Immunol ; 212: 108350, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31982645

RESUMO

Autoimmune thyroiditis (AIT)-related brain damage is one of most severe extrathyroidal manifestations of AIT, but the mechanism remains unclear. In this study, we confirmed that protein disulfide-isomerase A3 (PDIA3) is expressed in both thyroid and brain tissues of mouse, and found the significantly increased serum levels of anti-PDIA3 antibody (PDIA3Ab) in classical mouse models of thyroiditis. In addition, we investigated the PDIA3-specific autoimmune reaction in thyroid and brain tissues in a mouse model with high-serum PDIA3Ab induced by immunization with recombinant PDIA3 protein. PDIA3-immunized mice had elevated serum thyrotropin and impaired learning and memory. PDIA3-expressing cells had IgG deposition, and IgG colocalized with C3 in the thyroid and brain tissues of PDIA3-immunized mice, resulting in membrane attack complex formation. Our results suggest that PDIA3 protein may be a common autoantigen shared by the thyroid and brain tissues and involve in the thyroidal and intracerebral damage through activating complement system.


Assuntos
Autoanticorpos/imunologia , Encéfalo/imunologia , Encefalite/imunologia , Doença de Hashimoto/imunologia , Isomerases de Dissulfetos de Proteínas/imunologia , Glândula Tireoide/imunologia , Tireoidite Autoimune/imunologia , Animais , Apoptose/imunologia , Autoantígenos/imunologia , Encéfalo/patologia , Encéfalo/fisiopatologia , Encéfalo/ultraestrutura , Modelos Animais de Doenças , Encefalite/patologia , Encefalite/fisiopatologia , Potenciais Pós-Sinápticos Excitadores/fisiologia , Doença de Hashimoto/patologia , Doença de Hashimoto/fisiopatologia , Potenciação de Longa Duração/fisiologia , Aprendizagem em Labirinto , Camundongos , Glândula Tireoide/patologia , Tireoidite Autoimune/patologia , Tireoidite Autoimune/fisiopatologia
10.
J Dermatol ; 46(8): 702-709, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31197884

RESUMO

The association between alopecia areata (AA) and autoimmune thyroid diseases (AITD) has been suggested; however, the chronological relationship between AA and AITD remains elusive. A systematic review and meta-analysis were conducted to assess the association between AA and AITD focusing on the prevalence of thyroid antibodies, thyroid diseases and serological thyroid dysfunctions, respectively. Data collection was performed in October 2018 by searching for articles in two electronic databases: Medline and Embase. Case-control, cohort and cross-sectional studies were included. Meta-analysis of studies eligible for quantitative synthesis was performed to estimate pooled odds ratios of thyroid antibodies; thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (TG-Ab), diagnosed thyroid diseases and serological thyroid dysfunctions. Four hundred and eighty nine research papers were identified and 17 studies with 262 581 patients and 1 302 655 control subjects were included for quantitative synthesis. AA was significantly associated with both TPO-Ab and TG-Ab. In comparison, there was no significant association between AA and diagnosed hypothyroidism or hyperthyroidism and serological hypothyroidism or hyperthyroidism. In conclusion, AA is significantly associated with the existence of thyroid antibodies rather than with clinical or laboratory thyroid abnormality. Lack of long-term follow-up data is a limitation of the existing published work. Our findings do not support routine screening of thyroid diseases for asymptomatic AA patients but highlight the potential future risk of AITD particularly in severe and refractory AA.


Assuntos
Alopecia em Áreas/imunologia , Autoanticorpos/sangue , Glândula Tireoide/fisiopatologia , Tireoidite Autoimune/epidemiologia , Alopecia em Áreas/sangue , Autoanticorpos/imunologia , Humanos , Prevalência , Tireoidite Autoimune/imunologia , Tireoidite Autoimune/fisiopatologia , Fatores de Tempo
12.
Microvasc Res ; 123: 68-73, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30611746

RESUMO

BACKGROUND: The impairment of endothelial function in type 1 diabetes mellitus (DM1) is considered as the basis of microvascular complications. In DM1 patients autoimmune thyroiditis is a frequent comorbidity which may be responsible for further deterioration of microcirculation function. In studies investigating the relationship between cardiovascular risk factors and microvascular function, skin microcirculation is widely used. The aim of our study was to evaluate the impact of coexisting autoimmune thyroiditis on skin microcirculation in children with type I diabetes mellitus. SUBJECTS: The study group consisted of 25 pediatric DM1 patients, 25 pediatric patients with type 1 diabetes and autoimmune thyroiditis (DM1 + AIT) and 29 control subjects matched for age and gender. The DM1 and DM1 + AIT patients were also matched for age at onset of DM and diabetes duration. METHODS: Performed capillaroscopy studies employed non-selective stimuli such as post-occlusive reactive hyperemia (PORH) and venous occlusion (VO) tests. The relative area covered by capillaries (coverage) and the distance between capillaries were assessed. These measurements were performed before tests as well as after PORH and VO. RESULTS: Coverage at baseline, after PORH and VO and distance after VO differ significantly between control subjects and the group DM1 + AIT. The coverage at baseline, after PORH and VO were significantly smaller in DM1 + AIT compared with the control group. Post-hoc analysis after controlling for lipids levels showed that differences between the DM1 + AIT and control group were remained only for coverage at baseline and after VO. Significant differences between DM1 + AIT and DM1 and control group for coverage after VO were also presented. CONCLUSIONS: Coexisting autoimmune thyroiditis significantly deteriorates skin microcirculation function in pediatric non-complicated type 1 diabetic patients. This process is independent of patient age, diabetes duration and age of diabetes onset.


Assuntos
Diabetes Mellitus Tipo 1/fisiopatologia , Angiopatias Diabéticas/fisiopatologia , Microcirculação , Microvasos/fisiopatologia , Pele/irrigação sanguínea , Tireoidite Autoimune/fisiopatologia , Adolescente , Fatores Etários , Estudos de Casos e Controles , Criança , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/diagnóstico por imagem , Angiopatias Diabéticas/diagnóstico por imagem , Angiopatias Diabéticas/etiologia , Feminino , Humanos , Hiperemia/fisiopatologia , Masculino , Angioscopia Microscópica , Microvasos/diagnóstico por imagem , Oclusão Terapêutica , Tireoidite Autoimune/complicações , Tireoidite Autoimune/diagnóstico por imagem
13.
Curr Med Imaging Rev ; 15(1): 61-65, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31964328

RESUMO

OBJECTIVE: The aim of the research was to determine the dependence of the blood flow velocity in the thyroid arteries in patients with Autoimmune Thyroiditis (AIT) on the presence of atherosclerotic carotid disease and the level of systemic blood pressure. METHODS: The research involved 20 patients with AIT in euthyroid state, 30 patients AIT in euthyroid state with stable Coronary Heart Disease (CHD), 30 patients with stable CHD and 30 healthy individuals. Participants of the research were examined using ultrasound of carotid arteries and inferior thyroid arteries. Parameters of blood flow velocity were compared with the level of systemic blood pressure. RESULTS: In AIT peak systolic velocity and resistance index in the inferior thyroid arteries were significantly higher than in healthy individuals and patients with CHD (p<0.05). In patients with CHD velocity parameters in carotid arteries were high, unlike in the healthy individuals and patients with AIT (p<0.05). In patients with AIT without CHD the atherosclerotic changes of carotid arteries were not found. Increased systemic blood pressure was noticed in all patients with CHD without significant differences between groups. CONCLUSION: The value of peak systolic velocity and resistance index of inferior thyroid arteries in autoimmune thyroiditis are noticed even with euthyroidism and do not depend on systemic blood pressure and atherosclerosis of carotid arteries. Increasing the thyroid arterial blood flow velocity parameters should be considered as sign of an active inflammatory period AIT, where advanced fibrosis is not present.


Assuntos
Aterosclerose/fisiopatologia , Velocidade do Fluxo Sanguíneo/fisiologia , Artérias Carótidas/fisiopatologia , Glândula Tireoide/irrigação sanguínea , Tireoidite Autoimune/fisiopatologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional/fisiologia , Glândula Tireoide/diagnóstico por imagem
14.
Pediatr Blood Cancer ; 66(1): e27452, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30270575

RESUMO

BACKGROUND: Immune thrombocytopenia (ITP) is an acquired immune-mediated disorder characterized by isolated thrombocytopenia. Pediatric ITP patients are prone to develop autoantibodies such as antithyroglobulin (TG) and antithyroperoxidase (TPO), even in the absence of clinical signs of autoimmune disease. The aim of this multicenter retrospective study was to evaluate (1) the prevalence of positivity of antithyroid antibodies (TPO and TG) in a large cohort of pediatric patients with chronic ITP; (2) the role of autoimmune thyroiditis as a prognostic factor for chronicity of ITP. PROCEDURE: For this retrospective study, we collected data from patients diagnosed as affected by chronic ITP between 2011 and 2014 in six centers belonging to the Italian Association of Pediatric Haematology and Oncology (AIEOP). RESULTS: From the analysis of data, we found a significantly higher prevalence of antithyroid antibodies in children with chronic ITP (11.6%) than in the pediatric population (1.2%-1.3%). No correlation has been found between the platelet count and the prevalence of positive antithyroid antibodies at any detection time of the study. CONCLUSIONS: The results of our study demonstrated that (1) the prevalence of positivity for antithyroid antibodies (anti-TPO and anti-TG) in pediatric patients with chronic ITP results is significantly higher than in the pediatric population; (2) autoimmune thyroiditis does not seem to play a role as a prognostic factor for chronicity of ITP in pediatric patients.


Assuntos
Autoanticorpos/sangue , Biomarcadores/sangue , Iodeto Peroxidase/imunologia , Púrpura Trombocitopênica Idiopática/sangue , Tireoidite Autoimune/fisiopatologia , Adolescente , Autoanticorpos/imunologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Itália/epidemiologia , Masculino , Prevalência , Prognóstico , Púrpura Trombocitopênica Idiopática/epidemiologia , Púrpura Trombocitopênica Idiopática/imunologia , Estudos Retrospectivos , Tireoidite Autoimune/imunologia
15.
J Clin Pharm Ther ; 44(1): 102-108, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30306604

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Although a beneficial effect of selenium (Se) administration has been proposed in adults with autoimmune thyroiditis (AT), there is a paucity of similar data in children and adolescents. The purpose of the study was to investigate whether administration of a high dose of organic Se (200 µg daily as l-selenomethionine) has an effect on antithyroid antibody titres in children and adolescents with AT. METHODS: Seventy-one (71) children and adolescents, with a mean age of 11.3 ± 0.3 years (range 4.5-17.8), diagnosed with AT (antibodies against thyroid peroxidase [anti-TPO] and/or thyroglobulin [anti-Tg] ≥60 IU/mL, euthyroidism or treated hypothyroidism and goitre in thyroid gland ultrasonography) were randomized to receive 200 µg l-selenomethionine or placebo daily for 6 months. Blood samples were drawn for measurement of serum fT4, TSH, anti-TPO and anti-Tg levels, and thyroid gland ultrasonography was performed at the entry to the study and after 6 months of treatment. RESULTS AND DISCUSSION: At the end of the study, a statistically significantly higher reduction in anti-Tg levels was observed in the Se group compared to the placebo group (Δ: -70.9 ± 22.1 vs -6.7 ± 60.6 IU/mL, P = 0.021). Although anti-TPO levels were also decreased in the Se group, this change was not statistically different from that of the control group (Δ: -116.2 ± 68.4 vs +262.8 ± 255.5 IU/mL, P = 0.219). No significant difference in thyroid gland volume was observed between the two study groups (P > 0.05). WHAT IS NEW AND CONCLUSION: In this original study, organic Se supplementation appears to reduce anti-Tg levels in children and adolescents with AT.


Assuntos
Suplementos Nutricionais , Selenometionina/administração & dosagem , Tireoidite Autoimune/terapia , Adolescente , Criança , Pré-Escolar , Método Duplo-Cego , Feminino , Humanos , Masculino , Glândula Tireoide/imunologia , Glândula Tireoide/fisiopatologia , Tireoidite Autoimune/fisiopatologia , Resultado do Tratamento
16.
Indian J Pediatr ; 86(2): 180-182, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30128632

RESUMO

A seven-months-old girl under treatment for pneumonia presented with generalized edema, decreased urinary output and was found to have hypertension, muco-cutaneous fungal infection and pulmonary hypertension. Investigations revealed that she had heavy proteinuria, hypertriglyceridemia, hypoalbuminemia and elevated levels of free T3 and T4 with suppression of TSH levels in the serum. A diagnosis of autoimmune thyroiditis (AT) in thyrotoxic phase was made on the basis of clinical presentation and presence of anti-TPO antibodies and reduced uptake in thyroid (technetium) scintigraphy. The child responded to carbimazole therapy and propranolol. The case is presented to remind pediatricians about the rare occurrence of auto-immune thyroiditis in infancy with rare complications such as nephrotic syndrome and pulmonary hypertension.


Assuntos
Síndrome Nefrótica/complicações , Tireoidite Autoimune/complicações , Carbimazol/uso terapêutico , Feminino , Doença de Hashimoto/complicações , Doença de Hashimoto/fisiopatologia , Humanos , Hipertireoidismo/complicações , Hipertireoidismo/fisiopatologia , Hipertrigliceridemia , Hipoalbuminemia , Lactente , Síndrome Nefrótica/fisiopatologia , Pneumonia/terapia , Propranolol/uso terapêutico , Tecnécio/sangue , Tireoidite Autoimune/tratamento farmacológico , Tireoidite Autoimune/fisiopatologia , Tireotropina , Tri-Iodotironina/sangue
17.
Exp Clin Endocrinol Diabetes ; 127(5): 281-288, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-29890552

RESUMO

BACKGROUND: Co-inhibitory receptors (IR), such as TIGIT and FCRL3, provide a checkpoint against highly destructive immune responses. Co-expression of TIGIT and FCRL3, in particular, has been linked to the HELIOS+ subset of regulatory CD4+FOXP3+T-cells. Of these, CD4+FOXP3-exon(E)2+ cells have higher expression of IR and exhibit strongest suppressive properties. Nevertheless, how the expression of TIGIT, FCRL3, HELIOS, and FOXP3E2 is regulated in chronic autoimmune thyroiditis (AT), is not known. METHODS: Thirty patients with AT [encompassing spontaneously euthyroid (euAT), hypothyroid-untreated and L-thyroxine-treated cases)] and 10 healthy controls (HC) were recruited. FCRL3, TIGIT, HELIOS and FOXP3E2 mRNA expression levels in peripheral blood (PB) T cells were measured via quantitative real-time PCR and compared to clinicopathological factors. RESULTS: The TIGIT and FCRL3 expression levels from T cells of AT cases were inversely related to the thyroid volume, and were significantly increased in hypothyroid patients (on+off L-thyroxine), but not euAT cases. The FCRL3 expression in PB T cells positively correlated with thyroid-peroxidase autoantibody levels; by contrast, T cells from aged AT patients and combined samples (AT+HC) accumulated more TIGIT mRNA. The patients with higher TIGIT mRNA levels had a greater prevalence of hypothyroidism, showing higher peak thyrotropin levels at diagnosis or at follow-up. CONCLUSIONS: Multiple IR, namely FCRL3 and TIGIT, but not the transcription factors HELIOS and FOXP3E2, showed increased mRNA levels in PB T cells from end-stage, long-standing and/or more aggressive AT, in proportion to disease severity. A relation with major clinical subphenotypes was observed, thereby identifying IR as potentially important players in AT.


Assuntos
Expressão Gênica , Receptores Imunológicos/metabolismo , Índice de Gravidade de Doença , Linfócitos T/metabolismo , Tireoidite Autoimune/sangue , Tireotropina/sangue , Adulto , Fatores Etários , Idoso , Feminino , Fatores de Transcrição Forkhead/metabolismo , Humanos , Fator de Transcrição Ikaros/metabolismo , Masculino , Pessoa de Meia-Idade , RNA Mensageiro/metabolismo , Tireoidite Autoimune/classificação , Tireoidite Autoimune/fisiopatologia
19.
Georgian Med News ; (278): 39-45, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29905543

RESUMO

The isolated hypothyroxinemia of pregnancy (IHP) has gained specific attention in the specialized literature during the recent years as the possible factor impeding the intellectual development of fetus and increasing the risk of complications related with pregnancy, delivery and perinatal period. Aim of the study was to define the importance of isolated hypothyroxinemia in the development of obstetric and somatic pathologies in outpatient population of pregnant females. The study of prospective design was performed at the base of "David Gagua Clinic" Ltd. Based on hospital referral we selected the pregnant patients who were diagnosed for isolated hypothyroxinemia in the 1st trimester of pregnancy by clinical-laboratory studies. 104 pregnant females with isolated hypothyroxinemia were included in the main group, and 58 pregrant females of reproductive age who were not identified to have thyroid pathology by screening studies were included in the control group,. The questionnaire used in the study process included the retrospective medical history data, demographic findings, information about premorbid background, genetic burden of somatic pathology, social-economical factors (including education level, living conditions, economic income, family environment etc.) and concomitant somatic pathology. In addition, it included the clinical and para-clinical study data and pregnancy follow-up findings. The test studies for thyroid status were performed every trimester and after one month postpartum. The software packages Microsoft Excel (2010) and SPSS/v.12 was used for statistical treatment of data. The digital data is presented by M±STD, where M is the arithmetic mean and STD is the standard deviation of arithmetic mean. To define the confidence interval for the indices and their relation, we calculated 2 and p, whose critical value was defined to be 0.05. Based on analysis of the acquired data, we found out that pregnant females with isolated hypothyroxinemia were more statistically demonstrating asthenia, dry skin, increased hair loss and fragile nails, and from somatic disorders - pregnancy-associated vomiting and anemia. From concomitant diseases, allergic disorders (18.2%), primary dysmenorrhea (27.8%), spontaneous abortions (25%) were taking the highest incidence rate and other obstetric complications (premature delivery, late delivery) were higher in the main group, though statistically significant difference was not demonstrated. It must be noted that isolated hypothyroxinemia in the studied cohort was mostly found in 1st trimester of pregnancy, whereas according to the literature data, the latter is demonstrated more frequently in the second or third trimester. The above mentioned makes us consider that the iodine deficit in the cohort of pregnant females studied by us was probably present before pregnancy as well and maybe with even higher extent. Thus, the isolated hypothyroxinemia developed in the very first trimester of pregnancy still has its negative impact on the pregnancy course and outcome, despite of applied treatment. According to performed studies and their results, for the prevention of obstetric and perinatal complications, its important to administer iodine preparations together with folic acid at pregravid stage in addition to complete elimination of diet abnormalities, plan the pregnancy in stable normothyroxinemia conditions and at positive energetic balance. In addition, its desirable to perform the repeated thyroid status evaluation in the first trimester of pregnancy and timely administration of adequate therapeutic measures in case of finding any pathology.


Assuntos
Aborto Espontâneo/diagnóstico , Iodo/deficiência , Complicações na Gravidez/diagnóstico , Nascimento Prematuro/diagnóstico , Tiroxina/deficiência , Aborto Espontâneo/sangue , Aborto Espontâneo/fisiopatologia , Aborto Espontâneo/prevenção & controle , Adolescente , Adulto , Alopecia/sangue , Alopecia/diagnóstico , Alopecia/fisiopatologia , Estudos de Casos e Controles , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/fisiopatologia , Feminino , Humanos , Hipertensão/sangue , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Iodo/sangue , Isquemia Miocárdica/sangue , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/fisiopatologia , Obesidade/sangue , Obesidade/diagnóstico , Obesidade/fisiopatologia , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/fisiopatologia , Complicações na Gravidez/prevenção & controle , Primeiro Trimestre da Gravidez , Nascimento Prematuro/sangue , Nascimento Prematuro/fisiopatologia , Nascimento Prematuro/prevenção & controle , Estudos Prospectivos , Fatores de Risco , Tireoidite Autoimune/sangue , Tireoidite Autoimune/diagnóstico , Tireoidite Autoimune/fisiopatologia , Tireotropina/sangue , Tiroxina/sangue
20.
J Clin Endocrinol Metab ; 102(9): 3437-3442, 2017 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-28911140

RESUMO

Context: Autoimmune thyroid disease is more common in women than in men. Fetal microchimerism has been implicated as a potential explanation for this disparity. Objective: The objective of this study was to evaluate the relationship between parity and thyroid autoimmunity in the US population. Design, Setting, Patients: The National Health and Nutrition Examination Survey was used to identify females with antithyroperoxidase (TPOAb) and antithyroglobulin antibody (TgAb) measurements and parity data. Subjects (n = 4864) were categorized as never pregnant (n = 909) or previously pregnant (n = 3955). The association of parity with thyroid autoantibodies was examined both qualitatively and quantitatively. Thyroid autoimmunity was defined as TPOAb and/or TgAb titers above the reference limits. Results: Previous pregnancy carried an odds ratio (OR) of 1.55 [95% confidence interval (CI): 1.26 to 1.91] for thyroid autoimmunity compared with never pregnant. Number of pregnancies was associated with thyroid autoimmunity: OR = 1.37 (95% CI: 1.02 to 1.84); 1.4 (95% CI: 1.08 to 1.81); 1.52 (95% CI: 1.18 to 1.96); and 1.73 (95% CI: 1.38 to 2.18) for 1, 2, 3, and ≥4 pregnancies, respectively. Because ever-pregnant women differed in several variables-age, race, smoking status, history of thyroid disease, and urinary iodine level-from never-pregnant women (P < 0.001), a multivariate regression analysis was performed, which showed no association of pregnancy with thyroid autoimmunity. The association was further examined utilizing an age-matched analysis, which confirmed the absence of an association between thyroid autoimmunity and parity. Conclusion: Although we initially observed a strong association between parity and thyroid autoimmunity, after controlling for age and other variables, we were unable to identify an association.


Assuntos
Autoanticorpos/imunologia , Paridade/imunologia , Tireoglobulina/imunologia , Tireoidite Autoimune/epidemiologia , Tireoidite Autoimune/imunologia , Adulto , Estudos de Coortes , Intervalos de Confiança , Bases de Dados Factuais , Feminino , Humanos , Incidência , Análise Multivariada , Inquéritos Nutricionais , Razão de Chances , Gravidez , Resultado da Gravidez , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Tireoglobulina/sangue , Doenças da Glândula Tireoide/epidemiologia , Doenças da Glândula Tireoide/imunologia , Tireoidite Autoimune/fisiopatologia , Estados Unidos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...