Endocrine Abstracts

Atrial fibrillation (AF) is the commonest dysrhythmia (after sinus tachycardia) complicating hyperthyroidism. We have previously reported increased vascular mortality in hyperthyroidism and postulate this reflects the prevalence of AF. We recruited a consecutive series of 425 subjects with overt hyperthyroidism (n=334 females, 91 males) and determined the prevalence and outcome of AF. All had 12 lead ECG and 24h Holter monitoring before and after antithyroid treatment with thi...

Graves' disease (GD) is an autoimmune disease of the thyroid gland with unknown aetiology thought to be caused by a complex interaction between genetic and environmental factors. To date, the HLA region on chromosome 6p21 and the CTLA-4 gene on chromosome 2q33 are thought to account for about 50% of the genetic component of GD with the remaining genetic contribution likely to be made up of many genes each exerting a small effect on predisposition to disease. A recent study (To...

Introduction :CH diagnosis has advanced from no screening in the past , to cord bloodscreening -free thyroxine(FT4) ,Tawam and Thyroid Stimulating Hormone (TSH),Oasis Hospitals- to the present National Screening Programme (NSP) for capillary TSH from January ,1998.Aim :To screen all newborns and to scan and treat all positive cases before 21 days and to monitor progress and outcome....

Objective: To determine the 24hour thyroid hormone profile on patients with combined T3/T4 therapy.Methods: Two subgroup of patients (10 on combined T3/T4 (study, S) and 10 T4 alone (control, C) were randomly selected from 697 patients who were already involved in WATTS study, after ethical approval. Prior to study entry all patients were on 100micrograms or more of T4. The study group received 10micrograms of T3 in place of 50micrograms of T4 while the ...

Due to early demission of women soon after parturition neonatal (nn) TSH-screening of the new born becomes a problem. Therefore we investigated, whether measurements of TSH (Units per liter), free thyroxine (fT4 picogram per millilitre) and antibodies against thyroxine-peroxidase (a-TPO, Units per millilitre) in cord blood of spontaneously delivered babies at term, might be an alternative. Routine (nn) TSH-screening was recommended to be carried out on day 5 of life. Their mot...

Pretibial myxoedema (thyroid-associated dermopathy), an extrathyroidal manifestation of Graves disease, is a localized thickening of the skin due to accumulation of acid mucopolysacharides (glycosaminoglycans). Almost invariably, pretibial myxoedema occurs in the presence of ophthalmopathy.We report the case of a 57-year-old man of North African origin, who presented with pretibial myxoedema as the first manifestation of Graves disease. He was admitted w...

Background: Community based surveys have revealed that approximately 20% of patients taking thyroxine have low serum TSH concentrations. Likewise, a high proportion of patients (27%) have been found to have high TSH concentrations. Suboptimal thyroxine treatment, in particular overtreatment, is associated with significant potential health risks including atrial fibrillation and osteoporosis. In Sheffield, thyroxine treated patients are routinely enrolled on a computerised thyr...

In the thyroid gland the volume of colloid in the follicles varies considerably. The usually used number weighted mean volume (Vn) does not describe this variation in the distribution of the volume of colloid.Aim: To develop a set of assumption-free stereological methods to determine the variation of the volume of colloid in respect of number and size and to determine the coefficient of this variation (CV). For this purpose we introduce the volume-weight...

Lithium blocks the release of organic iodine and thyroid hormone from the thyroid gland without affecting thyroidal radioactive iodine (RAI) uptake. From August 2001, we have been using lithium carbonate 800mg nocte as an adjunct to RAI treatment for thyrotoxicosis. Antithyroid medication is stopped and lithium started 3 days before RAI. Lithium is continued for 10 days in total with levels checked at 3 and 10 days. Thyroid function tests (TFTs) are measured 1, 3, 6, 9 and 12 ...

Aims: To evaluate thyroid gland dysfunction during interferon alfa (INF-alpha)therapy in patients with the hepatitis B virus (HBV) and hepatitis C virus (HCV)Methods: 58 patients with HCV and 18 patients with HBV were studied prospectively before and with 2 months intervals during INF-alpha therapy. Measurements of serum thyroxine,triiodothyronine, thyrotropine, triiodothyronine resin uptake, thyroid peroxidase antibodies (TPOAbs), and thyroglobulin anti...

Since the thyroid is diffusely active in Graves' disease (GD) but exhibits focal activity in toxic nodular goitre (TNG), we tested the hypothesis that hypothyroidism will occur more frequently following radioactive iodine treatment (RAI), in patients with GD compared to those with TNG. To do this we reviewed the outcome of treatment in 86 patients, age 49.7 plus/minus 1.5 years (mean plus/minus SEM), with GD, and 77 patients, age 62.7 plus/minus 1.3 years, with TNG, followed o...

Uptake of ingested iodide (I-) in the thyroid is achieved through an active transport system, the sodium iodide symporter (NIS). The gland has the ability to accumulate I- from the bloodstream by a factor of 20-40. Seaweeds, which in vivo bear the same relationship to seawater, as does the thyroid to the bloodstream, have a dramatically more efficient I- uptake system, accumulating I- from seawater by a factor of anything up to 1 mil...

The majority of clinically palpable masses affecting the thyroid are benign. Malignant thyroid tumours are the commonest endocrine malignancies yet are rare. Most are of a single distinct cellular type, though mixed cellularity tumours also occur, the commonest of which is papillary and follicular. We describe 2 cases with more than one differentiated tumour in each thyroid gland.CASE 1A 44y builder with a family history of medulla...

The purpose of this work was to investigate the effect of thyrotropin (TSH) on the thyroglobulin and on the polypeptides distribution in primary cultures of human thyroid cells.Thyroid cells isolated from cold nodules (follicular adenoma) were cultured for 5 to 8 days in the presence of 0.05 to 25 mU/ml of TSH (TSH cells) or in the absence of the hormone (control cells). After homogenization of the cells, thyroglobulin radioimmunoassay was performed. The...

Genetic variants of the HLA class II region (DRB1, DQB1 and DQA1) and CTLA-4 contribute to susceptibility to Graves' disease (GD). Whilst disease susceptibility has been mapped to a non-coding 6.1kb 3' region of CTLA-4, the primary aetiological variants within the HLA class II region remain unknown. The aims of this study were (i) determine which of the three HLA class II loci account for the primary association with GD and (ii) examine disea...

The cardiac effects of subclinical hypothyroidism (SCH i.e. increased circulating TSH with normal T4) have been documented. While overt hypothyroidism causes increased central arterial stiffness (CAS) and augmentation gradient (AI) 1, there are only limited data in SCH. We have measured CAS, AG and augmentation Index (AI) (AG/Pulse pressure x 100) in patients with SCH before and after L-thyroxine (synthroid) therapy.Peripheral pulse pressure w...

Nonautoimmune hyperthyroidism (NAH) inherited as an autosomal dominant trait can result from activating germline mutations in the thyrotropin receptor (TSHR) gene. Clinical features described include nonremitting thyrotoxicosis, absence of the features of autoimmune thyrotoxicosis, advanced bone age and increased growth velocity. We report a family with a heterozygous germline mutation of the TSHR gene resulting in the substitution of serine (AGC) by asparagine (AAC) at codon ...

This study aims to recruit 22,000 women in early gestation to screen for thyroid failure. The trial is randomised such that half the women are being tested in early gestation (group1) while the remainder (group 2) are tested after delivery. As T4 is important for the developing foetal brain, the IQ of the children from group 1, whose mothers will have been treated with T4, is expected to be higher than that from group 2.Women are entered on the basis of ...

Thymidine kinase 1 (TK1), deoxycytidine kinase (dCK), and thymidine phosphorylase (dThdPase) are the enzymes involved in pyrimidine and purine metabolism; TK1 activity is correlated with growth processes, and dThdPase is involved in the mechanisms of angiogenesis. The increased activities of TK1, dCK and dThdPase or the increased expression of genes for theses enzymes have been found in different tumors. The aim of the study was to estimate the expression of mRNA, specific for...

Objective. Globus pharyngeus is a term used to describe an abnormal throat sensation in the absence of any pathological cause. A thyroid goitre is one of the pathologies that needs to be excluded prior to making the diagnosis as it is thought that a goitre may cause similar symptoms. However, it is well recognised that postoperatively thyroidectomy patients complain of globus type symptoms.It is also recognised that most thyroidectomies are carried out in middle aged women and...

Introduction:Hypothyroidism may be associated with bradycardia, low voltage complexes,ST-T wave changes, atrioventricular and intraventricular conduction disturbances. Extrasystoles and tachyarrhythmias of both atrial and ventricular origins have been described in hypothyroidism with the ventricular tachyarrhythmias associated with prolonged QT interval.Aims: To ascertain the prevalence of cardiac arrhythmias in primary hypothyroidism.<p class="abste...

The tyrosine kinase receptor, Tie-2, is expressed on endothelial cells where it has a role in angiogenesis in physiological and tumorigenic processes. We have shown that Tie-2 is also expressed on differentiated human thyroid follicular cells, and that its expression is increased in hyperplasia. This study aimed to elucidate the role of the Tie-2 axis in thyroid cells by examining regulation of Tie-2 expression in primary cultures of human thyroid follicular cells and the diff...