ETA2024 Poster Presentations Hyperthyroidism (9 abstracts)
Thymic hyperplasia is accurate to detect new onset graves’ hyperthyroidism and resolves after restoring euthyroidism
Giuseppe Bellastella 1 , Lorenzo Scappaticcio 2 , Nicole Di Martino 3 , Pamela Ferrazzano 1 , Paola Caruso 4 , Maria Ida Maiorino 1 , giovanni docimo 3 , Pierpaolo Trimboli 5 & Katherine Esposito 1
1Aou University of Campania "Luigi Vanvitelli", Italy; 2University OF Campania Vanvitelli, University OF Campania Vanvitelli, Naples, Italy; 3University of Campania Vanvitelli, Italy; 4University of Campania Luigi Vanvitelli, Naples, Italy; 5Thyroid Center, Oncology Institute of Southern Switzerland, Lugano, Switzerland
Objectives: Abnormal liver blood tests (ALBTs), neutropenia (NEU) and thymic hyperplasia (TH) are new features of Graves’ disease (GD). Our objectives were: a) to calculate the accuracy of TH in discriminating between Graves’ and non-Graves’ thyrotoxicosis, compared to ALBTs, NEU and Graves’ orbitopathy (GO); b) to explore the outcome of GD associated TH and non-GD associated TH.
Methods: We prospectively analyzed consecutive adult patients with newly diagnosed thyrotoxicosis from January 2018 to June 2023. TH was detected via neck ultrasound (nUS) then confirmed and followed by magnetic resonance imaging (MRI). For GD vs non-GD clinical sensitivity (SE) and specificity (SPEC), accuracy, positive predictive value (PPV) and negative predictive value (NPV) of GO, TH, ALBTs and NEU were calculated.
Results: 264 thyrotoxic patients were included. TH was found in 16.4% (20/122) of GD vs 1.4% (2/142) in non-GD (p < 0.001). SE, SPEC, accuracy, PPV and NPV of the four extrathyroidal manifestations of GD were as follows, respectively: GO 26%, 100%, 66%, 100%, 61%; ALBTs 41%, 89%, 69%, 76%, 66%; NEU 5%, 100%, 56%, 100%, 55%; TH 16%, 98%, 61%, 91%, 98%. In 18 of them TH regressed within 12 months after achieving euthyroidism under antithyroid drug therapy, while in the remaining two TH regressed six months after thyroid surgery. In the two non-GD patients with TH thymus disappeared along with euthyroidism.
Conclusions: TH in the hyperthyroidism scenario provides a high PPV for GD. A conservative approach for the diagnostic work-up and initial management of thyrotoxicosis associated TH should be adopted.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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