M. E. Boriskova, U. Farafonova, P. A. Pankova, M. Bikov, E. A. Ramazanova
Backgraund. Papillary thyroid cancer (PTC) has a favorable course and low mortality rates. However, the incidence of morbidity and mortality continues to increase, especially in the high-risk group. BRAF mutation is a marker of the PTC aggressive course. Aims. Тo study the relationship between surgical treatment tactics and the BRAF positive PTC prognosis. Materials and methods. Our prospective study included 80 patients with BRAF positive PTC, operated from 2009 to 2016 y. Surgical tactics were determined by existing clinical guidelines. To the patients with BRAF positive thyroid cancer it is proposed to perform thyroidectomy with central compartment lymph node dissection. BRAF status was determined by the PCR method in fine needle aspiration biopsy material (FNAB). Results. Recurrence was detected in 7 of the 18 patients of the hemi/thyroidectomy group. Among 62 patients from the group of thyroidectomy with central compartment lymph node dissection recurrence was detected only in 3 cases. The mean recurrence time also differed significantly, and in the group of patients with (hemi)thyroidectomy without central compartment lymph node dissection is detected earlier (53 months and 59.61 months). Also, organ-preserving operations without central compartment lymph node dissection in BRAF positive tumor has worse result, regardless of T stage. Conclusions. In the presence of BRAF-positive PTC thyroidectomy with central compartment lymph node dissection is indicated.
{"title":"Surgical tactics optimization for treatment of BRAF positive papillary thyroid cancer","authors":"M. E. Boriskova, U. Farafonova, P. A. Pankova, M. Bikov, E. A. Ramazanova","doi":"10.14341/ket9424","DOIUrl":"https://doi.org/10.14341/ket9424","url":null,"abstract":"Backgraund. Papillary thyroid cancer (PTC) has a favorable course and low mortality rates. However, the incidence of morbidity and mortality continues to increase, especially in the high-risk group. BRAF mutation is a marker of the PTC aggressive course. \u0000Aims. Тo study the relationship between surgical treatment tactics and the BRAF positive PTC prognosis. \u0000Materials and methods. Our prospective study included 80 patients with BRAF positive PTC, operated from 2009 to 2016 y. Surgical tactics were determined by existing clinical guidelines. To the patients with BRAF positive thyroid cancer it is proposed to perform thyroidectomy with central compartment lymph node dissection. BRAF status was determined by the PCR method in fine needle aspiration biopsy material (FNAB). \u0000Results. Recurrence was detected in 7 of the 18 patients of the hemi/thyroidectomy group. Among 62 patients from the group of thyroidectomy with central compartment lymph node dissection recurrence was detected only in 3 cases. The mean recurrence time also differed significantly, and in the group of patients with (hemi)thyroidectomy without central compartment lymph node dissection is detected earlier (53 months and 59.61 months). Also, organ-preserving operations without central compartment lymph node dissection in BRAF positive tumor has worse result, regardless of T stage. \u0000Conclusions. In the presence of BRAF-positive PTC thyroidectomy with central compartment lymph node dissection is indicated.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83085976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Ruyatkina, A. A. Molchanova, Alina S. Ruyatkina, L. Rozhinskaya
Thyroid hormone resistance syndrome (RTH) is a rare disorder characterized by reduced peripheral tissue responses to thyroid hormones (TH) and elevated levels of circulating free thyroid hormones. Resistance to thyroid hormone is caused by mutations of the thyroid hormone receptor beta (THRB) gene. In this article, we present case of 26-years-old women who presented with unclear signs and symptoms. Thyroid morphology and function were evaluated with standard ultrasound of the thyroid, scintigraphy and cytological specimen obtained by FNAB. The features of the basic assessment of thyroid status with an emphasis on the concept of “±feedback” of thyroid-stimulating hormone (TSH) and TH. A differential diagnosis of TSH-secreting pituitary adenoma and RTH was discussed. Heterozygous mutation p.P453T in the THRB gene was detected. Thus, the given clinical case demonstrates the necessity of the thorough examination of patients in identifying disorders of the principle of “±feedback”. The observation in dynamics is recommended.
{"title":"Thyroid hormone resistance syndrom: difficulties in differential diagnosis","authors":"L. Ruyatkina, A. A. Molchanova, Alina S. Ruyatkina, L. Rozhinskaya","doi":"10.14341/KET9522","DOIUrl":"https://doi.org/10.14341/KET9522","url":null,"abstract":"Thyroid hormone resistance syndrome (RTH) is a rare disorder characterized by reduced peripheral tissue responses to thyroid hormones (TH) and elevated levels of circulating free thyroid hormones. Resistance to thyroid hormone is caused by mutations of the thyroid hormone receptor beta (THRB) gene. In this article, we present case of 26-years-old women who presented with unclear signs and symptoms. Thyroid morphology and function were evaluated with standard ultrasound of the thyroid, scintigraphy and cytological specimen obtained by FNAB. The features of the basic assessment of thyroid status with an emphasis on the concept of “±feedback” of thyroid-stimulating hormone (TSH) and TH. A differential diagnosis of TSH-secreting pituitary adenoma and RTH was discussed. Heterozygous mutation p.P453T in the THRB gene was detected. Thus, the given clinical case demonstrates the necessity of the thorough examination of patients in identifying disorders of the principle of “±feedback”. The observation in dynamics is recommended.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85967309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The first 1000 days of life (the period between conception and the second birthday) is a window of opportunity for brain development, a unique period when the foundations for optimal growth and development of the nervous system are laid throughout the entire life. Previously it was believed that the main factor that negatively affects the psychomotor development of a child is maternal hypothyroidism in the early stages of pregnancy. However, numerous experimental and epidemiological studies have shown that the development of the nervous system of the fetus is disrupted when a woman has isolated hypothyroxinemia in early pregnancy. The cause of neuropsychiatric disorders in this case is the inadequate availability of maternal thyroxin for the developing brain. Universal salt iodization and fortification of flour with folic acid and iron is a reliable means of preventing micronutrient deficiency in the first 1000 days of life. It is important that this prevention begins before conception and lasts until the end of the neurogenesis period. However, in practice, effective mass methods of prevention are ignored in favor of certain “individual” approaches, the possibilities of which are severely limited.
{"title":"The cognitive dissonance","authors":"G. Gerasimov, Герасимов Григорий Анатольевич","doi":"10.14341/KET9662","DOIUrl":"https://doi.org/10.14341/KET9662","url":null,"abstract":"The first 1000 days of life (the period between conception and the second birthday) is a window of opportunity for brain development, a unique period when the foundations for optimal growth and development of the nervous system are laid throughout the entire life. Previously it was believed that the main factor that negatively affects the psychomotor development of a child is maternal hypothyroidism in the early stages of pregnancy. However, numerous experimental and epidemiological studies have shown that the development of the nervous system of the fetus is disrupted when a woman has isolated hypothyroxinemia in early pregnancy. The cause of neuropsychiatric disorders in this case is the inadequate availability of maternal thyroxin for the developing brain. Universal salt iodization and fortification of flour with folic acid and iron is a reliable means of preventing micronutrient deficiency in the first 1000 days of life. It is important that this prevention begins before conception and lasts until the end of the neurogenesis period. However, in practice, effective mass methods of prevention are ignored in favor of certain “individual” approaches, the possibilities of which are severely limited.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74316825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yu. A. Dolinskaya, S. Shevchenko, V. Maksimov, E. Voropaeva, O. Rymar
Patients who received treatment for the first malignant neoplasm remain in the group at increased risk of developing a second primary tumor throughout their later life. A rare case of medullary thyroid cancer and renal cell carcinoma of the kidney is described in one patient. Medullary thyroid cancer is an orphan disease. The patient and his first-line relatives underwent molecular-genetic testing, the presence of a hereditary form of medullary cancer was excluded. During the observation, malignant kidney formation was detected, and surgical treatment was performed. The patient because of treatment and surveillance does not have data for the progression of thyroid cancer and kidney cancer, compensation for concomitant diseases has been achieved. When observing patients with medullary thyroid cancer, it is necessary to use the existing modern diagnostic arsenal, including positron emission tomography, since patients remain in the group at increased risk of disease progression and development of the second tumor throughout the entire subsequent life. In addition, this case clearly illustrates the need for a routine study of calcitonin as a diagnostic marker for the progression of medullary thyroid cancer.
{"title":"Combination of medullary thyroid cancer and renal cell carcinoma in one patient","authors":"Yu. A. Dolinskaya, S. Shevchenko, V. Maksimov, E. Voropaeva, O. Rymar","doi":"10.14341/KET9259","DOIUrl":"https://doi.org/10.14341/KET9259","url":null,"abstract":"Patients who received treatment for the first malignant neoplasm remain in the group at increased risk of developing a second primary tumor throughout their later life. A rare case of medullary thyroid cancer and renal cell carcinoma of the kidney is described in one patient. Medullary thyroid cancer is an orphan disease. The patient and his first-line relatives underwent molecular-genetic testing, the presence of a hereditary form of medullary cancer was excluded. During the observation, malignant kidney formation was detected, and surgical treatment was performed. The patient because of treatment and surveillance does not have data for the progression of thyroid cancer and kidney cancer, compensation for concomitant diseases has been achieved. When observing patients with medullary thyroid cancer, it is necessary to use the existing modern diagnostic arsenal, including positron emission tomography, since patients remain in the group at increased risk of disease progression and development of the second tumor throughout the entire subsequent life. In addition, this case clearly illustrates the need for a routine study of calcitonin as a diagnostic marker for the progression of medullary thyroid cancer.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72791506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. The most common thyroid disease, accompanied by thyrotoxicosis syndrome, is Graves' disease (GD). Information about the role of Yersinia in the development of this disease is contradictory. Aims. To study the significance of Yersinia (Y.) enterocolitica and Y. pseudotuberculosis in the development of Graves' disease. Materials and methods. 78 patients with GD. Identification of antibodies to Y. was carried out by the following methods: 1. agglutination test (AT) with suspensions of live virulent cultures Y. pseudotuberculosis, Y. enterocolitica O:3 and O:9; 2. indirect hemagglutination test (IHET) with the use of erythrocyte diagnosticum; 3. determination of IgA and IgG antibodies against pathogenicity factors of Y. enterocolitica strains by immunoblotting (30 patients with GD). Results. Diagnostically significant titers of antibodies to Y. pseudotuberculosis and Y. enterocolitica were obtained in all patients with GD by AT. The greatest total thyroid volume determined by ultrasound investigation (p = 0.010) and the maximum duration of the disease (p = 0.040) were determined in the group of patients with the maximum antibody titer. No significant relation was found between the titer of antibodies to Yersinia and the levels of thyroid hormones stimulating the thyroid antibodies.The test for detection of IgA antibodies by immunoblotting was negative in 30 patients with GD (9 patients with a titer of antibodies by AT 1:800 – 1:1600, 17 – 1:400, 4 – 1:200). In all cases with the maximum antibody titer in AT, the positive IgG antibodies to the antigens YopM (Yop2a), YopH (Yop2b), V-antigen, YopD were found. The GD duration in patients with negative titers of antibodies by the immunoblotting test was less than with the positive one (p = 0.010). The privative clinical and anamnestic data and negative results by IHET confirmed the absence of active and/or transferred Yersinia infections in all the examined patients with GD. Conclusions. The cross-reacting antibodies to the antigens of Y. enterocolitica are determined in the serum of GD patients by AT and immunoblotting. The diagnostic titer of these antibodies is more often detected in patients with greater GD duration and larger volume of the thyroid gland. The absence of a link between the titer of these antibodies and the levels of thyroid hormones, the antibodies to the thyrotropin receptors of pituitary, as well as negative results by IHET with a diagnosticum that does not contain outer membrane proteins of pathogenic Yersinia, deny the trigger role of Yersinia infections as an initiating factor in the development of GD.
{"title":"Yersinia infections and Graves’ disease","authors":"L. Khamnueva, T. V. Goma, V. Klimov","doi":"10.14341/ket9416","DOIUrl":"https://doi.org/10.14341/ket9416","url":null,"abstract":"Background. The most common thyroid disease, accompanied by thyrotoxicosis syndrome, is Graves' disease (GD). Information about the role of Yersinia in the development of this disease is contradictory. \u0000Aims. To study the significance of Yersinia (Y.) enterocolitica and Y. pseudotuberculosis in the development of Graves' disease. \u0000Materials and methods. 78 patients with GD. Identification of antibodies to Y. was carried out by the following methods: 1. agglutination test (AT) with suspensions of live virulent cultures Y. pseudotuberculosis, Y. enterocolitica O:3 and O:9; 2. indirect hemagglutination test (IHET) with the use of erythrocyte diagnosticum; 3. determination of IgA and IgG antibodies against pathogenicity factors of Y. enterocolitica strains by immunoblotting (30 patients with GD). \u0000Results. Diagnostically significant titers of antibodies to Y. pseudotuberculosis and Y. enterocolitica were obtained in all patients with GD by AT. The greatest total thyroid volume determined by ultrasound investigation (p = 0.010) and the maximum duration of the disease (p = 0.040) were determined in the group of patients with the maximum antibody titer. No significant relation was found between the titer of antibodies to Yersinia and the levels of thyroid hormones stimulating the thyroid antibodies.The test for detection of IgA antibodies by immunoblotting was negative in 30 patients with GD (9 patients with a titer of antibodies by AT 1:800 – 1:1600, 17 – 1:400, 4 – 1:200). In all cases with the maximum antibody titer in AT, the positive IgG antibodies to the antigens YopM (Yop2a), YopH (Yop2b), V-antigen, YopD were found. The GD duration in patients with negative titers of antibodies by the immunoblotting test was less than with the positive one (p = 0.010). The privative clinical and anamnestic data and negative results by IHET confirmed the absence of active and/or transferred Yersinia infections in all the examined patients with GD. \u0000Conclusions. The cross-reacting antibodies to the antigens of Y. enterocolitica are determined in the serum of GD patients by AT and immunoblotting. The diagnostic titer of these antibodies is more often detected in patients with greater GD duration and larger volume of the thyroid gland. The absence of a link between the titer of these antibodies and the levels of thyroid hormones, the antibodies to the thyrotropin receptors of pituitary, as well as negative results by IHET with a diagnosticum that does not contain outer membrane proteins of pathogenic Yersinia, deny the trigger role of Yersinia infections as an initiating factor in the development of GD.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91376039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Gerasimov, Герасимов Григорий Анатольевич, F. Haar, van der Haar Frits, J. Lazarus, H. John
Universal salt iodization (USI) strategies gained strong momentum in countries of the Southern Europe and Central Asia (SECA) region during the 2000–2009 decade. By the end of the first decade, several countries in the region had already reached the goal of optimum iodine nutrition; other countries were quickly approaching this goal, and in only a few countries the progress toward USI had remained slow. This paper reports an overview of the two Sub-Regional workshops (for countries of Eastern Europe and Central Asia and South-Eastern Europe) conducted in 2015 and 2016. Both workshops demonstrate that the SECA region remains on track in the pursuit of USI for sustainable IDD elimination. Notwithstanding the noted imperfections, none of the data or information from countries of the region suggested that the conquest of iodine deficiency is seriously threatened. However, more efforts should be made to develop and streamline USI strategies in Russia and Ukraine, two major countries that are lagging behind.
{"title":"Overview of Iodine Deficiency Prevention Strategies in the South-Eastern Europe and Central Asia Region: 2009–2016","authors":"G. Gerasimov, Герасимов Григорий Анатольевич, F. Haar, van der Haar Frits, J. Lazarus, H. John","doi":"10.14341/KET9531","DOIUrl":"https://doi.org/10.14341/KET9531","url":null,"abstract":"Universal salt iodization (USI) strategies gained strong momentum in countries of the Southern Europe and Central Asia (SECA) region during the 2000–2009 decade. By the end of the first decade, several countries in the region had already reached the goal of optimum iodine nutrition; other countries were quickly approaching this goal, and in only a few countries the progress toward USI had remained slow. This paper reports an overview of the two Sub-Regional workshops (for countries of Eastern Europe and Central Asia and South-Eastern Europe) conducted in 2015 and 2016. Both workshops demonstrate that the SECA region remains on track in the pursuit of USI for sustainable IDD elimination. Notwithstanding the noted imperfections, none of the data or information from countries of the region suggested that the conquest of iodine deficiency is seriously threatened. However, more efforts should be made to develop and streamline USI strategies in Russia and Ukraine, two major countries that are lagging behind.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"32 1","pages":"16-22"},"PeriodicalIF":0.0,"publicationDate":"2018-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78541059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Voronkova, Воронкова Ия Александровна, A. M. Lapshina, Лапшина Анастасия Михайловна, L. Gurevich, Гуревич Лариса Евсеевна, L. Rozhinskaya, Рожинская Людмила Яковлевна, T. Britvin, Бритвин Тимур Альбертович, A. Krivosheev, Кривошеев Алексей Викторович, Ilya V. Kim, Ким Илья Викторович, S. Kuznetsov, Кузнецов Сергей Николаевич, N. Mokrysheva, Мокрышева Наталья Георгиевна
Most clinicians are well aware of the coexistence of medullary thyroid cancer and hyperparathyroidism in hereditary and sporadic multiple endocrine neoplasia syndromes. Тhe reported incidence of nonmedullary thyroid carcinoma in patients with primary hyperparathyroidism (pHPT) is only approximately 3%. Papillary thyroid carcinomas (PTC) is a malignant epithelial tumour. PTC represent up to 87% of all thyroid carcinomas. Atypical parathyroid adenoma (APA) are a subset of parathyroid neoplasms that exhibit some of the features of parathyroid carcinoma but lack unequivocal invasive growth. APA represents about 0.5–4% of cases of PHPT. As a group, they may be considered tumors of uncertain malignant potential. The clinical importance, and long-term outcomes as well as appropriate operative management and surveillance are not well defined for APA probably due to the overall low prevalence as well as the lack of a standard definition of APA. We report two cases of a 63-year-old woman and 57-year-old man with a synchronous atypical parathyroid adenoma and papillary thyroid carcinoma. One of this patients had a classic symptoms of pHPT, including severe metabolic bone disease and renal disease, but another didn’t have. The mean preoperative calcium was 3,48 and 4,1 (range 2.12–2.6) mmol/l and a mean parathyroid hormone (PTH) of 1300 and 1533 (range 15–65) pg/ml, respectively. Thyroid ultrasound didn’t show a nodule with features of the thyroid carcinoma in both cases. The thyroid cancer was suspected after intraoperative revision. The patients underwent a total thyroidectomy and surgical excision of the parathyroid adenoma. Surgical pathology showed papillary microcarcinoma in both cases (in the first – unilateral, in the second – bilateral) and APA. Awareness of this condition will enable clinicians to evaluate for possible thyroid pathology in patients with primary hyperparathyroidism. Both of these endocrine conditions could then be managed with a single surgery involving concomitant resection of the thyroid and parathyroid glands.
{"title":"Two cases synchronous atypical parathyroid adenomas and papillary thyroid carcinoma","authors":"I. Voronkova, Воронкова Ия Александровна, A. M. Lapshina, Лапшина Анастасия Михайловна, L. Gurevich, Гуревич Лариса Евсеевна, L. Rozhinskaya, Рожинская Людмила Яковлевна, T. Britvin, Бритвин Тимур Альбертович, A. Krivosheev, Кривошеев Алексей Викторович, Ilya V. Kim, Ким Илья Викторович, S. Kuznetsov, Кузнецов Сергей Николаевич, N. Mokrysheva, Мокрышева Наталья Георгиевна","doi":"10.14341/ket9497","DOIUrl":"https://doi.org/10.14341/ket9497","url":null,"abstract":"Most clinicians are well aware of the coexistence of medullary thyroid cancer and hyperparathyroidism in hereditary and sporadic multiple endocrine neoplasia syndromes. Тhe reported incidence of nonmedullary thyroid carcinoma in patients with primary hyperparathyroidism (pHPT) is only approximately 3%. Papillary thyroid carcinomas (PTC) is a malignant epithelial tumour. PTC represent up to 87% of all thyroid carcinomas. Atypical parathyroid adenoma (APA) are a subset of parathyroid neoplasms that exhibit some of the features of parathyroid carcinoma but lack unequivocal invasive growth. APA represents about 0.5–4% of cases of PHPT. As a group, they may be considered tumors of uncertain malignant potential. The clinical importance, and long-term outcomes as well as appropriate operative management and surveillance are not well defined for APA probably due to the overall low prevalence as well as the lack of a standard definition of APA. We report two cases of a 63-year-old woman and 57-year-old man with a synchronous atypical parathyroid adenoma and papillary thyroid carcinoma. One of this patients had a classic symptoms of pHPT, including severe metabolic bone disease and renal disease, but another didn’t have. The mean preoperative calcium was 3,48 and 4,1 (range 2.12–2.6) mmol/l and a mean parathyroid hormone (PTH) of 1300 and 1533 (range 15–65) pg/ml, respectively. Thyroid ultrasound didn’t show a nodule with features of the thyroid carcinoma in both cases. The thyroid cancer was suspected after intraoperative revision. The patients underwent a total thyroidectomy and surgical excision of the parathyroid adenoma. Surgical pathology showed papillary microcarcinoma in both cases (in the first – unilateral, in the second – bilateral) and APA. Awareness of this condition will enable clinicians to evaluate for possible thyroid pathology in patients with primary hyperparathyroidism. Both of these endocrine conditions could then be managed with a single surgery involving concomitant resection of the thyroid and parathyroid glands.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"22 1","pages":"40-48"},"PeriodicalIF":0.0,"publicationDate":"2018-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88753633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Kvitkova, Квиткова Людмила Владимировна, D. S. Vinichenko, Виниченко Дарья Сергеевна, D. Borodkina, Бородкина Дарья Андреевна, S. F. Zinchuk, Зинчук Сергей Фадеевич, N. Fomina, Фомина Наталья Викторовна, Sergey S. Maximov, Максимов Сергей Алексеевич
Backgraund. The development of cardiovascular complications in patients with diffuse-toxic goiter (DTZ) is an actual problem of thyroidology. (SSS) in patients with DTZ. Aims. To assess the contribution of zinc deficiency in the formation of cardiovascular complications in patients with Graves’ disease. Methods. The study included 113 women aged 25–60 years with the diagnosis of DTZ: 54.0% ( n = 61) with an average severity of thyrotoxicosis, 46.0% ( n = 52) with severe. Duration of the disease is 1–5 years. The control group consisted of 37 women aged 25–60 years without pathology of the thyroid gland and CCC. All patients were evaluated: in the blood – the level of thyroid-stimulating hormone (TTG), free thyroxine (over T4), the concentration of antibodies to the thyroid-stimulating hormone receptor (AT to RTTG); in the hair – the concentration of zinc; ultrasound (ultrasound) of the thyroid gland, echocardiography (EchoCG), daily monitoring of electrocardiography (CM ECG). Results. At DTZ deficiency of zinc in hair was observed in 66.4% ( n = 75), in the control group – in 27.0% ( n = 10) patients ( p = 0.01). More often, zinc deficiency was found at a severe degree of DTZ in 82.7% ( n = 43), atrial fibrillation (AF) in 77.4% ( n = 24) cases, in CHF – 78.8% ( n = 41) cases. The diagnostic model and the table of risk factors of CHF in points, including the definition of the level of zinc in the hair, are developed with the help of logistic regression. It is advisable to use the table for all patients with DTZ to determine the degree of CHF risk, with an average and high risk of developing CHF in the treatment of DTZ, it is shown to include zinc preparations. Conclusion. The obtained data allow to consider that the zinc deficiency increases the probability of development of AF and CHF in patients with DTZ of severe severity, needs diagnostics and correction.
{"title":"Thе role of zinc in the development of cardiovascular complications in patients with Graves’ disease","authors":"L. Kvitkova, Квиткова Людмила Владимировна, D. S. Vinichenko, Виниченко Дарья Сергеевна, D. Borodkina, Бородкина Дарья Андреевна, S. F. Zinchuk, Зинчук Сергей Фадеевич, N. Fomina, Фомина Наталья Викторовна, Sergey S. Maximov, Максимов Сергей Алексеевич","doi":"10.14341/KET8270","DOIUrl":"https://doi.org/10.14341/KET8270","url":null,"abstract":"Backgraund. The development of cardiovascular complications in patients with diffuse-toxic goiter (DTZ) is an actual problem of thyroidology. (SSS) in patients with DTZ. Aims. To assess the contribution of zinc deficiency in the formation of cardiovascular complications in patients with Graves’ disease. Methods. The study included 113 women aged 25–60 years with the diagnosis of DTZ: 54.0% ( n = 61) with an average severity of thyrotoxicosis, 46.0% ( n = 52) with severe. Duration of the disease is 1–5 years. The control group consisted of 37 women aged 25–60 years without pathology of the thyroid gland and CCC. All patients were evaluated: in the blood – the level of thyroid-stimulating hormone (TTG), free thyroxine (over T4), the concentration of antibodies to the thyroid-stimulating hormone receptor (AT to RTTG); in the hair – the concentration of zinc; ultrasound (ultrasound) of the thyroid gland, echocardiography (EchoCG), daily monitoring of electrocardiography (CM ECG). Results. At DTZ deficiency of zinc in hair was observed in 66.4% ( n = 75), in the control group – in 27.0% ( n = 10) patients ( p = 0.01). More often, zinc deficiency was found at a severe degree of DTZ in 82.7% ( n = 43), atrial fibrillation (AF) in 77.4% ( n = 24) cases, in CHF – 78.8% ( n = 41) cases. The diagnostic model and the table of risk factors of CHF in points, including the definition of the level of zinc in the hair, are developed with the help of logistic regression. It is advisable to use the table for all patients with DTZ to determine the degree of CHF risk, with an average and high risk of developing CHF in the treatment of DTZ, it is shown to include zinc preparations. Conclusion. The obtained data allow to consider that the zinc deficiency increases the probability of development of AF and CHF in patients with DTZ of severe severity, needs diagnostics and correction.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"1 1","pages":"30-39"},"PeriodicalIF":0.0,"publicationDate":"2018-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76555264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. E. Soboleva, Соболева Дарья Евгеньевна, S. Dora, Дора Светлана Владимировна, T. Karonova, Каронова Татьяна Леонидовна, A. Volkova, Волкова Анна Ральфовна, E. Grineva, Гринева Елена Николаевна
Backgraund. Globally, it is estimated that 2 billion individuals have an insufficient iodine intake. Aim. To assess iodine status and the effectiveness of iodine deficiency prophylaxis in adult population of St. Petersburg. Methods. А retrospective analysis of the prevalence neonatal hyperthyrotropinemia in St. Petersburg for the period 2013–2014 was made. In a cross-sectional study were included 542 residents of St. Petersburg aged 18-77 years. All participants were divided into 3 groups according to age. Pregnant women were evaluated separately. All participants were questioned, the values of urinary iodine concentration (UIC) were analyzed. Results. The frequency of neonatal thyroid-stimulating hormone concentrations above 5 mU/L was 6.9%. Iodized salt was used by 41.1% of all surveyed persons and 52.2% of pregnant women. Iodine supplements were taken by half of pregnant women. Median UIС of all participants was 91.2 mcg/L and corresponded to mild iodine deficiency. Median UIC in pregnant women was 112.4 mcg/L and corresponded to insufficient iodine intake. Conclusions. The population of St. Petersburg lives in a region of mild iodine deficiency. Prophylaxis of iodine deficiency held in St. Petersburg in 2013–2015 was not effective enough. Persons of reproductive age and pregnant women had mild iodine deficiency.
{"title":"Iodine status of Saint Petersburg adult residents","authors":"D. E. Soboleva, Соболева Дарья Евгеньевна, S. Dora, Дора Светлана Владимировна, T. Karonova, Каронова Татьяна Леонидовна, A. Volkova, Волкова Анна Ральфовна, E. Grineva, Гринева Елена Николаевна","doi":"10.14341/ket9478","DOIUrl":"https://doi.org/10.14341/ket9478","url":null,"abstract":"Backgraund. Globally, it is estimated that 2 billion individuals have an insufficient iodine intake. Aim. To assess iodine status and the effectiveness of iodine deficiency prophylaxis in adult population of St. Petersburg. Methods. А retrospective analysis of the prevalence neonatal hyperthyrotropinemia in St. Petersburg for the period 2013–2014 was made. In a cross-sectional study were included 542 residents of St. Petersburg aged 18-77 years. All participants were divided into 3 groups according to age. Pregnant women were evaluated separately. All participants were questioned, the values of urinary iodine concentration (UIC) were analyzed. Results. The frequency of neonatal thyroid-stimulating hormone concentrations above 5 mU/L was 6.9%. Iodized salt was used by 41.1% of all surveyed persons and 52.2% of pregnant women. Iodine supplements were taken by half of pregnant women. Median UIС of all participants was 91.2 mcg/L and corresponded to mild iodine deficiency. Median UIC in pregnant women was 112.4 mcg/L and corresponded to insufficient iodine intake. Conclusions. The population of St. Petersburg lives in a region of mild iodine deficiency. Prophylaxis of iodine deficiency held in St. Petersburg in 2013–2015 was not effective enough. Persons of reproductive age and pregnant women had mild iodine deficiency.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"13 1","pages":"23-29"},"PeriodicalIF":0.0,"publicationDate":"2018-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82511211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The new fourth edition of the WHO classification of tumors of endocrine organs published by the International agency for research of cancer (IARC) in 2017 as the previous third edition of 2004 pays substantial attention to the thyroid gland tumors. Experts revised criteria of malignancy in category of encapsulated non-invasive follicular thyroid neopasm with papillary-like nuclear features. The previous edition classified these tumors as malignant follicular variant of papillary thyroid carcinoma (PTC). The new edition considers their behavior status as borderline or tumors of uncertain malignant potential. An estimation of malignancy of follicular thyroid tumors is impossible in preoperative cytological smears due to unknown cytological markers of malignancy and in 10% tumors after surgery due to equivocal histological features of capsular/vascular invasion and/or doubtful PTC-like nuclear features. Criteria of non-invasive follicular thyroid neoplasm with papillary-like nuclear features as well as criteria of two classification categories of follicular and well differentiated tumors of uncertain malignant potential (UMP) are presented in this paper. A special attention is paid to diagnostic significance of invasive growth as a basic feature of malignancy. In connection with the revised criteria of international classification we discuss an importance of adequate histological examination and influence of new borderline categories on surgical treatment of encapsulated follicular thyroid tumors in the paper.
{"title":"Encapsulated follicular thyroid tumors of uncertain malignant potential in the new international histological classification","authors":"A. Abrosimov, Абросимов Александр Юрьевич","doi":"10.14341/KET9481","DOIUrl":"https://doi.org/10.14341/KET9481","url":null,"abstract":"The new fourth edition of the WHO classification of tumors of endocrine organs published by the International agency for research of cancer (IARC) in 2017 as the previous third edition of 2004 pays substantial attention to the thyroid gland tumors. Experts revised criteria of malignancy in category of encapsulated non-invasive follicular thyroid neopasm with papillary-like nuclear features. The previous edition classified these tumors as malignant follicular variant of papillary thyroid carcinoma (PTC). The new edition considers their behavior status as borderline or tumors of uncertain malignant potential. An estimation of malignancy of follicular thyroid tumors is impossible in preoperative cytological smears due to unknown cytological markers of malignancy and in 10% tumors after surgery due to equivocal histological features of capsular/vascular invasion and/or doubtful PTC-like nuclear features. Criteria of non-invasive follicular thyroid neoplasm with papillary-like nuclear features as well as criteria of two classification categories of follicular and well differentiated tumors of uncertain malignant potential (UMP) are presented in this paper. A special attention is paid to diagnostic significance of invasive growth as a basic feature of malignancy. In connection with the revised criteria of international classification we discuss an importance of adequate histological examination and influence of new borderline categories on surgical treatment of encapsulated follicular thyroid tumors in the paper.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"4 1","pages":"9-15"},"PeriodicalIF":0.0,"publicationDate":"2018-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86639203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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