E. Kolpakova, А. Voznesenskaya, E. A. Metreveli, L. Nikankina, E. Troshina
The novel coronavirus infection SARS-CoV-2 (COVID-19) has gone down in history as one of the deadliest pandemics in history. Since the first reports of SARS-CoV-2 infection, a lot of data has appeared regarding the features of the COVID-19 pathogenesis and the effect of the virus on various organs and tissues. It is known that SARS-CoV-2 can cause both pulmonary and systemic inflammation, causing multiple organ dysfunction. In addition, since the beginning of the pandemic, reports of the relationship between COVID-19 and thyroid dysfunction have continued to emerge. Numerous studies have demonstrated that the thyroid gland and the entire hypothalamus-pituitary-thyroid axis can be significant targets for the pathogenic effects of SARS-CoV-2.The classic thyroid dysfunctions in infectious diseases, also described in COVID-19, are subacute thyroiditis and secondary hypothyroidism. Of particular interest is the development of atypical thyroiditis-SARS-CoV-2 against the background of COVID-19, a condition first recorded during COVID-19, associated with formidable cardiovascular complications and high mortality in patients with COVID-19, not previously encountered in other viral infections.This article describes a clinical case of SARS-CoV-2 atypical thyroiditis in a patient with bilateral viral pneumonia in the acute period of COVID-19.
{"title":"Development of SARS-CoV-2 atypical thyroiditis in a patient with severe COVID-19","authors":"E. Kolpakova, А. Voznesenskaya, E. A. Metreveli, L. Nikankina, E. Troshina","doi":"10.14341/ket12745","DOIUrl":"https://doi.org/10.14341/ket12745","url":null,"abstract":"The novel coronavirus infection SARS-CoV-2 (COVID-19) has gone down in history as one of the deadliest pandemics in history. Since the first reports of SARS-CoV-2 infection, a lot of data has appeared regarding the features of the COVID-19 pathogenesis and the effect of the virus on various organs and tissues. It is known that SARS-CoV-2 can cause both pulmonary and systemic inflammation, causing multiple organ dysfunction. In addition, since the beginning of the pandemic, reports of the relationship between COVID-19 and thyroid dysfunction have continued to emerge. Numerous studies have demonstrated that the thyroid gland and the entire hypothalamus-pituitary-thyroid axis can be significant targets for the pathogenic effects of SARS-CoV-2.The classic thyroid dysfunctions in infectious diseases, also described in COVID-19, are subacute thyroiditis and secondary hypothyroidism. Of particular interest is the development of atypical thyroiditis-SARS-CoV-2 against the background of COVID-19, a condition first recorded during COVID-19, associated with formidable cardiovascular complications and high mortality in patients with COVID-19, not previously encountered in other viral infections.This article describes a clinical case of SARS-CoV-2 atypical thyroiditis in a patient with bilateral viral pneumonia in the acute period of COVID-19.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80120142","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}
E. Kolpakova, A. Elfimova, L. Nikankina, I. Dyakov, K. K. Bushkova, E. Troshina
In the midst of continuing coronavirus infection (COVID-19) there has been an increase in the incidence of various autoimmune pathologies. Particular attention to the potential relationship between coronavirus infection and autoimmune diseases is attracted by the positive therapeutic effect of the treatment of severe forms of COVID-19 with drugs used in the treatment of rheumatologically diseases.The results of the study should be the starting point for understanding the mechanisms of possible breakdown of immunological tolerance and the development of autoimmune thyroid diseases.AIM: To assess the risks of developing autoimmune thyroid disease after COVID-19, and to investigate the effect of therapy in the acute period on the possible development of autoimmune thyroid diseases.MATERIALS AND METHODS: This prospective comparative study included patients hospitalized at the National Medical Research Center for Endocrinology with a clinical and laboratory analysis of COVID-19 and bilateral polysegmental viral pneumonia (n=41). Patients with COVID-19 were divided into two subgroups: a subgroup of patients who received tocilizumab therapy in acute period (n=10), the second subgroup of patients who received symptomatic therapy during the acute period COVID-19 (n=31).To assess the functional status of the thyroid gland all patients underwent observation of the thyroid-stimulating hormone (TSH), free triiodothyronine (T3f), free thyroxine (T4f), antibodies to thyroperoxidase (Ab-TPO) and antibodies to the TSH receptor (Ab-recTSH).The concentrations of 27 signaling molecules in the blood serum were assessed by the technology of multiplex flow immunoassay using the Bio-Plex Pro Human Cytokine 27-plex Assay kit of cytokines and chemokines: interleukins-1b, -1ra, -2, 4-10, -12, -13, -15, -17 (IL-1b, IL-1ra, IL-2, IL - 4-10, IL-12, IL-13, IL-15, IL-17), Eotaxin, fibroblast growth factor (FGF), granulocyte- macrophage colony stimulating factor (GM-CSF), granulocyte colony stimulating factor (G -CSF), interferon-gamma (IFN-g), IFNγ-inducible protein 10 (IP-10), monocyte chemotactic protein-1 (MCP-1), also known as monocyte chemotactic and activating factor (MCAF), macrophage inflammatory protein -1 (MIP-1a and -1b), platelet growth factor BB (PDGF-bb), Regulated on Activation Normal T-cell Expressed and Secreted (RANTES), tumor necrosis factor-alpha (TNF-a), vascular endothelial growth factor (VEGF).All patients denied the presence of thyroid diseases, palpation of the thyroid gland revealed nodular formations in 5% of patients, and appropriate recommendations were given to patients.RESULTS: The overt hypothyroidism was detected in 2.4% of patients, subclinical - in 7.3% of patients in six months after the onset of coronavirus infection, and also found increased levels of the Ab-TPO in six months after recovery (p = 0.023 - Wilcoxon test). In the group of patients with increased Ab-TPO levels after COVID-19, statistically significantly high levels of IFN-g (p =
{"title":"COVID-19 and the possible development of autoimmune thyroid diseases","authors":"E. Kolpakova, A. Elfimova, L. Nikankina, I. Dyakov, K. K. Bushkova, E. Troshina","doi":"10.14341/ket12740","DOIUrl":"https://doi.org/10.14341/ket12740","url":null,"abstract":"In the midst of continuing coronavirus infection (COVID-19) there has been an increase in the incidence of various autoimmune pathologies. Particular attention to the potential relationship between coronavirus infection and autoimmune diseases is attracted by the positive therapeutic effect of the treatment of severe forms of COVID-19 with drugs used in the treatment of rheumatologically diseases.The results of the study should be the starting point for understanding the mechanisms of possible breakdown of immunological tolerance and the development of autoimmune thyroid diseases.AIM: To assess the risks of developing autoimmune thyroid disease after COVID-19, and to investigate the effect of therapy in the acute period on the possible development of autoimmune thyroid diseases.MATERIALS AND METHODS: This prospective comparative study included patients hospitalized at the National Medical Research Center for Endocrinology with a clinical and laboratory analysis of COVID-19 and bilateral polysegmental viral pneumonia (n=41). Patients with COVID-19 were divided into two subgroups: a subgroup of patients who received tocilizumab therapy in acute period (n=10), the second subgroup of patients who received symptomatic therapy during the acute period COVID-19 (n=31).To assess the functional status of the thyroid gland all patients underwent observation of the thyroid-stimulating hormone (TSH), free triiodothyronine (T3f), free thyroxine (T4f), antibodies to thyroperoxidase (Ab-TPO) and antibodies to the TSH receptor (Ab-recTSH).The concentrations of 27 signaling molecules in the blood serum were assessed by the technology of multiplex flow immunoassay using the Bio-Plex Pro Human Cytokine 27-plex Assay kit of cytokines and chemokines: interleukins-1b, -1ra, -2, 4-10, -12, -13, -15, -17 (IL-1b, IL-1ra, IL-2, IL - 4-10, IL-12, IL-13, IL-15, IL-17), Eotaxin, fibroblast growth factor (FGF), granulocyte- macrophage colony stimulating factor (GM-CSF), granulocyte colony stimulating factor (G -CSF), interferon-gamma (IFN-g), IFNγ-inducible protein 10 (IP-10), monocyte chemotactic protein-1 (MCP-1), also known as monocyte chemotactic and activating factor (MCAF), macrophage inflammatory protein -1 (MIP-1a and -1b), platelet growth factor BB (PDGF-bb), Regulated on Activation Normal T-cell Expressed and Secreted (RANTES), tumor necrosis factor-alpha (TNF-a), vascular endothelial growth factor (VEGF).All patients denied the presence of thyroid diseases, palpation of the thyroid gland revealed nodular formations in 5% of patients, and appropriate recommendations were given to patients.RESULTS: The overt hypothyroidism was detected in 2.4% of patients, subclinical - in 7.3% of patients in six months after the onset of coronavirus infection, and also found increased levels of the Ab-TPO in six months after recovery (p = 0.023 - Wilcoxon test). In the group of patients with increased Ab-TPO levels after COVID-19, statistically significantly high levels of IFN-g (p =","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85060487","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}
N. Manevska, N. Bozinovska, B. Stoilovska Rizova, S. Stojanoski, T. Makazlieva
INTRODUCTION. Typical clinical features of subacute thyroiditis (SAT) are commonly assessed such as – neck pain and high body temperature, as well as thyroid function abnormalities, elevated inflammatory markers, and strongly suggestive hypoechoic ultrasonography characteristics. Non-steroid anti-inflammatory agents and corticosteroids are used.AIM. To examine the clinical characteristics in patients with SAT, by determining the level of thyroid hormones, the size and structure of the thyroid gland as well as ultrasound and scintigraphy findings.MATERIALS AND METHODS. We performed retrospective analysis in 122 cases of SAT (both genders, mean age 45.05±12,18 years), in the period 2015-2020. We evaluated monthly frequency of the SAT occurrence, the clinical status of the patients including symptoms, body temperature, laboratory results of FT4 and TSH, CRP and ESR level, ultrasonography and scintigraphy findings.RESULTS. Most of the patients complained of neck pain, high body temperature was detected in 66/100 (66%) pts. CRP and ESR Patients were usually diagnosed in hyperthyroid phase of the disease. Enlarged thyroid gland was mostly seen on US, while 52 had normal thyroid gland, with predominantly hypoechoic non-chomogenous structure. Scintigraphy noted “empty” scan (without presentation of functional thyroid tissue) in 72/98 (73,47%) and hypofixation mainly in both lobes in 26/98 (26,53%) pts.CONCLUSION. The awareness of physicians needs to be increased in patients with neck pain for proper diagnosis of SAT, that is often is often misdiagnosed or delayed, leading to erroneous antibiotic overuse. Generally, nonsteroidal anti-inflammatory drugs are effective in reducing thyroid pain in patients with mild cases.
{"title":"Subacute thyroiditis and its clinical characteristics — a retrospective single center clinical study","authors":"N. Manevska, N. Bozinovska, B. Stoilovska Rizova, S. Stojanoski, T. Makazlieva","doi":"10.14341/ket12728","DOIUrl":"https://doi.org/10.14341/ket12728","url":null,"abstract":"INTRODUCTION. Typical clinical features of subacute thyroiditis (SAT) are commonly assessed such as – neck pain and high body temperature, as well as thyroid function abnormalities, elevated inflammatory markers, and strongly suggestive hypoechoic ultrasonography characteristics. Non-steroid anti-inflammatory agents and corticosteroids are used.AIM. To examine the clinical characteristics in patients with SAT, by determining the level of thyroid hormones, the size and structure of the thyroid gland as well as ultrasound and scintigraphy findings.MATERIALS AND METHODS. We performed retrospective analysis in 122 cases of SAT (both genders, mean age 45.05±12,18 years), in the period 2015-2020. We evaluated monthly frequency of the SAT occurrence, the clinical status of the patients including symptoms, body temperature, laboratory results of FT4 and TSH, CRP and ESR level, ultrasonography and scintigraphy findings.RESULTS. Most of the patients complained of neck pain, high body temperature was detected in 66/100 (66%) pts. CRP and ESR Patients were usually diagnosed in hyperthyroid phase of the disease. Enlarged thyroid gland was mostly seen on US, while 52 had normal thyroid gland, with predominantly hypoechoic non-chomogenous structure. Scintigraphy noted “empty” scan (without presentation of functional thyroid tissue) in 72/98 (73,47%) and hypofixation mainly in both lobes in 26/98 (26,53%) pts.CONCLUSION. The awareness of physicians needs to be increased in patients with neck pain for proper diagnosis of SAT, that is often is often misdiagnosed or delayed, leading to erroneous antibiotic overuse. Generally, nonsteroidal anti-inflammatory drugs are effective in reducing thyroid pain in patients with mild cases.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79050586","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: Thyrotoxic atrial fibrillation (TAF) is associated with an increase in total and cardiovascular mortality, mainly due to the thromboembolic events. Therefore, thromboembolism prevention is an important TAF treatment component. Thus, it seems interesting to identify TAF thromboembolic complications predictors.TAF is a potentially reversible state. However, the spontaneous reversion to sinus rhythm after the euthyroidism achievement does not occur in all patients. In patients with a history of thyrotoxicosis the hospitalization rate due to cardiovascular pathology, and due to atrial fibrillation (AF), in particular, is higher than in the general population, even after the radical treatment of thyrotoxicosis.The development of prediction tools for mentioned above TAF complications and adverse outcomes, would make it possible to create more detailed and high-quality guidelines for the management of patients with thyrotoxicosis-induced AF. At the same time, the predictors of TAF thromboembolic complications and TAF maintenance after the euthyroid state is achieved, are not well currently understood.AIM: The purpose of this study was to identify risk factors for TAF adverse outcomes: thromboembolic events and the lack of spontaneous reversion to sinus rhythm after the euthyroidism was achieved.MATERIALS AND METHODS: This is a retrospective study of 70 patients aged 24 to 70 years with a history of overt thyrotoxicosis and TAF. The following parameters were analyzed in all participants: thromboembolic events due to TAF, the presence of the spontaneous reversion to sinus rhythm after the euthyroidism was achieved and potentially associated with TAF adverse outcomes factors: a number of clinical and demographic factors, echocardiography data and characteristics of the TAF course. Regression analysis was performed to study the effect of these potential predictors on the risk of the thromboembolism and TAF maintenance. The cut-off points for the identified risk factors were determined by receiver operating characteristic (ROC) curves creating.RESULTS: The analysis showed that the only independent TAF thromboembolic complications predictor among studied parameters was the large left atrium diameter (>4.3 cm), and the predictors of TAF maintenance after the euthyroid state is achieved included the large left ventricle end-diastolic size (>4.5 cm) and the presence of left atrium dilation.CONCLUSION: In this study, echocardiographic parameters associated with TAF thromboembolic complications and TAF persistence after euthyroid state is achieved, were identified. This may be useful for the TAF adverse outcomes risk assessment tools development in the future.
{"title":"Factors, associated with the outcomes of the thyrotoxic atrial fibrillation","authors":"D. A. Ponomartseva, A. Babenko","doi":"10.14341/ket12729","DOIUrl":"https://doi.org/10.14341/ket12729","url":null,"abstract":"BACKGROUND: Thyrotoxic atrial fibrillation (TAF) is associated with an increase in total and cardiovascular mortality, mainly due to the thromboembolic events. Therefore, thromboembolism prevention is an important TAF treatment component. Thus, it seems interesting to identify TAF thromboembolic complications predictors.TAF is a potentially reversible state. However, the spontaneous reversion to sinus rhythm after the euthyroidism achievement does not occur in all patients. In patients with a history of thyrotoxicosis the hospitalization rate due to cardiovascular pathology, and due to atrial fibrillation (AF), in particular, is higher than in the general population, even after the radical treatment of thyrotoxicosis.The development of prediction tools for mentioned above TAF complications and adverse outcomes, would make it possible to create more detailed and high-quality guidelines for the management of patients with thyrotoxicosis-induced AF. At the same time, the predictors of TAF thromboembolic complications and TAF maintenance after the euthyroid state is achieved, are not well currently understood.AIM: The purpose of this study was to identify risk factors for TAF adverse outcomes: thromboembolic events and the lack of spontaneous reversion to sinus rhythm after the euthyroidism was achieved.MATERIALS AND METHODS: This is a retrospective study of 70 patients aged 24 to 70 years with a history of overt thyrotoxicosis and TAF. The following parameters were analyzed in all participants: thromboembolic events due to TAF, the presence of the spontaneous reversion to sinus rhythm after the euthyroidism was achieved and potentially associated with TAF adverse outcomes factors: a number of clinical and demographic factors, echocardiography data and characteristics of the TAF course. Regression analysis was performed to study the effect of these potential predictors on the risk of the thromboembolism and TAF maintenance. The cut-off points for the identified risk factors were determined by receiver operating characteristic (ROC) curves creating.RESULTS: The analysis showed that the only independent TAF thromboembolic complications predictor among studied parameters was the large left atrium diameter (>4.3 cm), and the predictors of TAF maintenance after the euthyroid state is achieved included the large left ventricle end-diastolic size (>4.5 cm) and the presence of left atrium dilation.CONCLUSION: In this study, echocardiographic parameters associated with TAF thromboembolic complications and TAF persistence after euthyroid state is achieved, were identified. This may be useful for the TAF adverse outcomes risk assessment tools development in the future.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"169 1-4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83434478","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}
A. Trukhin, S. M. Zakharova, M. Y. Dunaev, M. P. Isaeva, A. Garmash, E. Troshina
Advances in the development and improvement of medical technologies and methods of processing medical images make it possible to highlight clinically significant characteristics that were not previously available to classical methods of medical imaging. Ultrasound diagnostics of thyroid gland nodules has a huge potential medical images processing. The article presents an overview of the existing ultrasound classification systems for thyroid nodules malignancy and the prospects for the development of intellectual tools TIRADS (Thyroid Imaging Reporting and Data System) classification system.
{"title":"The role of artificial intelligence in the differential thyroid nodules ultrasound diagnostics","authors":"A. Trukhin, S. M. Zakharova, M. Y. Dunaev, M. P. Isaeva, A. Garmash, E. Troshina","doi":"10.14341/ket12730","DOIUrl":"https://doi.org/10.14341/ket12730","url":null,"abstract":"Advances in the development and improvement of medical technologies and methods of processing medical images make it possible to highlight clinically significant characteristics that were not previously available to classical methods of medical imaging. Ultrasound diagnostics of thyroid gland nodules has a huge potential medical images processing. The article presents an overview of the existing ultrasound classification systems for thyroid nodules malignancy and the prospects for the development of intellectual tools TIRADS (Thyroid Imaging Reporting and Data System) classification system.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83925199","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}
E. Fartushnyi, Yulia P. Sytch, I. Fartushnyi, K. Koshechkin, G. Lebedev
The article describes a method for assessing the malignancy potential of thyroid nodules and their stratification according to the European Thyroid Imaging And Reporting Data System (Eu-TIRADS) scale based on ultrasound diagnostic images using an artificial intelligence system. The method is based on the use of transfer learning technology for multi-parameter models of convolutional neural networks and their subsequent fine tuning. It was shown that even on a small dataset consisting of 1129 thyroid ultrasound images classified by 5 Eu-TIRADS categories, the application of the method provides high training accuracy (Accuracy: 0.8, AUC: 0.92). This makes it possible to introduce and use this technology in clinical practice as an additional tool (‘second opinion’) for an objective assessment of the risk of malignancy in thyroid nodules for the purpose of their further selection for fine needle biopsy.
{"title":"Stratification of thyroid nodules by Eu-TIRADS categories using transfer learning of convolutional neural networks","authors":"E. Fartushnyi, Yulia P. Sytch, I. Fartushnyi, K. Koshechkin, G. Lebedev","doi":"10.14341/ket12724","DOIUrl":"https://doi.org/10.14341/ket12724","url":null,"abstract":"The article describes a method for assessing the malignancy potential of thyroid nodules and their stratification according to the European Thyroid Imaging And Reporting Data System (Eu-TIRADS) scale based on ultrasound diagnostic images using an artificial intelligence system. The method is based on the use of transfer learning technology for multi-parameter models of convolutional neural networks and their subsequent fine tuning. It was shown that even on a small dataset consisting of 1129 thyroid ultrasound images classified by 5 Eu-TIRADS categories, the application of the method provides high training accuracy (Accuracy: 0.8, AUC: 0.92). This makes it possible to introduce and use this technology in clinical practice as an additional tool (‘second opinion’) for an objective assessment of the risk of malignancy in thyroid nodules for the purpose of their further selection for fine needle biopsy.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"44 16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88479297","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. Dzeranova, A. V. Tkachuk, E. Pigarova, M. Perepelova, I. V. Kim, A. Dorovskikh, A. Shutova
{"title":"The combination of papillary thyroid microcarcinoma and diffuse toxic goiter in a patient with acromegaly","authors":"L. Dzeranova, A. V. Tkachuk, E. Pigarova, M. Perepelova, I. V. Kim, A. Dorovskikh, A. Shutova","doi":"10.14341/ket12723","DOIUrl":"https://doi.org/10.14341/ket12723","url":null,"abstract":"","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73008696","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}
Serum thyroglobulin is the main biomarker for postoperative monitoring of papillary thyroid cancer recurrence however, the high prevalence of the disease dictates the need to find a reliable indicator for laboratory diagnosis of the tumor process. The presence of antibodies to thyroglobulin affects the prognosis of the disease and determines the likelihood of relapse; however, it is impossible to influence the level of antibodies using currently available methods. More commonly, trends in anti-thyroglobulin levels at the time of disease detection and after radical treatment are considered, but there is disagreement on the interpretation of the results. Currently, various alternative biomarkers are being proposed and studied, the evaluation and comparison of which will be the subject of this literature review.
{"title":"Alternative biomarkers of thyroid cancer","authors":"U. V. Buyvalenko, A. R. Levshina, E. E. Sakhnova","doi":"10.14341/ket12715","DOIUrl":"https://doi.org/10.14341/ket12715","url":null,"abstract":"Serum thyroglobulin is the main biomarker for postoperative monitoring of papillary thyroid cancer recurrence however, the high prevalence of the disease dictates the need to find a reliable indicator for laboratory diagnosis of the tumor process. The presence of antibodies to thyroglobulin affects the prognosis of the disease and determines the likelihood of relapse; however, it is impossible to influence the level of antibodies using currently available methods. More commonly, trends in anti-thyroglobulin levels at the time of disease detection and after radical treatment are considered, but there is disagreement on the interpretation of the results. Currently, various alternative biomarkers are being proposed and studied, the evaluation and comparison of which will be the subject of this literature review.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"215 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89191163","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: Oxidative stress in Graves’ disease can potentiate the cytotoxicity of neutrophils and support autoimmune inflammation. Elimination of hyperthyroidism with conservative therapy with thiamazole only in some cases leads to remission, which determines the necessity to search an immunological markers for etiotropic therapeutic approaches in treatment of the disease.AIM: To study the chemiluminescent and enzymatic activity of peripheral blood neutrophils in patients with Graves’ disease depending on hyperthyroidism compensation to determine the intracellular targets of immunotropic treatment.MATERIALS AND METHODS: Spontaneous and zymosan-induced chemiluminescence was evaluated using a 36-channel chemiluminescence analyzer «BLM-3607» (MedBioTech, Krasnoyarsk). The reactivity of peripheral blood neutrophils was characterized by: Tmax — the rate of development of the chemiluminescent reaction, Imax — the maximum level of reactive oxygen species (ROS) synthesis and the area under the chemiluminescence curve (S — total synthesis of ROS for 90 minutes of measurement). The activity of NAD(P)-dependent dehydrogenases in neutrophils was determined using the bioluminescent method.RESULTS: The prospective study included 126 women with Graves’ disease, aged 18 to 65 years, 93 (73.81%) with compensated and 33 (26.19%) with uncompensated hyperthyroidism. In uncompensated hyperthyroidism, the indicator S of spontaneous ROS and zymosan-induced lucigenin-dependent chemiluminescence increases significantly, both relative to the control and to the values of compensated hyperthyroidism patients. Antigenic neutrophils stimulation during luminol-dependent chemiluminescence in patients with recurrent hyperthyroidism demonstrated more than tenfold increase in the total synthesis of ROS relative to the control, but no statistically significant differences with compensated hyperthyroidism patients. A high level of NADH-GDG was established in patients with recurrent hyperthyroidism, both relative to the control range and to the patients with euthyroidism.CONCLUSION: Violation of oxygen peripheral blood neutrophils metabolism in patients with euthyroidism mainly affects the production of ROS, which is associated with hyperthyroidism compensation and the immunosuppressive effect of thiamazole. In patients with recurrent hyperthyroidism, there are more changes in the production of high-energy oxidants not only at initial oxidative reactions stage, but also at the level of secondary ROS, indicating the activation of cellular response immunological mechanisms.
{"title":"The chemiluminescent and enzymatic activity of blood neutrophils in patients with Graves' disease depending on hyperthyroidism compensation","authors":"M. Dudina, A. Savchenko, S. Dogadin, I. Gvozdev","doi":"10.14341/ket12717","DOIUrl":"https://doi.org/10.14341/ket12717","url":null,"abstract":"BACKGROUND: Oxidative stress in Graves’ disease can potentiate the cytotoxicity of neutrophils and support autoimmune inflammation. Elimination of hyperthyroidism with conservative therapy with thiamazole only in some cases leads to remission, which determines the necessity to search an immunological markers for etiotropic therapeutic approaches in treatment of the disease.AIM: To study the chemiluminescent and enzymatic activity of peripheral blood neutrophils in patients with Graves’ disease depending on hyperthyroidism compensation to determine the intracellular targets of immunotropic treatment.MATERIALS AND METHODS: Spontaneous and zymosan-induced chemiluminescence was evaluated using a 36-channel chemiluminescence analyzer «BLM-3607» (MedBioTech, Krasnoyarsk). The reactivity of peripheral blood neutrophils was characterized by: Tmax — the rate of development of the chemiluminescent reaction, Imax — the maximum level of reactive oxygen species (ROS) synthesis and the area under the chemiluminescence curve (S — total synthesis of ROS for 90 minutes of measurement). The activity of NAD(P)-dependent dehydrogenases in neutrophils was determined using the bioluminescent method.RESULTS: The prospective study included 126 women with Graves’ disease, aged 18 to 65 years, 93 (73.81%) with compensated and 33 (26.19%) with uncompensated hyperthyroidism. In uncompensated hyperthyroidism, the indicator S of spontaneous ROS and zymosan-induced lucigenin-dependent chemiluminescence increases significantly, both relative to the control and to the values of compensated hyperthyroidism patients. Antigenic neutrophils stimulation during luminol-dependent chemiluminescence in patients with recurrent hyperthyroidism demonstrated more than tenfold increase in the total synthesis of ROS relative to the control, but no statistically significant differences with compensated hyperthyroidism patients. A high level of NADH-GDG was established in patients with recurrent hyperthyroidism, both relative to the control range and to the patients with euthyroidism.CONCLUSION: Violation of oxygen peripheral blood neutrophils metabolism in patients with euthyroidism mainly affects the production of ROS, which is associated with hyperthyroidism compensation and the immunosuppressive effect of thiamazole. In patients with recurrent hyperthyroidism, there are more changes in the production of high-energy oxidants not only at initial oxidative reactions stage, but also at the level of secondary ROS, indicating the activation of cellular response immunological mechanisms.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80758581","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}
AIM: Hashimoto thyroiditis (HT) is the most common cause of goiter and acquired hypothyroidism in children and adolescents living in iodine-sufficient regions. In this study, we aimed to investigate the coexistence of other accompanying autoimmune diseases in patients aged 5–18 years who were diagnosed and followed up at the Pediatric Endocrinology Clinic of our hospital.MATERIAL AND METHODS: A total of 220 patients aged 5–18 years who were diagnosed with HT at the Pediatric Endocrinology Clinic of the University of Health Sciences Ankara City Hospital. Patient’ age at admission, sex, family history, complaints at admission, comorbidities, physical examination and laboratory findings, and clinical follow-up information were retrospectively reviewed.RESULTS: Of the 220 patients, 77.7% were female and 22.2% were male, with a mean age of 13.8±3.3 years. Of the 51.4 had euthyroidism, 40.4% had subclinical hypothyroidism,and 8.2% had overt hypothyroidism, respectively. Anti-thyroid peroxidase antibody was detected in 97% of patients and anti-thyroglobulin antibody (anti-Tg) was detected in 74% of patients. There was a family history of autoimmune disease in 36.4% of the patients. Autoimmune disease were present in 45 patients (20.4%). The most common autoimmune diseases in the patients were type 1 diabetes mellitus (T1DM) (14%), celiac disease (5%), skin diseases (2.7%), and rheumatologic diseases (1.3%). No statistically significant differences were found between the sex, age at diagnosis, current age, family history of autoimmune disease and thyroid function status of patients with HT and T1DM.The mean age of the patients followed up with HT with and without additional autoimmune disease was similar (p=0.644). In both groups, female sex was dominant. However, the number of male patients (35.6%) in the group with additional autoimmune disease was statistically significantly elevated than the group without autoimmune disease (19.9%) (p=0.016). The rate of subclinical hypothyroidism was statistically significantly elevated in the group without additional autoimmune disease (p<0.001). A statistically significant relationship was found between elevated Anti-Tg and additional autoimmune disease (OR=2.32 (95% CI; 1.16–4.56). The prevalence of additional autoimmune disease was increased 2.32 times in patients with elevated anti-Tg levels.There was no statistically significant correlation between the sex of the patients, their thyroid function status and thyroid autoantibodies (p=0.507). However, the prevalence of celiac disease was statistically significantly elevated in female patients (43.5%) than in male patients (6.7%) (p=0.014). In addition, the prevalence of T1DM was found to be statistically significantly elevated in males (93.8%) compared to females (52.2%) (p=0.007). 13.3% of patients with additional autoimmune disease were under the age of 10 and 64.4% were above the age of 10, this was statistically significant (p<0.01). T1DM was the most common
{"title":"Autoimmune diseases accompanying Hashimoto thyroiditis in pediatric patients","authors":"G. Gencan, B. Acar","doi":"10.14341/ket12720","DOIUrl":"https://doi.org/10.14341/ket12720","url":null,"abstract":"AIM: Hashimoto thyroiditis (HT) is the most common cause of goiter and acquired hypothyroidism in children and adolescents living in iodine-sufficient regions. In this study, we aimed to investigate the coexistence of other accompanying autoimmune diseases in patients aged 5–18 years who were diagnosed and followed up at the Pediatric Endocrinology Clinic of our hospital.MATERIAL AND METHODS: A total of 220 patients aged 5–18 years who were diagnosed with HT at the Pediatric Endocrinology Clinic of the University of Health Sciences Ankara City Hospital. Patient’ age at admission, sex, family history, complaints at admission, comorbidities, physical examination and laboratory findings, and clinical follow-up information were retrospectively reviewed.RESULTS: Of the 220 patients, 77.7% were female and 22.2% were male, with a mean age of 13.8±3.3 years. Of the 51.4 had euthyroidism, 40.4% had subclinical hypothyroidism,and 8.2% had overt hypothyroidism, respectively. Anti-thyroid peroxidase antibody was detected in 97% of patients and anti-thyroglobulin antibody (anti-Tg) was detected in 74% of patients. There was a family history of autoimmune disease in 36.4% of the patients. Autoimmune disease were present in 45 patients (20.4%). The most common autoimmune diseases in the patients were type 1 diabetes mellitus (T1DM) (14%), celiac disease (5%), skin diseases (2.7%), and rheumatologic diseases (1.3%). No statistically significant differences were found between the sex, age at diagnosis, current age, family history of autoimmune disease and thyroid function status of patients with HT and T1DM.The mean age of the patients followed up with HT with and without additional autoimmune disease was similar (p=0.644). In both groups, female sex was dominant. However, the number of male patients (35.6%) in the group with additional autoimmune disease was statistically significantly elevated than the group without autoimmune disease (19.9%) (p=0.016). The rate of subclinical hypothyroidism was statistically significantly elevated in the group without additional autoimmune disease (p<0.001). A statistically significant relationship was found between elevated Anti-Tg and additional autoimmune disease (OR=2.32 (95% CI; 1.16–4.56). The prevalence of additional autoimmune disease was increased 2.32 times in patients with elevated anti-Tg levels.There was no statistically significant correlation between the sex of the patients, their thyroid function status and thyroid autoantibodies (p=0.507). However, the prevalence of celiac disease was statistically significantly elevated in female patients (43.5%) than in male patients (6.7%) (p=0.014). In addition, the prevalence of T1DM was found to be statistically significantly elevated in males (93.8%) compared to females (52.2%) (p=0.007). 13.3% of patients with additional autoimmune disease were under the age of 10 and 64.4% were above the age of 10, this was statistically significant (p<0.01). T1DM was the most common ","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86863495","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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