• Title/Summary/Keyword: Thyroid dysfunction

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Surgical Treatment in Locally Advanced Thyroid Cancer - Trachea, Larynx, Esophagus Invasion Management (국소 진행된 갑상선암의 수술 - 기관 및 후두, 식도 침범의 치료)

  • Lee, Guk Haeng;Kang, Ju Yong
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.99-108
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    • 2018
  • Most thyroid cancers are well-differentiated cancers and have a very good prognosis. About 10% of thyroid cancer, however, invades the surrounding tissues, causing local recurrence and distant metastasis, and eventually affecting survival rate. In locally advanced thyroid cancers, the invasion of trachea, larynx and esophagus, can be occurred by primary tumor and may also result in lymph nodes metastasis. Surgical resection is still mainstay for the treatment of locally advanced thyroid cancer. The main purpose of the surgical resection is to eliminate the cancer completely, therefore, it can cause many complications such as dysfunction of the larynx, trachea and esophagus. It can have a serious effect on the quality of life, therefore there is still controversy on the extent of the surgery. The authors compare and analyze the opinions which were already discussed in the literatures published so far. These will help to select the surgical method.

Sjögren Syndrome after Radioiodine Therapy in Thyroid Cancer Patients

  • Lee, Hee Jin;Kim, Jae-Jeong;Kim, Young-Gun;Ahn, Hyung-Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.43 no.3
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    • pp.84-86
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    • 2018
  • Salivary and lacrimal gland dysfunction is relatively frequent after radioiodine therapy. In most cases this is a transient side effect, but in some patients it may persist for a long period or appear late. Radioiodine ($^{131}I$) therapy is often administered to patients following total thyroidectomy to treat well-differentiated follicular cell-derived thyroid cancer. In addition to the thyroid, $^{131}I$ accumulates in the salivary glands, giving rise to transient or permanent salivary gland damage. Salivary gland dysfunction following radioiodine therapy can be caused by radiation damage. But, it also may be associated with $Sj{\ddot{o}}gren$ syndrome (SS) developed after radioiodine therapy. It would be recommended that the evaluation for SS including anti-SSA/Ro and anti-SSB/La should be considered before and after radioiodine therapy.

A Case Report of Severe Hypocalcemia and Hypothyroidism after Tyrosine Kinase Inhibitor Treatment (티로신키나아제 억제제 치료 후 발생한 중증 저칼슘혈증 및 갑상선기능저하증 1례)

  • Lee, Eun Kyung;Lee, Young Ki;Hwangbo, Yul;Lee, You Jin
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.88-91
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    • 2018
  • After introducing tyrosine kinase inhibitors (TKIs) as promising treatments for radioactive iodine refractory advanced thyroid cancer patients, we more often meet patients with TKI-related hormone and electrolyte imbalances in clinics. Hypocalcemia associated with TKI is associated with an imbalance in calcium-vitamin D metabolism. TKI-related hypothyroidism is related to the metabolic rate of thyroid hormones. The two side effects usually occur in the early stages of TKI treatment, and if the imbalance is corrected appropriately, the effects are minor, but in severe cases, the TKI should be discontinued. The authors reported a case of severe hypocalcemia and thyroid dysfunction after TKI treatment. A 56-year-old man suffered from symptomatic hypocalcemia during TKI treatment, which was resolved after he stopped taking the TKI medication. Although calcium and vitamin D replacement have increased, hypocalcemia was recurred and TKI treatments have been permanently stopped due to serious weight loss in grade 3. After the interruption, his calcium levels normalized.

Thyroid disturbances in children treated with combined pegylated interferon-alpha and ribavirin for chronic hepatitis C

  • Rashed, Yasser K.;Khalaf, Fatma A.;Kotb, Sobhy E.
    • Clinical and Experimental Pediatrics
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    • v.63 no.2
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    • pp.52-55
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    • 2020
  • Background: Immunomodulatory properties of interferon (IFN) have been documented. It may induce autoimmune diseases such as autoimmune thyroiditis with hypo- or hyperthyroidism. In addition, it may impair thyroid hormone synthesis through affecting iodide organification in thyroid gland. Purpose: The aim of this study was to describe thyroid function tests disturbances in children with chronic hepatitis C (CHC) receiving pegylated interferon-alpha (PEG IFN-α) plus ribavirin. Methods: Fifty children with CHC virus infection who received combined pegylated interferon-alpha with ribavirin were selected. Other 50 apparently healthy children of matched age and sex (considered as control group) were selected. All children (100) were subject to liver function tests, virological studies, and follow-up of thyroid function test during and after the treatment course. Results: Our study showed that 28% of children received combined PEG IFN-α plus ribavirin showed subclinical hypothyroidism. After 24 weeks treatment with combined therapy of IFN plus ribavirin, the mean level of thyroid stimulating hormone (TSH) was 3.23±88 mU/mL, while TSH was 1.16±0.77 mU/mL before starting treatment. On the other hand, mean TSH was 1.09±0.92 mU/mL in normal control group. Conclusion: This study revealed an association between subclinical thyroid dysfunction and treatment with IFN-alpha and ribavirin in children. Further studies on larger number of patients and longer follow-up duration are recommended for further confirmation.

Clinical implications of anti-thyroglobulin antibody measurement before surgery in thyroid cancer

  • Jo, Kwanhoon;Lim, Dong-Jun
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1050-1057
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    • 2018
  • Thyroglobulin antibody (TgAb) is a class G immunoglobulin and a conventional marker for thyroid autoimmunity. From a clinical perspective, TgAb is less useful than thyroid peroxidase antibodies for predicting thyroid dysfunction. However, TgAb is found more frequently in differentiated thyroid cancer (DTC) and can interfere with thyroglobulin (Tg) measurements, which are used to monitor the recurrence or persistence of DTC. Recent studies suggested a small but consistent role for preoperative TgAb in predicting DTC in thyroid nodules, and in reflecting adverse tumor characteristics or prognosis, including lymph node metastasis, but this is still controversial. Postoperative TgAb can serve as a biomarker for remnant thyroid tissue, so follow-up measures of TgAb are useful for predicting cancer recurrence in DTC patients. Since high serum TgAb levels may also affect the fine needle aspiration washout Tg levels from suspicious lymph nodes of DTC patients, it is important to use caution when interpreting the washout Tg levels in patients who are positive for TgAb.

Short-term follow up of thyroid function after pediatric hematopoietic stem cell transplantation (소아 조혈모세포이식 후 단기간 갑상선 기능의 변화)

  • Lee, Seon-Ju;Lee, Jae-Wook;Lee, Dae-Hyoung;Kwon, Young-Joo;Park, Young-Shil;Hwang, Hui Sung;Kim, Sun Young;Park, Ji Kyoung;Jang, Pil-Sang;Jung, Min-Ho;Chung, Nak-Gyun;Jeong, Dae-Chul;Cho, Bin;Kim, Hack-Ki;Lee, Byung-Churl
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1211-1215
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    • 2006
  • Purpose : In this study, we analyzed the short term changes of thyroid function, incidence and risk factors of thyroid dysfunction soon after allogeneic hematopoietic stem cell transplantation (HSCT) in children. Methods : We enrolled 80 pediatric patients following allogeneic HSCT, at the Catholic HSCT center between January, 2004 and February, 2006. Serum TSH (thyroid stimulating hormone), total serum thyroxine and total serum triiodothyronine levels were systematically measured in 80 patients before the HSCT, and at 1 month, 6 months and 12 months after HSCT. Results : Thyroid function statistically decreased at 1 month after HSCT(P<0.001). Thyroid dysfunction at 1 month was observed in 43 (54 percent) of 80 patients, 31 (39 percent) of whom presented with euthyroid sick syndrome (ETS). Thyroid dysfunction was normalized within 1 year after HSCT. In univariate analysis, malignant disease and the presence of acute graft-versus-host disease (grade ${\geq}II$) were risk factors for ETS (P=0.04, 0.01 respectively). In multivariate analysis, we could not detect an independent risk factor for ETS (P=0.19, 0.06 respectively). Conclusion : The present study suggests that the incidence of thyroid dysfunction is high after allogeneic HSCT. Therefore, regular monitoring of thyroid hormone levels after HSCT is required.

Subclinical Hypothyroidism;Controversial Subjects and Therapeutic Regimen (준임상적 갑상선기능저하증;논란이 되는 주제들)

  • Park, Ji-Hun;Kim, Ho-Jun;Lee, Myeong-Jong
    • Journal of Korean Medicine for Obesity Research
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    • v.6 no.2
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    • pp.29-41
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    • 2006
  • Subclinical hypothyroidism is defined as a normal serum free thyroxine level combined with an elevated thyroid stimulating hormone level. The causes of subclinical hypothyroidism are the same as those of overt hypothyroidism. There is good evidence that subclinical hypothyroidism is associated with progression to overt disease. The management of subclinical hypothyroidism is remains controversial. Patients with a serum thyroid stimulating hormone level greater than 10 mU/L have a higher incidence of elevated serum low-density lipoprotein cholesterol concentrations; however, evidence is lacking for other associations. There is insufficient evidence that hormone treatment of subclinical hypothyroidism is beneficial. The use of thyroid stimulating hormone level lone as a diagnostic and assessment tool for hypothyroidism is inadequate because this test cannot identify numerous conditions this sentence is unclear in its meaning. Using an expanded list of clinical signs and symptoms associated with dysfunction of the Hypothalamus-Pituitary-Thyroid axis, it is possible to hypothesize that subclinical hypothyroidism may be more common in a population of patients with early signs of age-related diseases than most practitioners realize. To improve thyroid function in subclinical hypothyroidism patients, practitioners should become familiar with foods and nutrients that can hinder or support thyroid function.

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Subclinical Hypothyroidism during Quetiapine Treatment : A Case Report (Quetiapine 치료 중 발생한 무증상 갑상선 기능저하증 1례)

  • Na, Kyeong-Sae;Kim, Yong-Ku
    • Korean Journal of Biological Psychiatry
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    • v.14 no.1
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    • pp.68-71
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    • 2007
  • Quetiapine is an atypical antipsychotic drug with a benign side effect profile. However, recent studies have reported that thyroid dysfunction is associated with quetiapine treatment. The authors report a patient with DSM-IV bipolar I disorder who developed subclinical hypothyroidism during quetiapine treatment. The patient showed no significant clinical symptoms, but only abnormal thyroid function test findings including antithyroglobulin antibody. The abnormal thyroid function test findings were normalized after discontinuation of quetiapine. The subclinical hypothyroidism developed during quetiapine treatment may be associated with autoimmune process.

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