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Chmielewski M, VanNostrand J, Hollander M. Fever and Pleuritic Chest Pain in a 16-year-old Girl with Ulcerative Colitis. Pediatr Rev 2022; 43:586-589. [PMID: 36180542 DOI: 10.1542/pir.2021-004937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Tomov D, Levterova B, Mihaylova V, Troev D, Miteva M, Orbetzova M. SERUM ZONULIN LEVELS IN HYPOTHYROID AND EUTHYROID PATIENTS WITH HASHIMOTO'S THYROIDITIS - A PILOT STUDY. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2021; 17:449-454. [PMID: 35747862 PMCID: PMC9206160 DOI: 10.4183/aeb.2021.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CONTEXT Human zonulin is a protein that regulates the intercellular tight junctions in various tissues and organs of the human body. Hashimoto's thyroiditis (HT) is one of the most common endocrine autoimmune disorder, but the role of increased intestinal permeability in its pathogenesis is still being studied. OBJECTIVE AND DESIGN This pilot cross-sectional study investigates serum zonulin concentration in adults with Hashimoto's thyroiditis and assesses the relationship between zonulin levels, clinical hormonal and immunological characteristics. SUBJECTS AND METHODS A group of 62 adults with HT participated in this study and were divided into three groups: hypothyroid (n=33) euthyroid (n=25) and hyperthyroid (n=4). Serum zonulin was determined using an ELISA method. RESULTS Age, gender and BMI were different between groups (hypothyroid and euthyroid ones). Serum zonulin values ranged from 2.6 to 198.0 ng/mL in participants. A direct positive correlation was found between serum zonulin levels and weight and BMI (r = 0.351, p = 0.008 and r = 0.236, p = 0.05, respectively). CONCLUSIONS There is no correlation between zonulin and thyroid hormones or autoantibodies in Hashimoto thyroiditis patients. There is a difference in zonulin levels between the studied groups, but they are not statistically significant.
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Affiliation(s)
- D.G. Tomov
- Faculty of Pharmacy, Department of Bioorganic Chemistry, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - B.A. Levterova
- Faculty of Public Health, Department of Health Management and Health Economics, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - V.N. Mihaylova
- Faculty of Medicine, Department of Medical Biology, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - D.M. Troev
- “St. George” University Hospital, Clinic of Endocrinology and Metabolic Diseases, Department of Endocrinology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - M.Z. Miteva
- “St. George” University Hospital, Clinic of Endocrinology and Metabolic Diseases, Department of Endocrinology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - M.M. Orbetzova
- “St. George” University Hospital, Clinic of Endocrinology and Metabolic Diseases, Department of Endocrinology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
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Tran T, Maringe C, Benitez Majano S, Rachet B, Boutron‐Ruault M, Journy N. Thyroid dysfunction and breast cancer risk among women in the UK Biobank cohort. Cancer Med 2021; 10:4604-4614. [PMID: 34041857 PMCID: PMC8267139 DOI: 10.1002/cam4.3978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/05/2021] [Accepted: 04/29/2021] [Indexed: 12/24/2022] Open
Abstract
This study aimed to evaluate the association between thyroid dysfunction and breast cancer risk. We included 239,436 females of the UK Biobank cohort. Information on thyroid dysfunction, personal and family medical history, medications, reproductive factors, lifestyle, and socioeconomic characteristics was retrieved from baseline self-reported data and hospital inpatient databases. Breast cancer diagnoses were identified through population-based registries. We computed Cox models to estimate hazard ratios (HRs) of breast cancer incidence for thyroid dysfunction diagnosis and treatments, and examined potential confounding and effect modification by comorbidities and breast cancer risk factors. In our study, 3,227 (1.3%) and 20,762 (8.7%) women had hyper- and hypothyroidism prior to the baseline. During a median follow-up of 7.1 years, 5,326 (2.2%) women developed breast cancer. Compared to no thyroid dysfunction, there was no association between hypothyroidism and breast cancer risk overall (HR = 0.93, 95% confidence interval (CI): 0.84-1.02, 442 cases), but we found a decreased risk more than 10 years after hypothyroidism diagnosis (HR=0.85, 95%CI 0.74-0.97, 226 cases). There was no association with hyperthyroidism overall (HR=1.08, 95%CI 0.86-1.35, 79 cases) but breast cancer risk was elevated among women with treated hyperthyroidism (HR=1.38, 95%CI: 1.03-1.86, 44 cases) or aged 60 years or more at hyperthyroidism diagnosis (HR=1.74, 95%CI: 1.01-3.00, 113 cases), and 5-10 years after hyperthyroidism diagnosis (HR=1.58, 95%CI: 1.06-2.33, 25 cases). In conclusion, breast cancer risk was reduced long after hypothyroidism diagnosis, but increased among women with treated hyperthyroidism. Future studies are needed to determine whether the higher breast cancer risk observed among treated hyperthyroidism could be explained by hyperthyroidism severity, type of treatment or aetiology.
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Affiliation(s)
- Thi‐Van‐Trinh Tran
- Epidemiology of radiation GroupCenter for Research in Epidemiology and Population HealthINSERM U1018Paris Sud‐Paris Saclay UniversityVillejuifFrance
| | - Camille Maringe
- Inequalities in Cancer Outcomes NetworkDepartment of Non‐Communicable Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Sara Benitez Majano
- Inequalities in Cancer Outcomes NetworkDepartment of Non‐Communicable Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Bernard Rachet
- Inequalities in Cancer Outcomes NetworkDepartment of Non‐Communicable Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Marie‐Christine Boutron‐Ruault
- Health across Generations TeamCenter for Research in Epidemiology and Population HealthINSERM U1018Paris Sud‐Paris Saclay UniversityVillejuifFrance
| | - Neige Journy
- Epidemiology of radiation GroupCenter for Research in Epidemiology and Population HealthINSERM U1018Paris Sud‐Paris Saclay UniversityVillejuifFrance
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Asamoah E. Levothyroxine sodium oral solution to control thyroid function in a patient with hypothyroidism and celiac disease. Clin Case Rep 2021; 9:e04170. [PMID: 34094556 PMCID: PMC8163109 DOI: 10.1002/ccr3.4170] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/29/2021] [Accepted: 02/11/2021] [Indexed: 11/24/2022] Open
Abstract
Implementing a gluten-free diet and switching to the levothyroxine oral solution significantly improved malabsorptive and hypothyroid symptoms in a patient with hypothyroidism, Addison's disease, and celiac disease without the need to increase levothyroxine dosage.
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Affiliation(s)
- Ernest Asamoah
- Diabetes & Endocrinology CareCommunity Physicians NetworkIndianapolisINUSA
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CLINICAL AND ULTRASOUND PARALLELS IN DIAGNOSIS OF GASTROESOPHAGEAL REFLUX DISEASE AND AUTOIMMUNE THYROIDITIS. EUREKA: HEALTH SCIENCES 2020. [DOI: 10.21303/2504-5679.2020.001520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of the work: to study the relationship of ultrasound parameters of the thyroid gland with the clinical course, the level of thyroid hormones and indicators of the motor-secretory function of the gastrointestinal tract in patients with gastroesophageal reflux disease (GERD) and autoimmune thyroiditis (AIT). Materials and methods. The study involved three groups of patients. The first group consisted of 22 patients with isolated GERD. The second group included 20 patients suffering from GERD in combination with AIT in the hypothyroid stage. And the third group included 20 patients suffering from isolated AIT in the hypothyroid stage. The control group consisted of 15 apparently healthy individuals of the same age and sex. All patients underwent a comprehensive examination, which included the necessary set of clinical, laboratory and instrumental research methods in accordance with the local treatment protocols such as collection of complaints and anamnesis, patient examination, physical examination, clinical and biochemical analyzes, ECG, EGD, intragastric pH-metry. The patients underwent ultrasound examination of the motor-evacuation function of the esophagus and stomach with water load and an ultrasound examination of thyroid gland. The functional activity of thyroid gland was assessed by determining the level of thyroid hormones (TSH, T4 free, T3) by ELISA and the presence of antibodies to. Results. The study involved three groups of patients: patients with isolated gastroesophageal reflux disease, patients with a combined course of GERD and AIT in the hypothyroid stage and patients with isolated AIT in the hypothyroid stage. The most pronounced complaints, a higher level of thyroid-stimulating hormone and the most pronounced ultrasound changes are noted in patients with combined pathology. Ultrasound examination of the lower third of esophagus and stomach in patients of all three groups showed the presence of regurgitation, expansion of the lumen of the lower third of esophagus and an increase in the diameter of esophageal opening of diaphragm in varying degrees, in contrast to patients in the control group. Thus according to the results of thyroid sonography and ultrasound examination of the motor function of the lower third of esophagus and stomach, the most pronounced changes were found in the second group of patients who had a combined course of GERD and AIT. Conclusions. 1. A clear correlation was established between the clinical course, an increase in the level of thyroid hormones and ultrasound picture of thyroid gland and indicators of the motor-secretory function of the gastrointestinal tract in patients with GERD and AIT; It was shown that disorders in the activity of thyroid hormones affect the formation of motor-secretory disorders in patients with GERD with concomitant AIT which mutually aggravates the course of this comorbid pathology; Ultrasound diagnostics can be used as an evaluative method in this category of patients.
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Khizroeva J, Nalli C, Bitsadze V, Lojacono A, Zatti S, Andreoli L, Tincani A, Shoenfeld Y, Makatsariya A. Infertility in women with systemic autoimmune diseases. Best Pract Res Clin Endocrinol Metab 2019; 33:101369. [PMID: 31837981 DOI: 10.1016/j.beem.2019.101369] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Infertility consists by definition in" failure to achieve a clinical pregnancy after 12 months or more of regular unprotected intercourse" while the term subfertility means a delay to achieve pregnancy. Several factors can contribute to infertility or subfertility in patients with systemic autoimmune diseases. The association of systemic autoimmune conditions with endometriosis, celiac disease and thyroid autoimmunity that are well known causes of infertility and/or subfertility need to be taken in consideration when difficulties in the onset of pregnancy is reported. The majority of the used antirheumatic drugs do not interfere with fertility. However, the use of cyclophosphamide, limited to severe disease, can provoke premature ovarian failure; to preserve fertility a preventive treatment is available. Nonsteroidal anti-inflammatory drugs can cause temporary infertility and corticosteroids are associated to a prolonged time to pregnancy in some rheumatic diseases. Data on the association of antiphospholipid antibodies (aPL) with infertility are still debated but in general an increased rate of aPL is described patients undergoing medically assisted reproductive techniques. In systemic lupus erythematosus aPL and other autoantibodies (i.e. anti-oocytes) can contribute to the infertility of some patients. Subfertility, rather than infertility, is observed in patients with rheumatoid arthritis; the particular physical conditions of these women can also account for this. Physicians should not forget the patients' age, that is mandatory in order to preserve their chance to have children.
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Affiliation(s)
- Jamilya Khizroeva
- Department of Obstetrics and Gynecology of I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Cecilia Nalli
- Rheumatology and Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili Brescia, Italy
| | - Victoria Bitsadze
- Department of Obstetrics and Gynecology of I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Andrea Lojacono
- Obstetric and Gynecology Unit, Department of Clinical and Experimental Science, University of Brescia, ASST Spedali Civili Brescia, Italy
| | - Sonia Zatti
- Obstetric and Gynecology Unit, Department of Clinical and Experimental Science, University of Brescia, ASST Spedali Civili Brescia, Italy
| | - Laura Andreoli
- Rheumatology and Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili Brescia, Italy
| | - Angela Tincani
- Rheumatology and Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili Brescia, Italy; I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Russia.
| | - Yehuda Shoenfeld
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Russia; Department of Medicine 'B', The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Alexander Makatsariya
- Department of Obstetrics and Gynecology of I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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Aversa T, Corica D, Zirilli G, Pajno GB, Salzano G, De Luca F, Wasniewska M. Phenotypic Expression of Autoimmunity in Children With Autoimmune Thyroid Disorders. Front Endocrinol (Lausanne) 2019; 10:476. [PMID: 31354636 PMCID: PMC6640617 DOI: 10.3389/fendo.2019.00476] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 07/01/2019] [Indexed: 12/27/2022] Open
Abstract
Autoimmune thyroid diseases (AITDs), including Hashimoto's thyroiditis (HT) and Graves' disease (GD), tend to aggregate with other non-thyroidal autoimmune diseases (NTADs). Aim of this Mini-review is to report the most recent insights concerning the clustering of NTADs in pediatric patients with either HT or GD, the pathophysiology of AITDs and the metamorphic thyroid autoimmunity. A systematic literature research of the last 15 years, according to EQUATOR statement, was carried out through MEDLINE via PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) Embase, CINAHL, Cochrane Library, based on the following keywords: (autoimmune thyroid disease OR Hashimoto thyroiditis OR Grave's disease) AND (autoimmune comorbidities OR extra-thyroidal autoimmune disorders) AND (children OR adolescents OR pediatrics) AND (celiac disease OR type 1 diabetes mellitus OR arthropathies OR cutaneous diseases) AND (Turner syndrome OR Down syndrome). One-hundred and twenty-eight manuscripts were extrapolated but only seventeen were eligible. On the basis of the available reports it may be inferred that clustering of NTADs can be significantly modified by both patients' age at AITDs presentation and association with Down's syndrome (DS). Particularly, the association of AITDs with celiac disease and type 1 diabetes was most commonly reported in children than in adults. A sequential shifting from HT to GD has been described in children with AITDs, and it seems to be more frequent in children with DS than in those without DS. Coexistence of autoimmune diseases might be the result of a complex interaction among genetics, environment and epigenetic modifications that are able to affect gene expression, immune system response and, finally, the pathogenesis of autoimmune diseases.
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Affiliation(s)
- Christian A Koch
- Medicover GmbH, Berlin/Hannover, Germany.
- Carl von Ossietzky University of Oldenburg, Oldenburg, Germany.
- Technical University of Dresden, Dresden, Germany.
- University of Louisville, Louisville, KY, USA.
- The University of Tennessee Health Science Center, Memphis, TN, USA.
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