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Wang J, Wan K, Chang X, Mao RF. Association of autoimmune thyroid disease with type 1 diabetes mellitus and its ultrasonic diagnosis and management. World J Diabetes 2024; 15:348-360. [PMID: 38591076 PMCID: PMC10999045 DOI: 10.4239/wjd.v15.i3.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/14/2023] [Accepted: 01/18/2024] [Indexed: 03/15/2024] Open
Abstract
As a common hyperglycemic disease, type 1 diabetes mellitus (T1DM) is a complicated disorder that requires a lifelong insulin supply due to the immune-mediated destruction of pancreatic β cells. Although it is an organ-specific autoimmune disorder, T1DM is often associated with multiple other autoimmune disorders. The most prevalent concomitant autoimmune disorder occurring in T1DM is autoimmune thyroid disease (AITD), which mainly exhibits two extremes of phenotypes: hyperthyroidism [Graves' disease (GD)] and hypo-thyroidism [Hashimoto's thyroiditis, (HT)]. However, the presence of comorbid AITD may negatively affect metabolic management in T1DM patients and thereby may increase the risk for potential diabetes-related complications. Thus, routine screening of thyroid function has been recommended when T1DM is diagnosed. Here, first, we summarize current knowledge regarding the etiology and pathogenesis mechanisms of both diseases. Subsequently, an updated review of the association between T1DM and AITD is offered. Finally, we provide a relatively detailed review focusing on the application of thyroid ultrasonography in diagnosing and managing HT and GD, suggesting its critical role in the timely and accurate diagnosis of AITD in T1DM.
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Affiliation(s)
- Jin Wang
- Department of Ultrasound Medicine, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
| | - Ke Wan
- Faculty of Medicine and Health, The University of Sydney, Camperdown NSW 2050, Australia
| | - Xin Chang
- Department of Ultrasound Medicine, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
| | - Rui-Feng Mao
- School of Life Science, Huaiyin Normal University, Huai'an 223300, Jiangsu Province, China
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Goudot G, Berkane Y, de Clermont-Tonnerre E, Guinier C, Filz von Reiterdank I, van Kampen A, Uygun K, Cetrulo CL, Uygun BE, Dua A, Lellouch AG. Microvascular assessment of fascio-cutaneous flaps by ultrasound: A large animal study. Front Physiol 2022; 13:1063240. [PMID: 36589429 PMCID: PMC9797596 DOI: 10.3389/fphys.2022.1063240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives: Blood perfusion quality of a flap is the main prognostic factor for success. Microvascular evaluation remains mostly inaccessible. We aimed to evaluate the microflow imaging mode, MV-Flow, in assessing flap microvascularization in a pig model of the fascio-cutaneous flap. Methods: On five pigs, bilateral saphenous fascio-cutaneous flaps were procured on the superficial femoral vessels. A conventional ultrasound evaluation in pulsed Doppler and color Doppler was conducted on the ten flaps allowing for the calculation of the saphenous artery flow rate. The MV-Flow mode was then applied: for qualitative analysis, with identification of saphenous artery collaterals; then quantitative, with repeated measurements of the Vascularity Index (VI), percentage of pixels where flow is detected relative to the total ultrasound view area. The measurements were then repeated after increasing arterial flow by clamping the distal femoral artery. Results: The MV-Flow mode allowed a better follow-up of the saphenous artery's collaterals and detected microflows not seen with the color Doppler. The VI was correlated to the saphenous artery flow rate (Spearman rho of 0.64; p = 0.002) and allowed to monitor the flap perfusion variations. Conclusion: Ultrasound imaging of microvascularization by MV-Flow mode and its quantification by VI provides valuable information in evaluating the microvascularization of flaps.
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Affiliation(s)
- Guillaume Goudot
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States,Hôpital Européen Georges-Pompidou, Assistance Publique—Hôpitaux de Paris (APHP), Université Paris-Cité, Paris, France,*Correspondence: Guillaume Goudot,
| | - Yanis Berkane
- Hôpital Européen Georges-Pompidou, Assistance Publique—Hôpitaux de Paris (APHP), Université Paris-Cité, Paris, France,Shriners Children’s Boston, Boston, MA, United States,Centre Hospitalier Universitaire de Rennes, Université de Rennes 1, Rennes, France
| | - Eloi de Clermont-Tonnerre
- Shriners Children’s Boston, Boston, MA, United States,Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory Center for Transplantation Sciences, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States
| | - Claire Guinier
- Shriners Children’s Boston, Boston, MA, United States,Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory Center for Transplantation Sciences, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States
| | - Irina Filz von Reiterdank
- Shriners Children’s Boston, Boston, MA, United States,Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory Center for Transplantation Sciences, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States,Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Antonia van Kampen
- Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States,University Clinic of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany
| | - Korkut Uygun
- Shriners Children’s Boston, Boston, MA, United States,Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Curtis L. Cetrulo
- Shriners Children’s Boston, Boston, MA, United States,Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory Center for Transplantation Sciences, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States
| | - Basak E. Uygun
- Shriners Children’s Boston, Boston, MA, United States,Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Anahita Dua
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Alexandre G. Lellouch
- Shriners Children’s Boston, Boston, MA, United States,Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory Center for Transplantation Sciences, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States,Department of Plastic, Reconstructive and Aesthetic Surgery, Groupe Almaviva Santé, Clinique de l’Alma, IAOPC, Paris, France
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Yang J, Shin K, Lee J, Ha J, Lim DJ, Baek HS. Case 5: A 41-Year-Old Woman With Palpitation. J Korean Med Sci 2022; 37:e340. [PMID: 36472086 PMCID: PMC9723187 DOI: 10.3346/jkms.2022.37.e340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/03/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Jiwon Yang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kabsoo Shin
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeonghoon Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Han-Sang Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Assem Hussein M, Abdel Hamid A, M Abdel Samie R, Hussein E, Sadik Elsawy S. Duplex Hemodynamic Parameters of Both Superior and Inferior Thyroid Arteries in Evaluation of Thyroid Hyperfunction Disorders. Int J Gen Med 2022; 15:7131-7144. [PMID: 36110917 PMCID: PMC9470082 DOI: 10.2147/ijgm.s375016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/29/2022] [Indexed: 12/01/2022] Open
Abstract
Background Thyrotoxicosis may be caused by Graves’ disease or destructive thyroiditis. Differentiation between causes of thyrotoxicosis is crucial as management will differ. 99mTechnetium (Tc)-pertechnetate thyroid scintigraphy is currently the gold standard for this purpose, however, is expensive and uses ionizing radiation. Objective To evaluate the role of color flow Doppler Ultrasound (CDU) of the superior thyroid (STA) and inferior thyroid arteries (ITA) as an inexpensive, non-invasive tool that can aid in differentiating between Graves’ disease and thyroiditis and compare it with thyroid scintigraphy. Methods Sixty-nine patients with newly-diagnosed thyrotoxicosis and 30 controls were enrolled. Thyroid functions, thyroid scintigraphy, and CDU of STA and ITA with measurements of peak systolic velocity (PSV) and end diastolic velocity (EDV), were performed. According to thyroid scintigraphy results, patients were divided into two groups: 42 patients with Graves’ disease and 27 patients with thyroiditis. Results PSV and EDV of both STA and ITA were significantly higher in patients with Graves’ disease than thyroiditis (p-values <0.001). The STA-PSV had an equal sensitivity and specificity of 66.7%; cut-off value 76.57 cm/s, while those of STA-EDV were 73.8%, and 77.8% respectively; cut-off value 28.22 cm/s. ITA-PSV had a sensitivity and specificity of 76.2% and 77.8%, respectively; cut-off value 62.12 cm/s), while those of ITA-EDV were 78.6% and 77.8%, respectively; cut-off value 5.22 cm/s. Conclusion CDU parameters of the STA and ITA could be used as an alternative to thyroid scintigraphy for discriminating between Graves’ disease and thyroiditis.
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Affiliation(s)
- Maha Assem Hussein
- Internal Medicine Department, Faculty of Medicine, Kasr El-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Alaa Abdel Hamid
- Kasr El-Ainy Vascular Laboratory, Cairo University, Cairo, Egypt
| | - Rasha M Abdel Samie
- Internal Medicine Department, Faculty of Medicine, Kasr El-Ainy Hospital, Cairo University, Cairo, Egypt
- Correspondence: Rasha M Abdel Samie, Email
| | - Elshaymaa Hussein
- Nuclear Medicine Department, Faculty of Medicine, Kasr El-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Shereen Sadik Elsawy
- Internal Medicine Department, Faculty of Medicine, Kasr El-Ainy Hospital, Cairo University, Cairo, Egypt
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