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Endocr Metab Immune Disord Drug Targets 2022 Jun 16. Epub 2022 Jun 16.

Department of Endocrinology and Metabolism, Faculty of Medicine, Başkent University, Ankara, Turkey.

Backround: A considerable number of COVID-19 vaccines became available following the outbreak. Yet, various inflammatory and autoimmune complications have been reported following vaccination. We aimed to report the case of a type 1 diabetic patient converting from Hashimoto's thyroiditis to Graves' disease after the fourth dose of COVID-19 vaccine, thought to trigger an autoimmune/inflammatory syndrome induced by adjuvants (ASIA syndrome). Read More

Cureus 2022 May 4;14(5):e24742. Epub 2022 May 4.

Endocrinology, Brookdale University Hospital Medical Center, Brooklyn, USA.

Jod-Basedow phenomenon (JBP) is a rare thyrotoxic condition due to increased exogenous iodine exposure, also known as iodine-induced hyperthyroidism (IIH). Historically JBP was typically seen in iodine-deficient patients when exposed to increased amounts of iodine. However, in today's era, the most common cause of JBP is exposure to iodinated contrast media commonly used in various radiological examinations and interventional procedures, resulting in massive iodine exposure. Read More

Endocrinol Metab (Seoul) 2022 04 13;37(2):323-332. Epub 2022 Apr 13.

Division of Endocrinology and Metabolism, Department of Internal Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Background: Microvascular ultrasonography (MVUS) is a third-generation Doppler technique that was developed to increase sensitivity compared to conventional Doppler. The purpose of this study was to compare MVUS with conventional color Doppler (CD) and power Doppler (PD) imaging to distinguish Graves' disease (GD) from destructive thyroiditis (DT).

Methods: This prospective study included 101 subjects (46 GDs, 47 DTs, and eight normal controls) from October 2020 to November 2021. Read More

J Pak Med Assoc 2022 Mar;72(3):560-563

Department of Radiology, MINAR Cancer Hospital, Multan, Pakistan.

Pyrexia of unknown origin (PUO) is a challenging entity in medical practice from a diagnostic point of view. Sub-Acute Thyroiditis (SAT), that is an inflammatory condition of thyroid, self-limiting and easily treatable, is a very rare cause for PUO with a few published cases and unfortunately not considered in routine for the differential diagnosis (DD) of PUO. Usually, it presents with mild thyrotoxicosis signs and symptoms, painful goiter, and rarely with cervical Lymph adenopathy. Read More

Intern Med 2022 Feb 26. Epub 2022 Feb 26.

Department of Diabetes, Endocrinology and Metabolism/Department of Rheumatology and Clinical Immunology, Gifu University Graduate School of Medicine, Gifu University Graduate School of Medicine, Japan.

We treated a 22-year-old woman suffering from Graves' disease and thymic hyperplasia. She was referred to our institution for a close investigation of thyrotoxicosis and thymic mass. Thyroid tests and magnetic resonance imaging resulted in a diagnosis of Graves' disease and thymic hyperplasia. Read More

Case Rep Endocrinol 2022 12;2022:8804856. Epub 2022 Feb 12.

Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.

Background: Postmenopausal hirsutism could be due to a myriad of causes, including ovarian and adrenal tumours, ovarian hyperthecosis, exogenous androgens, and Cushing's syndrome. We report a patient who was found to have a rare cause of postmenopausal hirsutism. . Read More

Nucl Med Mol Imaging 2022 Feb 7;56(1):42-51. Epub 2022 Jan 7.

Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505 Republic of Korea.

Background: Technetium-99 m (Tc) pertechnetate thyroid uptake rate can be measured with a gamma probe or gamma camera. This study was performed to compare their diagnostic accuracy for evaluating patients with thyrotoxicosis.

Methods: We retrospectively reviewed Tc pertechnetate thyroid uptake rate records of patients by both gamma probe and camera methods at a tertiary center in Korea from November 2019 to June 2020. Read More

Q J Nucl Med Mol Imaging 2022 Jun 15;66(2):86-92. Epub 2022 Feb 15.

Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia.

Nuclear medicine methods were introduced in the 1940s for thyroid disease diagnosis and therapy. They is still a crucial part of thyroid nodules work-up. Thyroid imaging with iodine or iodine-analog isotopes is widely employed in patients with thyrotoxicosis and remains the only examination able to prove the presence of autonomously functioning thyroid tissue, which excludes malignancy with a high probability. Read More

Presse Med 2022 Feb 4;51(2):104116. Epub 2022 Feb 4.

Department of Nuclear Medicine, Cochin Hospital, Assistance Publique Hôpitaux de Paris, DMU Imagina, University of Paris France.

Radioiodine uptake (RAIU) test with iodine-123 (Na[I]I) or iodine-131 (Na[I]I) enables accurate evaluation and quantification of iodine uptake and kinetics within thyroid cells. Thyroid Scintigraphy (TS) employing Na[I]I or Tc-pertechnetate (Na[Tc]TcO) provides information regarding the function and topographical distribution of thyroid cells activity, including detection and localization of ectopic thyroid tissue. Destructive thyrotoxicosis is characterized by low RAIU with scintigraphically reduced radiotracer activity in the thyroid tissue, while productive thyrotoxicosis (i. Read More

Endocr Pract 2022 May 25;28(5):502-508. Epub 2022 Jan 25.

Thyroid Section, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Objective: Graves' disease (GD) is caused by the stimulation of thyrotropin receptors by autoantibodies. We compared the diagnostic accuracy of the thyroid-stimulating immunoglobulin (TSI) bioassay and thyrotropin-binding inhibitory immunoglobulin (TBII) assay in differentiating GD from other causes of thyrotoxicosis.

Methods: We retrospectively evaluated 493 patients with thyrotoxicosis who were tested with the third-generation TSI and TBII assays simultaneously. Read More

Front Endocrinol (Lausanne) 2021 6;12:780397. Epub 2022 Jan 6.

Endocrinology Division, Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil.

Background: Graves' disease (GD) is the most common cause of hyperthyroidism and can cause cardiac changes, such as pulmonary hypertension.

Methods: This is a prospective study in which we obtained demographic, clinical, laboratory data and characteristics of the GD, in addition to investigating cardiorespiratory function, focusing on the detection of pulmonary hypertension. Patients were separated into two groups: thyrotoxicosis and euthyroidism. Read More

J Endocrinol Invest 2022 May 11;45(5):1071-1077. Epub 2022 Jan 11.

Department of Endocrinology and Nutrition, Hospital General Universitario de Castellón, Avinguda de Benicàssim, 128, 12004, Castelló de la Plana, Castelló, Spain.

Aim: To describe a case series of thyrotoxicosis likely triggered by SARS-CoV-2 vaccination and to warn physicians about this potential correlation. To report clinical, laboratory and imaging findings and provide further information that goes in line with the underlying mechanisms.

Methods: Single-center case series based on all the information collected in the hospital medical records, as well as the temporal sequence between the onset of symptoms and COVID-19 vaccination. Read More

Khirurgiia (Mosk) 2021 (12):20-26

Harefield Hospital of the Royal Brompton and Harefield Hospital NHS Foundation Trust, Harefield, UK.

Objective: To evaluate and optimize surgical approaches to the management of retrosternal goiter.

Material And Methods: A cohort retrospective single-center study included 56 patients aged 68.3±9. Read More

Medicine (Baltimore) 2021 Dec;100(51):e28432

Division of Cardiology, Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.

Rationale: Graves' disease is the most common cause of thyrotoxicosis. Cardiovascular signs and symptoms are frequent in patients with thyrotoxicosis and right heart failure with severe tricuspid regurgitation (TR) is a rare manifestation of hyperthyroidism.

Patient Concerns: A 41-year-old woman with a history of Graves' disease presented to the emergency department with worsening generalized edema and dyspnea for a month. Read More

Arch Endocrinol Metab 2021 Nov 11;65(6):846-851. Epub 2021 Nov 11.

Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Acute suppurative thyroiditis (AST) is a rare but potentially life-threatening thyroid disease with a high mortality if left untreated. Thus, differentiation from other thyroid disorders is highly important in clinical practice. A 22-year-old male patient was admitted to a tertiary care hospital with cervical pain, palpitations, thyrotoxicosis, and an inhomogeneously enlarged right thyroid lobe. Read More

BMJ Case Rep 2021 Nov 9;14(11). Epub 2021 Nov 9.

Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK

Subacute thyroiditis following vaccination is an uncommon presentation of thyrotoxicosis. As the world undertakes its largest immunisation campaign to date in an attempt to protect the population from COVID-19 infections, an increasing number of rare post vaccine side effects are being observed. We report a case of a middle-aged woman who presented with painful thyroid swelling following the second dose of the COVID-19 mRNA vaccine BNT162b2 (Pfizer-BioNTech) with clinical, biochemical and imaging features consistent with destructive thyrotoxicosis. Read More

BMJ Case Rep 2021 Nov 1;14(11). Epub 2021 Nov 1.

Division of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

BMC Endocr Disord 2021 Oct 24;21(1):213. Epub 2021 Oct 24.

Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.

Background: Thyroid crisis is a life-threatening condition in thyrotoxic patients. Although differentiated thyroid cancer is one of the causes of hyperthyroidism, reports on thyroid crisis caused by thyroid cancer are quite limited. Here, we describe a case of thyroid crisis caused by metastatic thyroid cancer. Read More

J Med Case Rep 2021 Oct 23;15(1):519. Epub 2021 Oct 23.

The Aga Khan University Hospital, Karachi, Pakistan.

Background: Thyroid storm is an endocrine emergency and life-threatening condition discovered in 1926. There is no specific laboratory parameter that can differentiate or distinguish between thyroid storm and primary hyperthyroidism. Diagnosis is made on a clinical scoring system, including the Burch-Wartofsky point scale and Japanese Thyroid Association scoring system. Read More

Eur Heart J Case Rep 2021 Oct 12;5(10):ytab392. Epub 2021 Oct 12.

Divisione di Cardiologia, Fondazione IRCCS San Matteo Hospital, Viale Golgi 19, 27100 Pavia, Italy.

Background: Acute pericarditis as a sign of mediastinal mass is rare and aetiological diagnosis can be challenging without adequate imaging.

Case Summary: An 18-year-old woman came to our attention describing acute sharp chest pain radiated to the left arm, exacerbated with supine positioning and attenuated while sitting or leaning forward. The electrocardiogram showed diffuse ST elevation and PR depression, with sinus tachycardia. Read More

Eur Heart J Cardiovasc Imaging 2022 02;23(3):e129

Department of Cardiology, King's College Hospital, London, UK.

J Am Heart Assoc 2021 11 20;10(21):e021746. Epub 2021 Oct 20.

Department of Medicine UMass Medical School Worcester MA.

Background Atrial fibrillation (AF) commonly occurs in the setting of acute conditions. We aimed to identify the acute conditions associated with secondary AF (AF precipitants) including pneumonia/sepsis, pneumothorax, respiratory failure, myocarditis, pericarditis, alcohol intoxication, thyrotoxicosis, cardiothoracic surgery, other surgery in patients with newly diagnosed AF and determine their association with subsequent oral anticoagulant use. Methods and Results We assembled a cohort of patients in the UMass Memorial Healthcare system with a new diagnosis of AF with and without AF precipitants. Read More

Mol Genet Metab Rep 2021 Dec 4;29:100806. Epub 2021 Oct 4.

Division of Metabolic and Genetics, Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.

Propionic acidemia (PA) is a rare autosomal recessive inborn error of metabolism (IEM) with relatively higher prevalence in the United Arab Emirates (UAE). Absence of propionyl-CoA carboxylase (PCC) enzyme classically leads to acute decompensation in the early neonatal period. We report a novel homozygous frameshift variant Glu720Valfs*14 (NM_000282. Read More

J Med Case Rep 2021 Sep 25;15(1):473. Epub 2021 Sep 25.

Department of Endocrinology, Diabetology and Metabolism, Toyama Prefectural Rehabilitaion Hospital and Support Center for Children with Disabilities, 36 Shimo-Iino, Toyama-shi, Toyama, 931-8517, Japan.

Background: Resistance to thyroid hormone is a rare autosomal dominant disorder characterized by reduced responsiveness to thyroid hormone and can cause syndrome of inappropriate secretion of thyroid stimulating hormone. Although Graves' disease is a common autoimmune thyroid disorder, the coexistence of these two diseases is extremely rare and makes the diagnosis and treatment complicated, leading to the delayed diagnosis of resistance to thyroid hormone. We describe the case of a Japanese man with resistance to thyroid hormone coexisting with Graves' disease, in which the correct diagnosis of resistance to thyroid hormone was delayed by masking of the signs of syndrome of inappropriate secretion of thyroid stimulating hormone, with final diagnosis 30 years after the initial treatment for Graves' disease. Read More

Indian J Radiol Imaging 2021 Apr 27;31(2):311-317. Epub 2021 Jul 27.

Department of Radiodiagnosis, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India.

Differentiating Graves' disease from thyroiditis can be at times clinically challenging. The gold standard test (thyroid nuclear imaging scan) is expensive, not routinely available, and has radiation exposure. Color Doppler ultrasonography of thyroid represents a suitable alternate which can be used for differentiating these conditions by studying thyroid blood flow parameters. Read More

Cardiovasc Toxicol 2021 12 24;21(12):1012-1018. Epub 2021 Aug 24.

Drug Health Services, Royal Prince Alfred Hospital, Level 6, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.

This case report describes a 31-year-old man with 10 years of cocaine and cannabis dependence who developed reverse Takotsubo cardiomyopathy (rTC), a rare variant of Takotsubo cardiomyopathy. He presented to the Emergency Department (ED) with severe left temporal headache and vomiting which began whilst smoking cannabis and several hours after smoking methamphetamine and using cocaine via insufflation. Computed tomography and angiography of the brain was normal, and the headache resolved with analgesia. Read More

Gynecol Endocrinol 2021 Dec 13;37(12):1143-1150. Epub 2021 Aug 13.

Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.

Background: Hyperthyroidism is a state characterized by elevated serum level of thyroid hormones: thyroxine (T4) and triiodothyronine (T3). This is mainly related to the condition and functioning of the thyroid gland. In 60-80% of cases elevation of these hormones are caused by Grave's disease. Read More

Endocrine 2021 11 11;74(2):263-269. Epub 2021 Aug 11.

Mayo Clinic, Knowledge and Evaluation Research Unit, 200 First Street Southwest, Rochester, MN, 55905, USA.

Purpose: Nearly half the cases of thyroid cancer, a malignancy rapidly rising in incidence within the United States, are attributable to small and asymptomatic papillary thyroid cancers that will not increase mortality. A primary driver of thyroid cancer overdiagnosis is ultrasound use. It is therefore valuable to understand how inappropriate use of thyroid ultrasound is defined, analyze the current evidence for its frequency, and identify interventions to lessen misuse. Read More

Endocrine 2021 11 7;74(2):215-218. Epub 2021 Aug 7.

Department of Clinical and Experimental Sciences, SSD Medicina ad Indirizzo Endocrino-Metabolico, ASST Spedali Civili di Brescia, University of Brescia, 25123, Brescia, Italy.

Purpose: To evaluate the possible association between Covid-19 infection and subacute thyroiditis.

Methods: We reviewed the medical and imaging records of patients referred to our Department's outpatient setting dedicated to 'thyroid emergency' (records with a 'bollino verde'-green sticker, classifed as urgent) from April 2020 to October 2020. This outpatient clinic is devoted to patients requiring evaluation for severe hypothyroidism, thyrotoxicosis and neck discomfort or pain. Read More