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Expert Rev Clin Immunol 2021 Jun 2:1-23. Epub 2021 Jun 2.

Clinic for Nuclear Medicine and Competence Centre for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.

: During the COVID-19 pandemic thyroid gland alteration/dysfunction has been emerged as a possible endocrine complication. The present review is focused on inflammatory and autoimmune thyroid complications triggered by SARS-CoV-2 infection by searching through databases like MEDLINE and Scopus up to April 2021.: Beside the occurrence of 'non-thyroidal illness' in severe clinical conditions, alterations of thyroid function and structure may occur during COVID-19 as a consequence of either direct or indirect effects of SARS-CoV-2 infection on the gland. Read More

Cureus 2021 Mar 31;13(3):e14219. Epub 2021 Mar 31.

Department of Pulmonary and Critical Care Medicine, Detroit Medical Center Sinai-Grace Hospital, Detroit, USA.

Thyroid storm is an extremely rare yet life-threatening medical emergency. It results from the decompensation of undiagnosed or undertreated hyperthyroidism in the presence of an acute stressor such as trauma to the thyroid, infections, acute iodine load, withdrawal from the antithyroid medication, or surgical procedures (including thyroid surgery). Clinical features of thyroid storm include hyperthermia, tachycardia, respiratory distress, gastrointestinal and hepatic symptoms, and central nervous system dysfunction. Read More

AACE Clin Case Rep 2021 Jan-Feb;7(1):36-39. Epub 2020 Dec 28.

Division of Endocrinology, Diabetes, and Metabolism, Emory University, Atlanta, Georgia.

Objective: Concurrent autoimmune disorders, including autoimmune hepatitis (AIH), with Graves disease have been reported. Glucocorticoids can simultaneously lower thyroid hormone levels and treat AIH. Recurrence of hyperthyroidism is associated with recurrence of hepatitis. Read More

Medicine (Baltimore) 2021 Apr;100(14):e25062

Department of Ophthalmology, Osaka Medical College, Osaka, Japan.

Rationale: Enlargemento of the medial rectus is the most predominant factor of compressive optic neuropathy (CON) in Graves' disease. This case report indicates that CON could develop only from the hypertrophic superior levator and superior rectus (SL/SR) muscle in a patient with poorly controlled Graves' disease, and described the possible risk of FT3-thyrotoxicosis with a prominent goiter to develop the current rare case with a review of the literature.

Patient Concerns: A 66-year-old woman undergoing endocrine management of hyperthyroidism with prominent goiter visited the Department of Ophthalmology due to right-eye upper-eyelid retraction. Read More

J Int Med Res 2021 Apr;49(4):3000605211004702

Department of Endocrinology, Peking University International Hospital, Beijing, China.

Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare and rapidly progressive malignancy that carries a poor prognosis. PSCCT is easily misdiagnosed as acute thyroiditis or as another thyroid malignancy. We have reported a 76-year-old woman who presented with progressive neck pain for 1 month. Read More

Ann Saudi Med 2021 Mar-Apr;41(2):86-90. Epub 2021 Apr 1.

From the Department of Medicine, National Guard Health Affairs, Riyadh, Saudi Arabia.

Background: Thyrotoxicosis is a common medical problem. Thyroid nuclear imaging with either I or technetium-99m (Tc-99m) pertechnetate are used to determine the cause. Although I has been the standard technique, Tc-99m pertechnetate is now commonly used, acceptable and easier to perform. Read More

J Med Case Rep 2021 Apr 4;15(1):173. Epub 2021 Apr 4.

Department of Pathology, Duke University, Durham, NC, USA.

Background: Central hyperthyroidism is a rare form of hyperthyroidism caused by thyrotrope pituitary adenomas. It is characterized by elevated thyroid-stimulating hormone alongside high thyroxine and triiodothyronine. Goiter is the most common symptom of central hyperthyroidism. Read More

Clin Nucl Med 2021 06;46(6):e342-e343

From the Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases.

Abstract: A 76-year-old woman underwent 99mTcO4- thyroid scintigraphy to clarify thyrotoxicosis. In addition to suppressed thyroid uptake, an atypical tracer accumulation appeared on already know pulmonary adenocarcinoma in the left lung upper lobe. Surgical pathology was reviewed confirming the diagnosis of lung adenocarcinoma with focal mucins production and excluding a misdiagnosed differentiated thyroid carcinoma metastasis. Read More

Front Endocrinol (Lausanne) 2021 11;12:619161. Epub 2021 Mar 11.

Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

Ectopic thyrotropin-secreting pituitary adenoma (ectopic TSH-oma) is a rare disorder that is easily misdiagnosed in clinical work. We report one patient who presented with hyperthyroidism and a suprasellar mass. In this case, preoperative diagnosis of suprasellar ectopic thyrotropin-secreting pituitary adenoma was challenging. Read More

Endocr Pract 2021 Mar 9. Epub 2021 Mar 9.

Division of Endocrinology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.

S D Med 2020 Dec;73(12):572-574

Avera Sacred Heart Hospital, Yankton, South Dakota.

Presented here is a case of thyroid storm. Thyroid storm is a rare and life-threatening pathology that requires delicate management, even at presentation. Important nuances of care are discussed, including avoidance of iodinated contrast until a thionamide has been administered and proper selection of a beta-blocker. Read More

BMC Endocr Disord 2021 Feb 27;21(1):33. Epub 2021 Feb 27.

Department of Diabetes and Endocrinology, Beaumont Hospital, Dublin 9, Republic of Ireland.

Background: Immune checkpoint inhibitors (ICIs) are a novel class of oncological agents which are used to treat a number of malignancies. To date seven agents have been approved by the Food and Drug Administration (FDA) to treat both solid and haematological malignancies. Despite their efficacy they have been associated with a number of endocrinopathies. Read More

BMJ Case Rep 2021 Feb 9;14(2). Epub 2021 Feb 9.

Endocrinology Department, Royal Free London NHS Foundation Trust, Herts, UK.

This manuscript describes the case of a young woman, with no prior psychiatric history, who developed hypomania and paranoia as the principal presenting features of Graves' disease. After starting treatment with carbimazole and propranolol, symptoms resolved without the use of antipsychotic drugs. Close liaison between psychiatry and endocrinology services was essential. Read More

Front Endocrinol (Lausanne) 2020 21;11:587065. Epub 2021 Jan 21.

Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.

Background: Lutetium 177 (Lu) - DOTATATE is a form of peptide receptor radionuclide therapy (PRRT) utilized in the treatment of neuroendocrine tumors. Data on Lu-DOTATATE-induced thyroid dysfunction is limited.

Case Description: A 29-year-old male with  positive metastatic paraganglioma enrolled under the Lu-DOTATATE trial (NCT03206060) underwent thyroid function test (TFT) evaluation comprised of thyroid stimulating hormone (TSH) and free thyroxine (FT4) immunoassay measurements per protocol prior to Lu-DOTATATE therapy. Read More

Cureus 2020 Dec 28;12(12):e12347. Epub 2020 Dec 28.

Department of Endocrinology, Shanxi Cardiovascular Hospital, TaiYuan, CHN.

Cardiogenic shock occurs when the heart is unable to pump enough blood for the needs of the body. Hypopituitarism is a condition in which the pituitary gland does not produce enough of one or more hormones, and it rarely occurs with thyrotoxicosis. We report a rare case of cardiogenic shock induced by anterior pituitary hypofunction and thyrotoxicosis. Read More

Q J Nucl Med Mol Imaging 2021 Jun 26;65(2):113-123. Epub 2021 Jan 26.

Department of Advanced Medical and Surgical Sciences, Luigi Vanvitelli University of Campania, Naples, Italy.

Medical treatment is the primary therapeutic option for thyrotoxicosis/hyperthyroidism. Two groups of causes of thyrotoxicosis (i.e. Read More

Q J Nucl Med Mol Imaging 2021 Jun 26;65(2):124-131. Epub 2021 Jan 26.

Department of Endocrine Surgery, Third Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland -

Hyperthyroidism is a set of disorders that involve excess synthesis and secretion of thyroid hormones by the thyroid gland, which leads to thyrotoxicosis. The most common forms of hyperthyroidism include diffuse toxic goiter (Graves' disease), toxic multinodular goiter (Plummer disease), and a solitary toxic adenoma. The most reliable screening measure of thyroid function is the thyroid-stimulating hormone (TSH) level. Read More

Eur Heart J Case Rep 2020 Dec 21;4(6):1-5. Epub 2020 Oct 21.

Respiratory Department, The Mid Yorkshire Hospitals NHS Trust, Aberford Road, Wakefield WF1 4DJ, UK.

Background: Acute pericarditis is frequently encountered in clinical practice; however, pericarditis as the first presentation of Graves' disease is rare and mainly limited to case reports in the literature. We hereby report a case in which a young patient presented with pericarditis as the first manifestation of Graves' disease.

Case Summary: A 24-year-old male was admitted to hospital with presenting complaint of left-sided chest pain, gradual in onset, 6/10 in intensity, sharp in character, increased by deep breathing and improved by leaning forward. Read More

Rozhl Chir 2020 ;99(11):492-496

Introduction: Retrosternal goiter is an enlarged thyroid mass of which more than 50% is located in the mediastinum. Indications for surgery of retrosternal goiter include ineffective pharmacological treatment, mechanical syndrome, suspicion of malignancy and thyrotoxicosis. Computed tomography is the gold standard in the diagnosis of retrosternal goiter. Read More

J ASEAN Fed Endocr Soc 2020 19;35(2):224-232. Epub 2020 Nov 19.

Department of Epidemiology, Singapore Clinical Research Institute, Singapore.

We characterize the clinical and laboratory characteristics of 5 patients with Graves' thyrotoxicosis whose serum free thyroxine (fT4) concentration decreased unexpectedly to low levels on conventional doses of carbimazole (CMZ) therapy. The initial fT4 mean was 40.0 pM, range 25-69 pM. Read More

Probl Endokrinol (Mosk) 2020 Oct 1;66(5):15-23. Epub 2020 Oct 1.

Endocrinology Research Centre.

Background: Graves' Orbitopathy (GO) - also known as Thyroid Eye Disease (TED) - is an autoimmune condition in the modern sense. It is closely associated with autoimmune thyroid diseases. Cytokine-mediated mechanisms play a critical part in immunopathogenesis of autoimmune thyroid diseases including GO. Read More

Front Endocrinol (Lausanne) 2020 27;11:580264. Epub 2020 Nov 27.

Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China.

TSH-secreting pituitary neuroendocrine tumor (PitNET) is one of the causes of central hyperthyroidism. The incidence of TSH PitNET is far lower than that of other PitNETs. The clinical manifestations of TSH PitNETs mainly include thyrotoxicosis or thyroid goiter, secretion disorders of other anterior pituitary hormones, and mass effect on the pituitary gland and its surrounding tissues. Read More

J Stroke Cerebrovasc Dis 2021 Jan 30;30(1):105414. Epub 2020 Oct 30.

Department of Neurosurgery, Nagasaki Prefecture Shimabara Hospital, 7895 Shimokawasiri, Shimabara, Nagasaki 855-0816, Japan.

Background: Moyamoya vessels are cerebral vasculopathies characterized by net-like collateral vessel formation at the cerebral basal area and stenosis of the terminal internal carotid artery, proximal middle cerebral artery, and anterior cerebral artery. A diagnosis of Moyamoya disease depends on the bilateral presence of Moyamoya vessels. Moyamoya disease associated with Graves' disease has rarely been reported to be a cause of ischemic events due to hyperthyroidism. Read More

Mol Imaging Radionucl Ther 2020 10;29(3):88-97

Miami Cancer Research Center, Miami, USA

Studies on the first years of radioactive iodine (RAI) use in thyroid diseases have focused on hyperthyroidism. Saul Hertz's success with RAI in thyrotoxicosis fueled a seamless transition to Samuel Seidlin's investigations with RAI in thyroid cancer. These landmark events embody nuclear ontology, a philosophical foundation for the creation and existence of radio-therapeutic principles that continue to influence clinical practices today. Read More

AACE Clin Case Rep 2020 Sep-Oct;6(5):e279-e281. Epub 2020 Aug 6.

Endocrine Department, Robert Wood Johnson University Hospital Somerset, Somerville, New Jersey.

Objective: We present a patient with long standing hypothyroidism who developed hyperthyroidism secondary to Graves disease. Recognition of this disease phenomenon is crucial to ensure prompt diagnosis and close follow-up.

Methods: The patient was evaluated with thyroid function testing and thyroid antibody testing. Read More

AACE Clin Case Rep 2020 Jan-Feb;6(1):e19-e22. Epub 2020 Sep 26.

Objective: Iodine deficiency disorders (IDDs) remain a major public health concern in most parts of the world but are extremely rare in North America. We describe a case of goiter in a young male with dietary history and findings suggestive of IDD.

Methods: Laboratory and imaging procedures including thyroid function tests, autoantibodies, urine iodine, thyroid ultrasound, and radioactive iodine (RAI) uptake scan were performed. Read More

Clin Med (Lond) 2020 09;20(5):e204-e205

Malacca General Hospital, Malacca, Malaysia.

A 34-year-old woman (gravida 4; para 3) at 17 weeks of pregnancy presented with abnormal behaviour for 3 weeks associated with difficulties in walking. She had been admitted 2 months prior with hyperemesis gravidarum and was also diagnosed with thyrotoxicosis. Vomiting and poor oral intake persisted after discharge. Read More

Eur J Obstet Gynecol Reprod Biol 2020 Oct 1;253:206-212. Epub 2020 Aug 1.

EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London (UCL), London, UK. Electronic address:

Objective: To evaluate the ultrasound diagnostic rates of complete hydatidiform moles (CHM) and partial hydatidiform moles (PHM) in women presenting with a missed miscarriage, the clinical complications at diagnosis and the risk of gestational trophoblastic neoplasia (GTN) after surgical evacuation and to compare our findings with those of the published literature by completing a systematic review and meta-analysis STUDY DESIGN: Retrospective review of the data of 295 women diagnosed with a histologically confirmed hydatidiform moles (HM) over a 15-year period, including 128 CHM and 167 PHM. All women were referred to a regional specialist centre for follow-up and further management. An electronic search of PubMed, Google Scholar and MEDLINE was performed for studies published between September 1973 and September 2017 reporting on the early ultrasound diagnosis of hydatidiform mole. Read More

BMC Endocr Disord 2020 Aug 27;20(1):133. Epub 2020 Aug 27.

Department of Diabetes and Endocrinology, Beaumont Hospital and the RCSI, Dublin, Ireland.

Background: Graves' disease is the commonest cause of thyrotoxicosis whilst thyrotropin (TSH)-producing pituitary adenomas (thyrotropinomas, TSHomas) are very rare and account for just 1-2% of all pituitary adenomas. Coexistence of a TSHoma and Graves' disease has been very rarely reported. Here, we report a case of a patient whose initial presentation with primary thyrotoxicosis due to Graves' disease, was subsequently followed by a relapse of thyrotoxicosis due to a probable TSHoma. Read More

Front Endocrinol (Lausanne) 2020 6;11:523. Epub 2020 Aug 6.

Department of Endocrinology and Metabolism, Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, China.

Thyroid stimulating hormone (TSH) secreting pituitary adenoma (TSHoma) is a rare cause of hyperthyroidism. To date there have been only thirteen cases reporting the coexistence of TSHoma with Graves' disease (GD). The diagnosis and management for such hyperthyroidism due to both etiologies remain challenging. Read More