This letter discusses the publication by Feng et al.Iodine,selenium,and vitamin D are closely associated with thyroid hormone production in humans;however,the efficacy of selenium and vitamin D supplementation for typ...This letter discusses the publication by Feng et al.Iodine,selenium,and vitamin D are closely associated with thyroid hormone production in humans;however,the efficacy of selenium and vitamin D supplementation for type 2 diabetes mellitus(T2DM)patients with Hashimoto’s thyroiditis(HT)remains controversial.In the retrospective study we discuss herein,the authors highlighted significant improvements in thyroid function,thyroid antibodies,blood glucose,and blood lipid in T2DM patients with HT following addition of vitamin D and selenium to their antidiabetic regimens,underscoring the value of these supplements.Our team is currently engaged in research exploring the relationship between micronutrients and HT,and we have obtained invaluable insights from the aforementioned study.Based on this research and current literature,we recommend a regimen of 4000 IU/day of vitamin D and 100-200μg/day of selenium for over three months to six months for patients with HT,particularly for those with concurrent T2DM.展开更多
The study by Feng et al,explores treatment approaches for these coexisting conditions.It emphasizes the potential advantages of selenium and vitamin D supplementation but also raises methodological and patient selecti...The study by Feng et al,explores treatment approaches for these coexisting conditions.It emphasizes the potential advantages of selenium and vitamin D supplementation but also raises methodological and patient selection concerns.Findings indicate a complex interplay between interventions and disease markers,prompting the need for further research.Despite limitations,the study offers valuable insights into managing the intricate relationship between type 2 diabetes mellitus and Hashimoto's thyroiditis.The authors'contributions shed light on potential treatment avenues,although careful consideration of study design and patient characteristics is warranted for future investigations in this domain.展开更多
Objective: The purpose of this study was to investigate the effect of Hashimoto’s thyroiditis on efficacy of <sup>131</sup>I ablation in intermediate- and high-risk of thyroid papillary carcinoma patients...Objective: The purpose of this study was to investigate the effect of Hashimoto’s thyroiditis on efficacy of <sup>131</sup>I ablation in intermediate- and high-risk of thyroid papillary carcinoma patients. The findings will help to develop a personalized treatment plan for patients with thyroid papillary carcinoma complicated with Hashimoto’s thyroiditis. Material and Methods: From January 2016 to December 2020, patients who were diagnosed with intermediate- and high-risk PTC with lymph node metastasis were analyzed retrospectively, excluding patients with incomplete clinical data, distant metastasis, positive TGAb, TSH Results: A total of 525 patients (166 males and 359 females) were included in the study, including 368 patients in ER group (70.1%) and 157 patients in NER group (29.9%). Eleven factors including combining Hashimoto’s thyroiditis, pre-ablative Tg levels, sex, tumor diameter, extraglandular invasion, multifocal, bilateral lesions, central lymph node metastasis, lateral lymph node metastasis, lymph node metastasis rate, thyroglobulin were statistically different between ER group and NER group with significance at P Conclusion: Hashimoto’s thyroiditis, Ps-Tg level and lateral lymph node metastasis are potential predictors for short-term efficacy of <sup>131</sup>I treatment in intermediate- and high-risk thyroid papillary carcinoma. Hashimoto’s thyroiditis, high Ps-Tg level and increased number of lateral lymph node metastasis reduce the efficacy of <sup>131</sup>I therapy in patients with intermediate and high risk thyroid papillary carcinoma.展开更多
Papillary thyroid cancer(PTC)represents 80%-85%of thyroid cancer and its prevalence has been rising in the last decades.Primary thyroid lymphoma(PTL)accounts for 3%of extranodal lymphomas and about 5%of thyroid malign...Papillary thyroid cancer(PTC)represents 80%-85%of thyroid cancer and its prevalence has been rising in the last decades.Primary thyroid lymphoma(PTL)accounts for 3%of extranodal lymphomas and about 5%of thyroid malignancies,having a prevalence of one or two cases per million people.Mucosa-Associated Lymphoid Tissue lymphoma represents approximately30%of PTL.Both entities have an indolent course and a very good prognosis.Diagnosis is made by ultrasound and fine needle aspiration(FNA)or surgery specimen pathology.They have also been associated with Hashimoto’s thyroiditis(HT),but pathogenesis and its links remains to be known.Treatment remains controversial and surgery is generally accepted in cases of disease limited to thyroid,as the present.Patients with thyroid nodules should be observed and followed.If there is an enlargement by ultrasound or clinical symptoms,FNA should be performed promptly.Patients with HT deserve additional surveillance,since this condition is associated with both PTC and PTL.In this case,the management with surgery and radioactive iodine ablation therapy was effective for both entities.Patients with thyroid nodules should be properly evaluated with ultrasound and thyroid function tests.If there is an enlargement of the neck,reported by symptoms or ultrasound,it requires further investigation.HT is associated to both PTC and PTL so if the enlargement of the nodules is on this context additional tests such as FNA should be performed.In this case,the patient was managed with surgery and radioactive iodine ablation therapy and it was effective for both entities.展开更多
Dear Editor,I am Dr. Yao Fu, from the Department of Ophthalmology,Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. I write to present a rare case of Ascher syndrome...Dear Editor,I am Dr. Yao Fu, from the Department of Ophthalmology,Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. I write to present a rare case of Ascher syndrome.Ascher syndrome was described first in 1920, presenting as a combination of blepharochalasis, double lip, and non-toxic goitre(1)It is considered to be a rare, sporadic.展开更多
AIM: To define the association between Hashimoto’s thyroiditis and coeliac disease in Dutch patients. METHODS: A total of 104 consecutive patients with Hashimoto’s thyroiditis underwent coeliac serological tests (an...AIM: To define the association between Hashimoto’s thyroiditis and coeliac disease in Dutch patients. METHODS: A total of 104 consecutive patients with Hashimoto’s thyroiditis underwent coeliac serological tests (antigliadins, transglutaminase and endomysium antibodies) and HLA-DQ typing. Small intestinal biopsy was performed when any of coeliac serological tests was positive. On the other hand, 184 patients with coeliac disease were subjected to thyroid biochemical (thyroid stimulating hormone and free thyroxine) and thyroid serological tests (thyroglobulin and thyroid peroxidase antibodies). RESULTS: Of 104 patients with Hashimoto’s thyroiditis, sixteen (15%) were positive for coeliac serology and five patients with documented villous atrophy were diagnosed with coeliac disease (4.8%; 95% CI 0.7-8.9). HLA-DQ2 (and/or -DQ8) was present in all the five and 53 patients with Hashimoto’s thyroiditis (50%; 95% CI 43-62). Of 184 patients with coeliac disease, 39 (21%) were positive for thyroid serology. Based on thyroid biochemistry, the 39 patients were subclassified into euthyroidism in ten (5%; 95% CI 2-9), subclinicalhypothyroidism in seven (3.8%; 95% CI 1.8-7.6), and overt hypothyroidism (Hashimoto’s thyroiditis) in 22 (12%; 95% CI 8-16). Moreover, four patients with coeliac disease had Graves’ disease (2%; 95% CI 0.8-5) and one patient had post-partum thyroiditis. CONCLUSION: The data from a Dutch population confirm the association between Hashimoto’s thyroiditis and coeliac disease. Screening patients with Hashimoto’s thyroiditis for coeliac disease and vice versa is recom- mended.展开更多
Hashimoto's Thyroiditis is a common Autoimmune disease,and clinical related research has made great progress.This article summarizes the clinical and experimental studies on Hashimoto's Thyroiditis in recent y...Hashimoto's Thyroiditis is a common Autoimmune disease,and clinical related research has made great progress.This article summarizes the clinical and experimental studies on Hashimoto's Thyroiditis in recent years,summarizes in five aspects from its western medicine pathogenesis(Genetics,Environment,Gender,Immunity,mi RNA),traditional Chinese medicine etiology and pathogenesis,western medicine treatment(Glucocorticoid therapy,Chemokine receptor antagonist therapy,Nutrition therapy),traditional Chinese medicine therapy(Treatment by type,Treatment by stages,Treatment by liver,Treatment by spleen and kidney,Treatment by gas,blood,phlegm and blood stasis,Prescription of experience,Characteristic theory of physician and Characteristic therapy of Traditional Chinese Medicine)and combine traditional Chinese and western medicine treatment,and puts forward the integrated treatment of traditional Chinese and western medicine is the general trend of future diagnosis and treatment of Hashimoto thyroiditis.展开更多
[Objectives]To explore the efficacy of Xiaojin Capsules combined with Selenium Yeast Capsules in the treatment of Hashimoto's thyroiditis(HT)with abnormal thyroid function.[Methods]A total of 180 HT patients who w...[Objectives]To explore the efficacy of Xiaojin Capsules combined with Selenium Yeast Capsules in the treatment of Hashimoto's thyroiditis(HT)with abnormal thyroid function.[Methods]A total of 180 HT patients who were treated in the First Affiliated Hospital of Henan University and Henan Provincial People's Hospital from December 2020 to December 2021 were selected as the research subjects and randomly divided into the observation group(n=120)and the control group(n=60)in at a tratio of 2∶1 ratio according to their visiting time.The observation group was treated with Xiaojin Capsules(oral,5 capsules each time,twice a day for 12 weeks)and Selenium Yeast Capsules(oral,1 capsule each time,twice a day for 12 weeks).The control group was treated with only Selenium Yeast Capsules(oral,1 capsule each time,twice a day for 12 weeks).[Results]The difference in the levels of thyroid peroxidase antibody(TPO-Ab),thyroglobulin antibody(TGAb),serum free triiodothyronine(FT_(3)),serum free thyroxine(FT_(4)),and thyroid stimulating hormone(TSH)between the observation group and control group was statistically significant(P<0.05).The diameters of thyroid between the observation group and the control group before,during and after treatment were significantly different(P<0.05).The total effective rate of the observation group was 82.5%(99/120),which was significantly higher than 56.67%(34/60)in the control group,and the difference was statistically significant(P<0.05).The cure rate(22.50%)in the observation group was significantly higher than the control group(3.33%),and the difference was statistically significant(P<0.01).The ineffective rate of the observation group was 17.50%,which was significantly lower than that of the control group(40.00%),and the difference was statistically significant(P<0.01).The markedly effective rate of the observation group was 40.83%,which was significantly higher than that of the control group(31.67%),and the difference was statistically significant(P<0.05).The effective rate in the observation group was 191%,and the effective rate in the control group was 21.67%,and the difference was not statistically significant(P>0.05).[Conclusions]Xiaojin Capsules combined with Selenium Yeast Capsules in the treatment of HT can eliminate or alleviate the clinical symptoms and signs,significantly reduce the levels of TPO-Ab and TGAb in serum,restore thyroid function,improve thyroid shape and structure in the treatment of HT,and the clinical effect is satisfactory.展开更多
Aim: To determine levels of serum trace elements and vitamins, and to find out possible correlations between these elements and vitamins with thyroid function tests and thyroid autoantibody levels in patients having H...Aim: To determine levels of serum trace elements and vitamins, and to find out possible correlations between these elements and vitamins with thyroid function tests and thyroid autoantibody levels in patients having Hashimoto’s thyroiditis (HT). Methods: The study included 51 premenauposal women with untreated HT, aged 18 to 56 years without any known chronic diseases or chronic medicine usage, and 27 healthy premenauposal women aged 19 to 42 years old. Trace elements (selenium, zinc, copper, iron levels) and vitamins [A, E, B12, 25-OH-D, 1,25(OH)2D and folic acid levels] were evaluated in patient and control groups. Results: Consequently, serum trace elements and vitamin B12 levels did not significantly differ in patients with HT and control group. Thyroid functioning tests and autoantibody levels did not show any correlation with the levels of trace elements, vitamin A, vitamin E and 25-OH vitamin D. A correlation was detected between vitamin B12 and Anti thyroid peroxidase levels. Conclusion: The negative correlation between vitamin B12 and Anti thyroid peroxidase levels may demonstrate the necessity to screen the patients with HT for atrophic gastritis. We believe that more comprehensive studies with larger sample sizes are needed in which patients are randomized according to their nutritional status.展开更多
In recent years,the incidence of Hashimoto’s thyroiditis and thyroid cancer has shown a rapid growth trend.These two diseases have severely affected the public health.Many epidemiological studies have shown that thyr...In recent years,the incidence of Hashimoto’s thyroiditis and thyroid cancer has shown a rapid growth trend.These two diseases have severely affected the public health.Many epidemiological studies have shown that thyroid cancer is often associated with Hashimoto’s thyroiditis.Hashimoto’s thyroiditis may promote the occurrence of thyroid cancer,as well as affecting the progression of the tumor,lymph node metastasis,and even the prognosis of patients.In this paper,the relationship between Hashimoto’s thyroiditis and thyroid cancer and the pathogenesis of thyroid cancer are reviewed regarding molecular mechanism,clinical pathology,and serology.展开更多
Late onset peripheral spondyloarthritis is a particular clinical form of spondyloarthritis, occurring at the age of 50 years or older. Hashimoto’s thyroiditis (HT) is the most frequent autoimmune thyroid disorder res...Late onset peripheral spondyloarthritis is a particular clinical form of spondyloarthritis, occurring at the age of 50 years or older. Hashimoto’s thyroiditis (HT) is the most frequent autoimmune thyroid disorder responsible for considerable morbidity. HT is well known to be associated with many systemic autoimmune, it is less clear whether a similar association may also be present for spondyloarthritis. Here, we report a case of late onset peripheral spondyloarthritis in a 62-year-old African woman with a 12-year history of Hashimoto’s thyroiditis, a previously undescribed association in the literature. The diagnosis of Late onset peripheral spondyloarthritis was made according to the Assessment of SpondyloArthritis international Society (ASAS) criteria for peripheral spondyloarthritis (presence of arthritis, enthesitis and Human Leukocyte Antigen B27). She was treated with methotrexate and celebid. After 6 months of treatment, the evolution was favourable with an overall improvement in her symptomatology and quality of life. The coexistence of late onset peripheral spondyloarthritis and Hashimoto’s thyroiditis may be related to the presence of a genetic background predisposing to both diseases.展开更多
Objective To evaluate the clinical and pathological features of Riedel's thyroiditis(RT),and current diagnostic and treatment methods for that disease.Methods Five RT cases identified by surgery and pathological e...Objective To evaluate the clinical and pathological features of Riedel's thyroiditis(RT),and current diagnostic and treatment methods for that disease.Methods Five RT cases identified by surgery and pathological examinations at Peking Union Medical College Hospital from 1985 to 2009 were analyzed and compared with the cases reported in the literature in terms of clinical and pathological features.Immunohistochemical staining of kappa and lambda light chains was carried out for RT tissues from all the five patients.Results All the five cases were females,aged 45-55 years.Elevation of serum thyroid autoantibodies was found in only one patient,who had longer disease duration than the others.Pathological examination revealed invasive fibrosclerosis of the thyroid follicles,thyroid capsule,and the surrounding tissues.In RT tissues,the number of cells containing lambda chains was a little higher than those containing kappa chains.Conclusions RT is a rare disease which might be more common in middle-aged females than in other populations.Pathological features include the destruction of thyroid follicle,extension into surrounding tissues by inflammatory cells and fibrous tissues.Immunohistochemical staining of kappa and lambda chains could help diagnose RT.展开更多
Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this stu...Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this study,we aimed to explore the microbial community in thyroid tissues and its contribution to papillary thyroid cancer(PTC).In parallel,we performed microbial profiling and transcriptome sequencing in the tumor and adjacent normal tissues of a large cohort of 340 PTC and benign thyroid nodule(BTN)patients.Distinct microbial signatures were identified in PTC,BTN,and their adjacent nontumor tissues.Intra-thyroid tissue bacteria were verified by means of bacteria staining,fluorescence in situ hybridization,and immunoelectron microscopy.We found that 17 bacterial taxa were differentially abundant in PTC compared with BTN,which included enrichment in PTC of the pathobionts Rhodococcus,Neisseria,Streptococcus,Halomonas,and Devosia,and depletion of the beneficial bacteria Amycolatopsis.These differentially abundant bacteria could differentiate PTC tumor tissues(PTC-T)from BTN tissues(BTN-T)with an area under the curve(AUC)of 81.66%.Microbial network analysis showed increased correlation strengths among the bacterial taxa in PTC-T in comparison with BTN-T.Immunefunction-corresponding bacteria(i.e.,Erwinia,Bacillus,and Acinetobacter)were found to be enriched in PTC with Hashimoto’s thyroiditis.Moreover,our integrative analysis revealed that the PTC-enriched bacteria had a positive association with key PTC-oncogenic pathway-related genes,including BRAF,KRAS,IRAK4,CTNNB1,PIK3CA,MAP3K7,and EGFR.In conclusion,our results suggest that intratumor bacteria dysbiosis is associated with the thyroid tumorigenesis and oncogenic signaling pathways of PTC.展开更多
Introduction: Thyroid states can be associated with psychiatric manifestations, be it hypothyroid, hyperthyroid or even euthyroid. The effect of depression is significant in subclinical hypothyroidism. Sometimes, its ...Introduction: Thyroid states can be associated with psychiatric manifestations, be it hypothyroid, hyperthyroid or even euthyroid. The effect of depression is significant in subclinical hypothyroidism. Sometimes, its signs and symptoms are indistinguishable from Major Depressive Disorder. Our immunological system and early embryologic origins also play a role in the coexistence of other comorbidities like Pernicious Anemia. Case: A 35-year-old Hispanic female presented with significant low mood, somnolence, weight gain, increased hunger, cold intolerance and epigastric pain. It is important to note the variety of clinical manifestations of our hypothyroidism patient to understand its associations and help us with a better approach to treatment. Discussion: Standard approaches to treatment of Subclinical Hypothyroidism will depend mostly on laboratory findings such as TSH levels and free T4. Individualized therapy chosen for our patient was based on his mood symptoms, laboratory findings and coexistence of Pernicious Anemia. The use of daily 0.025 mg of levothyroxine, 10 mg of escitalopram oxalate and weekly injections of cyanocobalamin were treatments of choice. Conclusion: During follow up of our patient, we can conclude that Levothyroxine and Escitalopram Oxalate were able to improve hypothyroidism symptoms, reduce thyroglobulin and peroxidase antibodies and improve mood symptoms including cognitive functions. In addition to this, weekly cyanocobalamin injections were integrated into the management. As parietal cell antibodies decreased, gastrointestinal symptoms also disappeared. By addressing the concerns of our patient, we improved quality of care, and this is reflected in the patient’s wellbeing in physical and psychological.展开更多
The pathogenesis of Hashimoto’s encephalopathy has not been clearly elucidated and involvement of autoimmune damage has been proposed. We report a 23-year-old man who was emergently hospitalized for paroxysmal syncop...The pathogenesis of Hashimoto’s encephalopathy has not been clearly elucidated and involvement of autoimmune damage has been proposed. We report a 23-year-old man who was emergently hospitalized for paroxysmal syncope and involuntary tremor with normal physical examination except for low heart rate. The patient was characterized by neurological symptoms, mild hypothyroidism, enlarged pituitary gland and extremely elevated thyrotropin, which all were reversed with levothyroxine alone. The case indicated that the pituitary-thyroid dysfunction may play a role in the pathogenesis of Hashimoto’s encephalopathy, hence, evaluation of pituitary gland should be recommended in diagnosis and treatment of Hashimoto’s encephalopathy.展开更多
Vitamin D deficiency is a global problem,which has taken the form of a pandemic.Existing data indicate that vitamin D is not only a nutrient.It has also a hormone-specific activity.Vitamin D is characterized by anti-i...Vitamin D deficiency is a global problem,which has taken the form of a pandemic.Existing data indicate that vitamin D is not only a nutrient.It has also a hormone-specific activity.Vitamin D is characterized by anti-inflammatory and immunomodulatory properties.Chronic autoimmune thyroiditis is a disease of autoimmune genesis,in which lymphocytic infiltration gradually destroys thyroid tissue.There are some evidences about vitamin D deficiency and the development of chronic autoimmune thyroiditis.The article has reviewed the current literature about the impact and the benefits of vitamin D on thyroid antibodies levels.展开更多
Primary thyroid lymphoma(PTL)is an exceptionally rare and highly aggressive potentially curable malignant disease.We report three typical cases of PTL referred to our hospital.All three cases had long history of Hashi...Primary thyroid lymphoma(PTL)is an exceptionally rare and highly aggressive potentially curable malignant disease.We report three typical cases of PTL referred to our hospital.All three cases had long history of Hashimoto’s thyroiditis,and presented with progressively enlarging neck mass.The first two cases were confirmed by surgical biopsy to be diffuse large B cell lymphoma,and received radiotherapy combined with chemotherapy,or received only chemotherapy.The third case was confirmed by core needle biopsy to be mucosa-associated lymphoid tissue lymphoma,and received radiotherapy.In summary,confirmation of PTL diagnosis is essential for further clinical decisions.Core biopsy should be one of the most important methods to make the diagnosis of PTL,while the use of fine needle aspiration cytology alone is still limited in diagnosing PTL.展开更多
基金Supported by the Discipline Construction Project of Hunan University of Chinese Medicine,No.22JBZ002.
文摘This letter discusses the publication by Feng et al.Iodine,selenium,and vitamin D are closely associated with thyroid hormone production in humans;however,the efficacy of selenium and vitamin D supplementation for type 2 diabetes mellitus(T2DM)patients with Hashimoto’s thyroiditis(HT)remains controversial.In the retrospective study we discuss herein,the authors highlighted significant improvements in thyroid function,thyroid antibodies,blood glucose,and blood lipid in T2DM patients with HT following addition of vitamin D and selenium to their antidiabetic regimens,underscoring the value of these supplements.Our team is currently engaged in research exploring the relationship between micronutrients and HT,and we have obtained invaluable insights from the aforementioned study.Based on this research and current literature,we recommend a regimen of 4000 IU/day of vitamin D and 100-200μg/day of selenium for over three months to six months for patients with HT,particularly for those with concurrent T2DM.
文摘The study by Feng et al,explores treatment approaches for these coexisting conditions.It emphasizes the potential advantages of selenium and vitamin D supplementation but also raises methodological and patient selection concerns.Findings indicate a complex interplay between interventions and disease markers,prompting the need for further research.Despite limitations,the study offers valuable insights into managing the intricate relationship between type 2 diabetes mellitus and Hashimoto's thyroiditis.The authors'contributions shed light on potential treatment avenues,although careful consideration of study design and patient characteristics is warranted for future investigations in this domain.
文摘Objective: The purpose of this study was to investigate the effect of Hashimoto’s thyroiditis on efficacy of <sup>131</sup>I ablation in intermediate- and high-risk of thyroid papillary carcinoma patients. The findings will help to develop a personalized treatment plan for patients with thyroid papillary carcinoma complicated with Hashimoto’s thyroiditis. Material and Methods: From January 2016 to December 2020, patients who were diagnosed with intermediate- and high-risk PTC with lymph node metastasis were analyzed retrospectively, excluding patients with incomplete clinical data, distant metastasis, positive TGAb, TSH Results: A total of 525 patients (166 males and 359 females) were included in the study, including 368 patients in ER group (70.1%) and 157 patients in NER group (29.9%). Eleven factors including combining Hashimoto’s thyroiditis, pre-ablative Tg levels, sex, tumor diameter, extraglandular invasion, multifocal, bilateral lesions, central lymph node metastasis, lateral lymph node metastasis, lymph node metastasis rate, thyroglobulin were statistically different between ER group and NER group with significance at P Conclusion: Hashimoto’s thyroiditis, Ps-Tg level and lateral lymph node metastasis are potential predictors for short-term efficacy of <sup>131</sup>I treatment in intermediate- and high-risk thyroid papillary carcinoma. Hashimoto’s thyroiditis, high Ps-Tg level and increased number of lateral lymph node metastasis reduce the efficacy of <sup>131</sup>I therapy in patients with intermediate and high risk thyroid papillary carcinoma.
基金supported by 4th Incentives for Research of the Universidad Peruana de Ciencias AplicadasLima-Peru(Grant-UPC-401-2014)
文摘Papillary thyroid cancer(PTC)represents 80%-85%of thyroid cancer and its prevalence has been rising in the last decades.Primary thyroid lymphoma(PTL)accounts for 3%of extranodal lymphomas and about 5%of thyroid malignancies,having a prevalence of one or two cases per million people.Mucosa-Associated Lymphoid Tissue lymphoma represents approximately30%of PTL.Both entities have an indolent course and a very good prognosis.Diagnosis is made by ultrasound and fine needle aspiration(FNA)or surgery specimen pathology.They have also been associated with Hashimoto’s thyroiditis(HT),but pathogenesis and its links remains to be known.Treatment remains controversial and surgery is generally accepted in cases of disease limited to thyroid,as the present.Patients with thyroid nodules should be observed and followed.If there is an enlargement by ultrasound or clinical symptoms,FNA should be performed promptly.Patients with HT deserve additional surveillance,since this condition is associated with both PTC and PTL.In this case,the management with surgery and radioactive iodine ablation therapy was effective for both entities.Patients with thyroid nodules should be properly evaluated with ultrasound and thyroid function tests.If there is an enlargement of the neck,reported by symptoms or ultrasound,it requires further investigation.HT is associated to both PTC and PTL so if the enlargement of the nodules is on this context additional tests such as FNA should be performed.In this case,the patient was managed with surgery and radioactive iodine ablation therapy and it was effective for both entities.
基金Supported by Shanghai Science and Technology Development Funds(No.17411963800)Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant(No.20161421)+1 种基金Clinical Research Program of Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine(No.JYLJ014)the Science and Technology Commission of Shanghai(No.17DZ2260100)
文摘Dear Editor,I am Dr. Yao Fu, from the Department of Ophthalmology,Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. I write to present a rare case of Ascher syndrome.Ascher syndrome was described first in 1920, presenting as a combination of blepharochalasis, double lip, and non-toxic goitre(1)It is considered to be a rare, sporadic.
文摘AIM: To define the association between Hashimoto’s thyroiditis and coeliac disease in Dutch patients. METHODS: A total of 104 consecutive patients with Hashimoto’s thyroiditis underwent coeliac serological tests (antigliadins, transglutaminase and endomysium antibodies) and HLA-DQ typing. Small intestinal biopsy was performed when any of coeliac serological tests was positive. On the other hand, 184 patients with coeliac disease were subjected to thyroid biochemical (thyroid stimulating hormone and free thyroxine) and thyroid serological tests (thyroglobulin and thyroid peroxidase antibodies). RESULTS: Of 104 patients with Hashimoto’s thyroiditis, sixteen (15%) were positive for coeliac serology and five patients with documented villous atrophy were diagnosed with coeliac disease (4.8%; 95% CI 0.7-8.9). HLA-DQ2 (and/or -DQ8) was present in all the five and 53 patients with Hashimoto’s thyroiditis (50%; 95% CI 43-62). Of 184 patients with coeliac disease, 39 (21%) were positive for thyroid serology. Based on thyroid biochemistry, the 39 patients were subclassified into euthyroidism in ten (5%; 95% CI 2-9), subclinicalhypothyroidism in seven (3.8%; 95% CI 1.8-7.6), and overt hypothyroidism (Hashimoto’s thyroiditis) in 22 (12%; 95% CI 8-16). Moreover, four patients with coeliac disease had Graves’ disease (2%; 95% CI 0.8-5) and one patient had post-partum thyroiditis. CONCLUSION: The data from a Dutch population confirm the association between Hashimoto’s thyroiditis and coeliac disease. Screening patients with Hashimoto’s thyroiditis for coeliac disease and vice versa is recom- mended.
基金National key research and development program 2018(No.2018YFC1704100)Study on renowned traditional Chinese medicine physicians’academic viewpoints,characteristic diagnosis and treatment,and experience in prevention and treatment of major diseases in central China(No.2018YFC1704103)。
文摘Hashimoto's Thyroiditis is a common Autoimmune disease,and clinical related research has made great progress.This article summarizes the clinical and experimental studies on Hashimoto's Thyroiditis in recent years,summarizes in five aspects from its western medicine pathogenesis(Genetics,Environment,Gender,Immunity,mi RNA),traditional Chinese medicine etiology and pathogenesis,western medicine treatment(Glucocorticoid therapy,Chemokine receptor antagonist therapy,Nutrition therapy),traditional Chinese medicine therapy(Treatment by type,Treatment by stages,Treatment by liver,Treatment by spleen and kidney,Treatment by gas,blood,phlegm and blood stasis,Prescription of experience,Characteristic theory of physician and Characteristic therapy of Traditional Chinese Medicine)and combine traditional Chinese and western medicine treatment,and puts forward the integrated treatment of traditional Chinese and western medicine is the general trend of future diagnosis and treatment of Hashimoto thyroiditis.
基金Supported by Scientific Research Project for Maternal and Child Care Fund of China Population Welfare Foundation(FY202001213921)。
文摘[Objectives]To explore the efficacy of Xiaojin Capsules combined with Selenium Yeast Capsules in the treatment of Hashimoto's thyroiditis(HT)with abnormal thyroid function.[Methods]A total of 180 HT patients who were treated in the First Affiliated Hospital of Henan University and Henan Provincial People's Hospital from December 2020 to December 2021 were selected as the research subjects and randomly divided into the observation group(n=120)and the control group(n=60)in at a tratio of 2∶1 ratio according to their visiting time.The observation group was treated with Xiaojin Capsules(oral,5 capsules each time,twice a day for 12 weeks)and Selenium Yeast Capsules(oral,1 capsule each time,twice a day for 12 weeks).The control group was treated with only Selenium Yeast Capsules(oral,1 capsule each time,twice a day for 12 weeks).[Results]The difference in the levels of thyroid peroxidase antibody(TPO-Ab),thyroglobulin antibody(TGAb),serum free triiodothyronine(FT_(3)),serum free thyroxine(FT_(4)),and thyroid stimulating hormone(TSH)between the observation group and control group was statistically significant(P<0.05).The diameters of thyroid between the observation group and the control group before,during and after treatment were significantly different(P<0.05).The total effective rate of the observation group was 82.5%(99/120),which was significantly higher than 56.67%(34/60)in the control group,and the difference was statistically significant(P<0.05).The cure rate(22.50%)in the observation group was significantly higher than the control group(3.33%),and the difference was statistically significant(P<0.01).The ineffective rate of the observation group was 17.50%,which was significantly lower than that of the control group(40.00%),and the difference was statistically significant(P<0.01).The markedly effective rate of the observation group was 40.83%,which was significantly higher than that of the control group(31.67%),and the difference was statistically significant(P<0.05).The effective rate in the observation group was 191%,and the effective rate in the control group was 21.67%,and the difference was not statistically significant(P>0.05).[Conclusions]Xiaojin Capsules combined with Selenium Yeast Capsules in the treatment of HT can eliminate or alleviate the clinical symptoms and signs,significantly reduce the levels of TPO-Ab and TGAb in serum,restore thyroid function,improve thyroid shape and structure in the treatment of HT,and the clinical effect is satisfactory.
文摘Aim: To determine levels of serum trace elements and vitamins, and to find out possible correlations between these elements and vitamins with thyroid function tests and thyroid autoantibody levels in patients having Hashimoto’s thyroiditis (HT). Methods: The study included 51 premenauposal women with untreated HT, aged 18 to 56 years without any known chronic diseases or chronic medicine usage, and 27 healthy premenauposal women aged 19 to 42 years old. Trace elements (selenium, zinc, copper, iron levels) and vitamins [A, E, B12, 25-OH-D, 1,25(OH)2D and folic acid levels] were evaluated in patient and control groups. Results: Consequently, serum trace elements and vitamin B12 levels did not significantly differ in patients with HT and control group. Thyroid functioning tests and autoantibody levels did not show any correlation with the levels of trace elements, vitamin A, vitamin E and 25-OH vitamin D. A correlation was detected between vitamin B12 and Anti thyroid peroxidase levels. Conclusion: The negative correlation between vitamin B12 and Anti thyroid peroxidase levels may demonstrate the necessity to screen the patients with HT for atrophic gastritis. We believe that more comprehensive studies with larger sample sizes are needed in which patients are randomized according to their nutritional status.
文摘In recent years,the incidence of Hashimoto’s thyroiditis and thyroid cancer has shown a rapid growth trend.These two diseases have severely affected the public health.Many epidemiological studies have shown that thyroid cancer is often associated with Hashimoto’s thyroiditis.Hashimoto’s thyroiditis may promote the occurrence of thyroid cancer,as well as affecting the progression of the tumor,lymph node metastasis,and even the prognosis of patients.In this paper,the relationship between Hashimoto’s thyroiditis and thyroid cancer and the pathogenesis of thyroid cancer are reviewed regarding molecular mechanism,clinical pathology,and serology.
文摘Late onset peripheral spondyloarthritis is a particular clinical form of spondyloarthritis, occurring at the age of 50 years or older. Hashimoto’s thyroiditis (HT) is the most frequent autoimmune thyroid disorder responsible for considerable morbidity. HT is well known to be associated with many systemic autoimmune, it is less clear whether a similar association may also be present for spondyloarthritis. Here, we report a case of late onset peripheral spondyloarthritis in a 62-year-old African woman with a 12-year history of Hashimoto’s thyroiditis, a previously undescribed association in the literature. The diagnosis of Late onset peripheral spondyloarthritis was made according to the Assessment of SpondyloArthritis international Society (ASAS) criteria for peripheral spondyloarthritis (presence of arthritis, enthesitis and Human Leukocyte Antigen B27). She was treated with methotrexate and celebid. After 6 months of treatment, the evolution was favourable with an overall improvement in her symptomatology and quality of life. The coexistence of late onset peripheral spondyloarthritis and Hashimoto’s thyroiditis may be related to the presence of a genetic background predisposing to both diseases.
文摘Objective To evaluate the clinical and pathological features of Riedel's thyroiditis(RT),and current diagnostic and treatment methods for that disease.Methods Five RT cases identified by surgery and pathological examinations at Peking Union Medical College Hospital from 1985 to 2009 were analyzed and compared with the cases reported in the literature in terms of clinical and pathological features.Immunohistochemical staining of kappa and lambda light chains was carried out for RT tissues from all the five patients.Results All the five cases were females,aged 45-55 years.Elevation of serum thyroid autoantibodies was found in only one patient,who had longer disease duration than the others.Pathological examination revealed invasive fibrosclerosis of the thyroid follicles,thyroid capsule,and the surrounding tissues.In RT tissues,the number of cells containing lambda chains was a little higher than those containing kappa chains.Conclusions RT is a rare disease which might be more common in middle-aged females than in other populations.Pathological features include the destruction of thyroid follicle,extension into surrounding tissues by inflammatory cells and fibrous tissues.Immunohistochemical staining of kappa and lambda chains could help diagnose RT.
基金supported by the National Natural Science Foundation of China(81772850 and 82273300)。
文摘Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this study,we aimed to explore the microbial community in thyroid tissues and its contribution to papillary thyroid cancer(PTC).In parallel,we performed microbial profiling and transcriptome sequencing in the tumor and adjacent normal tissues of a large cohort of 340 PTC and benign thyroid nodule(BTN)patients.Distinct microbial signatures were identified in PTC,BTN,and their adjacent nontumor tissues.Intra-thyroid tissue bacteria were verified by means of bacteria staining,fluorescence in situ hybridization,and immunoelectron microscopy.We found that 17 bacterial taxa were differentially abundant in PTC compared with BTN,which included enrichment in PTC of the pathobionts Rhodococcus,Neisseria,Streptococcus,Halomonas,and Devosia,and depletion of the beneficial bacteria Amycolatopsis.These differentially abundant bacteria could differentiate PTC tumor tissues(PTC-T)from BTN tissues(BTN-T)with an area under the curve(AUC)of 81.66%.Microbial network analysis showed increased correlation strengths among the bacterial taxa in PTC-T in comparison with BTN-T.Immunefunction-corresponding bacteria(i.e.,Erwinia,Bacillus,and Acinetobacter)were found to be enriched in PTC with Hashimoto’s thyroiditis.Moreover,our integrative analysis revealed that the PTC-enriched bacteria had a positive association with key PTC-oncogenic pathway-related genes,including BRAF,KRAS,IRAK4,CTNNB1,PIK3CA,MAP3K7,and EGFR.In conclusion,our results suggest that intratumor bacteria dysbiosis is associated with the thyroid tumorigenesis and oncogenic signaling pathways of PTC.
文摘Introduction: Thyroid states can be associated with psychiatric manifestations, be it hypothyroid, hyperthyroid or even euthyroid. The effect of depression is significant in subclinical hypothyroidism. Sometimes, its signs and symptoms are indistinguishable from Major Depressive Disorder. Our immunological system and early embryologic origins also play a role in the coexistence of other comorbidities like Pernicious Anemia. Case: A 35-year-old Hispanic female presented with significant low mood, somnolence, weight gain, increased hunger, cold intolerance and epigastric pain. It is important to note the variety of clinical manifestations of our hypothyroidism patient to understand its associations and help us with a better approach to treatment. Discussion: Standard approaches to treatment of Subclinical Hypothyroidism will depend mostly on laboratory findings such as TSH levels and free T4. Individualized therapy chosen for our patient was based on his mood symptoms, laboratory findings and coexistence of Pernicious Anemia. The use of daily 0.025 mg of levothyroxine, 10 mg of escitalopram oxalate and weekly injections of cyanocobalamin were treatments of choice. Conclusion: During follow up of our patient, we can conclude that Levothyroxine and Escitalopram Oxalate were able to improve hypothyroidism symptoms, reduce thyroglobulin and peroxidase antibodies and improve mood symptoms including cognitive functions. In addition to this, weekly cyanocobalamin injections were integrated into the management. As parietal cell antibodies decreased, gastrointestinal symptoms also disappeared. By addressing the concerns of our patient, we improved quality of care, and this is reflected in the patient’s wellbeing in physical and psychological.
文摘The pathogenesis of Hashimoto’s encephalopathy has not been clearly elucidated and involvement of autoimmune damage has been proposed. We report a 23-year-old man who was emergently hospitalized for paroxysmal syncope and involuntary tremor with normal physical examination except for low heart rate. The patient was characterized by neurological symptoms, mild hypothyroidism, enlarged pituitary gland and extremely elevated thyrotropin, which all were reversed with levothyroxine alone. The case indicated that the pituitary-thyroid dysfunction may play a role in the pathogenesis of Hashimoto’s encephalopathy, hence, evaluation of pituitary gland should be recommended in diagnosis and treatment of Hashimoto’s encephalopathy.
文摘Vitamin D deficiency is a global problem,which has taken the form of a pandemic.Existing data indicate that vitamin D is not only a nutrient.It has also a hormone-specific activity.Vitamin D is characterized by anti-inflammatory and immunomodulatory properties.Chronic autoimmune thyroiditis is a disease of autoimmune genesis,in which lymphocytic infiltration gradually destroys thyroid tissue.There are some evidences about vitamin D deficiency and the development of chronic autoimmune thyroiditis.The article has reviewed the current literature about the impact and the benefits of vitamin D on thyroid antibodies levels.
文摘Primary thyroid lymphoma(PTL)is an exceptionally rare and highly aggressive potentially curable malignant disease.We report three typical cases of PTL referred to our hospital.All three cases had long history of Hashimoto’s thyroiditis,and presented with progressively enlarging neck mass.The first two cases were confirmed by surgical biopsy to be diffuse large B cell lymphoma,and received radiotherapy combined with chemotherapy,or received only chemotherapy.The third case was confirmed by core needle biopsy to be mucosa-associated lymphoid tissue lymphoma,and received radiotherapy.In summary,confirmation of PTL diagnosis is essential for further clinical decisions.Core biopsy should be one of the most important methods to make the diagnosis of PTL,while the use of fine needle aspiration cytology alone is still limited in diagnosing PTL.
