DOCSLIB.ORG

European Thyroid Association 34Th Annual Meeting of the Abstracts

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
European Thyroid Association 34Th Annual Meeting of the Abstracts 34th Annual European Meeting Thyroid of the Association Abstracts We would like to advise that the text of the abstracts is the authors’ responsibility. No change has been made to the main text. Aula Magna University of Lisbon 5th – 9th September 2009 Lisbon Portugal eta09.com OP 01 Topic Highlights OP01 PRELIMINARY RESULTS OF A PHASE 1 STUDY OF XL184, A MET, VEGFR2 AND RET KINASE INHIBITOR (TKI), ADMINISTERED ORALLY TO PATIENTS WITH MEDULLARY THYROID CANCER (MTC) Razelle Kurzrock1, Steven Sherman2, David Pfister3, Roger B. Cohen4, Douglas Ball5, David Hong1, Chaan Ng6, John Frye7, Linda Janisch8, Mark J. Ratain8, Ravi Salgia8 1MD Anderson Cancer Center, Department of Investigational Cancer Therapeutics, Phase I Clinical Trials Program, Division of Cancer Medicine, Houston, United States, 2MD Anderson Cancer Center, Department of Endocrine Neoplasia, Division of Internal Medicine, Houston, United States, 3Memorial Sloan Kettering Cancer Center, New York, United States, 4Fox Chase Cancer Center, Philadelphia, United States, 5Johns Hopkins University, Baltimore, United States, 6MD Anderson Cancer Center, Department of Radiology, Houston, United States, 7Exelixis, South San Francisco, United States, 8University of Chicago, Department of Medicine, Section of Hematology/Oncology, Chicago, United States Background: XL184 is an oral TKI that strongly inhibits cell proliferation in MTC-derived cells harboring activated RET. Pharmacodynamic studies showed substantial inhibition of RET and MET phosphorylation in a MTC xenograft model. Methods: Adults with advanced solid tumors received XL184 in a 3+3 study design. Primary objectives include evaluation of safety and pharmacokinetic parameters and maximum tolerated dose (MTD) determination. RECIST response was assessed on day 28 and every 8 weeks. Markers of anti-angiogenic therapy, tumor markers, and RET status are being analyzed. Adverse events as of the December 1, 2008 data transfer (AEs) and pharmacokinetic data are reported for all patients. Pharmacodynamic data and efficacy are reported for the 37 patient MTC subgroup. Results: Eighty-five patients were enrolled. XL184-related AEs were primarily Grade 1/2. Grade 3 related-AEs in ≥2 patients include fatigue (9%), palmar-plantar erythema (PPE, 8%), diarrhea, increased AST and decreased weight (4% each), and increased ALT and hypertension (3% each). One report of a related Grade 4 AE included pulmonary embolism. The MTD of 175mg QD was determined based on dose-limiting toxicities of PPE, mucositis, transaminitis and increased lipase. The terminal half-life is ~100 hrs. XL184 induced changes in biomarkers of angiogenesis including PlGF, VEGF-A, sVEGFR2, and sMET. Of the MTC patients with measurable disease, 14 of 34 (41%) had a PR (9 confirmed, 26%) and the disease control rate (PR + SD > 3 months) was 84%. Response in MTC patients appears independent of RET status and most MTC patients have had reductions in plasma calcitonin and CEA. Conclusions: XL184 is generally well tolerated, the MTD is defined. In MTC patients with measurable disease, 41% achieved a PR as a best response and the majority derived clinical benefit. A global phase 3 pivotal study of XL184 in MTC is ongoing. OP02 THE THYROID HORMONE RECEPTOR ALPHA LOCUS AND BONE: A ROLE FOR THE CIRCADIAN CLOCK GENE REV-ERB-ALPHA Marco Medici1, Joyce B. Van Meurs1, Michael Verbiest1, Wendy M. Van der Deure1, Andre G. Uitterlinden1, Theo J. Visser1, Robin P. Peeters1 1Erasmus Medical Center, Endocrinology, Rotterdam, Netherlands Objectives: Thyroid hormone (TH) action is mediated via the TH receptors alpha (TRα) and beta. TRα is the predominant receptor in bone. A knock-in mutation, which leads to a 10-fold reduction in ligand-binding of TRα, results in delayed bone development and osteosclerosis in mice (Vennström et al., 2002). However, no human data on genetic variation in TRα and bone are available. We therefore studied the TRα locus in relation to bone mineral density (BMD), bone geometry and fracture risk in nearly 6000 Caucasian subjects. Methods: 15 Polymorphisms were selected that covered THRA and the 10 kb surrounding region,which includes Rev-Erb-alpha, a circadian clock gene located on the opposite chromosomal strand partially overlapping TRα. We genotyped 5974 persons aged 55 years and older, of whom data on bone endpoints were available. Results: All polymorphisms were in HWE and had no associations with TH levels. Male TRα-rs1568400-G allele carriers had a lower lumbar spine BMD (1.16±0.006 (mean ±SE) vs 1.18±0.006, p=0.018), a lower femoral neck BMD (0.89±0.006 vs 0.91±0.005, p=0.024) and a higher buckling ratio (14.0±0.05 vs 13.8±0.04, p=0.020), an indicator of bone instability. Rev-Erb-alpha-rs939347-A allele homozygotes had a 1.41 times higher BMD-loss (p=0.003) and a 1.56 times higher risk of vertebral fractures (OR=1.64(1.08-2.48)) compared to carriers of the wildtype allele. Rev-Erb-alpha-rs2269457-G allele carriers had a 1.12 times higher overall fracture risk (HR=1.16(1.02-1.32)) compared to non-carriers. Additionally, these carriers had a lower section modulus (1.14±0.006 vs 1.16±0.005, p=0.006), an indicator of bone bending strength. Conclusions: Although replication is needed, we show that TRα-rs1568400 is associated with BMD and bone geometry. Moreover, polymorphisms in the TRα antisense-gene Rev- Erb-alpha (rs939347 and rs2269457) are associated with BMD-loss, bone geometry and fracture risk. Rev-Erb-alpha expression has been shown to influence splicing and expression of TRα, suggesting that the effects of Rev-Erb-alpha on bone might be TRα- mediated. OP03 MICRORNA CLASSIFICATION OF THYROID FOLLICULAR NEOPLASIA Maria Rossing1,2, Ricardo Henao3, Ole Winther3, Mikkel Klausen2, Christian Godballe4, Annelise Krogdahl5, Martin Glud2, Finn Cilius Nielsen2, Finn Noe Bennedbæk1 1Herlev Hospital, Department of Endocrinology and Metabolism, Herlev, Denmark, 2Rigshospitalet, University of Copenhagen, Department of Clinical Biochemistry, Copenhagen, Denmark, 3Bioinformatics Centre, University of Copenhagen, Copenhagen, Denmark, 4Odense University Hospital, Head & Neck Surgery, Odense, Denmark, 5Odense University Hospital, Department of Pathology, Odense, Denmark Objective: Due to the limitations of the cytopathological classification of thyroid nodules, the preoperative assessment of malignancy is a major clinical problem. microRNAs (miRNAs) are small (about 22 nucleotides), non-coding, and single-stranded RNAs. miRNAs regulate the translation and stability of specific messenger RNAs (mRNA) mainly by imperfect base pairing with 3'untranslated regions of the mRNA. In this way miRNAs are believed to regulate about 30% of all protein-coding genes in mammals. Since miRNAs are frequently changed during malignant progression, the identification of differentially expressed miRNAs could improve the diagnosis of malignant tumors. We therefore aimed to generate a miRNA-based classifier, which could distinguish between thyroid follicular adenomas and carcinomas. Methods: The expression of miRNAs was examined on frozen tissue samples in 15 follicular adenomas, 12 fetal adenomas and 14 follicular carcinomas by microarray analysis and classifiers were generated by leave-one-out cross-validation. We have used NcodeTM Human miRNA Microarray V3 (mirBase 10,0) and NcodeTM Rapid miRNA Labelling System. Upon hybridization and washing, scanning was performed with an Agilent DNA Microarray Scanner. Results: We show that a three-microRNA signature is sufficient to differentiate between follicular adenomas and carcinomas, with 92% sensitivity and 93% specificity for malignancies. Due to similarities in the miRNA expression patterns, it was not possible to differentiate between fetal adenomas and follicular carcinomas. For validation we examined eight follicular tumours (six adenomas and two carcinomas) originating from a different hospital. All, except one adenoma, which was classified as a carcinoma, were classified according to its original histopathological diagnosis. Conclusion: A miRNA classifier can differentiate between follicular adenomas and carcinomas. For future perspectives we intend to apply the classifier upon the fine-needle aspirate as an additive diagnostic tool, trying to solve the clinical dilemma associated with follicular thyroid lesions. OP04 CHARACTERISATION AND PLASTICITY OF ADULT STEM/PROGENITOR CELLS IN THE HUMAN THYROID Alessandra Fierabracci1, Maria Ausiliatrice Puglisi1, Laura Giuliani1, Stefano Mattarocci2, Marco Gallinella-Muzi3 1Children's Hospital Bambino Gesù, Autoimmunity and Organ Regeneration Laboratory, Rome, Italy, 2CNR, Istituto di Neurobiologia e Medicina Molecolare, Rome, Italy, 3Tor Vergata University, Department of Surgery, Rome, Italy We recently isolated a population of adult stem/progenitor cells in the normal human thyroid. The method was based on the enzymatic digestion of fresh surgical thyroid specimens, followed by culture of cells in the presence of EGF and bFGF. Self-replicating spheroid lines composed of clonally derived cells were obtained. Objectives: We aimed to characterise spheroids and prove their plasticity. Methods: Immunophenotyping by FACS analysis and RT-PCR were employed to characterize 12 generated lines. Spheroids were seeded in 3D collagen gel cultures in differentiation medium to verify their plasticity toward the thyroidal phenotype. Co-culture with a neuroblastoma cell line was used to verify the plasticity toward the neuronal lineage. Experiments of mesenchymal differentiation of spheroids were also attempted.
Load more

Recommended publications
  • Basedow's Bonanza-Graves' Disease
    Journal of Liver Research, Disorders & Therapy Short Communication Open Access The prosperous goitre: basedow’s bonanza-graves’ disease Keywords: graves’ disease, auto-antibodies, thyroid gland, goiter, HLA CD40, CTLA-4, thyroglobulin, TSH receptor, PTPN 22, T cell Volume 4 Issue 3 - 2018 cytokines, toxic goitre, autoimmune hyperthyroidism, oncocytes Anubha Bajaj Abbreviations: TS Ab, thyroid stimulating antibody; TBII, Laboratory AB Diagnostics, India TSH binding inhibitor immunoglobulin; TSB Ab: thyroid stimulation blocking antibody; Anti TPO Ab, anti thyroid peroxidase antibody; Correspondence: Anubha Bajaj, Laboratory A.B. Diagnostics, Anti TG Ab, anti thyroglobulin antibody; TG, thyroglobulin; TSH R, A-1, Ring Road, Rajouri Garden, New Delhi 110027, India, Email [email protected] thyrotropin receptor; HLA, human leucocyte antigen; TRAb, TSH receptor autoantibodies Received: April 6, 2018 | Published: May 11, 2018 Introduction iodide symporter (a protein located in the baso-lateral membrane of An autoimmune disease constituting of hyperthyroidism due the thyrocytes) with an enhanced iodine uptake and a deficiency of to circulating auto-antibodies against thyrotropin (TSH receptor) TSH receptor which mobilizes protein C kinase pathway to control is delineated as Graves Disease.1 An upsurge in thyroid hormone cell proliferation. Pituitary secretion of TSH is restricted with synthesis, secretions and glandular enlargement is elucidated. Aberrant the antagonistic feedback mechanism of the accumulated thyroid glandular stimulation
    [Show full text]
  • Treatment of Radiation-Induced Nodular Goiters
    TREATMENT OF RADIATION-INDUCED NODULAR GOITERS ZsoltG. de Papp,RalphA. Pincusand LouisH. Hempelmann University of Rochester School of Medicine and Dentistry, Rochester, New York Retrospective and prospective epidemiological all patients presented to palpation as solitary or mul studies have shown that prior radiation exposure is tiple nodulesrangingin size from somethat were an important factor in the development of thyroid barely palpable to one massive nodular goiter meas cancer and multinodular goiter in adolescents and uring 6 X 8 X 2 cm. Prior to start of therapy, all young adults (1 ) . In retrospective studies of young patients were examined at least twice by the two persons with thyroid cancer, a history of antecedent senior authors to check on the accuracy and re radiation therapy to the neck or upper chest can producibility of the clinical findings. In each patient usually be elicited by specific questioning (2) . In with a palpably abnormal gland, the serum PB! and prospectivesurveysof selectedpopulationsof young 24-hr 131Juptake were determined, and a “scintiscan― adults with known radiation exposure, the incidence of the gland was carried out. In all but one patient, of neoplasticthyroid diseasecan be remarkably there was no evidence of hypothyroidism. high (1 ) . For example, in the 19 young Marshall In seven patients with nonfunctioning, fixed, stony, Islanders whose thyroid glands were heavily irradi hard or rapidly enlarging nodules, surgery was per ated during childhood by radioactive fission products formed. This was followed by suppressive therapy from a nuclear explosion in 1954, 15 or 78% de with L-thyroxin (0.2 mg daily) for 10 days; then, veloped nodular thyroid disease by 1967 (3) .
    [Show full text]
  • Thyroid Ultrasound
    Review Article Thyroid ultrasound Vikas Chaudhary, Shahina Bano1 Department of Radiodiagnosis, Employees’ State Insurance Corporation Model Hospital, Gurgaon, Haryana, 1Department of Radiodiagnosis, Lady Hardinge Medical College and Associated Smt. Sucheta Kriplani and Kalawati Hospitals, New Delhi, India ABSTRACT Thyroid ultrasonography has established itself as a popular and useful tool in the evaluation and management of thyroid disorders. Advanced ultrasound techniques in thyroid imaging have not only fascinated the radiologists but also attracted the surgeons and endocrinologists who are using these techniques in their daily clinical and operative practice. This review provides an overview of indications for ultrasound in various thyroid diseases, describes characteristic ultrasound findings in these diseases, and illustrates major diagnostic pitfalls of thyroid ultrasound. Key words: Color doppler, high resolution ultrasonography, thyroid, ultrasound, ultrasound elastography INTRODUCTION 1. To confirm presence of a thyroid nodule when physical examination is equivocal. High‑resolution ultrasonography (USG) is the most sensitive 2. To characterize a thyroid nodule(s), i.e. to measure the imaging modality available for examination of the thyroid dimensions accurately and to identify internal structure gland and associated abnormalities. Ultrasound scanning is and vascularization. non‑invasive, widely available, less expensive, and does not use 3. To differentiate between benign and malignant thyroid any ionizing radiation. Further, real time ultrasound imaging masses, based on their sonographic appearance. helps to guide diagnostic and therapeutic interventional 4. To differentiate between thyroid nodules and other procedures in cases of thyroid disease. The major limitation cervical masses like lymphadenopathy, thyroglossal cyst of ultrasound in thyroid imaging is that it cannot determine and cystic hygroma.
    [Show full text]
  • Thyroid Nodules Are Extremely Common in the General Population
    2. THE PATHOLOGY OF THYROID CANCER SYLVIA L. ASA Professor, Department of Laboratory Medicine & Pathobiology, University of Toronto; Pathologist-in-Chief, University Health Network and Toronto Medical Laboratories; Freeman Centre for Endocrine Oncology, Mount Sinai & Princess Margaret Hospitals; Toronto, Ontario Canada Thyroid nodules are extremely common in the general population; it has been esti- mated that about 20% of the population has a palpable thyroid nodule and approxi- mately 70% has a nodule that can be detected by ultrasound (1). The prevalence of thyroid nodules is greater in women than in men, and multiple nodules are more common than solitary nodules. The differential diagnosis of the thyroid nodule includes numerous entities, non-neoplastic and neoplastic, benign and malignant (2–5). The pathologist has an important role to play in their evaluation. The use of fine needle aspiration biopsy has significantly improved our ability to identify specific high-risk disorders and to facilitate their management in an expeditious and cost-effective manner. Patients who require surgery for further confirmation of the disease process rely upon the pathologist to correctly characterise their nodule and pathologists are actively involved in research to clarify the pathogenesis of thyroid disease. While some of these entities are readily diagnosed based on specific features seen in a routine slide stained with conventional dyes, the morphologic evaluation of many of these lesions is fraught with controversy and diagnostic criteria are highly variable from Pathologist to Pathologist (6). Nevertheless, histology remains the gold standard against which we measure outcomes of cytology, intraoperative consultations, molecular and other studies, and it represents the basis on which we determine patient management and the efficacy of various therapies.
    [Show full text]
  • Thyroid Nodules Update in Diagnosis and Management Shrikant Tamhane1* and Hossein Gharib2,3
    Tamhane and Gharib Clinical Diabetes and Endocrinology (2015) 1:11 DOI 10.1186/s40842-015-0011-7 REVIEW ARTICLE Open Access Thyroid nodules update in diagnosis and management Shrikant Tamhane1* and Hossein Gharib2,3 Abstract Thyroid nodules are very common. With widespread use of sensitive imaging in clinical practice, incidental thyroid nodules are being discovered with increasing frequency. Their clinical importance is primarily related to the need to exclude malignancy (4.0 to 6.5 percent of all thyroid nodules), assess for their functional status and any pressure symptoms caused by them. New Molecular tests are marketed for the assessment of thyroid nodules for the presence of cancer. The high prevalence of thyroid nodules requires evidence-based rational strategies for their differential diagnosis, risk stratification, treatment, and follow-up. This review addresses advances and controversies in thyroid nodule evaluation, including the new molecular tests, and their management considering the current guidelines and supporting evidence. Keywords: Thyroid, Thyroid Nodules, Molecular markers, Benign, Malignant, FNA, Management, Ultrasonography Introduction disorders, benign and malignant can cause thyroid nod- Thyroid nodule is a discrete lesion within the thyroid ules (Table 1) [1, 5]. gland that is radiologically distinct from the surrounding Fine needle aspiration (FNA) biopsy is the most accur- thyroid parenchyma. Thyroid nodules are common. ate method for evaluating thyroid nodules and helps to They are discovered as an accidental finding by a pa- identify patients who require surgical resection [6]. If a tient, or as an incidental finding during a routine phys- serum TSH is normal or elevated, and the nodule meets ical examination in 3 to 7 % [1] or by a radiologic criteria for sampling, the next step in the evaluation of a procedure: 67 % with ultrasonography (US) imaging, thyroid nodule is a FNA biopsy.
    [Show full text]
  • Heterogenous Morphologic Forms of Goiter in Autoimmune Thyroid Disease
    WJOES Heterogenous Morphologic Forms of Goiter in Autoimmune Thyroid Disease: An Insight based10.5005/jp-journals-10002-1140 on a Prospective Surgical Series ORIGINAL ARTICLE Heterogenous Morphologic Forms of Goiter in Autoimmune Thyroid Disease: An Insight based on a Prospective Surgical Series of 88 Cases PRK Bhargav ABSTRACT Usually, both GD and HT have diffuse goiter due to bilateral Two commonest forms of autoimmune thyroid disease (AITD) symmetrical involvement of thyroid gland by the disease are Graves’ disease (GD) and Hashimoto’s thyroiditis (HT) with process.7 But, in 20 to 30% of cases, they may be associated a diffuse goiter. The nature of goiter apart from clinical presenta- with nodules or assymetrical enlargement.8-11 The variability tion is crucial in the management of AITD. But, the goiter is not always diffuse, leading to diagnostic confusion. In this context, in proportion of nodularity depends upon clinical or sono- we conducted a prospective study on the goiter morphology in graphic methods of evaluation. In a classical case of AITD AITD. This is a prospective study conducted in Endocrine Surgery department of a teritiary care teaching hospital in South India (i.e. with usual clinical presentation, cardinal signs and over a period of 1 year. The cohort is a surgical series of 88 cases diffuse goiter), the standard diagnostic protocol with imaging of AITD (GD = 53; HT = 35). Morpho logy of all the ex vivo speci- and serology suffices, but appears to be insufficient in AITD mens were studied, documented and correlated with clinical and radiological forms of goiter. Sex ratio was M:F = 74:14.
    [Show full text]
  • Thyroid Nodules MARY JO WELKER, M.D., and DIANE ORLOV, M.S., C.N.P
    PRACTICAL THERAPEUTICS Thyroid Nodules MARY JO WELKER, M.D., and DIANE ORLOV, M.S., C.N.P. Ohio State University College of Medicine and Public Health, Columbus, Ohio Palpable thyroid nodules occur in 4 to 7 percent of the population, but nodules found incidentally on ultrasonography suggest a prevalence of 19 to 67 percent. The major- O A patient informa- ity of thyroid nodules are asymptomatic. Because about 5 percent of all palpable nod- tion handout on thy- roid nodules, written ules are found to be malignant, the main objective of evaluating thyroid nodules is to by the authors of this exclude malignancy. Laboratory evaluation, including a thyroid-stimulating hormone article, is provided on test, can help differentiate a thyrotoxic nodule from an euthyroid nodule. In euthyroid page 573. patients with a nodule, fine-needle aspiration should be performed, and radionuclide scanning should be reserved for patients with indeterminate cytology or thyrotoxico- sis. Insufficient specimens from fine-needle aspiration decrease when ultrasound guidance is used. Surgery is the primary treatment for malignant lesions, and the extent of surgery depends on the extent and type of disease. Ablation by postopera- tive radioactive iodine is done for high-risk patients—identified as those with metasta- tic or residual disease. While suppressive therapy with thyroxine is frequently used postoperatively for malignant lesions, its use for management of benign solitary thy- roid nodules remains controversial. (Am Fam Physician 2003;67:559-66,573-4. Copy- right© 2003 American Academy of Family Physicians.) Members of various thyroid nodule is a palpable jects 19 to 50 years of age had an incidental family practice depart- swelling in a thyroid gland with nodule on ultrasonography.
    [Show full text]
  • Anatomy, Physiology and Pathology of the Thyroid Gland Anatomy Thyroidthyroid Anatomyanatomy
    Thyroid Tarek Mahdy Ass Professor of Endocrine And Bariatric Surgery Mansoura Faculty Of Medicine Mansoura - Egypt TheThe ThyroidThyroid GlandGland NamedNamed afterafter thethe thyroidthyroid cartilagecartilage (Greek:(Greek: ShieldShield--shaped)shaped) TheThe ThyroidThyroid GlandGland VercelloniVercelloni 1711:1711: ““aa bagbag ofof wormsworms”” whosewhose eggseggs passpass intointo thethe esophagusesophagus forfor digestivedigestive purposespurposes ParryParry 1825:1825: ““aa vascularvascular shuntshunt”” toto cushioncushion thethe brainbrain fromfrom suddensudden increasesincreases inin bloodblood flowflow ThyroidThyroid EmbryologyEmbryology Medial portion of thyroid gland Arises frome the endodermal tissue of the base of tongue posteriorly, the foramen cecum - lack of migration results in a retrolingual mass Attached to tongue by the thyroglossal duct - lack of atrophy after thyroid descent results in midline cyst formation (thyroglossal duct cyst) Descent occurs about fifth week of fetal life - remnants may persist along track of descent Lateral lobes of thyroid gland Derived from a portion of ultimobranchial body, part of the fifth branchial pouch from which C cells are also derived (calcitonin secreting cells) Lingual Thyroid (failure of descent) Verification that lingual mass is thyroid by its ability to trap I123 Lingual thyroid Chin marker Significance: May be only thyroid tissue in body (~70% of time), removal resulting in hypothyroidism; treatment consists of TSH suppression to shrink size Anatomy, physiology and
    [Show full text]
  • NACB LMPG Thyroid Disease
    Volume 13/2002 The National Academy of Clinical Biochemistry Presents LABORATORY MEDICINE PRACTICE GUIDELINES LABORATORY SUPPORT FOR THE DIAGNOSIS OF THYROID DISEASE ARCHIVED NACB: Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease Laurence M. Demers, Ph.D., F.A.C.B.and Carole A. Spencer Ph.D., F.A.C.B. LABORATORY MEDICINE PRACTICE GUIDELINES Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease Table of Contents Section I. Foreword and Introduction Section 2. Pre-analytic factors Section 3. Thyroid Tests for the Laboratorian and Physician A. Total Thyroxine (TT4) and Total Triiodothyronine (TT3) methods B. Free Thyroxine (FT4) and Free Triiodothyronine (FT3) tests C. Thyrotropin/ Thyroid Stimulating Hormone (TSH) measurement D. Thyroid Autoantibodies: • Thyroid Peroxidase Antibodies (TPOAb) • Thyroglobulin Antibodies (TgAb) • Thyrotrophin Receptor Antibodies (TRAb) E. Thyroglobulin (Tg) Measurement F. Calcitonin (CT) and ret Proto-oncogene G. Urinary Iodide Measurement H. Thyroid Fine Needle Aspiration (FNA) and Cytology I. Screening for Congenital Hypothyroidism Section 4. The Importance of the Laboratory - Physician Interface Appendices and Glossary References Editors: Laurence M. Demers, Ph.D., F.A.C.B. Carole A. Spencer Ph.D., F.A.C.B. Guidelines Committee: The preparation of this revised monograph was achieved with the expert input of the editors, members of the guidelines committee, experts who submitted manuscripts for each section and many expert reviewers, who are listed in Appendix A. The material in this monograph represents the opinions of the editors and does not represent the official position of the National Academy of Clinical Biochemistry or any of the co-sponsoring organizations. The National Academy of Clinical Biochemistry is the official academy of the American Association of Clinical Chemistry.
    [Show full text]
  • Study of Pathological Variations of Solitary Thyroid Nodule by Abdullah Al Mamun, Zahedul Alam, Rojibul Haque & Dewan M Hasan National Institute of ENT, Bangladesh
    Global Journal of Medical Research: J Dentistry and Otolaryngology Volume 14 Issue 3 Version 1.0 Year 2014 Type: Double Blind Peer Reviewed International Research Journal Publisher: Global Journals Inc. (USA) Online ISSN: 2249-4618 & Print ISSN: 0975-5888 Study of Pathological Variations of Solitary Thyroid Nodule By Abdullah Al Mamun, Zahedul Alam, Rojibul Haque & Dewan M Hasan National Institute of ENT, Bangladesh Abstract- Objective: To find out the incidence of malignancy in patient with solitary thyroid nodule. Methods: This cross-sectional study was carried out with 100 solitary thyroid nodular patients who admitted in Otolaryngology & Head-Neck Surgery Department of Sir Salimullah Medical College Mitford Hospital (SSMCMH) & Bangabondhu Sheikh Mujib Medical Univercity (BSMMU), Dhaka, from July 2011 to December 2012,where all patients were admitted through out patient department. All patients were selected as per described criteria from the Department of Otolaryngology & Head-Neck Surgery, SSMCMH & BSMMU. Diagnosed the cases by detail history, clinical examination,investigations,analysed data presented by various tables, figures. Results: In this study mean age of the patients of solitary thyroid nodule was 35.6±13.54 years and the highest frequency (38%) was within 21-30 years of age with female predominance (78%). Thyroid swelling was the common presentation in all9100%) cases, some patients also presented with other symptoms like cervical lymphadenopathy 13(13%) cases, dysphagia 1(1%), dyspnoea 1(1%), hoarseness of voice 1(1%) case & no bone metastetic found. Keywords: solitary thyroid nodule, papillary carcinoma, follicular carcinoma, medulary carcinoma. GJMR-J Classification: NLMC Code: WK 200, WF 490 StudyofPathologicalVariationsofSolitaryThyroidNodule Strictly as per the compliance and regulations of: © 2014.
    [Show full text]
  • 9| Thyroid Disorders 10
    433 Medicine Team Thyroid disorders 10|Thyroid Disorders 9| Thyroid disorders 1 | P a g e 433 Medicine Team Thyroid disorders Objectives: 1. Describe the anatomy and physiology related to thyroid gland 2. Know the Hypothyroidism: presentation, diagnosis and management 3.Define the Goiter and thyroid nodules 2 | P a g e 433 Medicine Team Thyroid disorders Thyroid gland Thyroid gland is made up of follicles and has 2 lobes and connected by the isthmus • more volume in men, increase with age and bodyweight and decrease with iodine intake • Located in front of larynx 99.9 % of T4 and T3 are bound to protein in the blood: TBG, albumin, Thyroid hormones: lipoprotein Follicular cells of the thyroid is the main site of hormones synthesis • Mainly T4 and small amount of T3 • T4 and T3 synthesis and secretion is regulated by pituitary TSH. • TSH is inhibited by T4 and T3, stimulated by TRH Thyroid hormone action: Thyroid hormones In children: delayed act on the bone In brain: cognitive growth and and bone impairment epiphyseal growth development Regulate metabolic Act on cardiac rate and little muscle: tachy and change in bradycardia bodyweight Goiter: Chronic enlargement of thyroid gland not due to neoplasm What causes goiter: Goiters can occur when the thyroid gland produces either too much thyroid hormone (hyperthyroidism) Assess thyroid function by : not enough (hypothyroidism) Free T4, FT3 Normal production (nontoxic multinodular goiter) TSH Sporadic: Diet (cabbage, Caulifower) Ultrasound neck 3 | P a g e 433 Medicine Team Thyroid disorders HYPOTHYROIDISM: Etiology Failure of the thyroid to produce sufficient thyroid Hormone.
    [Show full text]
  • Goitre – Causes, Investigation and Management
    Thyroid Goitre Causes, investigation and management Kiernan Hughes Creswell Eastman Background Goitre refers to an enlarged thyroid gland. Causes of goitre Goitre refers to an enlarged thyroid. Common causes of goitre include autoimmune disease, the formation of one or more include autoimmune disease, thyroid nodules and iodine thyroid nodules and iodine deficiency (Table 1). Goitre deficiency. occurs when there is reduced thyroid hormone synthesis Objective secondary to biosynthetic defects and/or iodine deficiency, This article outlines the causes, investigation and leading to increased thyroid stimulating hormone (TSH). management of goitre in the Australian general practice This stimulates thyroid growth as a compensatory setting. mechanism to overcome the decreased hormone synthesis. Elevated TSH is also thought to contribute to an enlarged Discussion Patients with goitre may be asymptomatic, or may present thyroid in the goitrous form of Hashimoto thyroiditis, in with compressive symptoms such as cough or dysphagia. combination with fibrosis secondary to the autoimmune Goitre may also present with symptoms due to associated process in this condition. In Graves disease, the goitre hypothyroidism or hyperthyroidism. Thyroid stimulating results mainly from stimulation by the TSH receptor hormone is the appropriate first test for all patients with goitre; antibody (Figure 1). if this hormone is low a radionuclide scan is helpful. Thyroid ultrasound has become an extension of physical examination When diffuse enlargement of the thyroid occurs in the absence of and should be performed in all patients with goitre. Ultrasound nodules and hyperthyroidism, it is referred to as a diffuse nontoxic can determine what nodules should be biopsied. Treatment goitre. This is sometimes called ‘simple goitre’ because of the options for goitre depend on the cause and the clinical absence of nodules, or ‘colloid goitre’ because of the presence of picture and may include observation, iodine supplementation, uniform follicles that are filled with colloid.
    [Show full text]