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Marek Ruchała - One of the best experts on this subject based on the ideXlab platform.
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Biochemical and ultrasonographic parameters influencing thyroid nodules elasticity.
Endocrine, 2014Co-Authors: Ewelina Szczepanek-parulska, Kosma Woliński, Adam Stangierski, Edyta Gurgul, Marek RuchałaAbstract:Elastography is a method of tissue stiffness assessment. It has already been demonstrated that thyroid cancers are less elastic than benign lesions. However, little is known about other factors, which might influence the stiffness of thyroid nodules and disrupt the prediction of malignancy using this technique. The aim of this study was to conduct the first systematic assessment of factors potentially affecting the elasticity of thyroid lesions. One hundred and twenty-two patients with thyroid nodular disease admitted for thyroidectomy underwent preoperative ultrasonography and sonoelastography. The definite diagnosis of thyroid lesions was based on histological examination. What was evaluated in the study was the influence of composition, size, localization, nodularity, and selected laboratory parameters on thyroid nodule elasticity. Firstly, association between the above-mentioned factors and elasticity was assessed in benign lesions. Secondly, all nodules (benign and malignant) were divided into subgroups according to the presence or absence of particular features, which turned out to be an important disturbing factor increasing the stiffness of the lesion in the first step of analysis. There were 22 malignant and 371 benign lesions. The analysis of benign lesions revealed that the presence calcifications (p < 0.0001) significantly increased nodule stiffness. Partially, cystic nodules were significantly less elastic than solid ones (p = 0.03). There was also positive correlation between nodule size and stiffness (p < 0.0001). Lesions localized in the isthmus were significantly less elastic than nodules in other localizations. (p = 0.0001). Solitary nodules were less elastic than lesions in multinodular goiter (p = 0.006). Correlation between Tg concentration and stiffness was significant (p < 0.0001, r = 0.24). The concentration of Anti-Thyroid Autoantibodies was associated with stiffness at the border of significance. However, there was no significant difference between benign lesions in patients with diagnosed chronic autoimmune thyroiditis and patients without the disease. The analysis of the entire group of nodules revealed that shear wave elastography is a valuable modality of thyroid nodule assessment, with sensitivity of over 95 % and specificity of about 70 %. However, the stiffness value of the lesion might be increased in the case of nodules containing calcifications, cystic component, and those of size above 20 mm. Certain clinical conditions or attributes of the lesions influence the stiffness values of thyroid nodules. Identifying these variables is the basis for a credible interpretation of the results of a sonoelastographic examination and makes it possible to estimate the risk of thyroid nodule malignancy adequately.
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The calcium-phosphate balance, modulation of thyroid autoimmune processes and other adverse effects connected with thyroid arterial embolization.
Endocrine, 2013Co-Authors: Grzegorz Kamiński, Andrzej Jaroszuk, Ariadna Zybek, Krzysztof Brzozowski, Piotr Piasecki, Piotr Zięcina, Marek RuchałaAbstract:In search of new treatment options for thyroid diseases, when conventional procedures are ineffective, contraindicated or associated with serious side effects, safety of thyroid arteries embolization in the treatment of particular thyroid diseases was evaluated. The study included eight subjects with retrosternal toxic goiter, six patients affected by Graves’ disease, five cases of retrosternal non-toxic goiter, two subjects with post-amiodarone hyperthyroidism, and one patient with severe thyroid-related orbitopathy, who underwent selective embolization of thyroid arteries. The study assessed and compared calcium–phosphate balance, modulation of thyroid autoimmunity and the presence of different side effects in patients who underwent the procedure. In addition, the serum concentrations of thyroid hormones, Anti-Thyroid Autoantibodies and thyroid volume have been measured. Five of all enrolled subjects (22.7 %) experienced transient, not clinically relevant hypocalcaemia with no need for calcium supplementation. There were no significant changes in serum calcium levels in patients after embolization of both inferior thyroid arteries. The transient side effects associated with the treatment were neck pain and a slight increase in body temperature. Noted high concentration of free thyroid hormones immediately after the procedure was not accompanied by worsening of symptoms or signs of thyrotoxicosis. In patients with Graves’ disease, a significant decrease in thyrotropin receptor antibodies level was observed. Thyroid arterial embolization does not disturb permanently calcium–phosphate balance, modulates positively thyroid autoimmune processes and is associated with no serious post-procedure side effects. Hence, it may be considered as a safe and effective treatment modality for selected thyroid disorders.
Grzegorz Kamiński - One of the best experts on this subject based on the ideXlab platform.
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The calcium–phosphate balance, modulation of thyroid autoimmune processes and other adverse effects connected with thyroid arterial embolization
Endocrine, 2014Co-Authors: Grzegorz Kamiński, Andrzej Jaroszuk, Ariadna Zybek, Krzysztof Brzozowski, Piotr Piasecki, Piotr Ziecina, Marek RuchalaAbstract:In search of new treatment options for thyroid diseases, when conventional procedures are ineffective, contraindicated or associated with serious side effects, safety of thyroid arteries embolization in the treatment of particular thyroid diseases was evaluated. The study included eight subjects with retrosternal toxic goiter, six patients affected by Graves’ disease, five cases of retrosternal non-toxic goiter, two subjects with post-amiodarone hyperthyroidism, and one patient with severe thyroid-related orbitopathy, who underwent selective embolization of thyroid arteries. The study assessed and compared calcium–phosphate balance, modulation of thyroid autoimmunity and the presence of different side effects in patients who underwent the procedure. In addition, the serum concentrations of thyroid hormones, Anti-Thyroid Autoantibodies and thyroid volume have been measured. Five of all enrolled subjects (22.7 %) experienced transient, not clinically relevant hypocalcaemia with no need for calcium supplementation. There were no significant changes in serum calcium levels in patients after embolization of both inferior thyroid arteries. The transient side effects associated with the treatment were neck pain and a slight increase in body temperature. Noted high concentration of free thyroid hormones immediately after the procedure was not accompanied by worsening of symptoms or signs of thyrotoxicosis. In patients with Graves’ disease, a significant decrease in thyrotropin receptor antibodies level was observed. Thyroid arterial embolization does not disturb permanently calcium–phosphate balance, modulates positively thyroid autoimmune processes and is associated with no serious post-procedure side effects. Hence, it may be considered as a safe and effective treatment modality for selected thyroid disorders.
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The calcium-phosphate balance, modulation of thyroid autoimmune processes and other adverse effects connected with thyroid arterial embolization.
Endocrine, 2013Co-Authors: Grzegorz Kamiński, Andrzej Jaroszuk, Ariadna Zybek, Krzysztof Brzozowski, Piotr Piasecki, Piotr Zięcina, Marek RuchałaAbstract:In search of new treatment options for thyroid diseases, when conventional procedures are ineffective, contraindicated or associated with serious side effects, safety of thyroid arteries embolization in the treatment of particular thyroid diseases was evaluated. The study included eight subjects with retrosternal toxic goiter, six patients affected by Graves’ disease, five cases of retrosternal non-toxic goiter, two subjects with post-amiodarone hyperthyroidism, and one patient with severe thyroid-related orbitopathy, who underwent selective embolization of thyroid arteries. The study assessed and compared calcium–phosphate balance, modulation of thyroid autoimmunity and the presence of different side effects in patients who underwent the procedure. In addition, the serum concentrations of thyroid hormones, Anti-Thyroid Autoantibodies and thyroid volume have been measured. Five of all enrolled subjects (22.7 %) experienced transient, not clinically relevant hypocalcaemia with no need for calcium supplementation. There were no significant changes in serum calcium levels in patients after embolization of both inferior thyroid arteries. The transient side effects associated with the treatment were neck pain and a slight increase in body temperature. Noted high concentration of free thyroid hormones immediately after the procedure was not accompanied by worsening of symptoms or signs of thyrotoxicosis. In patients with Graves’ disease, a significant decrease in thyrotropin receptor antibodies level was observed. Thyroid arterial embolization does not disturb permanently calcium–phosphate balance, modulates positively thyroid autoimmune processes and is associated with no serious post-procedure side effects. Hence, it may be considered as a safe and effective treatment modality for selected thyroid disorders.
Marek Ruchala - One of the best experts on this subject based on the ideXlab platform.
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The calcium–phosphate balance, modulation of thyroid autoimmune processes and other adverse effects connected with thyroid arterial embolization
Endocrine, 2014Co-Authors: Grzegorz Kamiński, Andrzej Jaroszuk, Ariadna Zybek, Krzysztof Brzozowski, Piotr Piasecki, Piotr Ziecina, Marek RuchalaAbstract:In search of new treatment options for thyroid diseases, when conventional procedures are ineffective, contraindicated or associated with serious side effects, safety of thyroid arteries embolization in the treatment of particular thyroid diseases was evaluated. The study included eight subjects with retrosternal toxic goiter, six patients affected by Graves’ disease, five cases of retrosternal non-toxic goiter, two subjects with post-amiodarone hyperthyroidism, and one patient with severe thyroid-related orbitopathy, who underwent selective embolization of thyroid arteries. The study assessed and compared calcium–phosphate balance, modulation of thyroid autoimmunity and the presence of different side effects in patients who underwent the procedure. In addition, the serum concentrations of thyroid hormones, Anti-Thyroid Autoantibodies and thyroid volume have been measured. Five of all enrolled subjects (22.7 %) experienced transient, not clinically relevant hypocalcaemia with no need for calcium supplementation. There were no significant changes in serum calcium levels in patients after embolization of both inferior thyroid arteries. The transient side effects associated with the treatment were neck pain and a slight increase in body temperature. Noted high concentration of free thyroid hormones immediately after the procedure was not accompanied by worsening of symptoms or signs of thyrotoxicosis. In patients with Graves’ disease, a significant decrease in thyrotropin receptor antibodies level was observed. Thyroid arterial embolization does not disturb permanently calcium–phosphate balance, modulates positively thyroid autoimmune processes and is associated with no serious post-procedure side effects. Hence, it may be considered as a safe and effective treatment modality for selected thyroid disorders.
Malgorzata Wasniewska - One of the best experts on this subject based on the ideXlab platform.
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Subclinical Hypothyroidism in Children: When a Replacement Hormonal Treatment Might Be Advisable
Frontiers in endocrinology, 2019Co-Authors: Giuseppe Crisafulli, Tommaso Aversa, Giuseppina Zirilli, Giovanni Battista Pajno, Domenico Corica, Filippo De Luca, Malgorzata WasniewskaAbstract:Aim of this mini review was to analyze the main variables which should be taken into account when the decision regarding a possible treatment with L-T4 has to be considered for a child with subclinical hypothyroidism (SH). The indications of periodical monitoring and vigilance have been also discussed. It was inferred that therapy should be recommended for children with underlying Hashimoto's thyroiditis and progressive deterioration of thyroid status over time, particularly in the cases with goiter and hypothyroid symptoms and in those with associated Turner syndrome or Down's syndrome and/or other autoimmune diseases. Treatment might also be recommended for children with proatherogenic metabolic abnormalities. Treatment is not advisable in children with idiopathic and mild SH, no goiter, no hypothyroid symptoms and negative Anti-Thyroid Autoantibodies. In the absence of any therapeutic intervention, clinical status and thyroid function tests should be periodically monitored, in order to individuate the children who might benefit from treatment. It has been suggested that children with a persistent mild elevation of TSH, who are not treated with L-T4, should undergo biochemical monitoring of thyroid function and re-assessment of clinical status every 6 months. After 2 years with stable thyroid function tests, the interval between monitoring can be extended.
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Evaluation of Subclinical Hypothyroidism in Children and Adolescents: A Single-Center Study
International journal of endocrinology, 2016Co-Authors: Kamila Such, Malgorzata Wasniewska, Aneta Gawlik, Aleksandra Dejner, Agnieszka Zachurzok, Aleksandra Antosz, Tomasz Gawlik, Ewa Małecka-tenderaAbstract:The main purpose of our retrospective study was to evaluate the medical care of the patients with subclinical hypothyroidism (sHT) and to investigate the rationale for administering L-thyroxine (LT-4) to young sHT patients. Patients and Methods. Based on a retrospective review of the charts of 261 patients referred to the Endocrinology Outpatient Clinic between 2009 and 2014 with suspicion of sHT, 55 patients were enrolled for further analysis. Data collected was baseline age, anthropometric measurements, serum TSH, fT4, fT3, Anti-Thyroid Autoantibodies, positive family history, absence/presence of clinical symptoms, length of follow-up, and data concerning LT-4 therapy (therapy: T1; no therapy: T0). Results. T1 encompassed 33 (60.0%) patients. There were no differences between T1 and T0 () with regard to age, TSH concentrations, BMI -score, and hSDS values, though follow-up was longer in T1 (). Four (11.8%) children in T1 and none in T0 had a positive family history of thyroid disorders. Fifteen (68.2%) patients in group T0 became euthyroid. One (1.8%) girl (T1) developed overt hypothyroidism. Conclusions. A small percentage of patients can proceed to overt hypothyroidism. Only positive family history seemed to influence the decision to initiate LT-4 therapy. Further prospective studies are warranted in order to establish treatment indications, if any, and the mean recommended dosage of LT-4.
Makoto Yoneda - One of the best experts on this subject based on the ideXlab platform.
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Anti-glutamate receptor ɛ2 antibodies in psychiatric patients with Anti-Thyroid Autoantibodies – A prevalence study in Japan
Neuroscience letters, 2012Co-Authors: Yuhei Chiba, Makoto Yoneda, Omi Katsuse, Yukitoshi Takahashi, Misako Kunii, Atsushi Ihata, Atsuhisa Ueda, Mitsuhiro Takeno, Takashi Togo, Yoshio HirayasuAbstract:Abstract Patients with Anti-Thyroid antibodies (ATAs) present various kinds of psychiatric conditions. When these psychiatric patients with ATAs (PPATs) show responsiveness to immunotherapy, they are frequently diagnosed with a diffuse progressive type of Hashimoto's encephalopathy (HE). Anti-glutamate receptor ɛ2 subunit (GluRɛ2) antibodies have previously been reported in HE patients. However, it is unclear whether there is any relationship between PPATs, including HE patients, and anti-GluRɛ2 antibodies. We investigated anti-GluRɛ2 antibodies in the serum and cerebrospinal fluid (CSF) of 15 PPATs, and we compared the results with those of 11 patients with neuropsychiatric systemic lupus erythematosus (NPSLE), an anti-glutamate receptor antibody-related disease. We then compared the neuropsychiatric symptoms between the PPATs with and without anti-GluRɛ2 antibodies. The prevalence of anti-GluRɛ2 antibodies was significantly higher in the CSF than in the serum of PPATs (41.7% versus 6.7%; p = 0.040). The prevalence of anti-GluRɛ2 antibodies was slightly higher in the CSF of PPATs than NPSLE patients. PPAT-GluR(+)s showed a significantly higher prevalence of emotional instability (100% versus 33.3%; p = 0.03) and also showed a significantly lower prevalence of delusions (0% versus 100%; p = 0.001) and hallucinations (17% versus 83%; p = 0.038) than PPAT-GluR(−)s. Our results suggest that anti-GluRɛ2 antibodies may be associated with the neuropsychiatric manifestation of PPATs.
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High prevalence of serum Autoantibodies against the amino terminal of α-enolase in Hashimoto's encephalopathy
Journal of Neuroimmunology, 2007Co-Authors: Makoto Yoneda, Akihiro Fujii, A. Ito, H. Yokoyama, H. Nakagawa, Masaru KuriyamaAbstract:Recently,wediscoveredAutoantibodiesagainsttheamino(NH2)-terminalof α-enolase(NAE)inpatientswithHashimoto'sencephalopathy(HE) (83.3%; 5/6) [Fujii, A., Yoneda, M., Ito, T., Yamamura, O., Satomi, S., Higa, H., Kimura, M., Suzuki, M., Yamashita, M., Yuasa, T., Suzuki, H., Kuriyama, M., 2005. Autoantibodies against the amino terminal of α-enolase are a useful diagnostic marker of Hashimoto's encephalopathy. J. Neuroimmunol. 162, 130–136]. We further investigated the anti-NAE Autoantibodies in 25 patients who fit the diagnostic criteria for HE, based on the presence of Anti-Thyroid antibodies and responsiveness to immunotherapy. In this study, we demonstrated a high prevalence (68%, 17 of 25) and high specificity of anti-NAE Autoantibodies in patients with HE, and clarified the clinical features of HE. This result demonstrated that anti-NAE Autoantibodies, in addition to Anti-Thyroid Autoantibodies, are emphasized as useful serological diagnostic markers of HE. © 2007 Elsevier B.V. All rights reserved.
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High prevalence of serum Autoantibodies against the amino terminal of alpha-enolase in Hashimoto's encephalopathy.
Journal of neuroimmunology, 2007Co-Authors: Makoto Yoneda, Akihiro Fujii, A. Ito, H. Yokoyama, H. Nakagawa, Masaru KuriyamaAbstract:Recently, we discovered Autoantibodies against the amino (NH(2))-terminal of alpha-enolase (NAE) in patients with Hashimoto's encephalopathy (HE) (83.3%; 5/6) [Fujii, A., Yoneda, M., Ito, T., Yamamura, O., Satomi, S., Higa, H., Kimura, M., Suzuki, M., Yamashita, M., Yuasa, T., Suzuki, H., Kuriyama, M., 2005. Autoantibodies against the amino terminal of alpha-enolase are a useful diagnostic marker of Hashimoto's encephalopathy. J. Neuroimmunol. 162, 130-136]. We further investigated the anti-NAE Autoantibodies in 25 patients who fit the diagnostic criteria for HE, based on the presence of Anti-Thyroid antibodies and responsiveness to immunotherapy. In this study, we demonstrated a high prevalence (68%, 17 of 25) and high specificity of anti-NAE Autoantibodies in patients with HE, and clarified the clinical features of HE. This result demonstrated that anti-NAE Autoantibodies, in addition to Anti-Thyroid Autoantibodies, are emphasized as useful serological diagnostic markers of HE.