The Experts below are selected from a list of 6759 Experts worldwide ranked by ideXlab platform
Akira Miyauchi - One of the best experts on this subject based on the ideXlab platform.
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3 5 3 triiodothyronine Thyrotoxicosis due to increased conversion of administered levothyroxine in patients with massive metastatic follicular thyroid carcinoma
The Journal of Clinical Endocrinology and Metabolism, 2008Co-Authors: Akira Miyauchi, Nobuyuki Amino, Kaoru Kobayashi, Fumio Matsuzuka, Yuuki Takamura, Akihiro Miya, Nagaoki Toyoda, Emiko Nomura, Mitsushige NishikawaAbstract:Objective: Some patients with massive metastatic thyroid carcinoma exhibit T3 Thyrotoxicosis. We investigated the prevalence and cause of T3 Thyrotoxicosis and the clues to the diagnosis. Design: Serum free T3 (FT3), free T4 (FT4), and TSH were measured in patients with massive metastases from papillary, follicular, or medullary thyroid carcinomas (31, 20, and seven patients, respectively). Patients without recurrence served as controls. Thyrotoxic patients were reexamined 1 wk after withdrawal of levothyroxine. Type 1 and type 2 iodothyronine deiodinase (D1 and D2) activities were measured in three tumor tissues from thyrotoxic patients. Main Outcome: The serum FT3 level and FT3/FT4 ratio in the follicular carcinoma (FC) group were significantly higher than those in the papillary carcinoma group or patients without recurrence. Four patients (20%) in the FC group but none in the other groups demonstrated T3 Thyrotoxicosis or a FT3/FT4 ratio greater than 3.5. One week after withdrawal of levothyroxine, bot...
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quantitative measurement of thyroid blood flow for differentiation of painless thyroiditis from graves disease
Clinical Endocrinology, 2007Co-Authors: Hisashi Ota, Nobuyuki Amino, Shuji Fukata, Shinji Morita, Kaoru Kobayashi, Sumihisa Kubota, Naohisa Kamiyama, Akira MiyauchiAbstract:Summary Objective Differentiation between destruction-induced Thyrotoxicosis and Graves’ Thyrotoxicosis is important for selection of proper therapy. It is, however, often difficult to make this distinction without measurement of radioactive iodine uptake. We investigated the possibility that assessment of thyroid blood flow would allow differentiation between the two entities. Patients and measurements One hundred and fourteen untreated patients with Thyrotoxicosis (56 Graves’ disease, 28 painless thyroiditis, 30 subacute thyroiditis) and 25 normal controls were examined. Serum levels of freeT4 (FT4), freeT3 (FT3) and TSH were measured by chemiluminescent immunoassay, and anti-TSH receptor antibodies (TSH-binding inhibitory immunoglobulin, TBII) were measured by enzyme-linked immunosorbent assay. Thyroid volume and blood flow (TBF) were measured quantitatively by ultrasonography. Results TBF was significantly higher in Graves’ disease (mean ± 1SD: 14·9 ± 6·4%, P < 0·0001) than in painless thyroiditis (0·8 ± 0·5%), subacute thyroiditis (0·9 ± 0·7%) and in normal controls (0·8 ± 0·5%). All patients with Graves’ disease had TBF values of more than 4% and all patients with painless thyroiditis and subacute thyroiditis had TBF values less than 4%. TBF values significantly correlated with values of radioactive iodine uptake (RAIU) either at 3 h (r = 0·492, P < 0·01) or 24 h (r = 0·762, P < 0·001) within the Graves’ disease and painless thyroiditis groups. There was no relationship between TBF values and thyroid volumes or values of TBII in the Graves’ disease group. All patients with Graves’ disease had positive TBII of 15% or more. Three of 28 patients with painless thyroiditis and one of 30 patients with subacute thyroiditis had positive TBII. Conclusion TBF was quantitatively measured by power Doppler ultrasonography and was more effective than TBII for differentiation between destruction-induced Thyrotoxicosis (painless or subacute thyroiditis) and Graves’ Thyrotoxicosis. TBF values of less than 4% in untreated thyrotoxic patients are laboratory signals of destruction-induced Thyrotoxicosis and if these are determined, the radioactive iodine uptake test can be omitted for differential diagnosis of these two types of Thyrotoxicosis.
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transient hyperthyroidism after withdrawal of antithyroid drugs in patients with graves disease
Endocrine Journal, 2004Co-Authors: Sumihisa Kubota, Shuji Fukata, Kanji Kuma, Hajime Tamai, Hidemi Ohye, Akira MiyauchiAbstract:The development of silent thyroiditis in patients with a history of Graves' disease is common, especially in the postpartum period. We describe herein patients with Graves' disease who developed transient hyperthyroidism but not silent thyroiditis after withdrawal of antithyroid drug (ATD). If such patients are diagnosed as recurrence of Graves' disease, they may receive ATD or radioiodine therapy unnecessarily. We investigated the characteristics of these patients to prevent unnecessary therapy. We retrospectively studied 22 patients with Graves' disease who showed transient Thyrotoxicosis after withdrawal of ATD. Two of 22 patients were male and the mean ages (+/- SD) were 33.7 +/- 12.6 yr. We observed these patients for 28.5 +/- 12.8 (mean +/- SD; range 12-53) months after transient Thyrotoxicosis, and measured TSH, FT4, and TSH binding inhibitor immunoglobulin in sera. Radioiodine uptake was measured in 6 of them. The radioiodine uptake in the 4 patients was not suppressed (27.5%, 28.0%, 32.7%, 38.1%). These uptake levels indicate that their Thyrotoxicosis was not caused by silent thyroiditis. Most of the 22 patients became euthyroid within 6 months. This study suggests a new therapeutic option as follows: in the case of young patients with mild Thyrotoxicosis after withdrawal of ATD, physicians should follow them up for one month without medication unless they have unbearable symptoms or complications.
Madeleine Duvic - One of the best experts on this subject based on the ideXlab platform.
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Thyrotoxicosis after denileukin diftitox therapy in patients with mycosis fungoides
The Journal of Clinical Endocrinology and Metabolism, 2006Co-Authors: Farah Ghori, Lauren Pinterbrown, Kristel D Polder, Ana O Hoff, Robert F Gagel, Steven I Sherman, Madeleine DuvicAbstract:Context: Denileukin diftitox is a recombinant novel fusion protein of diphtheria toxin and the ligand-binding domain of human IL-2. Denileukin diftitox binds to the high-affinity IL-2 receptor on the cell surface, and it is internalized by endocytosis and enzymatically cleaved. The cytotoxic A-fragment of the toxin inhibits protein synthesis and causes cell death. Objective: The objective of this study was to recognize Thyrotoxicosis in association with denileukin diftitox therapy. Design: This study was a retrospective case series. Setting: The setting of this study was a comprehensive cancer center. Patients: Eight mycosis fungoides patients who were receiving 9 or 18 μg/kg·d iv denileukin diftitox for 5 d every 3 wk were identified with Thyrotoxicosis. Intervention(s): Thyroid testing was performed. Hypothyroidism after Thyrotoxicosis was treated. Results: In eight mycosis fungoides patients who developed transient Thyrotoxicosis during therapy, thyroid function tests were normal before onset of therap...
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brief report Thyrotoxicosis after denileukin diftitox therapy in patients with mycosis fungoides
2006Co-Authors: Farah Ghori, Lauren Pinterbrown, Kristel D Polder, Ana O Hoff, Robert F Gagel, Steven I Sherman, Madeleine DuvicAbstract:Results: In eight mycosis fungoides patients who developed transient Thyrotoxicosis during therapy, thyroid function tests were normal before onset of therapy. Clinical Thyrotoxicosis developed within days of the first cycle of denileukin diftitox therapy in four patients and after the second cycle in the other four patients. Symptoms included tremors, nervousness, tachycardia, diarrhea, and weight loss. After cessation of denileukin diftitox, Thyrotoxicosis resolved in all patients; two became euthyroid, and five became hypothyroid, requiring levothyroxine therapy. One patient was lost to follow-up.
Farah Ghori - One of the best experts on this subject based on the ideXlab platform.
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Thyrotoxicosis after denileukin diftitox therapy in patients with mycosis fungoides
The Journal of Clinical Endocrinology and Metabolism, 2006Co-Authors: Farah Ghori, Lauren Pinterbrown, Kristel D Polder, Ana O Hoff, Robert F Gagel, Steven I Sherman, Madeleine DuvicAbstract:Context: Denileukin diftitox is a recombinant novel fusion protein of diphtheria toxin and the ligand-binding domain of human IL-2. Denileukin diftitox binds to the high-affinity IL-2 receptor on the cell surface, and it is internalized by endocytosis and enzymatically cleaved. The cytotoxic A-fragment of the toxin inhibits protein synthesis and causes cell death. Objective: The objective of this study was to recognize Thyrotoxicosis in association with denileukin diftitox therapy. Design: This study was a retrospective case series. Setting: The setting of this study was a comprehensive cancer center. Patients: Eight mycosis fungoides patients who were receiving 9 or 18 μg/kg·d iv denileukin diftitox for 5 d every 3 wk were identified with Thyrotoxicosis. Intervention(s): Thyroid testing was performed. Hypothyroidism after Thyrotoxicosis was treated. Results: In eight mycosis fungoides patients who developed transient Thyrotoxicosis during therapy, thyroid function tests were normal before onset of therap...
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brief report Thyrotoxicosis after denileukin diftitox therapy in patients with mycosis fungoides
2006Co-Authors: Farah Ghori, Lauren Pinterbrown, Kristel D Polder, Ana O Hoff, Robert F Gagel, Steven I Sherman, Madeleine DuvicAbstract:Results: In eight mycosis fungoides patients who developed transient Thyrotoxicosis during therapy, thyroid function tests were normal before onset of therapy. Clinical Thyrotoxicosis developed within days of the first cycle of denileukin diftitox therapy in four patients and after the second cycle in the other four patients. Symptoms included tremors, nervousness, tachycardia, diarrhea, and weight loss. After cessation of denileukin diftitox, Thyrotoxicosis resolved in all patients; two became euthyroid, and five became hypothyroid, requiring levothyroxine therapy. One patient was lost to follow-up.
Hong Liu - One of the best experts on this subject based on the ideXlab platform.
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peak systolic velocity of superior thyroid artery for the differential diagnosis of Thyrotoxicosis
PLOS ONE, 2012Co-Authors: Xiaolong Zhao, Yong Wang, Lili Chen, Yao Wang, Linuo Zhou, Fangfang Zeng, Hong LiuAbstract:Aim The differentiation of destruction-induced Thyrotoxicosis and Graves’ disease (GD) is of great importance for selection of proper therapy. Radioactive iodine uptake (RAIU) is the gold standard for differentiating these two conditions but its application has remained somewhat limited. Thyroid color Doppler flow sonography (CDFS) is a potential alternative of RAIU but more supporting evidence is warranted. In the present study, a standard operative procedure was developed to measure the mean peak systolic velocity of superior thyroid artery (STA-PSV) and evaluate its role in the differential diagnosis of Thyrotoxicosis. Methods A total of 135 patients with untreated Thyrotoxicosis were enrolled into one retrospective study (GD, n = 103; thyroiditis, n = 32) and another prospective study recruited 169 patients (GD, n = 118; thyroiditis, n = 51). Thirty normal controls were also enrolled. Thyroid function, anti-TSH-receptor antibody (TRAb), RAIU, CFDS of thyroid and STA-PSV were performed for each patient. Receiver operator curve (ROC) was used to evaluate the diagnostic value of STA-PSV in a retrospective study so as to seek the optimal cutoff point. Then the cutoff point value was used to validate its diagnostic value in a prospective study and in another Thyrotoxicosis population. Results STA-PSV of GD was significantly higher than that of thyroiditis in both retrospective and prospective studies. The area under the ROC curve of mean STA-PSV was 0.8799 and 0.9447 in the retrospective and prospective studies respectively. If a mean STA-PSV cutoff point of 50.5 cm/s was set from the retrospective analysis for the prospective study, the sensitivity and specificity in distinguishing GD from thyroiditis were 81.04% and 96.08% respectively. Mean STA-PSV and TRAb had similar area under ROC. The coefficients of variation in STA-PSV measurement were lower than 10% for the euthyroid, thyroiditis and GD groups. Conclusions STA-PSV is a feasible supplement alternative of RAIU for differentiating the causes of Thyrotoxicosis.
Takahisa Hirose - One of the best experts on this subject based on the ideXlab platform.
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Superior thyroid artery mean peak systolic velocity for the diagnosis of Thyrotoxicosis in Japanese patients.
Endocrine journal, 2010Co-Authors: Toyoyoshi Uchida, Kageumi Takeno, Masahiro Goto, Rei Kanno, Sayaka Kubo, Satomi Takahashi, K. Azuma, Ken Sakai, Yoshio Fujitani, Takahisa HiroseAbstract:Thyrotoxicosis with diffuse thyroid disease can be caused by Graves' disease (GD) or destructive thyroiditis (DT). Optimal treatment of the underlying condition requires a prompt and accurate method for the diagnosis of Thyrotoxicosis. This study evaluated measurement of the mean peak systolic velocity of the superior thyroid artery (STA-PSV) by ultrasonography in detecting Thyrotoxicosis in Japanese patients. We recruited 44 patients with untreated GD, 13 with DT, 55 with treated GD, and 49 subjects without thyroid disease. Blood samples were taken to analyze thyroid function and STA-PSV was measured by ultrasonography. The mean STA-PSV was the highest in the untreated GD group, followed by treated GD patients and then those with DT. Receiver operating characteristic curves of the STA-PSV values demonstrated that the area under the curve required discriminating untreated GD from DT was 0.941. The optimal sensitivity and specificity were 83.7% and 92.3%, respectively, using 45 cm/sec as the cutoff value. In conclusion measurement of STA-PSV by ultrasonography is useful for the diagnosis of Thyrotoxicosis in Japanese patients.
