BACKGROUND: Melatonin plays an important role in immunity and has been linked to autoimmune diseases. Possible associations of single-nucleotide polymorphisms (SNPs) of melatonin receptor type 1A (MTNR1A) and 1B (MTNR1B), with autoimmune thyroid disease in an ethnic Chinese (i.e., Taiwanese) population were examined.
MATERIALS AND METHODS: Totally, 83 Hashimoto's thyroiditis patients, 319 Graves' disease (GD), and 369 controls were recruited. Three SNPs (rs6553010, rs13140012, and rs2119882) of MTNR1A and three SNPs (rs1387153, rs10830963, and rs1562444) of MTNR1B were genotyped.
RESULTS: There were a reduced frequency of the C allele of rs2119882 and a reduced percentage of the CC+CT genotype in the GD group compared to the control group (p = 0.039, odds ratio (OR) = 0.79, 95% confidence interval (CI) = 0.63~0.99, and p = 0.032, OR = 0.72, 95% CI = 0.53~0.97, respectively). There was a significant difference in the percentage of the AT haplotype of the combination of rs13140012 and rs2119882 between the GD and control groups (p = 0.010, OR = 1.34, 95% CI = 1.07~1.67). In addition, there were significant associations of anti-thyroid peroxidase antibody titers with rs13140012 and rs2119882, and the AATT genotype of the combination of rs13140012 and rs2119882 (p = 0.003, 0.003, and 0.004, respectively). There were no significant associations of SNPs and possible haplotypes of MTNR1B with susceptibility to GD.
CONCLUSIONS: Genetic variants of rs2119882 of MTNR1A and the AT haplotype of the combination of rs2119882 and rs13140012 were associated with GD susceptibility in an ethnic Chinese population. The results support the involvement of the melatonin pathway in the pathogenesis of GD.
Immune System Diseases (2) Graves Disease (3), Autoimmune Diseases (1), Thyroiditis (1), more mentions
BACKGROUND: National guidelines emphasize the importance of incorporating patient preferences into the recommendations for the treatment of Graves' disease. Many patients use the Internet to obtain health information, and search results can affect their treatment decisions. This study compares the readability and accuracy of patient-oriented online resources for the treatment of Graves' disease by website affiliation and treatment modality.
METHODS: A systematic Internet search was used to identify the top websites discussing the treatment of Graves' disease. Readability was measured using 5 standardized tests. Accuracy was assessed by a blinded, expert panel, which scored the accuracy of sites on a scale of 1 to 5. Mean readability and accuracy scores were compared among website affiliations and treatment modalities.
RESULTS: We identified 13 unique websites, including 2 academic, 2 government, 5 nonprofit, and 4 private sites. There was a difference in both readability (mean 13.2, range 9.1-15.7, P = .003) and accuracy (mean 4.04, range 2.75-4.50, P = .019) based on website affiliation. Government sites (mean readability 11.1) were easier to read than academic (14.3, P < .01), nonprofit (13.9, P < .01), and private sites (13.5, P < .05). Academic sites (mean accuracy 4.50) were more accurate than private sites (3.56, P < .05).
CONCLUSION: Online patient resources for the treatment of Graves' disease are written at an inappropriately high reading level. Academic sites contain both the most accurate and the most difficult to read information. Private sites represented the majority of our top results but contained the least accurate information.
RATIONALE: Treatment choices are limited, when deciding how to manage thyrotoxicosis and moderate to severe Graves ophthalmopathy (GO) with suspected optic nerve damage in patients with elevated liver transaminase levels. The situation become even more complicated, if methimazole induced hepatotoxicity is suspected and intravenous methylprednisolone is co-administrated.
PATIENT CONCERNS: A 74-year-old woman presented with spontaneous retro-bulbar pain, eyelid swelling and inconstant diplopia.
DIAGNOSES: Thyrotoxicosis and severe GO with suspected optic nerve damage and drug induced liver injury (DILI).
INTERVENTIONS: Intravenous methylprednisolone pulse therapy was administered to treat GO and methimazole was continued for thyrotoxicosis. Dose of methimazole was reduced after exclusion of concurrent infection and active liver disease.
OUTCOMES: The GO symptoms (eyelid swelling, sight loss, proptosis, retro-bulbar pain, diplopia) markedly decreased after the treatment course. Liver transaminases spontaneously returned to normal ranges and remained normal during the next 12 months until the Graves' disease until the treatment was completed.
LESSONS: 1. The interaction of methimazole and methylprednisolone may result in DILI. 2. In a patient without concomitant liver diseases MP can be continued if the methimazole dose is reduced if no other treatment options are available.
Thyrotoxicosis (4), Liver Diseases (2), Graves Ophthalmopathy (2), more mentions
... about the long-term side-effects of different treatments for hyperthyroidism... men and women AbstractText: Healthcare registers were used to find hyperthyroid patients over 35 years of age who were treated with ... radioiodine treatment AbstractText: Compared with treatment with radioiodine, surgery for hyperthyroidism is associated with a lower risk of all-cause and ...
... Evaluate efficacy of add-on Se on medical treatment in GD AbstractText: Double-blind, placebo-controlled, randomized supplementation trial AbstractText: Academic endocrine outpatient clinic AbstractText: Seventy untreated hyperthyroid patients with GD AbstractText: Additionally to methimazole (MMI), patients received for 24 weeks either sodium selenite 300 µg/d po or placebo.
... iodine contrast media (ICM) which may induce or even worsen hyperthyroidism AbstractText: A cross-sectional study followed by a longitudinal study on patients with subclinical hyperthyroidism AbstractText: 810 consecutive IHD outpatients without known thyroid diseases or ... then followed up for 1 year AbstractText: 58 patients had hyperthyroidism at baseline (HB, 7.2%), independently associated to FT4 levels, thyroid ...
... coronary computed tomography angiographies of patients with overt and subclinical hyperthyroidism for quantitative parameters and plaque morphology AbstractText: Seven hundred forty ... 3 groups: 51 patients with overt, 74 patients with subclinical hyperthyroidism, and 619 patients with euthyroidism... Patients with overt hyperthyroidism, followed by those with subclinical hyperthyroidism, had the most high-risk plaque features: napkin ring (21.6 ...
AbstractText: Graves' hyperthyroidism (GH) interferes with iron metabolism and elevates ferritin... Gender and smoking status had an impact on ferritin, hepcidin and thyroid hormones Keyword: Graves’ hyperthyroidism. Keyword: ferritin. Keyword: hepcidin. Keyword: iron metabolism.
BACKGROUND: Immunomodulatory therapies, including CTLA-4 and PD-1 inhibitors, provide a directed attack against cancer cells by preventing T cell deactivation. However, these drugs also prevent the down-regulation of auto-reactive T cells, resulting in immune-related adverse events (IRAEs). Reports show a varied incidence of endocrine IRAEs, ranging from 0-63%.
OBJECTIVE: To describe the frequency and clinical characteristics of endocrine IRAEs in patients taking cancer immunomodulatory therapies.
DESIGN: Retrospective cohort study.
PATIENTS: 388 patients aged ≥18 years who were prescribed ipilimumab, nivolumab, and/or pembrolizumab between 2009-2016 at our institution.
MEASUREMENTS: Biochemical criteria were used to define endocrine IRAEs, including thyroid, pituitary, pancreas, and adrenal dysfunction, following use of immunomodulatory therapies.
RESULTS: 50 endocrine IRAEs occurred in our cohort, corresponding to a rate of 12.9%. The most common endocrine IRAEs were thyroid dysfunction (11.1%), with a lower incidence of pituitary dysfunction (1.8% of patients).
CONCLUSIONS: Over 12% of patients receiving ipilimumab, nivolumab, and/or pembrolizumab in our study sample developed an endocrine IRAE. Patients who undergo treatment with immunomodulatory therapies should be monitored for the development of endocrine IRAEs. This article is protected by copyright. All rights reserved.
... acting on the vasculature and if these effects are confined only to arterial vessels supporting the thyroid or not. This review aims to collate current available data about Lugol's solution and other iodide preparations in the management of Graves' disease and give some suggestions where more research is needed Keyword: Adjuvant treatment. Keyword: Escape. Keyword: Hyperthyroidism. Keyword: Iodide. Keyword: Thyroidectomy.
Graves Disease (4), Thyrotoxicosis (1), Hyperthyroidism (1), more mentions
... the prevalence ranging from 2.4% to 31%) and of Graves' hyperthyroidism (with the prevalence being up to 5... On the other hand, the basis for development of hyperthyroidism is mechanistically unclear, and it is merely speculative that autoantigens ... to the development of anti-thyrotropin receptor antibodies and Graves' hyperthyroidism in subjects who are immunologically predisposed to this ailment.
Oncology (1), Immune System Diseases (1) Hyperthyroidism (5), Hypothyroidism (4), Autoimmune Thyroiditis (1), more mentions