The Journal of Clinical Endocrinology & Metabolism,
Journal Year:
2020,
Volume and Issue:
105(12), P. 3704 - 3720
Published: Sept. 14, 2020
Abstract
Context
Invited
update
on
the
management
of
systemic
autoimmune
Graves
disease
(GD)
and
associated
orbitopathy
(GO).
Evidence
acquisition
Guidelines,
pertinent
original
articles,
reviews,
meta-analyses.
synthesis
Thyrotropin
receptor
antibodies
(TSH-R-Abs),
foremost
stimulatory
TSH-R-Abs,
are
a
specific
biomarker
for
GD.
Their
measurement
assists
in
differential
diagnosis
hyperthyroidism
offers
accurate
rapid
Thyroid
ultrasound
is
sensitive
imaging
tool
Worldwide,
thionamides
favored
treatment
(12-18
months)
newly
diagnosed
GD,
with
methimazole
(MMI)
as
preferred
drug.
Patients
persistently
high
TSH-R-Abs
and/or
persistent
at
18
months,
or
relapse
after
completing
course
MMI,
can
opt
definitive
therapy
radioactive
iodine
(RAI)
total
thyroidectomy
(TX).
Continued
long-term,
low-dose
MMI
administration
valuable
safe
alternative.
Patient
choice,
both
initial
presentation
GD
recurrence,
should
be
emphasized.
Propylthiouracil
to
during
first
trimester
pregnancy.
TX
best
performed
by
high-volume
thyroid
surgeon.
RAI
avoided
patients
active
GO,
especially
smokers.
Recently,
promising
an
anti-insulin-like
growth
factor-1
monoclonal
antibody
active/severe
GO
was
approved
Food
Drug
Administration.
COVID-19
infection
risk
factor
poorly
controlled
hyperthyroidism,
which
contributes
infection–related
mortality
risk.
If
not
severe,
steroid
postponed
while
local
preventive
measures
offered.
Conclusions
A
clear
trend
towards
serological
medical
has
emerged.
JAMA,
Journal Year:
2023,
Volume and Issue:
330(15), P. 1472 - 1472
Published: Oct. 17, 2023
Importance
Overt
hyperthyroidism,
defined
as
suppressed
thyrotropin
(previously
thyroid-stimulating
hormone)
and
high
concentration
of
triiodothyronine
(T
3
)
and/or
free
thyroxine
(FT
4
),
affects
approximately
0.2%
to
1.4%
people
worldwide.
Subclinical
low
concentrations
normal
T
FT
,
0.7%
Untreated
hyperthyroidism
can
cause
cardiac
arrhythmias,
heart
failure,
osteoporosis,
adverse
pregnancy
outcomes.
It
may
lead
unintentional
weight
loss
is
associated
with
increased
mortality.
Observations
The
most
common
Graves
disease,
a
global
prevalence
2%
in
women
0.5%
men.
Other
causes
thyrotoxicosis
include
toxic
nodules
the
thyrotoxic
phase
thyroiditis.
Common
symptoms
anxiety,
insomnia,
palpitations,
loss,
diarrhea,
heat
intolerance.
Patients
disease
have
diffusely
enlarged
thyroid
gland,
stare,
or
exophthalmos
on
examination.
(ie,
which
develop
autonomous
function)
from
local
compression
structures
neck
by
such
dysphagia,
orthopnea,
voice
changes.
Etiology
typically
be
established
based
clinical
presentation,
function
tests,
thyrotropin-receptor
antibody
status.
Thyroid
scintigraphy
recommended
if
are
present
etiology
unclear.
Thyrotoxicosis
thyroiditis
observed
symptomatic
treated
supportive
care.
Treatment
options
for
overt
antithyroid
drugs,
radioactive
iodine
ablation,
surgery.
subclinical
patients
at
highest
risk
osteoporosis
cardiovascular
those
older
than
65
years
persistent
serum
level
less
0.1
mIU/L.
Conclusions
Relevance
Hyperthyroidism
2.5%
adults
worldwide
First-line
treatments
surgery,
treatment.
choices
should
individualized
patient
centered.
European Thyroid Journal,
Journal Year:
2022,
Volume and Issue:
11(1)
Published: Jan. 4, 2022
Autoimmune
thyroid
disease
(AITD)
is
the
most
common
human
autoimmune
disease.
The
two
major
clinical
manifestations
of
AITD
are
Graves'
and
Hashimoto's
thyroiditis
(HT).
characterized
by
lymphocytic
infiltration
gland,
leading
either
to
follicular
cell
damage,
gland
destruction,
development
hypothyroidism
(in
HT)
or
hyperplasia,
induced
antibodies
which
activate
thyrotropin
receptor
(TSHR)
on
thyrocytes,
hyperthyroidism.
aim
this
review
present
up-to-date
picture
molecular
cellular
mechanisms
that
underlie
pathology
AITD.
Based
studies
involving
patients,
animal
models,
lines,
we
discuss
key
events
loss
immune
tolerance
autoantigens
as
well
signaling
cascades
destruction
gland.
Special
focus
given
interplay
between
environmental
genetic
factors,
ncRNAs
microbiome
contributing
development.
In
particular,
describe
mechanistic
models
SNPs
in
genes
involved
regulation
function,
such
CD40,
TSHR,
FLT3,
PTPN22,
predisposition.
significance
novel
diagnostic
prognostic
biomarkers
based
composition
also
underscored.
Finally,
possible
probiotic
supplementation
function
European Thyroid Journal,
Journal Year:
2022,
Volume and Issue:
11(1)
Published: Jan. 4, 2022
Hyperthyroidism
caused
by
Graves’
disease
(GD)
is
a
relatively
rare
in
children.
Treatment
options
are
the
same
as
adults
–
antithyroid
drugs
(ATD),
radioactive
iodine
(RAI)
or
thyroid
surgery,
but
risks
and
benefits
of
each
modality
different.
The
European
Thyroid
Association
guideline
provides
new
recommendations
for
management
pediatric
GD
with
without
orbitopathy.
Clinicians
should
be
alert
that
may
present
behavioral
changes
declining
academic
performance
Measurement
serum
TSH
receptor
antibodies
recommended
all
patients
hyperthyroidism.
Management
include
first-line
use
prolonged
course
methimazole/carbimazole
ATD
treatment
(3
years
more),
preference
dose
titration
instead
block
replace
ATD,
to
avoid
propylthiouracil
use.
Where
definitive
required
either
total
thyroidectomy
RAI
recommended,
aiming
complete
ablation
personalized
activity.
We
recommend
avoiding
children
under
10
age
favor
surgery
large
goiter.
Pediatric
endocrinologists
involved
cases.
Frontiers in Cell and Developmental Biology,
Journal Year:
2025,
Volume and Issue:
12
Published: Jan. 6, 2025
Graves
disease
(GD),
an
autoimmune
affects
the
thyroid
gland,
results
in
hyperthyroidisms
and
goiter.
The
main
cause
of
GD
is
not
clearly
defined;
however,
stimulating
autoantibodies
for
hormone
receptor
(TSHR)
known
as
thyroid-stimulating
immunoglobulins
(TSIs)
are
primary
proposed
mechanism.
TSI
activation
TSHRs
gland
excessive
release
hormones
with
subsequent
development
hyperthyroidism
cellular
process
macroautophagy/autophagy
implicated
pathogenesis
other
diseases.
Autophagy
plays
a
critical
role
many
diseases
different
stages
same
through
modulation
immunity
inflammatory
response.
In
addition,
autophagy
also
thyroid-associated
ophthalmopathy
(TAO).
However,
exact
well
explained.
Therefore,
this
review
discusses
how
intricately
involved
regarding
its
protective
harmful
effects.
Journal of Endocrinological Investigation,
Journal Year:
2021,
Volume and Issue:
45(4), P. 875 - 882
Published: Nov. 18, 2021
As
COVID-19
became
a
pandemic,
the
urgent
need
to
find
an
effective
treatment
vaccine
has
been
major
objective.
Vaccines
contain
adjuvants
which
are
not
exempt
from
adverse
effects
and
can
trigger
autoimmune/inflammatory
syndrome
induced
by
(ASIA).
There
is
very
little
information
about
autoimmune
endocrine
disease
ASIA
after
use
of
mRNA-based
SARS-CoV2
vaccination.
Frontiers in Immunology,
Journal Year:
2021,
Volume and Issue:
12
Published: April 26, 2021
Toll-like
receptors
(TLRs)
are
important
initiators
of
the
immune
response,
both
innate
and
acquired.
Evidence
suggests
that
gene
polymorphisms
within
TLRs
cause
malfunctions
certain
key
TLR-related
signaling
pathways,
which
subsequently
increases
risk
autoimmune
diseases.
We
illustrate
discuss
current
findings
on
role
receptor
in
numerous
diseases
this
review,
such
as
type
1
diabetes
mellitus,
Graves’
disease,
rheumatoid
arthritis,
systemic
lupus
erythematosus
multiple
sclerosis.
The
study
genetic
variation
different
populations
has
shown
a
complex
interaction
between
immunity
environmental
factors.
This
TLR
affect
susceptibility
to
differently
various
populations.
identification
can
expand
our
understanding
pathogenesis
diseases,
will
guide
effective
medical
management
provide
insight
into
prognosis
advanced
treatments.
