Hyperthyroidism: aetiology, pathogenesis, diagnosis, management, complications, and prognosis

The Lancet Diabetes & Endocrinology, Год журнала: 2023, Номер 11(4), С. 282 - 298

Опубликована: Фев. 24, 2023

Язык: Английский

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Current concepts regarding Graves’ orbitopathy

Journal of Internal Medicine, Год журнала: 2022, Номер 292(5), С. 692 - 716

Опубликована: Май 23, 2022

Graves' orbitopathy (GO) is an orbital autoimmune disorder and the main extrathyroidal manifestation of disease, most common cause hyperthyroidism. GO affects about 30% patients, although fewer than 10% have severe forms requiring immunosuppressive treatments. Management requires a multidisciplinary approach. Medical therapies for active moderate-to-severe (traditionally, high-dose glucocorticoids) often provide unsatisfactory results, subsequently surgeries are needed to cure residual manifestations. The aim this review updated overview current concepts regarding epidemiology, pathogenesis, assessment, treatment GO, present emerging targeted therapeutic perspectives. Original articles, clinical trials, systematic reviews, meta-analyses from 1980 2021 were searched using following terms: orbitopathy, thyroid eye glucocorticoids, radiotherapy, rituximab, cyclosporine, azathioprine, teprotumumab, TSH-receptor antibody, smoking, hyperthyroidism, hypothyroidism, thyroidectomy, radioactive iodine, antithyroid drugs. Recent studies suggest secular trend toward milder phenotype GO. Standardized assessment at clinic allows better general management plan. Treatment still relies in cases on systemic-mainly intravenous-glucocorticoids as monotherapy or combination with other therapies-such mycophenolate, radiotherapy-but novel biological agents-including tocilizumab-have achieved encouraging results.

Язык: Английский

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Thyroid dysfunction in COVID-19

Nature Reviews Endocrinology, Год журнала: 2024, Номер 20(6), С. 336 - 348

Опубликована: Фев. 12, 2024

Язык: Английский

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COVID-19 and thyroid function: What do we know so far?

Frontiers in Endocrinology, Год журнала: 2022, Номер 13

Опубликована: Дек. 19, 2022

Coronavirus disease 2019 (COVID-19) was characterized as a pandemic in March, 2020 by the World Health Organization. COVID-19 is respiratory syndrome that can progress to acute distress syndrome, multiorgan dysfunction, and eventually death. Despite being considered disease, it known other organs systems be affected COVID-19, including thyroid gland. Thyroid gland, well hypothalamus pituitary, which regulate functioning of most endocrine glands, express angiotensin-converting enzyme 2 (ACE2), main protein functions receptor SARS-CoV-2 binds enter host cells. In addition, gland extremely sensitive changes body homeostasis metabolism. Immune system cells are targets for hormones T3 T4 modulate specific immune responses, cell-mediated immunity, natural killer cell activity, antiviral action interferon (IFN) proliferation T- B-lymphocytes. However, studies show patients with controlled hypothyroidism hyperthyroidism do not have higher prevalence nor they worse prognosis when infected virus. On hand, retrospective observational studies, prospective case reports published last two years reported abnormal function related infection or even several weeks after its resolution. Indeed, variety disorders been documented patients, non-thyroidal illness (NTIS), subacute thyroiditis thyrotoxicosis. has already consequence administration vaccines against SARS-CoV-2. Overall, data revealed may occur during convalescence post-COVID condition phase. Although cellular molecular mechanisms completely understood, evidence suggests “cytokine storm” an important mediator this context. Thus, future needed better investigate pathophysiology dysfunction induced at both clinical levels.

Язык: Английский

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Subacute thyroiditis – Is it really linked to viral infection? Retrospective hospital patient registry study

The Journal of Clinical Endocrinology & Metabolism, Год журнала: 2025, Номер unknown

Опубликована: Янв. 15, 2025

Abstract Objective Subacute thyroiditis (SAT) is a painful inflammatory disorder of the thyroid gland, which – after phase thyrotoxicosis leads to transient, or less frequently permanent hypothyroidism. Apart from strong association with specific HLA alleles, causes are uncertain. Viral disease has been hypothesised as trigger, Enteroviruses, namely Echoviruses and Coxsackieviruses, showing seasonal distribution that coincides incidence SAT. In first year COVID-19 pandemic, strict hygiene measures led sharp decline in infections thus offered opportunity test this hypothesis. Methods We analysed national registry data hospitalised patients Germany during years 2015 2022 (Federal statistical Office (Destatis), Wiesbaden, Germany) surveillance on infectious diseases same (clinical-virology.net RKI). Statistical analysis includes modelling seasonality by month, polynomial autoregression Granger causality assess dependency future SAT frequencies past ones, virus frequency, respectively. Results Our study confirms previously described epidemiological findings higher females peak late summer coinciding enteroviruses until 2019. 2020, pattern remained unchanged, except for marked reduction other pathogens (except SARS-CoV-2) due hygienic measures. Moreover, 2021 was apparently unaltered through pandemic. Conclusions provides evidence despite their pattern, Coxsackieviruses not cause no (including Influenza A B, Parainfluenza, Rhinovirus, Human Coronaviruses including showed any association.

Язык: Английский

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SARS-CoV-2 vaccine may trigger thyroid autoimmunity: real-life experience and review of the literature

Journal of Endocrinological Investigation, Год журнала: 2022, Номер 45(12), С. 2283 - 2289

Опубликована: Июль 12, 2022

Язык: Английский

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COVID-19 vaccination and thyroiditis

Best Practice & Research Clinical Endocrinology & Metabolism, Год журнала: 2023, Номер 37(4), С. 101759 - 101759

Опубликована: Март 3, 2023

Язык: Английский

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Increased prevalence of autoimmune thyroid disease after COVID-19: A single-center, prospective study

Frontiers in Endocrinology, Год журнала: 2023, Номер 14

Опубликована: Март 8, 2023

Thyroid dysfunctions associated with SARS-CoV-2 acute infection have been extensively described since the beginning of COVID-19 pandemics. Conversely, few data are available on occurrence thyroid autoimmunity after resolution. We assessed prevalence autoimmune disease (ATD) and in survivors three months hospital admission.Single-center, prospective, observational, cohort study performed at ASST Papa Giovanni XXIII Hospital, Bergamo, Italy. 599 were prospectively evaluated for function thyroperoxidase antibodies (TPOAb), thyroglobulin (TgAb). When a positive antibody concentration was detected, ultrasound performed. Multiple logistic regression model used to estimate association between demographic characteristics, respiratory support, comorbidities. Autoimmunity results compared 498 controls referred our Institution non-thyroid diseases before pandemic onset. A sensitivity analysis comparing 330 patients age sex-matched performed.Univariate multivariate found that female sex positively (OR 2.01, SE 0.48, p = 0.003), type 2 diabetes (T2DM) negatively 0.36, 0.16, 0.025) autoimmunity; hospitalization, ICU admission, or treatment not (p > 0.05). TPOAb greater than controls: 15.7% vs 7.7%, 0.002. Ultrasonographic features thyroiditis present 94.9% antibodies. TSH within normal range 95% patients.Autoimmune doubled as controls, suggesting role eliciting autoimmunity.

Язык: Английский

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Subacute THYROiditis Related to SARS-CoV-2 VAccine and Covid-19 (THYROVAC Study): A Multicenter Nationwide Study

The Journal of Clinical Endocrinology & Metabolism, Год журнала: 2023, Номер 108(10), С. e1013 - e1026

Опубликована: Апрель 25, 2023

Abstract Context The aims of the study are to compare characteristics subacute thyroiditis (SAT) related different etiologies, and identify predictors recurrence SAT incident hypothyroidism. Methods This nationwide, multicenter, retrospective cohort included 53 endocrinology centers in Turkey. participants were divided into either COVID-19–related (Cov-SAT), SARS-CoV-2 vaccine–related (Vac-SAT), or control (Cont-SAT) groups. Results Of 811 patients, 258 (31.8%) Vac-SAT group, 98 (12.1%) Cov-SAT 455 (56.1%) Cont-SAT group. No difference was found between groups with regard laboratory imaging findings. etiology not an independent predictor In entire cohort, steroid therapy requirement younger age statistically significant for recurrence. C-reactive protein measured during onset, female sex, absence antithyroid peroxidase (TPO) positivity, (early) hypothyroidism, irrespective etiology. On other hand, probable established hypothyroidism differed from that Conclusion Since there is no terms follow-up parameters outcomes, COVID-19– can be treated followed up like classic SATs. Recurrence determined by requirement. Steroid independently predicts may sometimes transient overall also associated a lower risk

Язык: Английский

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Endocrine system after 2 years of COVID-19 vaccines: A narrative review of the literature

Frontiers in Endocrinology, Год журнала: 2022, Номер 13

Опубликована: Ноя. 10, 2022

Purpose The purpose of this study was to describe the current knowledge on potential endocrine adverse effects post-COVID-19 vaccines. Methods A PubMed/MEDLINE, Web Science, and Scopus research performed. Case reports, case series, original studies, reviews written in English published online up 31 July 2022 were selected reviewed. final reference list defined based relevance each paper scope review. Results available data showed that side are generally rare with favorable outcome, being thyroid disorders most common. Conversely, type 1 diabetes mellitus rare; adrenal pituitary events even anecdotal. Finally, clinical studies suggest no impact female reproductive system male couple fertility. Conclusion Overall, these show that, after 2 years COVID-19 vaccines, is not heavily threatened.

Язык: Английский

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