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Journal articles on the topic 'Tsh-rh'

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Published: 4 June 2021
Last updated: 11 February 2022

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1

Pontikides, Nickolaos, Spyridon Karras, Antonios Papagiannis, Athina Kaprara, Panagiotis Anagnostis, George Noussios, Argyrios Doumas, et al. "Recombinant Human Thyrotropin-Aided Radioiodine Therapy in Tracheal Obstruction by an Invading Well-Differentiated Thyroid Carcinoma." Case Reports in Otolaryngology 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/579527.

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Papillary thyroid carcinomas (PTCs) usually extend to lymph nodes in the neck and mediastinum. Rarely, they invade the neighboring upper airway anatomical structures. We report a 56-year-old woman who presented with symptoms of upper airway obstruction. Imaging studies revealed a lesion derived from the thyroid which invaded and obstructed the trachea, which appeared to be a highly differentiated PTC. Total thyroidectomy was performed, with removal of the endotracheal part of the mass along with the corresponding anterior tracheal rings. Two months later, a whole body I131scan after recombinant human thyroid-stimulating hormone (rh-TSH) administration was performed and revealed a residual mass in upper left thyroid lobe. Subsequently, 150 mCi I131were given following rh-TSH administration. Nine months later, there was no sign of residual tumor. This case is the first one reported in the literature regarding rh-TSH administration prior to RAI ablation in a PTC obstructing the trachea.
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2

Ma, Loretta, AnneMarie Gagnon, Anne Landry, Timothea Le, Fengxia Xiao, Cathy Sun, Heather Lochnan, Dylan Burger, and Alexander Sorisky. "Thyroid-Stimulating Hormone-Stimulated Human Adipocytes Express Thymic Stromal Lymphopoietin." Hormone and Metabolic Research 50, no. 04 (February 19, 2018): 325–30. http://dx.doi.org/10.1055/s-0044-101834.

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AbstractWhen recombinant human (rh) thyroid-stimulating hormone (TSH) is administered to thyroid cancer survivors, an acute extra-thyroidal effect raises pro-inflammatory cytokines and activates platelets. Thymic stromal lymphopoietin (TSLP) is a cytokine recently implicated in platelet activation. Our aim was to measure platelet microparticle levels after rhTSH stimulation in vivo, and to investigate TSLP expression in TSH-stimulated human adipocytes in culture. Blood samples for total and platelet microparticle analysis were obtained from thyroid cancer survivors before (day 1) and after rhTSH administration (day 5). Adipocytes, differentiated from stromal preadipocytes isolated from adipose tissue from surgical patients, were stimulated with TSH. TSLP mRNA expression, protein expression, and protein release into the adipocyte medium were measured. The level of platelet microparticles in thyroid cancer patients rose 5-fold after rhTSH stimulation. TSH upregulated TSLP mRNA expression in adipocytes in culture through a pathway that was inhibited by 66% by H89, a protein kinase A inhibitor. TSLP protein expression rose in response to TSH, and TSH-stimulated TSLP release into the medium was completely blocked by dexamethasone. In conclusion, TSLP is a novel TSH-responsive adipokine. Future studies will be needed to address the potential role of adipocyte-derived TSLP and whether it is linked to TSH-dependent platelet activation.
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Antunes, T. T., A. Gagnon, B. Chen, F. Pacini, T. J. Smith, and A. Sorisky. "Interleukin-6 release from human abdominal adipose cells is regulated by thyroid-stimulating hormone: effect of adipocyte differentiation and anatomic depot." American Journal of Physiology-Endocrinology and Metabolism 290, no. 6 (June 2006): E1140—E1144. http://dx.doi.org/10.1152/ajpendo.00516.2005.

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Adipose cells are extrathyroidal targets of thyroid-stimulating hormone (TSH). TSH stimulates interleukin-6 (IL-6) release from adipocytes. We examined TSH responsiveness as a function of stage of differentiation or adipose tissue depot in cultured adipose cells and determined the effect of TSH on extrathyroidal IL-6 production in vivo. Stromal preadipocytes, isolated from human abdominal subcutaneous or omental adipose tissue, and their differentiated counterparts were studied. IL-6 protein concentration in the medium was measured after TSH stimulation. Basal IL-6 release was greater for preadipocytes than differentiated adipocytes, whether derived from subcutaneous or omental fat depots. A depot-dependent effect (omental > subcutaneous) on basal IL-6 release was observed for preadipocytes (1.6-fold, P < 0.05); a similar trend for differentiated adipocytes was not significant (6.2-fold, P > 0.05). IL-6 responsiveness to TSH was observed upon differentiation, but only for subcutaneous adipocytes (1.9-fold over basal, P < 0.001). To determine if TSH could stimulate IL-6 release from extrathyroidal tissues in vivo, we measured serum IL-6 levels from five thyroidectomized patients who received recombinant human (rh) TSH and found that levels increased by threefold on days 3 and 4 ( P < 0.05) after its administration. Our data demonstrate that stage of differentiation and fat depot origin affect basal and TSH-stimulated IL-6 release from adipose cells in culture. Furthermore, rhTSH elevates serum IL-6 response in thyroidectomized patients, indicating an extrathyroidal site of TSH action.
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Dedov, Ivan I., Pavel O. Rumyantsev, Ksenia S. Nizhegorodova, Konstantin Y. Slashchuk, Valentina S. Yasyuchenya, Marina S. Sheremeta, Michail V. Degtyarev, Larisa V. Nikankina, and Galina A. Melnichenko. "Recombinant human thyrotropin in radioiodine diagnostics and radioiodine ablation of patients with well-differentiated thyroid cancer: the first experience in Russia." Endocrine Surgery 12, no. 3 (December 27, 2018): 128–39. http://dx.doi.org/10.14341/serg9806.

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Background. Traditional endogenous stimulation of thyroid-stimulating hormone (TSH) by means of long-term withdrawal of thyroid hormones for radioiodine diagnostics and radioiodine therapy causes severe hypothyroidism, which worsens patients’ general well-being and may lead to side effects and cause tumor growth and dissemination. Exogenous stimulation with recombinant human TSH (rh-TSH, thyrotropin-alfa) causes short-term increases in TSH levels and does not have the above-mentioned side effects. Purpose. To estimate the efficacy and safety of rh-TSH in preparation of patients with well-differentiated thyroid cancer for radioiodine diagnostics and radioiodine therapy. Methods. We conducted an interventional single-center prospective unblinded uncontrolled study of the efficacy and safety of thyrotropin-alfa to prepare patients with well-differentiated thyroid cancer to radioiodine diagnostics and post-surgery radioiodine ablation. The study included 88 patients with well-differentiated thyroid cancer: 54 patients were prepared for post-surgery radioiodine ablation; 34 patients – for radioiodine diagnostics to evaluate combined treatment efficacy and exclusion of tumor recurrence. The level of TSH, thyroglobulin, antibodies to thyroglobulin, whole body scintigraphy, and side effects were measured during exogenous stimulation with thyrotropin-alfa. Results. The level of TSH reached or exceed the target level (30 mIU/ml) 24 hours after the first injection of recombinant thyrotropin-alfa in 86% of patients; after 48 hours in 100%, the level exceeding 100 IU/ml was observed in 66 (75.1%) patients. The maximum levels of thyroglobulin and antibodies to thyroglobulin were reached 72 and 48 hours after the first injection, respectively. The injections of thyrotropin-alfa were well-tolerated by the patients. In the group for radioiodine diagnostics 2 (5.8%) patients complained of fatigue, 1 (2.9%) patient had signs of dyspeptic disorder, while in the group for radioiodine ablation 4 (7.4%) patients complained of fatigue, 1 (1.8%) patient had marked memory problems that disappeared later (they must have been caused by the patient’s advanced age (82 years)). Conclusions. Exogenous recombinant human thyroid-stimulating hormone (thyrotropin-alpha) is highly effective in preparation of patients with well-differentiated thyroid cancer for radioiodine diagnostics and radioiodine ablation. It does not have side effects, which are typical of withdrawal of thyroid hormones. The levels of thyroglobulin and antibodies to thyroglobulin measured 72 hours after the first injection of thyrotropin-alfa have the biggest diagnostic informative value.
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5

Gall, E., M. C. Eberle, E. Deshayes, I. Raingeard, H. Lemoyne-De-Forges, and J. Bringer. "Valeur pronostique du relargage précoce de thyroglobuline au cours de l’irathérapie sous rh-TSH." Annales d'Endocrinologie 76, no. 4 (September 2015): 357. http://dx.doi.org/10.1016/j.ando.2015.07.183.

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6

Kadambi, Prahlad, MA Ramprakash, Gandi Soujanya, and L Sushanth Prabhath Reddy. "Association between Thyroid Profile and Serum Bilirubin Levels in Term Neonates on Day 3 of Life." Asian Journal of Clinical Pediatrics and Neonatology 8, no. 2 (July 9, 2020): 42–45. http://dx.doi.org/10.47009/ajcpn.2020.8.2.8.

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Background: Neonatal indirect hyperbilirubinemia is a common clinical scenario that manifests as jaundice in the first week of life. Studies have shown that the physiological peak of serum bilirubin (SBR) levels is highest at 72 hours of life as a result of which SBR is measured at 72 hours of life routinely. The American Academy of Pediatricians (AAP) recommends routine screening for congenital hypothyroidism within the first week of life for all neonates. In common practice, both parameters are assessed simultaneously at 72 hours of life. This study aims to correlate thyroid Profile and serum bilirubin levels assessed in term neonates at 72 hours of life. Subjects and Methods: Our retrospective study included 105 term neonates born through cesarean-section at MMCHRI, Kanchipuram; between August 2018 and August 2019. Pre-term, neonates born to eclamptic, pre-eclamptic, diabetic, hypothyroid, Rh-incompatible mothers were excluded from the study. The data collected included Birth Weight, Gestational Age, Thyroid Profile (T3, T4, TSH), SBR (Total and Direct). Data were analyzed using SPSS v16. Results: The mean gestational age of the study population was 268.05 6.25 days, and mean birth weight was 2.997 0.36 kgs. The mean serum levels of total bilirubin were 11.36 3.52 mg/dl. The mean serum fT3, fT4, TSH levels were 8.17 23.2 pg/ml, 2.16 1.68 ng/dl and 4.07 3.4 mIU/ml respectively. A positive association was noted between serum TSH and total serum bilirubin (r= 0.176, p = 0.067) but not statistically significant. Conclusion: Our study has not shown a significant association between serum TSH and SBRT in term neonates. However, the simultaneous assessment remains practical in practice.
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Eberle-Pouzeratte, M. C., and I. Raingeard. "Évaluation d’un protocole de stimulation mixte couplant sevrage court en lévothyroxine et rh-TSH avant irathérapie en Languedoc-Roussillon." Annales d'Endocrinologie 78, no. 4 (September 2017): 261. http://dx.doi.org/10.1016/j.ando.2017.07.131.

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8

Tiosano, Dov, Lea Even, Zila Shen Orr, and Ze’ev Hochberg. "Recombinant Thyrotropin in the Diagnosis of Congenital Hypothyroidism." Journal of Clinical Endocrinology & Metabolism 92, no. 4 (April 1, 2007): 1434–37. http://dx.doi.org/10.1210/jc.2006-2134.

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Abstract Context: A modern approach to congenital hypothyroidism requires a definitive diagnosis of the underlying mechanisms; this can be achieved within the first weeks of life. When uncertainty persists, treatment is commenced, and the definitive diagnosis of congenital hypothyroidism is deferred to the age of 3 yr. Objectives: The interruption of thyroid replacement treatment is perceived as risky by parents and physicians. The aim of this pilot study was to test the possibility of a definitive diagnosis during thyroid replacement treatment, using stimulation of thyroid tissue by recombinant human (rh)TSH. Subjects: Eight patients, three boys and five girls, age 5–15 yr (mean, 9.5 ± 3.7 yr), with congenital hypothyroidism that had been diagnosed by the neonatal screening program, and having their diagnosis verified between the ages of 3–4 yr, were reevaluated while on thyroid replacement therapy. Interventions: Patients received im 0.6 mg/m2 rhTSH on two consecutive days. Results: rhTSH pharmacokinetics, maximal concentration, t1/2, and area under the curve in children were different as compared with adults. In the patients with intact TSH receptors, free T4 levels decreased after the first and the second injection of rhTSH (P = 0.0137 and P = 0.0149, respectively). All eight children showed identical scintigraphy after rhTSH administration as compared with thyroid replacement withdrawal. Conclusions: The use of rhTSH is effective for definitive diagnosis of congenital hypothyroidism during thyroid replacement treatment, and no safety issues were encountered.
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Nielsen, Viveque Egsgaard, Steen J. Bonnema, and Laszlo Hegedüs. "Transient Goiter Enlargement after Administration of 0.3 mg of Recombinant Human Thyrotropin in Patients with Benign Nontoxic Nodular Goiter: A Randomized, Double-Blind, Crossover Trial." Journal of Clinical Endocrinology & Metabolism 91, no. 4 (April 1, 2006): 1317–22. http://dx.doi.org/10.1210/jc.2005-2137.

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Background: Recombinant human (rh) TSH, in doses from 0.01 to 0.9 mg, has been used to augment the effect of radioiodine (131I) therapy in patients with a benign nontoxic nodular goiter. Transient thyroid enlargement and thyrotoxicosis may be seen following 131I therapy. Aim: The aim of the study was to investigate whether rhTSH per se causes goiter enlargement, until now an issue evaluated only in healthy nongoitrous subjects. Methods: In random order, 10 patients with nontoxic nodular goiter [mean 39.8 ± 20.5 (sd) ml] received either 0.3 mg rhTSH or isotonic saline in a double-blinded crossover design. Thyroid volume (by ultrasound) and function were closely monitored during the following 28 d. Results: Saline injection did not affect thyroid function or size. After rhTSH, median serum TSH increased from baseline 0.97 mU/liter (range 0.39–1.56) to 37.0 mU/liter (range 18.5–55.0) at 24 h (P &lt; 0.01), with a subsequent decline to subnormal levels at d 7. Mean free T4 and free T3 increased significantly from baseline to a maximum at 48 h. Twenty-four hours after rhTSH, the mean goiter volume was significantly increased by 9.8 ± 2.3% (sem) (P = 0.01) and after 48 h by 24.0 ± 5.1% (P = 0.002). The goiter enlargement had reverted at d 7. Nine patients had symptoms of hyperthyroidism and/or cervical compression after rhTSH, as opposed to one during placebo treatment (P &lt; 0.02). Conclusions: A transient average goiter enlargement of up to 24% is seen after 0.3 mg rhTSH. This may lead to a significant cervical compression when used for augmentation of 131I therapy in patients with goiter. The use of lower doses of rhTSH needs to be explored.
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Bãrbuş, Elena, Claudiu Peştean, Maria Iulia Larg, and Doina Piciu. "Quality of life in thyroid cancer patients: a literature review." Medicine and Pharmacy Reports 90, no. 2 (April 26, 2017): 147–53. http://dx.doi.org/10.15386/cjmed-703.

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Introduction. Quality of life (QoL) has received increasing interest in the last years, especially in patients with cancer. This article aims to analyze a selection of medical research papers regarding the quality of life in patients with thyroid carcinoma. We overviewed the main QoL aspects derived from several studies and highlighted those less researched issues, which could represent a solid base for future clinical studies.Method. We used an integrative selection method of medical literature, choosing mostly "free access" studies, as it was considered that they could be easily viewed, searched and researched including by patients.Results. After an integrative literature review, we selected 16 relevant studies. Patients with thyroid cancer have several factors influencing their QoL, with both physical and psychological impact. The decisive factors are the quality of the surgical act, radioiodine therapy, follow-up using rh-TSH vs. hormonal withdrawal, access to behavioral help and the relationship with their physician.Conclusion. We must understand the emotional impact of the cancer diagnosis on the patient and we must collaborate in order to help the patient restore the psychosomatic balance and to recover the quality of life.
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Li, Yujuan, Hua Gao, Zhen Li, Xinxin Zhang, Yizhi Ding, and Fengao Li. "Clinical Characteristics of 76 Patients with IgG4-Related Hypophysitis: A Systematic Literature Review." International Journal of Endocrinology 2019 (December 18, 2019): 1–10. http://dx.doi.org/10.1155/2019/5382640.

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Background. IgG4-related hypophysitis (IgG4-RH) is a rare disease, and its prevalence remains unclear. In recent years, an increasing number of cases have been reported because of the increasing recognition of this disease. We aimed to summarize case reports of IgG4-RH and outline the clinical features and outcomes. Methods. We performed PubMed search of articles using the search terms “hypophysitis [AND] IgG4.” Consequently, only 54 English articles (76 cases) met Leporati’s diagnostic criteria. Results. Of the 76 cases, the ratio of men to women was 1.5 : 1, and the age at diagnosis was 54.1 ± 17.8 years. The median IgG4 concentration was 405.0 mg/dl. Anterior hypopituitarism, isolated central diabetes insipidus, and panhypopituitarism were observed in 14 (18.4%), 12 (15.8%), and 44 (57.9%) cases, respectively. The sequence of anterior hormone deficiency was as follows: gonadotropin (68.4%), ACTH (63.2%), TSH (59.2%), GH (48.7%), and prolactin (42.1%). The median number of involved organs was 1.5, and the lung (18.4%), retroperitoneum (17.1%), kidney (15.8%), submandibular glands (14.5%), and pancreas (13.2%) were the common involved organs. Elevated IgG4 concentration and normal IgG4 level were in 42 (76.4%) and 13 (23.6%) cases, respectively. Patients with elevated serum IgG4 concentration were older (60.9 ± 14.3 vs 45.6 ± 17.4, p=0.001) and male-prone (78.6% vs 40.4%, p=0.003) and had a susceptibility of multiple organ involvement (78.6% vs 35.0%, p=0.001) compared to those with normal serum IgG4 levels. Males were older at disease onset (61.5 ± 12.6 vs 42.9 ± 18.8, p<0.001) and had a higher IgG4 concentration (425.0 vs 152.5, p=0.029) and a greater number of involved organs (2.0 vs 0.0, p=0.001), while isolated hypophysitis was more prominent in female (63.3% vs 26.1%, p=0.001). Conclusion. In this review, we found that there were different characteristics between different genders. Patients with elevated serum IgG4 level in terms of some clinical features were also different from those with normal serum IgG4 level. However, the data in this review were limited by bias and confounding. Further clinical studies with larger sample sizes are warranted.
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Han, Yeon-Hee, Seok Tae Lim, Kuk-No Yun, Sung Kyun Yim, Dong Wook Kim, Hwan-Jeong Jeong, and Myung-Hee Sohn. "Comparison of the Influence on the Liver Function Between Thyroid Hormone Withdrawal and rh-TSH Before High-Dose Radioiodine Therapy in Patients with Well-Differentiated Thyroid Cancer." Nuclear Medicine and Molecular Imaging 46, no. 2 (April 21, 2012): 89–94. http://dx.doi.org/10.1007/s13139-012-0132-1.

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Vaiano, Angela, A. Claudio Traino, Giuseppe Boni, Mariano Grosso, Patrizia Lazzeri, Chiara Colato, Maria Vittoria Dav??, et al. "Comparison between remnant and red-marrow absorbed dose in thyroid cancer patients submitted to 131I ablative therapy after rh-TSH stimulation versus hypothyroidism induced by L-thyroxine withdrawal." Nuclear Medicine Communications 28, no. 3 (March 2007): 215–23. http://dx.doi.org/10.1097/mnm.0b013e328014a0f6.

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Heinzel, A., K. Kley, H. W. Mueller, and H. Hautzel. "A Comparison of rh-TSH and Thyroid Hormone Withdrawal in Patients with Differentiated Thyroid Cancer: Preliminary Evidence for an Influence of Age on the Subjective Well-being in Hypothyroidism." Hormone and Metabolic Research 44, no. 01 (November 22, 2011): 54–59. http://dx.doi.org/10.1055/s-0031-1295415.

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15

Digra, Madhu, Ravinder Kumar, and Dinesh Kumar. "Thyroid profile in women with menstrual disorders." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 8 (July 26, 2017): 3300. http://dx.doi.org/10.18203/2320-1770.ijrcog20173130.

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Background: Thyroid dysfunction influences both menstrual flow and fertility, likely through changes in sex hormone levels, gonadotrophin release and possibly ovarian function. Objectives of this work were to study thyroid related complaints and thyroid function tests in patients with menstrual irregularities like menorrhagia, oligomenorrhoea, amenorrhoea, hypomenorrhoea and ploymenorrhoea, to study menstrual patterns in women with diagnosed thyroid disease-hypothyroidism/hyperthyroidism and to study changes in menstrual patterns, if any in these patients during the course of treatment of thyroid disease, who receive correct treatmentMethods: This study was conducted in the Department of Obstetrics and Gynecology in Government L.D. Hospital, Government Medical College, Srinagar during the period from 2006 to 2007. There were two groups under which the study was conducted. Group A: Seventy-five patients of DUB from Department of Gynecology in reproductive age group (15-45 years) presenting with menstrual irregularities like menorrhagia, oligomenorrhoea, amenorrhoea, hypomenorrhoea and ploymenorrhoea were studied for thyroid profile. Group B comprised of 25 patients including already diagnosed 17 hypothyroid and 8 hyperthyroid patients. The study protocol included thorough history taking, general physical examination, meticulous per speculum and pelvic examination and routine investigations like Hb, BT, CT, TLC, DLC, Platelet count and ABO-Rh in all patients, Serum T3, T4, TSH estimation.Results: Most of the patients were in 35-45 years age group. Prevalence of infertility was more in hypothyroid group. 22.66% patients with DUB were detected as hypothyroid where as 13.33% patients were detected as hyperthyroid.Conclusions: Thyroid function tests, many of which are sensitive radioimmunoassay, radiometric assays and even new chemiluminescence method, which can detect minute changes in hormone levels must be done in women presenting with menstrual disorders.
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Bonnema, Steen J., Viveque E. Nielsen, Henrik Boel-Jørgensen, Peter Grupe, Peter B. Andersen, Lars Bastholt, and Laszlo Hegedüs. "Recombinant Human Thyrotropin-Stimulated Radioiodine Therapy of Large Nodular Goiters Facilitates Tracheal Decompression and Improves Inspiration." Journal of Clinical Endocrinology & Metabolism 93, no. 10 (October 1, 2008): 3981–84. http://dx.doi.org/10.1210/jc.2008-0485.

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Introduction: The impact on tracheal anatomy and respiratory function of recombinant human (rh)TSH-stimulated 131I therapy in patients with goiter is not clarified. Methods: In a double-blinded design, patients (age 37–87 yr) with a large multinodular goiter (range, 99–440 ml) were randomized to placebo (n = 15) or 0.3 mg rhTSH (n = 14) 24 h before 131I therapy. The smallest cross-sectional area of the trachea (SCAT; assessed by magnetic resonance imaging) and the pulmonary function were determined before, 1 wk, and 12 months after therapy. Results: Data on goiter reduction have been reported previously. In the placebo group, no significant changes in the lung function or SCAT were found throughout the study. In the rhTSH group, a slight decrease was observed in the forced vital capacity 1 wk after therapy, whereas the mean individual change in SCAT was significantly increased by 10.5% (95% confidence interval = 0.9–20.0%). A further increase in SCAT to 117 ± 36 mm2 (P = 0.005 compared with 92 ± 38 mm2 at baseline) was seen at 12 months, corresponding to a mean of 31.4% (95% confidence interval = 16.0–46.8%). The expiratory parameters did not change significantly, whereas forced inspiratory flow at 50% of the vital capacity (FIF50%) increased from initially 3.34 ± 1.33 liters/sec to ultimately 4.23 ± 1.88 liters/sec (P = 0.015) in the rhTSH group, corresponding to a median increase of 24.6%. By 12 months, the relative improvements in FIF50% and in SCAT were inversely correlated to the respective baseline values (FIF50%: r = −0.47, P = 0.012; SCAT: r = −0.57, P = 0.001). Conclusion: On average, neither compression of the trachea nor deterioration of the pulmonary function was observed in the acute phase after rhTSH-augmented 131I therapy. In the long term, tracheal compression is diminished, and the inspiratory capacity improved, compared with 131I therapy alone.
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Tamilarasi, S., S. N. S. Minnalkodi, and Geetha Prasad. "Thyroid disorders in patients with abnormal uterine bleeding in tertiary care hospital in Chengalpattu district." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 9 (August 27, 2020): 3847. http://dx.doi.org/10.18203/2320-1770.ijrcog20203515.

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Background: A relationship between the thyroid gland and the gonads is suggested by far more frequent occurrence of thyroid disorders in women than in men by clinical appearance of goiter during pregnancy, puberty, and menopause. Aim of this study was to determine the association between menstrual irregularities and thyroid dysfunction. To analyse the pattern of menstrual dysfunction among women with a thyroid disorder.Methods: This cross-sectional study was done in Karpaga Vinayaga Institute of Medical Sciences and Research Center - obstetrics and gynecology OPD. Over 6 months in the year 2019. 100 women who presented with abnormal uterine bleeding with the below exclusion criteria. Detailed history taking with an emphasis on age, parity, infertility, and menstrual disorders. Evaluation by pelvic examination along with the general physical examination of those with menstrual complaints. Routine investigations like Hb, BT, CT, TLC, DLC, platelet count, and ABO-Rh in all. Then all patients were subjected to estimation of serum T3, T4, TSH with early morning samples.Results: Menorrhagia presents in 39.4% of patients in the normal cohort and 63.6% in the thyroid dysfunction cohort. Hypomenorrhea presents in 4% normal cohort and 9.1% thyroid dysfunction cohort. Hypothyroidism presents in 7.27%, subclinical hypothyroidism in 1.81%, and hyperthyroidism in 0.92% of patients. Amenorrhoea presents in 16.2% of patients of the normal cohort and 9.1% of patients of thyroid dysfunction cohort. No statistical significance between amenorrhoea and thyroid dysfunction.32.3% in the normal cohort and 36.4% in thyroid dysfunction cohort had a bulky uterus. No statistical association exists between thyroid dysfunction and uterine size. In a histopathological examination of the endometrium, 49.5% in the normal cohort and 54.5% thyroid dysfunction cohort reported as proliferative endometrium. Amenorrhoea; the significant association between abnormal uterine bleeding and thyroid disorder (10%).Conclusions: The significant association between abnormal uterine bleeding and thyroid disorder (10%). It brings into focus the increased incidence of hypothyroidism among women with menorrhagia.
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Handkiewicz-Junak, Daria, Jozef Roskosz, Tomasz Gawlik, Tomasz Olczyk, Elzbieta Gubala, Aleksandra Kropinska, Kornelia Hasse-Lazar, and Barbara Jarzab. "rh-TSH (Thyrogen) aided radioiodine therapy in children and adolescents with DTC." Endocrine Abstracts, April 17, 2014. http://dx.doi.org/10.1530/endoabs.35.oc1.5.

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Mazzaferri, E. L., and N. Massoll. "Management of papillary and follicular (differentiated) thyroid cancer: new paradigms using recombinant human thyrotropin." Endocrine-related cancer, December 2002, 227–47. http://dx.doi.org/10.1677/erc.0.0090227.

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The incidence of differentiated thyroid cancer (DTC) has increased in many places around the world over the past three decades, yet this has been associated with a significant decrease in DTC mortality rates in some countries. While the best 10-year DTC survival rates are about 90%, long-term relapse rates remain high, in the order of 20-40%, depending upon the patient's age and tumor stage at the time of initial treatment. About 80% of patients appear to be rendered disease-free by initial treatment, but the others have persistent tumor, sometimes found decades later. Optimal treatment for tumors that are likely to relapse or cause death is total thyroidectomy and ablation by iodine-131 ((131)I), followed by long-term levothyroxine suppression of thyrotropin (TSH). On the basis of regression modeling of 1510 patients without distant metastases at the time of initial treatment and including surgical and (131)I treatment, the likelihood of death from DTC is increased by several factors, including age >45 years, tumor size >1.0 cm, local tumor invasion or regional lymph-node metastases, follicular histology, and delay of treatment >12 months. Cancer mortality is favorably and independently affected by female sex, total or near-total thyroidectomy, (131)I treatment and levothyroxine suppression of TSH. Treatments with (131)I to ablate thyroid remnants and residual disease are independent prognostic variables favorably influencing distant tumor relapse and cancer death rates. Delay in treatment of persistent disease has a profound impact on outcome. Optimal long-term follow-up using serum thyroglobulin (Tg) measurements and diagnostic whole-body scans (DxWBS) require high concentrations of TSH, which until recently were possible to achieve only by withdrawing levothyroxine treatment, producing symptomatic hypothyroidism. New paradigms, however, provide alternative pathways to prepare patients for (131)I treatment and to optimize follow-up. Patients with undetectable or low Tg concentrations and persistent occult disease can now be identified within the first year after initial treatment by recombinant human (rh)TSH-stimulated serum Tg concentrations greater than 2 microg/l, without performing DxWBS. These new follow-up paradigms promptly identify patients with lung metastases that are not evident on routine imaging, but which respond to (131)I treatment. In addition, rhTSH can be given to prepare patients for (131)I remnant ablation or (131)I treatment for metastases, especially those who are unable to withstand hypothyroidism because of concurrent illness or advanced age, or whose hypothyroid TSH fails to increase.
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F, Arecco. "Is it Possible to avoid rh-TSH test in Patients with Differentiated Thyroid Carcinoma by Using the Association between Ablation and Suppressive Thyroglobulin?" International Journal of Endocrinology and Metabolic Disorders 2, no. 2 (2016). http://dx.doi.org/10.16966/2380-548x.126.

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Mulhem, Elie. "In people with residual or metastatic differentiated thyroid cancer, what are the benefits and harms of recombinant human thyrotropin (rh TSH)-aided radioiodine treatment?" Cochrane Clinical Answers, May 7, 2014. http://dx.doi.org/10.1002/cca.63.

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22

Mariko, Tangiku, Tatsuo Ishizuka, Kei Fujioka, Saori Inui, Hideki Tani, Takako Maruyama, and Kouji Yamada. "SAT-244 Inflammatory Rathke Cleft Cyst Caused Hypothalamic Panhypopituitarism." Journal of the Endocrine Society 4, Supplement_1 (April 2020). http://dx.doi.org/10.1210/jendso/bvaa046.187.

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Abstract Background: Hypothalamic panhypopituitarism was a rare disease which was caused by brain tumors such as Rathke cyst, germinoma, malignant lymphoma and craniopharyngioma, and vascular accidents such as thrombosis and hemorrhage. We have found a rare case of hypothalamic panhypopituitarism occurred by the inflammation of Rathke cyst. Case presentation: A 77-year-old woman was admitted to our hospital because of severe headache, nausea, vomiting and fever. Hyponatremia (Na 131 meq/L) and increased CRP level (0.20 mg/dl) and no finding of gastroenterological examination and abdominal CT scanning were observed. Endocrinological examination revealed low levels of anterior pituitary hormones such as GH, LH, FSH and ACTH and increased PRL levels and low level of serum cortisol. Simultaneous CRH, TRH and LH-RH stimulations tests indicated low responses of TSH, LH, FSH and PRL and hyperesponse of ACTH (from 2.4 to 251 pg/ml). Radiological examination by enhanced MRI revealed high intensity of T2-weighted images and low and partial high intensities of T1-weighted images in swelling of pituitary gland and vanishment of high intensity of posterior lobe in T2-weighted images suggesting that the inflammatory wall of Rathke cyst. We searched previous data of ACTH and cortisol levels which showed normal level of ACTH (55.2 pg/ml) and cortisol 18.8 μ;g/dl) when headache and nausea arouse on 50 days before. Based on above results patient was diagnosed as hypothalamic hypopituitarism due to inflammatory Rathke cyst. Therefore, patient was treated with hormone replacement therapy by 20 mg of hydrocortisone. After these treatment, polyuria, urinary low osmotic pressure and hypernatremia appeared due to partial diabetes insipidus caused by the impairment of posterior lobe in pituitary gland, and diagnosed by the examination of vasopressin test. This patient was also treated by the oral desmopressin acetate hydrate (60 μ;g/day), and has been well-tolerated in the outpatient clinic. Conclusion: These results suggested that inflammatory Rathke cyst with inflammatory changes in hypothlamo-pituitary system raised a rare case of hypothalamic panhypopituitarism.Reference: Nishioka H. et al.: Clin Endocrinology (Oxf) 2006:64:184–188
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