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Objectives Patients with Hashimoto thyroiditis (HT) experience mental health complaints due to the immune system dysregulation. Preliminary evidence suggests that psychological interventions could improve patients' quality of life. Compassionate mind training (CMT) is part of compassion-focused therapy (CFT) and can be used to help individuals address physical and mental health difficulties. The present study sought to assess the acceptability and preliminary efficacy of Reset Your Immune System, a 6-week CMT-based online intervention, in patients with HT.Methods Nine women were randomly selected from a wider sample that undertook the online intervention. Upon completion, they were interviewed with nine standard open-ended questions. Additionally, pre- and post-intervention questionnaires were filled out.Results Qualitative analysis indicated that participants observed improvements in symptoms, sleep quality, self-awareness, stress-management, and self-regulation skills. Participants did experience some difficulties in undertaking compassion-related exercises. Quantitative analyses showed that negative affect, social/role limitations, and HT symptoms indicated a reliable change from pre- to post intervention.Conclusions Overall, Reset Your Immune System showed beneficial effects on patients with HT, suggesting that including psychological care as part of the standard treatment of HT might have added value. It is important to assess long-term effects in a larger sample through a randomized control trial.

Introduction:The literature demonstrates elevated immunoglobulin E (IgE) levels in autoimmune thyroid diseases and their relationship with allergic diseases. The purpose of this study was to describe the relationship between thyroid nodules and total serum IgE levels and metabolic parameters in patients with Hashimoto thyroiditis.Methods:The study included 627 Hashimoto thyroiditis patients [500 (female: 406, male: 94) with and 127 (female: 101, male: 26) without thyroid nodules] and 292 (female: 224, male: 68) healthy control patients. Total serum IgE levels, metabolic parameters, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), total cholesterol, low-density lipoprotein cholesterol, triglyceride, uric acid, free-T4, free-T3, thyroid stimulating hormone, anti-thyroglobulin, anti-thyroid peroxidase, C-reactive protein (CRP) levels, and sedimentation rate were measured in all groups. Moreover, SPSS was used to analyze the results.Results:The mean age, serum IgE levels, mean FBG, HbA1c, and CRP levels of the thyroid nodule group were statistically significantly higher than the non-nodule and control groups (p˂0.05). In all Hashimoto thyroiditis patients, metabolic parameter levels were statistically significantly higher than in control groups (p˂0.05).Conclusion:There is a significant relationship between serum total IgE levels and thyroid nodules. Furthermore, thyroid nodule development appears to be influenced by metabolic and inflammatory abnormalities. These findings confirm the presence of multisystem factors in the development of thyroid nodules.

IntroductionAutoimmune diseases concomitant with diabetes may complicate the treatment and adversely affect the prognosis. The most common is Hashimoto’s disease (HD). We compared diabetes control and prevalence of chronic complications in type 1 diabetes patients differing in the coexistence of HD.Material and methodsMedical records of 188 type 1 diabetics were analysed. Hashimoto’s disease was diagnosed based on medical history, as well as determination of the levels of thyroid peroxidase antibodies, hormones and ultrasound exa¬mination. Statistical analysis was performed using Statistica 10PL.ResultsHD was diagnosed in 43 patients (23%). The mean HbA1c was 8.8 ±1.5% in the group with HD, and 9 ±1.6% in the group without HD (ns). The prevalence of diabetes complications was similar in both groups: ischae¬mic heart disease was diagnosed in 19% of patients with HD and 19% without HD, cerebral vascular insufficiency – 8% and 7%, peripheral neuropathy – 14% and 12%, sensory polyneuropathy – 47% and 46%, diabetic foot – 7% and 8%, Charcot osteoarthropathy – 7% and 2%, cardiovascular neuropathy – 21% and 28%, neuropathy of the gastrointestinal tract – 5% and 6%, nephropathy – 12% and 19%, retinopathy – 42% and 43%, and cataract in 28% and 19%, respectively. Impaired hypoglycaemia perception was rarer in the group with HD: 9% vs. 25% (p ≈0.04).ConclusionsHashimoto’s disease does not significantly affect the level of type 1 diabetes control or the development of its complications. Only autonomic neuropathy in the form of impaired awareness of hypoglycaemia is rarer in patients with that thyroiditis.

Background: Hashimoto thyroiditis (HT) and Graves’ disease (GD) are autoimmune inflammatory thyroid disorders. The evolution from GD into HT is the most common scenario while the conversion from HT into GD seems to be less common. Case Presentation: A 20-year-old female patient referred to the endocrinology clinic with a three-month history of fatigue, lethargy, lack of appetite, constipation, menorrhagia, cold intolerance, and 5 kg weight gain in the last two months. Clinical examination showed dry skin, scalp hair loss, and painless hard goiter whereas thyroid ultrasound revealed generalized homogeneous hypoechoic thyroid hypertrophy. Laboratory tests demonstrated increased serum thyroid-stimulating hormone (TSH) 210 µIU/L (normal: 0.25-4.50), decreased free thyroxine (FT4) 0.37 ng/L (normal: 0.8-1.8) and free triiodothyronine (FT3) 1.94 pg/mL (normal: 1.8-4.6), and finally, increased thyroid peroxidase antibodies (anti-TPO) 462 IU/mL (normal: up to 34). Based on observations, HT was diagnosed and thus daily treatment with levothyroxine 75 mcg was started for the patient. Two months later, she referred with symptoms suggestive of hyperthyroidism with reduced TSH levels, which did not improve after levothyroxine cessation, thus more laboratory tests were conducted and revealed decreased TSH levels, increased T3 and T4, and TSH receptor stimulating antibody (TSAb)levels, and increased radioactive iodine uptake at 24 hours. Therefore, the diagnosis of GD was made. Five weeks after treatment, she was in full remission. Conclusion: Although the switch from HT into GD is rare, it can occur at any time during the disease. Nonetheless, early diagnosis and treatment would improve the quality of care.

Immune thrombocytopenia (ITP) is a disorder characterized by immune-mediated destruction of thrombocytes leading to peripheral blood platelet count of

Introduction Hashimoto thyroiditis (HT) may lead to muscle weakness due to hypothyroid dysfunction. However, clinical experience treating patients with HT suggests that neuromuscular symptoms may develop in these patients despite long-standing euthyroidism. Methods In 24 euthyroid patients with HT and 25 healthy controls, physical fatigability was assessed using the arm movement test (AMT) and 6-min walk test (6MWT). Fatigability was based on calculation of linear trend (LT) reflecting dynamic performance within subsequent constant time intervals. Perception of physical fatigue and muscle pain was analyzed using fatigue (FSMC) and pain questionnaires. Obtained results were correlated with clinical, neurophysiological and lab findings. Results HT patients showed a negative LT in 6MWT significantly differing from stable performance in controls. LT in AMT did not differ between HT and controls. FSMC scores and pain perception revealed significantly higher levels in HT patients than in controls. Physical FSMC score was primarily influenced by pain perception (standardized regression coefficient, beta = 0.633, p = 0.002). Neither pain score nor physical fatigue score showed a correlation with LT in 6MWT nor did mood, or anti-TPO antibody titer. Conclusion A significant physical fatigability could be shown in euthyroid HT patients despite missing obvious neuromuscular deficits in routine testing. Further, elevated pain and fatigue perception in HT patients seem to contribute to nonspecific muscle complaints in these patients. A possible pathogenic role of thyroid autoimmunity in hidden neuromuscular involvement may be suggested.

Faecal microbiota transplantation (FMT) is reportedly effective and safe for the management of recurrent or refractory Clostridioides difficile infection (CDI), yet real-world data of outcomes of FMT in Australia are limited. In this series, FMT safely resulted in resolution of CDI in 19 patients with reduced healthcare utilisation after 25 FMT, but one patient was diagnosed with an anti-nuclear antibody-positive constitutional illness and Hashimoto thyroiditis following FMT. Further prospective evaluation of the utility of FMT earlier in CDI treatment algorithms to minimise cost and morbidity, and recipient follow up for immune-mediated conditions, is required.

Many previous studies including ours have reported that athyreotic patients on levothyroxine (LT4) have relatively low serum free triiodothyronine (FT3) levels, whereas patients with large goitrous diseases often have high serum FT3 levels. Here we investigated Hashimoto thyroiditis (HT) patients on LT4 to study the relationship between thyroid volume (TV) and thyroid hormone status in hypothyroid patients on LT4. We retrospectively studied 408 euthyroid HT patients treated with LT4 for hypothyroidism; divided them as per TV and compared serum levels of free thyroxine (FT4) and FT3 and the FT3/FT4 ratio in each patient group with those in euthyroid matched control group. We also evaluated the association between serum FT3 level and FT3/FT4 ratio and TV among HT patients on LT4. In patients with TV

Colyak hastaligi, temelde bagirsak emilim bozukluguyla seyreden ve ortaya cikan kronik otoimmun bir hastaliktir. Diger otoimmun hastaliklar ile de birliktelik gosterebilir. Bu yazida, kronik Hashimato tiroiditli tanisiyla takipte parathormon yuksekliginin etiyolojik nedeni olarak colyak hastaligi saptanan bir olgu sunulmaktadir. Celiac disease is a chronic autoimmune intestinal absorption disorder disease progressing with gastrointestinal and extraintestinal symptoms and findings. It may be observed in association with other autoimmune diseases. Here, we present the case of a chronic Hashimoto thyroiditis patient with celiac disease as the etiologic cause of parathormone elevation.

Background: Hashimoto thyroiditis diagnosis is primarily established on clinical and laboratory findings; however, some hashimoto thyroiditis cases are euthyroid and seronegative. Moreover, these patients might also have normal conventional ultrasound findings. Aims: In our study, we aimed to distinguish the typical background characteristics of hashimoto thyroiditis using virtual touch tissue imaging quantification maps obtained with acoustic radiation force impulse imaging. Methods: Our study consisted of 28 hashimoto thyroiditis patients without characteristics of ultrasound findings and 28 healthy subjects. The thyroid parenchymal tissue mechanical properties were analyzed with the virtual touch tissue imaging quantification after ultrasound examination, and then related colored maps were obtained. Shear wave velocities were recorded (m/s) from the homogenous area where hardest and softest points were closest to each other on virtual touch tissue imaging quantification maps. The difference between the minimum and maximum shear wave velocities for each case (Δv) was calculated and recorded. Results: Assessment of virtual touch tissue imaging quantification maps revealed a significant difference between hashimoto thyroiditis and control groups in terms of maximum SWV’s, but no significant difference was observed between the minimum shear wave velocities (p Δv values were taken into account. In summary, the effects of chronic autoimmune thyroiditis can be distinguished by simply using Δv on virtual touch tissue imaging quantification maps. When the cut-off value of Δv was accepted 0.42, the diagnosis of hashimoto thyroiditis could be made with 88% accuracy. Conclusion: We suggest that shear wave velocities measurement on virtual touch tissue imaging quantification maps is a promising method in equivocal hashimoto thyroiditis cases, in which the diagnosis of hashimoto thyroiditis is unachievable with clinical, laboratory and conventional ultrasound findings.

Objective: To investigate clinical practice regarding the use of selenium supplementation in patients with Hashimoto’s thyroiditis (HT) among members of the European Thyroid Association (ETA). Methods: ETA members were invited to participate in an online survey investigating the use of selenium supplementation across the spectrum of benign thyroid diseases. Of 872 invited members, 242 (28%) completed the survey. After exclusion of basic scientists and non-European members, survey data from 212 respondents were eligible for further analyses. Responses from 65 (31%) individuals who did not at all recommend selenium, or only considered its use in the setting of a clinical trial, were not included in the final analysis of survey data from 147 respondents. ­Results: While only a minority of respondents (29 of 147, 20%) stated that the available evidence warrants the use of Se in patients with HT, a statistically significant majority (95 of 147; 65%, p < 0.001) used Se occasionally or routinely. Se was predominantly recommended for patients with HT not receiving LT4 (102 of 147; 69%) to reduce circulating thyroid autoantibody levels. Very few respondents routinely recommended Se to pregnant patients with HT. Conclusions: A minority of responding ETA members stated that the available evidence warrants the use of Se in HT, but a majority recommended it to some extent, especially to patients not yet receiving LT4. This is questionable, and selenium is not recommended to patients with HT according to current ETA guidelines. Ongoing and future trials may lead to the reversal of current medical practice.

OBJECTIVES We aimed to investigate the differences between spectral Doppler and Superb Microvascular Imaging (SMI; Canon Medical Systems, Tokyo, Japan) findings in children with Hashimoto thyroiditis (HT) and Graves disease (GD) compared to healthy control participants. METHODS The study included 34 patients with GD, 37 patients with HT, and 22 healthy volunteers. All patients with HT and 11 patients with GD were euthyroid; 23 patients with GD had symptoms of hyperthyroidism and had thyrotropin values of less than 0.5 mIU/L. Thyroid volumes, mean resistive indices, and peak systolic velocities along with vascularity indices (VIs) on Superb Microvascular Imaging were measured. RESULTS Patients with GD had a significantly higher mean thyroid volume (P

Cerebellar ataxia can be a rare possible presentation of autoimmune hypothyroidism. We report a case of a young 20 years old female, who presented with bilateral cerebellar ataxia without any other significant neurological features. In detail investigations, she was discovered to be a case of Hashimoto Thyroiditis with positive anti-thyroid peroxidase (TPOAb) antibody and low freeT4 and freeT3 levels. She improved dramatically with levothyroxine therapy and iv pulse methylprednisolone. Thus, hypothyroidism should be looked for as a reversible and treatable cause in all cases of bilateral cerebellar ataxia. Keywords:Hypothyroidism, Autoimmune, Cerebellar ataxia, TPOAb

The second most prevalent endocrine condition affecting women of reproductive age is thyroid disease. The difference between an increased thyroid-stimulating hormone (TSH) concentration and a normal free thyroxine hormone level is used to identify subclinical hypothyroidism. Thyroid autoantibodies, independent of thyroid hormone levels, are used to diagnose autoimmune thyroid disease (ATD). Thyroxine can help infertile women with these two types of thyroid illnesses have better birth outcomes during fertility treatment. We performed a systematic review using PubMed (Medline) as a major database and some other sources EMBASE, the Cochrane Library, Web of Science, Scopus, and Science Direct. We concentrated on four studies, including 806 patients. Our goal is to investigate the efficacy and risks of levothyroxine therapy in infertile women who are receiving fertility treatments and have subclinical hypothyroidism or adequate thyroid function as well as thyroid autoimmunity (euthyroid autoimmune thyroid disorder). Thyroid activity in hypothyroid women should be tracked at pregnancy confirmation and closely monitored during the pregnancy. Early in pregnancy, the dosage of levothyroxine (LT4) can be raised. To ensure optimum TSH levels during breastfeeding, we recommend that patients who are followed in the primary sector have their LT4 dose increased by their general practitioner before their first referral to an endocrinological outpatient clinic. It's important to pay more attention to and track pregnant women with hypothyroidism, who consider pregnancy, to get the best results. LT4 therapy can help subfertile women with subclinical hypothyroidism who are having in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) since it improves embryo growth, implantation rate, and live birth rate.

Oral lichen planus is a chronic T cell mediated inflammatory condition with multifactorial etiology. Being autoimmune mediated condition, it has been associated with other autoimmune disorders. This case report discusses the possible presentation of oral lichen planus in hypothyroid patients as a marker of severity of the thyroid deficient status and the possible pathogenetic link between both the conditions.

Die Hashimoto Thyreoiditis ist eine der haufigsten organspezifischen Autoimmunerkrankungen des Menschen mit konsekutiver Organdestruktion und folglich die haufigste Ursache einer primaren Hypothyreose in ausreichend jodversorgten Gebieten. Immunpathogenetisch nehmen die CD4+ T‑Zellen und ihre Differenzierungen eine Schlusselrolle ein. Atiologisch Einfluss haben genetische, aber auch Umweltfaktoren, existentielle Faktoren (weibliches Geschlecht) und auch der Darm und die Darmflora. Zur Diagnosestellung benotigt werden eine ausfuhrliche Anamnese, Sonographie und laborchemische Bestimmung der Schilddrusenfunktion und Schilddrusenantikorper. Bei laborchemischer Hypothyreose wird das fehlende Hormon durch synthetisch hergestelltes Levothyroxin ersetzt, mit besonderem Augenmerk auf Lebensphasen mit Mehrbedarf wie zum Beispiel Schwangerschaft. Ursache fur eine persistierende Beschwerdesymptomatik trotz laborchemisch euthyreoter Funktionslage unter Substitution kann einerseits eine Fehlzuordnung der Beschwerden (Co-Morbiditaten wie z. B. Vorliegen weiterer Autoimmunerkrankungen, chronische Uberlastung, psychiatrische Erkrankungen), Mangel an Vitamin- und Spurenelementen, aber auch pharmakokinetische und pharmakogenomische Eigenschaften der Levothyroxinmedikation sein. Andererseits werden Resistenzen, Transport- und Konversionsstorung von Schilddrusenhormon auf molekularbiologischer Ebene durch endogene Storungen wie Insulinresistenz und Nebenniereninsuffizienz diskutiert. Auch die Einflusse der Schilddruse auf die Psyche und umgekehrt scheinen mannigfaltig und auf vielen Ebenen stattzufinden. Es bedarf noch vieler groser randomisierter Studien und biochemischer, molekularbiologischer, genetischer Untersuchungen und Forschung im Bereich des Neuroimaging, um die komplexen Zusammenhange zu klaren.

Objective: Down syndrome (DS) is associated with multiple endocrinopathies; one of the most common is thyroid dysfunction. Hashimoto thyroiditis and Graves disease have a higher prevalence in patients with DS than in the general population. For this reason, the American Academy of Pediatrics recommends annual thyroid surveillance. To highlight the importance of these recommendations we present a patient with DS who arrived at the emergency room in critical condition who was later determined to have abnormal thyroid function.Methods: We describe a child with DS who presented in severe cardiogenic shock requiring extracorporeal membrane oxygenation, later determined to be secondary to thyroid storm. She had a thyroid-stimulating hormone level of 0.01 μIU/mL (reference range is 0.6 to 4.84 μIU/mL), free thyroxine level of 4.52 ng/dL (reference range is 0.97 to 1.67 ng/dL) and free triiodothyronine level of 7.38 pg/mL (reference range is 2.53 to 5.22 pg/mL). She also had a thyroid-stimulating immunoglobulin level 270% above baseline (reference range is

Purpose We performed a prospective study in patients with positive thyroid peroxidase antibodies (TPOAb), to describe their ultrasound (US) patterns and the prevalence of thyroid nodules. Methods In 195 consecutive patients, with positive TPOAb, thyroid US was performed by the same physician and equipment and categorized into four echographic patterns (EP). We determined the prevalence of thyroid nodules and their etiology confirmed by cytology or histology. Results The median TPOAb was 526 IUI/ml. EP1 or normal US was present in 9,7%; EP2 or early/indeterminate stage in 29,4%; EP3 or established thyroiditis in 45,4% and EP4 or advanced/late stage in 15,5% of the patients. TPOAb (median = 857 UI / ml) (p = 0.001), TSH and thyroid volume ​​were higher in EP3. A higher degree of fibrosis was associated with TPOAb > 1000 IU/ml(p = 0,003). Thyroid nodules were reported on US at 47,2% of HT. Fine needle aspiration(FNA) was performed in 49/60 nodules. Cytology: BII: 41 patients (83,7%), B V: 1 patient (2%): suspicious for lymphoma; B VI: 3 patients(6,1%) : Papillary thyroid carcinoma. Benign cytology was present in 56% of EP3 (p = 0,048). Conclusions Higher TPOAb, TSH levels, and thyroid volume were associated with EP3. Fibrosis correlated with TPOAb > 1000 IU/ml. In our population, benign nodules were associated with established thyroiditis patterns. The increased inflammation and immunological activity of Hashimoto thyroiditis (HT) could be a favorable environment for growth factors for benign nodular development.

Objective The baseline treatment of differentiated thyroid cancer (DTC) consists of thyroidectomy followed by postoperative risk-adapted radioiodine therapy (RAIT) when indicated. The choice of most appropriate RAI activities to administer with the aim to reach an efficient remnant ablation and reduce the risk of recurrence is yet an open issue and the detection of basal factors that may predict treatment response seems fundamental. The aim of this study was to investigate the potential role of Hashimoto thyroiditis (HT) in predicting 1-year and 5-year treatment response after RAIT and prognosis. Methods We retrospectively included 314 consecutive patients (174 low-risk and 140 intermediate-risk) who received thyroidectomy plus RAIT. One-year and 5-year disease status was evaluated according to 2015 ATA categories response based upon biochemical and structural findings. Results HT was reported histopathologically in 120 patients (38%). DTC patients with concomitant HT received a higher number of RAITs and cumulative RAI activities. Initial RAIT reached an excellent response in 63% after one year and 84% after 5 years. The rate of excellent response one year and 5-year after first RAIT was significantly lower in HT groups, compared to not HT (p Conclusions HT may affect the efficacy of RAIT in low to intermediate risk DTC, particularly reducing the successful rate of excellent response after RAIT. Instead, HT did not have a prognostic impact such as stimulated sTg.

Purpose Hashimoto thyroiditis (HT) is considered the most common autoimmune thyroid disease. A growing body of evidence suggests that HT incidence correlates with excessive iodine intake. We should probe the effects of excessive iodine intake in HT development and its possible mechanism. Methods The study recruited 20 patients: 10 with HT and 10 with nodular goiter. We detected the expression of an apoptosis-related protein caspase-3 by immunohistochemistry. In vitro study, we explored the proliferation and apoptosis status in thyroid follicular cells (TFCs) stimulated at different iodine concentrations by MTT and flow cytometry. Then we performed RNA sequence analysis of Nthy-ori3-1 cells treated for 48h with different KI concentrations to probe the underlying mechanism. Finally, we used RT-PCR to verify its results. Results We identified apoptosis in thyroid tissue obtained from HT patients coincides with the increase of caspase-3 levels. In vitro study, iodine suppressed proliferation of TFCs and promoted TFCs apoptosis in a dose-dependent manner. RNA sequence results showed that high concentration of iodine activate the hypoxia-inducible factor-1α (HIF-1α)-mediated hypoxia pathway coincide with the upregulation of N-myc downregulated gene-1 (NDRG1) expression. Conclusions Our study confirmed that excessive iodine adsorption activates the HIF-1α-mediated hypoxia pathway to promote apoptosis of TFCs, which may be an important risk factor contributing to HT development.

New-onset type 1 diabetes mellitus is an uncommon but possible complication triggered by severe acute respiratory syndrome-related coronavirus 2 infection Metabolic inflammation supported by cytokine storm leading to pancreatic beta cells destruction is the most probable link between coronavirus disease 2019 (COVID-19) and diabetes Here, we describe the case of a 51-year-old female suffering from Hashimoto thyroiditis, who came to our attention for new-onset polyuria-polydipsia syndrome associated with hyperglycemia after a mild form of COVID-19 recognized two months before and already recovered Type 1 diabetes was diagnosed

Background: Autoimmune thyroid disease in women is associated with subfertility and early pregnancy loss, and patients with primary ovarian insufficiency have a high prevalence of thyroid autoimmune disorders. The aim of this study was to investigate the association between Hashimoto thyroiditis (HT) and ovarian reserve.Methods: Levels of serum thyroid stimulating hormones, thyroid autoantibodies, and anti-Müllerian hormone (AMH) were measured in women with HT and a healthy control group between 2018 and 2019. Result: Evaluation was made of 108 premenopausal women with HT. A control group was formed of 172 healthy female subjects with normal anti-thyroid antibody levels and thyroid function. Serum AMH levels were determined to be significantly lower in the HT group compared to the control group.Conclusion: Ovarian reserve evaluated by serum AMH concentration is affected by thyroid autoimmunity independently of anti-thyroid antibodies type or titers.

Objectives: To determine whether thyroidectomy improves quality of life in patients with Hashimoto thyroiditis with persistent symptoms despite biochemical euthyroidism. Methods: A retrospective cohort study was conducted of patients undergoing thyroidectomy for Hashimoto thyroiditis at our institution between 2014 and 2018. The following variables were collected: age, race, body mass index, preoperative symptoms, preoperative thyroid peroxidase antibody titer, thyroglobulin antibody titer, thyroid-stimulating hormone, free thyroxine, specimen weight, and histologic presence of thyroiditis. Outcomes included general health score on the Short Form 36 (SF-36) Health and responses to a questionnaire addressing postoperative disease management. Results: A total of 19 patients were included in the study, 18 of whom were female with a mean age of 48 years. The majority of patients were Caucasian. There were no significant differences between the postoperative general health scores of the patients with Hashimoto thyroiditis and scores from a healthy control population (66.9 vs 74.1; 95% CI: −16.9 to +2.5, P = .16). There were also no differences between groups within the 7 SF-36 subscores. Elevation in preoperative thyroperoxidase antibody correlated with lower reported postoperative energy levels ( r = −0.63, P = .016) and emotional well-being ( r = −.55, P = .041); 87.5% of respondents reported being moderately or extremely happy with their decision to proceed with surgery. Conclusions: Quality of life in patients with Hashimoto thyroiditis who undergo thyroidectomy is equivalent to the general population, and the majority are satisfied with surgery. Thyroidectomy is a consideration for patients with persistent symptoms despite optimization on medical therapy.

RESUMO CONTEXTUALIZACAO: A tiroidite de Hashimoto (TH) pode associar-se a diferentes niveis de disfuncao tiroideia. Ainda nao esta esclarecido de que forma a disfuncao tiroideia ligeira, a autoimunidade e a inflamacao cronica contribuem para um risco cardiovascular aumentado nos doentes com TH. Desta forma, este estudo pretende avaliar o grau de insulinorresistencia, o perfil lipidico e a inflamacao de baixo grau nos doentes com TH. METODOS: Este estudo inclui um total de 228 individuos com tiroidite de Hashimoto, que foram divididos em tres grupos de acordo com os niveis de TSH - TSH 0.35-2.49 μUI/ml, TSH 2.50-4.94 μUI/ml e TSH>4.94 μUI/ml. Foram determinados os testes de funcao tiroideia, anticorpos anti-tiroideus, perfil lipidico, indices de insulinorresistencia, proteina C reativa de alta sensibilidade, vitamina B12, acido folico e homocisteina. A analise estatistica foi realizada com ANOVA, t-test de Student, correlacoes de Pearson e regressao linear multipla. RESULTADOS: 93.9% da nossa populacao e do sexo feminino e a media das idades e 47.1±15.4 anos. Nao foram encontradas diferencas estatisticamente significativas entre os grupos, relativamente a idade, sexo e indice de massa corporal (IMC). Os valores de Modelo de Avaliacao da Homeostasia da Insulinorresistencia (HOMA-IR) foram estatisticamente diferentes entre os tres grupos (p

Erythema annulare centrifugum (EAC) is an unusual skin condition appearing as recurrent erythematous annular eruptions associated with autoimmune disorders, infections, and various neoplastic conditions. We present a very rarely reported association of EAC with Hashimoto thyroiditis (HT) in a young male. A 26-year-old male recently diagnosed as case of HT presented in the dermatology clinic with nine-month history of non-itchy persistent annular lesions on the body. The morphology and biopsy of lesions confirmed the diagnosis of EAC. HT is a part of the spectrum of autoimmune thyroid diseases with its own specific cutaneous manifestations. Our case also depicts the impact of antigen-antibody related immunological reaction, which might be involved in the development of both HT and EAC, and it could be the stages of the same pathological condition of two different clinical presentations.

The link between chronic urticaria and accompanying thyroid disease is still not understood, with current treatment focusing on antihistamines and levothyroxine. A 35-year-old female patient presented with chronic idiopathic urticaria and facial angioedema for 9 months prior to evaluation. Oral corticosteroid therapy, antihistamines, leukotriene-antagonists, selenium, and omalizumab were all administered, with the disease relapsing within several days, accompanied with facial angioedema of varying severity. Laboratory results were negative for antinuclear antibodies (ANA) and cytoplasmic antineutrophil antibodies (ANCA). Immunoglobulins and complement levels were normal. Autologous serum testing, and skin-prick test for common inhalatory allergens were all normal. Levothyroxine was then administered with no effect on the symptoms. After considering all of the available treatment options, the patient decided to undergo total thyroidectomy. Urticaria and angioedema subsided on the third postoperative day, and she remains free of symptom recurrence during 10 months of postoperative follow-up. Her antiTPO titer decreased from > 1300 to 31.1 kIU/L and antiTG decreased from 272 to 4.9 kIU/L three months after the surgery. The most important element in this case report is an unexpected extra-thyroid presentation of an autoimmune thyroid disease, with a newly described association with facial angioedema. Additional important evidence may confirm the hypothesis that both conditions are indeed caused by a common immunological patohogenetic pathway that should be routinely evaluated in patients presenting with chronic idiopathic urticaria.

Most cases of autoimmune hypothyroidism are due to Hashimoto thyroiditis (HT). It is sometimes difficult to distinguish HT from mucosa associated lymphoid tissue (MALT) lymphoma using cytology or histology alone. This has necessitated the use of immunohistochemistry and other molecular techniques. A descriptive study was undertaken to determine the prevalence of MALT lymphoma and other associations of HT using histopathological and immunohistochemical methods. For testing of kappa and lambda antibodies, paraffin sections were prepared for immunohistochemical staining using a peroxidase-antiperoxidase immune complex method. Immunostaining in HT, demonstrated a polyclonal lymphoid population, as evidenced by dual positivity for kappa and lambda staining cells, whereas MALT lymphoma revealed a monoclonal lymphoid population, with strong positivity for kappa immunostaining and lack of lambda light chain expression. The proportion of MALT lymphoma in surgically treated cases of HT in the present study was 3.5% (95% CI: 0%–8.3%). The common malignancy associated with HT was papillary carcinoma of the thyroid (8.8%). Among the benign conditions, nodular colloid goiter (7%) was more commonly associated. Although modern molecular techniques are available for the confirmation of lymphomas, they are more expensive, time consuming and are available only in a few centers. Strict morphological criteria can differentiate HT from MALT lymphoma, but in suspicious cases, paraffin section immunohistochemistry using light chain restriction can offer comparable and reliable results. Since papillary carcinoma and MALT lymphoma have been associated with HT, these patients require careful surveillance.

Objectives Treatment of children with Hashimoto thyroiditis (HT) and particularly of those with coexistent diabetes mellitus type 1 (TIDM) and normal/mildly elevated serum TSH is controversial. The aim of the study was to evaluate the natural course of HT in children with TIDM compared with children with no other coexistent autoimmunity and investigate for possible predictive factors of thyroid function deterioration. Methods Data from 96 children with HT, 32 with T1DM (23 girls, nine boys) mean (sd) age: 10.6 (2.3) years, and 64 age and sex-matched without T1DΜ (46 girls, 18 boys), mean (sd) age: 10.2 (2.9) years were evaluated retrospectively. They all had fT4 and TSH values within normal ranges and available data for at least three years’ follow-up. Results During the follow-up period, 11 children (34.4%) with TIDM exhibited subclinical hypothyroidism and two children (6.2%) progressed to overt hypothyroidism compared to 12 (18.8%) and two (3.1%) among children without TIDM, respectively. Among children with HT, a higher percentage (40.6%) of children with T1DM progressed to subclinical or overt hypothyroidism, compared with children (21.9%) with similar characteristics but without TIDM or other coexistent autoimmunity. Conclusions The annual conversion rate from euthyroidism to hypothyroidism in children with T1DM was significantly higher compared to sex and age-matched children without TIDM. Prospective randomized trials are needed to support the view of an earlier intervention therapy even in milder degrees of thyroid failure in these children.

Objective: To determine the circulatory miRNA expression levels in patients with Hashimoto thyroiditis (HT) at the time of diagnosis and follow-up period compared with healthy controls. Methods: We collected blood samples from 34 patients with HT (4 males and 30 females) at the time of first diagnosis (Group P) and euthyroid period (Group E). Thirty-three healthy controls (Group H) blood samples were also included in the study. Expression levels of five different circulating miRNAs (miR-22, miR-141, miR-155, miR-375, miR-451) were evaluated using real-time polymerase chain reaction. Results: There was a significant difference in miR-375 levels between the groups P and H. Also, for miR-451, there was a significant difference between the P and E groups. Finally, there was a moderate positive correlation between thyroid-stimulating hormone values and miR-22 expression levels for the P group. Conclusion: miRNAs have important roles at all stages of the diseases. More studies must be performed in all thyroid diseases and autoimmune diseases, including HT.

Objective and background: Hashimoto's thyroiditis (HT) is both a B cell- and T cell-mediated, organ-specific autoimmune disease. No current treatment for underlying pathological mechanisms is avail...

Hashimoto thyroiditis (HT) is one of the most common autoimmune diseases, and the incidence of HT continues to increase. Long-term, uncontrollable HT results in thyroid dysfunction and even increases carcinogenesis risks. Since the origin and development of HT involve many complex immune processes, there is no effective therapy for HT on a pathogenesis level. Although bioinformatics analysis has been utilized to seek key genes and pathways of thyroid cancer, only a few bioinformatics studies that focus on HT pathogenesis and mechanisms have been reported. In the present study, the Gene Expression Omnibus dataset (GSE29315) containing 6 HT and 8 thyroid physiological hyperplasia samples was downloaded, and differentially expressed gene (DEG) analysis, Gene Ontology analysis, Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, protein–protein interaction analysis, and gene set enrichment analysis were performed. In total, 85 DEGs, containing 76 up-regulated and 9 down-regulated DEGS, were identified. The DEGs were mainly enriched in immune and inflammatory response, and the signaling pathways were involved in cytokine interaction and cytotoxicity. Moreover, ten hub genes were identified, and IFN-γ, IFN-α, IL6/JAK/STAT3, and inflammatory pathways may promote the origin and progression of HT. The present study indicated that exploring DEGs and pathways by bioinformatics analysis has important significance in understanding the molecular mechanisms of HT and providing potential targets for the prevention and treatment of HT.

Objective: Thyroid nodules are highly prevalent and a common clinical problem worldwide. How to identify the nature of a nodule is a major concern of clinicians. Fine needle aspiration cytology (FN...

Lysosomial diseases and autoimmune diseases are systemic disorders. Their clinical manifestations can overlap with the broad spectrum of one another. Their association has been rarely reported. We report a new case of systemic lupus erythematous (SLE) associated to antiphospholipid syndrome (APS) and Hashimoto thyroiditis occurring in Niemann-Pick disease (NPD) type B patient. A 42-year-old woman with a familial history of NPD was diagnosed with a NPD type B at the age of ten. Twenty years later (2008), she complained of inflammatory arthralgia with acute dyspnea. She was diagnosed with SLE (according to ACR criteria) and Hashimoto disease with positive IgG anti-cardiolipin and IgA anti-beta2 glycoprotein. In 2018, she presented a left segmental pulmonary embolism. Antiphospholipid syndrome was retained. She was treated with steroids, hydroxychloroquine, anticoagulation therapy and levothyroxine. Her SLE treatment was re-enforced by cyclophosphamide because of corticosteroid dependence and recurrent hemolytic crises.

Introduction: Thyroiditis comprises various group of disorders with some form of thyroid inflammation. Hashimoto thyroiditis is the most common and clinically significant type of thyroiditis seen commonly in middle age females and also one of the most common cause of goitre seen in iodine sufficient regions. Endemic goitre a major health problem, still prevalent in various regions of india even after implementation of widespread national salt iodisation programme by Government of India. This study performed in tertiary centre of western coastal area where seafood is the staple diet of large number of people and inspite of widespread use of iodised salt large number of patients dignosed with HT. The proposed study is intended to further establish the role of histopathological study along with its correlation with clinical, biological and radiological parameters in the diagnosis of Hashimoto thyroiditis. Aim: To record the morphological features along with its correlation with clinical, biochemical and ultrasonographic picture of this disease in western coastal endemic area for goitre and document morphological variation, if any and also to identify any thyroid neoplasm that may develop in the background of HT. Materials and Methods: In this retrospective study records of patients with histological diagnosis of Hashimoto thyroiditis was conducted with respect to their clinical presentation, thyroid profile, antibody titre and ultrasonographic features. Results: A total 55 patients with histopathological diagnosis of HT were included in the study. The histological slides were reviewed and reclassified into two groups based on hurthle cell change. Thus, 35 cases were diagnosed as HT while remaining were categorised as chronic lymphocytic thyroiditis. Ninety seven percent of patients were females and majority of them presented within 5 years of onset of symptoms. An amount of 68% patients had diffuse goitre, 33% were clinically euthyroid and 60.6% were biochemically hypothyroid. Antibody titre were elevated in 78% patients. In most of the cases USG picture showed hypoechogenecity with increased vascularity. Histopathological features were diagnostic and characteristic. Conclusion: In the present study majority of patients were females in the middle age group with clinical presentation of diffuse goitre and inspite, of widespread use of iodised salt in this studied population large number of patients diagnosed with Hashimoto thyroiditis. Therefore, author conclude that all females of middle age group in an endemic area for goitre should be screened and also histologically confirmed by biopsy for this thyroiditis.

Attention Deficit Hyperactivity Disorder (ADHD) is a disease that canlead to extremely important academic, social and psychiatric problems. Alongwith being genetically induced, some accompanying conditions can lead to theexacerbation of the clinic. In this case report, we discussed the increase inattention deficit problems in a 14-year-old girl with Hashimoto thyroiditis. InADHD; in the first application, in cases where symptom severity does notdecrease despite the treatment, and if clinical presentation deteriorates, itis important to evaluate the patient in terms of general medical condition.This Hashimoto Thyroiditis case, manifested by the worsening of cognitivefunction and attention without the emergence of somatic signs suggested theimportance of treating the patient as a whole, and that mental functions andbodily functions cannot be considered separately., Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB), son derece önemliakademik, sosyal ve psikiyatrik sorunlara yol açabilen bir hastalıktır. Genetiknedenli olmakla birlikte bazı eşlik eden durumlar kliniğin şiddetlenmesineneden olabilmektedir. Biz bu olgu sunumunda, Hashimoto Tiroiditi gelişen 14yaşındaki bir kız hastada var olan dikkat eksikliği sorunlarının artışını elealdık. DEHB’de; ilk başvuruda, tedaviye rağmen belirti şiddetinin azalmadığı veklinik tablonun kötüleştiği durumlarda medikal açıdan hastanındeğerlendirilmesi önem taşımaktadır. Bedensel işaretler ortaya çıkmadanbilişsel fonksiyon ve dikkat becerisindeki kötüleşme ile kendini gösterenHashimoto Tiroiditi vakası; hastanın bütün olarak ele alınmasının önemini,zihinsel işlevler ile bedensel işlevlerin birbirinden ayrı düşünülemeyeceğinigöstermesi bakımından paylaşılmaya değer bulunmuştur.

Amaç: Hipotiroidi toplumda en sık görülen endokrinolojik hastalıklardan birisidir. Bu çalışmada, Hashimoto hipotiroiditine bağlı tedavi atında ötiroid olan hastalar ile subklinik hipotirodi tanısı alan hastalarda depresif semptom varlığı araştırılarak sağlıklı kontroller ile karşılaştırıldı.Yöntem: Bu çalışma Kocaeli Devlet Hastanesi İç Hastalıkları Kliniği’nde 2017-2019 yılları arasında yürütüldü. Kocaeli Devlet Hastanesi İç Hastalıkları Kliniği’nde tiroid hastalığı nedeni ile takip edilen hastalar, tiroid fonksiyon testi sonuçlarına göre tedavi altında ötiroid olan Hashimoto tiroiditi olanlar ve subklinik hipotiroidisi olanlar şeklinde ikiye ayrıldı. Her iki gruba da Beck depresyon ölçeği uygulandı. Ayrıca bir kontrol grubu oluşturularak aynı ölçek uygulandı.Bulgular: Çalışmaya toplam 43 hasta ve 31 kontrol alındı. Bunlardan 32’si ötiroid seyreden Hashimoto tiroiditi olan, 11’i de subklinik hipotiroidisi olan hastalardı. Ötiroid hastaların ortalama tiroid stimulan hormon (TSH) düzeyi 2,3±0,9 mU/L iken subklinik hipotiroidisi olan hastalarınki 8,2±2,7 mU/L idi. Hastaların ortalama Beck depresyon skoru 14,1±8,9 idi. Kontrol grubunun ortalama Beck depresyon skoru 6,4±5,2 olarak saptandı. Kontrol grubu ile ötiroid Hashimoto grubu arasında Beck depresyon skoru açısından anlamlı fark saptanırken (p

Introduction: The most common type of autoimmune thyroiditis is Hashimoto thyroiditis (HT), which is the leading cause of hypothyroidism. Although ultrasound examination aids in the diagnosis of the disease, it does not have a specific quantitative value. The aim of this study was to evaluate the parenchymal echogenicity alterations of the thyroid gland in adolescent patients with HT using B-mode gray scale histogram and to reveal the predictive value of this technique in the diagnosis of HT.Methods: A total of 76 patients with HT and 46 healthy controls were prospectively examined by the gray scale histogram analysis method. The analysis included the thyroid echogenicity/strap muscle echogenicity ratio (TESER) and thyroid stimulating hormone (TSH), antithyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG).Results: The mean TESER that was significantly lower in the HT group compared to the control group (1.36±0.46 vs 2.24±0.59; p

BackgroundHashimoto thyroiditis and type II diabetes are chronic diseases which have adverse consequences impacting emotional and cognitive functioning. Healthful behaviours focused on improvement of one’s health or on combating the illness play a key role in psychosocial functioning of a person, particularly one suffering from a long-term illness. The aim of the research was the measurement and analysis of healthful behaviours and the distinction of variables determining healthful behaviours. We attempted to examine the connection between adhering to healthful behaviours, and the level of illness acceptance, self-efficacy and self-esteem, in terms of exhibiting healthful behaviours in the above-mentioned groups of patients.Participants and procedureThe study group consisted of 140 persons (70 persons with type II diabetes, 70 persons with Hashimoto’s disease). The following measurement techniques were used: the Health Behaviour Inventory by Z. Juczyński, the General Self-Efficacy Scale by R. Schwarzer and M. Jerusalem adapted for Polish by Z. Juczyński, the Acceptance of Illness Scale by B. J. Felton, T. A. Revenson and G. A. Hinrichsen, and the Self-Esteem Scale by M. Rosenberg.ResultsThe results show that for the group of type II diabetes patients self-efficacy constitutes a statistically significant moderate positive predictor of psychological attitude and appropriate eating habits, and is a positive weak predictor of general healthful behaviour and prophylaxis at the tendency level. For Hashimoto’s sufferers the sense of self-efficacy is a statistically significant moderate predictor of healthful behaviours.ConclusionsThe study investigated significant relations between the level of illness acceptance, the sense of self-efficacy and self-esteem, and engagement in healthful behaviour. The sense of self-efficacy determines higher healthful practices in both research groups. The study allowed for a comparison of two groups of long-term illnesses sufferers – type II diabetes, and Hashimoto’s disease – in terms of adhering to healthful behaviours, and dependencies between selected psychological variables and patients’ preferred healthful behaviours.