Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4)
How to Trip Rapid Review
Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)
Step 2: press
Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.
and in particular of GD. From a clinical point of view, Alemtuzumab-induced GD is characterized by a surprisingly high rate of remission, both spontaneous and after antithyroid drugs, as well as by a spontaneous shift to hypothyroidism, which is supposed to result from a change from stimulating to blocking TSH-receptor antibodies. These immune and clinical peculiarities support the concept that antithyroid drugs should be the first-line treatment in Alemtuzumab-induced Graves' hyperthyroidism. (...) Autoimmune Thyroid Diseases in Patients Treated with Alemtuzumab for Multiple Sclerosis: An Example of Selective Anti-TSH-Receptor Immune Response Alemtuzumab, a humanized anti-CD52 monoclonal antibody, is approved for the treatment of active relapsing-remitting multiple sclerosis (MS). Alemtuzumab induces a rapid and prolonged depletion of lymphocytes from the circulation, which results in a profound immuno-suppression status followed by an immune reconstitution phase. Secondary
thyroid function follow-up in female SSc patients [showing a borderline high (although in the normal range) thyroid-stimulating hormone level, antithyroid peroxidase antibody positivity, and a small thyroid with a hypoechoic pattern], and, when necessary, appropriate treatments. In conclusion, most of the studies show an association among SSc, AT, and hypothyroidism, such as an increased prevalence of TC overall in SSc patients with AT. Only few cases of GD have been also described in SSc.
with I in the First Affiliated Hospital of Xi'an Jiaotong University between 2010 and 2016. We collected the potential influencing factors, including demographic data (age, sex, family history), iodine intake state, antithyroid drugs (ATD) taking, thyroid texture, complications of hyperthyroidism, physical and laboratory examinations [thyroid weight, effective I half-life time (Teff), 24-h iodine uptake rate, tri-iodothyronine, thyroxine, free tri-iodothyronine (FT3), free thyroxine, thyroid (...) -stimulating hormone, thyroglobulin antibody, thyroid microsome antibody, thyrotropin receptor antibody], and final administered dosages according to Quimby formula. The correlations between the prognosis of GD patients and these factors were analyzed by logistic regression analysis.Out of 325 patients, 247 (76.00%) were treated successfully with radioiodine. GD patients who were cured by I therapy were more likely to have smaller thyroid [odds ratio (OR)=0.988, 95% confidence interval (CI)=0.980-0.996, P
therapeutic plasma exchange (TPE) procedures, to clear thyroid hormones and anti-TSH receptor antibodies from blood, resulting in a pre-surgical euthyroid state without antithyroid drug therapy. Two years after thyroidectomy, the patient is well under thyroid hormone replacement therapy with a normal granulocyte count. (...) Gravesâ€™ Disease Thyrotoxicosis and Propylthiouracil Related Agranulocytosis Successfully Treated with Therapeutic Plasma Exchange and G-CSF Followed by Total Thyroidectomy Antithyroid drugs can be a rare cause of agranulocytosis (0.5% of treated patients). Suspension of these drugs is mandatory in these patients and may result in worsening hyperthyroidism. We report the case of a 27-year-old woman who is 3 months post-partum, breastfeeding, and suffering with Graves' disease hyperthyroidism
regression, the odds ratios of developing strabismus following the diagnosis of Graves' disease were assessed. The prognostic indicators assessed include race, ethnicity, cigarette smoking (active), serum thyroid peroxidase (TPO) antibody positivity, serum thyroglobulin (Tg) antibody positivity, antithyroidal medication use, and steroid use.The study sample (45 cases 1:1 matched against 45 controls) was comprised primarily of non-Hispanic, non-Latino Caucasian women with TED (mean ± SD age 63.0 ± 13.1 (...) years). There were no significant predictors for the development of strabismus, including cigarette smoking (active), serum thyroid peroxidase (TPO) antibody positivity, serum thyroglobulin (Tg) antibody positivity, antithyroidal medication, and steroid use.No significant predictors of strabismus, a severe manifestation of Graves' ophthalmopathy, were identified following a diagnosis of TED in this study.
thyroxine (fT4), free triiodothyronine (fT3), thyrotropin receptor antibodies (TRAb), GO at diagnosis, or relapse after terminating treatment with antithyroid drugs. Two SNPs in VDR were associated with GD: rs10735810 (OR = 1.36, 95% CI: 1.02-1.36, p = 0.02) and rs1544410 (OR = 1.47, 95% CI: 1.03-1.47, p = 0.02). There was no difference in the mean vitamin D level between genotypes in either rs10735810 or rs154410.Patients with GD had lower vitamin D levels compared to the general population; however
with hyperaldosteronism, but exact causal relationship is not established. Autoimmune hyperthyroidism (Graves' disease) and primary hyperaldosteronism rarely coexist but underlying mechanisms associating the two are still unclear.A 32-year-old Sri Lankan female was evaluated for new onset hypertension in association with hypokalemia. She also had features of hyperthyroidism together with high TSH receptor antibodies suggestive of Graves' disease. On evaluation of persistent hypokalemia and hypertension, primary (...) hyperaldosteronism due to right-sided adrenal adenoma was diagnosed. She was rendered euthyroid with antithyroid drugs followed by right-sided adrenalectomy. Antithyroid drugs were continued up to 12 months, after which the patient entered remission of Graves' disease.Autoimmune hyperthyroidism and primary hyperaldosteronism rarely coexist and this case report adds to the limited number of cases documented in the literature. Underlying mechanism associating the two is still unclear but possibilities
Subclinical Hypothyroidism and Thyroid Autoimmunity Are Not Associated With Fecundity, Pregnancy Loss, or Live Birth. Prior studies examining associations between subclinical hypothyroidism and antithyroidantibodies with early pregnancy loss and live birth suggest mixed results and time to pregnancy (TTP) has not been studied in this patient population.This study sought to examine associations of prepregnancy TSH concentrations and thyroid autoimmunity with TTP, pregnancy loss, and live birth (...) or the presence of antithyroidantibodies were not associated with fecundity, pregnancy loss, or live birth. Thus, women with subclinical hypothyroidism or thyroid autoimmunity can be reassured that their chances of conceiving and achieving a live birth are likely unaffected by marginal thyroid dysfunction.
evidence of autoimmunity, a typical goiter, and presence of TSH receptor antibodies (TRAb). TPO-Ab may be present in either case. USPSTF recommendation level: B; evidence, fair (1|⊕⊕⊕○). 2.1.2. For overt hyperthyroidism due to Graves' disease or thyroid nodules, antithyroid drug (ATD) therapy should be either initiated (before pregnancy if possible, and for those with new diagnoses) or adjusted (for those with a prior history) to maintain the maternal thyroid hormone levels for free T 4 at or just (...) , good (1|⊕⊕⊕⊕). 4.0. Autoimmune thyroid disease and miscarriage 4.1. A positive association exists between the presence of thyroid antibodies and pregnancy loss. Universal screening for antithyroidantibodies, and possible treatment, cannot be recommended at this time. As of January 2011, only one randomized interventional trial has suggested a decrease in the first trimester miscarriage rate in euthyroid antibody-positive women, but treatment duration was very brief before the outcome of interest
´-Triiodothyroacetic acid 1010 Thyroid-enhancing preparations 1010 Thyromimetic preparations 1010 Selenium 1010 Questions and Guideline Recommendations 1011 Q1 When should antithyroidantibodies be measured? 1011 R1 TPOAb measurements and subclinical hypothyroidism 1011 R2 TPOAb measurements and nodular thyroid disease 1011 R3 TPOAb measurements and recurrent miscarriage 1011 R4 TSHRAb measurements in women with Graves’ disease who have had thyroidectomy or RAI treatment before pregnancy 1011 Q2 What is the role (...) = thyroxine; TPOAb = anti-thyroid peroxidase antibodies; TRIAC = 3,5,3´-triiodothyroacetic acid; TSH = thyrotropin; TSHRAb, TSH receptor antibodies. Table 1 (Continued)994 For example in some grading systems “should not” implies that there is substantial evidence to support a recommenda- tion. However the grading method employed in this guide- line enables authors to use this language even when the best evidence level available is “expert opinion.” Although different grading systems were employed
uptake and not discriminatory Uptake occasionally seen in type 1 thyroiditis TSH receptor Ab may be present in type 1 thyroiditis if there is underlying Graves disease Type 1 – antithyroid drugs Type 2 – corticosteroids Thyroidectomy may be required Can be difficult to distinguish between type 1 and 2 thyroiditis ESR = erythrocyte sedimentation rate; RAI = radioactive iodine therapy; TA = toxic adenoma; TMNG = toxic multinodular goitre; TPO Ab = thyroid peroxidase antibody; Tg = thyroglobulin; TSH (...) = thyroid peroxidase antibody; Tg = thyroglobulin; TSH receptor Ab = thyroid stimulating hormone-receptor antibody; WBC = white blood count. * Uptake may be low in iodine induced thyrotoxicosisFOCUS Evaluating and managing patients with thyrotoxicosis 568 Reprinted from AustRAliAn F Amily PhysiciAn Vol. 41, no. 8, August 2012 is recommended that propylthiouracil be used in the first trimester and then changed to carbimazole in the second trimester. 4 Antithyroid drugs can be stopped in about 30
if there is a convincing clinical picture for hypothyroidism, despite the absence of tsh elevation, to exclude the (much less common) possibility of central hypothyroidism due to pituitary or hypothalamic pathology (Figure 1). thyroid autoantibodies Reprinted from AustRAliAn F Amily PhysiciAn Vol. 41, no. 8, August 2012 557 testing is recommended in euthyroid patients who have positive antithyroidantibodies, as progression to hypothyroidism is more common in this patient group. 2 A diagnosis of hypothyroidism (...) in itself is not an indication for thyroid imaging. thyroid ultrasonography is only indicated to evaluate suspicious structural thyroid abnormalities (ie. palpable thyroid nodules). While thyroid radionucleotide scanning may be useful in elucidating the aetiology of hyperthyroidism, it has no role in the work-up for hypothyroidism. there is an association between chronic thyroiditis and (antithyroid peroxidase and antithyroglobulin antibodies) are positive in 95% of patients with autoimmune thyroiditis
of antithyroid peroxidase antibodies (38). Thyroglobulin is released along with thyroid hormone in subacute, painless, and palpation thyroiditis, whereas its release is suppressed in the setting of exogenous thyroid hormone administration. Therefore, if not elucidated by the history, factitious ingestion of thyroid hormone can be distinguished from other causes of thyrotoxicosis by a low serum thyroglobulin level and a near-zero RAIU (39). In patients with antithyroglobulin antibodies, which interfere (...) than one treatment (150). The prevalence of hypothyroidism following 131 I therapy is increased by normalization or elevation of TSH at the time of treatment resulting from ATD pretreatment and by the presence of antithyroidantibodies (166). The activity of radioiodine used to treat TMNG, cal- culated on the basis of goiter size to deliver 150–200 µCi per gram of tissue corrected for 24-hour RAIU, is usu- ally higher than that needed to treat GD. In addition, the RAIU values for TMNG may be lower
. Concentrations of antithyroid peroxidase antibodies, antithyroglobulin antibodies, antithyrotropin receptor antibodies, and TSH level were measured in all patients. MG clinical course, treatment received, and treatment results were evaluated.Autoimmune thyroid diseases were diagnosed in 92 (26.8%) of MG patients including 4.4% with Graves (GD), 9% with Hashimoto thyroiditis (HT), and 13.4% with antithyroidantibodies only. GD patients had ocular symptoms more often than patients with antithyroidantibodies (...) Prevalence and impact of autoimmune thyroid disease on myasthenia gravis course Autoimmune thyroid diseases (ATDs) frequently accompany myasthenia gravis (MG) and may influence its course. We aimed to determine the association and impact of ATD with early- (<50 years), late-onset MG, or thymoma-MG.Prevalence of ATD was measured in a cross-sectional study of 343 consecutive patients with MG (236 F, 107 M) aged 4-89 years; 83.8% were seropositive, in 2.9%, anti-MuSK antibodies were detected
(here delirium, mania, and EEG-slowing) and their relation to serum autoantibody levels. Antithyroid-peroxidase autoantibodies, the hallmark of autoimmune thyroiditis, were found in the serum and also in the cerebrospinal fluid. Diagnostic analyses found no evidence of limbic encephalopathies characterized by serum antibodies against intracellular, synaptic, or further cell surface antigenic targets, neoplasm, and connective tissue or vasculitis diseases. A potential contribution of bipolar disorder
have evaluated the amount of either thyroid hormones, or antithyroid, or anti-microsomal, or anti-peroxidase antibodies (Abs) in patients with high amounts of Abs. In a diet devoid of carbohydrates (bread, pasta, fruit, and rice), free from goitrogenic food, and based on body mass index, the distribution of body mass and intracellular and extracellular water conducted for 3 weeks gives the following results: patients treated as above showed a significant reduction of antithyroid (-40%, P<0.013 (...) ), anti-microsomal (-57%, P<0.003), and anti-peroxidase (-44%, P<0,029) Abs. Untreated patients had a significant increase in antithyroid (+9%, P<0.017) and anti-microsomal (+30%, P<0.028) Abs. Even the level of anti-peroxidase Abs increased without reaching statistical significance (+16%, P>0064). With regard to the body parameters measured in patients who followed this diet, reduction in body weight (-5%, P<0.000) and body mass index (-4%, P<0.000) were observed. Since 83% of patients with high
, microbial translocation and immune activation [ Time Frame: 28 weeks ] In visits at weeks 4, 16 and 28 compared compared to baseline and screening Proportion of patients with viral rebound [ Time Frame: 15 days ] Two consecutive obtaining measurements of plasma viral load> 37 copies / mL separated by at least 15 days after discontinuation of antiretroviral therapy. Proportion of patients with autoimmunity markers induced by the vaccine as measured by: antithyroidantibodies (antithyroglobulin (...) , antithyroid peroxidase), antinuclear antibodies, antiphospholipid antibodies and rheumatoid factors. [ Time Frame: 16 weeks ] Evaluation on autoimmunity with antithyroidantibodies (antithyroglobulin, antithyroid peroxidase), antinuclear antibodies, antiphospholipid antibodies and rheumatoid factor at screening, baseline and week 16. Changes in the transcriptome of patients visits weeks 4, 16 and 28 compared to baseline (week -12) [ Time Frame: 28 weeks ] Weeks 4, 16 and 28 compared to baseline Evaluation
, antithyroid agents, or cytotoxic agents. Gestation-induced agranulocytosis has not been reported, so we present a case of gestation-induced agranulocytosis in this article.In this case, we present a Chinese woman (aged 25) in her 38th week of the first gestation who had the complication of agranulocytosis. No abnormality was detected in regular examinations before pregnancy and in the first trimester. Since the last trimester of pregnancy, the patient began to suffer from agranulocytosis and intermittent (...) fever, the maximum being temperature 38.8°C. At admission, the neutrophil granulocytes were 0.17 × 10 L and the bone marrow biopsy showed that agranulocytosis was detected, but the levels of red blood cell and megalokaryocyte were normal. In addition, antinuclear antibodies were detected at a dilution of 1:40, but anti-dsDNA, antiphospholipid antibody, and neutrophil granulocyte antibody were negative.The patient was empirically treated as having pneumonia.We tried to use granulocyte colony
euthyroid woman who presented to our hospital with palpitation, hand tremor, fatigue, and excessive sweating after HSG. Thyroid function tests revealed a thyroid stimulating hormone (TSH) level of 0.012 μIU/mL (range 0.38-4.34 μIU/mL), free T4 of 2.886 ng/dL (range 0.81-1.89 ng/dL), and free T3 levels of 9.4 pg/mL (range 1.80-4.10 pg/mL), and antithyroglobulin antibody of 31.78 IU/mL (range <115 IU/mL). The triiodothyronine uptake was 3.057 ng/mL (range 0.66-1.92 ng/mL). Serum iodine (SI) and urinary (...) iodine (UI) levels: SI of 4717.748 μg/L (range 45-90 μg/L) and UI of 18069.336 μg/L (range 26-705 μg/L).The patient was diagnosed with iodine-induced hyperthyroidism (IIH), but was not treated with antithyroid drugs. She has spontaneously recovered and is pregnant currently.This is the first reported case of overt IIH caused by HSG in a euthyroid patient without risk factors. It suggests that HSG also leads to excessive iodine absorption, which induces secondary hyperthyroidism.