Non-functioning pituitary adenomas (NFPAs), or as recently suggested, "non-functioning pituitary neuroendocrine tumors," are benign hypophyseal neoplasms that originate from adenohypophyseal cells. 1 NFPAs are not related to clinical or biochemical evidence of hormonal excess. 1,2 The lack of clinical symptoms of hormonal hypersecretion generally causes a delay in diagnosis. Therefore, NFPAs are commonly diagnosed when they are large enough to have mass effects on surrounding neurovascular structures. 1 The sphenoid sinus (SS) has a great importance as the gateway to the pituitary fossa during transnasal transsphenoidal surgery. It varies in size and shape and is located in the centre of the skull base. Various sinus and non-sinus diseases may affect the SS and can manifest in ways such as mucosal thickening, fluid collection, and partial or total opacification on radiologic imaging modalities.Isolated SS pathologies are relatively rare, and among patients with rhinosinusitis, isolated sphenoiditis incidence was reported as 1% to 3%. 3 Moreover, in a population-based study conducted on healthy individuals aged 50-65 years, SS mucosal thickening was detected in only 136 of 1963 sinuses (7%) on magnetic resonance imaging (MRI) scans. 4
Subacute thyroiditis(SAT) developed after SARS-CoV-2 vaccines has been less studied. We aimed to compare classical SAT and SAT developed after SARS-CoV-2 vaccines in the context of clinical aspects. Adults with SAT detected in 90 days of COVID-19 vaccination (CoronaVac® or Pfizer/BioNTech®) were grouped as Vac-SAT (CoronaVac-SAT and BioNTech-SAT). Those with a history of SARS-CoV-2 or upper respiratory tract infection in 6 months before the vaccination, or vaccination with another antiviral vaccine after COVID-19 vaccination were excluded. Those with SAT detected before COVID-19 pandemic were grouped as Classical-SAT. Of total(n=85), female/male(54/31) ratio and age(43(23-65)) were similar in Vac-SAT(n=23) and Classical-SAT(n=62) groups. Duration between vaccine and SAT was 45(7-90) days, and similar in CoronaVac-SAT(n=5) and BioNTech-SAT(n=18) groups. SAT-duration was 28(10-150) days, and higher in Vac-SAT than in Classical-SAT group(p=0.023). SAT was developed after the 1st dose vaccine in minority in CoronaVac-SAT(n=2) and BioNTech-SAT(n=3) groups(p=0.263). Previous LT4 use, and TSH elevation after resolution were more frequent in Vac-SAT than in Classical-SAT(p=0.027 and p=0.041, respectively). We included a considerable number of patients with SAT occurred after COVID-19 vaccines. We cannot provide clear evidence regarding the association of COVID-19 vaccines with SAT. SAT associated with CoronaVac® or BioNTech® seems unlikely to be occurred after the 1st dose, and to have a longer duration, more likely to be associated with previous LT4 use and lead TSH elevation after resolution than Classical-SAT. TSH should be followed-up after the resolution of SAT detected after COVID-19 vaccination.
Objective. To investigate the impact of body weight on the subclinical hypothyroidism observed in patients with PCOS. Methods. The study included 95 normal weight (Group-1) and 122 overweight or obese women (Group-2) with PCOS. The control group consisted of age and BMI matched healthy individuals and grouped as normal weight (n: 66, Group-3) and overweight or obese (n: 65, Group-4. Women with chronic disease such as overt thyroid dysfunction, late-onset adrenal hyperplasia, and diabetes were excluded from the study. Plasma glucose and lipid profile, thyroid hormones, insulin, FSH, LH, total testosterone, estradiol, progesterone and DHEA-S were measured. Results. While fasting glucose was similar, insulin and HOMA-IR were higher in Group-2 and Group-4 (p: 0.001). The groups were similar with respect to FSH, Estradiol, prolactine, DHEAS. While total testosterone and LH levels were higher (ptestosterone: 0,009), progesterone was lower in both PCOS groups (pprogesterone: 0.041). Free T3, free T4, thyroid antibodies were similar between the groups, but the prevalence of subclinical hypothyroidism was greater in Group-2 and-4 than in Group-1 and-3 (p: 0.044). TSH was only correlated with BMI (r: 0.122, p: 0.02). Conclusion. The increased prevalence of subclinical hypothyroidism in women with PCOS might be the result of increased BMI.
Background/Aim The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different aetiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. Methods This nationwide multicenter retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either coronavirus disease-2019 (COVID-19)-related SAT (Cov-SAT), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine-related SAT (Vac-SAT), or control SAT (Cont-SAT). Results Of the 811 patients, 258 (31·8%) were included in the Vac-SAT group, 98 (12·1%) in the Cov-SAT group, and 455 (56·1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. The aetiology of SAT was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein (CRP) measured during SAT onset, female gender, absence of anti-thyroid peroxidase (TPO) positivity, and absence of steroid therapy were statistically significant predictors of incident (early) hypothyroidism, irrespective of SAT aetiology. On the other hand, probable predictors of established hypothyroidism differed from that of incident hypothyroidism. Conclusion Since there is no difference in terms of follow-up parameters and outcomes, COVID-19- and SARS-CoV-2- vaccine related SATs can be treated and followed up like classical SATs. The recurrence was determined by the younger age and steroid therapy requirement. Steroid therapy independently predict incident hypothyroidism that may sometimes be transient in overall SATs and is also associated with lower risk of established hypothyroidism.
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