A UK reported case of Graves’ disease with thyroid hemiagenesis

Faulkner, Jack; Varadharajan, Kiran; Choudhury, Natasha

doi:10.1136/bcr-2018-228094

Cited by 5 publications

(6 citation statements)

References 22 publications

(44 reference statements)

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“…Such a conclusion can be evidenced by the case of a 49-yearold patient having one thyroid lobe (due to other lobe agenesia) who acquired hypothyroidism with signs of Hashimoto thyroiditis only in this age, and hyperthyroidism in the subsequent 2 years [61]. Currently, 17 similar cases are known [62].…”

Section: Discussionmentioning

confidence: 99%

Conversion From Hypothyroidism to Hyperthyroidism and Back After Anti-SARS-CoV-2 Vaccination

Ушаков

2022

J Endocrinol Metab

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Cases presenting with changes in various organs caused by anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination are rare. In particular, after such instances of vaccination, onset of subacute thyroiditis, Hashimoto thyroiditis, and Graves' disease was observed. We present the case of a 55-year-old woman whose hypothyroidism converted to hyperthyroidism after vaccination with Gam-COVID-Vac (Sputnik V). After the first dose of vaccine, a hormonal metabolism alteration was noted, i.e., conversion from hypothyroidism to euthyroidism. After the second dose of vaccine, onset of hyperthyroidism with thyrotoxicosis was noted without signs of subacute thyroiditis. Hyperthyroidism persisted for several weeks before reverting to hypothyroidism. Assessments did not reveal an increase in the patient's thyroid-stimulating hormone receptor antibody levels throughout the indicated period. However, after hyperthyroidism reverted to hypothyroidism, a significant increase in the peak systolic velocity of the superior thyroid arteries was observed, which is characteristic of hyperthyroidism. Owing to the known involvement of the autonomic nervous system (ANS) in blood vessel tone regulation, thyroid hormonogenesis, and stress, the ANS-mediated conversion from hypothyroidism to hyperthyroidism in certain individuals after receiving a vaccine, which may serve as a sufficient stimulus for ANS nerve centers, is highly probable. Therefore, diagnostic assessment of ANS condition should be performed before vaccination in patients with chronic thyroid disorders or diseases of other organs or organ systems. If changes in ANS are found, providing preemptive treatment before vaccination is recommended.

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Section: Discussionmentioning

confidence: 99%

Conversion From Hypothyroidism to Hyperthyroidism and Back After Anti-SARS-CoV-2 Vaccination

Ушаков

2022

J Endocrinol Metab

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“…The first reported case of THA and GD in the UK was by Faulkner et al in 2019. The patient was a 31-year-old female with left THA and GD who subsequently had right hemithyroidectomy and isthmusectomy [25]. TSH stimulation test and scintiscan with Tc-99 or Iodine had been used until the 1990s for differential diagnosis of GD and THA.…”

Section: Co-existing Thyroidal and Extra-thyroidal Pathologiesmentioning

confidence: 99%

“…Congenital anomalies during descent (i.e. the presence of thyroglossal cysts) are more common compared to the absence of either lobe which is quite rare [ 25 ]. The cause of THA is not known and possible theories include failure of descent, defects in lobulation, or genetic aberrations [ 4 ].…”

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

“…THA: Thyroid hemiagenesis.Veliz and Pineda, 2000[78]; HervasBenito et al, 2001 [79];Zangeneh et al, 2001 [80];Lee et al, 2003 [52];Ozgen et al, 2004 [81]; Baldini et al, 2005 [72]; Ruchala et al, 2008 [70]; Nebesio and Eugster, 2009 [73]; Kebapcilar et al, 2009 [75]; Serdengecti et al, 2009 [82]; Cakir et al, 2009 [74]; Berker et al, 2010 [35]; Philip et al, 2014 [83]; Cansu et al, 2017 [84]; Faulkner et al, 2019[25] …”

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confidence: 99%

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Thyroid Hemiagenesis: Narrative Review and Clinical Implications

Lesi¹,

Thapar²,

Appaiah³

et al. 2022

Cureus

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Thyroid Hemiagenesis (THA) is an uncommon, congenital anomaly defined by the absence of one thyroid lobe with or without the isthmus. Reports suggest it may be found more often in regions endemic for hypothyroidism. Genetic abnormalities are thought to have a role based on findings in monozygotic twins. Most cases are sporadic, however familiar clusters have also been documented. It is found more frequently in females. A majority of patients report no symptoms and THA is found incidentally during investigations or intraoperatively. THA is usually associated with normal thyroid function, but it can present with thyroid hypofunction.Since a majority of patients are asymptomatic, there are no specific recommendations for management. Ultrasound imaging and thyroid scintigraphy using technetium or iodine are useful in diagnosis. Its clinical importance occurs when the remnant thyroid lobe requires excision leading to the lifelong requirement for thyroxine supplementation.Published English literature (Medline, PubMed, and Embase databases) was searched. Medical subject headings (MeSH) terms used were "thyroid hemiagenesis," "one thyroid lobe," and "thyroid aplasia". Case reports, case series, and original articles were selected to provide a framework for this review.Articles reviewed were published in the past 20 years. The association of THA with thyroid cancer was explored. In this group, the F:M ratio was 3.25:1. Left THA constituted 53% of cases, right THA in 29.4%, and isthmus absence in 17.6% of cases. Also, the authors investigated the link between THA and hyperparathyroidism, both left and right THA are seen in an equal number of cases in the hyperparathyroidism subgroup. In patients with THA and Grave's disease, left THA was seen in a majority of cases (86.7%), while an equal number of left and right THA was observed in patients with Hashimoto's thyroiditis. In addition, congenital abnormalities associated with THA were observed, the left THA was seen in 60% and right THA in 40% of cases of this subgroup.The summative review provided a detailed insight into the epidemiology, aetiopathogenesis, genetics, symptomatology, diagnosis, and treatment for THA by combining findings and results from almost a hundred research papers from around the world. THA remains a poorly understood, often incidentally detected, abnormality in euthyroid patients undergoing investigations and treatment for other thyroid disorders.

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Carbimazole

2019

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A UK reported case of Graves’ disease with thyroid hemiagenesis

Cited by 5 publications

References 22 publications

Conversion From Hypothyroidism to Hyperthyroidism and Back After Anti-SARS-CoV-2 Vaccination

Conversion From Hypothyroidism to Hyperthyroidism and Back After Anti-SARS-CoV-2 Vaccination

Thyroid Hemiagenesis: Narrative Review and Clinical Implications

Carbimazole

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