Clinical features and pathogenesis of thyrotoxicosis in adult Melanesians in Papua New Guinea

Michelangeli, V. P.; Pawape, G; Sinha, Ashim; Ongugu, K; Linge, David; Sengupta, S H; Tait, Brian D.; Colman, Peter G

doi:10.1046/j.1365-2265.2000.00906.x

Cited by 8 publications

(8 citation statements)

References 30 publications

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“…However, many papers on thyroid disease report the results from pathology specimens and, in the absence of an endocrine clinic, the data are unreliable as most cases of thyrotoxicosis are treated medically, not surgically. Recently a high prevalence of autoimmune thyroid disease (Graves’ and Hashimoto’s) has been reported from Papua New Guinea 59 . In SE Asia juvenile Graves’ disease has been reported from Hong Kong 60 where adult Graves’ disease is also common 61 .…”

Section: Resultsmentioning

confidence: 99%

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Thyroid Surgery in the Tropics

Watters

Wall

2007

ANZ Journal of Surgery

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In the tropics thyroid surgery is carried out either by general surgeons or ear, nose and throat surgeons and there are few places with a subspecialist endocrine or head and neck surgeon. The aim of this review is to determine the pattern of thyroid pathology, surgery and surgical outcomes in the tropics. A review of thyroid surgery in tropical regions was carried out based on published articles in English in Medline (1965-2004). The findings are also discussed in the light of the authors' own experience of thyroid disease and thyroid surgery in four continents. The pattern of thyroid pathology varies in the tropics, particularly in regions where endemic goitre is common. Endemic goitre usually regresses with iodine therapy. There is a rising incidence of thyroid autoimmune disease, particularly Graves' disease and Hashimoto's thyroiditis, probably related to an environmental immunological stimulus associated with development. Surgery is indicated for the same reasons as in the developed countries: thyrotoxicosis (more often in the absence of radioactive iodine therapy), solitary thyroid nodule and multinodular or malignant goitre. However, a preoperative cytological diagnosis will only be available in important centres where there is a pathologist. Malignancy appears more prevalent in nodules and goitres in the tropics than in the developed countries, perhaps because patients with malignancy are more likely to be referred to a surgeon. Nonetheless, the evidence suggests that thyroid surgery can be carried out safely with a minimum of complications even in remote mission hospitals with limited facilities for investigation. Standards can be set in terms of surgical outcomes; for example, mortality (0%), permanent recurrent laryngeal nerve (RLN) injury (<2%), re-exploration for haematoma(<2%), permanent hypocalcaemia (<5%) and wound infection (2.5%). The choice of operation depends on the local pathology and the likelihood of being able to obtain lifelong thyroxine. Total thyroidectomy should be avoided whenever possible if thyroxine supplies are unreliable. Advanced thyroid cancer presents a therapeutic challenge and some cases will be unresectable. The management options are limited by the resources available. Similar surgical outcomes should be able to be achieved no matter where the surgery is carried out.

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Section: Resultsmentioning

confidence: 99%

“…Recently a high prevalence of autoimmune thyroid disease (Graves' and Hashimoto's) has been reported from Papua New Guinea. 59 In SE Asia juvenile Graves' disease has been reported from Hong Kong 60 where adult Graves' disease is also common. 61 Thyrotoxicosis affects 1.58% of the population in Singapore.…”

Section: Pathologymentioning

confidence: 99%

Thyroid Surgery in the Tropics

Watters

Wall

2007

ANZ Journal of Surgery

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“…Iodoamino acids such as monoiodotyrosine (MIT), diiodotyrosine (DIT), triiodothyronine (T3) and thyroxine (T4) have been identifi ed in S. thunbergii (Ito et al ., 1976). T3 and T4 are the same hormones produced by the thyroid gland central to metabolic regulation, and have a signifi cant role in Grave's disease and Hashimoto's thyroiditis (Michelangeli et al ., 2000). It is possible that some compounds mediating the iodoamino acids in Sargassum may affect human thyroid metabolism, and contribute to a traditionally observed pharmacological effects in thyroid disease (Liu et al .…”

Section: Brown Macroalgaementioning

confidence: 99%

Algal proteins, peptides and amino acids

Conde

Balboa

Parada

et al. 2013

Functional Ingredients From Algae for Foods and Nutraceuticals

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“…nodular goiter as the main biological basis of IIH was relatively rare in this area before USI. In addition, the significant increased incidence of hyperthyroidism found in Panshan with borderline iodine deficiency but without the influence of USI, suggested that the increment in iodine intake is not the only cause leading to an increase of hyperthyroidism (15,16).…”

Section: Panshanmentioning

confidence: 99%

Epidemiological survey on the relationship between different iodine intakes and the prevalence of hyperthyroidism

Yang

Teng

Shan

et al. 2002

European Journal of Endocrinology

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Objective: To investigate the effect of different levels of iodine intake on the prevalence of hyperthyroidism and the impact of universal salt iodization on the incidence of hyperthyroidism. Design: A comparative cross-sectional and longitudinal survey was conducted in three areas with borderline iodine deficiency, mild iodine excess (previously mild iodine deficiency) and severe iodine excess. Universal salt iodization had been introduced 3 years previously except in the area with borderline iodine deficiency. Methods: In total 16 287 inhabitants from three areas answered a questionnaire concerning the history of thyroid disease. Among them 3761 unselected subjects received further investigations including thyroid function, thyroid autoantibodies, thyroid ultrasonography and urinary iodine excretion. Results: Among areas with median urinary iodine excretion of 103 mg/l, 375 mg/l and 615 mg/l ðP , 0:05Þ; the prevalence of hyperthyroidism did not differ significantly (1.6%, 2% and 1.2%). The prevalence of subclinical hyperthyroidism was higher in areas with borderline iodine deficiency and mild iodine excess than in the area with severe excess iodine intake (3.7%, 3.9% and 1.1%, P , 0:001). The prevalence of Graves' disease and its proportion in hyperthyroidism did not differ among areas. The incidence of hyperthyroidism did not significantly increase after the introduction of universal salt iodization. Conclusion: Different iodine intakes under a certain range do not affect the prevalence and type of hyperthyroidism. Subclinical hyperthyroidism is more prevalent in the iodine deficient area than in the severe iodine excessive area. In the area with mild iodine deficiency, the introduction of universal salt iodization may not be accompanied by an increased incidence of hyperthyroidism.

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Clinical features and pathogenesis of thyrotoxicosis in adult Melanesians in Papua New Guinea

Abstract: The cause of this apparent sudden increase in Graves' disease in the coastal region around Port Moresby, an apparently iodine-replete area, remains unexplained.

Cited by 8 publications

References 30 publications

Thyroid Surgery in the Tropics

Thyroid Surgery in the Tropics

Algal proteins, peptides and amino acids

Epidemiological survey on the relationship between different iodine intakes and the prevalence of hyperthyroidism

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