Correlation between wayne′s score and laboratory evidence of thyrotoxicosis in Nigeria

Sabir, Anas Ahmad; Fasanmade, O.A; Abubakar, Sani Atta; Haruna, Garba Yunusa; Ohwovoriole, A.E

doi:10.4103/2384-5147.138944

Cited by 4 publications

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“…Relying on laboratory result of increase thyroid hormone and decrease thyroid-stimulating hormone is best establishing the diagnosis. 7 In this patient, we found a score of 16 (equivocal) according to the Wayne index (Table 1), but we had laboratory finding FT3 and FT4 increased significantly with very low TSH levels at <0.005 μIU/ml so the presumptive of thyrotoxicosis cannot be ignored. The equivocal score could be happening because the presence of elevated FT3 and FT4 concentrations could be partly due to the brief duration of increased hormonal levels in patients.…”

Section: Discussionmentioning

confidence: 68%

Case study: Thyrotoxicosis on women with complete hydatidiform molar pregnancy

Nugraha

Samodro²

2019

JKKI

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Thyrotoxicosis defined as a clinical manifestation of excess circulating thyroid hormone. Epidemiologic investigation reports 0.2% of thyrotoxicosis is caused by hydatidiform mole. The New England Trophoblastic Disease Centre (NETDC) mentioned that 20% of hydatidiform mole cases have thyrotoxicosis as one of its complications. The basic pathogenesis of thyrotoxicosis is the similarity of the HCG subunit to TSH which results in excessive stimulation of thyroid hormone. We present thethyrotoxicosis case in a 15-weeks pregnant woman with complete hydatidiform mole. The patient admitted to the hospital with blackish-red coloured bleeding and several hyperthyroidism complaints, laboratory test showed elevated levels of HCG and thyroid hormone and decreased TSH. Imaging studies done with ultrasound showed with snowflake pattern. The patient then treated with thyroid hormone suppressant therapy before the hydatidiform mole evacuation. Normalization of thyroid hormone levels should be made immediately before the mole evacuation to avoid lifethreatening thyroid storm complications. Tirotoksikosis merupakan manifestasi klinis akibat kelebihan hormon tiroid yang beredar dalam darah. Hasil epidemiologi mencatat sekitar 0,2% kasus tirotoksikosis dapat disebabkan oleh mola hidatidosa. The New England Thropoblastic Disease Centre (NETDC) menyebutkan 20% kasus mola hidatidosa di benua Asia memiliki komplikasi tirotoksikosis. Patofisiologi dasar tirotoksikosis adalah kemiripan subunit HCG dengan TSH yang mengakibatkan stimulasi produksi hormon tiroid yang berlebihan. Pada kesempatan ini dilaporkan sebuah kasus tirotoksikosis pada seorang wanita hamil usia 15 minggu dengan mola hidatidosa komplit. Pasien mengeluh perdarahan banyak berwarna merah kehitaman, disertai beberapa keluhan hipertiroidisme, hasil laboratorium menunjukkan peningkatan kadar HCG dan hormon tiroid, penurunan TSH disertai gambaran snowflake pattern pada hasil USG. Pasien kemudian diberikan terapi penekan hormon tiroid sebelum dilakukan evakuasi mola. Penekanan kadar hormon tiroid harus dilakukan segera sebelum tindakan evakuasi mola agar komplikasi badai tiroid yang dapat mengancam keadaan pasien dapat dicegah.

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Section: Discussionmentioning

confidence: 68%

Case study: Thyrotoxicosis on women with complete hydatidiform molar pregnancy

Nugraha

Samodro²

2019

JKKI

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“…Wayne's score is still useful for identifying hyperthyroidism based on clinical symptoms since test confirmation is often delayed. The diagnostic index assigns a score to the presence or absence of several hyperthyroidism signs and symptoms (Table 3) 23,24 . A thyroid function test should then be ordered to confirm the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Pneumonia Provocate Thyroid Storm in Graves Disease

et al. 2023

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Introduction: A thyroid crisis is an endocrine emergency involving many organ systems and can be fatal to the patient's survival. Although cases of thyroid crisis are rare, the mortality rate is significant which reaches 20–50%. The presence of comorbidities such as pneumonia infection increases the risk of death dramatically. Infection is a factor that can trigger thyroid crisis and exacerbate thyrotoxicosis. This condition of thyroid crisis most often occurs in people with hyperthyroidism caused by Graves' disease. We present the case of a patient with Graves' disease, aged 22 years, who developed a thyroid crisis due to community-acquired pneumonia infection. This study aims to provide a case report regarding the thyroid crisis due to pneumonia.Results: We carried out a physical and some appropriate supporting examinations to confirm the diagnosis. Wayne's index was 26, indicating hyperthyroidism. Assessment with Burch-Wartofsky obtained a score of 45, indicating suspicion of a thyroid storm. Then supportive care was provided to the patient. The community-acquired pneumonia as a triggering factor was treated with antibiotics. Thyrotoxicosis conditions were treated with antithyroid, beta-blocker, and glucocorticoid drugs. The patient's condition improved after treatment.Conclusion: It is crucial to detect and treat thyroid storm as quickly as possible since it has a high mortality rate. Wayne's score is useful for identifying hyperthyroidism based on clinical symptoms. The Burch-Wartofsky Point Scale scores are used to diagnose thyroid storms. Thyroid storm should be managed according to PERKENI (Perkumpulan Endokrinologi Indonesia) and ATA (American Thyroid Association) recommendations. This case serves as an example of how to make a proper diagnosis and treatment to prevent morbidity and death due to thyroid crisis.

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“…In the study by Sabit et al, mean Wayne index is 31.6. The sensitivity of the Wayne index in diagnosing hyperthyroidism is 86.9%, while the specificity is 96.6% [15,16].…”

Section: Discussionmentioning

confidence: 99%

The Profile of Thyrotropin-Releasing Hormone, T-Regulator, and Interleukin-4 of Untreated Graves’ Disease in Indonesia

Decroli

Elvira

Aprilia

2020

Asian J Pharm Clin Res

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Objective: This study was conducted to the profile of hormonal and immunological aspects, which is thyrotropin-releasing hormone (TRH), T-regulator (T-reg) Forkhead box P3 (FOXP3) gene polymorphism, and interleukin-4 (IL-4) of untreated Graves’ disease with hyperthyroid in M Djamil General Hospital Padang, Indonesia. Methods: A cross-sectional study was conducted to observe Graves’ disease with hyperthyroid in the Internal Medicine Department in Dr. M. Djamil Hospital, Padang, West Sumatera, Indonesia. Graves’ disease was confirmed by measuring free thyroxine (FT4), thyroid-stimulating hormone (TSH), and antithyroid peroxidase (anti-TPO). TRH, T-reg FOXP3 gene polymorphism, and IL-4 were examined with an enzyme-linked immunosorbent assay method. Results: Twenty-five subjects with Graves’ disease included in this study with an average of age is 27.48 (5.6) years. Mean Wayne index is 23.44 (1.4), mean serum FT4 level is 55.55 (17.98) pmol/l, median serum TSH level is 0.041 (0.004–0.053) mU/l, and mean anti-TPO level is 2697.539 (479.72) pg/ml. Median serum TRH level is 92.589 (24.843–253.186) pg/ml, mean T-reg FOXP3 gene polymorphism is 0.621 (0.23) ng/ml, and mean serum IL-4 level is 19.759 (7.03) pg/ml). Conclusion: Graves’ disease with hyperthyroid has median serum TRH level 92.589 (24.843-253.186) pg/ml and high levels of T-reg FOXP3 gene polymorphism and IL-4.

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Correlation between wayne′s score and laboratory evidence of thyrotoxicosis in Nigeria

Cited by 4 publications

References 0 publications

Case study: Thyrotoxicosis on women with complete hydatidiform molar pregnancy

Case study: Thyrotoxicosis on women with complete hydatidiform molar pregnancy

Case Report: Pneumonia Provocate Thyroid Storm in Graves Disease

The Profile of Thyrotropin-Releasing Hormone, T-Regulator, and Interleukin-4 of Untreated Graves’ Disease in Indonesia

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