Occult hypothyroidism and “metabolic insufficiency”

Jefferies, William McK.

doi:10.1016/0021-9681(61)90022-4

Cited by 8 publications

(2 citation statements)

References 30 publications

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“…Defined more than 50 years ago by Jefferies, occult hypothyroidism is characterized by vague and nonspecific complaints, few or absent clinical signs and specific laboratory values. Moreover, the response to treatment can be inconsistent or variable [ 7 ]. Most of the data on the involvement of radiation therapy in thyroid gland toxicity and, more precisely, the dose-volume-toxicity correlation comes from studies including patients with lymphoma and head and neck cancers [ 8 , 9 ].…”

Section: Radiation-induced Thyroid Toxicity—from Pathophysiology To Clinical Symptomsmentioning

confidence: 99%

“…In a cohort of 1787, 4 cases of Hashimoto’s tyroidites and 4 cases of “silent” tyreotoxicosis were reported, most of them being diagnosed in the first 2 years after Hodkin’s lymphomas radiotherapy of neck region. Illes and colleagues considered that in the case of Hodkin’s lymphoma, some of hypothyroidism may be related to thyroiditis, due to the increased immune reactivity associated with Hodgkin’s disease [ 5 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”

Section: Radiation-induced Thyroid Toxicity—from Pathophysiology To Clinical Symptomsmentioning

confidence: 99%

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An Underestimated Toxicity Radiation-Induced Hypothyroidism in Patients Multimodally Treated for Breast Cancer

Mireștean

Iancu

2021

JCM

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Radiation therapy is part of the therapeutic arsenal for breast cancer, whether it is adjuvant treatment after lumpectomy or radical mastectomy, or it is used as a palliative option in the case of metastatic or recurrent disease. Significant advances in diagnostic and therapeutic stratification of breast cancers have significantly prolonged survival, even in the metastatic stage. Exposure of patients during the course of the disease in a multidisciplinary therapeutic approach including chemotherapy, hormone therapy, targeted anti-HER therapies or CDK4/6 inhibitors had led to improved survival but with the price of additional toxicity. Among them, hypothyroidism is a well-known consequence of external radiation therapy, especially in the case of cervical region irradiation, including supraclavicular and infra-clavicular nodal levels. In this situation, the thyroid gland is considered as an organ at risk (OAR) and receives a significant dose of radiation. Subclinical hypothyroidism is a common endocrine disorder characterized by elevated TSH levels with normal levels of FT4 (free T4) and FT3 (free T3), and as a late effect, primary hypothyroidism is one of the late effects that significantly affects the quality of life for patients with breast cancer receiving multimodal treatment. Hypothyroidism has a significant impact on quality of life, most often occurring as late clinical toxicity, secondary to thyroid irradiation at doses between 30 and 70 Gy. Dose-volume parameters of irradiation, gland function at the beginning of the treatment and associated systemic therapies may be factors that alter thyroid radio-sensitivity and affect thyroid gland tolerance. In the case of head and neck tumor pathology, in which doses of >50 Gy are routinely used, the thyroid gland is generally considered as an OAR, the rate of radio-induced hypothyroidism being estimated at rates of between 20% and 52%. For breast cancer, the thyroid is often neglected in terms of dosimetry protection, the rate of late dysfunction being 6–21%.

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Section: Radiation-induced Thyroid Toxicity—from Pathophysiology To Clinical Symptomsmentioning

confidence: 99%