Prevalence of subclinical hyperthyroidism and relationship between thyroid hormonal status and thyroid ultrasonographic parameters in patients with non‐toxic nodular goitre

Rieu, M; Bekka, S.; Sambor, B; Berrod, Jean-Louis; Fombeur, J. P.

doi:10.1111/j.1365-2265.1993.tb01752.x

Cited by 42 publications

(19 citation statements)

References 29 publications

(30 reference statements)

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“…Other patients may have a long-standing visible goiter in the absence of other clinical symptoms. Hyperthyroidism, either subclinical or overtly symptomatic, is present in up to 25% of these patients (19). However, occasionally, the thyroid may extend into the thoracic cavity (substernal goiter) resulting in obstruction or pressure of structures within the cavity.…”

Section: Clinical Presentationmentioning

confidence: 98%

Approach to the Patient with Nontoxic Multinodular Goiter

Bahn

Castro

2011

The Journal of Clinical Endocrinology &Amp; Metabolism

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Thyroid nodules are very common, and although the majority are benign, approximately 5% may harbor malignancy. The evaluation of the patient with solitary thyroid nodule is generally straightforward and will typically include measurement of serum TSH to assess thyroid function and fine-needle aspiration biopsy of the nodule, with or without ultrasound (US) guidance. The approach to the patient with nontoxic multinodular goiter represents a more difficult problem for the clinician. All patients should have serum TSH measured to assess functional thyroid status and US examination to evaluate the number, size, and sonographic features of the nodules and assist in the selection of nodules that may need fine-needle aspiration biopsy. Patients with nodules yielding malignant cytology should be referred for surgery. Given the lack of reliable markers to predict biological behavior of nodules with suspicious (indeterminate) cytology, patients with such nodules are generally advised to have surgery, unless autonomous function of these nodules can be confirmed by scintigraphy. Most of these patients, however, will ultimately prove to have benign follicular tumors. Many patients with benign but large goiters may experience clinical symptoms of pressure, such as dysphagia, choking sensation, or airway obstruction. Such patients will often require surgery for alleviation of symptoms. In the absence of malignancy, asymptomatic patients may be observed. Radioactive iodine, commonly used in many parts of Europe, is safe and effective and may be a reasonable option for many patients. Periodic follow-up with neck palpation and US exam is recommended for all patients.

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Section: Clinical Presentationmentioning

confidence: 98%

Approach to the Patient with Nontoxic Multinodular Goiter

Bahn

Castro

2011

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…It seems that each individual has a different, genetically determined thyroid function set-point, and that small variations around this set-point, even within the normal range, can have important consequences on, for example, body weight (6). A better selection of subjects, by excluding subjects with autonomous thyroid nodules (68,69), and standardized (regarding time of day) and perhaps multiple TSH measurements to better define an individual's set-point (1), would increase the power of such association studies. This raises the possibility of estimating an individual's set-point based on his/her genetic make-up of thyroid hormone pathway genes.…”

Section: Concluding Remarks and Future Perspectivesmentioning

confidence: 99%

Genetic variation in thyroid hormone pathway genes; polymorphisms in the TSH receptor and the iodothyronine deiodinases

2006

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Serum thyroid parameters show substantial inter-individual variability, in which genetic variation is a major factor. Findings in patients with subclinical hyper-and hypothyroidism illustrate that even minor alterations in serum thyroid function tests can have important consequences for a variety of thyroid hormone-related clinical endpoints, such as atherosclerosis, bone mineral density, obesity, and heart rate. In the last few years, several studies described polymorphisms in thyroid hormone pathway genes that alter serum thyroid function tests. In this review, we discuss the genetic variation in the TSH receptor and iodothyronine deiodinases. We discuss the possible consequences of these studies for the individual patient and also the new insights in thyroid hormone action that can be obtained from these data.European Journal of Endocrinology 155 655-662

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“…Some patients with an autonomously functioning thyroid adenoma14 and about a quarter of patients with multinodular disease15 have persistently low serum TSH concentrations. Multinodular goitre and Graves' disease are the commonest of endogenous causes of subclinical hyperthyroidism 15.…”

Section: Causes Of Low Serum Tsh Concentrationsmentioning

confidence: 99%