Effect of therapy on the serum thyroglobulin concentration in patients with toxic diffuse goiter, toxic nodular goiter and toxic adenoma

1987 ◽  
Vol 10 (4) ◽  
pp. 351-357 ◽  
Author(s):  
Ulla-Britt Ericsson ◽  
L. Tegler ◽  
J. -F. Dymling ◽  
J. I. Thorell
Keyword(s):  
Nodular Goiter ◽  
Toxic Adenoma ◽  
Serum Thyroglobulin ◽  
Toxic Nodular Goiter ◽  
Effect Of Therapy ◽  
Diffuse Goiter ◽  
Thyroglobulin Concentration

Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases

2000 ◽  
Vol 39 (05) ◽  
pp. 133-138 ◽  
Author(s):  
W. Dembowski ◽  
H.-J. Schroth ◽  
K. Klinger ◽  
Th. Rink
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Thyroid Volume ◽  
Nodular Goiter ◽  
Thyroid Diseases ◽  
Hashimoto's Thyroiditis ◽  
Graves Disease ◽  
Normal Range ◽  
Serum Thyroglobulin ◽  
Diffuse Goiter ◽  
Hyperthyroid Patients

Summary Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto’s thyroiditis and 30 hyperthyroid patients with Graves’ disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto’s thyroiditis showed slightly decreased Tg levels. In Graves’ disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range (< 30 ng/ml). Conclusion: Elevated Tg levels indicate a high probability of thyroid diseases, such as malignancy, autonomy or Graves’ disease. However, as low Tg concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases.

scholarly journals Serum thyroglobulin level in newly detected thyrotoxicosis and its role in differential diagnosis of thyrotoxicosis

2021 ◽  
Vol 8 (3) ◽  
pp. 433
Author(s):  
Mohammad Omar Faruque ◽  
A. B. M. Kamrul-Hasan ◽  
M. Ahamedul Kabir ◽  
Rehnuma Nasim ◽  
Mohammad Jahangir Alam ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Elevated Serum ◽  
Nodular Goiter ◽  
Tertiary Hospital ◽  
Subacute Thyroiditis ◽  
Graves Disease ◽  
Serum Thyroglobulin ◽  
Cross Sectional ◽  
Toxic Nodular Goiter ◽  
Thyroglobulin Level

Background: Elevated serum thyroglobulin (Tg) level is commonly observed in various forms of thyrotoxicosis; the levels vary according to different etiologies. This study aimed at identifying the value of serum Tg level in the differential diagnosis of common etiologies of thyrotoxicosis.  Methods: This cross-sectional study was conducted at the endocrine outpatient department of a tertiary hospital in Bangladesh from March 2015 to May 2017. In this study, 200 subjects with newly detected untreated thyrotoxicosis were evaluated. Serum Tg was assayed by chemiluminescent immunometric assay.  Results: Serum Tg level was raised in 48% of subjects. Subjects aged ≥40 years, and those having a family history of thyroid disorders had relatively higher thyroglobulin levels. The frequency of subjects with an elevated Tg was highest in subacute thyroiditis (89.5%) followed by toxic nodular goiter (77.3%) and Graves’ disease (32.9%); the difference in the frequencies was statistically significant (p<0.001). Median Tg was highest in the subjects with subacute thyroiditis (132.6 ng/ml) followed by toxic nodular goiter (99.55 ng/ml); those with Graves’ disease had the lowest Tg level (12.5 ng/ml); the differences in median Tg levels across the three groups were also statistically significant (p<0.001).  Conclusions: Serum thyroglobulin level may be useful for the etiological diagnosis of thyrotoxicosis.

scholarly journals Graves’ Disease

2021 ◽  
Author(s):  
Paula Aragão Prazeres de Oliveira ◽  
Beatriz Nayara Muniz de Oliveira ◽  
Eduarda da Silva Souza Paulino ◽  
Fernanda Carolinne Marinho de Araujo ◽  
Paula Gabriele Tabosa Lyra
Keyword(s):  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Radioactive Iodine ◽  
Clinical Manifestations ◽  
Nodular Goiter ◽  
Graves Disease ◽  
Decompression Surgery ◽  
Excessive Sweating ◽  
Toxic Nodular Goiter ◽  
Diffuse Goiter

DG presents with three main presentations: hyperthyroidism with diffuse goiter, infiltrative ophthalmopathy and pre-tibial myxedema. Patients with Graves’ disease can rarely develop severe hyperthyroidism. The hyperthyroidism of Graves’ disease is characterized immunologically by the lymphocytic infiltration of the thyroid gland and by the activation of the immune system with elevation of the circulating T lymphocytes. In GD, goiter is characteristically diffuse. May have asymmetric or lobular character, with variable volume. The clinical manifestations of hyperthyroidism are due to the stimulatory effect of thyroid hormones on metabolism and tissues. Nervousness, eye complaints, insomnia, weight loss, tachycardia, palpitations, heat intolerance, damp and hot skin with excessive sweating, tremors, hyperdefecation and muscle weakness are the main characteristics. In the laboratory diagnosis, biochemical and hormonal exams will be done to assess thyroid hormones and the antithyroid antibodies. Additionally, imaging tests may be performed, such as radioactive iodine capture in 24 hours, ultrasonography, thyroid scintigraphy and fine needle aspiration. It is necessary to make the differential diagnosis of Graves’ disease for thyrotoxicosis, subacute lymphocytic thyroiditis and toxic nodular goiter. The treatment of DG aims to stop the production of thyroid hormones and inhibit the effect of thyroid hormones on the body. Hyperthyroidism caused by DG can be treated in the following ways: it may be the use of synthetic antithyroid medicines, thionamides, MMI being a long-term medicine, it allows a single daily dose, and adherence to treatment occurs, a disadvantage is that it cannot be used in pregnant women; beta-blockers, preferably used in the initial phase of DG with thionamides; radioactive iodine therapy (RAI), being the best cost–benefit and preventing DG recurrence; finally the total thyroidectomy, causing the withdrawal of the thyroid gland. Therefore, it should be discussed with the patient what is the best treatment for your case, with a view to the post and against each approach. If the patient develops Graves ophthalmopathy, in lighter cases the artificial tears should be used, and in more severe cases can be used as treatment, corticosteroids, orbital decompression surgery, prisms and orbital radiotherapy. In addition, the patient should keep their body healthy, doing exercise and healthy eating, following the guidance of their doctor.

The significance of serum thyroglobulin measurement before and after the treatment of toxic nodular goiter with 131I

2020 ◽  
Vol 41 (4) ◽  
pp. 344-349
Author(s):  
Boris Bonefačić ◽  
Tatjana Bogović Crnčić ◽  
Maja Ilić Tomaš ◽  
Neva Girotto ◽  
Svjetlana Grbac Ivanković
Keyword(s):  
Nodular Goiter ◽  
Serum Thyroglobulin ◽  
Toxic Nodular Goiter ◽  
Before And After

scholarly journals Elevated Serum Thyroglobulin and Low Iodine Intake Are Associated with Nontoxic Nodular Goiter among Adults Living near the Eastern Mediterranean Coast

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yaniv S. Ovadia ◽  
Dov Gefel ◽  
Svetlana Turkot ◽  
Dorit Aharoni ◽  
Shlomo Fytlovich ◽  
...  
Keyword(s):  
Eastern Mediterranean ◽  
Medical Center ◽  
Elevated Serum ◽  
Nodular Goiter ◽  
Cross Sectional Study ◽  
Iodine Intake ◽  
Mediterranean Coast ◽  
Thyroid Diseases ◽  
Serum Thyroglobulin ◽  
Cross Sectional

Background.Information about iodine intake is crucial for preventing thyroid diseases. Inadequate iodine intake can lead to thyroid diseases, including nontoxic nodular goiter (NNG).Objective.To estimate iodine intake and explore its correlation with thyroid diseases among Israeli adults living near the Mediterranean coast, where iodine-depleted desalinated water has become a major source of drinking water.Methods.Cross-sectional study of patients attending Barzilai Medical Center Ashkelon. Participants, who were classified as either NNG (n=17), hypothyroidism (n=14), or control (n=31), provided serum thyroglobulin (Tg) and completed a semiquantitative iodine food frequency questionnaire.Results.Elevated serum Tg values (Tg > 60 ng/mL) were significantly more prevalent in the NNG group than in the other groups (29% versus 7% and 0% for hypothyroidism and controls, resp.,P<0.05). Mean estimated iodine intake was significantly lower in the NNG group (65±30 μg/d) than in controls (115±60 μg/d) (P<0.05) with intermediate intake in the hypothyroid group (73±38 μg/d).Conclusions.Elevated serum Tg values and low dietary iodine intake are associated with NNG among adult patients in Ashkelon District, Israel. Larger studies are needed in order to expand on these important initial findings.

scholarly journals Screening of young subjects for goiter: role of ultrasonic examinations

1996 ◽  
Vol 42 (2) ◽  
pp. 17-20
Author(s):  
T. A. Zykova ◽  
A. L. Fefilov ◽  
O. A. Tsyganova ◽  
N. A. Martyushova ◽  
O. N. Sukhanova ◽  
...  
Keyword(s):  
Thyroid Dysfunction ◽  
Nodular Goiter ◽  
Sonographic Examination ◽  
Diffuse Goiter ◽  
Therapeutic Measures ◽  
Young Subjects

Eighty-two students in whom goiter was diagnosed by palpation were examined by ultrasonography. Assessment of the volume of the thyroid in these students revealed diffuse goiter in only 5.5% and nodular in 22% cases. Thyroid dysfunction was diagnosed in 16% subjects with diffuse or nodular goiter. Sonographic examination of the thyroid with an assessment of its volume and echostructure helps more accurately diagnose goiter and plan therapeutic measures.

scholarly journals Intractable hiccups as the presenting symptom of toxic nodular goiter

2018 ◽  
Vol 3 (3) ◽  
pp. e19
Author(s):  
Luís Miguel Fernandes Teles ◽  
Inês Domingues Neto ◽  
Bernardo Luís Fernandes Macedo ◽  
Fernando Moreira
Keyword(s):  
Nodular Goiter ◽  
Toxic Nodular Goiter ◽  
Intractable Hiccups

scholarly journals Radioiodine Treatment of Hyperthyroidism—Prognostic Factors for Outcome

2001 ◽  
Vol 86 (8) ◽  
pp. 3611-3617 ◽  
Author(s):  
Amit Allahabadia ◽  
Jacquie Daykin ◽  
Michael C. Sheppard ◽  
Stephen C. L. Gough ◽  
Jayne A. Franklyn
Keyword(s):  
Single Dose ◽  
Prognostic Factors ◽  
Nodular Goiter ◽  
Fixed Dose ◽  
Graves Disease ◽  
Cure Rate ◽  
Toxic Nodular Goiter ◽  
Large Size ◽  
Lower Cure Rate ◽  
Lower Cure

There is little consensus regarding the most appropriate dose regimen for radioiodine (131I) in the treatment of hyperthyroidism. We audited 813 consecutive hyperthyroid patients treated with radioiodine to compare the efficacy of 2 fixed-dose regimens used within our center (185 megabequerels, 370 megabequerels) and to explore factors that may predict outcome. Patients were categorized into 3 diagnostic groups: Graves’ disease, toxic nodular goiter, and hyperthyroidism of indeterminate etiology. Cure after a single dose of 131I was investigated and defined as euthyroid off all treatment for 6 months or T4 replacement for biochemical hypothyroidism in all groups. As expected, patients given a single dose of 370 megabequerels had a higher cure rate than those given 185 megabequerels, (84.6% vs. 66.6%, P &lt; 0.0001) but an increase in hypothyroidism incidence at 1 yr (60.8% vs. 41.3%, P &lt; 0.0001). There was no difference in cure rate between the groups with Graves’ disease and those with toxic nodular goiter (69.5% vs. 71.4%; P, not significant), but Graves’ patients had a higher incidence of hypothyroidism (54.5% vs. 31.7%, P&lt; 0.0001). Males had a lower cure rate than females (67.6% vs. 76.7%, P = 0.02), whereas younger patients (&lt;40 yr) had a lower cure rate than patients over 40 yr old (68.9% vs. 79.3%, P &lt; 0.001). Patients with more severe hyperthyroidism (P &lt; 0.0001) and with goiters of medium or large size (P &lt; 0.0001) were less likely to be cured after a single dose of 131I. The use of antithyroid drugs, during a period 2 wk before or after 131I, resulted in a significant reduction in cure rate in patients given 185 megabequerels 131I (P &lt; 0.01) but not 370 megabequerels. Logistic regression analysis showed dose, gender, goiters of medium or large size, and severity of hyperthyroidism to be significant independent prognostic factors for cure after a single dose of 131I. We have demonstrated that a single fixed dose of 370 megabequerels 131I is highly effective in curing toxic nodular hyperthyroidism as well as Graves’ hyperthyroidism. Because male patients and those with more severe hyperthyroidism and medium or large-sized goiters are less likely to respond to a single dose of radioiodine, we suggest that the value of higher fixed initial doses of radioiodine should be evaluated in these patient categories with lower cure rates.

Toxic Nodular Goiter and Adenoma

2018 ◽  
pp. 198-198
Author(s):  
Mala Dharmalingam ◽  
Prashant Kaduskar
Keyword(s):  
Nodular Goiter ◽  
Toxic Nodular Goiter
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