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Management of perioperative thyrotoxicosis - what to do when standard therapy is contraindicated or fails?
Front Endocrinol (Lausanne)
December 2024
Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
Background: Current guidelines recommend that hyperthyroid patients should be rendered euthyroid prior to surgical procedures. These guidelines rely heavily on the use of ATDs as the primary medication, and do not give recommendations for patients who have contraindications to ATDs, or for whom standalone ATD treatment is inadequate.
Objectives: To evaluate the efficacy and safety of adjunctive pharmacological therapy and/or therapeutic plasma exchange (TPE) in the perioperative management of patients with thyrotoxicosis who were intolerant to ATD or for whom standalone ATD therapy was inadequate to achieve euthyroidism prior to surgery.
Endoplasmic reticulum protein TXNDC5 modulates thyroid eye disease TGF-β1-induced myofibroblast transdifferentiation.
BMJ Open Ophthalmol
December 2024
Ophthalmology, National Yang Ming Chiao Tung University - Yangming Campus, Taipei, Taiwan
Aim: There remain limited therapies to treat thyroid eye disease (TED) orbital fibrosis, highlighting the urgency to develop novel targets. Transforming growth factor-β1 (TGF-β1)-induced myofibroblast transdifferentiation from orbital fibroblasts are important pathogenetic factor of TED. Endoplasmic reticulum (ER) stress may play a role in TED pathogenesis since it has been linked to liver, kidney, heart and lung fibrotic remodelling.
View Article and Find Full Text PDFIntroduction: Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare but severe complication of hyperthyroidism characterized by acute muscle weakness. This study reports the first case of THPP in an adolescent with type 1 diabetes mellitus (T1DM) and Graves' disease, triggered by high-dose insulin, high carbohydrate intake, and strenuous exercise. It highlights the clinical presentation, management, and implications of THPP in this context.
View Article and Find Full Text PDFLinsitinib Decreases Thyrotropin-Induced Thyroid Hormone Synthesis by Inhibiting Crosstalk Between Thyroid-Stimulating Hormone and Insulin-Like Growth Factor 1 Receptors in Human Thyrocytes and in Mice.
Thyroid
December 2024
Laboratory of Endocrinology and Receptor Biology, Bethesda, Maryland, USA.
Thyrotropin receptor (TSHR) and insulin-like growth factor 1 receptor (IGF-1R) have been shown to crosstalk in primary cultures of human thyrocytes (hThyros) and Graves' orbital fibroblasts. The phenomenon of TSHR/IGF-1R crosstalk has been largely studied in the pathogenesis of thyroid eye disease (TED) in human orbital fibroblasts. Here, we investigated the effects of inhibiting the IGF-1R-mediated contribution to crosstalk by linsitinib (Lins), a small-molecule IGF-1R kinase inhibitor, on TSH-induced regulation of thyroperoxidase (TPO) and thyroglobulin (TG) mRNAs and proteins in hThyros and on TPO and TG mRNAs and free thyroxine (fT4) levels in mice.
View Article and Find Full Text PDFEffect of micronutrients on the risk of Graves' disease: a Mendelian randomization study.
Front Nutr
December 2024
Department of Endocrinology and Metabolism, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Background: Micronutrient research on Graves' disease (GD) is limited and controversial. Therefore, in order to explore possible correlations between genetically predicted amounts of six micronutrients [Copper (Cu), Iron (Ir), Zinc (Zn), Calcium (Ca), Vitamin C (VC), and Vitamin D (VD)] and GD risk, we carried out Mendelian randomization research (MR).
Methods: We conducted an MR analysis using genome-wide association studies (GWAS) from people of European ancestry and aggregated information from UK Biobank to provide insight into the relationships between micronutrients and GD.
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