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Pathogenesis and Management Strategies in Radioiodine-Refractory Differentiated Thyroid Cancer: From Molecular Mechanisms Toward Therapeutic Approaches: A Comprehensive Review.
J Clin Med
November 2024
Department of Endocrinology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Thyroid cancer (TC) remains the most common cancer in endocrinology. Differentiated thyroid cancer (DTC), the most common type of TC, generally has a favorable outlook with conventional treatment, which typically includes surgery along with radioiodine (RAI) therapy and thyroid-stimulating hormone (TSH) suppression through thyroid hormone therapy. However, a small subset of patients (less than 5%) develop resistance to RAI.
View Article and Find Full Text PDFPhosphate Binder Impairs Levothyroxine Absorption in a Hypothyroid Patient With End-Stage Renal Disease.
Cureus
October 2024
Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
End-stage renal disease (ESRD) patients have an increased incidence of hypothyroidism, and those with serum thyroid stimulating hormone (TSH) levels above the reference range have excess mortality, increased cardiovascular disease, impaired health-related quality of life, and altered body composition. We report a patient with ESRD on chronic hemodialysis and Hashimoto's disease, who is on chronic levothyroxine therapy. Despite a high levothyroxine dose of 2.
View Article and Find Full Text PDFThe Complex Web of Interferences With Thyroid Function Tests.
Endocr Pract
January 2025
Division of Endocrinology, Metabolism and Lipid Research, Washington University in St. Louis, School of Medicine, St. Louis, Missouri. Electronic address:
Objective: Thyroid disorders are common. Serum thyroid stimulating hormone is frequently measured and is the single best initial biomarker to diagnose thyroid disease. Automated immunoassays used to evaluate thyroid function are susceptible to interferences that can affect test results and therefore clinical decisions.
View Article and Find Full Text PDFMyxedema coma secondary to levothyroxine malabsorption in a patient previously submitted to bariatric surgery.
Arch Endocrinol Metab
October 2024
University of Brescia Department of Clinical and Experimental Sciences Brescia Italy Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, Brescia, Italy.
Article Synopsis
- Treating hypothyroidism is complicated for patients with malabsorption, often requiring higher doses of oral levothyroxine (L-T4) due to impaired absorption.
- A case is presented of a young man with myxedema after undergoing biliopancreatic diversion surgery, showing severe hypothyroidism symptoms and requiring intravenous treatments.
- The case highlights the importance of monitoring Thyroid Stimulating Hormone (TSH) levels more frequently in post-bariatric surgery patients and suggests that liquid forms of L-T4 may be more effective than tablets in these cases.
Refractory hypothyroidism in children: an overview.
J Pediatr Endocrinol Metab
October 2024
Pediatric Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, 68796 Assiut University, Assiut, Egypt.
Article Synopsis
- - Refractory hypothyroidism (RF) occurs when TSH levels remain high despite increasing thyroid medication, often due to factors like poor compliance, dietary issues, and other medical conditions affecting medication absorption.
- - In children, RF is often asymptomatic or presents with mild symptoms similar to hypothyroidism, making early identification and treatment crucial to prevent complications from excessive thyroid medication.
- - This review seeks to explore the causes, symptoms, diagnostic approaches, and treatment options for RF in children, emphasizing the importance of endocrinologists in managing these cases effectively.
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