Best practices in the laboratory diagnosis, prognostication, prediction, and monitoring of Graves' disease: role of TRAbs.

Graves' disease (GD) is an autoimmune disorder characterized by activation of the TSH receptor by stimulatory autoantibodies (TSH Receptor Antibodies, or TRAbs), leading to unregulated thyroid hormone production. Diagnosis is largely based on the typical clinical picture and laboratory thyroid panel. Establishment of elevated serum levels of TRAbs by competitive binding assay or cell-binding assay has its unique role in diagnosis and management of GD, especially in the differential diagnosis, therapy selection, prognostication, evaluation of thyroid function during pregnancy, peri-conceptional and neonatal thyroid workup, and in certain special situation.

Transcriptomic profiling of thyroid eye disease orbital fat demonstrates differences in adipogenicity and IGF-1R pathway.

Despite recent advances in the treatment of thyroid eye disease thyroid-related eye disease (TED), marked gaps remain in our understanding of the underlying molecular mechanisms, particularly concerning the insulin-like growth factor-1 receptor (IGF-1R) pathway. To dissect the pathophysiology of TED, we used single-nucleus RNA-Seq to analyze orbital fat specimens from both patients with TED and matched individuals acting as controls. The analysis demonstrated a marked increase in the proportion of fibroblasts transitioning to adipogenesis in the orbital fat of patients with TED compared with that in control patients.

Increased incidence of Graves' disease during the COVID-19 pandemic in children and adolescents in the United States.

Introduction: Reports in adults indicate that Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) infection and vaccination trigger the expression of autoimmune disease such as Graves' disease, but the incidence of new onset Graves' disease and its temporal relationship to the peaks of COVID-19 cases in children are unclear.

Methods: This is a retrospective study of children and adolescents with new-onset Graves' disease diagnosed between September 2017 and August 2022, N=156, mean age of 12.5 ± 4 year (y), with a range of 2.

The ability of virtual noncontrast images to remove intrinsic and external iodine from the thyroid via dual-layer spectral detector computed tomography.

Background: Virtual noncontrast (VNC) images generated by dual-layer spectral computed tomography (DLCT) remove iodine influence from enhanced images to simulate true noncontrast (TNC) images. Previous research has demonstrated the high comparability of abdominal VNC images with TNC images, suggesting their potential as substitutes. Given the thyroid's significant iodine content, this study evaluated the efficacy of VNC images for removing both intrinsic and extrinsic iodine through an analysis of computed tomography (CT) attenuation and iodine density in TNC and enhanced VNC thyroid images.

Outcomes of Total Thyroidectomy in Large Goiters With Retrosternal Extension and Tracheal Compression: A Multivariate Analysis.

Introduction: Large retrosternal goiters often cause tracheal compression and deviation, leading to respiratory symptoms and complicating surgical treatment. Total thyroidectomy is the treatment of choice though it carries a risk of complications due to the altered anatomy and its proximity to vital structures. This study examines the outcomes of total thyroidectomy in patients with retrosternal goiters and assesses the impact of tracheal compression on clinical results.

Comparative effectiveness of various orbital decompression techniques in treating thyroid-associated ophthalmopathy: a systematic review and meta-analysis.

Background: In thyroid-associated ophthalmopathy (TAO), orbital decompression is a critical surgical approach for functional and aesthetic reasons. Meanwhile, the presence of surgical complications, especially the new onset of primary gaze diplopia, also influences postoperative patient satisfaction. This research investigates the effectiveness and potential risks associated with different orbital decompression in patients with TAO.

Novel immunoinflammatory blood markers in Graves' orbitopathy: insights into activity and severity.

Objective: This prospective case-control study examined the novel immunoinflammatory markers obtained from blood counts of patients with Graves' orbitopathy (GO), Graves' disease (GD) and healthy subjects.

Methods: Demographic data, white cell count parameters, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), platelet-to-neutrophil ratio (PNR), red cell distribution width (RDW), RDW-to-platelet ratio (RDW/PLT), MPV-to-lymphocyte ratio (MPV/ALC), eosinophil-to-lymphocyte ratio (ELR) and systemic immune-inflammatory index (SII) were evaluated. The European Group on Graves Orbitopathy scale and Clinical Activity Score were used for clinical activity and severity assessment.

Linsitinib inhibits IGF-1-induced cell proliferation and hyaluronic acid secretion by suppressing PI3K/Akt and ERK pathway in orbital fibroblasts from patients with thyroid-associated ophthalmopathy.

Thyroid-associated ophthalmopathy (TAO), an autoimmune disorder of the retrobulbar tissue, is present in up to 50 percent of Graves's hyperthyroidism patients. Insulin-like growth factor 1 receptor (IGF-1R) has received attention as a target for the development of therapeutic agent for TAO. IGF-1R and TSHR (thyroid stimulating hormone receptor) interact with each other to form a physical or functional complex, further promoting the development of TAO.

Role of the Laryngeal Adductor Reflex in the Prevention of Thermal Injury to the Recurrent Laryngeal Nerve in Thyroid Surgery: A Case Report.

Background: Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) aims to detect and prevent iatrogenic damage during thyroid surgery. Mechanisms of injury include traction, heat damage, and nerve transection. Continuous IONM (C-IONM) techniques detect impending damage due to traction and heat related when they are still reversible.

The value of signal intensity ratios of orbital tissue to white matter of orbital MRI in evaluating graves' orbitopathy.

Absract: PURPOSE: To investigate the signal intensity ratio (SIR) of orbital tissue to white matter in orbital magnetic resonance imaging (MRI) for assessing graves' orbitopathy (GO).

Methods: This study enrolled a total of 42 patients (79 eyes) with GO as the GO group, 10 patients (20 eyes) diagnosed with graves' disease (GD) without orbitopathy during the same period as the GD group, and 23 normal individuals with negative MRI results and no thyroid or eye diseases as the healthy control (HC) group. The signal intensity of the lacrimal gland (LG), extraocular muscle (EOM), ipsilateral temporal muscle (TM), ramus mandibulae, and white matter (WM) on MRI images was measured.

Impact of chronic lymphocytic thyroiditis on the diagnostic and intraoperative management of papillary thyroid cancer.

Background: Chronic lymphocytic thyroiditis is an autoimmune thyroid disorder and the most common cause of hypothyroidism in women. Many studies suggest that chronic lymphocytic thyroiditis contributes to a diagnostic challenge in thyroid nodules and may increase the risk of developing papillary thyroid cancer. This study examines preoperative clinical factors and tumor characteristics associated with papillary thyroid cancer among patients with chronic lymphocytic thyroiditis.

N6-methyladenosine modification of THBS1 induced by affluent WTAP promotes Graves' ophthalmopathy progression through glycolysis to affect Th17/Treg balance.

Graves' ophthalmopathy (GO) obvious manifestation is the imbalance of Th17/Treg. N6-methyladenosine (m6A) methylation is an important regulator of Th17/Treg balance. However, few reports narrate how m6A regulators mediate the role of genes in GO progression.

Causal effects of thyroid volume change on thyroid disease: a Mendelian randomization study.

Background: Observational studies have suggested an association between thyroid volume changes and thyroid disease, but the causal relationship and direction of these effects remain unclear. This study employs a two-sample Mendelian randomization (MR) approach to assess the effect of thyroid volume on clinically common benign and malignant thyroid diseases.

Methods: Summary data from genome-wide association studies (GWAS) were utilized for secondary data analysis to investigate the link between thyroid volume and disease.

Multiorgan Involvement: Is There a Relevant Pathogenetic Link?

Multisystem autoimmune disorders have different presenting symptoms with organ involvement phased over numerous years. We have a 56-year-old homemaker who is a known case of Graves' disease-post-thyroidectomy performed 20 years ago-and developed a volume overload state with exertional dyspnea for a period of 1.5 years.

Risk factors and clinical characteristics associated with post-radioactive iodine thyroid storm.

The occurrence of post-radioactive iodine thyroid storm among patients with hyperthyroidism is relatively rare and only a few cases have been reported. We conducted a literature review of cases reported from 1951 to 2023 and determined the risk factors and clinical characteristics of patients who developed thyroid storm. A total of 19 cases were documented and reviewed.

Challenges in the management of a secondary retrosternal goitre with superior vena cava syndrome.

Retrosternal or substernal goitre is a clinical entity defined when a significant proportion of the thyroid gland extends inferiorly through the thoracic inlet into the mediastinum. It has an incidence of 5.1-15.

Radiofrequency Ablation of Toxic Thyroid Nodules: An Early Experience of a Single Institution in the United States.

Objective: The field of endocrine surgery has been expanding its minimally invasive techniques to treat a wide range of thyroid pathologies. Radiofrequency ablation (RFA) is one targeted thermal therapy that has been identified as safe and effective for the treatment of benign pathologies as an alternative to surgery. We have employed RFA at our institution and are reporting our experience with this techniques safety, efficacy, and considerations in the treatment of toxic adenomas and multinodular goiters.

Hyperlipidemia and apolipoprotein E are associated with intraocular pressure of thyroid-associated ophthalmopathy in a Chinese population: a cross-sectional study.

Objective: This study aimed to explore the clinical characteristics of thyroid-associated ophthalmopathy (TAO) with hyperlipidemia and to identify the key lipid indicator.

Methods: Patients with TAO were recruited to this study and divided into two groups based on the presence of hyperlipidemia. TAO patients with hyperlipidemia were further classified based on the type of hyperlipidemia.

Comparison between thyroid stimulating immunoglobulin and TSH-receptor antibodies in the diagnosis and management of Graves' disease.

Introduction: TSH-receptor antibodies (TRAb) directed against the TSH receptor (TSH-R) induce hyperthyroidism in patients with Graves' disease (GD). TRAb detected by previous radioimmunoassay only reflects the presence of autoantibodies, but not the function of such antibodies. Thyroid stimulating immunoglobulins (TSI) is a relatively new method for assessing TSH-receptor antibodies function.

Identifying the Genetic Association Between Sjogren's Syndrome and Autoimmune Thyroid Disease: A Bidirectional Two-Sample Mendelian Randomization Study.

Background: Although observational studies have suggested a correlation between Sjogren's syndrome (SS) and autoimmune thyroid disease (AITD), a conclusive evidence supporting a causal relationship is still lacking. This study aims to explore the potential causal relationship between SS and AITD.

Methods: Using genome-wide association studies, we performed a bidirectional two-sample Mendelian randomization (MR) analysis.

A Review of Autoimmune Thyroid Diseases and Their Complex Interplay with Female Fertility.

Hashimoto thyroiditis and Graves' disease are autoimmune thyroid disorders that are common in women of reproductive age and have a complex relationship with female fertility and health of the maternal-fetal dyad. Both hyperthyroidism and hypothyroidism, whether subclinical or overt in severity, directly or indirectly affect nearly every level of the hypothalamic-pituitary-ovary axis, uterine and ovarian function, as well as fetal development from implantation through delivery. Autoimmunity itself also appears to negatively impact both spontaneous and assisted fertility, as well as miscarriage risk, although the mechanism remains unclear, and the presence and magnitude of risk is variable in published literature.

Intra-thoracic thyroid rests: an updated classification and case series.

Background: Thyroid rests are common and arise during embryological development, with aberrant descent of thyroid tissue along the thyro-thymic tract. These give rise to a range of pathologies, including goitre formation and malignancy. Thyroid rests have been graded I-IV based on their connection to the thyroid gland proper - grade I is a short protuberance, grade II & III are connected via a pedicle and fibrous band respectively, and grade IV is completely disconnected.

Multi-Omics Approaches to Discover Biomarkers of Thyroid Eye Disease: A Systematic Review.

Thyroid eye disease (TED) is an organ-specific autoimmune disorder that significantly impacts patients' visual function, appearance, and well-being. Despite existing clinical evaluation methods, there remains a need for objective biomarkers to facilitate clinical management and pathogenesis investigation. Rapid advances in multi-omics technologies have enabled the discovery and development of more informative biomarkers for clinical use.

Cancer and disease profiles for PTEN pathogenic variants in Japanese population.

A germline alteration in the PTEN gene causes a spectrum of disorders conceptualized as PTEN hamartoma tumor syndrome (PHTS), which show high risk of tumor development and a highly variable and complex phenotype. The diagnosis of PHTS is established in a proband by identification of a heterozygous germline PTEN pathogenic variant on molecular genetic testing. In this study, to understand more PTEN-associated clinical phenotype and PHTS in a Japanese population, we extracted 128 germline PTEN rare variants from 113,535 adult Japanese registered in Biobank Japan (BBJ), and categorized 29 pathogenic/likely pathogenic variants in 30 individuals (0.