MyMedR

Fulltext Cytogenetic and clinical profile of Down syndrome in Northeast Malaysia

Azman BZ, Ankathil R, Siti Mariam I, Suhaida MA, Norhashimah M, Tarmizi AB, et al.

Singapore Med J, 2007 Jun;48(6):550-4.

This study was designed to evaluate the karyotype pattern, clinical features and other systemic anomalies of patients with Down syndrome in Malaysia.

Matched MeSH terms: Congenital Hypothyroidism

Pseudohypoparathyroidism: A case of hypocalcemia and hypothyroidism diagnosed during the postpartum period

Lim KP, Yong SL

Malays Fam Physician, 2019;14(1):31-34.

PMID: 31289630

We describe a 29-year-old Para 1 post-Emergency Lower Segment Caesarean Section (EMLSCS) for fetal distress and Preterm Rupture of the Membrane (PROM) referred by the Obstetric team for persistent bradycardia. She had the typical features of Albright's Hereditary Osteodystrophy (AHO). The laboratory investigation revealed hypocalcemia, hyperphosphatemia with a high Parathyroid hormone (PTH) level and low free Thyroxine 4 (fT4) with high Thyroid Stimulating Hormone (TSH). The patient was diagnosed with Pseudohypoparathyroidism (PHP) Type 1A associated with TSH resistance based on the somatic features of AHO present as well as biochemical and radiological abnormalities.

Matched MeSH terms: Congenital Hypothyroidism

Fulltext Congenital Hypothyroidism in Children - A Cross-Sectional Study in a Tertiary Centre in Malaysia

Anuar Zaini A, Feng Tung Y, Ahmad Bahuri NF, Yazid Jalaludin M

J ASEAN Fed Endocr Soc, 2020;35(1):62-67.

PMID: 33790495 DOI: 10.15605/jafes.035.01.11

Introduction: The causes of congenital hypothyroidism (CHT) are thyroid dysgenesis (TD), dyshormonogenesis (TDH) or transient hypothyroidism (TH).

Methodology: This is a cross-sectional study looking at data over a period of 16 years (2000-2016). Confirmed cases had thyroid scan at the age of 3-years-old and repeated TFT (after 6 weeks off medications). Relevant data was collected retrospectively.

Results: Forty (60% female) children with CHT were included in the study. Thirty (75%) children presented with high cord TSH. Nine (23%) presented after 2 weeks of life. Majority were diagnosed with TDH (42.5%) with TD and TH of 40% and 17.5% respectively. Median cord TSH of children with TD was significantly higher compared to TDH and TH (p=0.028 and p=0.001 respectively). L-thyroxine doses were not significantly different between TD, TDH and TH at diagnosis or at 3 years.

Conclusions: TDH is highly prevalent in our population. TD may present after 2 weeks of life. One in five children treated for CHT had TH. Differentiating TD, TDH and TH before initiating treatment remains a challenge in Malaysia. This study provides clinicians practical information needed to understand the possible aetiologies from a patient's clinical presentation, biochemical markers and treatment regime. Reassessing TH cases may be warranted to prevent unnecessary treatment.

Matched MeSH terms: Congenital Hypothyroidism

Fulltext Audit of newborn screening programme for congenital hypothyroidism

Zarina AL, Rahmah R, Bador KM, Ng SF, Wu LL

Med J Malaysia, 2008 Oct;63(4):325-8.

PMID: 19385494 MyJurnal

Newborn screening for congenital hypothyroidism (CH) was implemented in Hospital UKM in December 2004 using cord blood sample. From the audit over a period of 25 months, a total of 13,875 newborn babies were screened with a coverage of 98.8%. From this cohort, the mean recall rate was 0.32%; unfortunately the mean percentage of recalled babies that came for retesting was only 79.5%. In addition, the mean sample rejection rate was high, i.e. 2.2%. Two babies were diagnosed to have CH. These findings implied that whilst the coverage of screening was good, there is a need for regular surveillance of performance of both clinical and laboratory personnel. In addition, a more concerted effort should be carried out to promote community awareness of such a programme.

Matched MeSH terms: Congenital Hypothyroidism/diagnosis*

Fulltext Multimorbidity After Surgical Menopause Treated with Individualized Classical Homeopathy: A Case Report

Mahesh S, Denisova T, Gerasimova L, Pakhmutova N, Mallappa M, Vithoulkas G

Clin Med Insights Case Rep, 2020;13:1179547620965560.

PMID: 33149716 DOI: 10.1177/1179547620965560

Classical homeopathy was shown to be beneficial in climacteric syndrome in many studies, but the clinical effect is unclear. To inspect if individualized classical homeopathy has a role in treating complaints after surgical menopause through real world case, we present a case of a 54-year-old Russian woman treated with individualized classical homeopathy for multimorbid conditions after surgical menopause examined for changes from homeopathic treatment. We assessed changes in climacteric symptoms, changes in comorbidities, and the general well-being of the patient. The woman had severe climacteric syndrome, pelvic inflammatory disease, dyslipidemia, obesity, hepatic steatosis, pancreatic lipomatosis, gall bladder disease, and mild subclinical hypothyroidism to begin with. She was treated with individualized classical homeopathy and followed up for 31 months. She was relieved of the vasomotor symptoms and psychological disturbances of climacteric syndrome, her weight reduced, the ultrasound scan showed absence of lipomatosis/gall bladder disease/hepatic steatosis. Blood tests showed reduction of thyroid stimulating hormone and a balance in the lipid status. Individualized classical homeopathy may have a role in the climacteric syndrome and comorbidities after surgical menopause. The efficacy of homeopathic therapy in climacteric problems must be scientifically investigated further.

Matched MeSH terms: Hypothyroidism

Fulltext Autoimmune polyglandular syndrome presenting with jaundice and thrombocytopenia

Norasyikin AW, Rozita M, Mohd Johan MJ, Suehazlyn Z

Med Princ Pract, 2014;23(4):387-9.

PMID: 24401542 DOI: 10.1159/000357645

OBJECTIVE: To report an uncommon presentation of a rare case of autoimmune polyglandular syndrome type IIIb in an elderly woman.
CLINICAL PRESENTATION AND INTERVENTION: A 62-year-old woman presented with anaemic symptoms and jaundice. Blood tests showed macrocytic anaemia due to vitamin B12 deficiency with Coombs negative haemolysis. A thyroid function test was consistent with hypothyroidism. Autoimmune antibody assays were positive for anti-parietal cell, anti-intrinsic factor and anti-thyroid peroxidase antibodies. A final diagnosis of autoimmune thyroiditis with pernicious anaemia, which constituted autoimmune polyglandular syndrome type IIIb, was made and the patient was treated with L-thyroxine, vitamin B12 injection and a blood transfusion. She was discharged uneventfully after a week of hospitalization.
CONCLUSION: This case showed that the presence of one autoimmune endocrine disease should prompt clinicians to look for other coexisting autoimmune diseases which may be asymptomatic despite positive autoantibodies.

Matched MeSH terms: Hypothyroidism/physiopathology

Fulltext Misleading free thyroxine (FT4): a case report

Nurul Hidayah Hashim, Intan Nureslyna Samsudin, Ana Dalila Masiman, Subashini C. Thambiah

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):320-322.

MyJurnal

Interpretation of thyroid function test (TFT) is often straightforward but in certain scenarios, discordance between the clinical impression and the laboratory results exists. A 50-year-old woman with a ten years history of hypothyroidism on levothyroxine presented with a recent notable change in TFT [elevated free thyroxine (FT4) and thyroid-stimulat- ing hormone (TSH)], in an otherwise clinically euthyroid and previously stable TFT, leading to levothyroxine being withheld. This case report highlights the possibility of assay interference as a cause of discordant TFT. It also draws the importance of close collaboration between clinicians and the laboratory to avoid unnecessary investigations and inappropriate management of such a case.

Matched MeSH terms: Hypothyroidism

Fulltext Hashimoto's thyroiditis: a rare cause for rhinosinusitis

Jeevanan J, Gendeh BS, Satpal S

Med J Malaysia, 2004 Aug;59(3):428-30.

PMID: 15727394

Rhinosinusitis is a common disorder with various etiological factors. In our clinical practice allergy seems to be a predominant cause followed by other less common causes like infection, drugs and aspirin hypersensitivity. We present a case of chronic rhinosinusitis secondary to hypothyroidism. Although hormonal causes like hypothyroidism have been proven to cause nasal congestion and rhinosinusitis, this is the first reported case of chronic rhinosinusitis in Hashimoto's thyroiditis in our center. This is a diagnosis of exclusion for chronic rhinosinusitis not responding to optimal medical therapy.

Matched MeSH terms: Hypothyroidism/complications

Effects of thyroxine on expression of proteins related to thyroid hormone functions (TR-α, TR-β, RXR and ERK1/2) in uterus during peri-implantation period

Sayem ASM, Giribabu N, Muniandy S, Salleh N

Biomed Pharmacother, 2017 Dec;96:1016-1021.

PMID: 29221723 DOI: 10.1016/j.biopha.2017.11.128

INTRODUCTION: Thyroid hormone is known to play important role during embryo implantation, however mechanisms underlying its actions in uterus during peri-implantation period has not been fully identified. In this study, we hypothesized that thyroid hormone could affect expression of proteins related to its function, where these could explain mechanisms for its action in uterus during this period.

METHODS: Female rats, once rendered hypothyroid via oral administration of methimazole (0.03% in drinking water) for twenty-one days were mated with fertile euthyroid male rats at 1:1 ratio. Pregnancy was confirmed by the presence of vaginal plug and this was designated as day-1. Thyroxine (20, 40 and 80 μg/kg/day) was then subcutaneously administered to pregnant, hypothyroid female rats for three days. A day after last injection (day four pregnancy), female rats were sacrificed and expression of thyroid hormone receptors (TR-α and β), retinoid X receptor (RXR) and extracellular signal-regulated kinase (ERK1/2) in uterus were quantified by Western blotting while their distribution in endometrium was visualized by immunofluorescence.

RESULTS: Expression of TRα-1, TRβ-1 and ERK1/2 proteins in uterus increased with increasing doses of thyroxine however no changes in RXR expression was observed. These proteins were found in the stroma with their distribution levels were relatively higher following thyroxine treatment.

CONCLUSIONS: Increased expression of TRα-1, TRβ-1 and ERK1/2 at day 4 pregnancy in thyroxine-treated hypothyroid pregnant rats indicate the importance of thyroxine in up-regulating expression of these proteins that could help mediate the uterine changes prior to embryo implantation.

Matched MeSH terms: Hypothyroidism/drug therapy; Hypothyroidism/genetics; Hypothyroidism/metabolism

Binary particle swarm optimization for feature selection in detection of infants with hypothyroidism

Zabidi A, Khuan LY, Mansor W, Yassin IM, Sahak R

Annu Int Conf IEEE Eng Med Biol Soc, 2011;2011:2772-5.

PMID: 22254916 DOI: 10.1109/IEMBS.2011.6090759

Hypothyroidism in infants is caused by the insufficient production of hormones by the thyroid gland. Due to stress in the chest cavity as a result of the enlarged liver, their cry signals are unique and can be distinguished from the healthy infant cries. This study investigates the effect of feature selection with Binary Particle Swarm Optimization on the performance of MultiLayer Perceptron classifier in discriminating between the healthy infants and infants with hypothyroidism from their cry signals. The feature extraction process was performed on the Mel Frequency Cepstral coefficients. Performance of the MLP classifier was examined by varying the number of coefficients. It was found that the BPSO enhances the classification accuracy while reducing the computation load of the MLP classifier. The highest classification accuracy of 99.65% was achieved for the MLP classifier, with 36 filter banks, 5 hidden nodes and 11 BPS optimised MFC coefficients.

Matched MeSH terms: Hypothyroidism/diagnosis*; Hypothyroidism/physiopathology

Optimization of MFCC parameters using Particle Swarm Optimization for diagnosis of infant hypothyroidism using Multi- Layer Perceptron

Zabidi A, Lee YK, Mansor W, Yassin IM, Sahak R

Annu Int Conf IEEE Eng Med Biol Soc, 2010;2010:1417-20.

PMID: 21096346 DOI: 10.1109/IEMBS.2010.5626712

This paper presents a new application of the Particle Swarm Optimization (PSO) algorithm to optimize Mel Frequency Cepstrum Coefficients (MFCC) parameters, in order to extract an optimal feature set for diagnosis of hypothyroidism in infants using Multi-Layer Perceptrons (MLP) neural network. MFCC features is influenced by the number of filter banks (f(b)) and the number of coefficients (n(c)) used. These parameters are critical in representation of the features as they affect the resolution and dimensionality of the features. In this paper, the PSO algorithm was used to optimize the values of f(b) and n(c). The MFCC features based on the PSO optimization were extracted from healthy and unhealthy infant cry signals and used to train MLP in the classification of hypothyroid infant cries. The results indicate that the PSO algorithm could determine the optimum combination of f(b) and n(c) that produce the best classification accuracy of the MLP.

Matched MeSH terms: Hypothyroidism/diagnosis*

Endemic goiter in Southeast Asia. New clothes on an old body

Ramalingaswami V

Ann Intern Med, 1973 Feb;78(2):277-83.

PMID: 4265088

Matched MeSH terms: Congenital Hypothyroidism/etiology

Fulltext Thyroid disorders and psychiatric morbidities

Sapini Y, Rokiah P, Nor Zuraida Z

Malaysian Journal of Psychiatry, 2009;18(2):1-9.

MyJurnal

The functional behavior of the thyroid is fundamental in most diseases and represents the basis for diagnosis and therapy. The status can be euthyroidism, hypothyroidism or hyperthyroidism. The psychiatric manifestation varies in different thyroid status. Those with hypothyroidism were described to have depression, psychosis and cognitive dysfunction. Meanwhile, those with hyperthyroidism were found to have psychosis, aggression, anxiety as well as cognitive impairment.

Matched MeSH terms: Hypothyroidism

Optimization of nuclear medicine procedures for the diagnosis and management of thyroid disorders: report of a research coordination meeting held in Vienna, 15-17 December 1986 under the auspices of the International Atomic Energy Agency

Ganatra R, Gembicki M, Nofal M

Nucl Med Commun, 1988 Feb;9(2):131-9.

PMID: 3386976

The third and final meeting of a coordinated research programme on the diagnosis and management of thyroid disorders was held in Vienna from 15 to 17 December 1986. The participants were from Czechoslovakia, Egypt, Israel, Malaysia and Thailand. Each participant had studied between 500 and 1000 patients for thyroid function evaluation by performing T3, T4 and TSH radioimmunoassays. Each had also used the newly available supersensitive immunoradiometric (IRMA) assay in a group of patients to compare the efficiency of the new assay with that of the conventional assay. A microcomputer was provided to each participant for data analysis. Internal quality control was studied by establishing precision profiles and external quality control was on the basis of pooled standard sera in different ranges. Recommendation for the strategy suggested T4 RIA as the test of first choice in each category of thyroid function. IRMA TSH was suggested as a second test in borderline cases.

Matched MeSH terms: Hypothyroidism/diagnosis

Fulltext Subclinical hypothyroidism among patients with depressive disorders

Siti Yazmin Zahari Sham, Nor Aini Umar, Zarida Hambali, Rosdinom Razali, Mohd Rizal Abdul Manaf

Malaysian Journal of Medicine and Health Sciences, 2014;10(2):71-78.

MyJurnal

Subclinical hypothyroidism (SHT) is a biochemical diagnosis, defined as an elevated Thyroid Stimulating Hormone (TSH) with normal free thyroxine (FT4). It affects 4-10% of the adult population and is more prevalent in elderly women. Its commonest cause is autoimmune thyroiditis, detected by anti- thyroid peroxidase antibody (TPO-Ab). About 2-5% of SHT patients progress to overt hypothyroidism annually. The SHT prevalence among depressed patients ranges between 3% and 17%. This study aimed to determine the prevalence of SHT and TPO-Ab positivity among patients diagnosed with depressive disorders. It was a cross-sectional study carried out in the Universiti Kebangsaan Malaysia Medical Centre over a 12 months period. Serum TSH, FT4 and TPO-Ab were measured. Results showed that 82% of depressed patients were euthyroid, 4% had SHT, 11% had subclinical hyperthyroidism and 2% had discordant thyroid function. TPO-Ab positivity among the subjects was 7%, one of whom had SHT. In conclusion, the prevalence of SHT and TPO-Ab positivity in the study population, at 4% and 7%, respectively, were comparable to previous findings.

Matched MeSH terms: Hypothyroidism

Fulltext Lingual thyroid--a lesson to learn (letter)

Ng CS, Mohd Razak MS

Med J Malaysia, 2005 Mar;60(1):115.

PMID: 16250296

Comment on: Ramzisham AR, Somasundaram S, Nasir ZM. Lingual thyroid--a lesson to learn. Med J Malaysia. 2004 Oct;59(4):533-4

Matched MeSH terms: Hypothyroidism/chemically induced

Severe hypothyroidism presenting with supraventricular tachycardia

Mak WW, Raja Nurazni RA, Mohamed Badrulnizam LB

Med J Malaysia, 2018 10;73(5):349-350.

PMID: 30350825 MyJurnal

Thyroid disease is common and can have various systemic manifestations including cardiac diseases. Hypothyroidism is commonly associated with sinus bradycardia, low QRS complexes, prolonged QT interval and conduction blocks but rarely may cause arrhythmias. We present a patient who presented with presyncope and supraventricular tachycardia with severe hypothyroidism. Patient responded well to thyroxine replacement with biochemical improvement, the disappearance of arrhythmia after restoration of euthyroidism suggests that hypothyroidism might be the cause of supraventricular tachycardia. The aim of this report is to underline the possible aetiological link between supraventricular tachycardia and hypothyroidism, although supraventricular arrhythmias are ordinary features of hyperthyroidism.

Matched MeSH terms: Hypothyroidism

Fulltext A case of lingual thyroid with hypothyroidism

Kandasami P, Mathews VK

Med J Malaysia, 1985 Mar;40(1):52-3.

PMID: 3831737

Cases of lingual thyroid are rare. The Johns Hopkins Hospital, New York, reported three cases of lingual thyroid in 800,000 admissions. We report here a case of lingual thyroid associated with hypothyroidism. The embryology, clinical features and principals of management are discussed.

Matched MeSH terms: Hypothyroidism/etiology*

Fulltext Functional analyses of C.2268dup in thyroid peroxidase gene associated with goitrous congenital hypothyroidism

Lee CC, Harun F, Jalaludin MY, Lim CY, Ng KL, Mat Junit S

Biomed Res Int, 2014;2014:370538.

PMID: 24745015 DOI: 10.1155/2014/370538

The c.2268dup mutation in thyroid peroxidase (TPO) gene was reported to be a founder mutation in Taiwanese patients with dyshormonogenetic congenital hypothyroidism (CH). The functional impact of the mutation is not well documented. In this study, homozygous c.2268dup mutation was detected in two Malaysian-Chinese sisters with goitrous CH. Normal and alternatively spliced TPO mRNA transcripts were present in thyroid tissues of the two sisters. The abnormal transcript contained 34 nucleotides originating from intron 12. The c.2268dup is predicted to generate a premature termination codon (PTC) at position 757 (p.Glu757X). Instead of restoring the normal reading frame, the alternatively spliced transcript has led to another stop codon at position 740 (p.Asp739ValfsX740). The two PTCs are located at 116 and 201 nucleotides upstream of the exons 13/14 junction fulfilling the requirement for a nonsense-mediated mRNA decay (NMD). Quantitative RT-PCR revealed an abundance of unidentified transcripts believed to be associated with the NMD. TPO enzyme activity was not detected in both patients, even though a faint TPO band of about 80 kD was present. In conclusion, the c.2268dup mutation leads to the formation of normal and alternatively spliced TPO mRNA transcripts with a consequential loss of TPO enzymatic activity in Malaysian-Chinese patients with goitrous CH.

Matched MeSH terms: Congenital Hypothyroidism/diagnosis; Congenital Hypothyroidism/enzymology*; Congenital Hypothyroidism/genetics*

Treatment of thyrotoxicosis with radioactive iodine: a report on 137 cases

Dharmalingam SK, Taek YS, Mahadev V

Med J Malaya, 1970 Sep;25(1):3-7.

PMID: 4249493

Matched MeSH terms: Hypothyroidism/etiology

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