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  1. Fulltext Salmonella Thyroid Abscess Treated by Serial Aspiration: Case Report and Literature Review
    Vengathajalam S, Retinasekharan S, Mat Lazim N, Abdullah B
    Indian J Otolaryngol Head Neck Surg, 2019 Oct;71(Suppl 1):823-826.
    PMID: 31742073 DOI: 10.1007/s12070-019-01654-6
    Thyroid abscesses are the most rare conditions of the thyroid gland but it could be potentially life threatening. Most patients are immunocompromised or has an underlying chronic thyroid disorder. We report a case of a 58 year-old lady with underlying uncontrolled diabetes mellitus and a long standing uninvestigated goiter who presented with lethargy, a new anterior neck swelling with dysphagia and change of voice. Ultrasound and computed tomography were performed and showed collection with multiple air pockets in the right thyroid lobule extending to the anterior mediastinum. She was started on intravenous antibiotics and underwent serial bedside aspiration. Her symptoms improved and complete resolution was achieved after serial aspirations and antibiotics.
    Matched MeSH terms: Thyroid Diseases
  2. Fulltext Gore-tex medialisation thyroplasty for unilateral vocal cord palsy: a tertiary centre 7 years experience
    Dayangku, N.P.S., Marina, M.B., Mawaddah, A., Sharifa Ezat, W.P., Abdullah, S.
    International Medical Journal Malaysia, 2016;15(2):13-17.
    MyJurnal
    Background: The resultant dysphonia and aspiration in unilateral vocal cord palsy can be overcome with
    medialisation thyroplasty. With this background, we aim to determine the aetiology of the unilateral vocal
    cord palsy and effectiveness of the phonosurgical procedure with Gore-Tex as a sole treatment. Methods:
    Within a seven year period, 37 Gore-Tex medialisation thyroplasty were performed for unilateral vocal cord
    palsy at our institution and medical records were retrospectively reviewed. Results: There were 18
    males and 19 females with mean age of 48.7 years (range 19–81 years). The predominant aetiology was
    thyroidectomy (43.2%) with benign thyroid disease predominates (n=13) over thyroid malignancy (n=3). Voice
    outcome was evaluated subjectively using visual analogue scoring system, results indicating that Gore-Tex
    medialisation thyroplasty was effective in addressing dysphonia in 62.5% (n=15) patients. However it alone
    cannot address aspiration seen in those with high vagal nerve lesion. Airway compromise occurred in two
    cases postoperatively (5.4%) presenting as acute stridor. Conclusion: In unilateral vocal cord palsy, Gore-Tex
    medialisation thyroplasty can effectively improve the resultant dysphonia and often accompanying aspiration
    which would otherwise be disabling for the patients.
    Matched MeSH terms: Thyroid Diseases
  3. Racial disparity in the prevalence of thyroid disorder during pregnancy
    Sakinah SO, Khalid BA, Aishah AB
    Ann Acad Med Singap, 1993 Jul;22(4):563-6.
    PMID: 8257059
    A study to determine the prevalence of goitre and abnormal thyroid status during pregnancy in Malaysian women was conducted. Two hundred and three women (Malay = 85, Chinese = 47 and Indian = 71) in the third trimester and with no known thyroid disease were studied. There was a marked racial disparity in the prevalence of goitre: Indian 61%, Malay 28% and Chinese 29% (p = 0.001). The serum thyrotropic hormone (TSH) was significantly higher in Indians (median: 1.36 uIU/ml) compared to Malays (1.14 uIU/ml, p = 0.009). The serum albumin was also significantly lower in Indians (mean +/- sd; 36.12 +/- 3.9 mmol/l) compared to Malays (39.3 +/- 4.8 mmol/l) or Chinese (39.1 +/- 5.2) (p < 0.001). Thyroid antibody was detected in 14.6% of these women with no significant racial difference in its prevalence. Three women were found to be thyrotoxic but none were hypothyroid. This study found a high prevalence of goitre among the pregnant Indian women, probably related to the protein malnutrition state. The high prevalence of positive thyroid antibody in our population indicates that a high percentage of women are at risk of developing postpartum thyroiditis.
    Matched MeSH terms: Thyroid Diseases/blood; Thyroid Diseases/diagnosis; Thyroid Diseases/epidemiology*
  4. Thyroid function, autoantibodies, and HLA tissue typing in children with alopecia areata
    Nanda A, Alsaleh QA, Al-Hasawi F, Al-Muzairai I
    Pediatr Dermatol, 2002 11 20;19(6):486-91.
    PMID: 12437547
    A total of 80 Kuwaiti children with alopecia areata (AA), without clinical evidence of thyroid disease, were screened for the presence of thyroid abnormalities, and 50 unrelated children with AA were tissue typed for human leukocyte antigen (HLA) class I and class II antigens. Thyroid abnormalities were detected in 14 children (17.5%). Among these, 11 children (14%) had thyroid autoantibodies. These observations highlight the significance of screening for thyroid abnormalities in children with chronic, recurrent, and/or extensive disease. The Kuwaiti children with AA were observed to have a significant association with HLA B21 (OR 18.850, 95% CI 4.404-80.677), B40 (OR 6.767, 95% CI 1.818-25.181), and HLA B12 (OR 4.833, 95% CI 1.198-19.505) antigens. These findings differed from those reported elsewhere.
    Matched MeSH terms: Thyroid Diseases/complications; Thyroid Diseases/immunology*
  5. Fine needle aspiration cytology of the thyroid--a review of experience in 1853 cases
    Jayaram G, Razak A, Gan SK, Alhady SF
    Malays J Pathol, 1999 Jun;21(1):17-27.
    PMID: 10879275
    1853 thyroid lesions subjected to cytological sampling (either by the fine needle aspiration or fine needle capillary sampling technique) from January 1992 to December 1997 at the University Hospital, Kuala Lumpur, were reviewed. Nodular goitre was the most common thyroid lesion needled (67.35%). Among the neoplastic lesions, follicular neoplasms predominated (64%), followed by papillary carcinoma (29.4%). In 325 cases, partial or total thyroidectomy had been done, providing material for histological review and cyto-histological correlation. Cytological diagnosis was found to have high sensitivity and specificity rates of over 75%. Besides, most non-neoplastic thyroid lesions could be diagnosed on cytology. The scope of cytology in the diagnosis of lymphomas, anaplastic and metastatic tumours rendered diagnostic biopsies (or thyroidectomy) unnecessary in these cases. Being a cost-effective technique and having the capacity to provide exact morphological diagnosis in a large variety of thyroid lesions, cytology is obviously the method of choice in the assessment of thyroid nodules.
    Matched MeSH terms: Thyroid Diseases/pathology
  6. Fulltext An Unusual Presentation of a Thyroid Malignancy: A Case Report
    Irfan, M., Baharuddin, A., Ananda Dorai, A.
    International Medical Journal Malaysia, 2010;9(1):55-57.
    MyJurnal
    Patient with thyroid mass rarely presents in emergency situation. It is because the nature of the mass is that it usually increases slowly in size. Thus, any surgical intervention can be planned electively. The most common condition that necessitates urgent intervention, is upper airway compromise due to sudden rapid increase in size of the swelling. This can be due to intralesional bleeding or superimposed infection on the enlarged gland. We report a case of urgent completion thyroidectomy performed to a patient with fungating recurrent papillary carcinoma who present with bleeding from the mass externally.
    Matched MeSH terms: Thyroid Diseases
  7. Fulltext A case of tuberculosis of the thyroid gland
    Puri MM, Dougall P, Arora VK
    Med J Malaysia, 2002 Jun;57(2):237-9.
    PMID: 24326661
    We report a case of tuberculosis of the thyroid gland associated with mediastinal lymphadenitis in a 30 years-old male, who presented with dysphagia and a mid line anterior neck swelling. Fine needle aspiration was positive for acid fast bacilli. He made an uneventful recovery with antituberculous drugs. Although seldom observed, tuberculosis should be kept in mind in te differential diagnisis of nodular lesions of the thyroid.
    Matched MeSH terms: Thyroid Diseases*
  8. Autoimmune antithyroid antibodies with special reference to their presence in human patients in Singapore
    STEIN J, STEIN B, YU M, CHEE M, CHEW BK
    Med J Malaysia, 1963 Dec;18:116-21.
    PMID: 14117279
    Matched MeSH terms: Thyroid Diseases*
  9. Fulltext Tuberculosis of the thyroid gland: a case report
    Cheah DSH
    Med J Malaysia, 1987 Jun;42(2):127-8.
    PMID: 3503186
    Tuberculosis of the thyroid gland is a rare condition. A case of tuberculosis of the thyroid gland presenting as a solitary thyroid nodule is presented. Management is operative intervention and anti-tuberculous chemotherapy. The final diagnosis is made after histopathological confirmation of the typical appearances.
    Matched MeSH terms: Thyroid Diseases/pathology*; Thyroid Diseases/surgery
  10. Fulltext Serum alpha-i acid glycoprotein in thyroid dysfunctions
    Ho CL, Cheah JS
    Med J Malaysia, 1982 Mar;37(1):70-1.
    PMID: 7121352
    The serum alpha-1 acid glycoprotein of 9 euthyroid subjects, 14 hypothyroid patients and 21 hyperthyroid patients was determined by radial immunodiffussion in agar plates. The serum alpha1 acid glycoprotein level in both the hypothyroid and hyperthyroid patients were significantly lowered when compared to the euthyroid subjects. There was no significant correlation between the alpha-1 acid glycoprotein level mid the Liothyronine resin uptake (T3 resin. uptake) and the serum total Thyroxine Iodide (T4I) level.
    Matched MeSH terms: Thyroid Diseases/blood*
  11. Fulltext Thyroid-Modulating Activities of Olive and Its Polyphenols: A Systematic Review
    Pang KL, Lumintang JN, Chin KY
    Nutrients, 2021 Feb 06;13(2).
    PMID: 33561976 DOI: 10.3390/nu13020529
    Olive oil, which is commonly used in the Mediterranean diet, is known for its health benefits related to the reduction of the risks of cancer, coronary heart disease, hypertension, and neurodegenerative disease. These unique properties are attributed to the phytochemicals with potent antioxidant activities in olive oil. Olive leaf also harbours similar bioactive compounds. Several studies have reported the effects of olive phenolics, olive oil, and leaf extract in the modulation of thyroid activities. A systematic review of the literature was conducted to identify relevant studies on the effects of olive derivatives on thyroid function. A comprehensive search was conducted in October 2020 using the PubMed, Scopus, and Web of Science databases. Cellular, animal, and human studies reporting the effects of olive derivatives, including olive phenolics, olive oil, and leaf extracts on thyroid function were considered. The literature search found 445 articles on this topic, but only nine articles were included based on the inclusion and exclusion criteria. All included articles were animal studies involving the administration of olive oil, olive leaf extract, or olive pomace residues orally. These olive derivatives were consistently demonstrated to have thyroid-stimulating activities in euthyroid or hypothyroid animals, but their mechanisms of action are unknown. Despite the positive results, validation of the beneficial health effects of olive derivatives in the human population is lacking. In conclusion, olive derivatives, especially olive oil and leaf extract, could stimulate thyroid function. Olive pomace residue is not suitable for pharmaceutical or health supplementation purposes. Therapeutic applications of olive oil and leaf extract, especially in individuals with hypothyroidism, require further validation through human studies.
    Matched MeSH terms: Thyroid Diseases/diet therapy*
  12. Sevoflurane induction in acute airway obstruction
    Chiu CL, Delilkan AE
    Hosp Med, 1998 Oct;59(10):828.
    PMID: 9850310
    Matched MeSH terms: Thyroid Diseases/complications; Thyroid Diseases/surgery
  13. Fulltext Clinical value of a rapid fully automated thyroid autoantibody assay in the diagnosis and management of graves disease
    Hanita, O., Azura, N.R., Faizal, M.M.Z.
    Medicine & Health, 2012;7(1):24-31.
    MyJurnal
    The most common cause of hyperthyroidism is Graves disease (GD) which is characterised by the presence of autoantibodies which binds to the TSH receptor (TRAb). Recently, a rapid, fully automated electrochemiluminescent immunoassay ElecsysAnti-TSHR for detection of autoantibodies to TSH receptor was made available for routine clinical use. The objective of this study is to evaluate this assay and to determine the sensitivity, specificity and cut-off value. Interassay and total imprecision (CV) were determined at 3.78-7.02 IU/L and 13.5-21.2 IU/L respectively. A total of 124 samples which comprised of 46 GD, seven Hashimoto thyroiditis (HD), 11 non autoimmune nodular goitre (NAG), 2 thyroid cancers (Ca) and 58 normal controls were retrospectively analysed to determine the sensitivity, specificity and cut-off value. Inter-assay CV’s were 2.4% at a concentration of 3.90 IU/L (range: 3.78-7.02 IU/l) and 0.8% at 20.80 IU/L (range:13.5-21.2 IU/l). Total imprecision was 3.8% at a concentration of 3.80 IU/L (range:13.5-21.2 IU/l) and 1.0% at 20.8 IU/L (range:13.5-21.2 IU/l). The ROC analysis of patients with GD, other thyroid disorders and normal controls revealed that the highest sensitivity (94%) and specificity (98%) were seen at cut-off value of 1.69 IU/L. Positive predictive value (PPV) and negative predictive value (NPV) was 95% and 94% respectively. At this derived cut-off value of 1.69 IU/L, we found that the sensitivity of TRAb positivity within the group of 29 newly diagnosed GD patients was 94%. Our results demonstrate that this fully automated assay with testing time of 27 minutes has high sensitivity in detecting GD and high specificity for discriminating other thyroid disease and represent major improvement in the diagnosis and management of patients with thyroid diseases.
    Matched MeSH terms: Thyroid Diseases
  14. Fulltext Weathering the Crisis: A Case of Thyroid Crisis with Propranolol-Induced Circulatory Collapse Successfully Treated with Therapeutic Plasma Exchange
    Cheah JM, Ng D, Low MY, Foo SH
    J ASEAN Fed Endocr Soc, 2019;34(2):206-209.
    PMID: 33442157 DOI: 10.15605/jafes.034.02.12
    Thyroid crisis is a life-threatening form of thyrotoxicosis characterized by multi-system dysfunction. Therapeutic plasma exchange has been reported to be effective in removing excessive circulating thyroid hormones. We present a 46-year-old female with recently diagnosed Graves' disease associated with thyrotoxic cardiomyopathy admitted for thyroid crisis complicated by propranolol-induced circulatory collapse, acute kidney injury and ischemic hepatitis. The tachyarrhythmia was refractory to conventional therapy. Initiation of TPE resulted in rapid clinical and biochemical stabilization.
    Matched MeSH terms: Thyroid Diseases
  15. Fulltext Understanding issues in preparing patients for radioactive iodine treatment of thyroid disorders
    Zanial AZ, Hamzah F
    The Malaysian Journal of Nursing, 2015;7(1):3-6.
    MyJurnal
    Thyroid disorders could be broadly categorised into benign and malignant diseases. Approaches for the
    management of benign and malignant thyroid disorders have been well documented including the treatment
    using radioactive iodine (RAI). RAI has long been used to treat hyperthyroidism and well differentiated
    thyroid cancer. Nevertheless, there are various factors that may influence the outcome of RAI treatment
    including matters related to patient preparations. Thus, healthcare personnel play an important role in
    assisting patients to make the necessary preparations. This article aims to give nurses and clinicians of
    various specialities an insight into the overview of RAI treatment for thyroid disorders particularly in
    Malaysia and further discusses the issues related to preparations of patients.
    Matched MeSH terms: Thyroid Diseases
  16. External laryngeal nerve in thyroid surgery: is the nerve stimulator necessary?
    Aina EN, Hisham AN
    Eur J Surg, 2001 Sep;167(9):662-5.
    PMID: 11759734 DOI: 10.1080/11024150152619282
    OBJECTIVE: To find out the incidence and type of external laryngeal nerves during operations on the thyroid, and to assess the role of a nerve stimulator in detecting them.
    DESIGN: Prospective, non-randomised study.
    SETTING: Teaching hospital, Malaysia.
    SUBJECTS: 317 patients who had 447 dissections between early January 1998 and late November 1999.
    MAIN OUTCOME MEASURES:
    Number and type of nerves crossing the cricothyroid space, and the usefulness of the nerve stimulator in finding them.
    RESULTS: The nerve stimulator was used in 206/447 dissections (46%). 392 external laryngeal nerves were seen (88%), of which 196/206 (95%) were detected with the stimulator. However, without the stimulator 196 nerves were detected out of 241 dissections (81%). The stimulator detected 47 (23%) Type I nerves (nerve > 1 cm from the upper edge of superior pole); 86 (42%) Type IIa nerves (nerve < 1 cm from the upper edge of superior pole); and 63 (31%) Type IIb nerves (nerve below upper edge of superior pole). 10 nerves were not detected. When the stimulator was not used the corresponding figures were 32 (13%), 113 (47%), and 51 (21%), and 45 nerves were not seen. If the nerve cannot be found we recommend dissection of capsule close to the medial border of the upper pole of the thyroid to avoid injury to the nerve.
    CONCLUSION: Although the use of the nerve stimulator seems desirable, it confers no added advantage in finding the nerve. In the event of uncertainty about whether a structure is the nerve, the stimulator may help to confirm it. However, exposure of the cricothyroid space is most important for good exposure in searching for the external laryngeal nerve.
    Matched MeSH terms: Thyroid Diseases/surgery*
  17. Fulltext Thyroid associated ophthalmopathy - a review
    Mallika PS, Tan AK, Aziz S, Syed Alwi SAR, Chong MS, Vanitha R, et al.
    Malays Fam Physician, 2009;4(1):8-14.
    PMID: 25606151 MyJurnal
    Thyroid associated ophthalmopathy is an autoimmune disorder affecting the orbital and periorbital tissues. Hyperthyroidism is commonly associated with thyroid associated ophthalmopathy, however in 5% to 10% of cases it is euthyroid. Genetic, environmental and endogenous factors play a role in the initiation of the thyroid ophthalmopathy. Smoking has been identified as the strongest risk factor for the development of the disorder. The pathogenesis involves activation of both humoral and cell mediated immunity with subsequent production of gycoaminoglycans, hyaluronic acid resulting in oedema formation, increase extraocular mass and adipogenesis in the orbit. The natural history of the disease progresses from active to inactive fibrotic stage over a period of years. Diagnosis is mainly clinical and almost all patients with ophthalmopathy exhibit some form of thyroid abnormality on further testing. Treatment is based on the clinical severity of the disease. Non-severe cases are managed by supportive measures to reduce the symptomatology and severe cases are treated by either medical or surgical decompression. Rehabilitative surgery is done for quiescent disease to reduce diplopia and improve cosmesis.
    Matched MeSH terms: Thyroid Diseases
  18. Fulltext A supersensitive in-house enzyme-linked immunosorbent assay (ELISA) for measurement of thyroid-stimulating hormone (TSH) and its clinical applications
    Goh KH, Goh ML, Thean ET, Khalid BA
    Med J Malaysia, 1992 Dec;47(4):248-60.
    PMID: 1303476
    A supersensitive ELISA was developed for measurement of thyroid-stimulating hormone (TSH) concentrations in serum using in-house rabbit polyclonal antisera and a commercial monoclonal antibody. The assay was optimised and validated by recovery, linearity and cross-reactivity experiments and further compared to other available assays and EQAS samples. Good precision was obtained with a working assay range of 0.2 to 100 mIU/L with < 10% coefficient of variation (CV) for both intra and interassay. The assay is highly sensitive and specific with a minimum detectable limit of 0.07 mIU/L and negligible cross-reactivities against LH, FSH, HCG and other pituitary peptides. Good correlations were obtained when compared to Abbott hTSH EIA (r = 0.993; p < 0.001; n = 85) and NETRIA IRMA (r + 0.995; p < 0.001; n = 76). The normal reference range established was 0.4 to 4.0 mIU/L (n = 76). TSH levels in serum of thyrotoxic patients (n = 83) were significantly lower (0.07 to 0.20 mIU/L, p < 0.0001) and completely distinct from normal values thereby obviating the requirement of a TRH-stimulation test. Stability studies showed that coated wells can be stored at 4 degrees C for at least 2 months. This highly sensitive in-house hTSH ELISA which is cheap, stable and readily available is useful for diagnosis and management of patients with various thyroid disorders.
    Matched MeSH terms: Thyroid Diseases/diagnosis
  19. Plasma renin and aldosterone in thyroid diseases
    Asmah BJ, Wan Nazaimoon WM, Norazmi K, Tan TT, Khalid BA
    Horm. Metab. Res., 1997 Nov;29(11):580-3.
    PMID: 9479560 DOI: 10.1055/s-2007-979105
    The effect of thyroid hormones on the renin-angiotensin-aldosterone system has not been fully resolved. Highly specific immunoassays for measurement of renin, aldosterone, free T4 (fT4), free T3 (fT3) and ultrasensitive TSH enables a direct and more accurate measurement of these hormones. We investigated the relationship between plasma renin, aldosterone and thyroid hormones in the basal state and after intravenous frusemide. This is a cross-sectional study involving 37 patients with thyrotoxicosis, 42 rendered euthyroid with normal fT4, fT3 and TSH levels, 17 with euthyroid levels of fT4 and fT3 but suppressed TSH, and 11 with hypothyroidism. Basal plasma renin was significantly higher in thyrotoxicosis (63.4 +/- 9.8 microU/ml, mean +/- SEM) compared to euthyroid (32.7 +/- 4.4 microU/ml) and hypothyroid (26.7 +/- 9.8 microU/ml). Basal plasma renin for euthyroid with suppressed TSH (41.0 +/- 7.4 microU/ml) was significantly higher than hypothyroid (p = 0.02). Basal plasma aldosterones were not significantly different except for suppressed TSH (157.7 +/- 13 pg/ml), which was higher than normal (109.9 +/- 10.4 pg/ml; p = 0.04). Following frusemide, plasma renin and aldosterone were significantly increased in all groups. Plasma renin was highly correlated to fT3 (r = 0.405, p < 0.001), total T3 (r = 0.359, p < 0.001), fT4 (r = 0.331, p < 0.001) and TSH (r = 0.300, p < 0.001) in the basal state, but less to total T4 (r = 0.248, p < 0.01). Plasma renin correlated poorly to serum aldosterone (r = 0.212, p < 0.03). This study clearly showed that regulation of renin was mainly influenced by fT3, and that aldosterone response to frusemide was blunted in thyrotoxicosis despite normal electrolytes.
    Matched MeSH terms: Thyroid Diseases/blood*
  20. Fulltext Prevalence of growth and endocrine disorders in Malaysian children with transfusion-dependent thalassaemia
    Tan KA, Lum SH, Yahya A, Krishnan S, Jalaludin MY, Lee WS
    Singapore Med J, 2019 Jun;60(6):303-308.
    PMID: 30556093 DOI: 10.11622/smedj.2018155
    INTRODUCTION: Endocrine dysfunction due to iron overload secondary to frequent blood transfusions is a common complication in children with transfusion-dependent thalassaemia (TDT). We ascertained the prevalence of endocrine dysfunction in children with TDT seen in a hospital setting in Malaysia.

    METHODS: We reviewed all patients with TDT who had ≥ 8 blood transfusions per year. Patients who had a history of stem cell transplantation, concurrent autoimmune diseases or were newly diagnosed to have TDT were excluded. Standard diagnostic criteria were used in the diagnosis of various endocrine dysfunctions.

    RESULTS: Of the 82 patients with TDT, 65% had at least one endocrine dysfunction. Short stature was the commonest (40.2%), followed by pubertal disorders (14.6%), hypoparathyroidism (12.3%), vitamin D deficiency (10.1%), hypocortisolism (7.3%), diabetes mellitus (5.2%) and overt hypothyroidism (4.9%). Subclinical hypothyroidism and pre-diabetes mellitus were seen in 13.4% and 8.6% of the patients, respectively. For children aged < 10 years, the prevalence of both thyroid dysfunction and hypoparathyroidism was 9.1%.

    CONCLUSION: Two-thirds of children with TDT experienced at least one endocrine dysfunction. Thyroid dysfunction and hypoparathyroidism may be missed if endocrine screening is only performed in children with TDT > 10 years of age. Close monitoring for endocrine dysfunction and hormonal therapy is essential to prevent long-term adverse outcomes.

    Matched MeSH terms: Thyroid Diseases/etiology; Thyroid Diseases/epidemiology
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