MyMedR

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

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

Fulltext Ultrasound of the cold thyroid nodule

Alif AK, Meah F

Med J Malaysia, 1984 Jun;39(2):123-6.

PMID: 6392839

Matched MeSH terms: Thyroid Diseases/diagnosis*

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

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*

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*

Fulltext Thyroid disorders in the aged

Peter Michael Barling

International e-Journal of Science, Medicine & Education, 2013;7(2):4-7.

MyJurnal

A review of current information related to the likely incidences of thyroid diseases in the aged population of Malaysia, raising issues such as the need for further epidemiological studies of iodine intake in relation to thyroid diseases within different geographical regions and population subtypes, the need for general country-wide iodization of salt, and the screening of elderly Malaysians for so-called “occult” thyroid diseases.

Matched MeSH terms: Thyroid Diseases

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: Thyroid Diseases*

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

The management of solitary thyroid nodules under local anaesthesia

Cunningham IG, Lee YK

Aust N Z J Surg, 1975 Aug;45(3):285-9.

PMID: 1058690

A group of patients with solitary nodules of the thyroid were treated at the University of Malaya by surgery under local anaesthesia. This was done in order to expedite exploration of a potentially malignant condition. This group comprised 43 patients, and four cancers were found. The standard technique used was satisfactory from the viewpoint of both the patient and the surgeon. The pattern of this condition in a Malaysian population is documented, the technique used is described, and thyroidectomy under local aneaesthesia is discussed.

Matched MeSH terms: Thyroid Diseases/pathology

Fulltext Spectrum of thyroid lesions in hospital Universiti Sains Malaysia over 11years and a review of thyroid cancers in Malaysia

Othman NH, Omar E, Naing NN

Asian Pac J Cancer Prev, 2009;10(1):87-90.

PMID: 19469631

INTRODUCTION: Endemic goitre is a major concern in many nations including Malaysia. Seven states in the country have been identified by Ministry of Health of Malaysia to have high incidence of goitre and one of these is Kelantan.

METHODS: This is a retrospective study over an 11-year period from 1994 to 2004 on all thyroid specimens submitted to the Pathology Department, Hospital Universiti Sains Malaysia (HUSM), in Kelantan. Epidemiological data were retrieved from the patients' records and pathology findings from the pathology reports.

RESULTS: During this period, Department of Pathology HUSM received a total of 1,486 thyroid specimens. The female to male ratio was 6:1 and the median age was 40.0 years. The duration of goitre ranged from one to 15 years. Histopathological examination showed 71.9 percent were non-neoplastic and 28.1 percent neoplastic lesions. The hospital-based incidence of nodular hyperplasia was 9.9 per 100,000 admitted patients per year. The hospital-based incidence of all types of malignant thyroid cancers was 3.5 per 100,000. The most common malignancy was papillary carcinoma 76.6 percent. The majority of the cancers (59.5 percent) occurred in a background of nodular hyperplasia. Thyroid cancers made up 4.9 percent of all cancers seen in HUSM.

CONCLUSION: This study suggests that malignant thyroid lesions arising from multi-nodular goitre are high in a population living in an iodine-deficiency area.

Matched MeSH terms: Thyroid Diseases/epidemiology*

Spectral sensitivity in patients with dysthyroid eye disease

Sharanjeet-Kaur, Dickinson CM, O'Donoghue E, Murray IJ

Ophthalmic Physiol Opt, 1997 May;17(3):232-8.

PMID: 9196665 DOI: 10.1111/j.1475-1313.1997.0_749.x

The majority of patients with dysthyroid eye disease have an acquired colour vision defect. However, no psychophysical investigation of selective damage to colour or flicker pathways has been carried out. In order to clarify the nature of the visual pathology, we have used a psychophysical technique (spectral sensitivity) to selectively stimulate the chromatic and achromatic mechanisms. Spectral spots of size 1 degree presented at a rate of 1 Hz on a bright 1000 td white background are detected by the chromatic mechanism but a rate of 25 Hz reveals the achromatic mechanism. Fifteen patients (28 eyes) between the ages of 50-70 years were tested. The study showed that all patients had reduced spectral sensitivity, either 1 Hz, 25 Hz or both. The patients with reduced 1 Hz or 25 Hz spectral sensitivity only had a shorter systemic and ocular duration of the condition, had no proptosis, normal intraocular pressures in primary gaze, slightly higher intraocular pressures on upgaze, normal visual field plots and FM 100-Hue error scores higher than the normal age-matched values. The patients with reduced both 1 Hz and 25 Hz spectral sensitivities had a longer systemic and ocular duration of the condition, had proptosis, normal intraocular pressures in primary position, higher intraocular pressures on upgaze and higher FM 100-Hue error scores than the age-matched normals and those in Groups 1 and 2. A total of 50% of patients in Group 3 had defective visual field plots. These data suggest that there is a damage of the large achromatic fibres and small chromatic fibres in dysthyroid eye disease. The mechanism of the damage could be one of ischaemic or mechanical or both.

Matched MeSH terms: Thyroid Diseases/complications; Thyroid Diseases/physiopathology*

Fulltext Solitary thyroid nodule--experience in a district hospital

Thambi Dorai CR

Med J Malaysia, 1988 Mar;43(1):55-8.

PMID: 3244321

Matched MeSH terms: Thyroid Diseases/diagnosis*

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

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*

Salmonella thyroid abscess-two case reports

Khoo KS, Koh PS, Ng KL

Gland Surg, 2020 Dec;9(6):2198-2203.

PMID: 33447571 DOI: 10.21037/gs-20-474

Acute suppurative thyroiditis account for <1% of thyroid diseases and is uncommon because of the gland's encapsulation, iodine-rich environment, good vascular supply and extensive lymphatic drainage. It has been reported in patients with underlying goiters, thyroid cancers and in immuno-compromised patients. The usual causative organisms are Staphylococci spp. and Streptococci spp. Rarer organisms include Klebsiella spp. and Salmonella spp. Due to its rarity (as there have been only 28 cases of Salmonella thyroid abscess being reported in the literature till 2020), only case reports are available to guide management. We report two cases of thyroid abscess due to Salmonella enteritidis in our institution that may herald the re-emergence of this uncommon infection of the thyroid gland and to raise awareness for all clinicians. Both patients presented with neck swelling, dysphagia and sepsis. Surgical intervention was warranted in both patients due to the severity of the disease and failed medical therapy. Recovery was uneventful following adequate surgical intervention and antibiotic therapy according to the culture and sensitivity report of the pathogen. This case report highlights that both patients were immunocompromised, and they contracted Salmonella thyroid abscess without any gastrointestinal involvement. Thus, a high index of suspicion for Salmonella thyroid abscess in immunocompromised patients can expedite the diagnosis and appropriate management can be commenced such as antibiotic therapy, percutaneous aspiration and surgical drainage in the event of failed medical therapy.

Matched MeSH terms: Thyroid Diseases

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

Relationship between levels of thyroid stimulating hormone, age, and gender, with symptoms of depression among patients with thyroid disorders as measured by the Depression Anxiety Stress Scale 21 (DASS-21)

Saidi S, Iliani Jaafar SN, Daud A, Musa R, Nik Ahmad NNF

Enferm Clin, 2018 Feb;28 Suppl 1:180-183.

PMID: 29650181 DOI: 10.1016/S1130-8621(18)30063-9

OBJECTIVE: The aim of this study was to investigate the correlation between levels of depression symptoms and age, thyroid-stimulating hormone levels, and stressful life events of the participants.

METHOD: Patients above 18 years old, with any thyroid disorders, and without psychiatric disorders were included in this study. All participants completed the Depression Anxiety Stress Scale 21 (DASS-21). The depression symptom score was calculated and interpreted as follows: less than 9: no depression; between 10 and 13: mild depression; between 14 and 20: moderate depression; between 21 and 27: severe depression, and more than 28: extremely severe depression.

RESULTS: The total number of participants in this study was 199. There was no correlation between age, thyroid stimulating hormone, and the DASS score. There was also no significant difference in the DASS-21 score between genders. However, there was a positive correlation between depression symptoms and stressful life events (r=0.201, n=199, p < 0.05).

CONCLUSIONS: These findings would suggest that increased depression symptom scores correlate with increased stressful life events. A larger study should be undertaken to confirm these findings.

Matched MeSH terms: Thyroid Diseases/blood*; Thyroid Diseases/complications

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*

Primary Squamous Cell Carcinoma of the Thyroid Gland

Ibrahim MI, Jusoh YR, Adam NN, Mohamad I

Iran J Otorhinolaryngol, 2018 Jan;30(96):65-68.

PMID: 29387667

Introduction: Primary squamous cell carcinoma (SCC) of the thyroid gland is one of the rarest types of all reported thyroid malignancies worldwide. It is very aggressive in nature and carries a poor prognosis. The surgical resection with adjuvant radiotherapy and chemotherapy is the most recommended treatment despite its poor reported outcome.

Case Report: A 74-year-old woman presented with a rapidly progressive neck swelling, with hoarseness and compressive symptoms. Physical examination revealed a multilobulated firm thyroid mass with unilateral vocal cord palsy. Histopathological findings confirmed the diagnosis of SCC while radiological investigations and panendoscopy findings ruled out the possibility of other primary tumors. A surgical intervention was performed; however, the patient eventually succumbed to death prior to undergoing an oncological treatment.

Conclusion: With no standard consensus to guide the management plan, SCC of the thyroid gland presents a great challenge for the managing team to come up with the best treatment option, due to its unfavorable rate of survival.

Matched MeSH terms: Thyroid Diseases

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