Early detection of biochemically occult autonomous thyroid nodules
Objective Autonomously functioning thyroid areas may be associated with subclinical or overt hyperthyroidism, but may exist even in the presence of normal TSH. This study was aimed at comparing the rate of autonomously functioning areas and their cardiac sequelae in patients with nodular goitre stud...
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| Veröffentlicht in: | European journal of endocrinology 2016-12, Vol.175 (6), p.615-622 |
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| creator | Brusca, N Virili, C Cellini, M Capriello, S Gargano, L Salvatori, R Centanni, M Santaguida, M G |
| description | Objective Autonomously functioning thyroid areas may be associated with subclinical or overt hyperthyroidism, but may exist even in the presence of normal TSH. This study was aimed at comparing the rate of autonomously functioning areas and their cardiac sequelae in patients with nodular goitre studied with the usual and a novel approach. Design and methods In total 490 adult outpatients with thyroid nodular goitre, living in a mild iodine-deficient area, were selected in our referral centre for thyroid diseases from 2009 to 2014 on the basis of a suspicion of thyroid functional autonomy. They were divided in three groups according to a non-conventional approach (excessive response to thyroxine treatment: group 1) or conventional approach (low/normal TSH with clinical suspicion or low TSH: groups 2 and 3). All patients of the study with the suspicion of thyroid functional autonomy underwent thyroid scan with radioactive iodine (I131) uptake (RAIU). Results The percentage of confirmed thyroid functional autonomy was 319/490, being significantly higher in group 3 than in groups 1 and 2 (81.5 vs 64.7 vs 52.6%; chi-square P |
| doi_str_mv | 10.1530/EJE-16-0568 |
| format | Article |
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This study was aimed at comparing the rate of autonomously functioning areas and their cardiac sequelae in patients with nodular goitre studied with the usual and a novel approach. Design and methods In total 490 adult outpatients with thyroid nodular goitre, living in a mild iodine-deficient area, were selected in our referral centre for thyroid diseases from 2009 to 2014 on the basis of a suspicion of thyroid functional autonomy. They were divided in three groups according to a non-conventional approach (excessive response to thyroxine treatment: group 1) or conventional approach (low/normal TSH with clinical suspicion or low TSH: groups 2 and 3). All patients of the study with the suspicion of thyroid functional autonomy underwent thyroid scan with radioactive iodine (I131) uptake (RAIU). Results The percentage of confirmed thyroid functional autonomy was 319/490, being significantly higher in group 3 than in groups 1 and 2 (81.5 vs 64.7 vs 52.6%; chi-square P < 0.0001). However, the diagnosis with non-conventional approach was made at a significant earlier age (P < 0.0001). Cardiac arrhythmias as well as atrial fibrillation were similarly detected by conventional and non-conventional approaches (chi-square test: P = 0.2537; P = 0.8425). Conclusions The hyper-responsiveness to thyroxine treatment should induce the suspicion of thyroid functional autonomy at an early stage, allowing to detect autonomous functioning areas in apparently euthyroid patients.</description><identifier>ISSN: 0804-4643</identifier><identifier>EISSN: 1479-683X</identifier><identifier>DOI: 10.1530/EJE-16-0568</identifier><identifier>PMID: 27647872</identifier><language>eng</language><publisher>England: Bioscientifica Ltd</publisher><subject>Aged ; Arrhythmias, Cardiac - blood ; Arrhythmias, Cardiac - diagnosis ; Arrhythmias, Cardiac - drug therapy ; Autonomy ; Clinical Study ; Complications ; Early Diagnosis ; Female ; Fibrillation ; Goiter, Nodular - blood ; Goiter, Nodular - diagnosis ; Goiter, Nodular - drug therapy ; Heart diseases ; Humans ; Hyperthyroidism ; Hyperthyroidism - blood ; Hyperthyroidism - diagnosis ; Hyperthyroidism - prevention & control ; Iodine ; Male ; Middle Aged ; Nodules ; Patients ; Thyroid diseases ; Thyroid gland ; Thyroid Nodule - blood ; Thyroid Nodule - diagnosis ; Thyroid Nodule - drug therapy ; Thyroid-stimulating hormone ; Thyrotropin - blood ; Thyroxine ; Thyroxine - blood ; Thyroxine - therapeutic use</subject><ispartof>European journal of endocrinology, 2016-12, Vol.175 (6), p.615-622</ispartof><rights>2016 European Society of Endocrinology</rights><rights>2016 European Society of Endocrinology.</rights><rights>Copyright BioScientifica Ltd. Dec 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b438t-24ff52d0b0b9b821c7d7c12a2a50d5f685649cff72f5138495442e0034d925293</citedby><cites>FETCH-LOGICAL-b438t-24ff52d0b0b9b821c7d7c12a2a50d5f685649cff72f5138495442e0034d925293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27647872$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brusca, N</creatorcontrib><creatorcontrib>Virili, C</creatorcontrib><creatorcontrib>Cellini, M</creatorcontrib><creatorcontrib>Capriello, S</creatorcontrib><creatorcontrib>Gargano, L</creatorcontrib><creatorcontrib>Salvatori, R</creatorcontrib><creatorcontrib>Centanni, M</creatorcontrib><creatorcontrib>Santaguida, M G</creatorcontrib><title>Early detection of biochemically occult autonomous thyroid nodules</title><title>European journal of endocrinology</title><addtitle>Eur J Endocrinol</addtitle><description>Objective Autonomously functioning thyroid areas may be associated with subclinical or overt hyperthyroidism, but may exist even in the presence of normal TSH. This study was aimed at comparing the rate of autonomously functioning areas and their cardiac sequelae in patients with nodular goitre studied with the usual and a novel approach. Design and methods In total 490 adult outpatients with thyroid nodular goitre, living in a mild iodine-deficient area, were selected in our referral centre for thyroid diseases from 2009 to 2014 on the basis of a suspicion of thyroid functional autonomy. They were divided in three groups according to a non-conventional approach (excessive response to thyroxine treatment: group 1) or conventional approach (low/normal TSH with clinical suspicion or low TSH: groups 2 and 3). All patients of the study with the suspicion of thyroid functional autonomy underwent thyroid scan with radioactive iodine (I131) uptake (RAIU). Results The percentage of confirmed thyroid functional autonomy was 319/490, being significantly higher in group 3 than in groups 1 and 2 (81.5 vs 64.7 vs 52.6%; chi-square P < 0.0001). However, the diagnosis with non-conventional approach was made at a significant earlier age (P < 0.0001). Cardiac arrhythmias as well as atrial fibrillation were similarly detected by conventional and non-conventional approaches (chi-square test: P = 0.2537; P = 0.8425). Conclusions The hyper-responsiveness to thyroxine treatment should induce the suspicion of thyroid functional autonomy at an early stage, allowing to detect autonomous functioning areas in apparently euthyroid patients.</description><subject>Aged</subject><subject>Arrhythmias, Cardiac - blood</subject><subject>Arrhythmias, Cardiac - diagnosis</subject><subject>Arrhythmias, Cardiac - drug therapy</subject><subject>Autonomy</subject><subject>Clinical Study</subject><subject>Complications</subject><subject>Early Diagnosis</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Goiter, Nodular - blood</subject><subject>Goiter, Nodular - diagnosis</subject><subject>Goiter, Nodular - drug therapy</subject><subject>Heart diseases</subject><subject>Humans</subject><subject>Hyperthyroidism</subject><subject>Hyperthyroidism - blood</subject><subject>Hyperthyroidism - diagnosis</subject><subject>Hyperthyroidism - prevention & control</subject><subject>Iodine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nodules</subject><subject>Patients</subject><subject>Thyroid diseases</subject><subject>Thyroid gland</subject><subject>Thyroid Nodule - blood</subject><subject>Thyroid Nodule - diagnosis</subject><subject>Thyroid Nodule - drug therapy</subject><subject>Thyroid-stimulating hormone</subject><subject>Thyrotropin - blood</subject><subject>Thyroxine</subject><subject>Thyroxine - blood</subject><subject>Thyroxine - therapeutic use</subject><issn>0804-4643</issn><issn>1479-683X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1PwzAQhi0EoqUwsaNILEgocHb8lRGq8qVKLCCxWYljq66SGOxk6L_HVQsDA9OddM-9unsQOsdwg1kBt4uXRY55DozLAzTFVJQ5l8XHIZqCBJpTTosJOolxDYBTD8doQgSnQgoyRfeLKrSbrDGD0YPzfeZtVjuvV6ZzumrTyGs9tkNWjYPvfefHmA2rTfCuyXrfjK2Jp-jIVm00Z_s6Q-8Pi7f5U758fXye3y3zmhZyyAm1lpEGaqjLWhKsRSM0JhWpGDTMcsk4LbW1gliGC0lLRikxAAVtSsJIWczQ1S73M_iv0cRBdS5q07ZVb9JZCssirQjMSEIv_6BrP4Y-XacI0PQ9CCISdb2jdPAxBmPVZ3BdFTYKg9qqVUmtwlxt1Sb6Yp851p1pftkflwnAOyD5i9qZfnA2Ofw39BvHcIJn</recordid><startdate>201612</startdate><enddate>201612</enddate><creator>Brusca, N</creator><creator>Virili, C</creator><creator>Cellini, M</creator><creator>Capriello, S</creator><creator>Gargano, L</creator><creator>Salvatori, R</creator><creator>Centanni, M</creator><creator>Santaguida, M G</creator><general>Bioscientifica Ltd</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>201612</creationdate><title>Early detection of biochemically occult autonomous thyroid nodules</title><author>Brusca, N ; Virili, C ; Cellini, M ; Capriello, S ; Gargano, L ; Salvatori, R ; Centanni, M ; Santaguida, M G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b438t-24ff52d0b0b9b821c7d7c12a2a50d5f685649cff72f5138495442e0034d925293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Arrhythmias, Cardiac - blood</topic><topic>Arrhythmias, Cardiac - diagnosis</topic><topic>Arrhythmias, Cardiac - drug therapy</topic><topic>Autonomy</topic><topic>Clinical Study</topic><topic>Complications</topic><topic>Early Diagnosis</topic><topic>Female</topic><topic>Fibrillation</topic><topic>Goiter, Nodular - blood</topic><topic>Goiter, Nodular - diagnosis</topic><topic>Goiter, Nodular - drug therapy</topic><topic>Heart diseases</topic><topic>Humans</topic><topic>Hyperthyroidism</topic><topic>Hyperthyroidism - blood</topic><topic>Hyperthyroidism - diagnosis</topic><topic>Hyperthyroidism - prevention & control</topic><topic>Iodine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nodules</topic><topic>Patients</topic><topic>Thyroid diseases</topic><topic>Thyroid gland</topic><topic>Thyroid Nodule - blood</topic><topic>Thyroid Nodule - diagnosis</topic><topic>Thyroid Nodule - drug therapy</topic><topic>Thyroid-stimulating hormone</topic><topic>Thyrotropin - blood</topic><topic>Thyroxine</topic><topic>Thyroxine - blood</topic><topic>Thyroxine - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brusca, N</creatorcontrib><creatorcontrib>Virili, C</creatorcontrib><creatorcontrib>Cellini, M</creatorcontrib><creatorcontrib>Capriello, S</creatorcontrib><creatorcontrib>Gargano, L</creatorcontrib><creatorcontrib>Salvatori, R</creatorcontrib><creatorcontrib>Centanni, M</creatorcontrib><creatorcontrib>Santaguida, M G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of endocrinology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brusca, N</au><au>Virili, C</au><au>Cellini, M</au><au>Capriello, S</au><au>Gargano, L</au><au>Salvatori, R</au><au>Centanni, M</au><au>Santaguida, M G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early detection of biochemically occult autonomous thyroid nodules</atitle><jtitle>European journal of endocrinology</jtitle><addtitle>Eur J Endocrinol</addtitle><date>2016-12</date><risdate>2016</risdate><volume>175</volume><issue>6</issue><spage>615</spage><epage>622</epage><pages>615-622</pages><issn>0804-4643</issn><eissn>1479-683X</eissn><abstract>Objective Autonomously functioning thyroid areas may be associated with subclinical or overt hyperthyroidism, but may exist even in the presence of normal TSH. This study was aimed at comparing the rate of autonomously functioning areas and their cardiac sequelae in patients with nodular goitre studied with the usual and a novel approach. Design and methods In total 490 adult outpatients with thyroid nodular goitre, living in a mild iodine-deficient area, were selected in our referral centre for thyroid diseases from 2009 to 2014 on the basis of a suspicion of thyroid functional autonomy. They were divided in three groups according to a non-conventional approach (excessive response to thyroxine treatment: group 1) or conventional approach (low/normal TSH with clinical suspicion or low TSH: groups 2 and 3). All patients of the study with the suspicion of thyroid functional autonomy underwent thyroid scan with radioactive iodine (I131) uptake (RAIU). Results The percentage of confirmed thyroid functional autonomy was 319/490, being significantly higher in group 3 than in groups 1 and 2 (81.5 vs 64.7 vs 52.6%; chi-square P < 0.0001). However, the diagnosis with non-conventional approach was made at a significant earlier age (P < 0.0001). Cardiac arrhythmias as well as atrial fibrillation were similarly detected by conventional and non-conventional approaches (chi-square test: P = 0.2537; P = 0.8425). Conclusions The hyper-responsiveness to thyroxine treatment should induce the suspicion of thyroid functional autonomy at an early stage, allowing to detect autonomous functioning areas in apparently euthyroid patients.</abstract><cop>England</cop><pub>Bioscientifica Ltd</pub><pmid>27647872</pmid><doi>10.1530/EJE-16-0568</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Arrhythmias, Cardiac - blood Arrhythmias, Cardiac - diagnosis Arrhythmias, Cardiac - drug therapy Autonomy Clinical Study Complications Early Diagnosis Female Fibrillation Goiter, Nodular - blood Goiter, Nodular - diagnosis Goiter, Nodular - drug therapy Heart diseases Humans Hyperthyroidism Hyperthyroidism - blood Hyperthyroidism - diagnosis Hyperthyroidism - prevention & control Iodine Male Middle Aged Nodules Patients Thyroid diseases Thyroid gland Thyroid Nodule - blood Thyroid Nodule - diagnosis Thyroid Nodule - drug therapy Thyroid-stimulating hormone Thyrotropin - blood Thyroxine Thyroxine - blood Thyroxine - therapeutic use |
| title | Early detection of biochemically occult autonomous thyroid nodules |
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