Objective: To evaluate parathyroid function and mineral metabolism in psychiatric patients users of lithium salts. Materials and methods: We measured the serum levels of calcium, ionized calcium, inorganic phosphorus, alkaline phosphatase, albumin, parathyroid hormone (PTH), urea, creatinine, 25-hydroxy-vitamin D and lithium of 35 patients diagnosed with bipolar disorder in use of lithium carbonate (LC) for at least one year (Lithium Group -LG) and 35 healthy subjects (Control Group -CG). Results: The LG and CG were matched by sex and age. There was only statistic difference in relation to the levels of PTH and ionized calcium, with p < 0.004 and p < 0.03, respectively. Secondary form of hyperparathyroidism (HPT) was found in eight (22.8%) LG patients and in none of the CG. There was no correlation between lithemia, usage time and dosage of LC. Conclusion: Our data demonstrate that lithium may create an imbalance in the parathyroid axis, characterized by elevated levels of PTH. Arq Bras Endocrinol Metab. 2014;58(6):619-24Keywords Lithium; parathyroid; mineral metabolism; hyperparathyroidism RESUMO Objetivo: Avaliar a função paratireoidiana e o metabolismo mineral em pacientes psiquiátricos usuários de sais de lítio. Materiais e métodos: Foram avaliados os níveis séricos de cálcio total, cálcio iônico, fósforo inorgânico, fosfatase alcalina, albumina, paratormônio (PTH), ureia, creatinina, 25-hidroxivitamina D e lítio de 35 pacientes diagnosticados com transtorno afetivo bipolar usuários de carbonato de lítio (CL) há pelo menos um ano (Grupo Lítio -GL) e 35 indivíduos saudáveis (Grupo Controle -GC). Resultados: O GL e o GC foram pareados por sexo e idade. Somente se observou diferença estatística em relação aos níveis de PTH e cálcio iônico, com p < 0,004 e p < 0,03, respectivamente. Hiperparatireoidismo secundário foi encontrado em oito (22.8%) pacientes do GL e em nenhum do GC. No GL, não houve correlação entre litemia, tempo de uso e posologia do CL. Conclusão: Nossos dados demonstram que o lítio pode suscitar um desequilíbrio no eixo paratireoideano, caracterizado por níveis elevados de PTH. Arq Bras Endocrinol Metab. 2014;58(6):619-24 Descritores Lítio; paratireoide; metabolismo mineral; hiperparatireoidismo

Aim: we aimed to compare the American Thyroid Association (ATA) and The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS) guidelines that stratify the risk of nodule malignancy and compare with cytological classification. Then, the diagnostic performance of the ATA and ACR TIRADS categories for predicting malignancy were performed. Methods: a total of 190 thyroid nodules image obtained from 120 individuals were classified in accordance with ACR TIRADS and ATA guidelines. After classified, all nodules were categorized by using cytological classification (2017 Bethesda System). Results: comparing diagnostic accuracy of each ultrasound classification, both of them revealed the same sensitivity and negative predictive value but ACR TIRADS reached higher positive predictive value. A high positive correlation between the two methods were found (r=0.860, p <0.0001). The ATA and ACR TIRADS classifications were correlated with the cytological analysis, but the correlation was weak. Conclusions: Both guidelines have similar accuracy in the ultrasound evaluation of thyroid nodules but have shown an overestimation of the presence of malignant thyroid neoplasms.