Dermopathy of Graves′ disease: Clinico-pathological correlation

Reddy, Sagili Vijaya Bhaskar; Gupta, Sushil K.; Jain, Manoj

doi:10.4103/2230-8210.95714

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…In our study, insulin resistance was identified as HOMA-IR ≥ 2 and insulin sensitivity was identified by HOMA-IR < 2. This was in line with earlier studies by Sinha et al [ 16 ] and Ray et al [ 17 ].…”

Section: Discussionsupporting

confidence: 94%

“…A recent study by Ray et al has showed TG/HDL-C and TC/HDL-C as insulin resistance markers in the ACS patients with impaired fasting glucose [ 17 ]. Our study included ACS patients who had normal glycemic levels and we also included Lp(a), along with the lipid profile parameters in the lipid ratios for prediction of insulin resistance, as south Indians are genetically known to have higher preponderance for CAD and higher Lp(a) levels and high incidence of central obesity and insulin resistance [ 23 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

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Lipoprotein Ratios as Surrogate Markers for Insulin Resistance in South Indians with Normoglycemic Nondiabetic Acute Coronary Syndrome

et al. 2014

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Background. Insulin resistance has been associated with dyslipidemia and cardiovascular disease. Even though homeostasis model assessment of insulin resistance (HOMA-IR) is a well-known insulin resistance predictor, estimation of serum lipoprotein ratios has been recently suggested as a surrogate marker for insulin resistance. Here, we evaluated the relationship between lipoprotein ratios and insulin resistance in normoglycemic nondiabetic south Indians with acute coronary syndrome. Methods. 100 normoglycemic nondiabetic ACS patients and 140 controls were enrolled in the study. Levels of fasting glucose, fasting insulin, and lipid profile [total cholesterol (TC), triglycerides (TG), and high density lipoprotein cholesterol (HDL-C)], lipoprotein(a) [Lp(a)] levels were measured and lipoprotein ratios were computed. HOMA-IR was used to calculate the insulin resistance. Receiver operating characteristic curves (ROC) analysis was used to compare the power of these lipoprotein ratios to predict insulin resistance. Results. Lipoprotein ratios were significantly higher in normoglycemic nondiabetic ACS patients, as compared to healthy controls, and were significantly correlated with HOMA-IR by Spearman's rank correlation analysis. ROC curve showed that Lp(a)/HDL-C and TG/HDL-C ratios were the best surrogate predictors of insulin resistance in normoglycemic nondiabetic ACS. Conclusion. This study demonstrates that serum lipoprotein ratios significantly correlate with insulin resistance in normoglycemic nondiabetic ACS. Lp(a)/HDL-C and TG/HDL-C ratios could be used as surrogate markers of insulin resistance in atherosclerosis-prone south Indians with normoglycemic nondiabetic ACS.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Lipoprotein Ratios as Surrogate Markers for Insulin Resistance in South Indians with Normoglycemic Nondiabetic Acute Coronary Syndrome

et al. 2014

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“…Graves’ dermopathy is an extra-thyroidal manifestation exclusively found in GD patients. Dermopathy develops in the presence of high TSHR antibody levels and is, with a frequency of 15%, a less common extra-thyroidal manifestation of GD ( 118 ). The main localization is pretibial and is associated with acropachy (digital clubbing, swelling of digits and toes, and periosteal reaction of extremity bones) in 20% of patients.…”

Section: Anti-thyroid Antibody Types: the Key To The Diagnosismentioning

confidence: 99%

Thyroid Autoimmunity: Role of Anti-thyroid Antibodies in Thyroid and Extra-Thyroidal Diseases

2017

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Autoimmune diseases have a high prevalence in the population, and autoimmune thyroid disease (AITD) is one of the most common representatives. Thyroid autoantibodies are not only frequently detected in patients with AITD but also in subjects without manifest thyroid dysfunction. The high prevalence raises questions regarding a potential role in extra-thyroidal diseases. This review summarizes the etiology and mechanism of AITD and addresses prevalence of antibodies against thyroid peroxidase, thyroid-stimulating hormone receptor (TSHR), and anti-thyroglobulin and their action outside the thyroid. The main issues limiting the reliability of the conclusions drawn here include problems with different specificities and sensitivities of the antibody detection assays employed, as well as potential confounding effects of altered thyroid hormone levels, and lack of prospective studies. In addition to the well-known effects of TSHR antibodies on fibroblasts in Graves’ disease (GD), studies speculate on a role of anti-thyroid antibodies in cancer. All antibodies may have a tumor-promoting role in breast cancer carcinogenesis despite anti-thyroid peroxidase antibodies having a positive prognostic effect in patients with overt disease. Cross-reactivity with lactoperoxidase leading to induction of chronic inflammation might promote breast cancer, while anti-thyroid antibodies in manifest breast cancer might be an indication for a more active immune system. A better general health condition in older women with anti-thyroid peroxidase antibodies might support this hypothesis. The different actions of the anti-thyroid antibodies correspond to differences in cellular location of the antigens, titers of the circulating antibodies, duration of antibody exposure, and immunological mechanisms in GD and Hashimoto’s thyroiditis.

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“…Almost all cases are preceded by severe thyroid associated orbitopathy (TAO) 2. However, PTM is rarely seen in Asians and this has been attributed to reduced severity of TAO, lower prevalence rates of smoking and ethnicity 3. Our patient did not have active TAO but had severe nodular PTM.…”

Section: Discussionmentioning

confidence: 74%

Pretibial myxoedema without thyroid associated orbitopathy in a patient with Graves’ disease

Lodha

Jain

Bhansali

2017

Postgraduate Medical Journal

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Dermopathy of Graves′ disease: Clinico-pathological correlation

Abstract: Dermopathy of Graves’ disease is a classical, but uncommon extrathyroidal manifestation of Graves’ disease. The images of a typical case of dermopathy of Graves’ disease are presented along with clinico-pathological correlation.

Cited by 8 publications

References 5 publications

Lipoprotein Ratios as Surrogate Markers for Insulin Resistance in South Indians with Normoglycemic Nondiabetic Acute Coronary Syndrome

Lipoprotein Ratios as Surrogate Markers for Insulin Resistance in South Indians with Normoglycemic Nondiabetic Acute Coronary Syndrome

Thyroid Autoimmunity: Role of Anti-thyroid Antibodies in Thyroid and Extra-Thyroidal Diseases

Pretibial myxoedema without thyroid associated orbitopathy in a patient with Graves’ disease

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