New biomarkers: prospect for diagnosis and monitoring of thyroid disease

Abstract

After the metabolic syndrome and its components, thyroid disorders represent the most common endocrine disorders, with increasing prevalence in the last two decades. Thyroid dysfunctions are distinguished by hyperthyroidism, hypothyroidism, or inflammation (thyroiditis) of the thyroid gland, in addition to the presence of thyroid nodules that can be benign or malignant. Thyroid cancer is typically detected via an ultrasound (US)-guided fine-needle aspiration biopsy (FNAB) and cytological examination of the specimen. This approach has significant limitations due to the small sample size and inability to characterize follicular lesions adequately. Due to the rapid advancement of high-throughput molecular biology techniques, it is now possible to identify new biomarkers for thyroid neoplasms that can supplement traditional imaging modalities in postoperative surveillance and aid in the preoperative cytology examination of indeterminate or follicular lesions. Here, we review current knowledge regarding biomarkers that have been reliable in detecting thyroid neoplasms, making them valuable tools for assessing the efficacy of surgical procedures or adjunctive treatment after surgery. We are particularly interested in providing an up-to-date and systematic review of emerging biomarkers, such as mRNA and non-coding RNAs, that can potentially detect thyroid neoplasms in clinical settings. We discuss evidence for miRNA, lncRNA and circRNA dysregulation in several thyroid neoplasms and assess their potential for use as diagnostic and prognostic biomarkers.

Diagnostic criteria and scoring systems for thyroid storm: An evaluation of their utility – comparative review

“…[1] The scale delves into Central Nervous System (CNS) manifestations, encompassing agitation, delirium, psychosis, and seizures, with points assigned commensurate with severity. [1–3] Gastrointestinal symptoms such as vomiting, diarrhea, and abdominal pain contribute to the assessment, where points align with symptom intensity. The heart rate, a pivotal sign, is scrutinized for tachycardia, escalating points as the heart rate surpasses defined thresholds.…”

“…[7] These criteria collectively provide a nuanced and comprehensive approach to identifying thyroid storm, reflecting the evolution of diagnostic methodologies. [1–7]…”

“…Without swift and appropriate treatment, it can lead to catastrophic consequences, including cardiac arrhythmias, organ failure, and even death. [ 1 , 2 ]…”

“…However, this is a complex task. [ 2 ] Various diagnostic criteria and scoring systems have been proposed over the years to assist healthcare providers in identifying thyroid storm cases. These tools aim to consolidate clinical features, laboratory data, and physical findings into a comprehensive assessment that guides treatment decisions.…”

“…This paper delves into the intricate landscape of thyroid storm diagnosis, critically evaluating the existing diagnostic criteria and scoring systems in the context of a narrative review. [ 1 , 2 ] By meticulously examining their strengths and limitations, we seek to shed light on the challenges healthcare professionals face when confronted with this formidable endocrine emergency. In doing so, we pave the way for a deeper understanding of thyroid storm and advocate for improvements in its diagnostic methodologies, ultimately enhancing the prospects for timely and life-saving interventions.…”