Uncommon Causes of Thyrotoxicosis

Mittra, Erik; Niederkohr, Ryan D.; Rodríguez, César Alonso; El-Maghraby, Tarek; McDougall, I. Ross

doi:10.2967/jnumed.107.041202

Cited by 28 publications

(11 citation statements)

References 162 publications

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“…Thyrotoxicosis, a condition of thyroid dysfunction is a clinical syndrome of hyper metabolism resulting from increased levels of serum T 4 and/or T 3 that affect all most all the physiological systems 5,6 . Thyrotoxicosis can result from a destructive process in the thyroid leading to an unregulated release of stored thyroid hormones without increased production 7 .…”

Section: Introductionmentioning

confidence: 99%

Allylpyrocatechol, isolated from betel leaf ameliorates thyrotoxicosis in rats by altering thyroid peroxidase and thyrotropin receptors

Panda

Sikdar

Biswas

et al. 2019

Sci Rep

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Allylpyrocatechol (APC) was isolated from betel leaf and its possible role in L-thyroxin (L-T 4 )-induced thyrotoxic rats was evaluated. The disease condition, thyrotoxicosis was confirmed by higher levels of thyroid hormones and low thyrotropin (TSH) in serum. Increased hepatic activities of 5′-mono-deiodinase(5′D1), glucose-6-phospatase (G-6-Pase); serum concentrations of alanine transaminase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase(LDH) and tumour necrosis factor-alpha(TNF-α) were observed in thyrotoxic rats. Hepatic lipid peroxidation(LPO) was also increased and the endogenous antioxidants were depleted in these rats. In western blot analysis thyroid peroxidase expression was found to be reduced, whereas thyrotropin receptor(TSHR) expression was enhanced in thyroid gland of these animals. On the other hand, APC treatment in thyrotoxic rats decreased the levels of serum thyroid hormones, ALT, AST, TNF-α and LDH, as well as hepatic 5′ D1 and G-6-Pase activities. However, it increased the serum TSH levels. APC also reduced the hepatic LPO and increased the cellular antioxidants in thyrotoxic rats. However, expression of TSHR was inhibited and TPO was increased by APC. The test compound also improved histological features in both liver and thyroid. Present report appears to be the first one that indicates the positive role of APC in ameliorating T 4 -induced thyrotoxicosis.

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Section: Introductionmentioning

confidence: 99%

Allylpyrocatechol, isolated from betel leaf ameliorates thyrotoxicosis in rats by altering thyroid peroxidase and thyrotropin receptors

Panda

Sikdar

Biswas

et al. 2019

Sci Rep

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“…Thyroid scintigraphy usually shows a low uptake pattern 1. Furthermore, in clinical practice, sometimes a patient's symptoms are not associated with the laboratory findings, as it happened in our case.…”

Section: Differential Diagnosismentioning

confidence: 49%

Intermittent and recurrent episodes of subclinical hypothyroidism, central hypothyroidism and T3-toxicosis in an elderly woman

Megías¹,

Iglesias

Villanueva

et al. 2012

BMJ Case Reports

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Exogenous thyrotoxicosis is usually caused by ingestion of excessive amounts of thyroid hormone, which could be intentional or surreptitious (known as factitious thyrotoxicosis). Non-pharmacological exogenous thyrotoxicosis is an exceptional event. One example is alimentary thyrotoxicosis, which is caused by the ingestion of meat or sausage containing thyroid tissue, inadvertently mixed with traces of muscles and other tissues of the animal's neck (hamburger thyrotoxicosis). We report for the first time a patient who had recurrent episodes of triiodothyronine (T3) toxicosis for several years due to inadvertent chronic consumption of contaminated traditional Spanish cold meat with porcine thyroid.

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“…Other differential diagnoses in such patients include thyroiditis (painless, acute, subacute, or drug-induced), iatrogenic thyrotoxicosis, thyrotoxicosis factitia, struma ovarii, and metastases from thyroid cancer (mostly from the follicular cell type). [ 2 3 ] A radioiodine TBS can help to diagnose struma ovarii and metastatic thyroid cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Calculation of the I-131 dose using radiation dosimetry is recommended, and the antithyroid drug should be given before I-131 treatment to decrease the chance of a thyroid storm. [ 2 ]…”

Section: Discussionmentioning

confidence: 99%

A case report of hyperfunctioning metastatic thyroid cancer and rare I-131 avid liver metastasis

2016

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Thyroid cancer is usually, relatively hypofunctional; most patients with thyroid cancer are clinically euthyroid. The combination of thyroid cancer and thyrotoxicosis is not common. We herein, report a case of follicular thyroid cancer with hyperfunctioning metastasis in a 43-year-old woman who presented with thyrotoxicosis, a cold right thyroid nodule, and low I-131 uptake at the thyroid bed. An additional total body scan with I-131 revealed a large radioiodine avid osteolytic bone metastasis with soft tissue masses and liver metastasis. The patient received treatment with total thyroidectomy, methimazole, and I-131 at a cumulative dose of 600 mCi along with recombinant human thyroid-stimulating hormone before the first I-131 treatment and palliative radiation. The patient had normal liver function test and experienced a mild degree of bone marrow suppression after I-131. At the 2-year follow-up, the patient was still alive with the progression of bone metastases but was doing well with less severe thyrotoxicosis, good ambulation, and an Eastern Cooperative Oncology Group performance status of 2. Clinicians should be aware of the unusual concurrent presentation of thyrotoxicosis and thyroid cancer, a differential diagnosis in patients with thyrotoxicosis and low or normal radioiodine uptake over the neck and also potential pitfalls during radionuclide treatment.

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Uncommon Causes of Thyrotoxicosis

Cited by 28 publications

References 162 publications

Allylpyrocatechol, isolated from betel leaf ameliorates thyrotoxicosis in rats by altering thyroid peroxidase and thyrotropin receptors

Allylpyrocatechol, isolated from betel leaf ameliorates thyrotoxicosis in rats by altering thyroid peroxidase and thyrotropin receptors

Intermittent and recurrent episodes of subclinical hypothyroidism, central hypothyroidism and T3-toxicosis in an elderly woman

A case report of hyperfunctioning metastatic thyroid cancer and rare I-131 avid liver metastasis

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