Thyroid dysfunction was more frequent in patients who had undergone mantle or neck radiotherapy.
Hypothyroidism was most often revealed from the 6th year on following radiotherapy. Thyroid autoantibody positivity was found to be more frequent in patients with thyroid dysfunction, and conversely, thyroid dysfunction was more frequent among the 28 patients with autoantibody positivity.
For substitution or isohor- ABC © S. Copyright © S. During the followup of long-term survivals, it has become evident that the treatment protocols used for HD may induce several malignant and nonmalignant late complications, which, presenting themselves years or decades after the successful treatment, decrease the survival rate of the patients and deteriorate their quality of life [3—5].
The diseases of the thyroid gland represent perhaps the most common, usually nonmalignant late complications, with the prevalence of hypothyroidism [6—10]. Neck radiotherapy RT may play a role in the development of hypothyroidism and the effect of chemotherapeutic agents on the thyroid has not yet been clarified [6—9, 11, 12]. Some studies were based on the detection of thyroid autoantibodies AB but since they included only a small number of cases, the data presented are contradictory as regards the pathological role of thyroiditis [6, 11, 13—15].
This has led us to detect the levels of antithyroid antibodies while regularly following up our HD patients with complete remission, and in case of positivity, we performed further examinations including thyroid ultrasonography and fine needle aspiration cytology.
The results are presented in this paper.
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Patients and Methods HD patients with complete remission for at least 1 year were followed up in our department between and The diagnosis of HD was based on histological examination in each case; the subtypes were categorized according to Lukes and Butler .
The clinical stage was determined using the Ann Arbor classification and their Cotswolds revision [17, 18]. For the evaluation of thyroid hormone levels and for the determination of the supersensitive thyroid stimulating hormone sTSH LIA-mat TSH assay was used, which is based on a noncompetitive, immunoluminometric sandwich technique Byk-Sangtec.
Using the above methods, normal ranges should be as follows: sTSH: 0. Hypothyroidism is considered to be subclinical, chemical or compensated if sTSH values alone are elevated while FT3 and FT4 are in könyök és térdízületek fájnak normal range.
The majority of patients have been followed up for thyroid function on a yearly basis. Thyroid dysfunction was considered at the first presentation of pathological thyroid hormone results. Normal ranges were as follows: antithyroid peroxidase antibody: 0.
Német kiadású könyvek klinikai orvostudomány területén Rövid leírás: The aim of this book is to harmonize the field of Otorhinolaryngology, Head and Neck Surgery and its interdisciplinary subjects within the European Community; to present the state-of-the-art in the field and to give standards for diagnostic and therapeutic procedures. It also covers such topics as patient evaluation and treatment, basic surgical procedures, thyroiditis ultrasound pictures well as more conservative approaches. The book is authored by renowned experts throughout Europe, and features a layout that facilitates quick and easy retrieval of information. Hosszú leírás: The aim of this book is to harmonize the field of Otorhinolaryngology, Head and Neck Surgery and its interdisciplinary subjects within the European Community; to present the state of the art in the field and to give standards for diagnostic and therapeutic procedures. The aim of this book is to harmonize the field of Otorhinolaryngology, Head and Neck Surgery and its interdisciplinary subjects within the European Community; to present the state of the art in the field and to give standards for diagnostic and therapeutic procedures.
Ultrasound diagnosis of the thyroid was performed using a 7. In the case of an increased antithyroid AB titer, ultrasound-guided thyroiditis ultrasound pictures needle thyroid biopsy was performed from both lobes.
Otorhinolaryngology, Head and Neck Surgery
For smear dyeing, buffered, modified Giemsa was employed . In the statistical analysis ¯2 testthe p! In cases Hormone analyses were continually performed in a smaller group of patients since thyroid dysfunction was suspected because of clinical symptoms, while in the majority of cases thyroid dysfunction was revealed during the course of a wideranging follow-up. Table 1 shows mean hormone results, standard deviation and minimum-maximum values.
Table 2 compares the characteristics of HD patients with normal and pathological thyroid function subclinical and manifest hypothyroidism together.
The groups do not show significant differences as regards mean age, age distribution in decades, histological subtypes, disease stage, general symptoms, and whether lymphangiography LAG was performed or not. Hypothyroidism was 1.
A significant difference, however, is that thyroid AB positivity was 3 times more common in patients with pathological thyroid function than in the euthyroid group. Out of the 38 HD patients with confirmed laboratory findings thyroiditis ultrasound pictures hypothyroidism, 7 had typical clinical symptoms.
In 16 cases certain symptoms were evidently related to the disease after laboratory results had been evaluated. Table 3 compares the characteristics of HD patients with AB positivity and negativity.
Characteristics of patients with HD by thyroid function Characteristics Thyroid function normal Total patients Table 4. Thyroid dysfunction was revealed in Out of the 28 HD patients with thyroid AB positivity, 26 underwent ultrasound examination and cytological analysis of the thyroid; table 4 shows the results.
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In 1 case, neither ultrasound scanning nor cytological analysis suggested thyroiditis but the patient was repeatedly AB-positive and laboratory analysis revealed subclinical hypothyroidism. Table 5 shows previous treatment for HD and the relationships between thyroid abnormalities.
However, no significant differences had been found between thyroid antibodies and previous treatment. Figure 1 shows the length of time between receiving neck or mantle RT and the onset or diagnosis of hypothyroidism.
Though the differences are not significant, and yearly data for thyroid function are available only for the past 4—5 years, it is clear that the onset of hypothyroidism is more remarkable from the 6th year following RT. Their long-term follow-up results have highlighted the fact that the 5- to 10year survival rate is only one, though a very important result of the therapy, since late complications of these therapeutic methods may, after years, significantly decrease the chances of survival and deteriorate the quality of life [3—5].
This is due to not only the different diagnostic and therapeutic methods of HD but also thyroiditis ultrasound pictures sensitivity of the laboratory tests employed.
The tests we used were sensitive, and the results were characteristic of the functional groups. No differences were found in the histological subtypes, disease stage, age at the diagnosis of HD between the groups of patients with normal and decreased thyroid function [9, 11, 12], though Green et al.
Add Stem Substances and preparations, or the breakdown products of such, which have been proved to possess carcinogenic or mutagenic properties or properties which may affect steroidogenic, thyroid, reproduction or other endocrine-related functions in or via the aquatic environment. Eurlexq4 Iodine contributes to the normal production of thyroid hormones and normal thyroid function A C-vitamin hozzájárul a normál kollagénképződéshez és ezen keresztül a porcok normál állapotának, működésének fenntartásához. EurLex-2 Only you don't have to remember the past in the same way you don't have to think about how you work your thyroid gland, or whatever else it is that your organs do. Csak a múltra nem kell emlékezned, mint ahogy arra sem kell emlékezned, hogyan működsz, a harmadik szemed, vagy bármi más amit az organizmusok tesznek. QED Thyroid cancer is one of those diseases that's caused by radiation.
In accordance with data in the literature [9, 11], hypothyroidism was found 1. Some authors believe that during disease staging and in the process of examinations using LAG and other iodinated contrast material, the iodide load may inhibit thyroid function, sTSH increases, which, stimulating cell division, results in an increased sensitivity for RT [8, 30, 31]. Studies have reported different conclusions on the relationship between LAG and hypothyroidism [8, 29, 30].
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Like the majority of these studies, we have not found any relationship between the iodinated load and thyroid hypofunction [6, 11]. We have found significant alterations for the confirmation of the relationship between the therapeutic methods for HD and the frequency of hypothyroidism [6—9, 11, 12].
Thyroid hypofunction was more frequent in patients who had been given mantle or neck irradiation — either RT alone or combined with ChT — than in patients who had thyroiditis ultrasound pictures received such RT treatment. This shows that in the case of combined treatment, ChT does not increase the incidence of hypothyroidism. We found that hypothyroidism developed most often the 6th year following RT, which is in accordance with the findings of Schimpff et al.
Several authors assume that autoimmune processes are responsible for the development of hypothyroidism following neck RT.
According to them, autoantigens are freed from the thyroid damaged by irradiation, which may lead to the development of thyroiditis [6, 8, 13]. Thyroiditis ultrasound pictures also noticed that the incidence of thyroid antibodies and the elevated sTSH level were less frequent in patients who had also received ChT than in patients who had received only RT, so they supposed that ChT, through its immunosuppressive effect, might control autoimmune thyroiditis induced by irradiation and thus inhibits the development of hypothyroidism .
Hypothyroidism and Thyroiditis after Therapy for Hodgkin’s Disease
The direct effect of chemotherapeutic agents on the thyroid, however, has not yet been clarified [9, 12]. According to data in the literature, the incidence not only of hypothyroidism but also that of Graves-Basedow disease hyperthyroidism was found to be higher following neck irradiation for HD; we had 2 cases of this.
It is thyroiditis thyroiditis ultrasound pictures pictures that thyroid damage, the release of autoantigens or T helper lymphocyte overbalance may trigger the autoimmune process [6, 8, 13]. Our results show that thyroid AB positivity was present in one third of the patients with thyroid dysfunction 3 times as much as compared to the other groupwhich suggests the possibility of autoimmune processes.
Conversely, thyroid dysfunction was noticed in more than half of the patients with AB positivity. Thus we cannot confirm the assumption that it is the autoantigens released from the thyroid damaged by RT that induce the development of thyroiditis.
This is confirmed by the observation that — under similar treatment — AB positivity was found 4 times more frequently in women than in men. It, however, did not reach the ratio of 7—8 times, which is quite common in autoimmune thyroiditis.
The fact that thyroid AB positivity was much more frequent in our HD patients one fifth as compared to the healthy population suggests that besides irradiation damage of the thyroid, hypothyroidism may develop in HD patients as a result of thyroiditis, which appears independently of the type of therapy employed.
Then by what immunological factors can we explain the thyroiditis that develops in HD patients?
It is assumed that changes in the immune reactivity of HD patients, immune regulation disorders, altered cytokine network and increased susceptibility to infections might also play a role in the development of thyroiditis [32, thyroiditis ultrasound pictures. The clinical picture of hypothyroidism following treatment for HD is usually ambiguous and often misleading since the most common symptoms are either associated with HD or are considered to be the late effects of antineoplastic therapy.
We had very few patients with manifest clinical symptoms, which underlines the necessity of regular laboratory control. If pathological laboratory findings are accompanied by symptoms of hypothyroidism, substitution therapy should be started.
There is no unanimous consent on the hormone therapy of patients with subclinical hypothyroidism confirmed by laboratory findings but without symptoms. However, several authors suggest substitution therapy for this group of patients, too, and their reason is that a raised sTSH level increases the risk of benign and malignant focal alterations in the thyroid thyroiditis ultrasound pictures, 10]. In HD patients with confirmed thyroiditis and normal thyroid function, hypothyroidism can be prevented by administering levothyroxine as isohormone therapy.
Our results emphasize the necessity of routine examination and analysis of thyroid function and thyroid AB during the follow-up of HD patients; regular control will help in the early detection and prevention of late complications.
In accordance with the latest recommendations for the therapy of HD patients, more attention should be paid to the protection of the thyroid and to the prevention of possible late complications, such as hypothyroidism, when planning the treatment.
Semin Radiat Oncol ;— Blood ;—
Eurlexq4 A pajzsmirigy rák az egyik, sugárzással összefüggő rákfajta. Thyroid cancer is one of those diseases that's caused by radiation. Hence, when the body requires more thyroid hormones, the gland secretes T4 into the bloodstream, and from there the T4 and its derivatives can affect all body cells. In addition, the Authority underlined a critical area of concern for propineb related to the endocrine-disrupting properties of the relevant metabolite 4-methylimidazolidinethione PTU which is classified as toxic for reproduction category 2 and has the thyroid as a target organ for toxicity. Eurlexq4 I have a thyroid condition.