Alterations of thyroid volume and nodular size during and after pregnancy in a severe iodine-deficient area

WOS: 000344176900017PubMed: 24811142ObjectiveThe effects of pregnancy on thyroid nodules were investigated in a few number of studies. We aimed to evaluate the prevalence of thyroid nodules, the changes in size, volume and number of nodules during pregnancy and after delivery in pregnant women. Design and methodsThis prospective study was performed in a severe iodine-deficient area and included 83 pregnant women (mean age 30455years). We evaluated thyroid hormone levels, ultrasound examination of thyroid and urine iodine concentration (UIE) at each trimester and at 3-month post-partum period (PP). All patients with thyroid nodules >1cm underwent fine-needle aspiration biopsy (FNAB) after the last visit at the PP. ResultsTwenty-six women had thyroid nodules on thyroid ultrasonography at the first trimester. the volume of single/dominant nodule showed enlargement during pregnancy and remained at the PP; however, it was not significant (first trimester: 083 +/- 08ml; second trimester: 092 +/- 1ml; third trimester: 099 +/- 12ml; PP: 092 +/- 12ml). the maximum diameter of single/dominant nodule in the third trimester of pregnancy (126 +/- 54mm) was greater than the first trimester (119 +/- 48mm) (P=0002). the number of nodules did not change during pregnancy. the mean TV increased during pregnancy and remained 3months after delivery (P<0001), and the maximum value of TV was reached in the third trimester (142 +/- 79ml). FNAB results revealed a 66% prevalence of malignancy among the nodules. ConclusionsThyroid nodules were present in 301% of pregnant women. While size of the single/dominant thyroid nodule increased significantly during pregnancy, the number of nodules did not change

Clinical characteristics and therapeutic outcomes of paroxysmal nocturnal hemoglobinuria patients in Turkey: a multicenter experience

The aim of this study is to collect paroxysmal nocturnal hemoglobinuria (PNH) patient data from hematology centers all over Turkey in order to identify clinical features and management of PNH patients. Patients with PNH were evaluated by a retrospective review of medical records from 19 different institutions around Turkey. Patient demographics, medical history, laboratory findings, and PNH-specific information, including symptoms at the diagnosis, complications, erythrocyte, and granulocyte clone size, treatment, and causes of death were recorded. Sixty patients (28 males, 32 females) were identified. The median age was 33 (range; 17-77) years. Forty-six patients were diagnosed as classic PNH and 14 as secondary PNH. Fatigue and abdominal pain were the most frequent presenting symptoms. After eculizumab became available in Turkey, most of the patients (n = 31/46, 67.4%) were switched to eculizumab. Three patients with classic PNH underwent stem cell transplantation. The median survival time was 42 (range; 7-183 months) months. This study is the first and most comprehensive review of PNH cases in Turkey. It provided us useful information to find out the differences between our patients and literature, which may help us understand the disease