Response to Letter to Levothyroxine absorption test results in patients with TSH elevation resistant to treatment

[No Abstract Available

US findings in euthyroid patients with positive antithyroid autoantibody tests compared to normal and hypothyroid cases

WOS: 000321103300001PubMed ID: 23302287PURPOSE We aimed to compare the ultrasonographic and laboratory parameters of euthyroid patients who have only positive antithyroid autoantibody test results with those of patients with a hypothyroid status of Hashimoto's thyroiditis (HT). MATERIALS AND METHODS Thirty-five patients with newly diagnosed HT, 35 euthyroid patients who have autoantibodies against thyroid peroxidase (TPOAb) and/or thyroglobulin (TgAb), and 40 controls were enrolled in the study. Plasma free T3, free T4, thyroid stimulating hormone, TPOAb, and TgAb levels were obtained retrospectively. For gray-scale ultrasonography, each thyroid gland of all individuals graded with gray-scale grading (GSG), which was determined according to the gland size, parenchymal structure, echogenicity, micronodulation, contour irregularity, and existence of hyperechoic septa. For Doppler analysis, the peak systolic velocity (S), resistive index (RI), and pulsatility index (PI) values were obtained from the superior thyroid artery (STA) and intrathyroidal artery (ITA). The color pixel ratio (CPR), which was computationally evaluated from a power Doppler image of all individuals, was used for quantification of the intrathyroidal vascularity. RESULTS Although the mean GSG values were higher in the HT and antibody-positive groups than they were in the control group, there was no significant difference between the HT and antibody-positive groups. The three study groups demonstrated no statistically significant difference with regard to the S, RI, or PI variables obtained from the STAs and ITAs. Although the CPR values were highest in the HT group, the difference between the HT and antibody-positive group did not reach statistical significance. CONCLUSION The euthyroid antibody-positive group revealed gray-scale and Doppler ultrasonographic findings that were similar to those of the HT group

Interleukin-10 (-1082G/A) Gene Polymorphism in Patients With Type 2 Diabetes With and Without Nephropathy

WOS: 000300591000004PubMed ID: 21861711Objective: Interleukin (IL)-10 is a major anti-inflammatory cytokine that plays a crucial role in the regulation of the immune system. IL-10 has met the criteria for an anti-inflammatory and an immunosuppressive cytokine, its activity may be important for clinical outcome of diabetic nephropathy (DN). We aimed at evaluating the relation between the genotypic and allelic frequencies of the IL-10 (-10820/A) polymorphisms, and their association with the risk to develop DN in the Turkish population. Research Design and Methods: The (IL)-10 (-1082G/A) genotypes were retrospectively determined in 43 patients with nephropathy and 48 without nephropathy and a control group of 112 healthy individuals. The polymorphisms were analyzed by polymerase chain reaction restriction fragment length polymorphism. Results: This genotype distribution was different between control subjects and patients with type 2 diabetes in which 24.2% were AA, 75.8% were GA, and 0% were GO (p 0.05). The genotype frequencies were AA, 27.9%; GA, 72.1%; and GG, 0% in patients with diabetes with nephropathy versus AA, 20.8%; GA, 79.2%; and CC, 0% in those without nephropathy (p > 0.05). Conclusions: The polymorphisms of IL-10 (-10820/A) genes were significantly associated with the occurrence of patients with type 2 diabetes. The IL-10 (-10820/A) genotype and allele frequencies were not different between patients with diabetes with nephropathy and those without nephropathy. Therefore, we conclude that the IL-10 (-10820/A) gene polymorphism is not associated with the development of DN in Turkish patients with type 2 diabetes

Adult Nesidioblastosis With Hypoglycemia Mimicking an Insulinoma: A Challenging Case

WOS: 000443007400007Introduction: Nesidioblastosis is the primary cause of persistent hyperinsulinemic hypoglycemia in infants but it is a rare entity for the adults. Nesidioblastosis is defined as an increase of pancreatic beta cells in number and in size. Case Presentation: We describe a rare case of nesidioblastosis with positive endoscopic ultrasonography result mimicking an insulinoma. A 35-year-old female patient had hypoglycemic episodes with high insulin level. Her investigation revealed low venous plasma glucose, high insulin and C-peptide level with positive 72-hour fasting test suggestive of hyperinsulinemic hypoglycemia. Abdominal computed tomography did not show any mass lesion. Endoscopic ultrasonography revealed a mass lesion sized as 1 cm in diameter in the pancreas. But, insulinoma like lesion couldn't be found intra-operatively. It was decided to perform distal pancreatectomy. After distal pancreatectomy, nesidioblastosis was diagnosed histopathologically. The patient was free from her symptoms after surgery. Conclusion: This case illustrates difficulties and limitations of imaging modalities and false positive result of EUS in a case of nesidioblastosis. When there is no insulinoma like lesion during operation, operation should be performed as gradient guided pancreatectomy by the way of selective arterial calcium injection test

Miscarriage, and TNF-alpha and osteopontin relationship in women patients with Hashimoto's thyroiditis

WOS: 000308949200016PubMed ID: 22558919Objective: Infertility and reproductive impairment can be compromised by abnormalities in both endocrine and immune system. TNF-alpha promotes apoptotic cell death in fetal membrane tissues and pro-inflammatory, proapoptotic, and procoagulant properties of TNF-alpha probably contribute to widely accepted abortogenic profile of this cytokine. The aim of this study was to assess the alteration in the levels of TSH, FT3, FT4, TNF-alpha, osteopontin in pregnant and controls. Methods: Study subjects were 28 pregnant women, 28 non-pregnant women, and 28 healthy controls. All subjects underwent venous blood drawing for levels of TNF-alpha, osteopontin, and also hormonal assays including the levels of anti-TPO, anti-TG antibodies, TSH, FT3, FT4. Results: Both patient and control groups are similar in terms of age. Pregnancy age in conceived patients is 23.64 +/- 2.040. No statistically meaningful relation was found in correlation analysis between TNF-alpha and osteopontin among the groups (p = 0.963). Anti-thyroglobuline antibody and anti-microsomal antibody levels were found to be higher in patients with non-pregnant patients with Hashimoto thyroiditis than the control group (p < 0.001). No statistically meaningful relation was found in terms of TNF-alpha (p = 0.66) and osteopontin serum levels (p = 0.50) in patient groups with or without miscarriage history. Conclusions: In our study, no statistically meaningful relation was found in terms of TNF-alpha and osteopontin serum levels in patient groups with and without miscarriage history