158 research outputs found
Initial response of young people with thyrotoxicosis to block and replace or dose titration thionamide
\ua9 2022 The authors Published by Bioscientifica Ltd.Objective: Patients with thyrotoxicosis are treated with anti-thyroid drug (ATD) using block and replace (BR) or a smaller, titrated dose of ATD (dose titration, DT). Design: A multi-centre, phase III, open-label trial of newly diagnosed paediatric thyrotoxicosis patients randomised to BR/DT. We compared the biochemical response to BR/DT in the first 6 months of therapy. Methods: Patients commenced 0.75 mg/kg carbimazole (CBZ) daily with randomisation to BR/DT. We examined baseline patient characteristics, CBZ dose, time to serum thyroid-stimulating hormone (TSH)/free thyroxine (FT4) normalisation and BMI Z-score change. Results: There were 80 patients (baseline) and 78 patients (61 female) at 6 months. Mean CBZ dose was 0.9 mg/kg/day (BR) and 0.5 mg/kg/day (DT). There was no difference in time to non-suppressed TSH concentration; 16 of 39 patients (BR) and 11 of 39 (DT) had suppressed TSH at 6 months. Patients with suppressed TSH had higher mean baseline FT4 levels (72.7 vs 51.7 pmol/L; 95% CI for difference 1.73, 31.7; P = 0.029). Time to normalise FT4 levels was reduced in DT (log-rank test, P = 0.049) with 50% attaining normal FT4 at 28 days (95% CI 25, 32) vs 35 days in BR (95% CI 28, 58). Mean BMI Z-score increased from 0.10 to 0.81 at 6 months (95% CI for difference 0.57, 0.86; P < 0.001) and was greatest in patients with higher baseline FT4 concentrations. Conclusions: DT-treated patients normalised FT4 concentrations more quickly than BR. Overall, 94% of patients have normal FT4 levels after 6 months, but 33% still have TSH suppression. Excessive weight gain occurs with both BR and DT therapy
The Development of Mouse APECED Models Provides New Insight into the Role of AIRE in Immune Regulation
Autoimmune polyendocrinopathy candidiasis ectodermal dystrophy is a rare
recessive autoimmune disorder caused by a defect in a single gene called AIRE
(autoimmune regulator). Characteristics of this disease include a variable
combination of autoimmune endocrine tissue destruction, mucocutaneous
candidiasis and ectodermal dystrophies. The development of Aire-knockout
mice has provided an invaluable model for the study of this disease. The aim
of this review is to briefly highlight the strides made in APECED research using
these transgenic murine models, with a focus on known roles of Aire in
autoimmunity. The findings
thus far are compelling and prompt additional areas of study which are discussed
Impact of Methimazole Treatment on Magnesium Concentration and Lymphocytes Activation in Adolescents with Graves’ Disease
Clinical disorders of extracellular calcium-sensing and the molecular biology of the calcium-sensing receptor
Glucocorticoid Replacement: Insufficient evidence to favour prednisolone over hydrocortisone in glucocorticoid replacement
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