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Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
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Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
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Amsterdam Public Health Research Institute, Amsterdam UMC, The Netherlands
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Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan, Amsterdam, The Netherlands
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Laboratory Specialized Diagnostics & Research, Department of Laboratory Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, The Netherlands
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conducted a systematic search in PubMed and Embase. In addition, we searched the following websites and guideline-specific databases: Guidelines International Network (G-I-N; http://g-i-n.net ), Trip database ( http://www.tripdatabase.com ), and Clinical
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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fluid biomarkers such as thyroid-stimulating hormone receptor antibody, and imaging biomarkers like elevated signal intensity (SI) of orbital tissues ( 3 , 6 ). However, there is no consensus on the specific markers used in the models and there are no
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hormones and can lead to hypothyroidism ( 7 ). Clinical manifestations of RTHβ depend on the severity of the mutation and individual and tissue-specific differences in resistance to thyroid hormones. Elevated thyroid hormone levels compensate for resistance
Institute of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
Wallenberg’s Centre of Molecular and Translational Medicine, Region Västra Götaland, Sweden
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Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden
Gothenburg Centre for Person Centred-Care (GPCC), Göteborg, Sweden
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Background
Mood disorders are common in Graves’ disease despite treatment. The pathogenic mechanisms involved are unknown and so is whether previous psychiatric disease influences these symptoms.
Methods
This is a longitudinal study conducted in Sweden on 65 women with newly diagnosed Graves’ disease and 65 matched controls. Participants were examined during hyperthyroidism and after 15 months of treatment. Examinations included blood sampling, and psychiatric testing with the Comprehensive Psychopathological Rating Scale for Affective Syndromes and the Structured Clinical Interview for DSM-IV – Axis I Disorders. We also performed two analyses of a national population-based registry to determine previous psychiatric diagnoses and previous prescriptions of psychoactive drugs in (i) all patients we asked to participate and (ii) all Swedish women given a diagnosis of hyperthyroidism during 2013–2018, comparing them to matched controls.
Results
There was no increased previous psychiatric comorbidity in Graves’ patients compared to controls. There was no higher prevalence of psychiatric diagnoses and prescriptions of psychoactive drugs between (i) included GD patients compared to those who declined participation and (ii) women with a hyperthyroidism diagnosis in 5 years prior to their diagnosis, compared to matched controls. Depression scores and anxiety scores were higher in patients compared to controls both during hyperthyroidism (depression (median (IQR): 7.5 (5.0–9.5) vs 1.0 (0.5–2.5) P < 0.001), anxiety: 7.7 (5.0–11) vs 2.5 (1.0–4.0) P < 0.001) and after treatment (depression: 2.5 (1.5–5.0) vs 1.5 (0.5-3.5) P < 0.05), anxiety: 4.0 (2.5–7.5) vs 3.0 (1.5-5.0) P < 0.05). Patients with a previous psychiatric condition, mild eye symptoms, and a younger age had more anxiety at 15 months compared to patients without these symptoms and a higher age (all p<0.05).
Conclusion
Graves’ disease affects patients’ mood despite treatment. A previous psychiatric condition, mild eye symptoms, and a younger age increase the vulnerability for long-lasting symptoms and require specific attention.
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
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Department of Endocrinology and Diabetes, Örebro University Hospital, Örebro, Sweden
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Thyroid Federation International, Kungsbacka, Sweden
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Swedish Thyroid Association, Stockholm, Sweden
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Swedish Thyroid Association, Stockholm, Sweden
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Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
Sweden and Wallenberg Center for Molecular and Translational Medicine, Västra Götaland Region, Göteborg, Sweden
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, 10 ). When the treatment goal is to improve patient function and well-being rather than prolong life, the patient's perception of their care is central and an important part of QoL measurement ( 11 ) and may need specific supportive actions. The
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significantly lower the risk for relapse of GD when added to the standard treatment. Although immunosuppressive drugs involved in the study included mycophenolic acid but not vedolizumab ( 14 ), specific data are lacking regarding the underlying vaccine immune
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work did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector. Consent Written consent has been obtained from the patient for publication of the results of procedures which had been used for
Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
Faculty of Medicine, University of Porto, Porto, Portugal
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Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
Faculty of Medicine, University of Porto, Porto, Portugal
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Faculty of Medicine, University of Porto, Porto, Portugal
North Lisbon University Hospital Center, Lisbon, Portugal
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University Hospital Center of São João, Porto, Portugal
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University Hospital Center of São João, Porto, Portugal
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Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
Faculty of Medicine, University of Porto, Porto, Portugal
University Hospital Center of São João, Porto, Portugal
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Faculty of Medicine, University of Porto, Porto, Portugal
University Hospital Center of São João, Porto, Portugal
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Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
Faculty of Medicine, University of Porto, Porto, Portugal
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the result of a second RNA extraction was negative for all genes after first extraction had been positive for two of the genes ( Table 2 ). In order to exclude some potential non-specificity of the viral genes amplified in the RT-PCR, we have also
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studies from East Asia have emphasized the significance of genetic variants as a reason for the higher prevalence of TPP. Loss of function mutations in the skeletal muscle-specific inward rectifying K+ (Kir) channel, particularly Kir2.6, were found to be
Department of Clinical Institute, Aalborg University, Aalborg, Denmark
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Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
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Department of Clinical Institute, Aalborg University, Aalborg, Denmark
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Department of Clinical Institute, Aalborg University, Aalborg, Denmark
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. Declaration of interest The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported. Funding This work did not receive any specific grant from any funding agency in the