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INSERM 1086 ANTICIPE, Caen University, Caen, France
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prostate cancer and were related to chronic autoimmune thyroiditis (CAT) ( 4 , 5 ). Diffuse thyroid uptake is also a well-known pattern in patients with CAT on 18 F-Fluorodeoxyglucose ( 18 FDG) PET/CT ( 6 , 7 ). Although some authors showed that thyroid
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Hakaru Hashimoto described 4 patients with a hitherto unknown cause for goitre, struma lymphomatosa, a century ago. He was careful to distinguish this from Riedel thyroiditis but it has become clear that fibrosis and atrophy of the thyroid are indeed components of Hashimoto thyroiditis, and in rare cases IgG4-related sclerosing disease may be an outcome. Although the cause of the lymphocytic infiltration was unknown to Hashimoto, we now know through the pioneering studies of N.R. Rose and E. Witebsky [J Immunol 1956;76:417–427] that this condition is the archetype for autoimmune destruction as a disease mechanism. In the last two decades in particular, there has been huge interest in unravelling the genetic basis for this and related autoimmune disorders. The list of polymorphisms associated with autoimmune thyroid disease grows each year, and in the case of vitiligo, which is frequently found in association with thyroid autoimmunity, we know that 27 separate susceptibility loci account for less than 20% of the heritability of this condition. Environmental and existential factors may turn out to be just as complex in number and in interactions. We can thus imagine a ‘Swiss cheese’ model for the causation of autoimmune thyroid disease, in which the effects of cumulative weaknesses line up – like the holes in slices of cheese – to allow the catastrophic event of autoimmune destruction to occur.
Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
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Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal
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Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal
Public Health Unit, ACES Baixo Mondego, Coimbra, Portugal
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Department of Endocrinology, Hospital University Centre of São João, Porto, Portugal
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Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal
Department of Pathology, Faculty of Medicine of the University of Porto, Porto, Portugal
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proinflammatory cytokines involved in the pathogenesis of chronic autoimmune thyroiditis (HT) ( 10 , 11 ). Our previous study showed that individuals with some of these genotypes were significantly more likely to have Hashimoto’s thyroiditis (HT) ( 11 ). The
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;87:370-378. 18258627 16 Winther KH, Watt T, Bjørner JB, Cramon P, Feldt-Rasmussen U, Gluud C, Gram J, Groenvold M, Hegedüs L, Knudsen N, Rasmussen ÅK, Bonnema SJ: The chronic autoimmune thyroiditis quality of life selenium trial (CATALYST): study protocol for a
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Objectives: Pregnancy induces changes in thyroid function, and thyroid dysfunction during gestation is associated with adverse outcomes. We examined the management of subclinical hypothyroidism and chronic autoimmune thyroiditis in pregnancy among Italian and Romanian endocrinologists. Methods: Members of the Associazione Medici Endocrinologi (AME) and Romanian Society of Endocrinology (RSE) were invited to participate in a web-based survey investigating the topic. Results: A total of 902 individuals participated in the survey, 759 of whom completed all sections. Among the respondents, 85.1% were aware of the 2017 American Thyroid Association guidelines about thyroid disease and pregnancy, and 82.9% declared that thyroid-stimulating hormone (TSH) screening at the beginning of pregnancy should be warranted. In a patient negative for peroxidase antibodies, 53.6% considered 2.5 mIU/L and 26.2% considered 4.0 mIU/L as the upper normal limit of TSH, and 50% would treat a patient with TSH 3.5 mIU/L with levothyroxine. About 20% did not suggest iodine supplementation. Isolated hypothyroxinemia detected in the first trimester would be treated by 40.8%. In patients undergoing ovarian stimulation, a TSH < 2.5 mIU/L would be targeted by 70%. Conclusions: Respondents globally appeared well informed about the management of thyroid autoimmunity and subclinical hypothyroidism in pregnancy. A more aggressive attitude in implementing iodine supplementation would be desirable. Most endocrinologists were convinced about an evident association between mild thyroid impairment and adverse outcomes in pregnancy, thus using a TSH value of 2.5 mIU/L as the threshold for diagnosing hypothyroidism and starting levothyroxine in pregnant women.
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the thyroid phenotypes investigated [ 9 ]. Chronic Autoimmune Thyroiditis in Euthyroid Individuals While 3 out of 4 respondents (72%) thought that there was evidence supporting Se use, 79% prescribed it sometimes, often, or always. Half of
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Significantly Reduces Thyroid Autoantibody Levels in Patients with Chronic Autoimmune Thyroiditis: A Systematic Review and Meta-Analysis . Thyroid . 2016 Dec ; 26 ( 12 ): 1681 – 92 . 10.1089/thy.2016.0256 27702392 1050-7256 12 Winther KH
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hormone concentrations, and titers of autoantibodies in patients with chronic autoimmune thyroiditis (CAIT). The authors are to be congratulated on the excellent planning and conduction of this randomized controlled trial (RCT), which has provided several
Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Institute of Clinical Medicine, Faculty of Health and Clinical Sciences, Copenhagen University, Copenhagen, Denmark
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QualityMetric Inc, Johnston, Lincoln, Rhode Island, USA
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Internal Medicine Research Unit, University Hospital of Southern Jutland, Aabenraa, Denmark
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Institute of Clinical Medicine, Faculty of Health and Clinical Sciences, Copenhagen University, Copenhagen, Denmark
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Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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chronic autoimmune thyroiditis quality of life selenium trial’ (CATALYST) ( 21 ), we aimed to investigate the effect of selenium supplementation on disease-specific QoL in patients with hypothyroidism due to AIT. Methods Study design and
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-term follow-up of antithyroid peroxidase antibodies in patients with chronic autoimmune thyroiditis (Hashimoto's thyroiditis) treated with levothyroxine. Thyroid 2008;18:755-760. 10.1089/thy.2008.0008 18631004 12 Chen PL, Wang PY, Hsu HY: Reversible
