WCIM 2014
16 32nd World Congress of Internal Medicine (October 24-28, 2014)
OS-END-25 Endocrinology
Is There a Relation Between Thyroid Autoantibodies and MPV in Hypothyroidism ?
Serkan YÜCESAN2, Meral MERT1, Zeynep ERTÜRK2, Selçuk SEZIKLI2, Yildiz OKUTURLAR2, Özlem HARMANKAYA2
Bakirköy Dr. Sadi Konuk Research and Training Hospital, Endocrinology and Metabolism, Turkey1, Ba- kirköy Dr. Sadi Konuk Research and Training Hospital,Internal Medicine, Turkey2
Background: Hypothyroidism is a prevalent endocrine disorder. The most common cause of hypothyroidism is autoimmune thyroid disorder. A possible prothrombotic effect of elevated thyrotropin (TSH) has been suggested. MPV can be used as a marker of platelet activity. The objective of the present study was to determine if there is an association between the MPV, serum TSH and auto-antibody(anti-TPO and anti-TG) concentrations.
Methods: We studied 145 adults with hypothyroidism (TSH >5 mIU/L ). We evaluate the mean values MPVs and their relation with auto-antibody and TSH levels.
Results: 126 female and 19 male patients were in enrolled in our study retrospective- ly. The mean level of the MPV in all patients was 8.41 femtoliters (fL) and the mean level of TSH was 13.41 mIU/L. Negative correlation (r:0.015) between MPV, age, and anti-TPO ve TG was found. There was no correlation between MPV and TSH. There was no statistically signifi cant difference between TSH, MPV, auto-antibody levels and age.
Conclusions: MPV is reported to be increased in vascular events like atherosclerotic thrombosis and to be decreased in acute infl ammation. The main pathophysiological process is infl ammation in autoimmune thyroid disease, so the possible explanation of negative correlation between MPV and autoantibodies is autoimmunity.
OS-END-26 Endocrinology
Vitamin D Levels in Patients with Autoimmune Thyroid Disease
Esref ERTURK1, Meral MERT2, Yildiz OKUTURLAR1, Ozlem SOYLUK2, Pinar KARAKAYA2, Ozlem HARMANKAYA1, A.Baki KUMBASAR1
Bakirköy Dr. Sadi Konuk Research and Training Hospital, Internal Medicine, Turkey1, Bakirköy Dr. Sadi Konuk Research and Training Hospital, Endocrinology and Metabolism, Turkey2
Background: It is known that vitamin D has effects on the immune system. Vitamin D is an important immune system regulator. Several observational studies show that, vitamin D inhibits proinfl ammatory processes by suppressing the enhanced activity of immune cells that take part in the autoimmune reaction. It has been suggested that vitamin D may play a role in the pathogenesis of several endocrine diseases, such as autoimmune thyroid diseases, hyperparathyroidism, diabetes mellitus, Addison’s disease. In this study it is aimed to fi nd a correlation between autoimmune thyroid disease and vitamin D.
Methods: Thyroid function test result, calcium, PTH and vitamin D levels were com- pared between a control group of 35 healthy people and 35 patients with a cross-sec- tional thyroid autoimmune disease.
Results: Mean ages are found to be 41.8±14.08 years and 45.6±13.46 years in pa- tients and controls respectively. Mean vitamin D, calcium and parathormone (PTH) levels in patients and control group are found to be 18.6±9.5 vs 39.13 ±14.6 ng/ml, 7.9±0.16 vs 8.67±0.80 mg/dl, 50.7±25.86 vs 56.21±18.17 pg/ml, respectively. Vitamin D levels were found to be signifi cantly lower than the control group in patients with autoimmune thyroid disease. There was no difference between the levels of PTH.
Conclusions: Analyzing of vitamin D, PTH and calcium parameters should be consid- ered in patients with autoimmune thyroid diseases. Treatment of vitamin D defi ciency may help increase the quality of life in tyroid patients.
OS-END-27 Endocrinology
Ultrasonography-Guided Core Needle Biopsy is More Useful Than Repeat Fine Needle Aspiration for Thyroid Nodule with Inconclusive Result
Hendra ZUFRY1
School of Medicine, Syiah Kuala University/ Dr. Zainoel Abidin General Teaching Hospital, Banda Aceh-Indonesia, Indonesia1
Background: The use of Core Needle Biopsy (CNB) as complementary test to diagnose thyroid nodules has been minimally reported and is currently being investigated. The aims of this study to investigate the utility and patient comfortof Ultrasonogra- phy-Guided CNB for thyroid nodules based on Bethesda System.
Methods: Sixty-fi ve patients of thyroid nodule with inconclusive and follicular neo- plasm data reported by fi ne-needle aspiration (FNA),divided to 32 patients undergone CNB with a 18-gauge, 7.5 cm, 1.1 and 1.6 cm specimen cutter TSK Acecut Auto- matic Biopsy Gun and 33 patients who refusing CNB were tested repeat FNA with a 23-gauge needle.. We used Visual Analog Scale (VAS) and Questioner to investigate patient comfort.
Results: From the follow-up, the overall rate of malignancy was of 78.5 % (CNB 84.3
%; FNA 72.7 %), with the diagnosis accuracy of CNB was significantly (P < 0.05) higher than that of FNA. Mild Pain was reported in 87.5 % of CNB patient; 84.8 % of FNA patients. Local pain after biopsy was reported in 30.3 % of FNA and 50 % of CNB patients.
Conclusions: This study has supported the assumption that CNB more useful than repeat FNA in thyroid nodules with inconclusive results, improving the diagnostic per- formance for malignancy,safely and comfort procedure.
OS-END-28 Endocrinology
Effect of Iodine Restriction on Thyroid Function in Subclinical Hypothyroid Patients in an Iodine-Replete Area: A Long Period Observation in a Large-Scaled Cohort
Ji Young JOUNG1, Yoon Young CHO1, Sun-Mi PARK1, Tae Hun KIM1, Na Kyung KIM1, Seo Young SOHN1, Sun Wook KIM1, Jae Hoon CHUNG1
Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea1
Background: This study aimed to evaluate the effect of iodine restriction on thyroid function in subclinical hypothyroidism (SCH) patients in an iodine-replete area.
Subjects & Methods: The study consisted of 146 patients who were diagnosed with SCH. Urinary iodine concentration (UIC) was measured in 82 patients; of these, 20 patients with UIC <300 μg/L were excluded, and 62 patients with UIC =300 μg/L were educated about the restriction of iodine-rich foods. Following the fi rst follow-up visit, these patients were divided into 2 groups based on the UIC level: group A (well controlled iodine intake, UIC <300 μg/L, n=40) and group B (poorly controlled iodine intake, UIC =300 μg/L, n=22). The remaining 64 patients did not restrict iodine rich foods (group C). The 82 patients with measured UICs were reevaluated every 3–6 months. Thyroid function and UIC were measured at each visit. The correlation be- tween serum TSH level and UIC was determined for the 82 patients in whom UIC was measured.
Results: Following 3–6 months of iodine restriction, the serum TSH levels signifi cantly decreased in group A (9.0 mU/L to 4.7 mU/L, p <0.01). In addition, the serum free T4 levels in group A signifi cantly increased (1.11 ± 0.23 ng/dL to 1.18 ± 0.17 ng/dL, p <0.05).
However, there were no signifi cant changes in serum TSH or free T4 levels in group B and C. Serum TSH levels were signifi cantly correlated with UIC (r=0.33, p <0.01).
Conclusion: Iodine restriction may decrease serum TSH levels in SCH patients, and se- rum TSH levels are strongly correlated with UIC. Therefore, restriction of iodine intake could be a primary treatment option in SCH patients in an iodine-replete area.
