• Title/Summary/Keyword: 갑상선 기능 검사

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Hypothyroidism after Treatment for Head and Neck Cancer (두경부암 치료후 발생하는 갑상선기능저하증)

  • 조재식;이상철;임상철;김종식;박종부;심우진
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.101-108
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    • 1997
  • Hypothyroidism is not uncommon complication of therapy for head and neck cancer. A series of 52 patients treated with either radiotherapy alone or combined with surgery was retrospectively studied. Diagnostic procedure included total T3, T4 and TSH measured by radioimmunoassay. The rate of hypothyroidism was 25% (subclinical 15.4%, clinical 9.6%). The incidence of hypothyroidism increased to 40% when radiotherapy was combined with surgery. Risk factors influenced a high incidence of hypothyroidism were : tumor stage, primary tumor site, combination of radiotherapy and surgery (especially combined with laryngectomy). We advocate routine monitoring of head md neck cancer patients for hypothyroidism after treatment and recommend levothyroxine replacement therapy for subclinical hypothyroidism.

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Thyroid dysfunction in premature infants (미숙아에서의 갑상선기능 장애)

  • Hong, Ki Bae;Park, Ji Yun;Chang, Young Pyo;Yu, Jeesuk
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.991-998
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    • 2009
  • Purpose : Thyroid hormone is essential for development of the brain in early life. Thyroid dysfunction is more common in the first 2-4 postnatal weeks of life in premature infants than in term infants. This study aimed to identify the prevalence and clinical course of thyroid dysfunction in prematurity. Methods : Premature infants admitted to and given neonatal screenings at Dankook University Hospital between April 1999 and March 2008 were included in this study. We retrospectively reviewed medical records and categorized subjects into six groups: normal, hypothyroidism, hyperthyrotropinemia, hypothyroxinemia, delayed onset of hypothyroidism, and delayed onset of hyperthyrotropinemia. Results : Among 599 subjects, 136 (23%) had initially abnormal thyroid function test (TFT); transient hypothyroxinemia was the most frequent condition (118, 20%). In addition, 8 (17%) of 46 subjects with initially normal TFT levels showed delayed onset of hyperthyrotropinemia with or without low free thyroxine ($fT_4$). Thyroxine was prescribed for 10 patients (1.7%) due to low $fT_4$ levels but was discontinued in 9 patients during follow-up. Thyroid scan confirmed ectopic thyroid in one patient. Conclusion : Thyroid dysfunction was frequently seen in premature infants, but most of the conditions were transient. In addition, some infants showed delayed TSH elevation on routine follow-up. Therefore, a recheck of the thyroid function of premature infants at 3-4 weeks is recommended, even if normal thyroid function is initially seen, especially in prematurity of less than 33 weeks of gestational age or birth weight of less than 2,500 grams.

Clinical Characteristics of Autoimmune Thyroid Disease Developed in Patients with Type 1 Diabetes Mellitus (1형 당뇨병 환자에서 갑상선 질환이 발생한 경우의 임상적 특성)

  • Lee, Se Min;Chung, Hye Rim;Hong, Su Young;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.48 no.3
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    • pp.292-297
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    • 2005
  • Purpose : It is known that 3-50 percent of type 1 diabetes mellitus(T1DM) patients develop autoimmune thyroid disease. We analyzed the clinical characteristics of autoimmune thyroid disease(AITD) developed in patients with T1DM in Korean. Methods : The medical records of 139 patients, who were followed up in Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1981 to Jul. 2004, were analyzed retrospectively. Results : Forty-four males and 95 females were enrolled. At least one of the autoantibodies for thyroid was positive in 54 cases. The detection rate for AITD was not correlated with sex ratio, control of T1DM, body mass index, age at diagnosis of T1DM, and familial history of thyroid disease, between two groups. In the male group, AITD was more frequently found at a younger age than in the female group. The frequency of AITD was significantly higher in the goiter group without sex differences. In the thyroid disease group, 40 patients(74.0 percent) were euthyroid, seven patients(12.9 percent) were hypothyroid, and seven patients(12.9 percent) were hyperthyroid. Conclusion : We should monitor thyroid function and autoantibodies routinely in T1DM patients who develop goiters, or young boys with T1DM.

Reevaluation of the Neonatal Screening Test for Congenital Hypothyroidism (선천성 갑상선기능저하증에 대한 신생아 선별검사의 재평가)

  • Kang, So Young;Chang, Young Pyo;Yu, Jeesuk
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.387-394
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    • 2005
  • Purpose : We performed this study to compare the TSH and free $T_4$ levels according to gestational age and birth weight, and to reevaluate the cut-off values in the neonatal screening test for congenital hypothyroidism. Methods : Total 2,133 neonates(1,749 healthy newborns and 384 sick neonates) were screened in Dankook University Hospital from May 2000 to January 2003. Neonates with abnormal TSH values (higher than $20{\mu}IU/mL$) or abnormal free $T_4$ levels(lower than 1 ng/dL) were recalled to recheck the thyroid function test. At that time, physical examinations and history-taking regarding perinatal problem, medication history, and mother's illness were undertaken. Results : Serum TSH and free $T_4$ values revealed no significant difference according to sex, delivery type, and Apgar score. The free $T_4$ levels showed statistically significant differences, with gestational age or birth weight(P<0.01). The recall rate of neonates due to abnormal screening test was 7.48 percent. Compared with original cut-off values, the recall rate of the new cut-off values setted to TSH higher than $20{\mu}IU/mL$ or free $T_4$ lower than 0.64 ng/dL decreased from 7.48 percent to 4.8 percent in the healthy group. But, it compromised sensitivity when applied to the sick group. Conclusion : In this study, neonatal free $T_4$ levels were significantly different according to birth weight, gestational age, and the presence of compromised condition. Although the recall rate by TSH > $20{\mu}IU/mL$ or free $T_4$ <1 ng/dL was relatively high, it was impossible to set up new cut-off values without compromising sensitivity. We think studies including a larger study population will be required to change the cut-off values.

A Correlation Analysis of Serum Creatinine Based eGFR and Serum Cystatin C Based eGFR with Thyroid Dysfunction Patients (갑상선기능이상 환자에서 크레아티닌과 시스타틴을 이용한 사구체여과율 검사결과의 상관성 연구)

  • Lim, Gu;Park, Hyung-Doo;Sung, Ho Joong
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.3
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    • pp.203-213
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    • 2017
  • Serum creatinine-based eGFR and serum cystatin C-based eGFR are the most popular methods for measuring renal function. Thyroid hormone is known to affect serum creatinine-based eGFR and serum cystatin C-based eGFR; however, the clinical significance of thyroid dysfunctional patients of renal function evaluation has not been fully elucidated to date. This study examined the effect of thyroid hormone on serum creatinine-based eGFR and serum cystatin C-based eGFR. Moreover, we also evaluated the correlation analysis between serum creatinine-based eGFR and serum cystatin C-based eGFR in patients with thyroid dysfunction. A total of 442 patients with hypothyroidism and 284 patients with hyperthyroidism were investigated. A correlation analysis between thyroid hormone and serum creatinine- (and cystatin C-) based eGFR was performed. A correlation analysis between thyroid hormone and serum cystatin-C based eGFR indicated that serum cystatin-C based eGFR is more of an independent biomarker than serum creatinine-based eGFR in thyroid dysfunction patients. Therefore, serum cystatin C-based eGFR more accurately reflects renal function than serum creatinine-based eGFR in thyroid dysfunction patients.

An Evaluation on the Thyroid Function Tests of the Patients with Autoimmune Thyroiditis (자가면역성 갑상선염환자의 갑상선기능 검사소견)

  • Lim, Jae-Yang;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.343-349
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    • 1994
  • The study was taken to analyze the laboratory findings of the 161 patients with autoimmune thyroiditis treated at Kyungpook University Hospital from January 1992 to July 1993. They were all female and mean age was 33 years ranging from 10 to 73 years. Mean radioactive iodine uptake(RAIU) of the thyroid was $30.90{\pm}21.80(mean{\pm}SD)%$ at 6 hours and $37.97{\pm}23.25%$ at 24 hours. Mean serum levels of thyroid hormones were $1.41{\pm}0.48$(ng/ml) of T3, $7.26{\pm}3.23$(ug/dl) of T4, and $1.11{\pm}0.66$(ng/dl) of free T4, while mean serum level of TSH was $17.99{\pm}30.72$(uIU/ml). Mean levels of serum autoantibodies were 24. $43{\pm}31.91$(U/ml) of antithyroglobulin antibody and $55.32{\pm}41.97$(U/ml) of antimicrosomal antibody. The correlation between RAIU and serum thyroid hormone levels was significantly negative, but the positive correlation between RAIU and serum TSH was noted. The correlation between thyroid hormones and TSH was significantly negative, but the positive correlation between RAIU and serum TSH was noted. The correlation between thyroid hormones and TSH was significantly negative, while antimicrosomal antibody titer revealed significantly positive correlation with TSH. The RAIU and free T4 showed negatively correlated with the increasing age. The Initial clinical findings of the patients with autoimmune thyroiditis revealed euthyroidism in 83.2%, hypothyroidism in 14.9%, and hyperthyroidism in 1.9%. The incidence of abnormally increased serum thyroglobulin, antithyroglobulin antibody, and antimicrosomal antibody were 21.3%, 97.5%, and 87.6%, respectively and these abnormalities were more frequent in the patients with documented clinical thyroid functional disturbances.

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Study of Autoantibody Concentration Distribution by Thyroid Fine Needle Aspiration Biopsy (갑상선 조직 검사에 따른 자가 항체 농도 분포 연구)

  • Kim, Jean-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.9
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    • pp.4320-4325
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    • 2013
  • This study was investigated the correlation between thyroid fine needle aspiration biopsy and serological test's concentrations. I examined fifty patients who were diagnosed with thyroid cancer from June 2012 to December 2012 in Pathology of a certain university hospital. Healthy fifty people were selected as a control group. Thyroid function tests were used as variables. In conclusion, The thyroglobulin and autoantibody was showed positive correlations in cancer groups. also Thyroglobulin Ab was showed a little correlation. If we examine this study items, we will get help in early diagnosis.

케이스로 보는 개 부신피질기능항진증과 갑상선기능저하증

  • Kim, Jin-Gyeong
    • Journal of the korean veterinary medical association
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    • v.43 no.6
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    • pp.526-535
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    • 2007
  • 부신피질기능항진증(HAC)과 갑상선기능저하증은 개에 있어 가장 일반적인 호르몬 질환이라고 할수있다. 정확한 진단을하고 가장 알맞은 검사 방법을 선택하기 위해서는 각 진단방법과 그에 대한 한계점을 명확히 알아야 할 것이다. 다음은 임상 증상에 따라 단계적으로 적용할수있는 호르몬 진단법에 대한 소개로써 복잡한 호르몬 질환에 대한 이해에 도움이 될 것으로 생각된다.

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Hypothyroidism Following Surgery and Radiation Therapy for Head and Neck Cancer (두경부암 환자에서 수술 및 방사선치료 후 갑상선 기능 저하)

  • Park, In-Kyu;Kim, Jae-Cheol
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.225-231
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    • 1997
  • Purpose : Radiation therapy in combination with surgery has an important role in the therapy of the head and neck cancer We conducted a prospective study for patients with head and neck cancer treated with surgery and radiation to evaluate the effect of therapies on the thyroid gland, and to identify the factors that might influence the development of hypothyroidism. Materials and Methods : From September 1986 through December 1994, 71 patients with head and cancer treated with surgery and radiation were included in this prospective study. Patients' age ranged from 32 to 73 years with a median age of 58 years. There were 12 women and 59 men. The primary tumor sites were larynx in 34 patients, hypopharynx in 13 patients, oral cavity in 12 patients, unknown primary of the neck in 6 patients, salivary gland in 3 patients, maxillary sinus in 2 patients, and oropharynx in 1 patient. Total laryngectomy with neck dissection was carried out in 45 patients and neck dissection alone in 26 patients. All patients were serially monitored for thyroid function (T3, T4, free T4, TSH, antithyroglobulin antibody and antimicrosomal antibody) before and after radiation therapy. Radiation dose to the thyroid gland ranged from 40.6Gy to 60Gy with a median dose of 50Gy The follow-up duration was 3 to 80 months. Results :The overall incidence of hypothyroidism was 56.3\%$);7 out of 71 patients $(9.9\%)$ developed clinical hypothyroidism and 33 patients $(46.4\%)$ developed subclinical hypothyroidism. No thyroid nodules, thyroid cancers, or hyperthyroidism was detected. Hypothyroidism developed earlier in patients who underwent total laryngectomy with neck dissection than in patients with neck dissection alone (P<0.05). The risk factor that significantly influenced the incidence of hypothyroidism was a combination of surgery (total laryngectomy with neck dissection) and radiation therapy (P=0.0000), Four of 26 patients $(15.4\%)$ with neck dissection alone developed hypothyroidism while 36 of 45 patients $(80\%)$ with laryngectomy and neck dissection developed hypothyroidism. Conclusion : The hypothyroidism following surgery and radiation therapy was a relatively common complication. The factor that significantly influenced theincidence of hypothyroidism was combination of surgery and radiation therapy. Evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests is recommended for an early detection of hypothyroidism and thyroid hormone replacement therapy is recommended whenever hypothyroidism develops.

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