Ascites is the accumulation of fluid in the abdominal cavity and is commonly attributed to various etiologies, including portal hypertension and peritoneal diseases. Hyperthyroidism is rarely associated with ascites, which is typically chylous and accompanied by high central venous pressure. We present a unique case of a 57-year-old woman with untreated hyperthyroidism who manifested non-chylous ascites without evidence of high venous pressure. Initially presenting with left lower leg pain, the patient presented with leg edema, abdominal distention, and diarrhea. A range of diagnostic tests ruled out common etiologies of ascites, such as liver cirrhosis, renal impairment, heart failure, infection, and malignancy. Ascites was characterized by low triglyceride levels, while no evidence of high venous pressure was found. Notably, the patient showed decreased levels of rapid turnover proteins, suggesting hypercatabolism and insufficient protein synthesis due to hyperthyroidism. Upon the initiation of antithyroid therapy, the patient\'s symptoms markedly improved. In conclusion, this report highlights a rare manifestation of hyperthyroidism that resulted in non-chylous ascites without high venous pressure. This underscores the need to include hyperthyroidism in the differential diagnosis of unexplained ascites, particularly in cases in which classical hyperthyroid symptoms are absent.

Graves\' disease (GD) is a prominent antibody-mediated autoimmune disorder characterized by stimulating antibodies (TRAb) that target the thyroid-stimulating hormone receptor (TSHR). Targeting and eliminating TRAb-producing B lymphocytes hold substantial therapeutic potential for GD. In this study, we engineered a novel chimeric antigen receptor T cell (CAR-T) therapy termed TSHR-CAR-T. This CAR-T construct incorporates the extracellular domain of the TSH receptor fused with the CD8 transmembrane and intracellular signal domain (4-1BB). TSHR-CAR-T cells demonstrated the ability to recognize and effectively eliminate TRAb-producing B lymphocytes both in vitro and in vivo. Leveraging this autoantigen-based chimeric receptor, our findings suggest that TSHR-CAR-T cells offer a promising and innovative immunotherapeutic approach for the treatment of antibody-mediated autoimmune diseases, including GD.

Autoimmune thyroid disorders are frequently encountered in clinical practice and consist of a spectrum ranging from Graves\' hyperthyroidism to Hashimoto\'s hypothyroidism. Generally, patients with autoimmune thyroid disorders will lean towards one end of the spectrum or the other, with fluctuations between hyper- and hypothyroidism rarely seen. This is especially the case when persistent hyperthyroidism occurs after a prolonged period of hypothyroidism. Here, we present a case of a young female patient initially presenting with Graves\' disease with a previous history of hypothyroidism.

Rheumatoid arthritis (RA) and autoimmune thyroid disease (AITD) can occur in the same patient in the autoimmune polyglandular syndrome 2. The association of the two conditions has been recognized long-time ago and the prevalence of AITD in patients with RA and vice versa is well assessed. Geographical variation of AITD and related autoantibodies in RA patients is partly due to ethnic and environmental differences of the studied populations. The impacts of thyroid disorders on RA outcome and vice versa are still controversy. In both AITD and RA genetic susceptibility and environmental factors play a synergic role in the development of the diseases. In this review we aimed at investigating the association of AITD and thyroid autoantibodies with RA, the common pathogenic pathways, the correlation with RA disease activity, and influence of the treatment.

BACKGROUND: Studies have suggested that patients with hyperthyroidism may have a higher risk of venous thromboembolism (VTE) compared to individuals with normal thyroid function, although the data is quite limited. This systematic review and meta-analysis aims to comprehensively investigate this risk by summarizing all available studies.
METHODS: A systematic review was performed using the MEDLINE and Embase databases from inception to February 2019 to identify all cohort studies that compared the risk of incident VTE in patients with hyperthyroidism versus individuals without hyperthyroidism. Pooled risk ratio and 95% confidence interval were calculated using random-effect, generic inverse-variance method.
RESULTS: A total of 5 retrospective cohort studies with 237,667 cases with hyperthyroidism and 4,615,907 comparators without hyperthyroidism were included. The pooled analysis found a significantly increased risk of incident VTE among patients with hyperthyroidism, with a pooled risk ratio of 1.332 (95% CI, 1.275-1.391; I2 14%). The funnel plot was asymmetric and may suggest the presence of publication bias in favor of studies that showed positive association.
CONCLUSIONS: A significantly increased risk of incident VTE among patients with hyperthyroidism compared to individuals without hyperthyroidism was demonstrated in this meta-analysis.

OBJECTIVE: To investigate whether the oxidative stress is involved in the evolution of Graves\' disease (GD) and Hashimoto thyroiditis (HT) into Papillary Thyroid Carcinoma (PTC), 8-hydroxy-2\'-deoxyguanosine (8-OHdG) and cancer related proteins (Bcl-2, p53 and Ki-67) expressions were evaluated in these pathologies.
METHODS: Immunohistochemical method was applied on 25 thyroid tissues. Allred score (AS) serving to evaluate the immunostaining is based on a scale from 0 to 8. \"Negligible expression\" was assigned to a score of 0 to 2, \"expression\" and \"overexpression\" were attributed to a score of 3-5 and ≥6 respectively.
RESULTS: PTC cancer cells exhibited 100% 8-OHdG \"overexpression\" compared to 87.5% in PTC non-malignant epithelial (NME) ones (p<0.05). Higher 8-OHdG AS was found in PTC NME cells compared to GD and HT (p<0.001, p<0.05 respectively). \"Overexpression\" of Bcl-2 was noted in all PTC cell types. Remarkably, just like the PTC cancer and NME cells 33.3% of HT and 50% of GD patients\' revealed simultaneous \"overexpression\" of Bcl-2 and 8-OHdG in epithelial cells. No staining was detected for p53 in all pathologies. PTC lymphoid cells exhibited 100% \"overexpression\" for 8-OHdG and Bcl-2 with concomitant \"negligible expression\" for Ki-67 in 87.5% of patients. In contrast, HT lymphoid cells showed 22.2% \"expression\" and GD 62.5% \"expression\" and 12.5% \"overexpression\" of Ki-67.
CONCLUSIONS: Simultaneous \"overexpression\" of 8-OHdG and Bcl-2 in GD and HT could be considered as prognostic markers while \"negligible expression\" of Ki-67 in PTC lymphoid cells suggests an anergic state favoring the tumor escapes from the immune system.