Hashimoto’s thyroiditis

桥本甲状腺炎
  • 文章类型: Journal Article
    目的:近年来,甲状腺癌(TC)的患病率呈上升趋势。加速的证据表明桥本甲状腺炎(HT)与TC之间存在显着关联。本研究包括精心设计的系统评价和荟萃分析,目的是仔细检查TC的风险并阐明HT的性别差异。
    方法:在信誉良好的在线数据库中进行了全面搜索,包括PubMed,科克伦图书馆,EMBASE,和WebofScience。检查了有关HT和TC之间相关性的英语出版物,没有时间限制。两位作者独立筛选了文章并提取了相关数据。使用STATA软件对收集的数据进行统计分析,允许计算合并的赔率比(OR)和95%置信区间(CI)。此外,对纳入性别特异性数据的研究进行了补充分析,以确定OR(女性与男性)和HT中TC的性别患病率。
    结果:共获得2,845条记录,本荟萃分析包括26项回顾性研究.结果表明HT在TC中具有重要作用(OR:2.22,95%CI:1.85-2.67)。补充分析表明,女性患者的TC患病率(0.31,95%CI:0.17-0.45)低于男性(0.37,95%CI:0.21-0.53)。然而,结果无统计学意义.
    结论:本系统综述和荟萃分析提供证据表明HT与TC的几率增加有关。HT患者的定期检讨具有积极的临床意义。
    OBJECTIVE: The prevalence of thyroid cancer (TC) has exhibited an upward trajectory in recent years. An accelerating amount of evidence shows a significant association between Hashimoto\'s thyroiditis (HT) and TC. The present study encompasses a meticulously designed systematic review and meta-analysis with the aim of scrutinizing the risk of TC and clarifying sex disparities in HT.
    METHODS: A comprehensive search was conducted across reputable online databases, including PubMed, Cochrane Library, EMBASE, and Web of Science. English-language publications on the correlation between HT and TC were examined without temporal restrictions. Two authors independently screened the articles and extracted pertinent data. The collected data underwent statistical analysis using the STATA software, enabling the calculation of the pooled Odds Ratio (OR) and 95% confidence intervals (CI). Additionally, a supplementary analysis was conducted on studies incorporating sex-specific data to determine the OR (female vs. male) and the sex-based prevalence of TC in HT.
    RESULTS: A total of 2,845 records were obtained, and 26 retrospective studies were included in this meta-analysis. The results indicated a significant role for HT in TC (OR: 2.22, 95% CI: 1.85-2.67). Supplementary analysis indicated that the prevalence of TC in HT patients was lower in women (0.31, 95% CI: 0.17-0.45) than in men (0.37, 95% CI: 0.21-0.53). However, the result was not statistically significant.
    CONCLUSIONS: This systematic review and meta-analysis provide evidence that HT is associated with increasing odds of TC. Regular review of HT patients holds positive clinical significance.
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  • 文章类型: Journal Article
    目标:自身免疫性甲状腺疾病的发生频率增加,特别是桥本氏甲状腺炎(HT)在文献中报道了几项研究,在儿童期发作的系统性红斑狼疮(cSLE)患者中。我们的研究旨在调查cSLE患者中甲状腺功能异常和HT的患病率及其影响因素。
    方法:对cSLE患者进行了甲状腺功能检查。人口统计,临床,并从病历中收集实验室特征和活动评分。将诊断为cSLE的患者与健康对照组的甲状腺功能异常频率进行比较。Mann-WhitneyU,独立样本t检验,和卡方或Fisher精确检验用于比较研究组。低于0.05的p值被认为是统计学上显著的。
    结果:在73例cSLE患者中,14(19.1%)患有亚临床甲状腺功能减退症,9(12.3%)有临床甲状腺功能减退症,12例(16.4%)被诊断为HT,12例(16.4%)有HT家族史。在5例甲状腺功能正常的患者和1例甲状腺自身抗体阳性的临界亚临床甲状腺功能减退患者中进行了甲状腺USG,并报告为甲状腺弥漫性异质性回声性增大。有和没有HT的组之间的临床和实验室数据或使用的药物没有显着差异;然而,HT患者的临床甲状腺功能减退症和HT家族史发生率较高。诊断为HT的患者的累积泼尼松龙剂量显着降低。与健康对照组相比,cSLE患者的HT频率明显更高。
    结论:结果表明,cSLE患者中HT的发生率增加,即使他们甲状腺功能正常,并建议对cSLE患者进行更频繁的筛查。
    OBJECTIVE: Increased frequency of autoimmune thyroid disease, particularly Hashimoto\'s thyroiditis (HT) was reported several studies in the literature, in individuals with childhood-onset systemic lupus erythematosus (cSLE). Our study aimed to investigate the prevalence and contributing factors of thyroid dysfunction and HT among cSLE patients.
    METHODS: Thyroid function tests were obtained cross-sectionally from cSLE patients. Demographic, clinical, and laboratory characteristics and activity scores were collected from medical records. Patients diagnosed with cSLE were compared to the healthy control group for the frequency of thyroid dysfunction. The Mann-Whitney U, independent samples t test, and the Chi-square or Fisher\'s exact test were used to compare study groups. A p-value below 0.05 was considered statistically significant.
    RESULTS: Out of 73 cSLE patients, 14 (19.1%) had subclinical hypothyroidism, 9 (12.3%) had clinical hypothyroidism, 12 (16.4%) were diagnosed with HT, and 12 (16.4%) had a family history of HT. Thyroid USG was performed in 5 euthyroid patients and 1 borderline subclinical hypothyroid patient with positive thyroid autoantibody and reported as diffuse heterogeneous echogenicity enlargement in the thyroid gland. There were no significant differences in clinical and laboratory data or medication used between the groups with and without HT; however, patients with HT had a higher frequency of clinical hypothyroidism and family history of HT. Cumulative prednisolone dose was significantly lower in patients diagnosed with HT. The frequency of HT was considerably higher in patients with cSLE compared to the healthy control group.
    CONCLUSIONS: The results demonstrate an increased incidence of HT in cSLE patients, even if they are euthyroid, and recommend that cSLE patients be screened more frequently.
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  • 文章类型: Case Reports
    僵硬人综合征(SPS)是一种罕见的神经系统疾病,其特征是慢性和进行性轴向肌肉僵硬和阵发性疼痛性肌肉痉挛。本病例研究描述了一名SPS患者(血清和脑脊液中抗GAD65抗体增加)合并桥本甲状腺炎,C3补体水平降低。临床表现,诊断方法,对这一独特病例的治疗方法进行了全面详细的描述。在这种情况下,我们全面介绍了一例SPS合并桥本甲状腺炎和相关的血清C3补体降低的病例,以及关于这一主题的当前数据的讨论。
    Stiff-person syndrome (SPS) is a rare neurological disorder characterized by chronic and progressive axial muscle rigidity and paroxysmal painful muscle spasms. The present case study described an SPS patient (increased anti-GAD65 antibody in serum and cerebrospinal fluid) with co-occurring Hashimoto\'s thyroiditis and decreased C3 complement levels. The clinical presentation, diagnostic approach, and treatment employed for this unique case were comprehensively described in detail. In this case, we comprehensively presented a case of SPS with co-occurring Hashimoto\'s thyroiditis and an associated decrease in serum C3 complement, as well as a discussion on the current data on this topic.
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  • 文章类型: Journal Article
    桥本甲状腺炎(HT)不仅是最常见的自身免疫性甲状腺疾病(AITD),但它也对患者的健康相关生活质量(HRQoL),它与分化型甲状腺癌有不同的联系。尽管其发病机制尚不完全清楚,氧化应激被认为起着重要作用。与晚期HT相关的甲状腺功能减退症可以用左甲状腺素替代疗法治疗;各种方法,如补充硒和限制碘的饮食已被提出作为早期阶段的疾病改善治疗,甚至甲状腺切除术也被建议用于难治性HT疼痛病例。然而,许多患者仍报告HRQoL欠佳,突出了这一领域未满足的医疗需求。在西方,中药(TCM)治疗HT的概念和方法并不广为人知。这里,我们提供了HT的中医概述,包括中药与硒的组合。我们包含来自临床试验和其他与复杂中医处方相关的研究的证据,中药中使用的单一草药,和植物化学物质;尽可能,我们描述了可能的潜在分子机制。研究结果表明,抗HT中药的主要活性成分具有公知或推测的抗氧化和抗炎活性,这可能解释了它们在HT中的潜在效用。进一步探索中医治疗HT的实践,并根据西方标准将其与基于证据和机制的方法相结合,可能有助于确定新的策略,以改变疾病的临床过程和/或更好地治疗患者的症状并改善其HRQoL。
    Hashimoto\'s thyroiditis (HT) is not only the most frequent autoimmune thyroid disease (AITD), but it also has a significant impact on patients\' health-related quality of life (HRQoL), and it has been variably associated with differentiated thyroid carcinoma. Even though its pathogenesis is still incompletely understood, oxidative stress is believed to play an important role. Hypothyroidism related to later stages of HT can be treated with levothyroxine substitution therapy; various approaches such as selenium supplementation and iodine-restricted diets have been proposed as disease-modifying treatments for earlier stages, and even thyroidectomy has been suggested for refractory cases of painful HT. Nevertheless, many patients still report suboptimal HRQoL, highlighting an unmet medical need in this area. The concepts and approaches of traditional Chinese medicine (TCM) in treating HT are not broadly known in the West. Here, we provide an overview of TCM for HT, including combinations of TCM with selenium. We encompass evidence from clinical trials and other studies related to complex TCM prescriptions, single herbs used in TCM, and phytochemicals; wherever possible, we delineate the probable underlying molecular mechanisms. The findings show that the main active components of TCM for HT have commonly known or presumed antioxidant and anti-inflammatory activities, which may account for their potential utility in HT. Further exploring the practices of TCM for HT and combining them with evidence- and mechanism-based approaches according to Western standards may help to identify new strategies to alter the clinical course of the disease and/or to treat patients\' symptoms better and improve their HRQoL.
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  • 文章类型: Journal Article
    目的:桥本甲状腺炎(HT)与甲状腺乳头状癌(PTC)之间的潜在关联已经从不同的角度进行了多年的研究。这项研究旨在评估HT对放射性碘(RAI)治疗后PTC患者临床结局的影响。
    方法:我们对2017年4月至2020年5月连续接受RAI治疗的PTC患者进行了回顾性研究。HT的诊断基于病理检查,将患者分为HT组和非HT组。年龄分布,性别,超声特征,乳头状变异,甲状腺外延伸,并观察到其他组织病理学特征。使用倾向评分匹配(PSM)比较两组在1年和3年随访时的临床特征和结果。
    结果:总计,纳入了782例PTC患者(570例女性,212名男子)。130例(16.6%)患者出现HT,并且与年轻的年龄有关,较小的原发性肿瘤,减少甲状腺外延伸,出现时淋巴结转移较少。在审查图像时,仅钙化和血流分布在US特征之间存在显着差异(P<0.05)。在随访结束时(三年),两组对RAI治疗的反应显着不同(ER:76.9%vs64.9%;IDR:11.5%vs17.2%;BIR:4.6%vs10.7%;SIR:6.9%vs7.2%,P=0.03)。HT患者的疾病证据较少(11.6%vs17.9%)。当与匹配组比较时,123对患者配对成功,发现患有HT的PTC患者对RAI治疗有更好的反应。
    结论:PTC伴HT患者在表现时具有较少侵袭性特征。重要的是,HT的存在不仅与结果有显著关联,但也可以防止复发的风险。
    OBJECTIVE: The potential association between Hashimoto\'s thyroiditis (HT) and papillary thyroid carcinoma (PTC) has been studied from different perspectives for many years. This study was aimed to evaluate the impact of HT on the clinical outcomes of PTC patients after radioactive iodine (RAI) therapy.
    METHODS: We conducted a retrospective study on consecutive patients with PTC who underwent RAI therapy from April 2017 to May 2020. The diagnosis of HT was based on pathological examination, and patients were divided into the HT and non-HT group. Distributions of age, gender, ultrasound features, papillary variants, extrathyroidal extension, and other histopathological characteristics were observed. Propensity score matching (PSM) was used to compare the clinical features and outcomes between the two groups at 1 and 3-year follow-up.
    RESULTS: In total, 782 patients with PTC were enrolled (570 women, 212 men). HT was presented in 130 (16.6%) patients, and was associated with younger age, smaller primary tumors, less extrathyroidal extension, and less lymph node metastasis at presentation. On review of the images, only calcification and blood flow distribution were significantly different among the US features (P < 0.05). At the end of follow-up (three years), the responses to RAI therapy were significantly different between the two groups (ER: 76.9% vs 64.9%; IDR:11.5% vs 17.2%; BIR: 4.6% vs 10.7%; SIR: 6.9% vs 7.2%, P = 0.03). Patients with HT had less frequently evidence of disease (11.6% vs 17.9%). When compared with the matched groups, 123 pairs of patients were successfully matched, PTC patients with HT were found to have a better response to RAI therapy.
    CONCLUSIONS: PTC patients with HT had less aggressive characteristics at presentation. Importantly, the presence of HT not only had a significant association with the outcome, but was also protective from the risk of recurrence.
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  • 文章类型: Journal Article
    桥本甲状腺炎(HT)的标志包括通过导致胰岛素抵抗(IR)而破坏甲状腺细胞,甲状腺功能减退,和代谢异常。Kisspeptin,spexin,和甘丙肽控制食欲和体重(BW)以调节代谢。这里,我们试图确定加兰宁,kisspeptin,和spexin与甲状腺功能正常的女性患者HT的病理生理学有关。
    45名患有HT的妇女和45名相同年龄的健康对照妇女参加了本研究。采用酶联免疫吸附试验(ELISA)法测定血清甘丙肽水平,spexin,和kisspeptin.
    与对照组相比,HT患者的kisspeptin水平明显升高(p<0.01),甘丙肽(p<0.01),抗甲状腺过氧化物酶(抗TPO)(p<0.001),抗甲状腺球蛋白(抗Tg)(p<0.001),体重指数(BMI)(p<0.05)。两组在spexin方面具有可比性,游离三碘甲状腺原氨酸-3(fT3),fT4,促甲状腺激素(TSH)水平,和胰岛素抵抗的稳态模型评估(HOMA-IR)。甘丙肽与kisspeptin呈正相关(p<0.01;r=0.786)。
    甲状腺功能正常的HT女性被发现具有较高水平的kisspeptin和galanin。这些结果表明,kisspeptin和galanin可能与甲状腺功能减退的发病机制有关,结果,我们认为这些标志物可能对HT患者的早期发现和治疗有益.
    UNASSIGNED: The hallmarks of Hashimoto\'s thyroiditis (HT) include the destruction of thyroid cells by leading to insulin resistance (IR), hypothyroidism, and metabolic abnormalities. Kisspeptin, spexin, and galanin control appetite and body weight (BW) to regulate metabolisms. Here, we sought to determine if galanin, kisspeptin, and spexin are linked to the pathophysiology of HT in euthyroid female individuals.
    UNASSIGNED: Forty-five women with HT and 45 healthy control women of the same age participated in the current study. The enzyme-linked immunosorbent assay (ELISA) method was used to measure the serum levels of galanin, spexin, and kisspeptin.
    UNASSIGNED: In comparison to the controls, HT patients had significantly higher levels of kisspeptin (p < 0.01), galanin (p < 0.01), anti-thyroid peroxidase (anti-TPO) (p < 0.001), anti-thyroglobulin (anti-Tg) (p < 0.001), and body mass index (BMI) (p < 0.05). The two groups were comparable in terms of spexin, free triiodothyronine-3 (fT3), fT4, thyroid-stimulating hormone (TSH) levels, and homeostatic model assessment for insulin resistance (HOMA-IR). Galanin and kisspeptin were seen to have a positive correlation (p < 0.01; r = 0.786).
    UNASSIGNED: Euthyroid women with HT were found to have higher levels of kisspeptin and galanin. These results imply that kisspeptin and galanin may be linked to the pathogenesis of hypothyroidism, and as a result, we believe that these markers may be beneficial in the early detection and treatment of HT patients.
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  • 文章类型: Journal Article
    桥本甲状腺炎(HT)是一种常见的自身免疫性甲状腺疾病,需要进一步研究以确定有效的治疗策略。HT的两个关键病理生理因素是炎症和氧化应激。Petunidin(PET)是一种具有抗炎和抗氧化特性的花青素。本研究旨在探讨PET对HT的作用及其机制。C57BL/6N小鼠注射佐剂乳化的甲状腺球蛋白建立HT动物模型。我们的结果表明,PET给药降低了TPOAb的浓度,TgAb,T3,T4,IgG,HT小鼠的IgA和IgM,伴随着卵泡形状的显著改变和淋巴细胞浸润的增加。此外,凋亡率,ROS水平,MDA含量,CD4+水平,IFN-γ和IL-17A水平,以及IFN-γ和IL-17的浓度在HT小鼠中升高,并通过PET治疗降低。此外,HT患者的NOX4和PKM2水平较高,与TPOAb呈正相关。IFN-γ,和IL-17浓度。在HT小鼠中,PET治疗降低了PKM2和NOX4蛋白的表达。总之,PET可通过抑制细胞凋亡改善甲状腺功能异常,通过调节HT小鼠NOX4/PKM2轴的氧化应激和Th1/Th17分化,表明其对HT干预的潜力很大。
    Hashimoto\'s thyroiditis (HT) is a prevalent autoimmune thyroid disease, necessitating further research to identify effective treatment strategies. Two key pathophysiological factors of HT are inflammation and oxidative stress. Petunidin (PET) is an anthocyanin with anti-inflammatory and antioxidant properties. This study aimed to investigate the effect and mechanism of PET on HT. C57BL/6N mice were injected with thyroglobulin emulsified with adjuvant to establish the HT animal model. Our results showed that PET administration decreased the concentrations of TPOAb, TgAb, T3, T4, IgG, IgA and IgM in HT mice, accompanied by significant alterations in follicle shape and increased lymphocyte infiltrations. Additionally, the apoptosis rate, ROS level, MDA content, CD4+ level, IFN-γ and IL-17A levels, as well as the concentrations of IFN-γ and IL-17, were elevated in HT mice and reduced by PET treatment. Furthermore, HT patients exhibited higher levels of NOX4 and PKM2, which were positively correlated with TPOAb, IFN-γ, and IL-17 concentrations. In HT mice, PET therapy decreased the expression of PKM2 and NOX4 proteins. In summary, PET can improve thyroid dysfunction by suppressing apoptosis, oxidative stress and Th1/Th17 differentiation through regulation of the NOX4/PKM2 axis in HT mice, suggesting its promising potential for HT intervention.
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  • 文章类型: Case Reports
    卵巢Struma,一种起源于成熟畸胎瘤生殖细胞的罕见卵巢肿瘤,通常表现为良性特征。然而,已记录了恶性转化的实例。
    本报告讨论了一名25岁的妇女,她于2020年5月接受了手术以从两个卵巢中去除畸胎瘤。2023年,超声检查显示她的骨盆有一个复杂的肿块。进一步的成像测试,包括CT,MRI,和F-18FDGPET/CT扫描,伴随着高水平的CA125蛋白,暗示她的左卵巢有肿块,最初被认为是卵巢癌。然而,手术后仔细检查发现甲状腺组织和几种类型的细胞生长,但没有癌症,确认诊断为卵巢甲状腺肿。甲状腺高代谢结节F-18FDGPET/CT病理证实桥本氏甲状腺炎。
    该病例强调了在卵巢肿块的鉴别诊断中考虑卵巢甲状腺肿的重要性,尤其是有畸胎瘤病史的患者.由于相似的临床症状和影像学,它突出了区分卵巢甲状腺肿和卵巢癌的挑战。卵巢甲状腺炎可能与桥本甲状腺炎有关。
    UNASSIGNED: Struma ovarii, a rare ovarian neoplasm originating from germ cells within mature teratomas, typically manifests benign characteristics. However, instances of malignant transformation have been documented.
    UNASSIGNED: This report discusses a 25-year-old woman who had surgery in May 2020 to remove teratomas from both ovaries. In 2023, an ultrasound showed a complex mass in her pelvis. Further imaging tests, including CT, MRI, and F-18 FDG PET/CT scans, along with high levels of the CA 125 protein, suggested a mass in her left ovary, initially thought to be ovarian cancer. However, a closer examination after surgery found thyroid tissue and several types of cell growth but no cancer, confirming the diagnosis of struma ovarii. The pathology of hypermetabolic thyroid nodules on F-18 FDG PET/CT confirmed Hashimoto\'s thyroiditis.
    UNASSIGNED: This case underscores the importance of considering struma ovarii in the differential diagnosis of ovarian masses, especially in patients with a history of teratomas. It highlights the challenges in distinguishing struma ovarii from ovarian cancer due to similar clinical signs and imaging. Struma ovarii can be associated with Hashimoto\'s thyroiditis.
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  • 文章类型: Journal Article
    多结节性甲状腺肿(MNG)是一种常见的甲状腺疾病,其特征是甲状腺内存在多个结节。虽然大多数MNG病例是良性的,有恶性肿瘤的风险,特别是在具有某些特征的结节中。MNG中隐匿性(潜伏性)甲状腺癌的共存提出了诊断和管理挑战,强调需要全面的调查和治疗策略。目的探讨甲状腺全切除术后无毒性MNG隐匿性甲状腺癌的发生率。材料和方法本研究人群包括2004年至2022年在塞萨洛尼基424总军医教育医院第二外科进行甲状腺全切除术的412例患者。数据收集包括患者的人口统计学特征,甲状腺切除术的手术指征,和组织病理学检查结果。所有412例患者的初始数据均可用,虽然319个人有足够的信息,由于无毒的MNG,271个子集接受了全甲状腺切除术。在上述小组中,253例经组织学证实为MNG。随后,对年龄进行了统计分析,性别,MNG与恶性肿瘤的关系,和其他甲状腺疾病。结果在总共412例甲状腺切除术中,271例患者仍需进行统计分析和研究。其中,253例患者经组织学证实为MNG。在组织学发现中,38例(14.02%)在MNG内发现隐匿性癌。主要组织学类型为甲状腺乳头状癌(PTC),占93.3%的病例。此外,18例(6.64%)确诊为MNG,桥本甲状腺炎(HT),和恶性肿瘤同时发生。结论MNG中隐匿性甲状腺癌的共存强调了甲状腺全切除术患者警惕评估和管理策略的重要性。这些发现强调需要全面的术前评估和术后监测,以检测和解决隐匿性甲状腺癌,从而优化患者护理和结果。
    Introduction Multinodular goiter (MNG) is a common thyroid disorder characterized by the presence of multiple nodules within the thyroid gland. While most cases of MNG are benign, there is a risk of malignancy, particularly in nodules with certain features. The coexistence of occult (latent) thyroid cancer within MNG presents diagnostic and management challenges, underscoring the need for comprehensive investigation and treatment strategies. Objective The objective of this retrospective study is to investigate the prevalence of occult thyroid carcinoma in non-toxic MNG following total thyroidectomy. Materials and methods The study population consisted of 412 patients who underwent total thyroidectomy between 2004 and 2022 at the Second Surgical Department of the 424 General Military Hospital of Education in Thessaloniki. Data collection included patients\' demographic characteristics, surgical indications for thyroidectomy, and histopathological examination findings. Initial data were available for all 412 patients, while sufficient information was present for 319 individuals, with a subset of 271 undergoing total thyroidectomy due to non-toxic MNG. Out of the aforementioned group, 253 cases were histologically confirmed as MNG. Subsequently, a statistical analysis was conducted concerning age, gender, the association of MNG with malignancy, and other thyroid disorders. Results Out of the total 412 thyroidectomies performed, 271 patients remained for statistical analysis and study. Among them, 253 patients had histologically confirmed MNG. Among the histological findings, 38 cases (14.02%) were identified with occult carcinoma within MNG. The predominant histological type was papillary thyroid carcinoma (PTC), comprising 93.3% of cases. Additionally, 18 patients (6.64%) were diagnosed with MNG, Hashimoto\'s thyroiditis (HT), and malignancy concurrently. Conclusions The coexistence of occult thyroid carcinoma within MNG underscores the importance of vigilant evaluation and management strategies in patients undergoing total thyroidectomy. These findings emphasize the need for comprehensive preoperative assessment and postoperative surveillance to detect and address occult thyroid cancer, thereby optimizing patient care and outcomes.
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  • 文章类型: Journal Article
    桥本脑病(HE)是一种鲜为人知的疾病。在所有年龄组都有描述,然而,没有特定的HE标记。此外,现有研究中的治疗数据往往存在分歧和矛盾.因此,我们的系统性和批判性综述旨在根据最新发现评估HE的诊断和治疗.浏览的数据库包括PubMed,Scopus,谷歌学者以及科克伦图书馆,搜索策略包括受控的词汇和关键词。共发现2443份手稿,自HE研究开始以来一直发表到2024年2月。为了确定从研究中收集的数据的有效性,使用RoB2工具进行偏倚评估.最终,我们的研究包括6项研究.在有精神和神经症状的患者的鉴别诊断中应考虑HE。根据我们的发现,阴性甲状腺过氧化物酶抗体(抗TPO)可能是排除HE的一个有价值的参数。尽管如此,此结果不能用于确认HE。此外,所提出的抗NH2-末端-α-烯醇化酶(抗-NAE)对HE是非特异性的。糖皮质激素治疗的有效率为60.94%,尽管31.67%的患者在治疗后复发。我们的评论强调了进行进一步大规模研究的重要性以及考虑潜在遗传因素的必要性。
    Hashimoto\'s encephalopathy (HE) has been a poorly understood disease. It has been described in all age group, yet, there is no specific HE marker. Additionally, the treatment data in the available studies are frequently divergent and contradictory. Therefore, the aim of our systematic and critical review is to evaluate the diagnosis and treatment of HE in view of the latest findings. The databases browsed comprised PubMed, Scopus, and Google Scholar as well as Cochrane Library, and the search strategy included controlled vocabulary and keywords. A total of 2443 manuscripts were found, published since the beginning of HE research until February 2024. In order to determine validity of the data collected from studies, bias assessment was performed using RoB 2 tool. Ultimately, six studies were included in our study. HE should be considered in the differential diagnosis in patients with psychiatric and neurological symptoms. According to our findings, negative thyroid peroxidase antibodies (anti-TPOs) may represent a valuable parameter in ruling out HE. Nonetheless, this result cannot be used to confirm HE. Furthermore, the proposed anti NH2-terminal-α-enolase (anti-NAE) is non-specific for HE. The effectiveness of glucocorticoid therapy is 60.94%, although relapse occurs in 31.67% of patients following the treatment. Our review emphasizes the significance of conducting further large-scale research and the need to take into account the potential genetic factor.
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