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BACKGROUND: Dysphagia is common among general population. Nevertheless, it is more common among patients with thyroid neoplasms or neurologic disease, presenting as one of the first complaints. Dysphagia characteristics classify and dichotomize its management, often requiring a thorough assessment excluding organic disease. CLINICAL CASE: A 46-year-old male patient with dysphagia produced by extraesophageal compression due to goiter with a neurological spectrum due to myasthenia gravis. CONCLUSIONS: With this case, we highlight the difference between the clinical spectrum of both entities and the characteristics both share. [ABSTRACT FROM AUTHOR]

Context. Propylthiouracil (PTU) could cause lupus or vasculitis-like hypersensitivities thus interfering with some other concomitant diseases. Objective. Clinicians must be aware of the side effects of medications, particularly after their introduction and long-term use. Some clinical manifestations may be similar to well-known drug side effects or hypersensitivity. Every unusual clinical scenario related to drug use must be evaluated individually and thoroughly. Subjects and Methods. Hands and feet skin changes were observed several days after PTU administration in a male patient with severe diffuse toxic goitre. A complete blood count, biochemistry analyses, thyroid function tests and antibodies, and immunology analyses were performed. Results. As the skin changes were distributed regionally, liver function tests were normal, and there were no signs of clinical deterioration, it was decided to continue PTU treatment and monitor the patient. The initial maculopapular rash quickly turned vesicular, then scaly. After two weeks, the skin changes were wholly restored, with no scarring. Hand, Foot, and Mouth disease (HFMD) was diagnosed after a thorough epidemiological survey and clinical workout. Conclusions. Our case study demonstrates that skin changes associated with HFMD may resemble those associated with PTU-induced vasculitis. [ABSTRACT FROM AUTHOR]

Background and Purpose: Pressure symptoms are usually uncommon in multinodular goitre (MNG). Imaging modalities fail to define the functional air flow dynamics of the upper airway. The airway-related changes due to MNG can be understood using a Pulmonary function test (PFT). To address this lacuna, this study was conducted to compare the pulmonary function profile of patients undergoing total thyroidectomy with benign MNGs using a pre-operative and post-operative pulmonary function test using Spirometry and assessing if surgery had an impact on airway status with varying volumes of thyroid gland measured with ultrasound Methods: The study was conducted in a tertiary care centre in South India between 2019-2020. Twenty-five patients with MNG undergoing total thyroidectomy were included in the study population. PFT (Spirometry -- Lung volume & Flow volume loop) was performed preoperatively and was compared with post-operative PFT after 6 weeks of surgery. The desired variables -- Forced Vital Capacity (FVC), Forced expiratory volume in 1 second (FEV1), FEV1 ratio & Peak expiratory flow rate (PEFR) were analysed & interpreted to ascertain changes in respective values attributable to surgery. Results: Mean (MEDIAN)thyroid gland volume(cc) of 25 participants in our study was 50.28 ±50.03. Statistically significant improvement was observed in the FVC (Preoperative mean 2.16 ± 0.59 to post-operative mean 2.43 ± 0.78), FEV1 (1.79 ± 0.53 to 2.07 ± 0.69), PEFR (356.8 ± 101.4 to 388 ± 99.4). However, the change in FEV1/FVC ratio (0.83 ± 0.05 to 0.84 ± 0.05) did not approach statistical significance. The study showed that in patients without restrictive lung disease, there is a statistically significant improvement in airflow dynamics following total thyroidectomy, irrespective of the volume of the gland. Conclusion: Alleviating upper airway obstruction is an important facet of surgical intervention for thyroid disease. Early surgery to prevent progressive worsening of the degree of obstruction should be considered, irrespective of the volume of the thyroid gland for patients with intrathoracic goitre and in cervical MNG with pre-existing airway compromise. [ABSTRACT FROM AUTHOR]

Background: Thyroid diseases bear a high burden in India. Thyroid enlargement needs further evaluation to rule out the neoplasm. With existing different evaluation tests, eliciting their validity would help in further management of thyroid swellings. Objective: To assess the clinical and pathological correlation of thyroid swellings. Methodology: A cross sectional study was conducted among fifty patients who presented with thyroid swellings to surgery department and Otolaryngology department, in a tertiary care hospital for a period of 21 months. The data was collected using a semi-structured questionnaire and all the patients were subjected to clinical examination, blood investigations, USG neck and fine needle aspiration cytology (FNAC) and histo-pathological examination. Results of each were evaluated against histo-pathological examination. Results: The mean age of the study subjects was 39.7±10.8 years. Multinodular goitre was the commonest thyroid swelling detected clinically (66.0%), on USG (36.0%) and histopathplogical examination (40.0%). However, FNAC showed colloid nodular goitre as the commonest (40.0%). Among the clinical examination, USG and FNAC, USG showed significant moderate agreement (κ=0.59, P<0.05)and FNAC showed significant perfect agreement (κ=0.91, P<0.05) with 88.2% sensitivity, 100.0%, specificity and positive predictive value 94.3% negative predictive value and 96.0% accuracy (P<0.05). Conclusion:FNAC is a good tool to evaluate thyroid swellings for malignancy. [ABSTRACT FROM AUTHOR]

Introduction. Thyroid surgery has increased in the pediatric population. One of the main issues following this surgery is the presence of a neck scar, which has been reported to have an impact on quality of life. Transoral endoscopic thyroidectomy is used in adult patients with good results, but there are few reports on the use of this technique in pediatrics. Clinical case. 17-year-old female patient diagnosed with toxic nodular goiter. As a result of the patient’s refusal to undergo conventional surgery due to the scar, transoral endoscopic lobectomy was carried out. The surgical technique used will be described. Discussion. In order to prevent the psychological and social impact of neck scars in children, and given the results published on the use of this technique in pediatrics, transoral endoscopic thyroidectomy stands as an alternative to conventional thyroidectomy in adequately selected patients eager to avoid neck scars. [ABSTRACT FROM AUTHOR]

Massive goiter with retrosternal extension is most frequently found in the anterior mediastinum; however, 10%-15% of the cases are found in the posterior mediastinum. It may induce symptoms caused by tracheal, esophageal, and recurrent laryngeal nerve compression. Surgery for such a huge mass requires a high degree of experience to avoid serious complications, particularly if it weighs .500 g. Herein, we report the case of a 64-year-old man who complained of neck swelling which was gradually increasing in size during the past 19 years and breathing difficulty that worsened during the past years. A 31 £ 16 cm heterogeneous enhancing mass that expanded the thyroid gland with retrosternal extension, pushing the main vessels posterolaterally and compressing the trachea, was detected during computed tomography of the neck and chest. Total thyroidectomy was performed safely via a transcervical approach. The recovery period was uneventful, and the patient was discharged 5 days later. Given the rarity of a massive goiter that pushes the main vessels and compresses the trachea in the posterior mediastinum, this case report emphasizes the treatment options and outcome of this condition. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid nodules are evaluated by fine-needle aspiration biopsy (FNAB) according to their radiologic characteristics. International guidelines recommend lobectomy according to the size of the nodules and FNAB results. The aim of this study is to assess whether lobectomy is one of the treatment choices in endemic areas. Methods: Patients who underwent lobectomy between January 2013 and September 2017 were studied retrospectively. Patients' demographic features, thyroid hormone levels, medications, FNAB results before the surgery, lobectomy indications, ultrasonographic features, final pathologies, and secondary surgical interventions were recorded. Results: Data of 388 patients who underwent lobectomy were examined. As patients were classified according to their FNAB results, all categories had higher malignancy rates than expected in the final pathology results. One hundred and eighteen (30.4%) patients had undergone completion thyroidectomy. The final pathology of the completion thyroidectomy samples showed 24.07% (n=26) malignancy. Discussion and Conclusion: FNAB is the gold standard for the malignancy risks in thyroid nodules in all guidelines. In endemic areas, this classification system may be inadequate. Two-staged thyroid surgery is becoming more popular. In our series, 30.4% of patients had undergone completion thyroidectomy according to their final pathology results. We need to add newer sights to guidelines for endemic areas. [ABSTRACT FROM AUTHOR]

Diving thyroid nodules are a limitation of radiofrequency ablation because the mediastinal component cannot be adequately identified by ultrasound (US). We aim to describe a new technique, the iceberg technique, to overcome this issue and explain our three-year experience of using this novel method. The iceberg technique consists of a two-stage treatment. First, the ablation of the cervical portion of the nodules (easily visualized during the initial US exam) using trans-isthmic access is performed using the moving-shot technique. After three to six months, there is a volumetric reduction of the treated portion, leading to retraction of the thyroid parenchyma. This brings the mediastinal component to the cervical region, thereby enabling a perfect visualization by US. Then, the second stage of treatment is carried out with complete nodule ablation, and the region that was treated first is looked at a second time. From April 2018 to April 2021, nine patients with nine benign nodules were submitted for the iceberg technique. No complications occurred during the entire follow-up period. The patients displayed normal hormonal levels after the procedures, and there was a significant volume reduction of the nodules until three months post-ablation. The iceberg technique is an effective and safe option for the radiofrequency treatment of diving goiters. [ABSTRACT FROM AUTHOR]

We report the case of a paediatric female patient affected by Bannayan-Riley- Ruvalcaba syndrome (BRRS) and congenital hypothyroidism (CH) with homozygous mutation of the TPO gene. She underwent total thyroidectomy at the age of seven years because of the development of a multinodular goiter. BRRS patients present an increased risk of benign and malignant thyroid disease since childhood because of inactivating mutation of PTEN, an onco-suppressor gene. Instead, homozygous mutations in the TPO gene can be associated with severe forms of hypothyroidism with goiter; previous studies have described cases of follicular and papillary thyroid cancer in CH patients with TPO mutation despite a perfectly controlled thyroid function with Levothyroxine therapy. To our knowledge, this is the first case that describes the possible synergic role of coexisting mutation of both TPO and PTEN in the development of multinodular goiter underlining the importance of a tailored surveillance program in these patients, especially during childhood. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to provide statistical data support for the development of thyroid phenotype-related follow-up and reference for follow-up duration and project selection by analyzing the clinical characteristics of thyroid phenotype in Pendred syndrome (PDS) based on multiple databases. MATERIALS AND METHODS: PDS-related pathogenic or possibly/pathogenic mutations were searched by Deafness Variation Database (DVD), ClinVar, and PubMed databases, the mutation sites were counted and the characteristics and thyroid phenotypes were analyzed. RESULTS: The median age of hearing phenotype onset in PDS cases reported in multiple databases was 1.0 (1.0, 2.0) years, the median age of thyroid phenotype onset was 14.5 (5.8, 21.0) years, and the median age that thyroid phenotype was more delayed than hearing phenotype was 10.0 (4.0, 17.0) years. There were significant differences in the distribution of onset time between the two phenotypes (Z=-4.560, p<0.01). In these patients, the positive rates of goiter, thyroid nodules, abnormal thyroid function, and perchlorate discharge test (PDT) were 78%, 78%, 69%, and 78%, respectively. Moreover, the number of thyroid phenotype-positive items in the genotype group with frameshift mutation was not significantly higher than that in the group without frameshift mutation (Z=-1.452, p=0.147). CONCLUSIONS: The early missed diagnosis of PDS may be due to the late onset of thyroid phenotype and the non-100% positive rate of examination items. Therefore, multi-item follow-up of the thyroid gland into adulthood will benefit patients. At present, the relationship between genotype and phenotype is still unclear, and prognosis cannot be determined according to genotype. [ABSTRACT FROM AUTHOR]

Background: Based on the critical role of MT4-MMP and MT6-MMP in carcinogenesis, we focused on MT4-MMP and MT6-MMP circulating levels in patients with thyroid nodules. Methods: Plasma samples were collected from three groups, including papillary thyroid cancer (PTC; n = 30), multinodular goiter (MNG; n = 30), and healthy subjects (n = 22). Enzyme-linked immunosorbent assay (ELISA) was used to obtain the concentration of MT4-MMP and MT6-MMP in the three groups. Results: Analysis of data demonstrated increased levels of MT4-MMP (PTC: 4.90 ± 1.35, MNG: 4.89 ± 1.37, and healthy: 3.13 ± 1.42) and MT6-MMP (PTC: 8.29 ± 2.50, MNG: 7.34 ± 2.09, and healthy:5.01 ± 2.13) in thyroid nodules by comparison with healthy subjects (P < 0.05). There were no significant differences in the levels of the two MT-MMPs between PTC and MNG (P > 0.05). Increased plasma levels of MT4-MMP (odds ratio = 2.48; 95% CI: 1.46--4.19; P = 0.001) or MT6-MMP (odds ratio = 1.81; 95% CI: 1.29--2.53; P = 0.001) were associated with increased risk of PTC tumorigenesis. Interestingly, a strong positive association was observed between MT4-MMP and MT6-MMP in the three groups (PTC: r = 0.766**, P = 0.000; MNG: r = 0.856**, P = 0.000; healthy r = 0.947**, P = 0.000). Areas under the ROC curve for MT4-MMP and MT6-MMP were 0.82 and 0.96, respectively. At the cutoff value > 4.7 (ng/mL), MT4-MMP and MT6-MMP showed a sensitivity of 63.3% and 90.0%, respectively, with 100% specificity. Conclusion: Our work has led us to imply that the higher levels of MT4-MMP and MT6-MMP are closely linked with both PTC and MNG tumorigenesis. They may probably promote the development of thyroid lesions; however, more research is needed to further clarify the current findings. [ABSTRACT FROM AUTHOR]

Nodular goiter has become increasingly prevalent in recent years. Clinically, there has been a burgeoning interest in nodular goiter due to the risk of progression to thyroid cancer. This review aims to provide a comprehensive summary of the mechanisms underlying the therapeutic effect of Chinese medicine (CM) in nodular goiter. Articles were systematically retrieved from databases, including PubMed, Web of Science and China National Knowledge Infrastructure. New evidence showed that CM exhibited multi-pathway and multi-target characteristics in the treatment of nodular goiter, involving hypothalamus-pituitary-thyroid axis, oxidative stress, blood rheology, cell proliferation, apoptosis, and autophagy, especially inhibition of cell proliferation and promotion of cell apoptosis, involving multiple signal pathways and a variety of cytokines. This review provides a scientific basis for the therapeutic use of CM against nodular goiter. Nonetheless, future studies are warranted to identify more regulatory genes and pathways to provide new approaches for the treatment of nodular goiter. [ABSTRACT FROM AUTHOR]

It is controversial that high-fluoride and high-iodine combined exposure affects the prevalence of dental fluorosis and goiter. The aim of this study was to explore the potential association between high-fluoride and high-iodine combined exposure with dental fluorosis and goiter. We retrieved relevant articles from PubMed, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database and China Science and Technology Journal Database (VIP). The query format was 1 # "Fluorosis" OR "Fluoride," 2 # "Iodine" OR "Iodide," and 3 # 1 AND 2. A total of 20 papers were included in this study after independent review by two investigators. Our analysis showed that high-fluoride and high-iodine biphasic exposure was significantly associated with the prevalence of goiter (OR = 4.69, 95% CI 2.82–7.80, P < 0.001). The prevalence of dental fluorosis was also significantly raised (OR = 11.71, 95% CI 7.57–18.14, P < 0.001). Sensitivity analysis suggested that combined statistics of multiple studies were reliable. For goiter, subgroup analysis revealed study province, sample size and published year as sources of heterogeneity (P < 0.001). For dental fluorosis, only sample size was the impact factor of heterogeneity. As well, funnel plot, Begg's test and Egger's test suggested there was no publication bias (P > 0.05). Overall, our study demonstrates that high-fluoride and high-iodine combined exposure is a risk factor for occurrence of dental fluorosis and goiter. The chronic of high-fluoride and high-iodine combined exposure is a significant higher risk of disease than normal. [ABSTRACT FROM AUTHOR]

Graves' disease (GD) is the most common cause of hyperthyroidism in children. A common GD symptom is a goiter. The usual biochemical profile in children with GD is a decreased thyroid hormone stimulating hormone (TSH) level and high free thyroxine (FT4) and free triiodothyronine (FT3) concentrations. The presence of thyroid receptor antibodies (TRAb) is the most important specific immunological sign for diagnosing GD. The treatment choices for pediatric GD are anti-thyroid drugs (ATDs), radioiodine, and thyroidectomy, but the risks and benefits of each modality are different. Management recommendations include the first-line use of a prolonged course of ATDs for at least 3 years and potentially 5 years or more. Rituximab and Teprotumumab are new novel alternative medications for the treatment of adult patients with GD and Graves' orbitopathy respectively, but evidence of the efficacy and safety of these drugs in pediatric patients with GD is lacking. [ABSTRACT FROM AUTHOR]

Background: Reduced field‐of‐view diffusion‐weighted imaging (rFOV‐DWI) could be proved to quantitatively identify papillary thyroid carcinoma (PTC) and there is no literature regarding the use of T1 mapping to distinguish nodular goiter (NG) from PTC. Purpose: To compare T1 mapping with rFOV‐DWI in differentiating NG and PTC. Study Type: Prospective study. Populations: Ninety‐five hospitalized patients with thyroid nodules were included in the research. Sequence: All subjects underwent T1‐weighted imaging, T2‐weighted imaging, rFOV‐DWI and T1‐mapping sequences. Assessment: The apparent diffusion coefficient (ADC) and T1 values of each thyroid nodule were measured, respectively. According to pathological results, the thyroid nodules were divided into two groups: Group 1 (NG) and Group 2 (PTC). Statistical Tests: An independent sample t test was used to evaluate the differences of ADC and T1 between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of T1, ADC, Thyroid Imaging Reporting and Data System (TI‐RADS) and T1 and ADC. Results: The T1 and ADC values of nodular goiter were both higher than those of PTC (p < 0.05). The area under the ROC curve (AUC) values of T1 and ADC were significantly higher than that of T1 or ADC alone (p < 0.05). The AUC value of T1 and ADC was as same as that of TI‐RADS. Conclusion: The combination of T1 mapping and rFOV‐DWI could effectively differentiate NG from PTC. And it has at least the same diagnostic value as the ultrasound‐based TI‐RADS classification. [ABSTRACT FROM AUTHOR]

Background: Injuries to the recurrent inferior laryngeal nerve (RLN) remain one of the major post-operative complications after thyroid surgery. In studies, temporary RLN damage during thyroidectomy is %2-11, and the rate of permanent RLN damage is %0.6-1.6. Complementary thyroidectomies have a higher complication rate compared to the first surgical procedure. In the last two decades, intraoperative neural monitoring has become a powerful tool for risk minimization. In our study, we aimed to retrospectively examine the patients who underwent complementary thyroidectomy and intraoperative nerve monitoring. Materials and Methods: Between January 2016 and February 2020, the files of 54 patients, who underwent complementary thyroidectomy and nerve monitoring in our clinic, were analyzed retrospectively. Patients who did not undergo nerve monitoring were not included in the study. The age, gender, pathology and indication, first surgery type, and the length of hospital stay of the patients, the reason for undergoing complementary thyroidectomy, and whether or not postoperative complications developed in the patients, were all recorded. Results: The mean age of the patients was 44.4 (16-82 years). The average length of hospital stay of the patients was 2.37 (1-5 days). According to the initial pathology results of the patients who underwent complementary thyroidectomy, 34 had papillary thyroid cancer, 6 had follicular thyroid carcinoma or suspicion, 1 had medullary thyroid carcinoma, 1 patient had Anaplastic thyroid carcinoma suspicion and 12 patients had Multinodular Goiter recurrence. Conclusions: As a result, complementary thyroid surgery poses an important problem for surgeons. It has a high rate of complications due to the formation of scar and loss of normal tissue planes. Therefore, we think that the use of intraoperative nerve monitoring during complementary thyroidectomy surgery may be helpful in reducing the occurrence of permanent or temporary recurrent laryngeal nerve damage. [ABSTRACT FROM AUTHOR]

Aim: Primary hyperparathyroidism and differentiated thyroid carcinoma are the most common endocrinological diseases. Since its first definition in the 1950s, nodular goiter and differentiated thyroid carcinoma in patients with primary hyperparathyroidism have been examined in many studies and an increase in cancer incidence has been found. In this study, we aimed to investigate the co-incidence of nodular goiter and differentiated thyroid cancer in patients with primary hyperparathyroidism. Material and Methods: One hundred seventy-two patients who underwent parathyroid surgery in our hospital between 2012 and 2015 were included in this study. Demographic, clinic, and surgical data of the patients were reviewed retrospectively. Results: The mean age of the patients was 54.3±11.3 years and 85.5% (n=147) of them were female. Nodular goiter was observed at a rate of 61.0% (n=105) in preoperative evaluation. Parathyroidectomy was performed in 125 (72.7%) and simultaneous total thyroidectomy was performed in 32 (18.6%) and lobectomy in 15 (8.7%) of the patients. Histopathologically, 94.8% (n=163) were interpreted as adenoma, 2.9% (n=5) as parathyroid hyperplasia, and 2.3% (n=4) as parathyroid carcinoma. Patients with papillary thyroid carcinoma (n=30) and benign (n=17) histopathologically were compared in terms of clinical and laboratory characteristics, and no significant difference was observed in any parameter. Conclusion: There was no significant increase in thyroid nodularity, but a significant increase was found in differentiated thyroid carcinoma incidence in patients with primary hyperparathyroidism in this study in accordance with the literature. This finding highlights the importance of preoperative thyroid evaluation in this patient group. [ABSTRACT FROM AUTHOR]

Introduction: Iodine deficiency disorders (IDD) have remained an unresolved public health problem in India. In this survey, we have estimated the prevalence of IDD among 6–12 years of school children in rural areas of north Karnataka, India and estimated the prevalence of low iodine content (

Background: The various reporting systems such as conventional system, UK/RC Path system, and The Bethesda System for Reporting Thyroid Cytology (TSBRTC) have been used to help create a standard reporting format for evaluating thyroid cytology smears. However, there is still an ongoing dispute as to which classification system is the best for the management of the patient with thyroid lesions. The aim of this study is to review the utility of three reporting systems in cytological evaluation of thyroid swellings. Materials and Methods: A total of 50 cases were included in study. Only adequate smears were included in the study. Cytology smears of all cases were reported and categorized as per three reporting systems. In cases in which surgical specimens were received for histopathological examination, diagnosis was correlated with cytology diagnosis. Results: Maximum patients (n = 27) were in the age group of 20–40 years. The comparison of conventional, TSBRTC, and UK/RC Path reporting systems of 50 thyroid cytology smears showed equivocal cases in the benign category (Category II). Conclusion: In the vast majority of the cases, it showed that TBSRTC and UK/RC Path system lead to better diagnostic yield, high sensitivity, and timely treatment of patients. TBSRTC has diagnostic accuracy of almost 98%. One of the most challenging categories was the Category III in TSBRTC or Thy3a which are heterogeneous category. The smears in these categories include features which do not permit them to be classified as either benign or malignant.

Objectives: Ultrasound diagnosis of thyroid nodules has greatly increased their detection rate. Their risk for malignancy is estimated between 7 and 15% in data from specialized centers which are used for guidelines recommendations. This high rate causes considerable anxiety to patients upon first diagnosis. Here, we retrospectively analyzed the malignancy rate of sonographically diagnosed nodules larger than 1 cm from a primary/secondary care center when long-term longitudinal follow-up was included. Patients/methods: In the study, 17,592 patients were diagnosed with a thyroid nodule larger than 1 cm, of whom 7776 were assessed by fine-needle aspiration cytology (FNAC) and 9816 by sonography alone. 9568 patients were initially discharged due to innocent results of FNAC and/or ultrasound. In 1904 patients, definitive histology was obtained, and 6731 cases were included in the long-term follow-up (up to 23 years, median 5 years). Results: Malignancy was histologically confirmed in 189 patients (1.1% of all) when excluding accidentally diagnosed papillary microcarcinomas. 155 were diagnosed during the first year of management, 25 in years 2–5 of follow-up, 9 in years 6–10 and nil in 1165 patients followed beyond 10 years. Conclusions: The malignancy rate of thyroid nodules from primary/secondary care was much lower than that previously reported. During follow-up for more than 5 years, their rate rapidly dropped to less than 1/1000 cases. This low malignancy rate may help to reassure patients first confronted with the diagnosis of a thyroid nodule, substantially reduce their anxiety and avoid unwarranted diagnostic and therapeutic procedures.

Background and aim: This study aims to review the indications, histopathology, and complications of thyroid operations in a resource-limited setting where the management is provided primarily by general surgeons.Material and methods: A retrospective study between Jun 2010 and March 2019 included 246 cases who underwent thyroid operations for a thyroid disorder in Al-Nasr Hospital, Ibb, Yemen. The patient's demographic characteristics, operative findings, complications, fine needle aspiration biopsy (FNAB) results, and outcomes were gathered and analyzed.Results: The mean age was 41.60± 8.31 years. The prevalence was high in the age group of 31–40 years and the female gender (87.8%). The main indication for thyroidectomy was compressional symptoms (35%). The main cytology findings were multinodular goiter (89%). Thyroid cancer was presented in 18(7.3%) patients; the most type was follicular thyroid carcinoma (FTC) in 9 patients. The most typical type of surgery was near-total thyroidectomy in 186 (75.6%) patients. Complications were presented in 47 (19.1%) patients, and total mortality was observed in 5(2.03%) patients. Intraoperative bleeding was the most typical complication in 36 (14.6%) patients. The sensitivity, specificity, and accuracy of FNAB were 98.35%, 98.28%, and 98.28%, respectively. FNAB was not precise enough in diagnosing FTC with a sensitivity of 55%.Conclusions: Even though the rate of complications following thyroidectomy in this study is still high. Most of the mentioned complications are temporary and easy to treat. Thyroidectomy may be viable even in a resource-limited setting or performed by general surgeons.

Abstract Background Primary congenital hypothyroidism (CH) is a rare endocrine disorder in cats with a largely unknown genetic cause. Objectives Describe the clinical presentation of CH in 11 affected cats and identify the causal genetic variant. Animals Eleven CH‐cats from 10 unrelated families, 11 CH‐free family members, 21 unrelated CH‐free cats, and 155 unrelated nondiagnosed cats from different breeds. Methods Case control study of CH‐cats and their siblings (2019‐2021). Diagnosis was based on low to low‐normal serum thyroxine (T4) concentrations, high thyroid‐stimulating hormone (TSH) concentrations and clinical signs compatible with CH. We identified the causal variant using Sanger sequencing, genotyping via PCR‐RFLP and variant interpretation using ACMG/AMP guidelines. Results All CH‐cats (5 weeks‐8 years) had disproportionate dwarfism. A goiter was not palpable in all. Thyroid scintigraphy with radiopertechnetate showed abnormally high uptake by thyroid glands, whereas scintigraphy with radioiodine showed abnormally low uptake, compatible with a defect in iodine organification by thyroid peroxidase (TPO). All cases were homozygous for TPO variant XM_006930524.4:c.430G>A(p.(Gly144Arg)), while none of the CH‐free cats were. All sampled parents were heterozygous for this recessive variant. This variant was found in 15 cat breeds with an estimated allele frequency of 9%. Conclusions and Clinical Importance Disproportionate dwarfism, abnormally high TSH and abnormally low to low‐normal T4 concentrations are diagnostic for CH in cats. All cases had dyshormonogenesis demonstrated by thyroid scintigraphy. This novel TPO missense variant (not described in humans) causes CH in cats and awareness of it can assist in diagnosis and breeding.

Background: The intrapulmonary ectopic thyroid gland is exceedingly rare since the ectopic thyroid was discovered. Only eight cases have been reported in the worldwide literature. We present a case of multiple intrapulmonary ectopic thyroid glands with nodular goiter in a 10-year-old girl. Case presentation: The girl was found with multiple intrapulmonary nodules in bilateral lungs during the treatment of nodular goiter. The intrapulmonary lesions were initially thought to be a high possibility of metastatic cancer. A computed tomography-guided percutaneous lung biopsy was performed, and the pathological examination confirmed that the diagnosis was ectopic intrapulmonary thyroid. Conclusion: The ectopic intrapulmonary thyroid should be considered when children with nodular goiter presenting with suspected metastases in the lung. [ABSTRACT FROM AUTHOR]

Introduction: Patients undergoing a total thyroidectomy for multinodular goiter typically have a long clinical history of the disease. They often come to surgery for compression symptoms, with no suspicion of neoplastic disease. For these patients, the incidence of microcarcinomas is high, even though we know that this does not affect subsequent therapies and long-term survival. On the other hand, when a true incidental carcinoma is present, the patient requires specific therapy and long-term follow-up. The purpose of the study was to identify the incidence of incidental carcinomas in the high prevalence region of goiter, the clinical-pathological characteristics of the tumor, and the therapeutic implications. Method: This is a retrospective study, from January 2010 to December 2020, on a case series of 1435 total thyroidectomies for goiters. All patients had a preoperative diagnosis of a benign disease. Gender, mean age, and mean duration from the initial diagnosis of goiter were evaluated along with the number and frequency of fine needle aspirations carried out. On the basis of the histological examination, the incidence of incidental carcinoma was then assessed (diameter ≥ 10 mm) as well as the incidence of microcarcinoma (diameter < 10 mm), the pathological characteristics (multifocality, capsular invasion), and the subsequent prescribed therapies. Results: Patients with incidental carcinoma numbered 41 (2.8%%), 34 women and 7 men. The mean age was 53.5 years, while the patients diagnosed with microcarcinoma were 88 (6.1%). The mean duration of the disease from initial diagnosis was 7.8 years. On average, these patients underwent 1.8 fine needle aspirations during the course of the disease, almost exclusively in the first four years. The mean diameter of the tumor was 1.35 cm (±0.3). Multifocality was present in six patients, while only one patient presented capsular invasion. The chi-square test delivered a significant dependence on gender in terms of the incidental diagnosis after Yates correction (chi-stat = 5.064; p = 0.024), highlighting a higher incidence in the female population. All patients underwent subsequent metabolic radiotherapy. The mean follow-up was 6.3 years and in the 35 patients examined, none displayed any recurrence of the disease. Conclusions: Incidental carcinoma is not uncommon in patients who have undergone total thyroidectomy for goiters. It must be differentiated from microcarcinoma for its therapeutic implications and the follow-up of the patient. Statistical analysis has shown that the only significant variable is gender. In a goiter area, the careful monitoring of patients is required to highlight suspicious clinical–instrumental aspects that may appear even several years after the initial diagnosis. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of follicular carcinoma is often difficult to make on pathological analysis, as the histological distinction from follicular adenoma rests solely on the presence of capsular or vascular invasion. Even on retrospective review of the histopathology after the disease biology has declared itself as malignant, the pathological diagnosis of malignancy may not be possible to make. Methods: We report three cases in which patients were initially diagnosed with benign follicular lesions, but re‐presented with locally recurrent disease and a subsequent malignant disease course. Results: We describe a rare entity of follicular thyroid carcinoma that demonstrates a locally recurrent and eventually metastatic disease phenotype, despite persistently benign pathological findings. Conclusion: We highlight that if local recurrence occurs in discrete anatomical tissue planes, or in the thyroid bed following open total thyroidectomy for 'benign multinodular goitre', the possibility of this rare presentation of follicular thyroid carcinoma should be considered. [ABSTRACT FROM AUTHOR]

Objective: systematic review assessed the overall incidence of hypoparathyroidism after Total thyroidectomy (TT) for benign goitres. Methods: A systematic search of PubMed, google scholar, Cochrane, and Pakmedinet under PRISMA (preferred reporting items for systematic reviews and Meta-analyses) guidelines was performed. All studies during the last 50 years where TT was performed for benign goitres and post-operative hypoparathyroidism was assessed were included. The total incidence of both transient and permanent hypoparathyroidism was calculated after TT for benign goitres. The risk of bias was also assessed. Results: Twelve studies were included in total including eight retrospective, three prospective observational studies, and one randomized trial. Three studies were from Turkey, 2 from Pakistan, 2 from Greece, and one each from Saudi Arabia, India, Denmark, Egypt, and the USA. 2809 TT were performed for benign goitres. Overall Transient hypoparathyroidism (THP) was noted in 290 (10%) patients while permanent hypoparathyroidism (PHP) was noted in 33(1.17%) patients. The highest incidence of permanent hypoparathyroidism was 17% in one study while the lowest was 0% in three studies. The highest incidence of transient hypoparathyroidism was 28.5% in one study while the lowest incidence was 2.5%. The risk of bias was high. Conclusion: TT for benign goitres is associated with 1.17 % overall risk (range 0%-17%) of PHP and 10% (range 2.5%- 28.5%) of THP. [ABSTRACT FROM AUTHOR]

Objective: The prevalence of thyroid dysfunction is higher in patients with diabetes, and its diagnosis couldenable a beter diabeticmanagement. The purpose of the present study is to examine the impact of pathophysiological changes in patients with Type-2 diabetes on the frequency of thyroid dysfunction, thyroid autoimmunity, thyroid nodule, and thyroid cancer in Turkey. Method: The study was conducted on a total of 3.276 patients with Type-2 diabetes who underwent thyroid tests and thyroid ultrasonography (US). The demographic characteristics, biochemical and hormonal values, thyroid US reports, and histopathologic reports were collected from electronic records of the patients. Results: Thyroid autoimmunity positive TPOab 15.9% (n = 524) and/orpositive TGab 9.9% (n = 327), the rate of positivity of both antibodies (TPOab + TGab) in the same patient, and total thyroid autoimmunity was found to be 32.57% (n=1067) in Type-2 diabeticpatients. Thyroid dysfunction wasdetected in 18.3% (n = 602) of these patients. The distribution of thyroid dysfunction was 9.09% (n = 298) subclinical hypothyroidism, 4.1% (n = 135) clinical hypothyroidism, 3.1% (n = 102) subclinical hyperthyroidism, 2.0% (n = 67) clinical hyperthyroidism. Also, 67.9% (n = 2225) thyroid nodules, and 5% (n = 164) thyroid cancer cases were detected. Conclusion: Thyroid dysfunction was foundincreased in patients with Type-2 diabetes at significant levels. [ABSTRACT FROM AUTHOR]

Objective: Some factors (age, weight, height, body mass index, body surface area, puberty stage, and iodine nutrition status) may affect thyroid volume (TV). We aimed to investigate the differences between chronological age and height age in interpreting goiter. Materials and Methods: The thyroid ultrasonography records of 420 children aged 1--18 years were evaluated. We searched the difference between the interpretations of goiter by recalculating the TV standard deviation score (SDS) in terms of both chronological ages and corrected for height age. We also evaluated those with negative thyroid autoantibodies and normal thyroid hormone levels by subgroup analysis. The evaluation of TV according to chronological age and height age and the change of goiter interpretation were compared with the McNemar test. Results: A total of 180 children who had euthyroid and negative thyroid autoantibodies were analyzed. A weak correlation was detected between TV and age (r=0.29, p<0.001), body weight (r=0.35, p<0.001), height (r=0.32, p<0.001), height age (r=0.32, p<0.001), body weight SDS (r=0.20, p=0.008) and height SDS (r=0.21, p=0.005). When the changes of goiter interpretation were compared, a statistically significant difference was determined in the whole group (p=0.029); however, there was no significant difference in children who were both euthyroid and found to have negative thyroid auto-antibodies (p=0.375). Conclusion: We observed that the interpretation of goiter changed according to chronological age and height age if thyroid hormone level and/or thyroid autoantibody positivity were included. [ABSTRACT FROM AUTHOR]

Background: Māori have an increased incidence of thyrotoxicosis when compvared to non‐Māori, however there are limited data on benign non‐toxic nodular thyroid disease. Aims: The aims of this study were to determine the rates of non‐toxic multinodular goitre (NTMNG) surgery for Māori and non‐Māori and to determine if there were differences in thyroid size between Māori and non‐Māori undergoing total thyroidectomy for NTMNG. Methods: Single centre study of patients undergoing thyroidectomy for NTMNG from 1 December 2006 to 30 November 2016. Results: Māori were overrepresented amongst the 427 patients who underwent surgery for NTMNG at 34% compared to the expected ~17% of the background Māori adult population in the region. At the time of surgery, Māori were younger (P = 0.004) and had a larger thyroid gland (P < 0.001) when compared to non‐Maori also undergoing total/near total thyroidectomy. Complication rates were low across all ethnic groups. Conclusion: Māori have increased rates of surgery for NTMNG compared to non‐Māori and thyroid size is larger at the time of surgery. The reasons for this are currently unknown and more research is required. [ABSTRACT FROM AUTHOR]

Background: The various reporting systems such as conventional system, UK/RC Path system, and The Bethesda System for Reporting Thyroid Cytology (TSBRTC) have been used to help create a standard reporting format for evaluating thyroid cytology smears. However, there is still an ongoing dispute as to which classification system is the best for the management of the patient with thyroid lesions. The aim of this study is to review the utility of three reporting systems in cytological evaluation of thyroid swellings. Materials and Methods: A total of 50 cases were included in study. Only adequate smears were included in the study. Cytology smears of all cases were reported and categorized as per three reporting systems. In cases in which surgical specimens were received for histopathological examination, diagnosis was correlated with cytology diagnosis. Results: Maximum patients (n = 27) were in the age group of 20-40 years. The comparison of conventional, TSBRTC, and UK/RC Path reporting systems of 50 thyroid cytology smears showed equivocal cases in the benign category (Category II). Conclusion: In the vast majority of the cases, it showed that TBSRTC and UK/RC Path system lead to better diagnostic yield, high sensitivity, and timely treatment of patients. TBSRTC has diagnostic accuracy of almost 98%. One of the most challenging categories was the Category III in TSBRTC or Thy3a which are heterogeneous category. The smears in these categories include features which do not permit them to be classified as either benign or malignant. [ABSTRACT FROM AUTHOR]

Background: Thyroid gland diseases are a topical medical and social problem of modern society. Thyroid gland disorders are the second most prevalent disease among endocrine abnormalities after diabetes mellitus globally. Development of thyroidology was influenced by different civilizations. The description of thyroid gland diseases in historical sources is an illustration of the tight connection between basic and clinical sciences. Thyroidology is one of the very crucial fields of modern endocrinology and it is also well-developed in Georgia. Aim: to study the history of the development of thyroidology in Georgia. Methods: Desk research is conducted to review the empirical evidence on the development of thyroidology in Georgia, to identify the main drivers and key actors of the process and analyze their roles in the development of thyroidology in Georgia. The search for relevant publications with the above-mentioned keywords is conducted in the following databases: PubMed, ScienceDirect, Medline, Cochrane Database of Systematic Reviews, and Google Scholar. Literature is searched in January-September 2022. The language of publications is limited to English, Georgian, and Russian. Results: Evidence-based publications about the development of thyroidology in Georgia were/.,m Conclusions: Georgia is situated in cross broader of many countries. The development of medicine in Georgia was influenced by the different cultures and civilizations. At the same time, the development of thyroidology in Georgia is also affected by the local factors and health needs of the local population. [ABSTRACT FROM AUTHOR]

Cases of Goiter related to iodine deficiency in cross-breed goat kids in Basrah, Iraq are very scarce, and little information has been provided; therefore, the present study highlighted a clinical case of goat kids suffering from Goiter due to iodine deficiency with hematological and biochemical evaluation. The study examined 44 cross-breed goat kids, 1-3 months old (males and females), who showed painless palpable enlargement on one side of the cranio-ventral neck region or near the throat rejoin with weakness and alopecia. Ten clinically healthy kids of the same age were considered a control group. This study's diseased and control group was subjected to complete clinical examinations. Diseased animals show painless palpable and visible enlarged thyroid glands with or without enlargement of the neck, sparse hair coats with little alopecia, slow growth rate, irregular appetite or unwillingness to suck, weakness, and emaciation. Furthermore, the presence of thyroid thrill during palpation of jugular furrow was also detected. Moreover, diseased goat kids show no significant difference in body temperature; however, a significant increase was encountered in respiratory rate with a significant decrease in heart rate. On the other hand, no significant changes have been detected in the hematological analysis between diseased goat kids and the control group concerning the chemical analysis between the diseased cross-breed goat kids and the control group; the results of the present study indicated a significant increase in TSH, whereas, T3, T4, FT4, glucose level, Vit. E (α-tocopherol) and serum glutathione peroxides were lowered in diseased cross-breed goat kids compared with the control group. In contrast, a significant hyper- cholesterolemia was indicated in diseased animals than in the control group. It was concluded that Goiter in kids could reflect harm effects terminated mostly with death. Therefore, improving the maternal diet is an important reason to reduce the development of the disease. [ABSTRACT FROM AUTHOR]

PTEN hamartoma tumor syndrome (PHTS) is a rare genetic cancer and tumor predisposition syndrome. Due to the wide spectrum of clinical manifestations and variable age at onset, the pathways leading to a PHTS diagnosis are difficult and highly variable. Many patients were found to have PHTS after a cancer diagnosis, missing the opportunity of prevention or enhanced cancer screening. This retrospective study evaluated a PHTS cohort followed in a high‐risk surveillance clinic in a comprehensive cancer institution. A significant portion of the patients (60.9%, 14/23) had at least one cancer diagnosis (average age 34.6 years at diagnosis). A significant portion (78.3%, 18/23) were affected with clinically significant goiters (age 27.9 years), and many (60.9%, 14/23) had partial or total thyroidectomy (age 27.1 years). The average age at goiter diagnosis or thyroidectomy is younger than a cancer diagnosis. In 12 individuals who were affected with clinically significant goiter and cancer, all cancers were diagnosed after the thyroid disease (6.3 years). As clinically significant thyroid nodules in childhood or early young adulthood are common in PHTS, but uncommon for general population, these early onset thyroid nodules may alert the clinician to initiate PHTS‐targeted evaluation and genetic testing. [ABSTRACT FROM AUTHOR]

Background. Gemstone spectral contrast-enhanced CT with virtual noncontrast (VNC) images and iodine maps can potentially reduce the number of required CT scans for thyroid lesions. However, data regarding the clinical utility of VNC images and iodine maps in characterizing thyroid lesions and distinguishing thyroid papillary carcinoma from nodular goiter are still limited. Purpose. To determine whether VNC images and iodine density could reliably aid in characterizing thyroid lesions and distinguishing thyroid papillary carcinoma from nodular goiter compared with true noncontrast (TNC) images. Methods. This retrospective study included patients with thyroid papillary carcinoma or nodular goiter who underwent TNC and contrast-enhanced gemstone spectral CT scans. The consistency of qualitative parameters, including intralesional calcification, necrosis, lesion boundary, thyroid edge interruption, and lymph node metastasis, between TNC and VNC images, was analyzed using the kappa statistic. TNC attenuation, VNC attenuation, absolute attenuation between TNC and VNC, and iodine density were compared between thyroid papillary carcinoma and nodular goiter by using Student's t-test. The diagnostic performance for distinguishing papillary carcinoma from nodular goiter was evaluated by using the area under the receiver operating characteristic curve (AUC) value, sensitivity, and specificity. Results. VNC and TNC imaging showed comparable performance in delineating calcification, necrosis, lesion boundary, thyroid edge interruption, and lymph node metastasis (all k > 0.75). Papillary carcinoma showed significantly lower absolute attenuation between VNC and TNC than nodular goiter (7.86 ± 6.74 vs. 13.43 ± 10.53, P = 0.026), which was similarly observed for iodine density (31.45 ± 8.51 vs. 37.27 ± 10.34, P = 0.016). The iodine density showed higher diagnostic performance (AUC = 0.727), accuracy (0.773 vs. 0.667), sensitivity (0.750 vs. 0.708), and specificity (0.786 vs. 0.643) than the absolute attenuation between TNC and VNC images (AUC = 0.683). Conclusions. VNC imaging, a promising substitute for TNC imaging, has comparable diagnostic efficacy for reliably characterizing thyroid lesions. Iodine density could be valuable for distinguishing thyroid papillary carcinoma from nodular goiter. [ABSTRACT FROM AUTHOR]

Background: Congenital hypothyroidism due to defects in iodotyrosine deiodinase has variable phenotypes and can present as hypothyroid or with normal thyroid testing. Methods: Whole exome sequencing was performed in individuals from two families originating from different regions of Sudan. Mass spectrometry of urine and serum iodotyrosines was performed on subjects from both families. Results: A novel iodotyrosine deiodinase (IYD) mutation (c.835C>T; R279C) was identified in individuals from two Sudanese families inherited as autosomal recessive. The mutation was identified by multiple in silica analyses to likely be detrimental. Serum and urine monoiodotyrosine (MIT) and diiodotyrosine (DIT) were markedly elevated in the homozygous subjects. Conclusion: Measurement of serum and urine DIT and MIT was more sensitive than that of urine iodine or serum thyroid function tests to determine the effect of the IYD mutation. [ABSTRACT FROM AUTHOR]

Thyroid disease and hyperparathyroidism (HPT) are among the most common endocrine disorders. Thyroid hormones play an important role in bone and calcium metabolism. The rate of HPT is greater in patients with thyroid disease than in the general medical population. Simultaneous occurrence of hyperthyroidism and hyperparathyroidism in the same patient is a rare combination. The clinical manifestations of hyperthyroidism may overshadow the more subtle and varied symptoms and signs of primary hyperparathyroidism. It poses difficult diagnostic and therapeutic problems. Both diseases, however, may have a profound influence on calcium metabolism. The resulting disturbances in thyrotoxicosis may simulate hyperparathyroidism. Contrariwise, the diagnosis of an associated parathyroid adenoma may be missed, or unnecessarily delayed because hypercalcemia is known to occur in hyperthyroidism. The coexistence of thyroiditis and thyroid nodules with parathyroid disorders is also known. Graves' disease (GD) and primary hyperparathyroidism (PHPT) are two common endocrine disorders. However the co- occurrence of hyperthyroidism and primary hyperparathyroidism (PHPT) is rare. However, the link between the two disorders remains unclarified. Hypercalcemia in Graves' hyperthyroidism should warrant a thorough investigation for concomitant primary hyperparathyroidism. Concomitant thyroid nodular disease and hyperparathyroidism (PHPT) disease has been also documented. PHPT is also reported in patients with thyroid malignancy. We hereby report a rare case of a patient who presented with coexistence of Hyperparathyroidism and Multinodular Goiter with Hashimotos Thyroiditis and Hyperthyroidism. [ABSTRACT FROM AUTHOR]

Introduction: Thyroidectomy is one of the most commonly performed surgical procedures worldwide. Although the mortality rate is currently approaching 0%, the incidence of complications in such a frequent surgery is not insignificant. The most frequent are postoperative hypoparathyroidism, recurrent injury, and asphyxial hematoma. The size of the thyroid gland has traditionally been considered one of the most important risk factors, but there is currently no study that analyzes it independently. The objective of this study is to analyze whether the size of the thyroid gland is an isolated risk factor for the development of postoperative complications. Patients and method: A prospective review of all patients who underwent total thyroidectomy at a third-level hospital between January 2019 and December 2021 was conducted. The thyroid volume was calculated preoperatively using ultrasound and, together with the weight of the definitive piece, was correlated with the development of postoperative complications. Results: One hundred twenty-one patients were included. When analyzing the incidence of complications based on the quartiles of weight and glandular volume, there were no significant differences in the incidence of transient or permanent hypoparathyroidism in any of the groups. No differences were found in terms of recurrent paralysis. No fewer parathyroid glands were visualized intraoperatively in patients with larger thyroid glands, nor did the number of them accidentally removed during surgery increase. In fact, a certain protective trend was observed with regard to the number of glands visualized and glandular size or in the relationship between thyroid volume and accidental gland removal, with no significant differences. Conclusion: The size of the thyroid gland has not been shown to be a risk factor for the development of postoperative complications, contrary to what has traditionally been considered. [ABSTRACT FROM AUTHOR]

We report the case of a paediatric female patient affected by Bannayan-Riley-Ruvalcaba syndrome (BRRS) and congenital hypothyroidism (CH) with homozygous mutation of the TPO gene. She underwent total thyroidectomy at the age of seven years because of the development of a multinodular goiter. BRRS patients present an increased risk of benign and malignant thyroid disease since childhood because of inactivating mutation of PTEN, an onco-suppressor gene. Instead, homozygous mutations in the TPO gene can be associated with severe forms of hypothyroidism with goiter; previous studies have described cases of follicular and papillary thyroid cancer in CH patients with TPO mutation despite a perfectly controlled thyroid function with Levothyroxine therapy. To our knowledge, this is the first case that describes the possible synergic role of coexisting mutation of both TPO and PTEN in the development of multinodular goiter underlining the importance of a tailored surveillance program in these patients, especially during childhood.

Background: The aim of this study was to investigate whether the presence of benign or malignant nodular thyroid disease affects levels of circulating angiogenesis cytokines. Methods: In this study we investigated levels of angiopoietin – 1 and -2 (Ang-1 and Ang-2 respectively), vascular endothelial growth factor –A (VEGF-A), galectin-3 (Gal-3), urokinase plasminogen activator receptor (uPAR) and plasminogen activation inhibitor – 1 (PAI-1) in 40 patients with differentiated thyroid cancer (DTC), 45 with thyroid papillary microcarcinoma (mPTC), 53 patients with multinodular goiter (MNG) and 58 controls. Six months after surgery 28 patients resubmitted blood samples. The diagnostic value of Ang-1 levels was evaluated with receiver operating characteristic (ROC) curves. Results: Statistically significant lower levels of Ang-1 were observed in DTC and MNG patients compared to controls (p

Background: Iodine is a trace element that is essential for the formation of thyroid hormones. It is essential for the human life’s growth and development. The thyroid gland size and functions affected by deficient or excessive intake of iodine. Iodine excess intake was found to associating with iodine-induced hyperthyroidism (IIH) and autoimmune thyroiditis. Aims and Objectives: The present study was to find the hyperthyroid goiter patient nutritional status by urinary iodine excretion (UIE) measurement and correlate them with thyroid hormone and thyroid autoantibodies. Materials and Methods: In this study, 100 adult hyperthyroid goiter ssubjects and 100 apparently normal adult subjects were conveniently recruited in this study.Urinary iodine estimation and serum TSH, fT4, fT3, AMA, and ATG were estimated,which were estimated for case and control groups. Results: The hyperthyroid goiter patient mean UIE concentration was 278.98 μg/L and 68% of excess UIE which was found. There was significant difference in the UIE between the hyperthyroid goiter patient and control (P