Short-term outcomes among patients with subclinical hypothyroidism undergoing primary percutaneous coronary intervention

Objectives: This study aimed to examine possible associations between previously undiagnosed subclinical hypothyroidism and short-term outcomes and mortality in a sample of Iraqi patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Design: This is a prospective observational cohort study. Setting: The study was conducted in a single tertiary referral centre in Baghdad, Iraq. Participants: Thyroid-stimulating hormone and free T4 levels were measured in 257 patients hospitalised with STelevation myocardial infarction who underwent primary percutaneous coronary intervention between January 2020 and March 2022. Main outcome measures: Adverse cardiovascular and renal events during hospitalisation and 30-day mortality were observed. Results: Previously undiagnosed subclinical hypothyroidism was detected in 36/257 (14%) ST-elevation myocardial infarction patients and observed more commonly in females than males. Patients with subclinical hypothyroidism had significantly worse short-term outcomes, including higher rates of suboptimal TIMI Flow (< III) (p =0.014), left ventricular ejection fraction ≤ 40% (p=0.035), Killip class >I (p=0.042), cardiogenic shock (p =0.016), cardiac arrest in the hospital (p= 0.01), and acute kidney injury (p= 0.044). Additionally, 30-day mortality was significantly higher in patients with subclinical hypothyroidism (p= 0.029). Conclusion: Subclinical hypothyroidism previously undiagnosed and untreated had a significant association with adverse short-term outcomes and higher short-term mortality within 30 days compared to euthyroid patients undergoing primary percutaneous coronary intervention. Routine thyroid function testing during these patients' hospitalisation may be warranted.

The spectrum of thyroid disorders at the Endocrine Clinic of Olabisi Onabanjo University Teaching Hospital, Sagamu, South-west, Nigeria

Background:Thyroid disorders constitute the second most common endocrine disordersworldwide, butthey are less commonly researched in thisenvironmentdue to low cost-effectiveness.Objective:Tostudy thespectrumofthyroid disordersat the EndocrinologyClinic ofa tertiary health facility in Sagamu, South-west, Nigeria,over two years.Method:Thisretrospectivestudywas conducted onallnewclinic attendees with thyroid disordersbetweenJanuary 2016 andDecember 2017.The data retrieved included clinicaldata,results of thyroid function tests and thyroid ultrasonographic scan.The patients weregroupedclinically into euthyroid, hypothyroid and thyrotoxicstates.Results:A total of 93 thyroid caseswereseen, and this constituted13.64% ofallnewendocrine consultations (682 patients).Themean age(±SD; range)of the patients was 37.6 (13.6; 15-78)years.Majority of the patients were females witha female-to-maleratio of 4.5:1.Out of these,77.4% hadGoitrous enlargement.Thyrotoxicosis wasthe most commonform of thyroid dysfunction,(72; 77.40%), mainly duetohyperthyroidism from Graves'disease(50; 69.44%),followed by toxic multinodular goitre (12; 16.67%),toxic solitary nodular goiter (5; 6.94%) andothers (5; 6.95 %).Hypothyroidism constituted 10.75%while euthyroid goitre constituted 11.85% of all thyroid cases.Conclusion:Auto-immune thyroiddisease remains the most common thyroid disorder amongendocrineclinicattendees. There isa needfor furtherstudies to elucidatethe likely aetiologies

Hypothyroïdie auto-immune revelée par une galactorrhée à Cotonou

La galactorrhée est l'un des signes révélateurs de l'hyperprolactinémie dont les étiologies sont multiples et variées. Si certaines de ces étiologies sont fréquemment retrouvées, d'autres par contre, telle que l'hypothyroïdie frustre semblent être rares. Nous rapportons ici un cas d'hypothyroïdie frustre auto-immune révélée par une hyperprolactinémie symptomatique qui a été traitée exclusivement avec succès par une hormonothérapie substitutive

Ethionamide-Induced Hypothyroidism in Children

Ethionamide is a second-line anti-tuberculosis drug used in the management of drug-resistant tuberculosis. Hypothyroidism is reported to be a rare adverse effect. A retrospective descriptive study was done of all children started on treatment for multidrug-resistant tuberculosis from 2006-2009; who received ethionamide as part of their drug regimen. Information collected included age; weight; human immunodeficiency virus (HIV) status; ethionamide dose and thyroid function tests. Seven of 13 (54) children developed hypothyroidism and received thyroxine for the duration of ethionamide treatment. Thyroid function returned to normal within two months of completion of tuberculosis treatment in six of the seven children (one lost to follow-up). Ethionamide-induced hypothyroidism is more common in this small number of patients than previously reported. The results warrant further studies to confirm these findings and elucidate possible reasons

Ethionamide-Induced Hypothyroidism in Children

Ethionamide is a second-line anti-tuberculosis drug used in the management of drug-resistant tuberculosis. Hypothyroidism is reported to be a rare adverse effect. A retrospective descriptive study was done of all children started on treatment for multidrug-resistant tuberculosis from 2006-2009; who received ethionamide as part of their drug regimen. Information collected included age; weight; human immunodeficiency virus (HIV) status; ethionamide dose and thyroid function tests. Seven of 13 (54) children developed hypothyroidism and received thyroxine for the duration of ethionamide treatment. Thyroid function returned to normal within two months of completion of tuberculosis treatment in six of the seven children (one lost to follow-up). Ethionamide-induced hypothyroidism is more common in this small number of patients than previously reported. The results warrant further studies to confirm these findings and elucidate possible reasons

Thyroid Dysfunction among Young Adults in Uganda

Background: Most studies on thyroid dysfunction have been on patients refereed for treatment; little is known about the prevalence in the general populations. The importance of knowing such prevalence data lies in that fact that subclinical thyroid dysfunction is an important risk on development of heart disease; osteoporosis; hypercholesterolemia and mental illness. This study set out to determine thyroid dysfunction prevalence in a health young adult population. Methods: A cross sectional study carried out at the College of Health Sciences; Makerere University enrolled 100 Undergraduate medical students by invitations through notices and announcements. Informed consent was sought after approval from research ethics committee. Results: Of the 100 students enrolled and the samples drawn; 83 tests for TSH and 82 tests for FT4 were successfully run. Three results were abnormal making a prevalence of 3.6for thyroid dysfunction; a high TSH (5.71) with a normal fT4 (19.2); a normal TSH (1.67) with a high fT4 (22.31) and one with a low TSH (0.03). The mean age of participants was 23 years; there were slightly more males 1.3:1.Conclusion: The prevalence of thyroid dysfunction in this cohort was low but falls in the range found elsewhere. These findings could inform the criteria of screening asymptomatic otherwise young health adults

Youth of West Cameroon are at High Risk of Developing IDD due to Low Dietary Iodine and High Dietary Thiocyanate

Objectives: Hypothyroidism in utero leading to mental retardation is highly prevalent and recurrent in developing countries where iodine deficiency and thiocyanate overload are combined. So; to explore and identify human population's risks for developing iodine deficiency disorders and their endemicity in Western Cameroon; with the aim to prevent this deficiency and to fight again it; urinary iodine and thiocyanate levels were determined. Methods: The district of Bamougoum in Western Cameroon was selected for closer study due to its geographic location predisposing for iodine deficiency disorders (IDD). A comprehensive sampling strategy included 24-h urine samples collected over three days from 120 school-aged children. Urinary iodine and thiocyanate levels were measured by colorimetric methods. Results: Twenty one percent of boys between the ages 3 and 19 were classified as iodine deficient. The prevalence of thiocyanate overload in the same population was found to be 20. Conclusion: Presence of endemic iodine deficiency and excessive thiocyanate in the population indicates that the region is at risk of iodine deficiency disorder. A multifactorial approach that includes improvement of diet; increasing iodine and minimizing goitrogen substances intake; soil and crop improvement and an iodine supplementation program may help alleviate IDD in the affected area studied