Biochemical pattern of thyroid function test and clinical impression of thyroid disorder in a rural tertiary health institution in Nigeria

Thyroid disorders are one of the most common endocrine disorders seen globally. Diagnostic challenge may arise both clinically and biochemically because of the multiple function of thyroid hormones (THs). Request for thyroid function test (TFT s) may be based on clinical impression that may suggest thyroid dysfunction or obvious symptoms and signs that are diagnostic of hyperthyroidism or hypothyroidism. Materials and Methods: This retrospective study looks at the biochemical patterns of TFTs and the clinical impression of thyroid disorders in a rural tertiary institution. Information extracted from the laboratory register includes indication for the test, the hospital number, the gender, the age, and the THs assayed. The corresponding biochemical pattern of the TFT result was established. Results: A total of 297 requests were submitted for TH assay; 34 were excluded from the present study because there were no clinical information. There were 239 females and 24 males giving a female-to-male ratio of 9.9:1. Majority of the requests (36.5%) were for goiters, followed by gynecological disorders (20.9%) and clinical thyroid disorders (17.9%). About 46% (45.8%) of the goiter cases were biochemically euthyroid, whereas 13.5% were biochemically primary hyperthyroid. Among the 47 cases of thyroid disorders by the physician's clinical impression, 27.7% were euthyroid, 17% were biochemically hyperthyroid, and 10.6% were hypothyroid. Of the 55 gynecological disorders assessed, only 7.3% show biochemical evidence of TH alteration with 56.4% being euthyroid. About 47% (46.6%) of those that did routine medical examination had altered TH level that includes hyperthyroidism and hypothyroidism. Conclusion: Goiter is the most prevalent thyroid disorder in this environment. Biochemical pattern of thyroid function test in our environment was mostly euthyroid despites clinical features suggestive of thyroid disorders

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

Correlation between autoimmune thyroid diseases and helicobacter pylori infection

Background: Helicobacter Pylori (H. Pylori) usually acquired in childhood, it colonizes the gastric mucosa of about 50% of the world's population at some time in their life. In eastern countries, H. pylori infection has a prevalence of approximately 70%. Objective: To correlate between H. pylori infection and autoimmune thyroid diseases (AITD). Patients and Methods: This is a cross-sectional study done on 200 patients selected as a convenient sample with upper GI upset. They were selected from gastroenterology outpatient clinics at Al-Hussein and Alexandria Police Hospitals, during the summer months of 2018. They were classified according to the results of stool H. pylori Ag testing into two groups; positive and negative (each group 100 patient). This is cross-sectional study done on 200 patients selected as a convenient sample Results: Our results indicated that patients with H. pylori infection were more susceptible to AITD. There was significant association between H. pylori infection and both Hashimoto's and Graves' disease. H. pylori infection had shown to be associated with elevated liver enzymes, anemia, and IL 17. Conclusion: There is a significant positive relationship between H. pylori infection and Hashimoto's disease (HT). There is a significant positive relationship between H. pylori infection and Graves' disease (GD)

A Two-Year Audit of Thyroid Disorders in an Urban Hospital in Nigeria

Thyroid disorders are the second commonly encountered disorders in endocrine clinics and are significant causes of medical morbidity and mortality. It is pertinent to note that in the Nigerian setting; there are challenges of sub-optimal investigative and therapeutic facilities especially as concerning thyroid disorders hence there is underreporting of this important group of endocrine disorders from our part of the world.The objective of this audit is to describe the pattern of presentation; investigation; management and outcome of thyroid disorders in patients attending the Lagos State University Teaching Hospital (LASUTH) Endocrine Center.This was a retrospective medical record review of patients with thyroid disorders who presented to the out patient department; the Medical and Emergency wards of LASUTH between June 2007-June 2009. The clinical; biochemical; serological and histological parameters were used to characterize the patients. Investigations done; treatment type; complications of thyroid disorders; hospitalization records and outcome of management were all documented.One hundred and seventy patients with thyroid disorders aged between 11 and 70 years were seen during the period under review. The male: female ratio was 1:7. Patients presenting with thyrotoxicosis were 128 in number thus giving an incidence rate per year of 64. Therapeutic options were essentially thionamides; betablockers; steroids; surgery; radioactive iodine (RAI) and thyroxine. The mean (SEM) duration of medication usage was 24.5 and the median medication duration was 24 months. RAI usage was low as its use was documented in 7of the subjects with thyroid dysfunction. The rate of occurrence of variable glucose intolerance was 28with frank diabetes mellitus diagnosed in 9of the cases of hyperthyroidism. Thyroid storm; psychiatric manifestations; thyrocardiac disease and cerebrovascular diseases were indications for hospitalizations. Two deaths were documented and these were due to thyrocardiac disease and thyroid storm.RAI usage is underutilized and the thionamides are the main stay of treatment for people presenting with thyrotoxicosis. Given the peculiarities of presentation of thyroid disorders in our practice and the challenges of poor accessibility to diagnostic and therapeutic facilities; it is imperative that management guidelines that take into consideration our resource poor background be set up

Interet de l'echographie thyroidienne: a propos du nodule thyroidien

L'echographie de la thyroide a pour but essentiel de: revendiquer une place de choix comme complement indispensable; mais indiscutable de l'examen clinique; permettre de faire le diagnostic differentiel entre des masses thyroidiennes et des masses extrathyroidiennes; apprecier l'echostructure des nodules thyroidiens et permettre leur surveillance en assurant avec precision la taille des nodules; et grace a la sensibilite de la technique; de detecter des nodules a un stade infra-clinique

Thyroid Diseases in Northern Nigeria: A 15 year review

Four hundred and thirteen patients had surgery for goitre (range of specimen 20-2000G). The mean age of the patients was 34.4 years and the mean duration of goitre 7 years. Three hundred and twenty-one patients (77.7) had nodular colloid goitre. Fifty-four patients (12.8) had primary thyroid cancer; forty-one (10) had follicular adenoma. Of the cancers; 4. (0.9) had a mixed papillary - follicular pattern and 3 (0.9) were anaplastic. One (0.2) patient had a lymphoma. Thyrotoxicosis was responsible for 23 (5.6) of all patients with goitre; 17 patients (4.1) had infective thyroiditis. Ten (2.4) with giant goitres died