Reports in Thyroid Research

Introduction: Thyroid papillary microcarcinomas revealed by cystic cervical lymph node metastasis are exceptionally observed. Cervical cystic masses are most often associated with branchial cleft cysts.
Case report: In this paper, we presented a 63 years old patient presenting an isolated lateral cervical cystic mass for which he was operated. Pathological examination of the surgical specimen found a lymph node metastasis of papillary carcinoma. The thyroidectomy performed afterwards found a papillary microcarcinoma that had gone unnoticed in the initial radiological examinations.
Discussion and conclusion: Latero-cervical cysts are usually benign, especially in young subjects. But the possibility of a metastatic lesion, in particular of a thyroid carcinoma, must be raised before such situations, hence the value of a good diagnostic strategy.

Thyroid disorders are among the most common endocrine pathologies and are often primary due to damage to the thyroid gland itself. Their overall prevalence is estimated at 10% and is dominated by subclinical or asymptomatic forms. Autoimmunity plays a crucial role in the majority of cases of dysthyroidism, thus explaining their frequent association with other systemic and/or organ-specific dysimmune diseases, including systemic vasculitis with antibodies. Apart from these "dysimmune" angiitis, thyroid involvement is exceptional in other systemic vasculitis, such as Takayasu's disease, and only a few sporadic observations are reported. As a result, the exact significance of thyroid deficiency during this vasculitis is not well known. It can be simply an accidental association but more likely seems to be a specific endocrine involvement of this vasculitis or two conditions sharing the same genetic predisposition. Similarly, the prognostic significance and the physiopathogenic mechanisms of these dysthyroidism associated with systemic vasculitis are not yet well understood.

The purpose of this review is to clarify the thyroid involvement during Takayasu's arteritis and to discuss possible pathogenic mechanisms for these thyropathies.

Women face various problems during the period of development in their life from child to adult. They usually present with cosmetic problems like unwanted hair growth like that of male, weight gain, dark and velvety patches on body folds and creases. Some also present with infertility and pregnancy related problems such as uteromalnutrition, resulting in intrauterine growth retardation, PCOD and X-syndrome. Any change in woman’s life should be suspected, diagnosed and managed at early possible to prevent long-term sequelae by three-fold.

Objectives: There is a known inverse association between serum vitamin D level and Hashimotos thyroiditis from observational studies, however, very few interventional studies explored the effect of replacing vitamin D on the course of the disease. The aim of this study was to assess the effect of vitamin D replacement on serum thyroid autoimmunity, thyroid stimulating hormone (TSH), free T4 (FT4) in subjects with both autoimmune subclinical hypothyroidism (SCH) and Vitamin D deficiency.

Methods: We assessed the effect of vitamin D3 replacement on sixty-four Saudi patients with SCH (defined as TSH>4.2 but less than 10 mIU/L) and vitamin D deficiency (defined as plasma level<50, nmol/L). We measured TSH, FT4, anti TPO antibody titer (Anti TPO) and vitamin D levels at baseline and 3 months after supplementation of Cholecalciferol at a weekly oral dose of 50,000 IU.

Results: The mean age of the participants was 40.0 ± 1.8 years, mean body mass index was 29.2 ± 0.6 kg/m2 and 64.7% of the participants were females. Mean TSH was 6.1 ± 0.3 mIU/L, mean FT4 was 14.5 ± 0.2 pmol/L, mean anti TPO level was 230.6 ± 96 IU/L and mean vitamin D level was 38.9 ± 3.6 nmol/L. Following 3 months of Cholecalciferol, serum 25 (OH) Vitamin D significantly increased to 62.1 ± 3.7 nmol/L, p<0.001, while TSH significantly decreased to 4.9 ± 0.26 mIU/L, p<0.001. There was a 64% reduction in anti TPO level which was negatively correlated with vitamin D level at baseline, r=-0.433, p=0.034.

Conclusion: Replacing vitamin D in Saudi subjects with mild autoimmune SCH and vitamin D deficiency significantly reduced serum TSH and improved thyroid autoimmunity. However, larger, randomized, controlled clinical trials for longer duration are needed to clarify the role of vitamin D replacement on the remission of mild SCH.