Advanced Research in Thyroiditis: From Clinical Presentation to a Multidisciplinary Approach

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 5108

Special Issue Editors


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Guest Editor
1. Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
2. Department of Endocrinology, C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, Romania
Interests: thyroid; adrenal; pituitary; osteoporosis; neuroendocrine tumors; bone; fracture; gynecological endocrinology
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Guest Editor
1. Department 4—Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
2. Thoracic Surgery Department, “Dr. Carol Davila” Central Emergency University Military Hospital, 013058 Bucharest, Romania
Interests: thyroid surgery; parathyroid surgery; lung neuroendocrine tumors; lung cancer; minimally invasive surgery; VATS; cervico-mediastinal surgery; thoracic-abdominal surgery; pleuro-pericardial disease; chest wall tumors
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The field of thyroiditis varies from acute to subacute and chronic forms. While majority of cases involve endocrinology practice, a strong link is related to different imaging techniques, infectious diseases, genetic background, and endocrine surgery in selected cases. Also, particular aspects involve pediatric population and pregnant women. We aim to provide a complex, multidisciplinary approach concerning different aspects of thyroiditis. We invite you to contribute to one or several papers (original study or review). We are particularly interested, but not exclusively, to: advanced research of pathogenic mechanisms; data on particular aspects like amiodarone – induced thyroiditis; overlapping disorders like Basedow-Graves’ disease and thyroid cancer, including primary lymphoma; surgical intervention on acute/suppurative cases and/and those with synchronous thyroid malignancies, new categories amid recent COVID-19 pandemic; Riedel’s thyroiditis; painless thyroiditis; correlations with cytological report, core biopsy data; new molecular and immunohistochemistry biomarkers; long term assessment of antibodies assays; poly-glandular autoimmune syndromes.

Dr. Mara Carsote
Dr. Claudiu Nistor
Guest Editors

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Keywords

  • acute thyroiditis, subacute thyroiditis, chronic thyroiditis
  • thyroid cancer
  • amiodarone
  • suppurative
  • thyroid surgery
  • antibody
  • poly-glandular autoimmune syndrome
  • thyroid lymphoma

Published Papers (3 papers)

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Research

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16 pages, 8705 KiB  
Article
A Comparative Analysis of Strain and 2D Shear Wave Elastography in the Diagnosis of Autoimmune Thyroiditis in Pediatric Patients
by Cristina Mihaela Roi, Andreea Borlea, Monica Simina Mihuta, Corina Paul and Dana Stoian
Biomedicines 2023, 11(7), 1970; https://doi.org/10.3390/biomedicines11071970 - 12 Jul 2023
Cited by 2 | Viewed by 1015
Abstract
This paper aims to assess the usefulness of shear-wave elastography (SWE) and strain elastography (SE) for identifying and monitoring thyroid gland changes in children diagnosed with chronic autoimmune thyroiditis (CAT). Our study included 77 children between the ages of six and eighteen. Of [...] Read more.
This paper aims to assess the usefulness of shear-wave elastography (SWE) and strain elastography (SE) for identifying and monitoring thyroid gland changes in children diagnosed with chronic autoimmune thyroiditis (CAT). Our study included 77 children between the ages of six and eighteen. Of these, 45 were diagnosed with CAT, while 32 had no thyroid pathology. Following a clinical examination and laboratory tests, an ultrasound was carried out, and then a SE (using a Hitachi Preirus machine) and SWE (using an Aixplorer Mach 30, Supersonic imagine, France) were performed in the same session. The median thyroid elastic index (EI) in the CAT group was 13.8 (13.3–17) kPa compared to 10.1 (9.3–11.2) kPa in healthy children (p < 0.0001). We found a median strain ratio (SR) of 1.2 (1.2–1.3) for CAT compared to 0.7 (0.6–0.9) for healthy thyroid tissue (p < 0.0001). The optimal cut-off value for predicting the presence of CAT in children using SR was >1 (Se = 82.2%, Sp = 87.5%, PPV = 90.2%, and NPV = 77.8%, AUROC = 0.850), while using SWE, the optimal cut-off value for predicting the presence of CAT in children was >12 kPa (Se = 88.9%, Sp = 93.7%, PPV = 95.2%, and NPV = 85.5%, AUROC = 0.943). Both techniques are useful for measuring thyroid tissue elasticity, and their diagnostic accuracy and reliability are comparable. Full article
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14 pages, 1949 KiB  
Article
Assessment of Thyroid Stiffness and Viscosity in Autoimmune Thyroiditis Using Novel Ultrasound-Based Techniques
by Dana Stoian, Andreea Borlea, Ioan Sporea, Alexandru Popa, Luciana Moisa-Luca and Alina Popescu
Biomedicines 2023, 11(3), 938; https://doi.org/10.3390/biomedicines11030938 - 17 Mar 2023
Cited by 2 | Viewed by 1412
Abstract
The estimation of viscosity by measuring the shear-wave dispersion (SWD) using ultrasound 2D shear-wave elastography (SWE) is becoming more and more popular. Recent research suggests that SWD can be used in addition to 2D-SWE (shear-wave speed) to diagnose diffuse liver disease. Viscosity was [...] Read more.
The estimation of viscosity by measuring the shear-wave dispersion (SWD) using ultrasound 2D shear-wave elastography (SWE) is becoming more and more popular. Recent research suggests that SWD can be used in addition to 2D-SWE (shear-wave speed) to diagnose diffuse liver disease. Viscosity was studied for the assessment of normal thyroid tissue. This study aims to evaluate the use of viscosity measurements in patients with chronic autoimmune thyroiditis using the SuperSonic MACH®30 ultrasound machine (Hologic SuperSonic Imagine, Aix-en-Provence, France) which provides the Vi PLUS mode for viscosity and the 2D SWE PLUS mode for shear-wave speed measurements. Valid measurements were obtained in 308 cases, 153 with chronic autoimmune thyroiditis (CAT) and 155 with no thyroid pathology (95.95% feasibility of the methods). The differences between the healthy group and the CAT group were statistically significant both for Vi PLUS (2.5 ± 0.4 vs. 2.8 ± 0.5, p < 0.0001) and for 2D-SWE PLUS (13.5 ± 3.3 vs. 23.1 ± 8.3, p < 0.0001). The diagnostic performance was poor for Vi PLUS alone (AUC = 0.69; cut-off > 2.5 Pa·s, se = 68.6%; sp = 64.52%) and good for 2D-SWE PLUS alone (AUC = 0.861; cut-off > 18.4 kPa, se = 69.9%; sp = 92.2%). Vi PLUS correlated with 2D-SWE PLUS, with the presence of CAT, the thyroid volume, levothyroxine replacement therapy and age. Statistically significant differences were found between the CAT subgroup receiving thyroid replacement therapy and the subgroup without therapy: 24.74 ± 8.33 vs. 21.93 ± 8.12 kPa for 2D-SWE (p = 0.0380) and 3 ± 0.5 vs. 2.7 ± 0.4 Pa·s for Vi PLUS (p = 0.0193). Elastography-based methods improve the classic ultrasound evaluation: 2D-SWE PLUS performed somewhat better in distinguishing CAT from normal thyroid tissue, while Vi PLUS made a slightly better assessment regarding the functional status. Full article
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Review

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21 pages, 1597 KiB  
Review
Reshaping the Concept of Riedel’s Thyroiditis into the Larger Frame of IgG4-Related Disease (Spectrum of IgG4-Related Thyroid Disease)
by Mara Carsote and Claudiu Nistor
Biomedicines 2023, 11(6), 1691; https://doi.org/10.3390/biomedicines11061691 - 11 Jun 2023
Cited by 2 | Viewed by 2041
Abstract
Recently, Riedel’s thyroiditis (RT) was assimilated into the larger spectrum of immunoglobulin IgG4-related disease (IgG4-RD) in addition to a particular frame of IgG4-related thyroid disease (IgG4-RTD), underlying IgG4-RT, IgG4-associated Hashimoto’s thyroiditis (and its fibrotic variant), and IgG4-related Graves’s disease. Our objective was to [...] Read more.
Recently, Riedel’s thyroiditis (RT) was assimilated into the larger spectrum of immunoglobulin IgG4-related disease (IgG4-RD) in addition to a particular frame of IgG4-related thyroid disease (IgG4-RTD), underlying IgG4-RT, IgG4-associated Hashimoto’s thyroiditis (and its fibrotic variant), and IgG4-related Graves’s disease. Our objective was to overview recent data on RT, particularly IgG4-RD and IgG4-RTD. The case and study– sample analysis (2019–2023) included 293 articles and selected 18 original studies: nine single case reports (N = 9, female/male = 2/1, aged: 34–79 years, 5/9 patients with serum IgG4 available data, 2/5 with high serum IgG4) and four case series (N = 21; 4/5 series provided data on IgG4 profile, 3/21 had serum IgG4 assays, and 2/3 had abnormally high values). IgG4-RD and thyroid findings were analyzed in three cohorts (N = 25). Another two studies (N = 11) specifically addressed IgG4-RTD components. On presentation, the patients may have hypothyroidism, transitory thyrotoxicosis, goiter, long-term history of positive anti-thyroid antibodies, and hypoechoic ultrasound thyroid pattern. The 5-year analysis (N = 66) showed the rate of serum IgG4 evaluation remained low; normal values do not exclude RT. Mandatory histological and immunohistochemistry reports point out a high content of IgG4-carrying plasma cells and IgG4/IgG ratio. Unless clinically evident, histological confirmation provides a prompt indication of starting corticoid therapy since this is the first-line option. Surgery, if feasible, is selective (non-responders to medical therapy, emergency tracheal intervention, and open/core needle biopsy). Current open issues are identifying the role of serum IgG4 assays in patients with IgG4-RD, finding out if all cases of RT are IgG4-mediated, applying IgG4-RTD criteria of differentiation among four entities, and providing an RT/IgG4-RTD guideline from diagnosis to therapy. It remains that the central aim of approaching RT in daily practice is the early index of suspicion in order to select patients referred for further procedures that provide enough histological/immunohistochemistry material to confirm RT and its high IgG4 burden. Full article
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