Werner & Ingbar's The Thyroid

 

Through ten outstanding editions, Werner & Ingbar's The Thyroid: A Fundamental and Clinical Text has been the go-to reference for the most comprehensive coverage of the thyroid, including anatomy, development, biochemistry, physiology, pathophysiology, and treatment of all thyroid disorders. Now in full color throughout, the 11th Edition of this award-winning text remains the clinician’s preferred source of authoritative information on the thyroid—an essential resource for all endocrinologists and thyroid surgeons.

• Includes thorough updates and new content throughout the text, especially on thyroid cytopathology, thyroid imaging, and targeted therapy of thyroid cancer as well as a new full-color format.
• Covers all aspects of the thyroid, including thyroid hormone synthesis and secretion, thyroid function, and disorders such as thyrotoxicosis, hypothyroidism, and cancer.
• Discusses surgical management of thyroid cancer, thyroid disruptors, thyroid hormone analogs, thyroid dysfunction’s effects on other organ systems, the aging thyroid, subclinical hypothyroidism and hyperthyroidism, and thyroid disease in pregnancy.
• Features insights from international experts, including new editor Dr. Peter Kopp of Northwestern University’s Feinberg School of Medicine.

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Table of Contents:

 

Cover

Title Page

Copyright

Dedication

Contributors

Preface to the Eleventh Edition

Preface to the First Edition

Contents

Section I: The Normal Thyroid

A. History, Development, Anatomy

Chapter 1: The heritage of the thyroid: A brief history

GOITER, CRETINISM, AND THE THYROID GLAND

GOITER AND IODINE

THYROTOXICOSIS

HYPOTHYROIDISM AND THE RECOGNITION OF THYROID FUNCTION

THERAPY OF HYPOTHYROIDISM

DISCOVERY OF THE ACTIVE PRINCIPLE AND THERAPY OF HYPOTHYROIDISM

SCREENING AND THERAPY OF CONGENITAL HYPOTHYROIDISM

DISCOVERY OF CURRENT CONCEPTS OF THYROID HORMONE SYNTHESIS, TRANSPORT, AND ACTION

AUTOIMMUNE ETIOLOGY OF GRAVES DISEASE AND HASHIMOTO THYROIDITIS

THYROID CANCER

OUTLOOK

REFERENCES

Chapter 2: Development and anatomy of the hypothalamic–pituitary–thyroid axis

THE HYPOTHALAMIC–PITUITARY AXIS

SIGNALING AND TRANSCRIPTIONAL MECHANISMS INVOLVED IN HYPOTHALAMUS ORGANOGENESIS

SIGNALING AND TRANSCRIPTIONAL MECHANISMS INVOLVED IN PITUITARY ORGANOGENESIS

THE THYROID GLAND

THYROID BUD FORMATION

THYROID MIGRATION

THYROID FOLLICULOGENESIS

DIFFERENTIATED THYROID FOLLICULAR CELLS

HISTOLOGY AND STRUCTURE

THYROID TRANSCRIPTION FACTORS

OTHER TRANSCRIPTION FACTORS INVOLVED IN THYROID DEVELOPMENT

IN VITRO GENERATION OF THYROID CELLS FROM PLURIPOTENT STEM CELLS

MODELING THYROID BY TRANSCRIPTION FACTORS OVEREXPRESSION

MODELING THYROID BY CHEMICAL PATHWAYS MANIPULATIONS

CONCLUSIONS

ACKNOWLEDGMENTS

REFERENCES

B. Thyroid Hormone Synthesis and Secretion

Chapter 3: Thyroid hormone synthesis: Thyroid iodide transport

IDENTIFICATION BY FUNCTIONAL EXPRESSION OF THE CDNA ENCODING RAT NIS

THE NIS MOLECULE

ISOLATION OF THE CDNA ENCODING HUMAN NIS (hNIS) AND ELUCIDATION OF THE GENOMIC ORGANIZATION OF hNIS

NIS IN EXTRATHYROIDAL TISSUES

NIS MECHANISM AND STOICHIOMETRY

SUBSTRATE SPECIFICITY OF NIS

NIS TRANSPORTS THE ENVIRONMENTAL POLLUTANT ClO4− WITH A 1 Na+:1 ClO4− STOICHIOMETRY

IODIDE TRANSPORT DEFECT, A CONGENITAL CONDITION CAUSED BY MUTATIONS IN THE NIS (SLC5A5) GENE

NIS KO MICE, A USEFUL MODEL FOR STUDYING MULTIPLE RAMIFICATIONS OF HYPOTHYROIDISM

REGULATION OF NIS TRANSCRIPTION

REGULATION OF NIS IN THE THYROID BY TSH

REGULATION OF NIS BY I−

REGULATION OF NIS BY A K+ CHANNEL

NIS IN THYROID CANCER

I− EFFLUX

NIS IN BREAST CANCER

IMPACT OF NIS ON PUBLIC HEALTH

NIS GENE TRANSFER

CONCLUDING REMARKS AND AVENUES FOR FUTURE INVESTIGATION

REFERENCES

Chapter 4: Thyroid hormone synthesis

IODIDE UPTAKE INTO THE THYROID

THE GENE AND PROTEIN STRUCTURE OF THE SODIUM/IODIDE SYMPORTER

FUNCTIONAL CHARACTERIZATION OF THE SODIUM/IODIDE SYMPORTER

REGULATION OF IODIDE UPTAKE AND SODIUM/IODIDE SYMPORTER FUNCTION AND EXPRESSION

MUTATIONS IN THE SODIUM/IODIDE SYMPORTER GENE

IODIDE EFFLUX FROM THE THYROID

PENDRED SYNDROME AND PENDRIN (PDS/SLC26A4)

PROTEIN STRUCTURE OF PENDRIN

EXPRESSION AND REGULATION OF PENDRIN

FUNCTIONAL CHARACTERIZATION OF PENDRIN

GOITER AND THYROID DYSFUNCTION IN PENDRED SYNDROME

ANOCTAMIN

SLC26A7

THYROGLOBULIN

STRUCTURE OF THE THYROGLOBULIN GENE AND PROTEIN

MUTATIONS IN THE THYROGLOBULIN GENE

THYROID PEROXIDASE

THE GENE AND PROTEIN STRUCTURE OF THYROID PEROXIDASE

FUNCTIONAL CHARACTERIZATION OF THYROID PEROXIDASE

EXPRESSION AND REGULATION OF THYROID PEROXIDASE

MUTATIONS IN THYROID PEROXIDASE

THE HYDROGEN PEROXIDE–GENERATING SYSTEM

CLONING OF THE DUAL OXIDASE AND THE DUAL OXIDASE MATURATION FACTOR GENES

THE PROTEIN STRUCTURE OF DUAL OXIDASES AND THE DUAL OXIDASE MATURATION FACTORS

EXPRESSION AND REGULATION OF DUAL OXIDASES AND THE DUAL OXIDASE MATURATION FACTORS

MECHANISM OF HYDROGEN PEROXIDE GENERATION

REGULATION OF HYDROGEN PEROXIDE ACTIVITY

GENETIC DEFECTS IN HYDROGEN PEROXIDE GENERATION

IODINATION AND THYROID HORMONE SYNTHESIS

OXIDATION OF THYROID PEROXIDASE TO COMPOUND I AND COMPOUND II

OXIDATION OF IODIDE

IODINATION AND COUPLING OF TYROSYL RESIDUES

INHIBITION OF THYROID PEROXIDASE BY THIONAMIDE DRUGS

CELLULAR UPTAKE AND PROTEOLYSIS OF THYROGLOBULIN

SECRETION OF THYROID HORMONES

DEHALOGENATION OF MONOIODOTYROSINE AND DIIODOTYROSINE

IODOTYROSINE (IYD/DEHAL1) DEIODINASE GENE AND PROTEIN

DEHALOGENASE DEFICIENCY

REFERENCES

C. Peripheral Thyroid Hormone Binding and Metabolism

Chapter 5: Thyroid hormone transport proteins

EVOLUTIONARY CONSIDERATIONS

FUNCTIONS OF THBPs

CLINICAL CONSIDERATIONS

THYROID-BINDING GLOBULIN

STRUCTURE AND FUNCTION

PHYSIOLOGIC REGULATION OF TBG IN HUMANS

PATHOLOGY

HUMAN SERPINA7 GENE SEQUENCE VARIANTS AFFECTING TBG CONCENTRATION OR FUNCTION

TRANSTHYRETIN

STRUCTURE AND FUNCTION

PHYSIOLOGIC REGULATION OF TTR IN HUMANS

PATHOLOGY

HUMAN TTR GENE SEQUENCE VARIANTS AFFECTING TTR CONCENTRATION OR FUNCTION

DYSTRANSTHYRETINEMIC HYPERTHYROXINEMIA

ALBUMIN

STRUCTURE AND FUNCTION

PATHOPHYSIOLOGY

HUMAN ALB GENE VARIANTS AFFECTING ALB CONCENTRATION OR FUNCTION

p.Arg242His

OTHER SEQUENCE VARIANTS AT Arg242

p.Arg246Ile

T3 VARIANTS OF FDH

MINOR CARRIERS

CLINICAL IMPLICATIONS OF THBPs

REFERENCES

Chapter 6: Intracellular pathways of iodothyronine metabolism/implications of deiodination for thyroid hormone action

STRUCTURE OF THE DEIODINASES

TOPOLOGY AND SUBCELLULAR LOCALIZATION

STRUCTURE–FUNCTION RELATIONSHIPS OF DEIODINASES AND MECHANISM OF DEIODINATION

SPECIFIC PROPERTIES OF THE DEIODINASES

TYPE 1 DEIODINASE

TYPE 2 DEIODINASE

TYPE 3 DEIODINASE

NONDEIODINATIVE METABOLISM OF IODOTHYRONINES

PHYSIOLOGIC ROLES OF THE SELENODEIODINASES

DEIODINASES AND THE REGULATION OF T3 PRODUCTION

ADAPTATION TO HYPOTHYROIDISM

INTRACELLULAR TRIIODOTHYRONINE HOMEOSTASIS

DEIODINASES AND REGULATION OF THYROTROPIN SECRETION

DEIODINASES AND THE BIOLOGIC EFFECTS OF THYROID HORMONE

DEIODINASES AND THE CENTRAL NERVOUS SYSTEM

DEIODINASES AND THE SKELETON

DEIODINASES AND METABOLISM

DEVELOPMENTAL ROLES OF THE DEIODINASES

MATERNAL–FETAL PHYSIOLOGY

TRIIODOTHYRONINE MODULATION OF PLACENTAL THYROID HORMONE TRANSFER

D3 EXPRESSION AND THE REQUIREMENT FOR THYROXINE IN NORMAL PREGNANCY

THE DEIODINASES IN HUMAN PATHOPHYSIOLOGY

NONTHYROIDAL ILLNESS

CONSUMPTIVE HYPOTHYROIDISM

DEIODINASES IN CANCER

HYPERTHYROIDISM AND OVEREXPRESSION OF DEIODINASES

DEIODINASES IN THE ISCHEMIC HEART

DEIODINASES IN LUNG INJURY

CONCLUSION

ACKNOWLEDGMENT

REFERENCES

D. Thyroid Hormone Action

Chapter 7: Intracellular actions by thyroid hormones

THYROID HORMONE TRANSPORT AND METABOLISM

TR-DEPENDENT SIGNALING OF TH WITH DIRECT BINDING TO DNA (TYPE 1)

THYROID HORMONE RESPONSE ELEMENTS

TRANSCRIPTIONAL REGULATION BY TRs

THYROID HORMONE RECEPTOR–INTERACTING COREPRESSORS/BASAL REPRESSION

THYROID HORMONE RECEPTOR–INTERACTING COACTIVATORS/TRANSCRIPTIONAL ACTIVATION

NEGATIVE REGULATION BY TRs

POSTTRANSLATIONAL MODIFICATION OF TR

RESISTANCE TO TH

THYROID HORMONE RECEPTOR ISOFORM KNOCKOUT AND KNOCKIN MICE

TRANSCRIPTIONAL CASCADES

TR-DEPENDENT SIGNALING OF TH WITH INDIRECT BINDING TO DNA (TYPE 2)

TR-DEPENDENT SIGNALING OF TH WITHOUT DNA BINDING (TYPE 3)

TR-INDEPENDENT TH SIGNALING (TYPE IV)

TH ANALOGS, DISRUPTORS, AND METABOLITES

SUMMARY

REFERENCES

Chapter 8: Thyroid hormone structure–function relationships

THYROID HORMONE STRUCTURE, METABOLISM, AND ACTIVITY

TR ACTIVATION BY NATURAL AND SYNTHETIC AGONISTS

DEVELOPMENT OF SELECTIVE TR SUBTYPE AGONISTS

STRUCTURE–FUNCTION RELATIONSHIPS AT TR MUTANTS—THE ISSUE OF TH RESISTANCE

TR ANTAGONISM

THYROID HORMONE INTERACTIONS WITH ALTERNATE RECEPTORS AND BINDING PROTEINS

THYRONAMINES AND ANALOGS

CONCLUSION

REFERENCES

E. Factors That Control Thyroid Function

Chapter 9: Chemistry and biosynthesis of thyrotropin

CHEMISTRY

GENES ENCODING THE SUBUNITS OF THYROTROPIN

CHROMOSOME LOCALIZATION

STRUCTURE OF THE COMMON α-SUBUNIT GENE

STRUCTURE OF THE THYROTROPIN-β–SUBUNIT GENE

CENTRAL HYPOTHYROIDISM DUE TO THYROTROPIN-β–SUBUNIT GENE ABNORMALITIES

PRETRANSLATIONAL REGULATION OF THYROTROPIN BIOSYNTHESIS

NEGATIVE REGULATORS

POSITIVE REGULATORS

SUMMARY OF PRETRANSLATION REGULATION OF THE HUMAN COMMON α- AND TSH-β–SUBUNIT GENE EXPRESSION

POSTTRANSLATIONAL PROCESSING OF THYROTROPIN

IN VITRO TRANSLATION OF THYROTROPIN-β–SUBUNIT AND α-SUBUNIT MESSENGER RNA

BIOSYNTHESIS OF THYROTROPIN IN INTACT CELLS

PROCESSING OF HIGH-MANNOSE PRECURSOR OLIGOSACCHARIDES

TERMINAL SULFATION AND SIALYLATION OF COMPLEX OLIGOSACCHARIDES

DEVELOPMENTAL AND ENDOCRINE REGULATION OF THYROTROPIN GLYCOSYLATION

BIOACTIVITY AND METABOLIC CLEARANCE OF THYROTROPIN

THREE-DIMENSIONAL CONFORMATION OF THYROTROPIN

RECOMBINANT HUMAN THYROTROPIN

REFERENCES

Chapter 10: The thyrotropin receptor

THE STRUCTURE OF THE THYROTROPIN RECEPTOR

THE THYROTROPIN RECEPTOR GENE

RECOGNITION OF THE RECEPTOR BY THYROTROPIN

PROPOSED MECHANISM OF ACTIVATION OF THE RECEPTOR BY TSH

ACTIVATION BY THYROSTIMULIN

ACTIVATION BY CHORIONIC GONADOTROPIN

ACTIVATION BY THYROTROPIN-RECEPTOR ANTIBODIES

ACTIVATION BY LOW–MOLECULAR-WEIGHT DRUG-LIKE CHEMICALS

DOWNREGULATION OF THE THYROTROPIN RECEPTOR

REFERENCES

Chapter 11: Aging and the thyroid

CHANGES IN THYROID ANATOMY WITH AGE

PHYSIOLOGIC CHANGES IN THYROID FUNCTION WITH AGE

CHALLENGES IN THE DIAGNOSIS AND MANAGEMENT OF THYROID DYSFUNCTION WITH AGE

CHALLENGES IN THE DIAGNOSIS AND MANAGEMENT OF NODULAR DISEASE AND THYROID CANCER

SUMMARY

REFERENCES

Chapter 12: Effects of drugs on TSH secretion, thyroid hormones’ absorption, synthesis, metabolism, and action

INTRODUCTION

DRUGS THAT ALTER SERUM TSH LEVELS (FIG. 12-1, PANEL 1)

DOPAMINE/DOPAMINE AGONISTS AND ANTAGONISTS

SOMATOSTATIN AND SOMATOSTATIN ANALOGS

REXINOIDS

OTHER DRUGS THAT SUPPRESS TSH SECRETION

DRUGS THAT REDUCE THYROID HORMONE ABSORPTION

BILE ACID SEQUESTRANTS

FERROUS SULFATE

SUCRALFATE AND ALUMINUM-CONTAINING ANTACIDS

CALCIUM CARBONATE AND PHOSPHATE BINDERS

OTHER MEDICATIONS THAT MAY REDUCE T4 INTESTINAL ABSORPTION

DRUGS THAT REDUCE SYNTHESIS AND SECRETION OF THYROID HORMONES (FIG. 12-1, PANEL 2)

THIONAMIDES (ANTITHYROID DRUGS)

IONIC INHIBITORS (PERCHLORATE, THIOCYANATE; SEE Chapter 13 ON THYROID DISRUPTORS)

LITHIUM

DRUGS THAT ALTER THE METABOLISM OF THYROID HORMONES (FIGS. 12-1, PANEL 3 AND 12-2)

DRUGS THAT INDUCE CYP3a (PHENYTOIN, CARBAMAZEPINE, PHENOBARBITAL, RIFAMPIN, RITONAVIR, SERTRALINE)

DRUGS THAT INHIBIT THE DEIODINATION OF T4 AND T3

PROPYLTHIOURACIL

PROPRANOLOL AND NADOLOL

DRUGS THAT ALTER THE TRANSPORT OR ACTION OF THYROID HORMONES (FIG. 12-1, PANEL 3)

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (SALICYLATES, SALSALATE, FENCLOFENAC)

FUROSEMIDE

HEPARIN AND FATTY ACIDS

ESTROGEN AND SELECTIVE ESTROGEN MODULATORS (SERM) (TAMOXIFEN, RALOXIFENE)

ANDROGENS

OTHER DRUGS ALTERING TBG LEVELS

DRUGS ACTING AT MULTIPLE SITES TO ALTER THYROID HORMONE HOMEOSTASIS

IODINATED RADIOGRAPHIC CONTRAST AGENTS

PHENYTOIN

AMIODARONE

GLUCOCORTICOIDS

CYTOKINES (INTERFERON, INTERLEUKIN, AND TUMOR NECROSIS FACTOR)

TYROSINE KINASE INHIBITORS

DRUGS ALTERING THYROID FUNCTION THROUGH ALTERATIONS IN IMMUNITY

IMMUNE RECONSTITUTION SYNDROME

ANTI-CD52 ANTIBODY ALEMTUZUMAB

CHECKPOINT INHIBITORS

REFERENCES

Chapter 13: Thyroid disruptors

INTRODUCTION

SUBSTANCES THAT INHIBIT THYROIDAL IODINE UPTAKE

PERCHLORATE

THIOCYANATE

NITRATE

COMPOUNDS WITH DIRECT ACTIONS ON THE THYROID HORMONE RECEPTOR

POLYCHLORINATED BIPHENYLS

POLYBROMINATED DIPHENYL ETHERS

BISPHENOL-A AND PHTHALATES

TRICLOSAN

COMPOUNDS THAT DISPLACE T4 FROM SERUM THYROID BINDING PROTEINS

PCBs AND PBDEs

COMPOUNDS THAT INHIBIT THYROPEROXIDASE ACTIVITY

ISOFLAVONES

COMPOUNDS THAT DECREASE T4 HALF-LIFE BY ACTIVATING HEPATIC ENZYMES

ORGANOCHLORINE PESTICIDES

DIOXINS AND FURANS

COMPOUNDS THAT INHIBIT DEIODINASE ACTIVITY

OTHER EXPOSURES

STYRENES

PERFLUORINATED AND GEN X COMPOUNDS

ORGANOPHOSPHATE PESTICIDES

SUNSCREENS

LEAD

SUMMARY

REFERENCES

Chapter 14: Nonthyroidal illness syndrome

INTRODUCTION

DESCRIPTION OF NTIS

CHANGES IN SERUM THYROID HORMONE AND THYROTROPIN CONCENTRATIONS

CHANGES IN THYROID HORMONE KINETICS

CHANGES IN THE HYPOTHALAMIC–PITUITARY–THYROID AXIS

CHANGES IN PERIPHERAL THYROID HORMONE METABOLISM

PATHOGENESIS OF NTIS

PATHOGENESIS OF CHANGES IN THE HYPOTHALAMIC–PITUITARY–THYROID AXIS

CHANGES IN HPT AXIS DURING FASTING

CHANGES IN HPT AXIS DURING ILLNESS

PATHOGENESIS OF CHANGES IN PERIPHERAL THYROID HORMONE METABOLISM

CHANGES IN SERUM IODOTHYRONINE–BINDING PROTEINS

CHANGES IN IODOTHYRONINE TRANSPORT INTO TISSUES

CHANGES IN IODOTHYRONINE DEIODINASES

CHANGES IN IODOTHYRONINE NUCLEAR RECEPTORS

CLINICAL RELEVANCE OF NTIS

PROGNOSTIC IMPORTANCE OF NTIS

DIAGNOSIS OF THYROID DISEASE IN NTIS

TREATMENT OF PATIENTS WITH NTIS

SPECIFIC TYPES OF NTIS

CHRONIC RENAL FAILURE

LIVER DISEASE

HUMAN IMMUNODEFICIENCY VIRUS INFECTION

PSYCHIATRIC DISEASE

CONCLUSION

REFERENCES

Chapter 15: Iodine deficiency and excess, endemic cretinism

INTRODUCTION

THE ECOLOGY OF IODINE

DIETARY SOURCES, ABSORPTION, AND METABOLISM OF IODINE

GOITROGENS

IODINE REQUIREMENTS

ADULTHOOD

PREGNANCY AND LACTATION

INFANCY AND CHILDHOOD

ASSESSMENT OF IODINE DEFICIENCY

URINARY IODINE CONCENTRATION

BREAST MILK IODINE CONCENTRATION

THYROID SIZE

THYROID-STIMULATING HORMONE AND THYROID HORMONES

THYROGLOBULIN

EFFECTS OF IODINE DEFICIENCY

THYROIDAL ADAPTATION TO IODINE DEFICIENCY

EFFECTS OF HYPOTHYROIDISM DUE TO IODINE DEFICIENCY ON THE DEVELOPING BRAIN

CRETINISM

THE BENEFITS OF CORRECTION OF IODINE DEFICIENCY

IODINE INTERVENTIONS IN SEVERELY DEFICIENT PREGNANT WOMEN

IODINE INTERVENTIONS IN MILD TO MODERATELY DEFICIENT PREGNANT WOMEN

INFANCY

CHILDHOOD

ADULTHOOD

THYROID CANCER

EPIDEMIOLOGY

TREATMENT AND PREVENTION

SALT FORTIFICATION WITH IODINE

IODINE SUPPLEMENTATION

EFFECTS OF EXCESS IODIDE

PHYSIOLOGIC RESPONSE TO EXCESS IODIDE

TOLERABLE UPPER LIMITS FOR IODINE INTAKE

MONITORING OF IODINE EXCESS IN POPULATIONS

SOURCES OF EXCESS IODIDE

IODINE-INDUCED HYPOTHYROIDISM OR GOITER IN THE ABSENCE OF APPARENT UNDERLYING THYROID DISEASE

IODINE AND THYROIDITIS

IODINE-INDUCED THYROTOXICOSIS

AMIODARONE-INDUCED THYROID DISEASE (SEE Chapter 11)

REFERENCES

Section II: Assessment of Thyroid Structure and Function

Chapter 16: Physical examination of the thyroid gland

HISTORY

PHYSICAL EXAMINATION

INSPECTION

PALPATION

FACING THE PATIENT

STANDING BEHIND THE PATIENT

AUSCULTATION

PALPATING LOBES AND EVALUATING THYROID SIZE

THYROID NODULES

HEMIAGENESIS

CONSISTENCY

PAIN/TENDERNESS

LYMPHADENOPATHY

DISTINGUISHING BENIGN FROM MALIGNANT DISEASE

REFERENCES

Chapter 17: Laboratory measurement of thyroid-related hormones, proteins, and autoantibodies in serum

INTRODUCTION

NOMENCLATURE FOR SENSITIVITY AND ASSESSMENT OF ASSAYS

FUNCTIONAL VERSUS ANALYTICAL SENSITIVITY OF ASSAYS

THYROID-STIMULATING HORMONE

METHODS FOR SERUM TSH MEASUREMENTS

REQUIREMENTS FOR SERUM TSH MEASUREMENTS

TSH ISOFORMS

INDICATIONS FOR TRH TESTING

TSH REFERENCE INTERVALS

THE CLINICAL UTILITY OF TSH MEASUREMENT

TSH AND THYROID FUNCTION ASSESSMENT IN PREGNANCY (SEE Chapter 66)

HOSPITALIZED PATIENTS

THYROID HORMONE MEASUREMENTS

SERUM TOTAL THYROID HORMONE (TT4 AND TT3) ASSAY METHODOLOGY

CLINICAL UTILITY OF TT4 AND TT3 MEASUREMENTS

TT4 AND TT3 REFERENCE INTERVALS

SERUM FREE THYROID HORMONE TESTS (FT4 AND FT3)

DIRECT FT4 AND FT3 METHODS

INDIRECT FT4 AND FT3 ESTIMATE TESTS

SERUM-FREE THYROXINE AND FREE TRIIODOTHYRONINE INDEXES

THYROID HORMONE–BINDING PROTEINS

FAMILIAL DYSALBUMINEMIC AND TRANSTHYRETIN-ASSOCIATED HYPERTHYROXINEMIAS

SERUM THYROGLOBULIN (Tg)

REQUIREMENTS FOR SERUM Tg METHODS

FACTORS THAT INFLUENCE CIRCULATING Tg CONCENTRATIONS

ANALYTICAL AND TECHNICAL CONSIDERATION

THYROID-SPECIFIC AUTOANTIBODIES

ANTI–TSH RECEPTOR AUTOANTIBODIES

ANTITHYROID PEROXIDASE AUTOANTIBODIES

ANTITHYROGLOBULIN AUTOANTIBODIES

INTERFERENCES WITH THYROID TEST OUTCOMES

INTERFERENCES WITH THYROID MEASUREMENT METHODOLOGIES

ASSAY INTERFERENCES

AUTOMATION OF THYROID TESTS

REFERENCES

Chapter 18: Nonisotopic thyroid imaging

INTRODUCTION

PLAIN RADIOGRAPHY

ULTRASONOGRAPHY

BASIC PHYSICS AND TECHNICAL PRINCIPLES (1)

CONDUCTING THE EXAMINATION

CLINICAL APPLICATIONS

DEVELOPMENTAL ABNORMALITIES

THE NORMAL THYROID GLAND

GOITER

DIFFUSE NONNEOPLASTIC THYROID DISEASES

NODULES AND MULTINODULAR GOITER

INTERVENTIONAL PROCEDURES

COMPUTED TOMOGRAPHY

BASIC PHYSICS PRINCIPLES (22)

THE NORMAL THYROID GLAND

DIFFUSE THYROID DISEASE

INCIDENTALOMAS

CT IN LARGE BENIGN GOITERS

ECTOPIC THYROID TISSUE

CT AND PREOPERATIVE PLANNING OF THYROID CARCINOMAS, LYMPHOMAS, AND METASTASIS

CT AND FOLLOW-UP OF THYROID CARCINOMAS

MAGNETIC RESONANCE IMAGING

BASIC PHYSICS PRINCIPLES (41)

NORMAL THYROID TISSUE

DIFFUSE THYROID DISEASE

THYROID INCIDENTALOMAS AND NODULE CHARACTERIZATION

PREOPERATIVE PLANNING OF THYROID CARCINOMAS: ASSESSING INVASION (48)

FOLLOW-UP OF THYROID CARCINOMAS

CONCLUSION

REFERENCES

Chapter 19: Thyroid radionuclide uptake and imaging studies

INTRODUCTION

RADIOPHARMACEUTICALS

MODALITIES

RADIOIODINE

UPTAKE STUDIES

PLANAR IMAGING: HYPERTHYROIDISM

PLANAR IMAGING: THYROID CANCER

TOMOGRAPHY

DOSIMETRY

FDG PET/CT IN THYROID CANCER

FDG PET/CT IN INCIDENTAL THYROID DISEASE

IMAGING OF MEDULLARY THYROID CANCER

CONCLUSIONS

REFERENCES

Chapter 20: Cytopathology of the thyroid gland

INTRODUCTION

SPECIMEN PREPARATIONS

THYROID FNA CLASSIFICATION

NONDIAGNOSTIC OR UNSATISFACTORY (CATEGORY I)

BENIGN (CATEGORY II)

ATYPIA OF UNDETERMINED SIGNIFICANCE/FOLLICULAR LESION OF UNDETERMINED SIGNIFICANCE (AUS/FLUS) (CATEGORY III)

FOLLICULAR OR ONCOCYTIC (HüRTHLE-CELL) NEOPLASM OR SUSPICIOUS FOR FOLLICULAR OR ONCOCYTIC (HüRTHLE-CELL) NEOPLASM (CATEGORY IV)

SUSPICIOUS FOR MALIGNANCY (CATEGORY V)

MALIGNANT (CATEGORY VI)

CORE NEEDLE BIOPSY

KEY CYTOMORPHOLOGIC FEATURES OF THYROID FINE-NEEDLE ASPIRATION DIAGNOSES

DIFFUSE TOXIC GOITER

CHRONIC LYMPHOCYTIC THYROIDITIS (11,15)

ATYPIA OF UNDETERMINED SIGNIFICANCE/FOLLICULAR LESION OF UNDETERMINED SIGNIFICANCE (AUS/FLUS)

SUSPICIOUS FOR FOLLICULAR NEOPLASM/FOLLICULAR NEOPLASM (INCLUDING TUMORS WITH ONCOCYTIC FEATURES)

MALIGNANT LESIONS

PAPILLARY THYROID CARCINOMA AND ITS VARIANTS

MEDULLARY THYROID CARCINOMA

POORLY DIFFERENTIATED CARCINOMA

ANAPLASTIC CARCINOMA

ROLE OF ANCILLARY STUDIES IN THE DIAGNOSIS OF THYROID TUMORS IN CYTOLOGIC SPECIMENS’ IMMUNOHISTOCHEMISTRY

REFERENCES

Chapter 21: Histopathology of the thyroid gland

NORMAL THYROID

PATHOLOGIC DIAGNOSIS OF THYROID LESIONS

DEVELOPMENTAL VARIATIONS

GOITER

GRAVES DISEASE/DIFFUSE TOXIC GOITER

DYSHORMONOGENETIC GOITER

IATROGENIC AND RELATED HYPERPLASIAS

AUTOIMMUNE THYROIDITIS

SILENT THYROIDITIS

SPECIFIC INFECTIOUS THYROIDITIS

GRANULOMATOUS THYROIDITIS

PALPATION THYROIDITIS

AMIODARONE INJURY WITH THYROTOXICOSIS

RIEDEL THYROIDITIS (AKA RIEDEL STRUMA)

COMBINED RIEDEL STRUMA AND FIBROSING HASHIMOTO THYROIDITIS

MISCELLANEOUS DISORDERS

RADIATION EFFECTS

AMYLOIDOSIS

BLACK THYROID

NEOPLASMS

BENIGN NEOPLASMS

ADENOMAS AND ADENOMATOUS NODULES

MALIGNANT NEOPLASMS

PAPILLARY CARCINOMA

FOLLICULAR CARCINOMA

HÜRTHLE-CELL NEOPLASM/ONCOCYTIC FOLLICULAR NEOPLASM

PATHOLOGIC DIAGNOSIS OF PAPILLARY AND FOLLICULAR CARCINOMA OF THYROID: CONTROVERSIES

CLEAR CELL TUMORS

HIGH-GRADE THYROID CARCINOMA

POORLY DIFFERENTIATED THYROID CARCINOMA

ANAPLASTIC CARCINOMA

SQUAMOUS CELL CARCINOMA, MUCOEPIDERMOID CARCINOMA, AND INTRATHYROIDAL THYMOMA-LIKE NEOPLASMS

MEDULLARY THYROID CARCINOMA

CALCITONIN NEGATIVE NEUROENDOCRINE CARCINOMA OF THYROID

LYMPHOMA

SARCOMA

CARCINOMA IN ECTOPIC THYROID TISSUE

METASTATIC NEOPLASMS

REFERENCES

Section III: Thyroid Diseases: Thyrotoxicosis

A. Causes of Thyrotoxicosis

Chapter 22: Pathogenesis of Graves disease

INTRODUCTION

AUTOIMMUNITY

DEFINITION OF AN AUTOANTIGEN

THE NATURE OF T CELLS

ANTIBODY AND T-CELL INTERACTIONS WITH ANTIGEN

SECOND SIGNALS

CRITERIA FOR AN AUTOIMMUNE DISEASE

RESTRICTION VERSUS POLYCLONALITY

THYROID IMMUNOLOGY

INTRATHYROIDAL B CELLS

AUTOANTIBODIES TO THE HUMAN TSHR

BIOACTIVITY OF TSHR ANTIBODIES

PREVALENCE OF TSHR ANTIBODIES IN GRAVES DISEASE

IMMUNOLOGIC CHARACTERISTICS OF TSHR ANTIBODIES

TSHR FUNCTION IN GRAVES DISEASE

LESSONS FROM MONOCLONAL TSHR ANTIBODIES WITH STIMULATING ACTIVITY

OTHER THYROID ANTIBODIES IN GRAVES DISEASE

THE INTRATHYROIDAL LYMPHOCYTIC INFILTRATE

FUNCTIONAL ANALYSIS OF INTRATHYROIDAL T CELLS

T-CELL SELECTION

APOPTOSIS IN GRAVES DISEASE

THE INTRATHYROIDAL T-CELL RECEPTOR V GENE REPERTOIRE

REGULATORY EFFECTS OF T CELLS IN AUTOIMMUNE THYROID DISEASE

THE Th17 CELLS

IMMUNE MECHANISMS IN THE PATHOGENESIS OF GRAVES DISEASE

FAILURE OF IMMUNE CELL DELETION AND/OR SUPPRESSION

SPECIFICITY CROSSOVER (MOLECULAR MIMICRY)

BYSTANDER EFFECTS

EPIGENETIC CHANGES

THYROID CELL EXPRESSION OF HLA MOLECULES

ANIMAL MODELS OF GRAVES DISEASE

KNOWN RISK FACTORS FOR PRECIPITATING GRAVES DISEASE (TABLE 22-5)

SUSCEPTIBILITY GENES

INFECTION

THYROID AUTOANTIBODIES

THYROID TISSUE DAMAGE

STRESS

SEX STEROIDS

THE X CHROMOSOME

THE POSTPARTUM PERIOD

MATERNAL MICROCHIMERISM

IODINE

IRRADIATION

OVERVIEW OF THE ETIOLOGY OF GRAVES DISEASE

REFERENCES

Chapter 23: Thyrotropin-induced thyrotoxicosis

INTRODUCTION

EPIDEMIOLOGY

PATHOLOGIC AND PATHOGENIC ASPECTS

SIGNS AND SYMPTOMS

LABORATORY AND BIOCHEMICAL FEATURES

SERUM THYROTROPIN AND THYROID HORMONE LEVELS

PITUITARY GLYCOPROTEIN HORMONE α-SUBUNIT

PARAMETERS OF PERIPHERAL THYROID HORMONE ACTION

DIAGNOSTIC TESTING

IMAGING STUDIES AND LOCALIZATION

DIFFERENTIAL DIAGNOSIS

TREATMENT AND OUTCOME

CRITERIA OF CURE AND FOLLOW-UP

REFERENCES

Chapter 24: Toxic adenoma and toxic multinodular goiter

EPIDEMIOLOGY

CLINICAL ASPECTS OF THYROID AUTONOMY

DIAGNOSIS OF THYROID AUTONOMY

NATURAL HISTORY

MORPHOLOGY

ETIOLOGY

LESSONS FROM EPIDEMIOLOGIC STUDIES

FROM HYPERPLASTIC GROWTH TO NODULAR TRANSFORMATION

TRANSFORMATION TO HOT THYROID NODULES

TREATMENT OF AUTONOMOUS THYROID NODULES (SEE CHAPTER 32)

SURGERY

RADIOIODINE THERAPY

COST-EFFECTIVE MANAGEMENT OF THYROID AUTONOMY

FOLLOW-UP

ACKNOWLEDGMENT

REFERENCES

Chapter 25: Trophoblastic tumors

INTRODUCTION

HUMAN CHORIONIC GONADOTROPIN

GRADATIONS OF SEVERITY

CLINICAL FEATURES

DIAGNOSIS

HYPEREMESIS GRAVIDARUM

MUTANT THYROID-STIMULATING HORMONE RECEPTOR

THERAPY

REFERENCES

Chapter 26: Sporadic painless, painful subacute and acute infectious thyroiditis

INTRODUCTION

DESTRUCTION-INDUCED THYROIDITIS

PAINFUL THYROID

SPORADIC PAINLESS THYROIDITIS

ETIOLOGY

CLINICAL MANIFESTATIONS

LABORATORY FINDINGS

CYTOLOGY

IMAGING

PATHOLOGY

DIFFERENTIAL DIAGNOSIS

CLINICAL MANAGEMENT

SUBACUTE THYROIDITIS

ETIOLOGY

INFECTIOUS ASSOCIATION

AUTOIMMUNE ASSOCIATION

GENETIC ASSOCIATION

CLINICAL MANIFESTATIONS

LABORATORY FINDINGS

CYTOLOGY

IMAGING

PATHOLOGY

DIFFERENTIAL DIAGNOSIS

CLINICAL MANAGEMENT

ACUTE INFECTIOUS THYROIDITIS

ETIOLOGY

BACTERIAL INFECTIONS

FUNGAL INFECTIONS

MYCOBACTERIAL INFECTIONS

PARASITIC INFECTIONS

SYPHILITIC INFECTIONS

THYROIDAL INFECTIONS IN IMMUNOCOMPROMISED PATIENTS

CLINICAL MANIFESTATIONS

LABORATORY FINDINGS

CYTOLOGY

IMAGING STUDIES

CLINICAL MANAGEMENT

REFERENCES

Chapter 27: Thyrotoxicosis of extrathyroidal origin

INTRODUCTION

EXOGENOUS THYROID HORMONE

CAUSES

CLINICAL PRESENTATION AND DIAGNOSIS

TREATMENT

THYROTOXICOSIS DUE TO METASTATIC THYROID CARCINOMA

DEFINITION AND EPIDEMIOLOGY

CLINICAL PRESENTATION AND DIAGNOSIS

TREATMENT

STRUMA OVARII

DEFINITION AND EPIDEMIOLOGY

CLINICAL PRESENTATION AND DIAGNOSIS

TREATMENT

ACKNOWLEDGMENT

REFERENCES

B. Organ System Manifestations

Chapter 28: Overview of the clinical manifestations of thyrotoxicosis

INTRODUCTION

PREVALENCE OF CLINICAL FINDINGS

ORGAN SYSTEM–SPECIFIC MANIFESTATIONS

CENTRAL NERVOUS SYSTEM

BEHAVIORAL HEALTH MANIFESTATIONS

CARDIOVASCULAR MANIFESTATIONS

PULMONARY MANIFESTATIONS

GASTROINTESTINAL MANIFESTATIONS

RENAL MANIFESTATIONS

INTEGUMENTARY FINDINGS

MUSCULOSKELETAL MANIFESTATIONS

REPRODUCTIVE CHANGES

HEMATOLOGIC MANIFESTATIONS

MODULATING FACTORS

AGE

PREGNANCY

COMORBIDITY

ETIOLOGY OF THYROTOXICOSIS

CLINICAL ASSESSMENT

REFERENCES

Chapter 29: Ophthalmopathy

INTRODUCTION

EPIDEMIOLOGY AND NATURAL HISTORY

PATHOGENESIS

RISK FACTORS AND PREVENTION

CLINICAL PRESENTATION

DIAGNOSIS

TREATMENT OF HYPERTHYROIDISM IN PATIENTS WITH GO

MANAGEMENT OF GO

CONCLUSIONS

REFERENCES

Chapter 30: The cardiovascular system in thyrotoxicosis

THYROID HORMONE ACTION ON THE HEART AND VASCULAR SYSTEM

CLINICAL CONSEQUENCES OF THYROTOXICOSIS

CARDIOVASCULAR SYMPTOMS AND SIGNS IN THYROTOXICOSIS

ATRIAL FIBRILLATION

ELECTROCARDIOGRAPHIC CHANGES

HEART FAILURE

HYPERTENSION AND VASCULAR DYSFUNCTION

MAJOR ADVERSE CARDIOVASCULAR EVENTS

ROLE OF OTHER HORMONES IN THYROTOXICOSIS

SUBCLINICAL THYROTOXICOSIS

AMIODARONE AND IODINE CONTAINING CONTRAST AGENTS

REFERENCES

Chapter 31: Thyroid hormones in intermediary metabolism, thermogenesis, and obesity

THYROID HORMONE SIGNALING, TISSUE- AND TARGET GENE–SPECIFICITY IN RELATION TO INTERMEDIARY AND ENERGY METABOLISM

THYROID HORMONE ACTION ON INTERMEDIARY METABOLISM

CARBOHYDRATE METABOLISM

CLINICAL CORRELATES

PROTEIN METABOLISM

CLINICAL CORRELATES

LIPID METABOLISM

CLINICAL CORRELATES

THYROID HORMONE ACTION ON ENERGY METABOLISM

THYROID HORMONE ACTION ON RESTING ENERGY EXPENDITURE

THYROID HORMONE ACTION ON ADAPTIVE THERMOGENESIS

THYROID HORMONE ACTION ON ACTIVITY-RELATED ENERGY EXPENDITURE

THYROID HORMONE ACTION ON THERMIC EFFECT OF FOOD

ENERGY STATUS AND THYROID HORMONE HOMEOSTASIS

CLINICAL CORRELATES

POTENTIAL USE OF THYROID HORMONE AS TREATMENT FOR WEIGHT LOSS AND DYSLIPIDEMIA

CONCLUSIONS

ACKNOWLEDGMENTS

REFERENCES

Chapter 32: The skeletal system in thyrotoxicosis

REGULATION OF THYROID STATUS

CONTROL OF INTRACELLULAR T3 AVAILABILITY

MECHANISM OF THYROID HORMONE ACTION

ROLE OF TSH IN BONE

BONE REMODELING CYCLE

SKELETAL CONSEQUENCES OF CHILDHOOD THYROTOXICOSIS

SKELETAL EFFECTS OF THYROID HORMONES IN ADULTS

POPULATION STUDIES IN NORMAL EUTHYROID INDIVIDUALS

STUDIES OF ADULT THYROTOXICOSIS

EFFECTS OF TREATMENT FOR THYROTOXICOSIS

SUBCLINICAL HYPERTHYROIDISM

PATIENTS TREATED WITH SUPPRESSIVE DOSES OF THYROXINE

REFERENCES

Chapter 33: Thyroid dermopathy and thyroid acropachy

THYROID DERMOPATHY

HISTOLOGIC FINDINGS IN THYROID DERMOPATHY

CLINICAL MANIFESTATIONS

PATHOGENESIS

DIFFERENTIAL DIAGNOSIS

TREATMENT

OUTCOMES OF THERAPY OF THYROID DERMOPATHY

FUTURE DIRECTIONS FOR THERAPY

THYROID ACROPACHY

REFERENCES

Chapter 34: Psychiatric and cognitive effects of thyrotoxicosis

INTRODUCTION

NEUROPSYCHIATRIC MANIFESTATIONS OF OVERT THYROTOXICOSIS

COGNITIVE MANIFESTATIONS OF OVERT THYROTOXICOSIS

SUBCLINICAL THYROTOXICOSIS: NEUROPSYCHIATRIC AND COGNITIVE ASPECTS

DIFFERENTIAL DIAGNOSIS: BEHAVIORAL SYNDROMES THAT MAY MIMIC THYROTOXICOSIS

PSYCHOLOGICAL FACTORS IN THE PATHOPHYSIOLOGY OF THYROTOXICOSIS

TREATMENT OF THYROTOXICOSIS: NEUROPSYCHIATRIC ASPECTS

POSSIBLE LINK BETWEEN THYROID HORMONE AND ATTENTION DEFICIT/HYPERACTIVITY DISORDER

USE OF THYROID HORMONE IN AFFECTIVE DISORDERS

LITHIUM AND THYROID FUNCTION

REFERENCES

Chapter 35: Thyrotoxic storm

CLINICAL FEATURES

LABORATORY FINDINGS

PATHOGENESIS

TREATMENT

THERAPY TO REDUCE THYROID HORMONE SYNTHESIS AND SECRETION

THERAPY DIRECTED AGAINST SYSTEMIC DISTURBANCES

THERAPY DIRECTED AGAINST THE PERIPHERAL ACTIONS OF THYROID HORMONE

THERAPY DIRECTED AGAINST PRECIPITATING ILLNESS

REFERENCES

C. Diagnosis and Management of Thyrotoxicosis

Chapter 36: Diagnosis of thyrotoxicosis

INTRODUCTION

CLINICAL DIAGNOSIS

CLUES FROM ROUTINE LABORATORY TESTS

LABORATORY TESTING FOR THYROTOXICOSIS

SERUM THYROXINE DETERMINATIONS

SERUM TRIIODOTHYRONINE DETERMINATIONS

SERUM THYROTROPIN DETERMINATIONS

SCREENING, CASE FINDING, AND DIAGNOSIS

DIAGNOSING THE CAUSE OF THYROTOXICOSIS

REFERENCES

Chapter 37: Treatment of thyrotoxicosis

INTRODUCTION

THYROTOXICOSIS CAUSED BY GRAVES DISEASE

DRUG THERAPY OF THYROTOXICOSIS CAUSED BY GRAVES DISEASE

ANTITHYROID DRUGS (Fig. 37-1)

MECHANISMS OF ACTION

INTRATHYROIDAL ACTIONS

EXTRATHYROIDAL ACTIONS

EFFECTS ON THE IMMUNE SYSTEM

CLINICAL PHARMACOLOGY OF THE ANTITHYROID DRUGS

METHIMAZOLE

PROPYLTHIOURACIL

CLINICAL CONSIDERATIONS IN THE USE OF ANTITHYROID DRUGS

SIDE EFFECTS OF ANTITHYROID DRUGS

FOLLOW-UP OF PATIENTS TAKING AN ANTITHYROID DRUG FOR GRAVES DISEASE

REMISSIONS AND ANTITHYROID DRUG THERAPY

THERAPY FACTORS RELATING TO REMISSION OF GRAVES DISEASE

DISCONTINUATION OF ANTITHYROID DRUG THERAPY

OTHER DRUGS USED IN THE TREATMENT OF THYROTOXICOSIS CAUSED BY GRAVES DISEASE

INORGANIC IODIDE

ORAL CHOLECYSTOGRAPHIC AGENTS

β-ADRENERGIC ANTAGONIST DRUGS

RADIOACTIVE IODINE THERAPY FOR THYROTOXICOSIS (Fig. 37-1)

PRACTICAL THERAPEUTIC CONSIDERATIONS

COMPLICATIONS AND POTENTIAL RISKS OF RADIOIODINE THERAPY

POSTRADIOIODINE WORSENING OF THYROID FUNCTION

RADIOIODINE THERAPY AND GRAVES OPHTHALMOPATHY

INDICATIONS FOR RADIOIODINE THERAPY

SURGICAL THERAPY FOR THYROTOXICOSIS (Fig. 37-1)

SPECIAL CONSIDERATIONS IN THE TREATMENT OF THYROTOXICOSIS

TREATMENT OF CHILDREN AND ADOLESCENTS

TREATMENT OF ELDERLY PATIENTS

THYROTOXICOSIS IN PREGNANT WOMEN AND DURING LACTATION

THYROTOXIC STORM

THYROTOXICOSIS DUE TO TOXIC ADENOMA AND MULTINODULAR GOITER

TOXIC ADENOMA

TOXIC MULTINODULAR GOITER

REFERENCES

Chapter 38: Subclinical thyrotoxicosis

ETIOLOGY

ENDOGENOUS SUBCLINICAL THYROTOXICOSIS

EXOGENOUS SUBCLINICAL THYROTOXICOSIS

EVALUATION

DIFFERENTIAL DIAGNOSIS

EPIDEMIOLOGY AND NATURAL HISTORY

CLINICAL AND BIOLOGIC IMPORTANCE

PHYSIOLOGY OF SUPPRESSION OF TSH SECRETION

CARDIOVASCULAR CONSEQUENCES

BONE AND MINERAL METABOLISM

COGNITIVE DYSFUNCTION AND DEMENTIA

TREATMENT

CHOICE OF TREATMENT MODALITY

SIDE EFFECTS OF TREATMENT FOR SUBCLINICAL THYROTOXICOSIS

FUTURE DIRECTIONS

REFERENCES

Section IV: Thyroid Diseases: Hypothyroidism

A. Causes of Hypothyroidism

Chapter 39: Chronic autoimmune thyroiditis

INTRODUCTION

PREDISPOSITION TO CHRONIC AUTOIMMUNE THYROIDITIS

PATHOGENESIS OF CHRONIC AUTOIMMUNE THYROIDITIS

ANTIGEN PRESENTATION

T-CELL RESPONSES

B-CELL RESPONSES

EFFECTOR MECHANISMS

EXPERIMENTAL AUTOIMMUNE THYROIDITIS

CLINICAL ASPECTS

ASSOCIATED DISORDERS

REFERENCES

Chapter 40: Genetic defects causing hypothyroidism

MONOGENIC CAUSES OF THYROID DYSGENESIS

KEY TRANSCRIPTION FACTOR MUTATIONS IN TD

NKX2-1

PAX8

FOXE1

GLIS3

TSHR

ADDITIONAL GENES ASSOCIATED WITH TD

NKX2-5

JAG1

CDCA8 (BOREALIN)

TUBB1

NETRIN 1 (NTN1)

SYNDROMES WHICH MAY BE ASSOCIATED WITH CH

GENETIC CAUSES OF DYSHORMONOGENESIS

THYROGLOBULIN

TPO

DUOX2 AND DUOXA2

IYD (PREVIOUSLY KNOWN AS DEHAL1)

SLC5A5 (NIS)

SLC26A4 (PENDRIN)

SLC26A7

EVIDENCE FOR AN UNDIAGNOSED GENETIC COMPONENT IN TD

REFERENCES

Chapter 41: Primary hypothyroidism due to other causes

INTRODUCTION

RADIOACTIVE IODINE (131I THERAPY)

THYROIDECTOMY

TREATMENT OF TOXIC NODULAR GOITER

TREATMENT OF NONTOXIC NODULAR GOITER

EXTERNAL RADIATION

HYPOTHYROIDISM DUE TO THERAPEUTIC PHARMACOLOGIC AGENTS

LITHIUM CARBONATE

CYTOKINES

AMIODARONE

TYROSINE KINASE INHIBITORS

IMMUNE CHECKPOINT INHIBITORS

OTHER DRUGS

HYPOTHYROIDISM DUE TO INFILTRATIVE DISORDERS

RIEDEL THYROIDITIS (INVASIVE FIBROUS THYROIDITIS)

AMYLOIDOSIS

SARCOIDOSIS

SCLERODERMA

HEMOCHROMATOSIS

CYSTINOSIS

OTHER INFILTRATIVE OR INFECTIOUS DISORDERS (SEE CHAPTER 22)

PRIMARY THYROID LYMPHOMA

CONSUMPTIVE HYPOTHYROIDISM

INDUSTRIAL AND ENVIRONMENTAL AGENTS (SEE CHAPTER 12)

EMBRYOLOGIC VARIANTS

LINGUAL THYROID (SEE CHAPTER 63)

REFERENCES

Chapter 42: Central hypothyroidism

INTRODUCTION

EPIDEMIOLOGY

PATHOGENESIS

CLINICAL FEATURES AND DIAGNOSIS

TREATMENT OF CeH

REFERENCES

B. Organ System Manifestations of Hypothyroidism

Chapter 43: Overview of the clinical manifestations of hypothyroidism

INTRODUCTION

CLINICAL MANIFESTATIONS

OVERT HYPOTHYROIDISM

SUBCLINICAL HYPOTHYROIDISM

CARDIOVASCULAR DISEASE AND MORTALITY

PULMONARY SYSTEM

NEUROPSYCHIATRIC FEATURES

MUSCULOSKELETAL SYSTEM

INFECTIOUS COMPLICATIONS

SKIN AND CONNECTIVE TISSUE

KIDNEYS AND ELECTROLYTE METABOLISM

GASTROINTESTINAL TRACT AND LIVER

HEMATOLOGY AND HEMOSTASIS

PITUITARY DISORDERS IN HYPOTHYROIDISM

ADRENAL DISORDERS IN HYPOTHYROIDISM

SUMMARY

REFERENCES

Chapter 44: Hypothyroidism and the heart

CLINICAL CONSEQUENCES OF HYPOTHYROIDISM

CV SYMPTOMS AND SIGNS

ELECTROCARDIOGRAPHIC CHANGES IN HYPOTHYROIDISM

CORONARY ARTERY DISEASE IN HYPOTHYROIDISM

CV RISK FACTORS IN HYPOTHYROIDISM

LIPIDS

BLOOD PRESSURE AND VASCULAR DYSFUNCTION

THROMBOGENESIS

SUBCLINICAL HYPOTHYROIDISM

SPECIAL SITUATIONS IN HYPOTHYROIDISM RELATED TO THE HEART

POSTACUTE MYOCARDIAL INFARCTION

HEART FAILURE

TREATMENT OF HYPOTHYROIDISM IN PATIENTS WITH CORONARY ARTERY DISEASE

CARDIAC SURGERY AND CARDIAC TRANSPLANTATION PROCEDURES

REFERENCES

Chapter 45: The skeletal system in hypothyroidism

PHYSIOLOGIC CONTROL OF THYROID HORMONE ACTION

THYROID HORMONE TRANSPORT AND METABOLISM IN BONE

THYROID HORMONE RECEPTOR FUNCTION IN BONE

ROLE OF TSH ON SKELETAL GROWTH AND MATURATION

SKELETAL DEVELOPMENT

SKELETAL CONSEQUENCES OF CHILDHOOD HYPOTHYROIDISM

SKELETAL CONSEQUENCES OF IMPAIRED SENSITIVITY TO THYROID HORMONE

SKELETAL CONSEQUENCES OF ADULT HYPOTHYROIDISM

A POSSIBLE ROLE FOR THYROID HORMONE SIGNALING IN OSTEOARTHRITIS

REFERENCES

Chapter 46: Psychiatric and cognitive effects of hypothyroidism

INTRODUCTION

PSYCHIATRIC AND COGNITIVE EFFECTS OF OVERT HYPOTHYROIDISM

PSYCHIATRIC AND COGNITIVE EFFECTS OF SUBCLINICAL HYPOTHYROIDISM

EFFECT OF THYROID FUNCTION VARIATIONS WITHIN THE NORMAL RANGE ON MOOD AND COGNITION

HASHIMOTO ENCEPHALOPATHY

REFERENCES

Chapter 47: Myxedema Coma

INTRODUCTION

CLINICAL FEATURES: PRECIPITATING EVENTS

GENERAL DESCRIPTION

HYPOTHERMIA

RESPIRATORY SYSTEM

CARDIOVASCULAR MANIFESTATIONS

GASTROINTESTINAL MANIFESTATIONS

RENAL AND ELECTROLYTE MANIFESTATIONS

NEUROPSYCHIATRIC MANIFESTATIONS

INFECTIONS

DIAGNOSIS

TREATMENT

VENTILATORY SUPPORT

HYPONATREMIA

HYPOTHERMIA

HYPOTENSION

GLUCOCORTICOID THERAPY

THYROID HORMONE THERAPY

COMMENTS

REFERENCES

C. Management of Hypothyroidism

Chapter 48: Diagnosis of hypothyroidism

INTRODUCTION

CLINICAL DIAGNOSIS

CLINICAL MANIFESTATIONS

PREDISPOSITION TO HYPOTHYROIDISM

CHRONIC AUTOIMMUNE THYROIDITIS AND HYPOTHYROIDISM

LABORATORY TESTING

SERUM THYROXINE DETERMINATIONS

SERUM TSH DETERMINATIONS

OTHER MEASURES OF THYROID HORMONE ACTION

SCREENING, CASE FINDING, AND DIAGNOSIS

DIAGNOSING THE CAUSE OF HYPOTHYROIDISM

FUTURE ADVANCES IN LABORATORY ASSESSMENT

REFERENCES

Chapter 49: Treatment of hypothyroidism

HISTORICAL PERSPECTIVE ON THE TREATMENT OF HYPOTHYROIDISM

LEVOTHYROXINE THERAPY

ENDPOINTS DURING LEVOTHYROXINE THERAPY

FACTORS AFFECTING LEVOTHYROXINE DOSE

INITIATION AND ADJUSTMENT OF LEVOTHYROXINE THERAPY

CHOICE OF LEVOTHYROXINE PRODUCT

LEVOTHYROXINE ABSORPTION, METABOLISM, AND TRANSPORT

LEVOTHYROXINE THERAPY IN SPECIFIC SUBPOPULATIONS

PATIENT SATISFACTION WITH LEVOTHYROXINE THERAPY

LEVOTHYROXINE THERAPY AND T3 LEVELS

THERAPIES OTHER THAN LEVOTHYROXINE

THYROID EXTRACTS

SYNTHETIC COMBINATION THERAPY

LIOTHYRONINE THERAPY

SUMMARY

REFERENCES

Chapter 50: Subclinical hypothyroidism

INTRODUCTION

ETIOLOGY AND NATURAL HISTORY

CLINICAL AND BIOLOGIC IMPORTANCE

CURRENT EVIDENCE

TREATMENT CONSIDERATIONS

TREATMENT RECOMMENDATIONS

CONCLUSIONS

REFERENCES

Section V: Thyroid Diseases: Nontoxic Diffuse and Multinodular Goiter

Chapter 51: Multinodular goiter: pathogenesis and management

INTRODUCTION

ETIOLOGY

EPIDEMIOLOGY

NATURAL HISTORY

CLINICAL MANIFESTATIONS

DIAGNOSIS EVALUATION

MANAGEMENT

IODINE SUPPLEMENTATION

TSH SUPPRESSIVE THERAPY WITH LEVOTHYROXINE

ANTITHYROID DRUGS

SURGERY

131I THERAPY

OTHER TREATMENT OPTIONS

SUMMARY

REFERENCES

Chapter 52: Clinical evaluation and management of thyroid nodules

CLINICAL EVALUATION

LABORATORY EVALUATION

SERUM HORMONE AND OTHER MEASUREMENTS

IMAGING STUDIES

ULTRASONOGRAPHY

ELASTOGRAPHY

RADIONUCLIDE THYROID SCINTIGRAPHY

OTHER IMAGING STUDIES

FINE-NEEDLE ASPIRATION BIOPSY

RISK STRATIFICATION FOR THYROID NODULES

TECHNIQUE OF FINE-NEEDLE BIOPSY

RESULTS OF FINE-NEEDLE BIOPSY

LIMITATIONS OF FINE-NEEDLE ASPIRATION BIOPSY OF THYROID NODULES

CLINICAL RECOMMENDATIONS BASED UPON FNA CYTOLOGY RESULTS

NONDIAGNOSTIC CYTOLOGY: BETHESDA I

BENIGN CYTOLOGY: BETHESDA II

ATYPIA OF UNDETERMINED SIGNIFICANCE/FOLLICULAR LESION OF UNDERMINED SIGNIFICANCE (AUS/FLUS) CYTOLOGY: BETHESDA III

FOLLICULAR NEOPLASM CYTOLOGY (INCLUDES HüRTHLE CELL NEOPLASM): BETHESDA IV

ROLE OF MOLECULAR TESTING FOR BETHESDA III AND IV NODULES

SUSPICIOUS FOR MALIGNANCY CYTOLOGY: BETHESDA V

MALIGNANT CYTOLOGY: BETHESDA VI

TREATMENT AFTER THYROID SURGERY

REFERENCES

Section VI: Thyroid Cancers

Chapter 53: Carcinomas of follicular epithelium: epidemiology and pathogenesis

RADIATION

EXTERNAL RADIATION AND THYROID CARCINOMA

INTERNAL RADIATION AND THYROID CARCINOMA

COMPARISON OF EXTERNAL AND INTERNAL RADIATION

PREVENTING IODINE 131–RELATED THYROID CARCINOMA

EVALUATION OF IRRADIATED PATIENTS

RADIATION AND OTHER HEAD AND NECK TUMORS

CLINICAL FEATURES OF RADIATION-RELATED THYROID NEOPLASMS

GENETIC PREDISPOSITION

SYNDROMIC NONMEDULLARY THYROID CARCINOMA

NONSYNDROMIC FAMILIAL NONMEDULLARY THYROID CARCINOMA (FNMTC)

GENETIC SUSCEPTIBILITY

PRE-EXISTING THYROID DISEASE

HORMONAL AND REPRODUCTIVE FACTORS

DIETARY FACTORS

IODINE AND GOITROGENS

OTHER DIETARY FACTORS

ANTHROPOMORPHIC AND METABOLIC FACTORS

SMOKING AND OTHER ENVIRONMENTAL AGENTS

SUMMARY

REFERENCES

Chapter 54: Genomic landscapes of thyroid cancers of follicular cell derivation

GENOMIC HALLMARKS OF NEOPLASMS ARISING FROM THYROID FOLLICULAR CELLS

FOLLICULAR NEOPLASMS

AUTONOMOUSLY FUNCTIONING ADENOMA

FOLLICULAR ADENOMA AND CARCINOMA

PAPILLARY CARCINOMA

NIFTP

RARE PTC VARIANTS

OTHER SOMATIC MUTATIONS

TERT PROMOTER MUTATIONS

SOMATIC COPY NUMBER ALTERATIONS

HÜRTHLE CELL NEOPLASMS

POORLY DIFFERENTIATED THYROID CANCER

ANAPLASTIC THYROID CANCER

GENETIC SUSCEPTIBILITY AND ENVIRONMENTAL FACTORS

DIAGNOSTIC IMPLICATIONS OF THYROID CANCER GENOMICS

REFERENCES

Chapter 55: Carcinoma of the follicular epithelium: surgical therapy

INTRODUCTION

THYROIDECTOMY NOMENCLATURE

EXTENT OF THYROIDECTOMY AND RISK OF COMPLICATIONS

SURGERY FOR INDETERMINATE THYROID NODULES

THYROIDECTOMY FOR THYROID CARCINOMA DERIVED FROM FOLLICULAR EPITHELIUM

CERVICAL LYMPH NODE DISSECTION NOMENCLATURE

EXTENT OF LYMPH NODE DISSECTION AND RISK OF COMPLICATIONS

LYMPHATIC DRAINAGE AND LOCATION OF NODAL METASTASIS IN THYROID CARCINOMA DERIVED FROM FOLLICULAR EPITHELIUM

CLINICAL ASPECTS OF NODAL METASTASIS IN THYROID CARCINOMA DERIVED FROM FOLLICULAR EPITHELIUM

PROGNOSIS OF NODAL METASTASIS IN THYROID CARCINOMA DERIVED FROM FOLLICULAR EPITHELIUM

CENTRAL LYMPH NODE DISSECTION

LATERAL LYMPH NODE DISSECTION

SUMMARY

REFERENCES

Chapter 56: Staging and prognosis of differentiated thyroid cancer

INTRODUCTION

STAGING TO PREDICT RISK OF THYROID CANCER DEATH

ELEMENTS AND COMPARISON OF PUBLISHED STAGING SYSTEMS

EVOLUTION OF THE TNM SYSTEM TO THE CURRENT 8TH EDITION

VALIDATION AND CONTROVERSIES IN 8TH EDITION TNM STAGING

PREDICTING THE RISK OF THYROID CANCER RECURRENCE

ELEMENTS OF INITIAL RISK STRATIFICATION SYSTEMS

VALIDATION AND CONTROVERSIES FOR INITIAL RISK SYSTEMS

DYNAMIC RISK STRATIFICATION/RESPONSE-TO-THERAPY

ELEMENTS OF DYNAMIC RISK STRATIFICATION

VALIDATION AND CONTROVERSIES FOR DYNAMIC RISK STRATIFICATION

HOW TO USE CURRENT RISK STRATIFICATION SYSTEMS IN PRACTICE

CONCLUSIONS

REFERENCES

Chapter 57: Medical management of differentiated epithelial cell thyroid cancer

RADIOACTIVE IODINE THERAPY

THE GOALS OF THE FIRST ADMINISTERED ACTIVITY OF RADIOACTIVE IODINE AFTER THYROIDECTOMY

ABLATION OF RESIDUAL NORMAL THYROID TISSUE

RAI TREATMENT AS AN ADJUVANT THERAPY

PREPARATION FOR RAI THERAPY

SELECTION OF RADIOACTIVE IODINE ACTIVITY FOR REMNANT ABLATION

WHOLE-BODY 131I SCANS AND SPECT/CT

RAI THERAPY FOR LOCAL OR DISTANT METASTATIC DISEASE

INDICATIONS FOR RAI THERAPY

TREATMENT OF PATIENTS WITH HIGH SERUM THYROGLOBULIN LEVELS AND NEGATIVE IMAGING STUDIES

COMPLICATIONS OF RAI THERAPY

FOLLOW-UP PARADIGMS

EARLY FOLLOW-UP RECOMMENDATIONS (FIRST YEAR AFTER INITIAL THERAPY)

FOLLOW-UP PARADIGMS BASED ON RESPONSE TO THERAPY RESTRATIFICATION

ONGOING, DYNAMIC RISK ASSESSMENT DURING LONG-TERM FOLLOW-UP

TSH-SUPPRESSIVE THYROID HORMONE THERAPY

EXTERNAL BEAM RADIOTHERAPY

SYSTEMIC THERAPY FOR ADVANCED DISEASE

BIOLOGICALLY TARGETED THERAPIES

CYTOTOXIC CHEMOTHERAPY

OTHER PALLIATIVE INTERVENTIONS FOR SYMPTOMATIC METASTATIC DTC

REFERENCES

Chapter 58: Papillary microcarcinomas

INCREASING INCIDENCE OF THYROID CANCER WITH STABLE MORTALITY

SURGERY OF PAPILLARY MICROCARCINOMA AND OUTCOMES

FREQUENT MULTIPLICITY AND REGIONAL LYMPH NODE METASTASIS

PROGNOSIS OF HIGH-RISK AND LOW-RISK PAPILLARY MICROCARCINOMA

SURGICAL APPROACH TO PMCs

ACTIVE SURVEILLANCE OF LOW-RISK PAPILLARY MICROCARCINOMA

HISTORY AND HYPOTHESIS

PROTOCOL OF THE ACTIVE SURVEILLANCE AT KUMA HOSPITAL

OUTCOMES OF ACTIVE SURVEILLANCE

EVALUATION OF THE RISK OF TRACHEA AND RECURRENT LARYNGEAL NERVE INVASION

INCIDENCES OF UNFAVORABLE EVENTS IN IMMEDIATE SURGERY VERSUS ACTIVE SURVEILLANCE

MEDICAL ECONOMY OF MANAGEMENT OF PAPILLARY MICROCARCINOMA

FACTORS THAT MIGHT BE ASSOCIATED WITH DISEASE PROGRESSION

NATURAL HISTORY OF PAPILLARY CARCINOMA

LIFETIME PROBABILITY OF DISEASE PROGRESSION

TUMOR VOLUME KINETICS DURING ACTIVE SURVEILLANCE

ESTIMATING TUMOR GROWTH BEFORE PRESENTATION

IMPLEMENTING ACTIVE SURVEILLANCE

REFERENCES

Chapter 59: Medullary thyroid cancer

NATURAL HISTORY

TUMOR PROGRESSION

PREOPERATIVE SCREENING

SURGICAL TREATMENT

DYNAMIC RISK STRATIFICATION AND FOLLOW-UP

RECURRENT AND PERSISTENT DISEASE

REOPERATION

DISTANT DISEASE

CONCLUSION

REFERENCES

Chapter 60: Poorly differentiated thyroid cancer, anaplastic thyroid cancer, and miscellaneous tumors of the thyroid

POORLY DIFFERENTIATED THYROID CANCER

DEFINITION/EPIDEMIOLOGY

TREATMENT/PROGNOSIS

ANAPLASTIC THYROID CANCER

INTRODUCTION

EPIDEMIOLOGY

PATHOGENESIS

CLINICAL PRESENTATION AND DIFFERENTIAL DIAGNOSIS

PATHOLOGY

GENOMICS/MOLECULAR PATHOLOGY/IMMUNOLOGY

STAGING

MANAGEMENT—GENERAL CONSIDERATIONS

MANAGEMENT—STAGE IVA

MANAGEMENT—STAGE IVB

MANAGEMENT—STAGE IVC

MANAGEMENT—OLIGOMETASTATIC STAGE IVC

PALLIATIVE AND HOSPICE CARE

ATC SUMMARY

MISCELLANEOUS TUMORS OF THE THYROID GLAND

HYALINIZING TRABECULAR TUMOR

SQUAMOUS CELL CARCINOMA

THYROID MUCOEPIDERMOID CARCINOMA

SCLEROSING MUCOEPIDERMOID CARCINOMA WITH EOSINOPHILIA

MUCINOUS CARCINOMA OF THE THYROID

ECTOPIC THYMOMA

SPINDLE EPITHELIAL TUMOR WITH THYMUS-LIKE DIFFERENTIATION

INTRATHYROID THYMIC CARCINOMA

PARAGANGLIOMA AND MESENCHYMAL/STROMAL TUMORS

HEMATOLYMPHOID TUMORS

GERM CELL TUMORS (BENIGN TERATOMA, IMMATURE TERATOMA, MALIGNANT TERATOMA)

SECONDARY MALIGNANCIES OF THE THYROID

ACKNOWLEDGMENTS

REFERENCES

Chapter 61: Thyroid cancer in children

RISK OF THYROID CANCER IN THE PEDIATRIC PATIENT WITH A THYROID NODULE

DIFFERENTIATED THYROID CANCERS

PAPILLARY THYROID CARCINOMA (PTC)

PAPILLARY THYROID MICROCARCINOMA (PTMC)

FOLLICULAR VARIANT PTC

FOLLICULAR THYROID CARCINOMA (FTC)

MEDULLARY THYROID CARCINOMA

MULTIPLE ENDOCRINE NEOPLASIA 2A

MULTIPLE ENDOCRINE NEOPLASIA 2B

EARLY THYROIDECTOMY IN MEN2

MANAGEMENT OF MTC IN MEN2

REFERENCES

Section VII: The Thyroid in Infancy and Childhood

Chapter 62: The maturation of thyroid function in the fetus, in the perinatal period and during childhood

MATURATION OF THYROID FUNCTION IN UTERO

ORGANOGENESIS AND STRUCTURAL DIFFERENTIATION OF THE THYROID GLAND

FUNCTIONAL DIFFERENTIATION OF THE THYROID GLAND AND ONSET OF THYROID HORMONE SYNTHESIS

THE ROLE OF THE PLACENTA FOR MATERNOFETAL INTERACTION

MATURATION OF THE HYPOTHALAMIC–PITUITARY–THYROID AXIS

SYNTHESIS OF THE THYROID HORMONE TRANSPORT PROTEINS

REGULATION OF THYROID HORMONE LEVELS IN UTERO BY SULFATION

REGULATION OF THYROID HORMONE LEVELS IN UTERO BY DEIODINATION

ONTOGENY OF TRANSMEMBRANE THYROID HORMONE TRANSPORTERS

ONTOGENY OF THYROID HORMONE RECEPTORS

THE ROLE OF THYROID HORMONES FOR THE FETUS AND THE CHILD

BRAIN DEVELOPMENT

COCHLEA DEVELOPMENT

RETINA DEVELOPMENT

MUSCLE AND MYOCARDIAL DEVELOPMENT

BONE DEVELOPMENT AND LINEAR GROWTH

METABOLIC EFFECTS

PERINATAL AND POSTNATAL CHANGES IN THYROID HORMONE SYNTHESIS AND METABOLISM

PHYSIOLOGIC CHANGES IN THE TERM NEONATE

THYROID FUNCTION IN THE PRETERM NEONATE

THYROID FUNCTION IN SMALL FOR GESTATIONAL AGE NEONATES

INFANTS, CHILDREN, AND ADOLESCENTS

REFERENCES

Chapter 63: Hypothyroidism in infants and children

CONGENITAL HYPOTHYROIDISM

NEWBORN SCREENING

RATIONALE FOR BIOCHEMICAL SCREENING FOR CH

PREMATURE AND VERY LOW–BIRTH-WEIGHT NEWBORNS

NEWBORNS WITH TRISOMY 21

EVALUATION OF NEWBORNS WITH A POSITIVE SCREENING RESULT

QUALITY ASSESSMENT OF SCREENING PROGRAMS

CLASSIFICATION OF CH (Table 63-2)

ETIOLOGY AND PATHOGENESIS

PERMANENT CH

TRANSIENT CH

CLINICAL PRESENTATION

DIAGNOSTIC EVALUATION (Table 63-3)

TREATMENT AND OUTCOME

ACQUIRED HYPOTHYROIDISM (CH)

ETIOLOGIES (Table 63-4)

CLINICAL PRESENTATION (Fig. 63-4)

EVALUATION

TREATMENT

PROGNOSIS

REFERENCES

Chapter 64: Impaired sensitivity to thyroid hormone: defects of transport, metabolism, and action

TH SECRETION, CELL-MEMBRANE TRANSPORT, METABOLISM, AND ACTION

THE PARADOX OF COEXISTING MANIFESTATIONS OF THYROID HORMONE DEFICIENCY AND EXCESS

THYROID HORMONE ACTION DEFECTS KNOWN AS RESISTANCE TO THYROID HORMONE

RESISTANCE TO THYROID HORMONE BETA (RTHβ)

CLINICAL CLASSIFICATION

INCIDENCE AND INHERITANCE

ETIOLOGY AND GENETICS

MOLECULAR MECHANISMS OF TR ACTION

PROPERTIES OF MUTANT TRβ RECEPTORS AND ASSOCIATED DOMINANT-NEGATIVE EFFECT

MOLECULAR BASIS OF THE VARIABLE RTHβ PHENOTYPE

RTHβ WITHOUT THRB GENE MUTATIONS (NON–TRβ-RTH)

ANIMAL MODELS OF RTHβ

PATHOGENESIS

PATHOLOGY

CLINICAL FEATURES

COURSE OF THE DISEASE

LABORATORY FINDINGS

TH AND ITS METABOLITES

THYROTROPIN AND OTHER THYROID STIMULATORS

THYROID GLAND ACTIVITY AND INTEGRITY OF HORMONE SYNTHESIS

IN VIVO EFFECTS OF TH

IN VITRO TESTS OF THYROID HORMONE ACTION

RESPONSES TO THE ADMINISTRATION OF THYROID HORMONE

EFFECTS OF OTHER DRUGS

DIFFERENTIAL DIAGNOSIS

TREATMENT

RESISTANCE TO THYROID HORMONE ALPHA (RTHα)

BACKGROUND

INCIDENCE AND INHERITANCE

ETIOLOGY AND GENETICS

MOLECULAR BASIS OF THE DEFECT AND PROPERTIES OF THE MUTANT TRα

ANIMAL MODELS OF RTHα (SEE ALSO ANIMAL MODELS UNDER RTHβ, ABOVE)

CLINICAL FEATURES

LABORATORY FINDINGS

DIFFERENTIAL DIAGNOSIS

TREATMENT

THYROID HORMONE CELL MEMBRANE TRANSPORTER DEFECT (THCMTD)

CELL MEMBRANE TRANSPORTERS OF TH

INHERITANCE AND INCIDENCE

ETIOLOGY

THE MCT8 GENE AND MUTATIONS

CLINICAL FEATURES AND COURSE OF THE DISEASE

LABORATORY FINDINGS

SERUM TESTS OF THYROID FUNCTION

OTHER SERUM TESTS

X-RAYS AND IMAGING

TESTS IN TISSUES

GENETIC TESTING

ANIMAL MODELS OF MCT8 DEFICIENCY

MOLECULAR BASIS OF THE DISORDER

DIFFERENTIAL DIAGNOSIS

TREATMENT

THYROID HORMONE METABOLISM DEFECT

INTRACELLULAR METABOLISM OF TH

ETIOLOGY AND GENETICS

INCIDENCE AND INHERITANCE

THE SBP2 GENE AND MUTATIONS

CLINICAL FEATURES AND COURSE OF THE DISEASE

LABORATORY FINDINGS

MOLECULAR BASIS OF THE DISORDER

THMD CAUSED BY MUTATION IN THE TRU-TCA1-1 GENE

ANIMAL MODELS OF THMD

DIFFERENTIAL DIAGNOSIS

TREATMENT

ACKNOWLEDGMENTS

REFERENCES

Chapter 65: Hyperthyroidism in the neonate, child, and adolescent

CLINICAL EVALUATION OF THE HYPERTHYROID STATE

BIOCHEMICAL EVALUATION OF THYROID FUNCTION

GRAVES DISEASE

ANTITHYROID DRUG THERAPY

RADIOACTIVE IODINE THERAPY

THYROIDECTOMY AND RISKS

SOMATIC COMPLICATIONS OF GD

NEONATAL THYROTOXICOSIS

FETAL CONSIDERATIONS

OTHER CAUSES OF HYPERTHYROIDISM

HASHITOXICOSIS

SUMMARY

REFERENCES

Section VIII: Thyroid Disorders in Pregnancy and Postpartum

Chapter 66: Thyroid disorders during preconception, pregnancy, and the postpartum period

PRECONCEPTION

EPIDEMIOLOGY

PHYSIOLOGY

CLINICAL OUTCOMES AND MANAGEMENT

PREGNANCY

EPIDEMIOLOGY

PHYSIOLOGY

DIAGNOSIS OF THYROID DISEASE

OVERT HYPOTHYROIDISM

SUBCLINICAL HYPOTHYROIDISM

ISOLATED HYPOTHYROXINEMIA

AUTOIMMUNE THYROID DISEASE IN PREGNANCY

HYPERTHYROIDISM

POSTPARTUM

POSTPARTUM THYROIDITIS

REFERENCES

Index

 

 

An aparitie	2 Jun. 2020
Autor	Lewis E. Braverman
Dimensiuni	21.6 x 4.4 x 27.9 cm
Editura	Lippincott Williams and Wilkins
Format	Hardcover
ISBN	9781975112967
Limba	Engleza
Nr pag	912