exudates and Thyroid-Diseases

Endocrine dysfunction due to iron overload secondary to frequent blood transfusions is a common complication in children with transfusion-dependent thalassaemia (TDT). We ascertained the prevalence of endocrine dysfunction in children with TDT seen in a hospital setting in Malaysia.. We reviewed all patients with TDT who had ≥ 8 blood transfusions per year. Patients who had a history of stem cell transplantation, concurrent autoimmune diseases or were newly diagnosed to have TDT were excluded. Standard diagnostic criteria were used in the diagnosis of various endocrine dysfunctions.. Of the 82 patients with TDT, 65% had at least one endocrine dysfunction. Short stature was the commonest (40.2%), followed by pubertal disorders (14.6%), hypoparathyroidism (12.3%), vitamin D deficiency (10.1%), hypocortisolism (7.3%), diabetes mellitus (5.2%) and overt hypothyroidism (4.9%). Subclinical hypothyroidism and pre-diabetes mellitus were seen in 13.4% and 8.6% of the patients, respectively. For children aged < 10 years, the prevalence of both thyroid dysfunction and hypoparathyroidism was 9.1%.. Two-thirds of children with TDT experienced at least one endocrine dysfunction. Thyroid dysfunction and hypoparathyroidism may be missed if endocrine screening is only performed in children with TDT > 10 years of age. Close monitoring for endocrine dysfunction and hormonal therapy is essential to prevent long-term adverse outcomes.

Topics: Adolescent; Adult; Blood Transfusion; Child; Child, Preschool; Cross-Sectional Studies; Endocrine System Diseases; Female; Growth Disorders; Humans; Hypoparathyroidism; Malaysia; Male; Prevalence; Thalassemia; Thyroid Diseases; Young Adult

Autoimmune thyroid disease (ATD) has been associated with other systemic autoimmune diseases. To date, there is limited data on thyroid disorders and autoimmune thyroid disease in Malaysia. The frequency of ATD among 189 systemic lupus erythematosus (SLE) patients was 6.3%, with 2.6% in the hyperthyroid group and 3.7% in the hypothyroid group. Hypothyroidism developed at a much younger mean age (24.3 years), suggesting that SLE might be a predisposing factor for the development of Hashimoto's thyroiditis. There was a higher rate of thyroid peroxidase antibody (TPO) positivity compared with anti-thyroglobulin antibody (Tg) in the hyperthyroid subgroup. This study also demonstrated a greater proportion of ATD patients who demonstrated high titres (≥ 1:6400) of TPO compared with high titres of Tg. Although there was an association between ATD and the presence of anti-Ro/SSA and/or anti-La/SSB antibodies, the absence of sicca symptoms and negative Schirmer's tests suggest a lack of association with secondary Sjogren's syndrome. A novel association between ATD and antiphospholipid syndrome (APS) was detected in our cohort. Hence we propose that patients affected by APS be routinely screened for ATD.

Topics: Adolescent; Adult; Age of Onset; Aged; Antiphospholipid Syndrome; Autoantibodies; Autoimmune Diseases; Biomarkers; Female; Humans; Lupus Erythematosus, Systemic; Malaysia; Male; Middle Aged; Predictive Value of Tests; Retrospective Studies; Risk Factors; Thyroid Diseases; Young Adult

Topics: Adult; Aged; Chi-Square Distribution; Female; Humans; Laryngoscopy; Malaysia; Male; Middle Aged; Pain Measurement; Postoperative Complications; Prospective Studies; Statistics, Nonparametric; Thyroid Diseases; Thyroidectomy; Treatment Outcome

A study to determine the prevalence of goitre and abnormal thyroid status during pregnancy in Malaysian women was conducted. Two hundred and three women (Malay = 85, Chinese = 47 and Indian = 71) in the third trimester and with no known thyroid disease were studied. There was a marked racial disparity in the prevalence of goitre: Indian 61%, Malay 28% and Chinese 29% (p = 0.001). The serum thyrotropic hormone (TSH) was significantly higher in Indians (median: 1.36 uIU/ml) compared to Malays (1.14 uIU/ml, p = 0.009). The serum albumin was also significantly lower in Indians (mean +/- sd; 36.12 +/- 3.9 mmol/l) compared to Malays (39.3 +/- 4.8 mmol/l) or Chinese (39.1 +/- 5.2) (p < 0.001). Thyroid antibody was detected in 14.6% of these women with no significant racial difference in its prevalence. Three women were found to be thyrotoxic but none were hypothyroid. This study found a high prevalence of goitre among the pregnant Indian women, probably related to the protein malnutrition state. The high prevalence of positive thyroid antibody in our population indicates that a high percentage of women are at risk of developing postpartum thyroiditis.

Topics: Adult; China; Cross-Cultural Comparison; Cross-Sectional Studies; Female; Goiter, Endemic; Humans; Incidence; India; Malaysia; Pregnancy; Pregnancy Complications; Protein-Energy Malnutrition; Serum Albumin; Sodium Pertechnetate Tc 99m; Thyroid Diseases; Thyroid Function Tests; Thyroid Hormones; Thyroiditis, Autoimmune; Thyrotropin

Topics: Adult; Diagnosis, Differential; Female; Humans; Malaysia; Male; Middle Aged; Thyroid Diseases; Thyroid Neoplasms

A group of patients with solitary nodules of the thyroid were treated at the University of Malaya by surgery under local anaesthesia. This was done in order to expedite exploration of a potentially malignant condition. This group comprised 43 patients, and four cancers were found. The standard technique used was satisfactory from the viewpoint of both the patient and the surgeon. The pattern of this condition in a Malaysian population is documented, the technique used is described, and thyroidectomy under local aneaesthesia is discussed.

Topics: Adenocarcinoma; Adenoma; Adult; Anesthesia, Local; Carcinoma, Papillary; Cysts; Ethnicity; Female; Humans; Lidocaine; Malaysia; Male; Posture; Thyroid Diseases; Thyroid Neoplasms; Thyroidectomy

Topics: Asian People; Autoantibodies; Autoimmune Diseases; Biomedical Research; Humans; Malaysia; Singapore; Thyroid Diseases; Thyroid Gland; Thyroiditis; Thyroiditis, Autoimmune