gastrins and Thyroid-Diseases

Today, calcitonin assay is used for the diagnosis of thyroid medullary cancer in the context of nodular thyroid disease. Calcitonin is an excellent marker of thyroid medullary cancer but some hypercalcitoninemia can also be related to other diseases, such as renal failure, endocrine tumors other than thyroid medullary cancer and sometimes to C cell hyperplasia, which is a not well-defined situation. Recent studies contributed to define calcitoninemia thresholds, which guide decision and avoid excessive invasive treatment.. After a brief reminder of physiological role of calcitonin and assays, the difficulties encountered in interpreting hypercalcitoninemia and its potential causes other than thyroid medullary cancer are addressed. Recent studies, on large series, now allow a better knowledge of specificity and sensitivity of calcitonin measurement in patients with nodular thyroid disease and a well-argued management.. In the future, calcitonin dosage will be ordered even more frequently, as some authors recommend it for the diagnosis of thyroid nodule. It is up to us to know how to use this remarkable marker, by considering all possible situations of benign hypercalcitoninemia and reserving aggressive treatments for patients who really need them.

Topics: Adult; Biomarkers; Calcitonin; Carcinoma, Medullary; Diagnosis, Differential; Endocrine Gland Neoplasms; Gastrins; Humans; Hypercalcemia; Hyperplasia; Kidney Failure, Chronic; Sensitivity and Specificity; Sepsis; Thyroid Diseases; Thyroid Gland; Thyroid Neoplasms; Thyroid Nodule

Topics: Cholecystokinin; Diabetes Mellitus; Endocrine Glands; Endocrine System Diseases; Female; Gastric Inhibitory Polypeptide; Gastrins; Gastrointestinal Hormones; Humans; Male; Somatostatin; Thyroid Diseases

Topics: Achlorhydria; Acromegaly; Adenoma; Adenoma, Islet Cell; Adolescent; Adult; Aged; Calcium; Cushing Syndrome; Diarrhea; Female; Gastric Acid; Gastrins; Glucagon; Humans; Hyperinsulinism; Hyperparathyroidism; Hypoglycemia; Hypokalemia; Male; Middle Aged; Neoplasms, Multiple Primary; Pancreatic Polypeptide; Pancreatitis; Parathyroid Glands; Parathyroid Neoplasms; Pituitary Neoplasms; Syndrome; Thyroid Diseases; Zollinger-Ellison Syndrome

Topics: Anemia, Pernicious; Antibodies; Atrophy; Autoimmune Diseases; Capillaries; Chronic Disease; Dyspepsia; Gastrectomy; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Hypertrophy; Intrinsic Factor; Metaplasia; Mitosis; Pentagastrin; Pepsin A; Peptic Ulcer; Pyloric Antrum; Radiography; Stomach; Stomach Neoplasms; Thyroid Diseases; Vagotomy

The vagus nerve (VN) has essential regulatory roles in the gastric acid secretion and gastrin release. Continuous intraoperative neuromonitoring (CIONM) via VN stimulation is a promising technique in thyroid surgery because it potentially avoids injury to the recurrent laryngeal nerve. However, no studies have investigated changes in gastric acid secretion and gastrin release during CIONM.. This prospective study of 58 thyroid surgery patients compared gastric acid and serum gastrin at five time points: (1) before skin incision, (2) after baseline calibration of CIONM probe, (3) +20 min from baseline, (4) before probe removal, and (5) after extubation. Patients were excluded if they had any history of using tobacco, acid suppression medications, or drugs that affect gastric motility. Patients were also excluded if they had any history of gastroesophageal reflux symptoms, gastroesophageal reflux disease, peptic ulcer disease, helicobacter pylori infection, or chronic kidney disease.. Non significant differences in mean gastric pH values were observed at all time points, i.e., (1) before skin incision (2.2 ± 0.2; p = 0.50), (2) after baseline calibration of CIONM probe (2.0 ± 0.8; p = 0.62), (3) +20 min from baseline (2.5 ± 0.5; p = 0.24), (4) before probe removal (2.9 ± 0.9; p = 0.52), and (5) after extubation (2.6 ± 1.0; p = 0.60). Comparisons of pH monitoring parameters revealed no significant differences in age, gender, side of CIONM (left vs. right), sequence of CIONM, or duration of CIONM. Gastrin values were normal in sequential determinations and did not significantly differ at any time points.. CIONM performed via VN stimulation during total thyroidectomy in healthy patients does not influence gastrin secretion and gastric pH.

Topics: Adolescent; Adult; Aged; Female; Gastric Acid; Gastric Acidity Determination; Gastrins; Humans; Male; Middle Aged; Monitoring, Intraoperative; Prospective Studies; Thyroid Diseases; Thyroidectomy; Vagus Nerve; Vagus Nerve Stimulation; Young Adult

The aim of this study was to investigate the prevalence of autoimmune gastritis, enterochromaffin-like cell (ECL-cell) hyperplasia and gastric neuroendocrine neoplasms type 1 (GNEN1) in patients with autoimmune thyroid disease.. Prospective observational study in a single institutional study.. One hundred and twenty patients with autoimmune thyroid disease were consecutively recruited from the Endocrine Unit. Upper gastrointestinal tract endoscopy (UGE) and biochemical parameters for autoimmune thyroid disease and autoimmune gastritis were assessed at recruitment and annually thereafter in patients with a mean follow-up of 37·5 ± 14·4 months. Autoimmune gastritis was defined by the presence of antiparietal cell antibodies (APCA) and histological confirmation after UGE. Serum gastrin and chromogranin Α were also measured.. One hundred and eleven patients had Hashimoto's thyroiditis and nine Graves' disease. Autoimmune gastritis was identified in 40 (38 with Hashimoto's thyroiditis and two with Graves' disease) patients all of whom had increased levels of gastrin and chromogranin Α; Helicobacter pylori infection was histologically identified in 15 of 40 (37·5%) patients. Six patients had isolated nodular ECL-cell hyperplasia and one mixed nodular and linear ECL-cell hyperplasia [7 of 40 (17·5%)]. Only increased gastrin (P = 0·03) levels predicted the presence ECL-cell hyperplasia. A GNEN1 developed in one patient with nodular ECL-cell hyperplasia after 39 months of follow-up.. Concomitant autoimmune gastritis was found in 33·3% of patients with autoimmune thyroid disease, 17·5% of whom had ECL-cell hyperplasia that evolved to GNEN1 in one (2·5%). Larger studies with longer follow-up are needed to define the incidence of GNEN1 in patients with autoimmune thyroid disease and ECL-cell hyperplasia and potential implications.

Topics: Aged; Autoimmune Diseases; Chromogranin A; Endoscopy; Enterochromaffin-like Cells; Female; Gastrins; Gastritis; Hashimoto Disease; Helicobacter Infections; Humans; Male; Middle Aged; Neuroendocrine Tumors; Phenotype; Prevalence; Prospective Studies; Risk; Stomach Neoplasms; Thyroid Diseases

To characterize the influence of six factors on human thyroid tissues at the cell-proliferation level. These six factors were the epidermal growth factor (EGF), the luteinizing-hormone-releasing hormone (LHRH), triiodothyronine, thyroxine, estradiol and gastrin.. Forty-eight human thyroid specimens were obtained from surgical resection and maintained alive for 48 h ex vivo (in vitro) under organotypic culture conditions. These specimens comprised 35 benign cases (17 multinodular goiters and 18 adenomas) and 13 cancers. Cell proliferation in the control and treated conditions (at a 5 nM dose) was assessed by means of the thymidine labeling index, which enables the percentage of cells in the S phase of the cell cycle to be determined in accordance with autoradiographic procedures.. The results show that, of the six factors tested here, EGF significantly (P < 0.05 to P < 0.001) increased cell proliferation in the greatest number of cancers as compared to what happened with the remaining five. Each of these six factors significantly increased or decreased proliferative cell activity in some 10%-30% of the cases under study.. Triiodothyronine, thyroxine, LHRH and gastrin may increase or decrease cell proliferation in human thyroid tissues, whether benign or malignant, to the same extent as other hormones and/or growth factors such as thyrotropin, EGF, insulin-like growth factor 1, transforming growth factor beta1 and estradiol the effects of which on thyroid cell proliferation are already well documented in the literature.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cell Division; Epidermal Growth Factor; Estradiol; Female; Gastrins; Gonadotropin-Releasing Hormone; Hormones; Humans; Male; Middle Aged; Organ Culture Techniques; Retrospective Studies; Thyroid Diseases; Thyroid Neoplasms; Thyroxine; Triiodothyronine

The relationship between thyroid disorders and gastric pathophysiology has been studied mainly from standpoints of gastric histology and gastric acid output capacity. Though anti-gastric antibody has been thought to play a part in this relationship, there have been no clear conclusions obtained about that. Since blood gastrin levels are easily measurable by radioimmunoassay today, the relationship between thyroid disorders and gastric pathophysiology has drawn attention again from a standpoint of gastrin levels. Seino et al. have reported about hypergastrinemia in hyperthyroidism, speculating that beta-adrenergic hyperresponsiveness of gastrin-producing cells could be the mechanism of hypergastrinemia. However, there are other reports which mentioned feedback mechanism between gastrin and gastric acid or interaction of gastrointestinal hormones as the main mechanism of hypergastrinemia. In this study, the problem of gastrin in Graves' disease and chronic thyroiditis were studied by measurement of fasting serum gastrin levels and gastric juice excretion in view of feedback mechanism between gastrin-producing cells and parietal cells which are the target cells of gastrin. Following results were obtained. Fasting serum gastrin levels in Graves' disease were 236.2 +/- 39.1 (mean +/- SE) pg/ml for 39 hyperthyroid patients and 126.3 +/- 23.9 pg/ml for 35 euthyroid patients. These levels were significantly higher than those of sex and age-matched control subjects with P less than 0.001 and P less than 0.05, respectively. Fasting serum gastrin levels in serial studies of 13 patients with Graves' disease were 222.3 +/- 56.7 pg/ml before treatment and 167.3 +/- 56.6 pg/ml at the time of euthyroid state after a mean observation period of 6.6 +/- 1.1 months. Fasting serum gastrin levels at the time of euthyroid state decreased significantly when compared with fasting serum gastrin levels before treatment (P less than 0.05). Fasting serum gastrin levels in chronic thyroiditis were 160.7 +/- 51.1 pg/ml for 24 hypothyroid patients and 96.4 +/- 24.7 pg/ml for 31 euthyroid patients. Each of these levels had no significant differences when compared with sex and age-matched control subjects. Fasting serum gastrin levels in serial studies of 10 patients with chronic thyroiditis were 81.1 +/- 18.0 pg/ml at the time of hypothyroid state and 91.5 +/- 15.2 pg/ml at the time of euthyroid state after a mean observation period of 7.1 +/- 2.1 months. Fasting serum gastrin levels bef

Topics: Adolescent; Adult; Aged; Autoantibodies; Chronic Disease; Female; Gastric Juice; Gastrins; Graves Disease; Humans; Male; Middle Aged; Thyroglobulin; Thyroid Diseases; Thyroid Function Tests; Thyroid Gland; Thyroiditis, Autoimmune

Fasting serum gastrin levels measured by radioimmunoassay were found to be elevated in patients with hyperthyroidism and low in patients with hypothyroidism. The oral administration of beef extracts resulted in more increase of serum gastrin in hyperthyroid patients than in normal subjects. After restoration of the euthyroid state by treatment, no more increase in serum gastrin levels was observed. Slight correlation between gastrin levels and serum T3 levels was observed in pretreated hyperthyroid patients (r = 0.40), but significant correlation between them was found after restoration of the euthyroid state by treatment (r = 0.50). However, it seemed to be able to divide into two groups in the pretreated patients. One was a patient group whose gastrin levels correlated closely to serum T3 levels (r = 0.83, p less than 0.01). The other was a group whose serum gastrin levels remained in low even in high T3 levels (r = 0.81, p less than 0.01). Different sensitivity to thyroid hormone in the G-cells of gastrointestinal tract may exist in these two groups, because patients age and duration of their illness were not different between them.

Topics: Adolescent; Adult; Female; Gastrins; Humans; Hyperthyroidism; Hypothyroidism; Male; Middle Aged; Thyroid Diseases; Triiodothyronine

Many alterations in metabolic and endocrine function occur in end-stage renal disease. Glucose intolerance is almost always present with uremia; it improves shortly after institution of regular hemodialysis. Hyperlipidemia (type IV) is prevalent, and atherosclerotic cardiovascular disease causes death in about 50% of patients receiving long-term hemodialysis. Although plasma levels of growth hormone usually are elevated, children with chronic renal failure show growth retardation. The occurrence of thyroid disorders is difficult to determine, since many clinical features of uremia are similar to those of hyperthyroidism and hypothyroidism. The incidence of duodenal ulcer is high, possibly due to high gastrin levels. Sex hormone disturbances are common. Anemia is a constant feature of chronic renal failure; patients usually tolerate it well.

Topics: Anemia; Blood Glucose; Gastrins; Gonadal Steroid Hormones; Growth Hormone; Humans; Hyperlipidemias; Insulin; Kidney Failure, Chronic; Renal Dialysis; Thyroid Diseases; Triglycerides; Uremia

Topics: Administration, Oral; Adult; Fasting; Female; Gastrectomy; Gastrins; Glycine; Growth Hormone; Humans; Hyperthyroidism; Hypothyroidism; Male; Middle Aged; Thyroid Diseases

Topics: Adrenalectomy; Adult; Age Factors; Aged; Diabetes Mellitus; Female; Gastrectomy; Gastrins; Gastrointestinal Diseases; Humans; Hypophysectomy; Liver Diseases; Male; Middle Aged; Obesity; Pituitary Diseases; Radioimmunoassay; Sex Factors; Stomach Neoplasms; Thyroid Diseases

Topics: Adenoma; Animals; Biopsy; Cell Count; Fluorescent Antibody Technique; Gastric Mucosa; Gastrins; Histocytochemistry; Humans; Hyperparathyroidism; Hyperplasia; Microscopy; Microscopy, Electron; Parathyroid Neoplasms; Peptides; Pylorus; Rabbits; Television; Thyroid Diseases

Topics: Adult; Aged; Arrhythmias, Cardiac; Female; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastrins; Goiter; Graves Disease; Humans; Hypothyroidism; Male; Middle Aged; Thyroid Diseases