MyMedR

Leask JT

Journal of the Straits Medical Association, 1891;2:20-2.

Matched MeSH terms: Hypothyroidism

Binary particle swarm optimization for feature selection in detection of infants with hypothyroidism

Zabidi A, Khuan LY, Mansor W, Yassin IM, Sahak R

Annu Int Conf IEEE Eng Med Biol Soc, 2011;2011:2772-5.

PMID: 22254916 DOI: 10.1109/IEMBS.2011.6090759

Hypothyroidism in infants is caused by the insufficient production of hormones by the thyroid gland. Due to stress in the chest cavity as a result of the enlarged liver, their cry signals are unique and can be distinguished from the healthy infant cries. This study investigates the effect of feature selection with Binary Particle Swarm Optimization on the performance of MultiLayer Perceptron classifier in discriminating between the healthy infants and infants with hypothyroidism from their cry signals. The feature extraction process was performed on the Mel Frequency Cepstral coefficients. Performance of the MLP classifier was examined by varying the number of coefficients. It was found that the BPSO enhances the classification accuracy while reducing the computation load of the MLP classifier. The highest classification accuracy of 99.65% was achieved for the MLP classifier, with 36 filter banks, 5 hidden nodes and 11 BPS optimised MFC coefficients.

Matched MeSH terms: Hypothyroidism/diagnosis*; Hypothyroidism/physiopathology

Fulltext Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis

Loh HH, Lim LL, Yee A, Loh HS

BMC Psychiatry, 2019 01 08;19(1):12.

PMID: 30621645 DOI: 10.1186/s12888-018-2006-2

BACKGROUND: Although depression is associated with changes in the hypothalamic-pituitary-thyroid axis, its relationship with subclinical hypothyroidism (SCH) is controversial. To date, there is a lack of data on the improvement of depressive symptoms with levothyroxine therapy among individuals with coexistent SCH.

METHODS: We conducted a meta-analysis to evaluate the association between SCH and depression including 1) the prevalence of depression in SCH (with a sub-analysis of the geriatric cohort), 2) thyroid stimulating hormone (TSH) level among patients with depression and 3) the effect of levothyroxine therapy among patients with SCH and coexistent depression.

RESULTS: In a pooled analysis of 12,315 individuals, those with SCH had higher risk of depression than euthyroid controls (relative risk 2.35, 95% confidence intervals [CI], 1.84 to 3.02; p

Matched MeSH terms: Hypothyroidism/diagnosis; Hypothyroidism/epidemiology*; Hypothyroidism/psychology*

Fulltext Serum alpha-i acid glycoprotein in thyroid dysfunctions

Ho CL, Cheah JS

Med J Malaysia, 1982 Mar;37(1):70-1.

PMID: 7121352

The serum alpha-1 acid glycoprotein of 9 euthyroid subjects, 14 hypothyroid patients and 21 hyperthyroid patients was determined by radial immunodiffussion in agar plates. The serum alpha1 acid glycoprotein level in both the hypothyroid and hyperthyroid patients were significantly lowered when compared to the euthyroid subjects. There was no significant correlation between the alpha-1 acid glycoprotein level mid the Liothyronine resin uptake (T3 resin. uptake) and the serum total Thyroxine Iodide (T4I) level.

Matched MeSH terms: Hypothyroidism/blood

Fulltext Congenital hypothyroid screening using cord blood TSH

Wu LL, Sazali BS, Adeeb N, Khalid BA

Singapore Med J, 1999 Jan;40(1):23-6.

PMID: 10361481

Clinical diagnosis of congenital hypothyroidism (CH) is difficult at birth without neonatal screening. In line with the priorities of the national health services in Malaysia towards preventive medicine, early diagnosis and treatment of CH is emphasised. We conducted a pilot study at Kuala Lumpur's Maternity Hospital between April 1995 and November 1995 to estimate the incidence of CH and also evaluated the problems associated with large-scale neonatal screening using a commercial TSH kit on cord bloodspots.

Matched MeSH terms: Congenital Hypothyroidism*; Hypothyroidism/blood; Hypothyroidism/epidemiology; Hypothyroidism/prevention & control*

Fulltext Lingual thyroid--a lesson to learn (letter)

Ng CS, Mohd Razak MS

Med J Malaysia, 2005 Mar;60(1):115.

PMID: 16250296

Comment on: Ramzisham AR, Somasundaram S, Nasir ZM. Lingual thyroid--a lesson to learn. Med J Malaysia. 2004 Oct;59(4):533-4

Matched MeSH terms: Hypothyroidism/chemically induced

Fulltext A case of lingual thyroid with hypothyroidism

Kandasami P, Mathews VK

Med J Malaysia, 1985 Mar;40(1):52-3.

PMID: 3831737

Cases of lingual thyroid are rare. The Johns Hopkins Hospital, New York, reported three cases of lingual thyroid in 800,000 admissions. We report here a case of lingual thyroid associated with hypothyroidism. The embryology, clinical features and principals of management are discussed.

Matched MeSH terms: Hypothyroidism/etiology*

Anaemia in infancy as a presenting feature of hypothyroidism

Harun, F.

Malaysian Journal of Child Health, 1991;3(1):40-44.

MyJurnal

Thyroid hormones mediate the biological activities of almost all organ systems in the body. Patients with a deficiency of these hormones may present with a wide spectrum of clinical symptomatology. This report is of an infant who presented with chronic anaemia which was found to be secondary to hypothyroidism associated with a hypoplastic lingual thyroid gland. Physicians need to be alert to the varied manifestations of hypothyroidism so as to avoid delay in diagnosis and treatment.

Matched MeSH terms: Hypothyroidism

Fulltext Audit of newborn screening programme for congenital hypothyroidism

Zarina AL, Rahmah R, Bador KM, Ng SF, Wu LL

Med J Malaysia, 2008 Oct;63(4):325-8.

PMID: 19385494 MyJurnal

Newborn screening for congenital hypothyroidism (CH) was implemented in Hospital UKM in December 2004 using cord blood sample. From the audit over a period of 25 months, a total of 13,875 newborn babies were screened with a coverage of 98.8%. From this cohort, the mean recall rate was 0.32%; unfortunately the mean percentage of recalled babies that came for retesting was only 79.5%. In addition, the mean sample rejection rate was high, i.e. 2.2%. Two babies were diagnosed to have CH. These findings implied that whilst the coverage of screening was good, there is a need for regular surveillance of performance of both clinical and laboratory personnel. In addition, a more concerted effort should be carried out to promote community awareness of such a programme.

Matched MeSH terms: Congenital Hypothyroidism/diagnosis*

Fulltext Hyperthyroidism following hypothyroidism--a case report

Kang BH

Med J Malaysia, 1991 Sep;46(3):287-9.

PMID: 1839927

A 25 year old female presented with hypothyroidism which was followed by the development of hyperthyroidism about 1 1/2 years later. This uncommon phenomenon is postulated to result from changes in the relative amounts of stimulatory and inhibitory TSH receptor antibodies. This case illustrates the possible continuum between Graves' disease and Hashimoto's thyroiditis within the broad spectrum of autoimmune thyroid disease.
Study site: Primary care clinic. University Malaya Medical Cengtre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Hypothyroidism/complications*

Fulltext Massive pericardial effusion in primary hypothyroidism

Hanip MR, Ong SB, Tan TT, Khalid BA

Med J Malaysia, 1989 Dec;44(4):341-3.

PMID: 2520045

A 44 year old lady with primary hypothyroidism presented with massive pericardial effusion without cardiac tamponade. Pericardial tap was done twice and the effusion resolved as the hypothyroid state improved. She remained hypertensive despite the euthyroid state. She was discharged well with L-thyroxine and anti-hypertensive therapy.

Matched MeSH terms: Hypothyroidism/complications*

An unusual cause of hypothyroidism (following excision of lingual thyroid) in a Chinese boy

Cheah JS, Loh FK

Med J Malaysia, 1973 Mar;27(3):217-9.

PMID: 4268928

Matched MeSH terms: Hypothyroidism/etiology*

Importance of right communication with healthcare providers and patients about the new levothyroxine formulation: an expert opinion from Asia Pacific Thyroid Advisory Board

Razvi S, Nicodemus N, Ratnasingam J, Arundhati D, Soh WEA, Kunavisarut T, et al.

Curr Med Res Opin, 2024 Sep;40(9):1533-1536.

PMID: 39104288 DOI: 10.1080/03007995.2024.2378984

Levothyroxine (LT4), being "narrow therapeutic index" drug, may lead to significant fluctuations in thyroid stimulating hormone (TSH) levels. Such fluctuations can result in clinically noteworthy disruptions in thyroid function and give rise to adverse clinical consequences. Consequently, regulatory standards for LT4 potency have been tightened, with the most stringent specifications requiring maintenance of potency within the range of 95-105% of the labeled dose throughout the entire shelf-life of the product. The LT4 new formulation with tightened specification adheres to these rigorous standards, demonstrating established bioequivalence to its older formulation while upholding an equivalent standard of safety and efficacy. Furthermore, the novel formulation exhibits enhanced stability and an extended shelf-life. Of paramount significance is its capacity to provide patients with accurate and consistent dosing, thereby effectively catering to their medical requirements. The primary objective of the Asia-Pacific advisory board meeting (held in June 2022 with endocrinologists, experts from India, Indonesia, Philippines, Thailand, Malaysia and Singapore) was to establish the importance of appropriate communication to HCPs, patients and other stakeholders regarding the LT4 new formulation. The aim of this brief review is to highlight the importance of communication with healthcare professionals that should focus on providing accurate information on the LT4 new formulation, emphasizing efficacy, safety, and bioequivalence with clear guidance and ensure that patients and clinicians are fully informed about any changes to medications such as LT4 to reduce the risk of unrelated adverse events being incorrectly attributed to the newer formulation.

Matched MeSH terms: Hypothyroidism/drug therapy

Endemic goitre in Sarawak, Malaysia: I. Somatic growth and aetiology

Maberly GF, Eastman CJ

Southeast Asian J Trop Med Public Health, 1976 Sep;7(3):434-42.

PMID: 1030847

A comparative epidemiological and anthropometric survey was conducted among Ibans, the largest indigenous ethnic group in Sarawak, in three regions where the endemicity of goitre exhibited marked differences , to assess the effect of endemic goitre on somatic growth. In the Ai river region the prevalence of goitre was 99.5%; 35% having grade 3 goitres, 55% grade 2 goitres and 9.5% grade 1 goitres. At Rubu the prevalence of endemic goitre was 74%; 3% having grade 3 goitre, 16% grade 2 goitre and 55% grade 1 goitre. In the Bajong region relatively few people were detected with goitre and most of these had migrated from other regions. Neurological cretinism was estimated at 3.6% in the severely goitrous Ai river population but was not detected in the other regions. Anthropometric data obtained from the three adult populations did not reveal any statistically significant differences in the following parameters: weight, height, weight/height ratio, height/sitting height ratios, head circumference, scapular skinfold thickness and left mid arm muscle circumference. The haemoglobin, serum total protein and serum albumin concentrations were similar in the three populations. It is concluded that endemic goitre occurs with a frequency of close to 100% in certain Iban populations which represents one of the highest incidences of endemic goitre in the world. Neurological cretinism is common in this population. Our observations suggest that body proportions and somatic growth do not vary among similar ethnic populations exhibiting greatly different endemicity of goitre. Although no iodine balance studies were performed, assessment of diets suggested that iodine deficiency is a significant contributory factor in the development of endemic goitre in Sarawak. Urgent attention to iodine supplementation is indicated to prevent the development of endemic goitre and neurological cretinism.

Matched MeSH terms: Congenital Hypothyroidism/epidemiology

Fulltext Functional analyses of C.2268dup in thyroid peroxidase gene associated with goitrous congenital hypothyroidism

Lee CC, Harun F, Jalaludin MY, Lim CY, Ng KL, Mat Junit S

Biomed Res Int, 2014;2014:370538.

PMID: 24745015 DOI: 10.1155/2014/370538

The c.2268dup mutation in thyroid peroxidase (TPO) gene was reported to be a founder mutation in Taiwanese patients with dyshormonogenetic congenital hypothyroidism (CH). The functional impact of the mutation is not well documented. In this study, homozygous c.2268dup mutation was detected in two Malaysian-Chinese sisters with goitrous CH. Normal and alternatively spliced TPO mRNA transcripts were present in thyroid tissues of the two sisters. The abnormal transcript contained 34 nucleotides originating from intron 12. The c.2268dup is predicted to generate a premature termination codon (PTC) at position 757 (p.Glu757X). Instead of restoring the normal reading frame, the alternatively spliced transcript has led to another stop codon at position 740 (p.Asp739ValfsX740). The two PTCs are located at 116 and 201 nucleotides upstream of the exons 13/14 junction fulfilling the requirement for a nonsense-mediated mRNA decay (NMD). Quantitative RT-PCR revealed an abundance of unidentified transcripts believed to be associated with the NMD. TPO enzyme activity was not detected in both patients, even though a faint TPO band of about 80 kD was present. In conclusion, the c.2268dup mutation leads to the formation of normal and alternatively spliced TPO mRNA transcripts with a consequential loss of TPO enzymatic activity in Malaysian-Chinese patients with goitrous CH.

Matched MeSH terms: Congenital Hypothyroidism/diagnosis; Congenital Hypothyroidism/enzymology*; Congenital Hypothyroidism/genetics*

Fulltext Clinical Practice Guideline: Management of Thyroid Disorders

Citation: Clinical Practice Guideline: Management of Thyroid Disorders. Putrajaya: Ministry of Health, Malaysia; 2019

Quick reference: http://www.acadmed.org.my/view_file.cfm?fileid=968

Keywords: CPG

Matched MeSH terms: Hypothyroidism

Severe hypothyroidism presenting with supraventricular tachycardia

Mak WW, Raja Nurazni RA, Mohamed Badrulnizam LB

Med J Malaysia, 2018 10;73(5):349-350.

PMID: 30350825 MyJurnal

Thyroid disease is common and can have various systemic manifestations including cardiac diseases. Hypothyroidism is commonly associated with sinus bradycardia, low QRS complexes, prolonged QT interval and conduction blocks but rarely may cause arrhythmias. We present a patient who presented with presyncope and supraventricular tachycardia with severe hypothyroidism. Patient responded well to thyroxine replacement with biochemical improvement, the disappearance of arrhythmia after restoration of euthyroidism suggests that hypothyroidism might be the cause of supraventricular tachycardia. The aim of this report is to underline the possible aetiological link between supraventricular tachycardia and hypothyroidism, although supraventricular arrhythmias are ordinary features of hyperthyroidism.

Matched MeSH terms: Hypothyroidism

Serum creatine kinase: an adjunct biochemical index of subclinical thyrotoxicosis?

Wan Nazaimoon WM, Siaw FS, Sheriff IH, Faridah I, Khalid BA

Ann. Clin. Biochem., 2001 Jan;38(Pt 1):57-8.

PMID: 11270843

Matched MeSH terms: Hypothyroidism/diagnosis; Hypothyroidism/enzymology

Fulltext Results of long-term follow-up after compensated fixed-dose therapy for thyrotoxicosis

Zaini A, Khir A, Doi SA, Chan SP, Paramsothy M, Khoo BH

J Int Med Res, 1992 Jun;20(3):279-88.

PMID: 1397673

To evaluate the effects of simple compensated fixed-dose iodine-131 therapy for thyrotoxicosis, the long-term results for 74 patients treated with a fixed dose of iodine-131 ranging from 5 to 12 mCi (185 to 444 MBq) were evaluated in the first 2 years of a trial. The dose selected was loosely based on the gross size of the thyroid gland. Routine antithyroid drug therapy was given for a minimum of 3 months after iodine-131 therapy. The mean (+/- SD) duration of follow-up was 74.5 +/- 42 months. The results indicated that roughly 25% of patients treated in this way will become hypothyroid after 5 years and that 85% are cured (need no further therapy during the follow-up period) using a single dose of iodine-131. Of those cured using a single iodine-131 dose, 81% were no longer receiving drugs after 6 months and 85% after 1 year. Such a regimen seems currently to be among the best available where prolonged periods of medication-free euthyroidism after therapy are sought.

Matched MeSH terms: Hypothyroidism/drug therapy; Hypothyroidism/etiology

Newborn Screening TSH Values Less Than 15 mIU/L Are Not Associated With Long-term Hypothyroidism or Cognitive Impairment

West R, Hong J, Derraik JGB, Webster D, Heather NL, Hofman PL

J Clin Endocrinol Metab, 2020 09 01;105(9).

PMID: 32598474 DOI: 10.1210/clinem/dgaa415

BACKGROUND: It is unclear whether newborns with mild thyrotropin elevation (mTSHe) are at risk of neurocognitive impairment. We assessed whether mTSHe at birth persists during childhood and compared neurocognitive functioning to siblings.

METHODS: This study encompassed children born in the Auckland region (New Zealand) with a newborn screen TSH level of 8 to 14 mIU/L blood, age 6.9 to 12.6 years at assessment, and their siblings. Thyroid function tests (serum TSH and free thyroxine) and neurocognitive assessments were performed, including IQ via the Wechsler Intelligence Scale for Children, fourth edition.

RESULTS: Ninety-six mTSHe individuals were studied, including 67 children recruited with 75 sibling controls. Mean mTSHe newborn TSH level was 10.1 mIU/L blood and 2.4 mIU/L at assessment (range, 0.8-7.0 mIU/L, serum). Although higher newborn TSH levels in the mTSHe group correlated with lower full-scale IQ scores (r = 0.25; P = .040), they were not associated with the magnitude of the IQ difference within sibling pairs (P = .56). Cognitive scores were similar for mTSHe and controls (full-scale IQ 107 vs 109; P = .36), with a minor isolated difference in motor coordination scores.

CONCLUSIONS: Our data do not suggest long-term negative effects of neonatal mild TSH elevation. TSH elevation below the screen threshold appears largely transient, and midchildhood neurocognitive performance of these children was similar to their siblings. We propose that associations between neonatal mild TSH elevation and IQ are due to familial confounders. We caution against the practice of reducing screening CH cutoffs to levels at which the diagnosis may not offer long-term benefit for those detected.

Matched MeSH terms: Congenital Hypothyroidism/blood; Congenital Hypothyroidism/complications; Congenital Hypothyroidism/diagnosis*; Congenital Hypothyroidism/epidemiology

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