Showing papers by "Francesco Latrofa published in 2012"
TL;DR: In papillary thyroid carcinoma, LT on histology must be carefully searched for because it is frequently associated with TgAb and therefore mistakenly low or undetectable Tg, which can be underestimated in patients with T g autoantibodies (TgAb).
Abstract: Context: Serum thyroglobulin (Tg), the marker of residual tumor in papillary thyroid carcinoma, can be underestimated in patients with Tg autoantibodies (TgAb) TgAb are due to a coexistent lymphocytic thyroiditis (LT) or the papillary thyroid carcinoma per se TgAb assays are highly discordant Design: We evaluated 141 patients with a clinical diagnosis of nodular thyroid disease, 32 of Hashimoto's thyroiditis, and four of Graves' disease, who underwent total thyroidectomy for an associated papillary thyroid carcinoma Patients were classified as papillary thyroid carcinoma-lymphocytic thyroiditis (PTC-T) and papillary thyroid carcinoma (PTC) according to the presence or absence of LT on histology Tg was measured before thyroid remnant ablation, when it is expectedly detectable, by an immunometric assay (IMA) and TgAb by three noncompetitive IMA and three competitive radioimmunoassays (RIA) The number of lymphocytes was compared with TgAb concentration Results: Seventy-two of 177 patients (407%) were
59 citations
TL;DR: Compared with thyroidectomy alone, total thyroid ablation allows the achievement of the best possible outcome and an improvement of GO within a shorter period of time.
Abstract: Context: In a previous study, we found that total thyroid ablation (thyroidectomy plus 131I) is associated with a better outcome of Graves' orbitopathy (GO) compared with thyroidectomy alone, as observed shortly (9 months) after glucocorticoid (GC) treatment. Objective: The objective of the study was to evaluate the outcome of GO in the same patients of the previous study over a longer period of time. Design: This was a follow-up of a randomized study. Setting: The study was conducted at a referral center. Patients: Fifty-two of 60 original patients with mild to moderate GO participated in the study. Interventions: Patients randomized into thyroidectomy (TX) or total thyroid ablation and treated with GC were reevaluated in 2010, namely 88.0 ± 17.7 months after GC, having undergone an ophthalmological follow-up in the intermediate period. Main Outcome Measures: The main outcome measures included the following: 1) GO outcome; 2) time to GO best possible outcome and to GO improvement; and 3) additional treat...
57 citations
TL;DR: Results of TgAb from P TC-T are more concordant than those from PTC because their epitope pattern is more restricted, and Discrepancy is lower when comparing assays with similar methodology.
Abstract: Context: Thyroglobulin autoantibodies (TgAb) have been proposed as a surrogate marker of thyroglobulin in the follow-up of differentiated thyroid carcinoma. Commercially available TgAb assays are often discordant. We investigated the causes of discrepancy. Design: TgAb were measured by three noncompetitive immunometric assays and three competitive RIA in 72 patients with papillary thyroid carcinoma and associated lymphocytic thyroiditis (PTC-T), 105 with papillary thyroid carcinoma and no lymphocytic thyroiditis (PTC), 160 with Hashimoto's thyroiditis, and in 150 normal subjects. The results of the six assays were correlated. TgAb epitope pattern, evaluated by inhibition of serum TgAb binding to thyroglobulin by TgAb-Fab regions A, B, C, and D, were compared in sera which were positive in all six assays (concordant sera) and positive in only one to five assays (discordant sera) were compared. TgAb International Reference Preparation (IRP) was measured in 2007 and 2009. Results: The correlations of the six...
48 citations
TL;DR: In absence of diplopia, MLD, but not LD, seems to be associated with its development in primary gaze, and the reduction in proptosis after MLD is greater than that after LD.
Abstract: Background: Patients with moderate to severe Graves' orbitopathy (GO) rather frequently require rehabilitative surgery after medical therapy. Diplopia is the most common side effect of orbital decompression (OD). The aim of this study was to evaluate the occurrence of postoperative diplopia in primary gaze after OD, and the influence of the surgical approach on this outcome. Moreover, we investigated the results in terms of proptosis reduction, and the long-term subjective satisfaction of patients treated with OD with regard to their appearance and ocular function. Methods: A retrospective evaluation of 247 patients with GO treated with medial and lateral decompression (MLD) or lateral decompression (LD) OD between January 2002 and December 2009 was performed. Results: The overall prevalence of postoperative diplopia in primary gaze was 55/247 (22.3%), with a statistically significant difference (p<0.001) between patients with (36/113, 31.2%) and those without (19/134, 14.2%) preoperative diplopia in seco...
40 citations
TL;DR: The epitope pattern of TgAb of SAT is restricted to the A region that is immunodominant in AITD and non-AITD, indicating that in the majority of patients with SAT, the autoimmune phenomena represent a non-specific and transient response to the release of thyroid antigens, rather than the expression of thyroid autoimmunity.
Abstract: Background: Thyroglobulin autoantibodies (TgAb) can develop in patients with subacute thyroiditis (SAT). Aim: Comparison of the epitope pattern of TgAb of patients with SAT, Hashimoto’s thyroiditis (HT) [autoimmune thyroid disease (AITD)] and non-toxic multinodular goiter (NTMG) (non-AITD). Subjects and methods: Serum TgAb from 10 patients with SAT, 45 with HT, and 19 with NTMG were evaluated. Serum TgAb binding to Tg was inhibited by 4 recombinant human TgAb-Fab, recognizing Tg epi tope regions A, B, C, and D. The ability of single TgAb-Fab to inhibit the binding of serum TgAb to Tg was evaluated in enzyme-linked immunosorbent assay. Results: Levels of inhibition were different for all TgAb-Fab in the 3 groups of patients. Inhibition by region A TgAb-Fab in SAT [50.5 (30.3–62.5)%] (median and 25th to 75th percentiles) was similar to HT [49.0 (38.0–69.5)%] and sig nificantly higher than in NTMG [25.0 (14.0–37.0)%]; by region B TgAb-Fab in SAT [0.0 (0.0–12.5)%] was significantly lower than in HT [28.0 (9.5–48.0)%] and similar to NTMG [9.0 (4.8–20.5)%]; by region C TgAb-Fab in SAT [9.5 (0.0–25.8)%] were similar to HT [23.0 (9.5–41)%] and NTMG [6.5 (1.7–21.5)%]; and by region D TgAb-Fab in SAT [0.0 (0.0–8.0)%] were lower than in HT [12.0 (1.0–28.5)%] and similar to NTMG [1.0 (0.0–5.0)%]. Conclusions: The epitope pattern of TgAb of SAT is restricted to the A region that is immunodominant in AITD and non-AITD. In the majority of patients with SAT, the autoimmune phenomena represent a non-specific and transient response to the release of thyroid antigens, rather than the expression of thyroid autoimmunity.
16 citations