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Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
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Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence...
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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...
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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
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An Ex vivo Culture System to Study Thyroid Development
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Clinical diagnostic gene expression thyroid testing.

David L Steward1, Richard T Kloos2

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0528, USA; Division of Endocrinology, Department of Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0528, USA.

Otolaryngologic Clinics of North America
|July 22, 2014
PubMed
Summary
This summary is machine-generated.

The Afirma Gene Expression Classifier (GEC) helps identify benign thyroid nodules. This avoids unnecessary surgeries for many patients with indeterminate fine-needle aspiration biopsies.

Keywords:
BiopsyDNA mutational analysisFine-needle aspirateGene expressionGenomicsMolecular diagnostic techniquesThyroid nodule

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Area of Science:

  • Endocrinology
  • Oncology
  • Molecular Diagnostics

Background:

  • Thyroid fine-needle aspiration biopsies are cytologically indeterminate in 15% to 30% of cases.
  • Approximately 75% of indeterminate thyroid nodules are benign upon surgical examination.
  • This leads to a high rate of unnecessary surgeries for benign conditions.

Purpose of the Study:

  • To evaluate the utility of the Afirma Gene Expression Classifier (GEC) in managing cytologically indeterminate thyroid nodules.
  • To determine if GEC results can safely de-escalate care and prevent unnecessary surgeries.

Main Methods:

  • Analysis of Afirma GEC performance in patients with indeterminate thyroid nodules (Bethesda categories III/IV).
  • Assessment of the negative predictive value (NPV) of the GEC.
  • Correlation of GEC results with surgical pathology outcomes.

Main Results:

  • The Afirma GEC achieved a negative predictive value of >=94% for indeterminate nodules.
  • A significant proportion of benign nodules with indeterminate cytology were identified as GEC benign.
  • This allowed for safe clinical observation in many cases.

Conclusions:

  • The Afirma GEC is effective in identifying benign indeterminate thyroid nodules.
  • GEC results can help reduce the number of diagnostic surgeries for benign thyroid nodules.
  • Clinical observation is a viable management strategy for GEC-benign nodules, aligning with guidelines.