Thyroid Diseases: Clarke SE

Luster M, Clarke SE, Dietlein M, Lassmann M, Lind P, Oyen WJ, Tennvall J, Bombardieri E, Anonymous00011. · Department of Nuclear Medicine, University of Würzburg, Josef-Schneider-Strasse 2, 97080 Würzburg, Germany. · Eur J Nucl Med Mol Imaging. · Pubmed #18670773 No free full text.

Abstract: INTRODUCTION: The purpose of the present guidelines on the radioiodine therapy (RAIT) of differentiated thyroid cancer (DTC) formulated by the European Association of Nuclear Medicine (EANM) Therapy Committee is to provide advice to nuclear medicine clinicians and other members of the DTC-treating community on how to ablate thyroid remnant or treat inoperable advanced DTC or both employing large 131-iodine ((131)I) activities. DISCUSSION: For this purpose, recommendations have been formulated based on recent literature and expert opinion regarding the rationale, indications and contraindications for these procedures, as well as the radioiodine activities and the administration and patient preparation techniques to be used. Recommendations also are provided on pre-RAIT history and examinations, patient counselling and precautions that should be associated with (131)I iodine ablation and treatment. Furthermore, potential side effects of radioiodine therapy and alternate or additional treatments to this modality are reviewed. Appendices furnish information on dosimetry and post-therapy scintigraphy.

Meier DA, Brill DR, Becker DV, Clarke SE, Silberstein EB, Royal HD, Balon HR, Anonymous00200. · William Beaumont Hospital, Royal Oak, Michigan, USA. · J Nucl Med. · Pubmed #12050333 links to  free full text

This publication has no abstract.

Mohan HK, Groves AM, Fogelman I, Clarke SE. · Department of Nuclear Medicine, Guy's and St. Thomas Hospital NHS Trust, London, United Kingdom. · Thyroid. · Pubmed #15361268 No free full text.

Abstract: Weight loss and bone disease in the elderly are very often attributed to malignancy. Rarely, benign treatable conditions may be overlooked. Thyrotoxicosis, a benign treatable condition, needs to be excluded in such patients. The diagnosis may be delayed, since the symptoms are often subtle, and secondary complications including bone disease (osteoporosis) are therefore more frequent at the time of presentation. The case presented here illustrates this well, and also highlights the value of measuring vitamin D levels in such patients. The most interesting aspect of this case was the reciprocal relationship between thyroxine and parathyroid hormone observed in maintaining calcium homeostasis in this thyrotoxic patient with low vitamin D levels.

Matakidou A, Hamel N, Popat S, Henderson K, Kantemiroff T, Harmer C, Clarke SE, Houlston RS, Foulkes WD. · Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK. · Carcinogenesis. · Pubmed #14633662 links to  free full text

Abstract: Benign thyroid disorders are strong risk factors for non-medullary thyroid cancer (NMTC). Germline variation in Tg (thyroglobulin) and TSHR (thyroid stimulating hormone receptor) confers an increased risk of benign thyroid disorders. To explore the hypothesis that polymorphic variation in these genes affects the risk of NMTC we compared the frequency of TgQ2511R, TSHR-P52T and TSHR-D727E genotypes in two series of NMTC cases and controls (group 1, Canadian 102 cases and 102 controls; group 2, British 202 cases and 298 controls). No significant association was seen with TSHR-P52T and TSHR-D727E genotypes and risk of NMTC. However, the frequency of the R-allele of TgQ2511R was over represented in NMTC cases in both study populations. The odds ratios associated with hetero- and homozygosity for the R-allele were 1.6 (95% confidence interval, 1.1-2.5) and 2.0 (95% confidence interval, 1.2-3.3), respectively. Although the risk of NMTC associated with the TgQ2511R R-allele is modest, its high prevalence in the general population suggests it may make a significant contribution to the incidence of NMTC.

Lacey NA, Jones A, Clarke SE. · Departments of Radiology and Nuclear Medicine, Guy's & St Thomas NHS Trust, St Thomas' Street, London SE1 5RT, UK. · Br J Radiol. · Pubmed #11459726 links to  free full text

Abstract: The purpose of the study was to assess the role of radionuclide imaging of hyperthyroid patients with no suspicion of nodules. (99)Tc(m) radionuclide scans performed on all 190 patients referred over a 2-year period with symptoms and thyroid function tests compatible with thyrotoxicosis were retrospectively reviewed. 73% of patients were referred by a hospital clinician and 27% were referred direct from the general practitioner. Referral letters and, where applicable, the clinical notes were reviewed and patients with suspected thyroid nodules were excluded. The results of (99)Tc(m) thyroid scans of the 190 patients (age range 23-93 years, mean 48 years) were reviewed. 152 (80%) patients had Graves' disease, 10 (5.3%) had Graves' disease with nodules, 6 (3.2%) had Graves' disease with non-functioning nodules, 5 (2.6%) had viral thyroiditis, 5 (2.6%) had autonomously functioning nodules and 12 (6.3%) were normal studies. Therefore, 20% of patients had a diagnosis other than solely Graves' disease. These diagnoses are important with respect to clinical management. In conclusion, routine radionuclide imaging is worthwhile, as a significant proportion of patients with clinical "Graves' disease" in this study would have received incorrect treatment without the result of this scan.

Fenton PA, Clarke SE, Owen W, Hibbert J, Hodgson SV. · Guy's, King's and St. Thomas' School of Medicine, London, United Kingdom. · Thyroid. · Pubmed #11288991 No free full text.

Abstract: Inherited cancer syndromes may predispose to more than one type of cancer, and these characteristically develop at an earlier age than their sporadic counterparts. The occurrence in a single individual of multiple, early onset primary cancers may indicate an inherited cancer susceptibility. Familial adenomatous polyposis (FAP), an autosomal, dominantly inherited susceptibility to colorectal adenomas and cancer also predisposes to childhood medulloblastomas and to a specific rare histologic type (cribriform variant) of papillary thyroid cancer. We describe a patient who developed a childhood medulloblastoma of the cerebellum, and subsequently a cribriform papillary thyroid cancer. These cancers predated the diagnosis of FAP in this patient, who was later found to have several relatives with FAP. The adenomatous polyposis coli (APC) mutation delineated in this family was in the region associated with those causing an increased risk of thyroid cancer. We submit that the diagnosis of the cribriform variant of papillary thyroid cancer in a young individual, especially after a previous cancer diagnosis, should alert the physician to the possibility of a diagnosis of FAP.

Thust S, Fernando R, Barwick T, Mohan H, Clarke SE. · No affiliation provided · Thyroid. · Pubmed #19119982 No free full text.

This publication has no abstract.