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Editorial
Radioiodine for Thyroid Cancer — Is Less More?
In this issue of the Journal, Schlumberger et al. and Mallick et al. describe the administration of radioiodine (iodine-131) after total thyroidectomy in patients with low-risk thyroid cancer. Postsurgical treatment has long played an important role in the management of this increasingly common…
- May 3, 2012
- Alexander E.K. and Larsen P.R.
- N Engl J Med 2012; 366:1732-1733
In this issue of the Journal, Schlumberger et al.¹ and Mallick et al.² describe the administration of radioiodine (iodine-131) after total thyroidectomy in patients with low-risk thyroid cancer. Postsurgical treatment has long played an important role in ...
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Original Article
Ablation with Low-Dose Radioiodine and Thyrotropin Alfa in Thyroid Cancer
Thyroid cancer is the most frequently occurring endocrine cancer, with more than 2100 new cases each year in the United Kingdom and more than 48,000 in the United States. Most cases are differentiated thyroid cancer, which is associated with a high 10-year survival rate (90 to 95%). Many patients…
- May 3, 2012
- Mallick U., Harmer C., Yap B., et al.
- N Engl J Med 2012; 366:1674-1685
In this trial, low-dose radioiodine was as effective as high-dose radioiodine in patients with differentiated thyroid tumors, and recombinant human thyrotropin (thyrotropin alfa) was as effective as thyroid hormone withdrawal.
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Original Article
Strategies of Radioiodine Ablation in Patients with Low-Risk Thyroid Cancer
Radioiodine (131I) is administered to patients with thyroid cancer after total thyroidectomy for three reasons–: first, to eradicate normal-thyroid remnants (ablation) in order to achieve an undetectable serum thyroglobulin level; second, to irradiate any neoplastic focus in order to decrease the…
- May 3, 2012
- Schlumberger M., Catargi B., Borget I., et al.
- N Engl J Med 2012; 366:1663-1673
- CME
This trial compared two thyrotropin-stimulation methods and two 131I doses for postoperative ablation in patients with low-risk thyroid cancer. Rates of ablation were similar in all treatment groups. Doses lower than those currently recommended may be adequate for this condition.
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Images in Clinical Medicine
Ectopic Thyroid Gland
Figure 1.
- March 8, 2012
- Aalaa M. and Mohajeri-Tehrani M.R.
- N Engl J Med 2012; 366:943
- Free Full Text
A 12-year-old girl presented with a lump in her neck. She had previously been found to have hypothyroidism and had been treated with levothyroxine.
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Images in Clinical Medicine
Lingual Thyroid
Figure 1.
- March 8, 2012
- Yu T.-Y. and Chang T.-C.
- N Engl J Med 2012; 366:e15
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A 45-year-old woman presented with long-standing dyspnea, especially when lying down, and dysphagia in association with solid food. She had been diagnosed with hypothyroidism at 43 years of age, at which time levothyroxine replacement therapy was initiated.
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Case Records of the Massachusetts General Hospital
Case 4-2012 — A 37-Year-Old Man with Muscle Pain, Weakness, and Weight Loss
Presentation of Case. Dr. Ian J. Barbash (Medicine): A 37-year-old man was admitted to this hospital because of muscle pain and weakness. The patient had been well until the evening before admission, when mild diffuse myalgias developed. He awoke in the morning with diffuse muscle cramps and…
- February 9, 2012
- Rhee E.P., Scott J.A., Dighe A.S.
- N Engl J Med 2012; 366:553-560
- CME
A 37-year-old man was admitted to this hospital because of 12 hours of muscle pain and weakness, resulting in the inability to rise from bed. Brief episodes of similar symptoms had occurred during the past month. He reported blurred vision, gynecomastia, and weight loss.
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Original Article
Antenatal Thyroid Screening and Childhood Cognitive Function
Active secretion of thyroid hormone in the fetus does not start until about 18 to 20 weeks' gestation. Studies in animals suggest that until fetal hormone secretion begins, the fetus is dependent on circulating free thyroxine (T4) in the mother for growth and development, including central nervous…
- February 9, 2012
- Lazarus J.H., Bestwick J.P., Channon S., et al.
- N Engl J Med 2012; 366:493-501
- CME
In this randomized trial, antenatal screening (at a median gestational age of 12 weeks 3 days) and treatment for hypothyroidism did not result in improved cognitive function in children at 3 years of age.
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Editorial
The Debate over Thyroid-Function Screening in Pregnancy
Maternal hypothyroidism in pregnancy has been associated with a range of adverse outcomes, most importantly miscarriage, preterm delivery, and reduced cognitive function in offspring. In surveys, almost half the obstetricians in private practices in Maine and the majority of obstetricians in a…
- February 9, 2012
- Brent G.A.
- N Engl J Med 2012; 366:562-563
Maternal hypothyroidism in pregnancy has been associated with a range of adverse outcomes, most importantly miscarriage, preterm delivery, and reduced cognitive function in offspring.¹ In surveys, almost half the obstetricians in private practices in ...
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Original Article
Brief Report: A Mutation in the Thyroid Hormone Receptor Alpha Gene
Thyroid hormones have diverse actions, which include regulation of skeletal growth, maturation of the central nervous system, cardiac and gastrointestinal function, and energy homeostasis. In addition, thyroid hormones control their own production by feedback inhibition of hypothalamic thyrotropin…
- January 19, 2012
- Bochukova E., Schoenmakers N., Agostini M., et al.
- N Engl J Med 2012; 366:243-249
On whole-exome sequencing, a child with clinical hypothyroidism but borderline-abnormal thyroid hormone levels was found to have a heterozygous nonsense mutation in THRα, encoding a mutant protein inhibiting wild-type receptor action in a dominant negative manner.
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Clinical Problem-Solving
A Hidden Solution
Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows. Stage. A 51-year-old woman presented to…
- December 1, 2011
- Pramyothin P., Leung A.M., Pearce E.N., Malabanan A.O., Braverman L.E.
- N Engl J Med 2011; 365:2123-2127
- CME
A 51-year-old woman presented to the ER with a 6-month history of intermittent palpitations, which had worsened that day. She described her pulse as fast but regular. She also reported worsening fatigue, heat intolerance, and an 18-kg (40-lb) weight loss.
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Review Article
Current Concepts: Short-Term and Long-Term Health Risks of Nuclear-Power-Plant Accidents
On March 11, 2011, a 9.0-magnitude earthquake struck the east coast of Japan. The total number of people who died in the earthquake and the tsunami that it generated is still being assessed, but the official estimation already exceeds 14,000. The natural disaster also caused substantial damage to…
- June 16, 2011
- Christodouleas J.P., Forrest R.D., Ainsley C.G., et al.
- N Engl J Med 2011; 364:2334-2341
- Free Full Text
- CME
Recent natural disasters in Japan led to a partial meltdown at the Fukushima nuclear power plant. This article reviews the history of such accidents, along with the short-term and long-term health risks associated with environmental exposure to nuclear fission products.
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Original Article
Brief Report: Recurrent PRKAR1A Mutation in Acrodysostosis with Hormone Resistance
Numerous hormones activate heterotrimeric G-protein–coupled receptors, which then activate G protein and adenylyl cyclase, generating intracellular cAMP. In turn, cAMP activates protein kinase A, resulting in the phosphorylation of specific proteins that mediate the physiological effects of these…
- June 9, 2011
- Linglart A., Menguy C., Couvineau A., et al.
- N Engl J Med 2011; 364:2218-2226
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The authors describe a germ-line mutation in the gene for PRKAR1A in three unrelated patients with acrodysostosis and resistance to multiple hormones. The mutated protein subunit impairs the response of protein kinase A to cyclic-AMP stimulation.
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Images in Clinical Medicine
Graves' Disease
Figure 1.
- May 19, 2011
- Delgado Hurtado J.J. and Pineda M.
- N Engl J Med 2011; 364:1955
- Free Full Text
A 43-year-old woman presented with fatigue and reported a weight loss of 22.5 kg (50 lb) during the previous 18 months. Physical examination revealed diaphoresis, cachexia, a resting heart rate of 110 beats per minute, and a diffusely enlarged, nontender thyroid gland.
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Original Article
Selenium and the Course of Mild Graves' Orbitopathy
Approximately half the patients with Graves' disease have ocular involvement (Graves' orbitopathy). Moderately severe and active forms of Graves' orbitopathy can be effectively treated with glucocorticoids, orbital irradiation, or both,, whereas milder forms may improve spontaneously and generally…
- May 19, 2011
- Marcocci C., Kahaly G.J., Krassas G.E., et al.
- N Engl J Med 2011; 364:1920-1931
- Free Full Text
This trial compared oral selenium, an antioxidant agent, or oral pentoxifylline, an antiinflammatory agent, with placebo in mild Graves' orbitopathy. Selenium significantly improved quality of life and eye involvement and slowed disease progression.
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Images in Clinical Medicine
Papules on the Eyelids, Lips, and Tongue
Figure 1.
- March 3, 2011
- Tehrani M.R.M. and Aalaa M.
- N Engl J Med 2011; 364:870
- Free Full Text
A 16-year-old boy presented with multiple flesh-colored papules and dermal nodules on his eyelids, lips, and tongue (Panels A, B, and C, respectively). Six years earlier, his mother had received a diagnosis of metastatic medullary thyroid cancer, at the ...
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Clinical Therapeutics
Radioiodine Therapy for Hyperthyroidism
Foreword. This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are…
- February 10, 2011
- Ross D.S.
- N Engl J Med 2011; 364:542-550
- CME
A 37-year-old woman receives a diagnosis of Graves' disease and is treated with methimazole for 1 year. After completing this treatment, she presents with recurrent symptoms of hyperthyroidism. Radioiodine ablation is recommended.
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Case Records of the Massachusetts General Hospital
Case 38-2010 — A 13-Year-Old Girl with an Enlarging Neck Mass
Presentation of Case. Dr. Michelle L. Katz (Pediatrics): A 13-year-old girl was seen in the pediatric endocrinology clinic of this hospital because of an enlarging neck mass. Eight days earlier, the patient noted swelling of her neck and pain on swallowing. Two days later, her primary care provider…
- December 16, 2010
- Misra M., Parangi S., Ross D.S., Shailam R., Sadow P.M.
- N Engl J Med 2010; 363:2445-2454
- CME
A 13-year-old girl was seen in the pediatric endocrinology clinic because of an enlarging neck mass. The thyroid gland was diffusely enlarged; levels of thyrotropin and antithyroglobulin antibodies were elevated. Ultrasonography revealed diffusely abnormal parenchyma with calcifications.
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Images in Clinical Medicine
Thyroid Ectopia in a Boy with Hypothyroidism
Figure 1.
- September 30, 2010
- Ghonge N.P. and Sahu A.K.
- N Engl J Med 2010; 363:1351
- Free Full Text
A 15-year-old boy presented with lifelong neck swellings that had been gradually increasing in size. He was otherwise asymptomatic. Physical examination was notable for a larger nodule in the infrahyoid area (Panel A, white arrow) and a smaller nodule in ...
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Correspondence
Myxedema Coma Induced by Ingestion of Raw Bok Choy
To the Editor: An 88-year-old Chinese woman was brought to the emergency department by her family, who reported that she had been lethargic and unable to walk or swallow for 3 days. She had been eating an estimated 1.0 to 1.5 kg of raw bok choy daily for several months in the belief that it would…
- May 20, 2010
- N Engl J Med 2010; 362:1945-1946
- Free Full Text
To the Editor: An 88-year-old Chinese woman was brought to the emergency department by her family, who reported that she had been lethargic and unable to walk or swallow for 3 days. She had been eating an estimated 1.0 to 1.5 kg of raw bok choy daily for ...
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Images in Clinical Medicine
Delayed Graves' Ophthalmopathy
Figure 1.
- May 6, 2010
- Nebesio T.D. and Eugster E.A.
- N Engl J Med 2010; 362:e60
- Free Full Text
An 18-year-old man who had received a diagnosis of Graves’ disease at 13 years of age presented with several months of progressive eye changes. Physical examination revealed exotropia of the right eye, bilateral proptosis, periorbital edema, and ...
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Medical Meetings Pediatrics Conferences and Meetings

2012 Certifying Examinations of the American Board of Pediatrics

The general pediatrics examination will be held in various cities, Oct. 16-18. Registration for first-time applicants is ongoing through May 3. Registration for re-registrants is ongoing through May 24. The following subspecialty examinations will be held in various cities: "Hospice and Palliative Medicine" (Oct. 4); "Pediatric Transplant Hepatology" (Oct. 11); "Pediatric Cardiology" (Nov. 7); "Pediatric Pulmonology" (Nov. 8); "Medical Toxicology" (Nov. 12); and "Pediatric Critical Care Medicine" (Nov. 14). Registration for first-time applicants is ongoing through April 30. Registration for re-registrants is ongoing through June 15.

Contact the American Board of Pediatrics, 111 Silver Cedar Court, Chapel Hill, NC 27514-1513; or call (919) 929-0461; or fax (919) 918-7114 or (919) 929-9255; or see http://www.abp.org .

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Browse Thyroid Disease

Showing 1 to 20 of 473 Articles

Filter Results

Radioiodine for Thyroid Cancer — Is Less More?

Ablation with Low-Dose Radioiodine and Thyrotropin Alfa in Thyroid Cancer

Strategies of Radioiodine Ablation in Patients with Low-Risk Thyroid Cancer

Ectopic Thyroid Gland

Lingual Thyroid

Case 4-2012 — A 37-Year-Old Man with Muscle Pain, Weakness, and Weight Loss

Antenatal Thyroid Screening and Childhood Cognitive Function

The Debate over Thyroid-Function Screening in Pregnancy

Brief Report: A Mutation in the Thyroid Hormone Receptor Alpha Gene

A Hidden Solution

Current Concepts: Short-Term and Long-Term Health Risks of Nuclear-Power-Plant Accidents

Brief Report: Recurrent PRKAR1A Mutation in Acrodysostosis with Hormone Resistance

Graves' Disease

Selenium and the Course of Mild Graves' Orbitopathy

Papules on the Eyelids, Lips, and Tongue

Radioiodine Therapy for Hyperthyroidism

Case 38-2010 — A 13-Year-Old Girl with an Enlarging Neck Mass

Thyroid Ectopia in a Boy with Hypothyroidism

Myxedema Coma Induced by Ingestion of Raw Bok Choy

Delayed Graves' Ophthalmopathy

Medical Meetings Pediatrics Conferences and Meetings

2012 Certifying Examinations of the American Board of Pediatrics

Trends: Most Viewed (Last Week)