A NEW LOOK AT HYPOTHYROIDISM Edited by Drahomira Springer A New Look at Hypothyroidism Edited by Drahomira Springer Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Igor Babic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published February, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org A New Look at Hypothyroidism, Edited by Drahomira Springer p. cm. ISBN 978-953-51-0020-1 Contents Preface IX Part 1 Introduction 1 Chapter 1 Hypothyroidism 3 Osama M. Ahmed and R. G. Ahmed Chapter 2 Environmental Thyroid Disruptors and Human Endocrine Health 21 Francesco Massart, Pietro Ferrara and Giuseppe Saggese Part 2 Autoimmune Thyroid Diseases 45 Chapter 3 Hashimoto’s Thyroiditis 47 Arvin Parvathaneni, Daniel Fischman and Pramil Cheriyath Chapter 4 Hashimoto's Disease 69 Noura Bougacha-Elleuch, Mouna Mnif-Feki, Nadia Charfi-Sellami, Mohamed Abid and Hammadi Ayadi Chapter 5 Hashimoto’s Disease - Involvement of Cytokine Network and Role of Oxidative Stress in the Severity of Hashimoto’s Thyroiditis 91 Julieta Gerenova, Irena Manolova and Veselina Gadjeva Chapter 6 Different Faces of Chronic Autoimmune Thyroiditis in Childhood and Adolescence 125 Ljiljana Saranac and Hristina Stamenkovic Part 3 Pregnancy and Childhood 133 Chapter 7 Treatment of Graves’ Disease During Pregnancy 135 Teresa M. Bailey VI Contents Chapter 8 Universal Screening for Thyroid Disorders in Pregnancy: Experience of the Czech Republic 147 Eliska Potlukova, Jan Jiskra, Zdenek Telicka, Drahomira Springer and Zdenka Limanova Chapter 9 Thyroid Function Following Treatment of Childhood Acute Lymphoblastic Leukemia 159 Elpis Vlachopapadopoulou, Vassilios Papadakis, Georgia Avgerinou and Sophia Polychronopoulou Chapter 10 Congenital Hypothyroidism and Thyroid Cancer 175 Minjing Zou and Yufei Shi Chapter 11 Hypothyroidism and Thyroid Function Alterations During the Neonatal Period 191 Susana Ares, José Quero, Belén Sáenz-Rico de Santiago and Gabriela Morreale de Escobar Chapter 12 Neonatal-Prepubertal Hypothyroidism on Postnatal Testis Development 209 S.M.L. Chamindrani Mendis-Handagama Chapter 13 Congenital Hypothyroidism due to Thyroid Dysgenesis: From Epidemiology to Molecular Mechanisms 229 Johnny Deladoey Chapter 14 Consideration of Congenital Hypothyroidism as the Possible Cause of Autism 243 Xiaobin Xu, Hirohiko Kanai, Masanori Ookubo, Satoru Suzuki, Nobumasa Kato and Miyuki Sadamatsu Preface This book provides both the basic and the most up-to-date information on the clinical aspect of hypothyroidism. This first part offers general and elaborated view on the basic diagnoses in overt and subclinical hypothyroidism, autoimmune thyroid diseases and congenital hypothyroidism. Researchers and clinicians experts provide results of their long time experience and results of their own scientific work. This information may be helpful for all of physician not only endocrine specialization. Introductory chapters summarize the basic theory of hypothyroidism; following chapters describe Hashimoto's disease and congenital hypothyroidism - the formation, the indication and the treatment. This first part contains many important specifications and innovations for endocrine practice. I would like to thank all of authors who had helped in the preparation of this book. We hope it would be useful as a current resource for endocrine specialists. Drahomira Springer Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital, Prague, Czech Republic [...]... normal connectivity is to be established This migration depends not only upon specialized cells such as the radial glial cells that form a scaffolding system but also on specific adhesion molecules in the extracellular matrix that are associated with the focal contacts linking migrating neurons with radial glial fibers (Mione and Parnavelas, 1994) These neurons migrate along radial glial fibers, and... fetal/perinatal development (Madeira et al., 1992) Early in fetal development (rats), thyroid hormone deficiency decreases radial glial cell maturation and therefore impairs cellular migration (Rami and Rabie, 1988), which can lead to irreversible changes in the Hypothyroidism 9 neuronal population and connectivity in this region Animals with experimentally induced congenital hypothyroidism show delayed... that are integral to the regulation of mood and cognition (Bauer et al., 2009) In hypothyroidism, replacement therapy with T4 remains the treatment of choice and resolves most physical and psychological signs and symptoms in most patients However, some patients do not feel entirely well despite doses of T4 that are usually adequate (Saravanan et al., 2002) In T4treated patients, it was found that reduced... environmental pollutants, causing a variety of toxic effects These environmental pollutants tend to degrade slowly in the environment, to bioaccumulate and to bioconcentrate in the food chain having long half-lives in mammalian fatty tissues Animals fats and breastfeeding are the most important human dietary sources (Kavlock et al., 1996) Several biomonitoring studies have detected many environmental pollutants... related to its effects on metabolism Physical symptoms of hypothyroidism- related reduced metabolic rate include fatigue, slowed heart rate, intolerance to cold temperatures, inhibited sweating and muscle pain Depression is a key psychological consequence of hypothyroidism and slow metabolism as well For women, slow metabolism can cause increased menstruation and even impair fertility Weight gain and... to both the pyramidal and the extrapyramidal systems (Porterfield, 2000) These problems include disturbances of gait, and in the more extreme forms, the individuals cannot walk or stand (Pharoah et al., 1981; Donati et al., 1992; Stanbury, 1997) If postnatal hypothyroidism is present, there is growth retardation and delayed or absent sexual maturation (Porterfield and Hendrich, 1993) Damage occurs both... reason, it seems that moderate iodine deficiency causes an imbalance in maternal thyroid homeostasis, especially toward the end of pregnancy, leading to isolated hypothyroxinemia suggestive of biochemical hypothyroidism Uncontrolled hypothyroidism in pregnancy can lead to preterm birth, low birth weight and mental retardation (Drews and Seremak-Mrozikiewicz, 2011) 7.4 Perinatal thyroid function and... neurological cretinism and myxedematous cretinism (Delange, 2000) Neurological cretinism is characterized by extreme mental retardation, deaf-mutism, impaired voluntary motor activity, and hypertonia (Delange, 2000) In contrast, myxedematous cretinism is characterized by less severe mental retardation and all the major clinical symptoms of persistent hypothyroidism (Delange, 2000) Iodide administration... increase the risk for Alzheimer’s disease, especially in women (Tan et al., 2008) However, most hypothyroid patients do not meet the criteria for a mental disorder A recent study evaluated brain glucose metabolism during T4 treatment of hypothyroidism (Bunevičius and Prange Jr, 2010) A reduction in depression and cognitive symptoms was associated with restoration of metabolic activity in brain areas that... Hypothyroidism during fetal and neonatal development results in delayed neuronal differentiation and decreased neuronal connectivity (Nunez et al., 1991) 8 References Ahmed OM, El-Gareib, AW, El-bakry, AM, Abd El-Tawab, S.M, Ahmed, RG Thyroid hormones states and brain development interactions Int J Devl Neurosc 2008; 26: 147–209 14 A New Look at Hypothyroidism Alm J, Hagenfeldt L, Larsson A, Lundberg K Incidence . that are usually adequate (Saravanan et al., 2002). In T4- treated patients, it was found that reduced psychological well being is associated with occurrence of polymorphism in the D2 gene (Panicker. decreases radial glial cell maturation and therefore impairs cellular migration (Rami and Rabie, 1988), which can lead to irreversible changes in the Hypothyroidism 9 neuronal population and. Pietro Ferrara and Giuseppe Saggese Part 2 Autoimmune Thyroid Diseases 45 Chapter 3 Hashimoto’s Thyroiditis 47 Arvin Parvathaneni, Daniel Fischman and Pramil Cheriyath Chapter 4 Hashimoto's