The demand for selenium (Se) increases during pregnancy since this element supports child growth, proper neuronal development and maternal thyroid function. The issue is particularly relevant for populations living in areas with a limited selenium supply, where many pregnant women opt for Se supplementation. The efficiency of this measure is unknown, although it seems vital in the prevention of severe Se deficiency. In order to evaluate this hypothesis, an observational study was conducted in Poland, where Se deficiency is prevalent. Pregnant women were invited to participate in the study and provided serum samples at the end of pregnancy (n = 115). Information on the supplemental intake of micronutrients was recorded in a face-to-face interview. In addition, serum samples were isolated from the cord blood of newborns at delivery (n = 112) and included in the analyses. Thyroid hormone status was evaluated by routine laboratory tests, and Se status was determined by total Se and selenoprotein P (SELENOP) concentrations and extracellular glutathione peroxidase (GPX3) activity. The three parameters of Se status correlated strongly within the group of mothers and within the group of newborns, with an additional significant correlation found among mother–child pairs. One-third of mothers reported additional Se intake, mainly as a component of multi-micronutrient supplements, at a mean (±SD) dosage of 42 ± 14 µg Se/day. Despite this regime, most of the women presented an insufficient Se status, with 79% of mothers displaying serum Se concentrations below 70 µg/L (indicating Se deficiency) and 22% showing levels below 45.9 µg/L (severe Se deficiency). The inadequate Se supply was also reflected in relatively low SELENOP concentrations and GPX3 activity. Neither total Se nor SELENOP or GPX3 levels were significantly higher in the group of mothers reporting the intake of supplements than in the non-supplementing group. Nevertheless, elevated SELENOP concentrations were observed in the subgroup receiving supplements with more than 55 µg/day. We conclude that the self-administered supplementation of small Se dosages was not sufficient to achieve replete Se status in the micronutrient scant area. However, the maternal Se deficit measured by either Se, SELENOP or GPX3 was transferred from mothers to the newborns, as the parameters correlated strongly in the mother–newborn pairs of samples. It is vital to re-evaluate the guidelines concerning pregnancy care and monitoring of micronutrient status during pregnancy, in particular in areas where deficiencies are present.
Rheumatoid arthritis (RA) and autoimmune diseases of the thyroid gland (AITD) often occur together. As autoimmune diseases, they share common pathological pathways, reflecting the fact that the treatment of the underlying disease can influence the course of thyroid disorders. The pharmacotherapy of RA is based on the supply of disease-modifying anti-inflammatory drugs with an increasing focus on biologics. This article aims to review the available literature describing the effects of biological treatments on thyroid function. The use of biological drugs may have the potential benefit of regulating the level of anti-thyroid antibodies. On the other hand, tumour necrosis factor-alpha (TNF-a) inhibitors are not indifferent to thyroid function and may increase the incidence of subacute thyroiditis. The coexistence of AITD and RA prompts consideration of the need for routine thyroid screening in RA patients and for RA screening in patients with thyroid disease who report joint problems. Rheumatoid arthritis (RA) and autoimmune diseases of the thyroid gland (AITD) often occur together. As autoimmune diseases, they share common pathological pathways, reflecting the fact that the treatment of the underlying disease can influence the course of thyroid disorders. The pharmacotherapy of RA is based on the supply of disease-modifying anti-inflammatory drugs with an increasing focus on biologics. This article aims to review the available literature describing the effects of biological treatments on thyroid function. The use of biological drugs may have the potential benefit of regulating the level of anti-thyroid antibodies. On the other hand, tumour necrosis factor-alpha (TNF-a) inhibitors are not indifferent to thyroid function and may increase the incidence of subacute thyroiditis. The coexistence of AITD and RA prompts consideration of the need for routine thyroid screening in RA patients and for RA screening in patients with thyroid disease who report joint problems.
The purpose of the study was to assess the clinical, biochemical, and sonographic factors influencing the performance of parathormone washout measurement (PTHw) vs. MIBI in the preoperative localization of parathyroid adenoma (PA). The studied group consisted of 39 patients with primary or tertiary hyperparathyroidism. The measurement of PTH concentrations was performed using an electro-chemiluminescence immunoassay. Scintigraphic localization of PA was carried out using dual-tracer planar neck scintigraphy, using 74 MBq 99mTc-pertechnetate and 740 MBq of 99mTc-MIBI. MIBI was unambiguously positive in 74% of patients. Among patients with negative or inconclusive MIBI, 90% had a positive PTHw result. Among patients with negative PTHw, two out of three had a positive MIBI result. The PTHw of lesions <10 mm in their largest diameter yielded positive results in 95%, compared to 75% for MIBI. For lesions ≥10 mm in largest diameter, 88% were visualised using MIBI. In conclusion, PTHw is a highly effective, easy, quick, safe, and relatively cheap procedure which might be considered for PA localisation, especially in patients with lesions presenting typical ultrasound features and a size below 10 mm. MIBI remains a useful procedure in specialized centres, particularly for patients in whom PTHw failed, larger lesions, and in cases of the ectopic location of PA.