Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Aug 2018
Review[Recommendation for Calcitonin Screening in Nodular Goiter].
Medullary thyroid cancer (MTC) arises from parafollicular C cells of the thyroid gland and is characterized by a calcitonin secretion. Basal calcitonin correlates with the tumor mass and is used as highly sensitive and specific tumor marker for MTC. Based on former assays, unspecific calcitonin increase has frequently been seen in Hashimoto's thyroiditis, kidney insufficiency, proton pump inhibitors etc. ⋯ Lower calcitonin values should be re-evaluated in intervals of 3 - 6 months; rising calcitonin levels may indicate an MTC. In this case, thyroid operation should be performed. The cure rate of MTC with calcitonin values < 100 pg/ml is nearly 100 % done by high volume surgeons.
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Dtsch. Med. Wochenschr. · Aug 2018
Review[Osteoarthropathies and Myopathies associated with Disorders of the Thyroid Endocrine System].
Triiodothyronine (T3) is a key regulator of bone, muscle and articular cartilage. Musculoskeletal symptoms of hyperthyroidism include loss of bone mass finally leading to osteoporosis and weakness of the skeletal musculature. Hypothyroidism on the other side frequently leads to muscle stiffness and cramping and, occasionally, results in rhabdomyolysis. ⋯ Recent findings underline the importance of local T3 generation by deiodinase type 2 and support the existence of local hypo- or hyperthyroidism. In the review, the implications of the recent literature for current understanding of osteoarthritis, myopathies and diabetic osteoarthropathy will be discussed. Further emphasis will be placed on the association of autoimmune thyroiditis with musculoskeletal diseases and fibromyalgia.