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=> 2007 "Tamanyo" => 377376 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Coronal and axial CT views (A, B) show a 6<span class="elsevierStyleHsp" style=""></span>cm heterogeneous mass in the head and uncinated process of the pancreas, with a necrotic cystic component and intense peripheral enhancement suggesting hypervascular behavior. Coronal and axial postoperative CT views (C, D) of the pancreatic mass: after surgery, complete resection was achieved. Maximum intensity projection, coronal and axial [<span class="elsevierStyleSup">18</span>F] FDG PET/CT images (E–G), performed five years after the pancreatic surgery, show a hypermetabolic retroperitoneal lymphadenopathy in the region of the surgical bed (SUVmax: 6.9), suggestive of tumor recurrence. Coronal and axial [<span class="elsevierStyleSup">99m</span>TC] octreotride SPECT/CT images (H, I) performed 3 years after the local recurrence, show expression of somatostatin receptors in the hepatic lesions and in the previously known retroperitoneal adenopathies. Coronal and axial last control CT views (J, K) showed enlargement of known liver lesions and appearance of new liver lesions; these findings were compatible with progressive disease. Hematoxylin eosin stain of the primary tumor (20×) reveals well-defined nests of cuboidal cells (Zellballen) separated by intensely vascularized fibrous septa; cells have moderately abundant, basophilic and granular cytoplasm (L), Ki67 index was 15–20% (M). The liver biopsy (N) was compatible with metastasis of paraganglioma; Ki67 index was 20–30% (O).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Maria D. Alcantara-Laguna, Yiraldine Herrera-Martínez, Marina E. Sánchez-Frías, Maria A. Gálvez-Moreno, Aura D. Herrera-Martínez" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Maria D." "apellidos" => "Alcantara-Laguna" ] 1 => array:2 [ "nombre" => "Yiraldine" "apellidos" => "Herrera-Martínez" ] 2 => array:2 [ "nombre" => "Marina E." "apellidos" => "Sánchez-Frías" ] 3 => array:2 [ "nombre" => "Maria A." "apellidos" => "Gálvez-Moreno" ] 4 => array:2 [ "nombre" => "Aura D." "apellidos" => "Herrera-Martínez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2530016421001051" "doi" => "10.1016/j.endinu.2020.12.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016421001051?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018022000075?idApp=UINPBA00004N" "url" => "/25300180/0000006900000001/v1_202202280604/S2530018022000075/v1_202202280604/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Relationship between vestibular syndrome and autoimmune thyroiditis" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "76" "paginaFinal" => "77" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ana Giribet Fernández-Pacheco, María Antonia Tomás Pérez, María Teresa Almela Rojo, Francisco José García-Purriños García" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Ana Giribet" "apellidos" => "Fernández-Pacheco" "email" => array:1 [ 0 => "ana.giribet.f.p@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "María Antonia" "apellidos" => "Tomás Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "María Teresa" "apellidos" => "Almela Rojo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Francisco José" "apellidos" => "García-Purriños García" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Health Sciences PhD program, Universidad Católica de Murcia (UCAM), Guadalupe, Murcia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital General Universitario Los Arcos del Mar Menor, Pozo Aledo, Murcia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Relación entre el síndrome vestibular y la tiroiditis autoinmune" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">For years, autoimmune hypothyroidism has been associated with the development of other diseases, demonstrating the possible role that antithyroid antibodies could play at the systemic level. Some of these diseases are coeliac disease, type 1 diabetes mellitus, pernicious anaemia, multiple sclerosis, vitiligo, dermatitis herpetiformis and chronic urticaria.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> There are also studies that show the association between autoimmune thyroid disease and vestibular dysfunction (Ménière's disease, benign positional paroxysmal vertigo, etc.), although to date they are scarce, with discordant results, and they do not clarify the role of antithyroid antibodies in the pathogenesis of vestibular dysfunction.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4</span></a> The objective of this work is to assess the relationship between peripheral vestibular syndrome and autoimmune thyroiditis.</p><p id="par0010" class="elsevierStylePara elsevierViewall">For this, an observational, descriptive, retrospective, cross-sectional epidemiological study was carried out between 1 November 2017 and 31 October 2018, at the Hospital Universitario Los Arcos del Mar Menor, in Murcia. The study analysed 52 patients who presented positive antiperoxidase and antithyroglobulin antibodies, or pathological data suggestive of lymphocytic thyroiditis after biopsy or surgical excision of the gland due to symptomatic multinodular goitre or suspicious thyroid nodules. In all of them, the history or presence of vertiginous symptoms was investigated, that is, the sensation that you or everything around you is spinning or moving, associated or not with nausea and vomiting, in the last year. Those excluded were patients with a history of previous otological problems or surgery, vascular or neurological disorders that could simulate vestibular symptoms (stroke, transient ischaemic attack, multiple sclerosis, etc.) and consumption of drugs that could have vestibular alterations as a secondary effect. Quantitative plasma levels of the hormones free T4 and TSH and antithyroid antibodies were determined by electrochemiluminescence immunoassay (ECLEIA). And for the data analysis, the statistical software IBM SPSS Statistics 24® was used.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Of the 52 patients included in the study, 19 presented clinical criteria compatible with vestibular dysfunction (36.5%), of whom 15 were women and four were men, with a mean age of 56.5 years. Patients with vestibular symptoms had significantly higher levels of TSH (18 ± 33.9 IU/ml) and lower levels of plasma T4 (0.95 ± 0.37 ng/dl) compared to those who did not, with p values of 0.039 and 0.04, respectively. No statistically significant relationship was found between the levels of antithyroid antibodies and the presence or absence of vestibular symptoms. However, 45% and 57% of patients with levels of antiperoxidase and antithyroglobulin antibodies greater than 700 IU/ml, respectively, had symptoms of dizziness. Of the 18 patients (34.6%) who underwent total thyroidectomy, all presented pathological characteristics indicative of lymphocytic thyroiditis. However, 22.2% of them had data suggesting multinodular goitre and 39% papillary thyroid cancer. Ten of the thyroidectomised patients also presented with a vertiginous syndrome and 70% of them reported clear clinical improvement after surgery.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Despite the limited sample size, our results show an increased prevalence of hypothyroidism in patients with vestibular dysfunction, compared to the general population (15-20%),<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> and better control of vertigo after thyroidectomy, which could be explained by the role played by thyroid autoimmunity in these patients. To date, the role of thyroid surgery in vestibular control in patients with autoimmune thyroiditis has not been described in the literature. That is why we believe it is necessary to propose new care protocols that include the study of thyroid function in patients who consult for vertigo, and also to highlight the anamnesis regarding the presence of symptoms compatible with peripheral vestibular disease in patients with autoimmune thyroiditis as well as the continuation or resolution of the vertiginous symptoms after thyroidectomy. With this, we could contribute to an early diagnosis of both diseases and it would give us the opportunity to carry out large-scale prospective randomised studies to clarify the involvement of antithyroid antibodies in vestibular disorders and the role of thyroid surgery in the treatment of severe vestibular dysfunction secondary to thyroid autoimmunity.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-06-25" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Giribet Fernández-Pacheco A, Tomás Pérez MA, Almela Rojo MT, García-Purriños García FJ. Relación entre el síndrome vestibular y la tiroiditis autoimmune. Endocrinol Diabetes Nutr. 2022;69:76–77.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Disease associations with autoimmune thyroid disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "RC Jenkins" 1 => "AP Weetman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/105072502320908312" "Revista" => array:6 [ "tituloSerie" => "Thyroid" "fecha" => "2002" "volumen" => "12" "paginaInicial" => "977" "paginaFinal" => "988" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12490075" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hashimoto thyroiditis and vestibular dysfunction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Chiarella" 1 => "D. Russo" 2 => "F. Monzani" 3 => "C Petrolo" 4 => "B Fattori" 5 => "G Pasqualetti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4158/EP161635.RA" "Revista" => array:6 [ "tituloSerie" => "Endocr Pract" "fecha" => "2017" "volumen" => "23" "paginaInicial" => "863" "paginaFinal" => "868" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28534686" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The relationship between benign paroxysmal positional vertigo and thyroid autoimmunity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K. Sari" 1 => "T. Yildirim" 2 => "H. Borekci" 3 => "I. Akin" 4 => "R. Aydin" 5 => "M. Ozkiris" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/00016489.2015.1021932" "Revista" => array:6 [ "tituloSerie" => "Acta Otolaryngol" "fecha" => "2015" "volumen" => "135" "paginaInicial" => "754" "paginaFinal" => "757" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25761528" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vestibular disorders in euthyroid patients with Hashimoto’s thyroiditis: role of thyroid autoimmunity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Chiarella" 1 => "S. Tognini" 2 => "A. Nacci" 3 => "R Sieli" 4 => "G Costante" 5 => "C Petrolo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/cen.12471" "Revista" => array:5 [ "tituloSerie" => "Clin Endocrinol (Oxf)" "fecha" => "2014" "volumen" => "81" "paginaInicial" => "600" "paginaFinal" => "605" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The epidemiology of dizziness and vertigo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "HK Neuhauser" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/B978-0-444-63437-5.00005-4" "Libro" => array:3 [ "fecha" => "2016" "paginaInicial" => "67" "paginaFinal" => "82" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/25300180/0000006900000001/v1_202202280604/S2530018022000014/v1_202202280604/en/main.assets" "Apartado" => array:4 [ "identificador" => "66730" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/25300180/0000006900000001/v1_202202280604/S2530018022000014/v1_202202280604/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018022000014?idApp=UINPBA00004N" ]
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