RESUMEN

PURPOSE: Previous studies have demonstrated handwriting changes in patients with overt hyperthyroidism due to Graves' disease. The aim of the present study was to investigate handwriting features in patients affected by overt autoimmune hypothyroidism. METHODS: Thirty subjects - 24 females and 6 males, mean and median age of 50.15 ± 16.8 years and 52.5 years, respectively - with overt hypothyroidism (OH) related to Hashimoto's thyroiditis (Group 1), and 30 age- and sex-matched euthyroid individuals (Group 2) were recruited to write a "standard text". Group 1 patients repeated the text once the euthyroid state was reached on L-T4 substitution therapy. Group 2 subjects wrote the text again 1 to 4 weeks thereafter. The letters underwent a detailed analysis by a handwriting expert, through inspection, a stereoscopic microscope and a magnifying glass. Furthermore, the time that both Groups took to go through with the text was clocked. RESULTS: None of the handwriting variables differed significantly within each Group and between the two Groups. Hypothyroid patients took significantly more time to go through with the text compared to the time taken once they became euthyroid (3.29 ± 1.66 vs 2.63 ± 1.55 minutes, respectively) and the time taken by the control group (p < 0.01). Of note, three Group 1 patients missed to copy some words or even whole sentences on the paper while they were overtly hypothyroid. CONCLUSIONS: The present study demonstrates that handwriting speed is able to disclose the impact of thyroid hormone deficiency on the central nervous system's functions. In particular, the longer time taken to go through with the text and the sentences missed by some hypothyroid patients, are the counterpart of psychomotor slowdown, impaired attention and memory loss peculiar to OH.

Asunto(s)

Hipertiroidismo , Hipotiroidismo , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Escritura Manual , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos

RESUMEN

BACKGROUND: Thyroid gland derives from one median anlage at the base of the tongue, and from the two fourth branchial pouches. A number of anomalies may occur during their migration. These can be in form of ectopic tissues, which are frequently found along the course of thyroglossal duct and rarely in other sites, many of these may develop same diseases as the thyroid gland. CASE PRESENTATION: A 36-years-old female presented with a 3 month history of left side neck mass. The mass disappeared following aspiration of brown colored fluid, which on cytological examination showed cells with nuclear irregularities that warranted the resection of the lesion. The histology demonstrated a thyroid papillary carcinoma arising within the branchial cyst. Thereafter, the patient underwent a total thyroidectomy with central lymph nodes dissection. Histology showed a multifocal papillary carcinoma with central lymph nodes metastases. Only four cases of primary thyroid carcinomas in neck branchial cyst have been described so far. CONCLUSION: In a lateral cystic neck mass, although rare, occurrence of ectopic thyroid tissue and presence of a papillary thyroid carcinoma should be kept in mind.