Diagnostic role of thyroid elastography in pediatric patients with Hashimoto's thyroiditis and Graves’ disease: A prospective controlled study

ObjectiveHashimoto's thyroiditis and Graves’ disease are autoimmune diseases of the thyroid gland, and both diseases are diagnosed with ultrasound findings and autoantibody height. However, ultrasound (US) findings may be normal in both diseases rarely. In some pediatric studies, it was reported that shear wave velocity values in autoimmune thyroiditis were significantly higher than normal thyroid parenchyma and it was recommended to be used as a diagnostic method. Our study will address the evaluation of patients with Hashimoto's thyroiditis and Graves’ disease by thyroid elastography and the role of this method in diagnosis.Materials and methods28 patients with Hashimoto's thyroiditis, 20 patients with Graves’ disease and 40 healthy controls were enrolled in our study prospectively. Thyroid Elastography and US were applied to all patients.ResultsIn US, Hashimoto's thyroiditis had a hypoechoic echo pattern compared to graves’ disease (p < 0.05). When shear wave velocity (SWV) value of children with Hashimoto's thyroiditis and Graves’ disease were compared with the control group, thyroid tissue showed more stiffness in both disease groups (p = 0.001). When SWV values were compared between Hashimoto's thyroiditis and Graves’ disease, there was no statistically significant difference (p = 0.73).ConclucionSWV values were found to be higher in children with Hashimoto's thyroiditis and Graves’ disease compared to the control group and contributes to the diagnosis of these diseases. However, the elastography technique alone is not sufficient to differentiate. Hashimoto's thyroiditis and Graves’ disease.     

Altered expression of IL36γ and IL36 receptor (IL1RL2) in the colon of patients with Hirschsprung’s disease

Purpose

Hirschsprung’s disease associated enterocolitis (HAEC) is the most common cause of morbidity and mortality in Hirschsprung’s disease (HSCR). Altered intestinal epithelial barrier function and abnormal microbiota are implicated in the pathogenesis of HAEC. IL-36γ, a member of the IL-1 superfamily, is involved in host defense and contributes to proinflammatory responses and development of inflammatory diseases. The IL36 receptor (IL1RL2) is an important mediator molecule in the inflammatory response. Animal data suggests that IL1RL2 is involved in mucosal healing. We designed this study to investigate the hypothesis that the IL-36γ axis is altered in HSCR.

Methods

We investigated IL-36γ and IL1RL2 expression in ganglionic and aganglionic bowel of HSCR patients (n = 10) and controls (n = 10). qPCR, Western blotting and confocal immunofluorescence were performed.

Main results

qPCR and Western blot analysis revealed that IL-36γ is strongly expressed in the aganglionic and ganglionic colon of patients with HSCR. ILR1L2 expression was significantly decreased in HSCR specimens compared to controls (p < 0.05). Confocal microscopy revealed a markedly increased expression of IL36γ in the colonic epithelium of patients with HSCR compared to controls. IL1RL2 was localized in the colonic epithelium and showed a markedly decreased expression in all HSCR specimens.

Conclusion

To our knowledge, we report for the first time the expression of IL36γ and ILRL2 in the colon of patients with HSCR. The increased expression of IL36γ and the markedly decreased expression of IL1RL2 in the aganglionic and ganglionic bowel in HSCR may result in an increased inflammatory response and altered mucosal response healing leading to the susceptibility to develop HAEC.