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Carmen Sydlik Division of Pediatric Endocrinology, Center for Pediatric and Adolescent Medicine Inn-Salzach-Rott, Altoetting, Germany

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Ilja Dubinski Division of Pediatric Endocrinology, Dr. von Hauner Children's Hospital, University Hospital Munich, LMU Munich, Munich, Germany

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Susanne Bechtold Division of Pediatric Endocrinology, Dr. von Hauner Children's Hospital, University Hospital Munich, LMU Munich, Munich, Germany

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Heinrich Schmidt Division of Pediatric Endocrinology, Dr. von Hauner Children's Hospital, University Hospital Munich, LMU Munich, Munich, Germany

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, as triiodothyronine/free triiodothyronine (T3/fT3) levels may be low ( 1 , 2 ). In healthy individuals, fT3 levels can be stable over a wide range of corresponding TSH levels ( 3 ). The regulation of thyroid hormones is reflected in an adjusting fT3

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Qiankai Jin Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Guoqing Huang Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Xiaoqing Tian Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Yimeng Shu Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Ximisinuer Tusongtuoheti Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Yushan Mao Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China

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, and its evaluation in different regions and ethnicities is of importance. This study is part of the 2019 Zhejiang Zhenhai study, and the aim was to discuss the relationship between TSH, free triiodothyronine (FT3), FT4, and FT3/FT4 levels within the

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Ling Sun Department of Cardiology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
Section of Pacing and Electrophysiology, Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China

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Wenwu Zhu Department of Cardiology, Xuzhou Central Hospital, Xuzhou Clinical School of Nanjing Medical University, Xuzhou, Jiangsu, China

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Yuan Ji Department of Cardiology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China

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Ailin Zou Department of Cardiology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China

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Lipeng Mao Department of Cardiology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
Dalian Medical University, Dalian, Liaoning, China

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Boyu Chi Department of Cardiology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
Dalian Medical University, Dalian, Liaoning, China

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Jianguang Jiang Department of Cardiology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China

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Xuejun Zhou Department of Cardiology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China

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Qingjie Wang Department of Cardiology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China

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Fengxiang Zhang Section of Pacing and Electrophysiology, Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China

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.13(0.62, 2,12) 0.313 AKI, acute kidney injury; BNP, brain natriuretic peptide; DBP, diastolic blood pressure; FT3, free triiodothyronine; FT4, free thyroxine; LVEF, left ventricular ejection fraction; NSTEMI, non-ST segment elevation myocardial

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Till Ittermann Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

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Rehman Mehmood Khattak Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
Department of Zoology, Islamia College Peshawar (CU), Peshawar, Pakistan

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Marcello R P Markus Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany

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Jens-Peter Kühn Institute of Radiology, University Hospital, Carl-Gustav-Carus University, Dresden, Germany

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Marie-Luise Kromrey Department of Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany

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Giovanni Targher Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy

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Antje Steveling Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany

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Matthias Nauck Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany

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Henry Völzke Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

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-stimulating hormone (mIU/L) 1.19 (0.87, 1.60) 0.35 (0.25, 0.44) 3.88 (3.59, 5.27) Free triiodothyronine (fT3) (pmol/L) 4.63 (4.29, 5.05) 4.76 (4.35, 5.12) 4.45 (4.10, 4.80) Free thyroxine (fT4) (pmol/L) 13.3 (12.3, 14.4) 14.3 (13.0, 15

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Ayse Nurcan Cebeci Paediatric Endocrinology, Department of Friedrich-Alexander University Hospital, Erlangen, Germany

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Vera Schempp Paediatric Endocrinology, University Hospital, Bonn, Germany

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Katharina Förtsch Paediatric Endocrinology, University Hospital, Düsseldorf, Germany

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Bettina Gohlke Paediatric Endocrinology, University Hospital, Bonn, Germany

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Michaela Marx Paediatric Endocrinology, Department of Friedrich-Alexander University Hospital, Erlangen, Germany

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Helmuth-Guenther Dörr Paediatric Endocrinology, Department of Friedrich-Alexander University Hospital, Erlangen, Germany

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Joachim Woelfle Paediatric Endocrinology, Department of Friedrich-Alexander University Hospital, Erlangen, Germany

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While subclinical or overt hypothyroidism are common in Down syndrome (DS); Graves’ disease (GD) is rare (ranges 0.6–3%). We aimed to evaluate the clinical features, course, and treatment of GD in children with DS and compare them with those without DS. Among 161 children with GD, 13 (8 female, 5 male) had DS (8%). Data were collected retrospectively from patients’ medical records. The mean age at diagnosis was 10.6 ± 4.5 years, with a female-to-male ratio 1.6:1. The main symptoms were weight loss (n = 6), increased irritability (n = 3), and increased sweating (n = 3). None had orbitopathy. Seven of 11 patients with a thyroid ultrasound at diagnosis had a goitre. On admission, all had thyroid-stimulating hormone (TSH) <0.01 mU/L (normal range (NR): 0.51–4.30), free triiodothyronine, free thyroxine (mean ± s.d .), and thyrotrophin receptor antibodies (median, range) were 22.2 ± 10.2 pmol/L (NR: 3.5–8.1), 50.2 ± 18.7 pmol/L (NR 12.6–20.9), and 17.0 (2.89–159.0) U/L (NR <1), respectively. Patients were treated either with methimazole (n = 10) or carbimazole (n = 3), a dose of 0.54 ± 0.36 mg/kg/day. The treatment was ‘block and replace’ in ten patients and ‘dose titration’ in three patients, with a mean duration of 43.4 ± 11.0 months. Of 13 patients, four are still receiving primary treatment, three are in remission, one patient had two medically treated recurrences, three underwent surgery without complications, and two patients were lost to follow-up. Our data show that the clinical course of GD in patients with DS was similar to those without DS and suggest that a prolonged medical therapy should be the preferred option.

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Xiaowen Zhang Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School, Branch of National Clinical Research Centre for Metabolic Diseases, Endocrine and Metabolic Disease Medical Center, Drum Tower Hospital affiliated to Nanjing University Medical School, Nanjing, China

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Chen Han Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School, Branch of National Clinical Research Centre for Metabolic Diseases, Endocrine and Metabolic Disease Medical Center, Drum Tower Hospital affiliated to Nanjing University Medical School, Nanjing, China
Department of Endocrinology and Metabolism, Drum Tower Clinical Medical College, Southeast University, Nanjing, China

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Hongwei Wang State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Nanjing University School of Medicine, Nanjing, China

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Xinghong Sun Department of Ophthalmology, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, China

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Xin Dou Department of Radiology, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, China

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Xueying He Department of Radiology, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, China

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Di Wu Department of Radiology, Southeast University Medical School Affiliated Zhongda Hospital, Nanjing, China

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Shanmei Shen Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School, Branch of National Clinical Research Centre for Metabolic Diseases, Endocrine and Metabolic Disease Medical Center, Drum Tower Hospital affiliated to Nanjing University Medical School, Nanjing, China

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Dalong Zhu Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School, Branch of National Clinical Research Centre for Metabolic Diseases, Endocrine and Metabolic Disease Medical Center, Drum Tower Hospital affiliated to Nanjing University Medical School, Nanjing, China

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Xinlin Zhang Department of Cardiology, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, China

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Yan Bi Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School, Branch of National Clinical Research Centre for Metabolic Diseases, Endocrine and Metabolic Disease Medical Center, Drum Tower Hospital affiliated to Nanjing University Medical School, Nanjing, China

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smoking, duration of GD, and duration of TED were collected. Blood cell counts were obtained and NLR was calculated by dividing the absolute neutrophil count by the lymphocyte count. Serum TSH, free triiodothyronine, free thyroxine, and thyroid

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Katica Bajuk Studen Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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Simona Gaberšček Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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Edvard Pirnat Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia

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Nataša Bedernjak Bajuk Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia

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Andreja Vendramin Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia

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Vito Majcen Department of Nuclear Medicine, SB Celje, Celje, Slovenia

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Katja Zaletel Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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ultrasound, and at least one of the following – thyroid swelling; pain and tenderness of the thyroid gland/lobe; decreased serum level of thyrotropin (TSH); elevated serum level of free thyroxine (free T 4 ) and/or free triiodothyronine (free T 3

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Ru-Xuan Zhao Department of Endocrinology, Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Ting-Ting Shi Department of Endocrinology, Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Sha Luo Department of Nuclear Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Yun-Fu Liu Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Zhong Xin Department of Endocrinology, Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Jin-Kui Yang Department of Endocrinology, Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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drug use, and history of smoking were recorded. Clinical data including serum free triiodothyronine 3 (FT3), free triiodothyronine 4 (FT4), thyroid-stimulating hormone (TSH), and thyrotropin receptor antibody (TRAb) levels were measured to assess

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Xiaoya Zheng Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Heng Xiao Department of Hepatobiliary Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Jian Long Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Qiang Wei Prevention of Disease Department, Chongqing Jiulongpo District Hospital of Traditional Chinese Medicine, Chongqing, China

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Liping Liu Department of Ultrasound, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Liping Zan Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Wei Ren Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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free triiodothyronine (FT3), free thyroxine (FT4), ultrasensitive thyroid-stimulating hormone (uTSH), and thyroid antithyroglobulin autoantibody (TgAb) were detected with an immunochemical-automated analyzer (Beckman Coulter UniCelDxI 800; Beckman

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Yuegui Wang Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China

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Liwei Hong Department of Nuclear Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China

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Caiyun Yang Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China

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Guorong Lv School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China
Quanzhou Medical College, Quanzhou, Fujian, China

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Kangjian Wang Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China

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Xuepeng Huang Department of Nuclear Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China

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Haolin Shen Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China

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triiodothyronine, and thyrotropin receptor antibody Levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyrotropin receptor antibody (TRAb) in patients' venous blood were measured using an electroluminescent immunoassay (Beckman, DXI800) after

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