Thyroiditis

BackgroundHashimoto's thyroiditis (HT) is the most common autoimmune thyroid disease (AITD) and is characterized by the presence of thyroid autoantibodies against thyroid peroxidase and/or thyroglobulin. Several studies have found that the global prevalence of HT has increased in recent decades, while others show the opposite.Methods and resultsThe objective of this scoping review was to synthesize and analyze the different studies that have evaluated the prevalence of HT (in adults) and the possible associated factors. The following databases were consulted, as follows: MEDLINE, Web of Science, PubMed, and Scopus. The search terms "epidemiology", "prevalence", and "Hashimoto disease" and "Hashimoto thyroiditis" were used. The search was limited to articles published between January 1965 and October 2024, and only articles in English were considered. In order to reduce selection bias, each article was scrutinized using the JBI Critical Appraisal Checklist independently by two authors. Studies were included if the number of participants (study population and/or cases and controls, depending on the study design) was clearly described and duplicate studies were excluded. A total of 59 studies were identified, the vast majority of them used a cross-sectional design, using different methods of disease assessment.ConclusionsGlobally, the prevalence of HT is estimated to be between 5-10%; some areas with prevalences > 20% and others < 0.5% were identified. Prevalence is also higher in women than in men. Multiple underlying factors (genetic, epigenetic, environmental, and lifestyle), together with socioeconomic, nutritional, overdiagnosis, inter alia, may explain (at least in part) the wide variability in the prevalence of HT.

IntroductionHashimoto's thyroiditis (HT), a common autoimmune thyroid disorder, is widely discussed on video-sharing platforms. However, user-generated content about HT lacks systematic scientific validation. This study evaluates the reliability and quality of HT-related videos on three major social media platforms: YouTube, Bilibili, and TikTok.MethodsBetween December 1, 10, 2024, the top 200 videos meeting the criteria retrieved under default search settings using a newly registered user account were included for each platform. These videos were from 107 YouTube accounts, 56 Bilibili accounts and 90 TikTok accounts. Metrics including video parameters and creator profiles were recorded. Content quality was evaluated using five validated assessment tools: PEMAT (Patient Education Materials Assessment Tool), VIQI (Video Information and Quality Index), GQS (Global Quality Score), mDISCERN (modified DISCERN), and JAMA (Journal of the American Medical Association) standards.ResultsTikTok videos showed the highest audience engagement. YouTube had more team-based accounts (43.9%), while TikTok and Bilibili predominantly featured individual accounts, with TikTok featuring a notably higher proportion of verified individual accounts (86.7%). Solo narration was the most common video style across YouTube (62.5%) and TikTok (70.0%), while in Bilibili, it was the medical scenario. In contrast, YouTube and Bilibili offered a broader range of content, including TV programs, documentaries, and educational courses. The varying emphases of different assessment tools rendered it difficult to determine which platform boasts the highest content quality, but the video quality scores across all platforms are not satisfying. Additionally, we found that content produced by verified creators was of higher quality compared to that of unverified creators, with this trend being particularly evident among individual accounts.ConclusionSocial media platforms provide partial support for the dissemination of health information about HT, but the overall video quality remains suboptimal. We recommend that professional creators pursue platform certification to enhance the dissemination of high-quality HT-related videos.

The expanding clinical utilization of immune checkpoint inhibitors (ICIs) in oncology has brought increasing attention to thyroid dysfunction as a prominent immune-related adverse event (irAE). Elucidating the pathophysiological mechanisms underlying ICI-induced thyroiditis represents a critical step toward developing evidence-based diagnostic protocols and targeted therapeutic interventions for cancer patients undergoing immunotherapy. This comprehensive review systematically examines current advances in understanding the etiopathogenesis of ICI-induced thyroiditis. First, we described pharmacological characterization of ICIs, then discussed multifactorial analysis of cellular and molecular contributors to thyroid autoimmunity following ICI administration and finally analyzed critical evaluation of emerging hypotheses regarding primary pathogenic drivers. Through this review, we aim to establish mechanistic connections between ICI pharmacodynamics and thyroid tissue immunopathology.

Background and objectivesSeronegative autoimmune encephalitis (AE), defined by an appropriate clinical phenotype in the absence of known neuronal autoantibodies, poses diagnostic and therapeutic challenges due to clinical heterogeneity and lack of definitive biomarkers. We conducted a systematic review and meta-analysis of individual patient data to characterize the phenotypes, treatment responses, and prognostic factors in seronegative AE.MethodsWe included 213 cases from 30 studies published between 2014 and 2024 and 11 from a local cohort meeting Graus criteria for seronegative AE. We extracted details on clinical and paraclinical features, immunotherapy, and outcomes measured via the modified Rankin Scale (mRS) and Clinical Assessment Scale for Autoimmune Encephalitis (CASE). Multivariate regression and dimensionality reduction analyses identified prognostic markers.ResultsOf 224 patients (median age 49 years, 50.9% male), 72 (32.1%) had limbic encephalitis (LE) and 152 (67.9%) had antibody-negative probable AE (ANPRA). Good outcome (mRS score ≤2) was more common in LE (49/72, 68.1%) than in ANPRA (76/154, 50.0%) (p DiscussionSeronegative AE comprises clinically and prognostically distinct subtypes. Early immunotherapy is the key modifiable factor influencing outcome. We advocate for biomarker discovery and prospective, systematically reported cohort studies to improve stratification and treatment strategies in this diagnostically challenging population.