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Erik K. Alexander, MD
Associate Physician, Brigham and Women's Hospital
Professor of Medicine, Harvard Medical School

Brigham and Women's Hospital
Department of Medicine
75 Francis Street
Boston, MA 02115

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Research Narrative:

Dr. Alexander currently participates in clinical research involving thyroid disease and pregnancy, and thyroid nodules & thyroid cancer. He has investigated the timing and onset of increased levothyroxine requirement during gestation.  These data demonstrate that thyroid hormone requirements increase early in gestation, and increase approximately 40% throughout pregnancy.  These findings have translated into broad clinical recommendation for patients.  Current clinical guidelines recommend that all women the known, treated hypothyroidism optimize thyroid function prenatally, and once pregnant, increase their levothyroxine by 2 additional tablets weekly of their current daily dosage of levothyroxine.  By doing so, the risk of maternal and fetal hypothyroidism (and their adverse complications) are substantially reduced. 

Separate, Dr. Alexander's research has focused on the clinical understanding and optimal diagnostic strategies for patients with thyroid nodular disease.  Dr. Alexander maintains the largest U.S. registry of consecutive thyroid nodules evaluated and aspirated via a multidisciplinary approach.   These data from over 6,000 consecutive patients with clinically relevant thyroid nodules have provided insight into how such nodules are optimally evaluated.  For example, data from this registry confirms that patients with multiple thyroid nodules >1cm require aspirations of multiple nodules as opposed to previous misconceptions that only the largest nodules should be evaluated.  

Most recently, Dr. Alexander has led a national, multi-center study validating the Afirma gene expression classifier for thyroid nodule evaluation.   These data confirm the ability of this test to significantly expand our pre-operative risk assessment for patients wtih cytologically indeterminate thyroid nodules, and by doing so also reduces the extent of unnecessary surgery.

Northwestern University Medical School , 1997, MD

Board of Directors, American Thyroid Association

Courses Taught:
2005-2012, Brigham & Women's Hospital, Principle Clinical Experience, Overall 3rd Year clinical experience for Harvard Medical Students

2002-2012, Brigham & Women's Hospital, Internal Medicine Clerkship - 3rd Year, Core 3rd Year clerkship in Internal Medicine

2002-2012, Brigham & Women's Hospital, 4th Year Subinternship in Internal Medicine

Publications (Pulled from Harvard Catalyst Profiles):

1. Wong KS, Lorch J, Alexander EK, Marqusee E, Cho NL, Nehs MA, Doherty GM, Barletta J. Prognostic Significance of Extent of Invasion in Poorly Differentiated Thyroid Carcinoma. Thyroid. 2019 Aug 09.

2. Angell TE, Maurer R, Wang Z, Kim MI, Alexander CA, Barletta JA, Benson CB, Cibas ES, Cho NL, Doherty GM, Doubilet PM, Frates MC, Gawande AA, Krane JF, Marqusee E, Moore FD, Nehs MA, Larsen PR, Alexander EK. A Cohort Analysis of Clinical and Ultrasound Variables Predicting Cancer Risk in 20,001 Consecutive Thyroid Nodules. J Clin Endocrinol Metab. 2019 Jul 16.

3. Cherella CE, Angell TE, Richman DM, Frates MC, Benson CB, Moore FD, Barletta JA, Hollowell M, Smith JR, Alexander EK, Cibas ES, Wassner AJ. Differences in Thyroid Nodule Cytology and Malignancy Risk between Children and Adults. Thyroid. 2019 Jul 12.

4. Angell TE, Alexander EK. Thyroid Nodules and Thyroid Cancer in the Pregnant Woman. Endocrinol Metab Clin North Am. 2019 Sep; 48(3):557-567.

5. Wong KS, Lorch JH, Alexander EK, Nehs MA, Nowak JA, Hornick JL, Barletta JA. Clinicopathologic Features of Mismatch Repair-Deficient Anaplastic Thyroid Carcinomas. Thyroid. 2019 May; 29(5):666-673.

6. Silva de Morais N, Stuart J, Guan H, Wang Z, Cibas ES, Frates MC, Benson CB, Cho NL, Nehs MA, Alexander CA, Marqusee E, Kim MI, Lorch JH, Barletta JA, Angell TE, Alexander EK. The Impact of Hashimoto Thyroiditis on Thyroid Nodule Cytology and Risk of Thyroid Cancer. J Endocr Soc. 2019 Apr 01; 3(4):791-800.

7. Lindeman BM, Nehs MA, Angell TE, Alexander EK, Gawande AA, Moore FD, Doherty GM, Cho NL. Effect of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP) on Malignancy Rates in Thyroid Nodules: How to Counsel Patients on Extent of Surgery. Ann Surg Oncol. 2019 Jan; 26(1):93-97.

8. Cherella CE, Feldman HA, Hollowell M, Richman DM, Cibas ES, Smith JR, Angell TE, Wang Z, Alexander EK, Wassner AJ. Natural History and Outcomes of Cytologically Benign Thyroid Nodules in Children. J Clin Endocrinol Metab. 2018 09 01; 103(9):3557-3565.

9. Chen AL, Renshaw AA, Faquin WC, Alexander EK, Heller HT, Cibas ES. Thyroid FNA biopsies comprised of abundant, mature squamous cells can be reported as benign: A cytologic study of 18 patients with clinical correlation. Cancer Cytopathol. 2018 05; 126(5):336-341.

10. Angell TE, Van Benschoten O, Cohen DA, Haas AV, Alexander EK, Marqusee E. POSITIVE THYROTROPIN RECEPTOR ANTIBODIES IN PATIENTS WITH TRANSIENT THYROTOXICOSIS. Endocr Pract. 2018 Jun; 24(6):512-516.