About

Charles Choe is a Clinical Professor in the Department of Medicine at UC San Diego. His research focuses on areas related to blood glucose regulation, hyperglycemia, and postprandial blood glucose management. He has contributed to the understanding of circulating ApoJ and its association with insulin resistance in humans, as well as the impact of systems approaches to inpatient glycemic management and the evaluation and management of osteoporosis in hip-fracture patients. His work also includes studies on microvascular flow and foot sensation with external compression, regulation of adiponectin by antidiabetic therapies, and the role of self-monitoring of blood glucose during treatment of type 2 diabetes. Choe has authored numerous publications derived from MEDLINE/PubMed and other sources, indicating a significant contribution to the fields of medicine, endocrinology, metabolism, and physiology.

Research topics

• Medicine
• Internal medicine
• Endocrinology
• Gastroenterology
• Pathology
• Radiology

Selected publications

• Assessing the accuracy of thyroid nodule risk-stratification tools in Hispanic and non-Hispanic patients

  Journal of the Endocrine Society · 2026-04-01

  articleOpen access

  Abstract Context Ultrasound risk categories (thyroid imaging, reporting, and data systems, TI-RADS), fine-needle aspiration cytology (Bethesda), and molecular classifiers guide thyroid nodule management. However, these tools may perform differently across populations due to differences in thyroid cancer characteristics among Hispanic patients. Objective In this study, we compared the predictive performance of these tools in Hispanic vs non-Hispanic patients using surgical pathology as the gold standard. Methods We performed a retrospective study of adult patients (≥18 years) evaluated for thyroid nodules from January 2023 to June 2024 at a tertiary academic medical center. Nodules were stratified using TI-RADS, Bethesda, and molecular testing. Malignancy was confirmed by final surgical pathology, and positive predictive value was assessed within diagnostic strata among resected nodules. Results A total of 308 patients (421 nodules) were included in the analytic cohort, with 29.2% being Hispanic. Mean age was 54.3 ± 15.4 years in Hispanic patients and 58.8 ± 16.1 years in non-Hispanic patients (P = .02). TI-RADS and Bethesda distributions were similar by ethnicity. Among TI-RADS4 nodules undergoing surgery, malignancy risk was higher in Hispanic patients (32.7% vs 12.0%; odds ratio [OR] 3.57, 95% CI 1.63-7.78; P = .001). Among Bethesda III/IV nodules with suspicious molecular results, malignancy was higher in Hispanic patients (78.6% vs 34.8%; adjusted OR 8.72, 95% CI 1.35-96.0; P = .022). Overall, Hispanic patients had higher odds of malignancy (OR 2.14, 95% CI 1.26-3.64; P = .0047). Conclusion Despite similar use of diagnostic tools, Hispanic patients had higher malignancy rates overall and within select diagnostic strata. These findings suggest variation in risk estimate performance across populations and support multicenter validation in diverse cohorts.

  PublisherDOI

• IP18-23 BISPHOSPHONATES FOR THE MANAGEMENT OF NEPHROLITHIASIS IN HIGH-RISK STONE FORMING PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

  The Journal of Urology · 2026-04-27

  article
  PublisherDOI

• Tracheal nodularity and paratracheal soft tissue nodule: post-radioactive iodine treatment changes with peculiar visual and pathologic findings in a case of metastatic follicular variant papillary thyroid carcinoma: a case report

  Journal of Medical Case Reports · 2025-03-03 · 1 citations

  articleOpen access

  BACKGROUND: Follicular variant papillary thyroid carcinoma is a distinct subtype of papillary thyroid carcinoma that can occasionally present with aggressive features, including distant metastases and extrathyroidal extension. While radioactive iodine ablation is a well-established treatment for residual disease, its post-treatment effects on tracheal and paratracheal structures remain poorly characterized. CASE PRESENTATION: A 22-year-old male individual of Taiwanese descent presented with an enlarged neck mass and was diagnosed with follicular variant papillary thyroid carcinoma. He underwent thyroidectomy, modified radical neck dissection, and postoperative radioactive iodine-131 ablation (100 mCi). A total of 1 year later, a chest computed tomography revealed a paratracheal soft tissue nodule and tracheal nodularity. Bronchoscopy with endobronchial ultrasound-guided sampling identified multiple 2-3 mm submucosal tracheal nodules containing white exudate. Cytopathologic analysis of both the paratracheal soft tissue nodule and the tracheal wall nodules revealed mucinous material without evidence of malignancy or inflammation. Microbiologic studies were negative for infection. CONCLUSION: These atypical bronchoscopic and pathologic findings likely represent post-radioactive iodine treatment changes. The patient remained without evidence of disease for 22 months, ongoing on thyroid suppression levels of thyroxine hormone replacement. The case represents successful radioactive iodine treatment of papillary thyroid carcinoma residual disease after surgical resection, with the first described pathologic findings to correlate with these post-treatment changes.

  PublisherOA PDFDOI

• PD33-12 BISPHOSPHONATE TREATMENT IS ASSOCIATED WITH LOWER INCIDENCE OF UROLOGY ENCOUNTERS, KIDNEY STONE DIAGNOSES AND PROCEDURES

  The Journal of Urology · 2025-04-08

  article
  PublisherDOI

• SAT339 Osteopenia In The Setting of Mild Autonomous Cortisol Secretion

  Journal of the Endocrine Society · 2023

  Senior authorCorresponding
  • Medicine
  • Internal medicine
  • Endocrinology

  Abstract Disclosure: J.J. Mao: None. K.C. McCowen: None. C. Choe: None. Jimmy J. Mao, MD (1); Karen C. McCowen (1); Charles H. Choe (1)(1) Division of Endocrinology, Diabetes, and Metabolism, University of California San Diego, La Jolla, CA. Background: Over 80% of adrenal incidentalomas are benign adrenal cortical adenomas, of which 30-50% are found to have mild autonomous cortisol secretion (MACS). Bone fragility is a known complication of MACS. Clinical Case: A 57-year-old postmenopausal female with no prior history of fracture, venous thromboembolism, and atherosclerotic cardiovascular disease, was referred for incidental bilateral adrenal nodules. Body mass index was normal at 21 kg/m2, and no clinical stigmata of Cushing syndrome were noted on physical exam. Unenhanced computed tomography scan revealed a 4.6 cm right adrenal nodule and a 3.3 cm left adrenal nodule; both nodules measured less than -18 Hounsfield Units. Biochemical work-up for pheochromocytoma, primary aldosteronism, and non-classical congenital adrenal hyperplasia was negative. Evaluation for hypercortisolism revealed a morning cortisol of 20.3 mcg/dL (ref. 4-22 mcg/dL) with concurrent adrenocorticotropic hormone of <5 pg/mL (ref. 6-50 pg/mL), 24-hour urine free cortisol of 16.9 mcg (ref. 4-50 mcg), and midnight salivary cortisol of 0.07 mcg/dL (ref. <0.09 mcg/dL). A 1 mg dexamethasone suppression test measured on two separate occasions was elevated at 6.3 mcg/dL and 7.9 mcg/dL (ref. <1.8 mcg/dL). A subsequent 8 mg dexamethasone suppression test was also elevated at 6.1 mcg/dL (ref. <1.8 mcg/dL). The diagnosis of MACS was made. A bone mineral density (BMD) scan revealed T-scores at the right femoral neck, left femoral neck, and lumbar spine at -1.6, -1.3, and -0.8, respectively. Ten-year probability of major osteoporotic fracture and hip fracture were 8.3% and 1.0%, respectively. To reduce the risk for future fractures, the decision was made to proceed with adrenal vein sampling (AVS) in preparation for potential adrenalectomy. Conclusion: MACS is the most frequent hormonal abnormality in adrenal incidentalomas, with an estimated prevalence of 0.8-2 cases per 1000 persons. A previous prospective study found that surgical cure of unilateral MACS may lead to a substantial risk reduction (up to 15-fold) of future incident asymptomatic vertebral fractures. Additionally, the highest risk for clinical fracture in those with adrenal adenomas (either nonfunctional or with cortisol hypersecretion) appears to occur at 7-10 years after initial diagnosis. BMD does not perfectly correlate with fracture risk, so unilateral adrenalectomy (if lateralization is observed on AVS) and/or pharmacotherapy should be strongly considered in patients with an expected longevity of >10 years even with mild osteopenia and low fracture risk assessment tool scores. Presentation: Saturday, June 17, 2023

  PublisherOA PDFDOI

• PSAT324 Altered Mental Status, Hypercalcemia, and Atrial Fibrillation Induced by Post-Parathyroidectomy Thyroiditis

  Journal of the Endocrine Society · 2022 · 3 citations

  • Medicine
  • Internal medicine
  • Endocrinology

  Abstract Background Parathyroidectomy-induced thyroiditis is a rare but possibly underreported phenomenon. It has been reported in primary, secondary, and tertiary hyperparathyroidism, and typically presents with transient thyrotoxicosis in the days to weeks following surgery. Clinical Case A 66-year-old man with end stage renal disease complicated by tertiary hyperparathyroidism and no prior history of thyroid disease or cardiac dysrhythmia was admitted for parathyroidectomy. A multinodular goiter and four enlarged parathyroid glands were identified intraoperatively. With significant thyroid retraction, removal of the inferior parathyroid glands, left superior parathyroid gland, and one-half of the right superior parathyroid gland was successfully performed without complication. Despite normalization of the parathyroid hormone level after surgery, the patient's preoperative hypercalcemia was noted to paradoxically worsen, rising from a corrected total calcium of 10.9 mg/dL (ref. 8.5-10.4 mg/dL) to 12.2 mg/dL. This was observed concurrently with the development of worsening mental status and new onset atrial fibrillation with rapid ventricular rate, prompting beta blockade initiation. Administration of intravenous crystalloid and subcutaneous calcitonin rapidly normalized his serum calcium but did not resolve the altered mentation or cardiac arrhythmia. Thyroid function tests revealed thyroid stimulating hormone 0.05 mIU/L (ref. 0.49-4.67 mIU/L), free thyroxine (T4) 3.8 ng/dL (ref. 0.7-1.9 ng/dL), and total triiodothyronine 144 ng/dL (ref. 60-181 ng/dL). Thyroid stimulating immunoglobulin was negative, and a thyroid ultrasound demonstrated multiple bilateral thyroid nodules with no evidence of increased vascularity of the gland. Serial thyroid function tests over several days revealed spontaneous biochemical improvement in the patient's T4-thyrotoxicosis that correlated with improved mentation. An exhaustive metabolic, infectious, and radiologic work-up yielded no alternative explanation for his initial change in mental status. By postoperative day 6, his cardiac dysrhythmia and altered mentation completely resolved, and the free T4 improved to 2.1 ng/dL, allowing for hospital discharge. His free T4 normalized a week later. Conclusion Our patient's postoperative course appears to have been driven by surgically induced thyroiditis. There are no current recommendations for routine postoperative screening for parathyroidectomy-induced thyroiditis, but biochemical testing should be considered if signs or symptoms of thyrotoxicosis such as unexplained altered mentation, cardiac dysrhythmias, and/or worsening hypercalcemia emerge. Doing so may allow for a rapid and cost-effective approach towards a unifying diagnosis. Bilateral cervical exploration is a known risk factor. Other possible risk factors include the presence of a multinodular goiter and significant intraoperative thyroid retraction, though further characterization of these is needed. Treatment is supportive, as cases typically self-resolve. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

  PublisherDOI

• Abstract #1183817: Case Series of Two TERT Mutation-Positive Benign Follicular Thyroid Adenomas

  Endocrine Practice · 2022-05-01

  article1st authorCorresponding
  PublisherDOI

• Leukocytosis and PTHrP-Mediated Hypercalcemia: Ominous Signs in an Indolent Thyroid Nodule

  Journal of the Endocrine Society · 2021

  • Medicine
  • Radiology
  • Pathology

  Abstract Introduction/Background: Anaplastic thyroid cancer is a rare thyroid malignancy with a bad prognosis. There are few systemic markers, as thyroglobulin is not usually synthesized in these poorly differentiated malignancies. Clinical Case - Diagnostic Evaluation, Treatment, and Follow Up: A 70-year old man presented in 2016 with a right thyroid nodule, slowly growing since 2012. The nodule was 10cm on neck CT and ultrasound showed a hyperechoic mass with central hypoechoic area, and coarse calcifications. Fine needle biopsy showed a follicular neoplasm. By 2019, neck CT showed enlargement of the nodule to 13 cm. Repeat thyroid biopsy was benign. Lobectomy was recommended due to size but not performed. In 2020, he developed neck discomfort and painful thigh swelling. WBC was significantly elevated at 27,000 (4000-10000) /mm3. Ultrasound showed no evidence of necrosis or abscess in the nodule. WBC rose progressively to 96,000/mm3 (ANC 94,200). CT chest showed further enlargement of the thyroid mass, a soft tissue shoulder mass and lung nodules suspicious for metastases. Laryngoscopy revealed a distorted larynx from external compression, and possible vocal-fold involvement (motion impairment) without airway compromise. Biopsy of the shoulder mass, lung nodule, and thigh masses all showed metastatic anaplastic thyroid cancer. Full infectious disease evaluation and molecular testing for BCR-ABL and JAK2 mutations were negative. Thus, leukocytosis was determined to be reactive in the setting of malignancy. Serum calcium of 14.7 mg/dL (8.5 - 10.6mg/dL) prompted hospital admission. Bone metastases were not visible on imaging. Hypercalcemia was treated effectively (to 8.3mg/dL) with IV fluids, calcitonin and IV bisphosphonates. Workup revealed suppression of PTH to 4 pg/mL (15-65 pg/mL) and low 25 Vitamin D of 21 ng/mL (30-80ng/L). Subsequently PTHrP was elevated at 53.4 pmol/L (<2.3pmol/L) and 1,25 Vitamin D inappropriately normal at 48.9 pg/mL (20- 79.3pg/mL), suggested humoral hypercalcemia of malignancy. The patient declined further treatment beyond hospice care. Clinical Lesson/Conclusion: Significant, sudden leukocytosis and hypercalcemia prompted further evaluation of his long-standing apparently benign thyroid nodule leading to a diagnosis of anaplastic thyroid cancer. Presumably this mass had been a follicular thyroid cancer, misdiagnosed on cytology, that subsequently de-differentiated. There are uncommon reports of leukocytosis complicating anaplastic thyroid cancer, where elevated GCSF and IL-6 were noted. We suspect this same etiology here. Hypercalcemia is extremely rare other than one report of PTHrP-secreting anaplastic thyroid cancer. Thus, high, rising calcium and PTHrP levels may reflect level of disease activity in anaplastic thyroid cancer.

  PublisherOA PDFDOI

• “My Rapidly Growing Neck”

  Clinical Thyroidology · 2020-06-01

  articleSenior author
  PublisherDOI

• Abstract #463 Adipsic Diabetes Insipidus: Improved Management Using a Handheld Sodium Analyzer for Fingerstick Capillary Blood

  Endocrine Practice · 2019-04-01 · 1 citations

  article
  PublisherDOI

Frequent coauthors

• Brad Kimura

  University of California, San Diego

  10 shared

• Young‐Bum Kim

  Harvard University

  6 shared

• Ji A Seo

  Korea University

  6 shared

• Won Min Hwang

  6 shared

• Dong Mee Lim

  Konyang University Hospital

  6 shared

• Theodore P. Ciaraldi

  University of California, San Diego

  5 shared

• Robert R. Henry

  Medical University of South Carolina

  5 shared

• Christos S. Mantzoros

  Beth Israel Deaconess Medical Center

  4 shared

Labs

• Charles ChoePI