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multinodular goitre

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https://www.readbyqxmd.com/read/28302234/tuberculous-dactylitis-with-concomitant-thyroid-involvement-a-rare-presentation-of-childhood-tuberculosis
#1
Sobia Qamar, Farrah Naz, Samia Naz, Iftikhar Ejaz
Extrapulmonary tuberculosis rarely presents as thyroid involvement along with other manifestations, and poses a diagnostic challenge on account of paucibacillary nature of disease. In general, the diagnosis of tuberculosis is based on epidemiological risk factors, clinical features, imaging studies, in addition to a positive skin testing or Interferon Gamma Release Assay (IGRA). A 14-year boy presented with history of fever and weight loss for one year. On examination, he had painful swelling of fingers and toes along with a painless thyroid nodule and squint...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28291538/-pyoderma-gangrenosum-associated-with-anti-proteinase-3%C3%A2-antineutrophil-cytoplasmic-antibodies-pr3-anca-induced-by-propylthiouracil
#2
A Coster, J-L Dargent, N de Visscher, P Levecque, P-P Roquet-Gravy
BACKGROUND: Synthetic antithyroid drugs are often used in the treatment of hyperthyroidism, regardless of aetiology. They may cause various side effects, including the development of anti-neutrophil cytoplasmic antibodies (ANCA), ANCA-associated vasculitis, and neutrophilic dermatoses. Propylthiouracil (PTU) is the antithyroid drug most frequently implicated in ANCA-associated diseases specifically involving anti-myeloperoxidase ANCA (MPO-ANCA). To our knowledge, there are no clinical reports describing the association of pyoderma gangrenosum (PG) and anti-proteinase3-ANCA (PR3-ANCA) induced by PTU, with ANCA levels decreasing after antithyroid drug withdrawal...
March 10, 2017: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/28274949/management-of-endocrine-disease-subclinical-thyrotoxicosis-prevalence-causes-and-choice-of-therapy
#3
Allan Carle, Stine Linding Andersen, Kristien Boelaert, Peter Laurberg
Subclinical thyrotoxicosis is a condition affecting up to 10% of the population in some studies. We have reviewed literature and identified studies describing prevalences, causes and outcomes of this condition. Treatment should be considered in all subjects if this biochemical abnormality is persistent, especially in case of symptoms of thyrotoxicosis or in the presence of any complication. In particular, treatment should be offered in those subclinically thyrotoxic patients with a sustained serum TSH below 0...
March 8, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28272855/a-fifteen-year-experience-of-total-thyroidectomy-for-the-management-of-simple-multinodular-goitres-in-a-low-medium-income-country
#4
A O Afolabi, O O Ayandipo, O O Afuwape, O A Ogundoyin
INTRODUCTION: Total thyroidectomy as a treatment for simple multinodular goitre is not well recognised in most centres in low middle income countries. METHOD: This paper is a retrospective review of outcomes of total thyroidectomy for simple multinodular goitres in the last fifteen years in a tertiary hospital in Nigeria. RESULTS: A total of 652 thyroidectomies were done from January 2001 to December 2015. Simple multinodular goitres were indication for a total thyroidectomy in 447 patients (68...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28255974/thyroid-lesions-in-patients-with-acromegaly-case-control-study-and-update-to-the-meta-analysis
#5
Kosma Woliński, Adam Stangierski, Edyta Gurgul, Barbara Bromińska, Agata Czarnywojtek, Martha Lodyga, Marek Ruchała
INTRODUCTION: Acromegaly results from oversecretion of growth hormone and subsequently insulin growth factor-1. According to some authors, the disease can cause increased prevalence of nodular goitre and thyroid cancer (TC). However, the number of studies comparing acromegalic patients with control groups is low. We aimed to assess the prevalence of thyroid lesions in patients with acromegaly in comparison to an age- and sex-matched control group and to update the meta-analysis previously performed in our department by the same authors...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28049119/bilateral-brachiocephalic-vein-compression-an-unusual-and-rare-presentation-of-multinodular-goitre
#6
Caitlin Jane McNeill, Joseph Dalby Sinnott, David Howlett
An interesting and rare case where a longstanding multinodular goitre causes sudden onset symptoms of superior vena cava obstruction. The symptoms were caused by bilateral brachiocephalic vein compression against the first rib. The patient's symptoms included upper limb and facial swelling, whereas her lower limbs were not oedematous (figure 1). The patient underwent CT imaging which showed a multinodular retrosternal thyroid filling the space created by the first rib, sometimes known as the thoracic outlet...
October 8, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/28031847/infiltrative-thyrotoxicosis-an-unusual-case-of-diffuse-large-b-cell-lymphoma
#7
Michael T McCarthy, Michael Keyes, James O'Hare, Neville Shine, Rajnish K Gupta
Thyrotoxicosis is most commonly caused by Graves' disease, toxic multinodular goitre, a functioning thyroid adenoma, or thyroiditis. Extrinsic infiltrative conditions affecting the thyroid gland are typically destructive, and associated with thyroid hypofunction. We describe the case of a 61-year-old woman who presented to our hospital with symptoms of thyrotoxicosis, neck swelling and thyroid function tests consistent with hyperthyroidism. An ultrasound revealed a multinodular goitre with retrosternal extension, but CT imaging suggested thyroid gland infiltration, with cervical lymphadenopathy...
November 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27872536/phrenic-nerve-palsy-as-initial-presentation-of-large-retrosternal-goitre
#8
Arsheed Hussain Hakeem, Imtiyaz Hussain Hakeem, Fozia Jeelani Wani
Unilateral phrenic nerve palsy as initial presentation of the retrosternal goitre is extremely rare event. This is a case report of a 57-year-old woman with history of cough and breathlessness of 3 months duration, unaware of the thyroid mass. She had large cervico-mediastinal goiter and chest radiograph revealed raised left sided hemidiaphragm. Chest CT scan did not reveal any lung parenchymal or mediastinal pathology. The patient underwent a total thyroidectomy through a cervical approach. The final pathology was in favor of multinodular goitre...
December 2016: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27855230/a-case-of-thyroid-fibromatosis-a-rare-lesion-of-this-gland
#9
Joana Simões-Pereira, Rafael Adame Cabrera, Valeriano Leite
Thyroid fibromatosis is a very rare lesion; to our knowledge, there are only four cases reported in the medical literature. Herein, we report the clinical case of a woman with thyroid fibromatosis with a long follow-up (11 years). A 63-year-old female patient, with an increasing multinodular goitre without compressive symptoms, was admitted to total thyroidectomy. The histology revealed a spindle-cell proliferation with fibroblastic characteristics with no atypia and thin capillary vessels. Immunohistochemistry was positive for beta-catenin, focally to desmin and alfa-actin and negative for cytokeratins and CD34...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27847655/surgical-management-of-life-threatening-thyroid-haematoma-following-occult-blunt-neck-trauma
#10
Ronak Ved, Neil Patel, Michael Stechman
A 42-year-old man arrived at the emergency department in severe respiratory distress, requiring immediate intubation and ventilation. An emergency computed tomography (CT) neck scan identified a substantial haematoma within a multinodular goitre, necessitating an emergency total thyroidectomy. It was later discovered that the patient had been the victim of an assault involving blunt trauma to the anterior neck. Five days postoperatively the patient was extubated and was well enough to self-discharge the following day...
2016: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/27530498/prospective-evaluation-of-intra-operative-quick-parathyroid-hormone-assay-as-an-early-predictor-of-post-thyroidectomy-hypocalcaemia
#11
Ashwini C Reddy, Gyan Chand, M Sabaretnam, Anjali Mishra, Gaurav Agarwal, Amit Agarwal, A K Verma, S K Mishra
BACKGROUND: Hypocalcaemia following total thyroidectomy is a major contributing factor in delayed hospital discharge and dissuading surgeons from day care thyroidectomy. We prospectively evaluated the utility of Intra-operative serum quick parathyroid hormone level measurement twenty minutes after total thyroidectomy in predicting post-operative hypocalcemia. MATERIAL AND METHODS: Prospective longitudinal study which included patients undergoing total thyroidectomy for benign or malignant thyroid disorders at SGPGIMS, Lucknow, India from November 2013 to February 2015...
October 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27422154/recombinant-human-thyrotropin-stimulation-prior-to-131-i-therapy-in-toxic-multinodular-goitre-with-low-radioactive-iodine-uptake
#12
M J Azorín Belda, A Martínez Caballero, G C Figueroa Ardila, M Martínez Ramírez, C A Gómez Jaramillo, J I Dolado Ardit, J Verdú Rico
AIM: Stimulation with recombinant human thyrotropin (rhTSH) increases thyroid radioiodine uptake, and is an aid to (131)I therapy in non-toxic multinodular goitre (MNG). However, there are not many studies using rhTSH prior to (131)I in toxic multinodular goitre to improve hyperthyroidism and compressive symptoms. MATERIAL AND METHOD: A prospective study was conducted on patients with MNG and hyperthyroidism. Patients were recruited consecutively and divided into group I, stimulated with 0...
January 2017: Revista Española de Medicina Nuclear e Imagen Molecular
https://www.readbyqxmd.com/read/27303120/management-of-large-size-mngs-and-stns-using-3d-endoscopic-technique-a-review-of-10-cases
#13
Shailesh Puntambekar, Vikrant Sharma, Sanjay Kumar, Sainath Mitkare, Geetanjali Joshi, Atul Dokrimare, Mangesh Panse
The role of endoscopic thyroidectomy has shown clear cosmetic benefits in the past. In this current study of 10 patients, we have tried to highlight the importance and benefits of 3D endoscopy in the management of large size multinodular goitres (MNGs) and solitary thyroid nodules (STNs). From March 2014 to July 2014, patients having a large volume of thyroid (>70 cc for one lobe) and nodule size (>6 cm) were enrolled for this study. A total of 10 patients underwent the procedure using the Karl Storz(TM) 3D endoscope system...
April 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27265913/ipilimumab-induced-autoimmune-hypophysitis-diagnostic-and-management-challenges-illustrated-by-a-clinical-case
#14
Pedro Marques, Ashley Grossman
Autoimmune hypophysitis has been described in patients on ipilimumab, a humanised monoclonal antibody increasingly used in the treatment of metastatic melanoma. A 67-year-old woman presented with severe fatigue, nausea and headaches following the third dose of ipilimumab, which was being given as treatment for metastatic melanoma (four administrations at three-weekly intervals). Hormonal evaluation confirmed hypocortisolism, with low gonadotrophins and a low thyroid-stimulating hormone with normal free T4 (she was on long-standing levothyroxine because of past surgery for a multinodular goitre)...
November 2015: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27263038/ultrasonographic-risk-factors-of-malignancy-in-thyroid-nodules
#15
A Rios, B Torregrosa, J M Rodríguez, D Rodríguez, A Cepero, M D Abellán, N M Torregrosa, A M Hernández, P Parrilla
INTRODUCTION: Between 40 and 50 % of the population will have at least one thyroid nodule, although only 5-8 % will have a malignant one. OBJECTIVE: The objective of this study was to establish the ultrasonographic characteristics which allow us to distinguish benignity from malignancy in thyroid nodules. METHODS: In the study population, inclusion criteria are (1) a single thyroid nodule and (2) multinodular goiter and exclusion criteria are (1) previous thyroid surgery and (2) fine needle aspiration (FNA) in the past month...
September 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27162701/concomitant-off-pump-coronary-artery-bypass-grafting-and-total-thyroidectomy-for-a-large-retrosternal-goitre-a-case-report-and-review-of-the-literature
#16
Savvas Lampridis, Man Chi Lau, Peter Mhandu, Haralabos Parissis
A 76-year-old male presented with angina and a large retrosternal goitre causing marked dyspnoea. Coronary angiography revealed triple vessel disease and moderately impaired left ventricular function. CT imaging demonstrated a substantial multinodular goitre extending into the posterior mediastinum to the level of the carina, with associated compression of the trachea and oesophagus. Preoperative thyroid function tests showed euthyroid state. The patient subsequently underwent off-pump coronary artery bypass grafting (OPCABG) ×2 with concomitant total thyroidectomy...
May 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27091372/prospective-evaluation-of-the-utility-of-routine-neuromonitoring-for-an-established-thyroid-surgical-practice
#17
Jane Lee, Sheila Fraser, Anthony Glover, Stan Sidhu
BACKGROUND: The use of routine intraoperative neuromonitoring (IONM) is controversial in thyroid surgery. Guidelines have been published to standardize IONM. This study examines the impact of routine IONM on a high-volume thyroid surgeon. METHODS: A prospective study was conducted using IONM between May 2013 and December 2014. Demographics, type of operation, pathology, recurrent laryngeal nerve (RLN) and external branch of the superior laryngeal nerve (EBSLN) visualization and sub-type classification, cricothyroid or cricopharyngeal twitch/electrode depolarization were obtained, and complications were recorded...
April 18, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27090545/a-rare-case-of-thyroid-storm
#18
Brock McMillen, Manvinder Shelley Dhillon, Sabrina Yong-Yow
Thyroid storm is a rare and life-threatening state of thyroid hormone excess. Rapid recognition of thyroid storm is key to decreasing the morbidity and mortality of this condition. Clinical manifestations of thyroid storm include unexplained weight loss, hyperactivity and irritability. The most common causes of thyrotoxicosis are Graves' disease, toxic multinodular goitre and toxic adenoma. We present a rare case of thyroid storm induced by dual nivolumab and ipilimumab immunotherapy in a patient receiving treatment for advanced melanoma...
April 18, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27090542/lymphoedema-of-the-upper-limb-a-rare-complication-of-thyroid-surgery
#19
Christopher Stephen, David Alexander Munnoch
A 40-year-old woman underwent an elective thyroidectomy for a non-toxic, multinodular goitre. In the early postoperative period, the patient developed a significant unilateral swelling of the right upper limb, which was subsequently confirmed to be lymphoedema. This was eventually treated successfully using liposuction and compression garment therapies. We report the case due to its rarity and present a possible explanation for such an unexpected complication based on known anatomical variations of lymphatic drainage of the upper limb...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27042514/effect-of-dissection-of-the-recurrent-laryngeal-nerves-on-parathyroid-insufficiency-during-total-thyroidectomy-for-multinodular-goitre
#20
Vengayil Sukumaran, Bhavuray Teli, Sreekant Avula, Jagadeesh Pavuluru
INTRODUCTION: Total thyroidectomy is the accepted standard treatment for benign goitrous enlargements. The surgical skill and technique is one of the most important factor which affect the outcome in thyroid surgery. Hypocalcaemia due to parathyroid insufficiency remains a significant postoperative morbidity after total thyroidectomy. The primary cause is unintentional damage to, or devascularization of, one or more parathyroid glands during surgery. AIM: To study the risk of hypocalcaemia due to recurrent laryngeal nerves (RLNs) dissection during total thyroidectomy for benign multinodular goitre (MNG)...
February 2016: Journal of Clinical and Diagnostic Research: JCDR
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