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Endocrinology and metabolism
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Autoimmune disease. Features specific to Graves’ disease (that do not occur with other causes): Eye signs – exophthalmos, ophthalmoplegia, chemosis of the conjunctivaePretibial myxoedemaThyroid acropachy
General Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rebecca Fish, Aisling Hogan, Aoife Lowery, Frank McDermott, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Yew-Wei Tan, Thomas Tsang
The blood tests confirm Graves’ disease. How will you treat her?Because she has eye signs, radioiodine is not an option. I would discuss with her the pros and cons of medical treatment versus surgery, but surgery would be my treatment of choice.I would offer her a total thyroidectomy.A recent Cochrane Review (2015) concluded that total thyroidectomy is superior to subtotal thyroidectomy (both bilateral subtotal and the Dunhill procedure) at preventing recurrent hyperthyroidism in Graves’ disease, with no increased risk of recurrent laryngeal nerve injury.
Thyroid ophtalmopathy manifesting as superior oblique paralysis
Published in Jan-Tjeerd de Faber, 28th European Strabismological Association Meeting, 2020
V. Oğuz, M. Yolar, H. Pazarli, S. Özkan
Seven patients composed of 4 females and 3 males who had been followed in the Department of Ophthalmology of the Cerrahpasa Faculty of Medicine of the University of Istanbul were followed up. The ages of the cases ranged between 27 and 72 years, the mean age being 50,28±18.09 years. All of these 7 cases who had been presented with a paralysis of the superior oblique muscle showed a binocular vertical diplopia at primary position. The history of the disease reminded systemic signs or symptoms which may be attributed to Graves disease in all these cases, for a further examination the coexistance of the following conditions were investigated as the previous reports[11,12]:
A decade of hospitalizations for hyperthyroidism in the US
Published in Baylor University Medical Center Proceedings, 2022
Hafeez Shaka, Michael Salim, Luke DeHart, Zain El-amir, Farah Wani, Asim Kichloo
There was a decrease in the crude hospitalization rate as well as the estimated incidence rate for hospitalization in patients with hyperthyroidism. There are likely multiple factors for this apparent decrease in hospitalizations without a significant decrease in the overall frequency of hyperthyroidism. One of the primary factors is likely better outpatient management of hyperthyroidism, leading to a reduction in hospitalizations due to thyrotoxicosis and its complications.1 Before 2005, the most popular method for treatment of Graves’ disease in the US was radioactive iodine, whereas many other countries preferred antithyroid drugs for management.25,26 Patients treated with radioactive iodine or surgery are likely to become hypothyroid compared to patients who received pharmacotherapy. This may also account for declining hospitalizations in the US.
Occurrence of sporadic medullary thyroid carcinoma in Graves’ disease in association with a RET proto-oncogene mutation
Published in Acta Clinica Belgica, 2022
Julian E. Donckier, Caroline Fervaille, Claude Bertrand
Thyroid carcinoma, the most common endocrine cancer, may occur in Graves’ disease with a mean event rate of 7% according to a recent meta-analysis [1]. Some studies have suggested an increased risk of differentiated thyroid cancer in patients with Graves’ disease, especially in the presence of thyroid nodules [2–5]. Medullary thyroid cancer (MTC) is less common, with 15 cases having been reported since 1980 [6–10]. The RET proto-oncogene encoding the transmembrane receptor of the tyrosine kinase family has been shown to exhibit mutations in MTC either in inherited syndromes or in sporadic cases [11–13]. To our knowledge, in none of the previous cases, such a mutation has been studied or found to be in association with Graves’ disease. Moreover, how Graves’ disease could drive the occurrence of this cancer has never been addressed. We here describe a case of MTC occurring in Graves’ disease in association with a RET mutation and discuss its characteristics as well as the possible links between both diseases.
Long-term follow-up results of PTMC treated by ultrasound-guided radiofrequency ablation: a retrospective study
Published in International Journal of Hyperthermia, 2021
Yalin Zhu, Ying Che, Shuhang Gao, Shuangsong Ren, Mengying Tong, Lina Wang, Fang Yang
The follow-up period after RFA lasted for 60 months. All tumor ablation foci disappeared during the follow-up period with the mean tumor diameter at 0.50 (0.29) cm and the mean volume at 0.06 (0.09) mL shown in Figure 2. Characteristics of the study cohort, tumors, and RFA parameters are shown in Table 1. All ablated tumors completely disappeared at the end of the follow-up period. At 1, 3, 6, 9, 12, 24, 36, 48, and 60 months after RFA, the complete resorption rate was 0, 0, 9.8 (10/102), 33.3 (34/102), 91.2 (93/102), 96.1 (98/102), 99 (101/102), 100, and 100%, respectively shown in Figure 3 and Table 2. By their 30- and 18-month post-RFA follow-ups, two patients developed ipsilateral neck lymph node metastasis in regions IV and VI, respectively. After RFA, 2.9% (3/102) of patients developed hoarseness—the main side effect. Three patients (2.9%) developed hyperthyroidism 1 week after RFA, but their thyroid functions normalized after a month shown in Table 3. One patient was diagnosed with Graves’ disease. Two patients (1.9%) developed subclinical hypothyroidism, and their thyroid functions normalized after a month. The TSH value in the initial treatment period was 0.06 (0.02) μIU/mL, and the rate at which the TSH target was achieved was 85.7%. The TSH value in the follow-up period was 1.47 (0.91) μIU/mL, and the compliance rate was 99.3%.