Information de reference pour ce titreAccession Number: | 00005792-201902220-00065.
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Author: | Liu, Xuehui MD a,*; Zhang, Jianping MD a; Meng, Zhaowei MD, PhD b,*; Yu, Hongxu MD a; Gao, Zhimin BD a; Li, Hongjun BD a; Liu, Na MD a
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Institution: | (a)Department of Nuclear Medicine, Third Central Hospital of Tianjin, Tianjin Institute of Hepatobiliary Disease, Tianjin Key Laboratory of Artificial Cell, Artificial Cell Engineering Technology Research Center of Public Health Ministry (b)Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
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Title: | A case report of 131I therapy for Graves' disease patient with hemiagenesis.[Article]
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Source: | Medicine. 98(8):e14606, February 2019.
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Abstract: | Rationale: Thyroid hemiagenesis is a rare congenital dysplasia, whereas a variety of pathological changes may occur in residual thyroid lobe. The most frequently described pathology in residual thyroid lobe is Graves' hyperthyroidism. Although 131I therapy has been generally recommended as the preferred treatment for Graves' disease (GD), subjects relating to hemiagenesis are very limited, especially in China.
Patient concerns: A 43-year-old female patient presented to our hospital on November 2014, with a 1-year history of palpitation, fatigue, and hand tremor. Her situation was getting worse within 2 months.
Diagnosis: The thyroid function tests were suggestive of thyrotoxicosis. The technetium thyroid scintigraphy only showed an enlarged right lobe with increased tracer uptake. Then, the agenesis of left lobe and isthmus was confirmed by ultrasound and magnetic resonance imaging (MRI). Thus, a diagnosis of GD with hemiageneis of the left lobe and isthmus of thyroid was made.
Interventions: Thiamazole was discontinued because of drug-induced hepatic injury. According to our procedures, the patient was treated by 131I.
Outcomes: Hypothyroidism was observed 3 months after 131I therapy. After replacement therapy with L-thyroxine (LT4), the state of euthyroid maintained.
Lessons: Once hypothyroidism occurs, regular application of LT4 and review of thyroid function is very important. Thus, patients' compliance needs to be strengthened. Besides, we could not convince the family members of our patient to undergo ultrasonographic examination. The genetic factor of the agenesis could not be proved in this case.
Copyright (C) 2019 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
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Author Keywords: | Graves' disease; radioactive iodine 131; thyroid hemiagenesis.
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References: | [1]. Melnick JC, Stemkowski PE. Thyroid hemiagenesis (hockey stick sign): a review of the world literature and a report of four cases. J Clin Endocrinol Metab 1981;52:247-51.
[2]. Karabay N, Comlekci A, Canda MS, et al. Thyroid hemiagenesis with multinodular goiter: a case report and review of the literature. Endocrine J 2003;50:409-13.
[3]. Bando Y, Nagai Y, Ushiogi Y, et al. Development of Graves' hyperthyroidism from primary hypothyroidism in a case of thyroid hemiagenesis. Thyroid 1999;9:183-7.
[4]. Ozaki O, Ito K, Mimura T, et al. Hemiaplasia of the thyroid associated with Graves' disease: report of three cases and a review of the literature. Surg Today 1994;24:164-9.
[5]. Wang R, Tan J, Zhang G, et al. Analysis of 2125 patients with hyperthyroidism after 131 I therapy: a retrospective study. Clin J Endocrinol Metab 2015;31:421-6.
[6]. Mikosch P, Gallowitsch HJ, Kresnik E, et al. Thyroid hemiagenesis in an endemic goiter area diagnosed by ultrasonography: report of sixteen patients. Thyroid 1999;9:1075-84.
[7]. Shabana W, Delange F, Freson M, et al. Prevalence of thyroid hemiagenesis: ultrasound screening in normal children. Eur J Pediatr 2000;159:456-8.
[8]. Maiorana R, Carta A, Floriddia G, et al. Thyroid hemiagenesis: prevalence in normal children and effect on thyroid function. J Clin Endocrinol Metab 2003;88:1534-6.
[9]. Greening WP, Sarker SK, Osborne MP. Hemiagenesis of the thyroid gland. Br J Surg 1980;67:446-8.
[10]. McLean R, Howard N, Murray IP. Thyroid dysgenesis in monozygotic twins: variants identified by scintigraphy. Eur J Nucl Med 1985;10:346-8.
[11]. Rajmil HO, Rodriguez-Espinosa J, Soldevila J, et al. Thyroid hemiagenesis in two sisters. J Endocrinol Invest 1984;7:393-4.
[12]. Greig WR, Henderson AS, Boyle JA, et al. Thyroid dysgenesis in two pairs of monozygotic twins and in a mother and child. J Clin Endocrinol Metab 1966;26:1309-16.
[13]. Rosenberg T, Gilboa Y. Familial thyroid ectopy and hemiagenesis. Arch Dis Child 1980;55:639-41.
[14]. Clifton-Bligh RJ, Wentworth JM, Heinz P, et al. Mutation of the gene encoding human TTF-2 associated with thyroid agenesis, cleft palate and choanal atresia. Nat Genet 1998;19:399-401.
[15]. Macchia PE, Lapi P, Krude H, et al. PAX8 mutations associated with congenital hypothyroidism caused by thyroid dysgenesis. Nat Genet 1998;19:83-6.
[16]. Gursoy A, Anil C, Unal AD, et al. Clinical and epidemiological characteristics of thyroid hemiagenesis: ultrasound screening in patients with thyroid disease and normal population. Endocrine 2008;33:338-41.
[17]. Bahn RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Endocrine Pract 2011;17:456-520.
[18]. Ruchala M, Szczepanek E, Skiba A, et al. Graves' hyperthyroidism following primary hypothyroidism due to Hashimoto's thyroiditis in a case of thyroid hemiagenesis: case report. Neuro Endocrinol Lett 2008;29:55-8.
[19]. Harisankar C, Preethi G. Recurrent thyrotoxicosis due to hyperfunction of multiple ectopic thyroid tissue and residual thyroid lobes 15 years after thyroidectomy: Evaluation using technetium scanning and hybrid single-photon emission computed tomography/CT. Thyroid Res Pract 2013;10:78-9.
[20]. Chiovato L, Fiore E, Vitti P, et al. Outcome of thyroid function in Graves' patients treated with radioiodine: role of thyroid-stimulating and thyrotropin-blocking antibodies and of radioiodine-induced thyroid damage. J Clin Endocrinol Metab 1998;83:40-6.
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Language: | English.
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Document Type: | Research Article: Clinical Case Report.
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Journal Subset: | Nursing. Clinical Medicine. Health Professions. Pharmacology.
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ISSN: | 0025-7974
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NLM Journal Code: | mny, 2985248r
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DOI Number: | https://dx.doi.org/10.1097/MD.00...- ouverture dans une nouvelle fenêtre
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