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A case report of (131)I therapy for Graves’ disease patient with hemiagenesis

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 (131)I therapy has been generally recommended as the pre...

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Autores principales: Liu, Xuehui, Zhang, Jianping, Meng, Zhaowei, Yu, Hongxu, Gao, Zhimin, Li, Hongjun, Liu, Na
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408000/
https://www.ncbi.nlm.nih.gov/pubmed/30813185
http://dx.doi.org/10.1097/MD.0000000000014606
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author Liu, Xuehui
Zhang, Jianping
Meng, Zhaowei
Yu, Hongxu
Gao, Zhimin
Li, Hongjun
Liu, Na
author_facet Liu, Xuehui
Zhang, Jianping
Meng, Zhaowei
Yu, Hongxu
Gao, Zhimin
Li, Hongjun
Liu, Na
author_sort Liu, Xuehui
collection PubMed
description 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 (131)I 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 (131)I. OUTCOMES: Hypothyroidism was observed 3 months after (131)I 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.
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spelling pubmed-64080002019-03-16 A case report of (131)I therapy for Graves’ disease patient with hemiagenesis Liu, Xuehui Zhang, Jianping Meng, Zhaowei Yu, Hongxu Gao, Zhimin Li, Hongjun Liu, Na Medicine (Baltimore) Research Article 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 (131)I 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 (131)I. OUTCOMES: Hypothyroidism was observed 3 months after (131)I 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. Wolters Kluwer Health 2019-02-22 /pmc/articles/PMC6408000/ /pubmed/30813185 http://dx.doi.org/10.1097/MD.0000000000014606 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Research Article
Liu, Xuehui
Zhang, Jianping
Meng, Zhaowei
Yu, Hongxu
Gao, Zhimin
Li, Hongjun
Liu, Na
A case report of (131)I therapy for Graves’ disease patient with hemiagenesis
title A case report of (131)I therapy for Graves’ disease patient with hemiagenesis
title_full A case report of (131)I therapy for Graves’ disease patient with hemiagenesis
title_fullStr A case report of (131)I therapy for Graves’ disease patient with hemiagenesis
title_full_unstemmed A case report of (131)I therapy for Graves’ disease patient with hemiagenesis
title_short A case report of (131)I therapy for Graves’ disease patient with hemiagenesis
title_sort case report of (131)i therapy for graves’ disease patient with hemiagenesis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408000/
https://www.ncbi.nlm.nih.gov/pubmed/30813185
http://dx.doi.org/10.1097/MD.0000000000014606
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