ABSTRACT
Abstract Fetal thyroid complications in pregnancy are uncommon, and are commonly related to the passage of substances through the placenta. The excessive iodine intake during the pregnancy is a well-known mechanism of fetal thyroid enlargement or goiter, and invasive procedures have been proposed for the treatment of fetal thyroid pathologies. In the present report, we demonstrate two cases from different centers of prenatal diagnosis of fetal thyroid enlargement and/or goiter in three fetuses (one pair of twins, wherein both fetuses were affected, and one singleton pregnancy). The anamnesis revealed the ingestion of iodine by the patients, prescribed from inadequate vitamin supplementation. In both cases, the cessation of iodine supplement intake resulted in a marked reduction of the volume of the fetal thyroid glands, demonstrating that conservative treatmentmay be an option in those cases. Also, clinicians must be aware that patients may be exposed to harmful dosages or substances during pregnancy.
Resumo As complicações fetais da tireoide na gravidez são incomuns e são comumente relacionadas à passagem de substâncias pela placenta. A ingestão excessiva de iodo durante a gravidez é um mecanismo bem conhecido de aumento da tireoide ou bócio fetal, e procedimentos invasivos foram propostos para o tratamento de patologias da tireoide fetal. No presente relato de caso, demonstramos dois casos de diferentes centros de diagnóstico pré-natal de aumento da tireoide fetal e/ou bócio em três fetos (um par de gêmeos, em que ambos os fetos foram afetados, e uma gravidez única). A anamnese revelou a ingestão de iodo pelos pacientes prescrita por suplementação inadequada de vitaminas. Nos dois casos, a interrupção da ingestão de suplemento de iodo resultou em uma redução acentuada do volume das glândulas tireoides fetais, demonstrando que o tratamento conservador pode ser uma opção nestes casos. Além disso, os médicos devem estar cientes de que as pacientes podem ser expostas a doses ou substâncias nocivas durante a gravidez.
Subject(s)
Humans , Female , Pregnancy , Adult , Prenatal Care/methods , Dietary Supplements/adverse effects , Goiter/etiology , Iodine/adverse effects , Self Care/adverse effects , Magnetic Resonance Imaging , Ultrasonography, Prenatal , Imaging, Three-Dimensional , Diseases in Twins/etiology , Diseases in Twins/diagnostic imaging , Fetal Diseases/etiology , Fetal Diseases/diagnostic imaging , Goiter/diagnostic imaging , Iodine/administration & dosageABSTRACT
We present a very unusual case of a baby born with antenatally diagnosed large neck swelling causing compression of trachea on imaging, who was euthyroid. There was no history of any thyroid disease in the mother and no history of exposure to known goitrogens. The goiter gradually reduced in size and baby’s thyroid function as well as neurodevelopment remained completely normal during follow-up.
Subject(s)
Adult , Female , Goiter/congenital , Goiter/pathology , Goiter/diagnostic imaging , Humans , Hypothyroidism , India , Infant, Newborn , Pregnancy , Pregnancy Complications , Thyroiditis, Autoimmune , Ultrasonography, PrenatalABSTRACT
Thyroid disorders are commonly encountered in general surgical practice. The purpose of this study was to determine how closely thyroid scintigraphy was ordered according to its indications in patients with thyroid diseases and the magnitude of its impact on the management. This cross-sectional study was carried out mainly at Isra University Hospital, Hyderabad over a period of 3 years from May 2005 to April 2008. All patients presenting with thyroid swelling and undergoing any type of thyroid operation were included in the study. Special emphasis was made on the indication of thyroid scintigraphy in these patients and its impact on the treatment. Out of 140 patients, 98 had thyroid scintigraphy done. Among these only 26 patients [26.5%] had it according the indication. In remaining 72 patients, thyroid scintigraphy did not reveal any added information to help in treatment plan. Thyroid scintigraphy is an overused investigation in thyroid patients. Routine use of thyroid scintigraphy in all goiter patients should be discouraged
Subject(s)
Humans , Goiter/diagnostic imaging , Thyroid Nodule , Goiter/surgery , Cross-Sectional Studies , Radionuclide ImagingABSTRACT
To study goiter and thyroid dysfunction in female adolescents residing in Lahore referred to Centre for Nuclear Medicine [CENUM], Mayo Hospital for thyroid scanning and thyroid function tests. Design: Retrospective study of thyroid size, thyroid scan patterns and serum FT, and TSH levels. Setting: Centre for Nuclear Medicine [CENUM], Mayo Hospital, Lahore Patients: 350 female adolescent referred during September 2002 to April 2003. Main outcome measures: adolescent goiter, thyroid nodules, hyperthyroidism, hypothyroidism, Graves' disease, toxic multinodular goiter. Among 350 adolescents 212[60.6%] had goiter of various grades mostly visible. Among goiterous patients 136[64.2%] had diffuse and 76 [35.8%] had nodular presentation. The number of patients with solitary nodular goiter [20.7%] was more than multinodular goiter [15.1%] and number of patients with solitary cold nodule [16.5%] was more than functioning nodule [4.2%]. The incidence of biochemical thyroid dysfunction, both overt and subclinical, was detected in 42[19.8%] patients and was significantly more frequent in patients with nodular than diffuse presentation [29% VS 14.7%; p<0.001] and in multinodular than solitary nodular goiter [p<0.005]. More than 80% of the patients with solitary nodular goiter were euthyroid. Simple goiter was detected in 116[54.7%], Graves' disease in 5[2.4%] and toxic multinodular goitre in 4[1.9%] patients. Overall incidence of hypothyroidism was more than double as compared to hyperthyroidism. Incidence of nodularity and hypothyroidism was more in large goiter but duration of goiter was not significant in promoting nodularity. Goiterous adolescents need urgent attention because they don't have just diffuse hypertro- phy with normal thyroid function. Many are afflicted with dysfunction and nodularity, particularly solitary cold nodule bearing risk of thyroid malignancy
Subject(s)
Humans , Female , Goiter/diagnostic imaging , Adolescent , Iodine , Thyroid Nodule , Thyroid Diseases , Nuclear Medicine Department, Hospital , Retrospective StudiesABSTRACT
"Les auteurs poursuivent une serie d'articles sur l'interet de l'echographie thyroidienne; entamee dans ""Panorama Medical"" no6 de juin 1994. Une description de l'echo-anatomie de la thyroide ainsi qu'une etude semiologique echographique du nodule thyroidien ont fait l'objet d'un premier expose. Dans cet article; les auteurs proposent une approche semiologique du goitre"
Subject(s)
Goiter/diagnostic imagingABSTRACT
Dans cette etude retrospective portant sur 16 cas de goitres plongeants; les auteurs trouvent; pour cette variete; une frequence de 5 pour cent de l'ensemble des goitres; une predominance du sexe femininet un age moyen des malades de 40 ans. Le diagnostic; evoque sur l'aspect de la masse cervicale; est confirmee par les examens radiologiques. Les accidents compressifs; complications evolutives habituelles; n'ont pas ete souvent rencontres. Le traitement chirurgical; realises dans tous les cas par le biais d'une cervicotomie transversale; a consiste en exereses partielles ou totales de goitres; qui se sont revees benins ou malins a l'histologie. Les suites simples de ces interventions confortent les auteurs dans le choix de la cervicotomie comme voie d'abord de predilection des goitres plongeants