ABSTRACT
A gentleman in his 90s presented with a slowly enlarging goitre over 18 months, causing manifestations of superior vena cava obstruction, dysphagia and hoarseness of voice. Investigations were suggestive of a fibrosing thyroid pathology. Surgical management was avoided due to high surgical risk. Treatment included prednisolone and tamoxifen with palliative management in the event of further medical deterioration. This article illustrates the difficulties in diagnosing and managing fibrosing thyroid diseases.
Subject(s)
Fibrosis , Hashimoto Disease , Thyroiditis , Humans , Male , Hashimoto Disease/complications , Hashimoto Disease/diagnosis , Hashimoto Disease/drug therapy , Thyroiditis/complications , Thyroiditis/drug therapy , Thyroiditis/diagnosis , Aged, 80 and over , Prednisolone/therapeutic use , Tamoxifen/therapeutic use , Diagnosis, Differential , Goiter/complications , Goiter/diagnosis , Thyroid Gland/pathologyABSTRACT
Movement disorders have been associated with hyperglycaemia including chorea, hemiballismus and choreoathetosis. In almost all documented cases, there is an association between clinical and radiological findings. We report a case of an 82-year-old man with hemichorea in the setting of hyperglycaemia and poorly controlled type 2 diabetes. He had subtle striatal changes on his radiology, and with intravenous fluids and insulin, his involuntary movements resolved on day 4, which correlated with improvement in glycaemic control. He was followed up through our local insulin stabilization programme after discharge.
