Toxic Multinodular Goitre: a Surprising Finding Marlene Rodrigues,1 Helena Ferreira,2 Ana Antunes,1,3 Olinda Marques3,4
Images in… BMJ Case Reports: first published as 10.1136/bcr-2017-221913 on 12 September 2017. Downloaded from Toxic multinodular goitre: a surprising finding Marlene Rodrigues,1 Helena Ferreira,2 Ana Antunes,1,3 Olinda Marques3,4 1Department of Pediatrics, DESCRIPTION Hospital de Braga, Braga, A 16-year-old healthy adolescent boy was referred Portugal 2 to the paediatric endocrinology clinic because of Department of Pediatrics, multiple thyroid nodules detected by cervical Hospital da Senhora da Oliveira ultrasound, in the context of cervical lymphade- Guimaraes EPE, Guimaraes, Portugal nopathies. There was no family history of thyroid Figure 1 Cervical ultrasound revelling multiples 3Pediatric Endocrinology Unit, disease. He denied recent infections, asthenia, nodules in the right thyroid lobe. (A) Predominantly Hospital de Braga, Braga, weight loss, sweating, palpitations, mood or sleep cystic nodule, (B) characteristic mixed nodule and (C) Portugal disturbances, dysphagia or dysphonia. At physical predominantly solid nodule. 4Department of Endocrinology, examination, an enlarged, irregular and fibro- Hospital de Braga, Braga, elastic thyroid, with a predominant right lobe, Portugal was identified. The remaining examination was Thyroid nodules are a frequent incidental normal. finding with an incidence between 9.4% and Correspondence to The analytical profile was thyroid stimulating 27.0%.1 In contrast to adults, TMNG is an Dr Marlene Rodrigues, rodrigues. f. marlene@ gmail. com hormone (TSH) <0.01 uUI/mL (normal 0.5–4.8 uncommon thyroid disease in paediatric age. The uUI/mL), free triiodothyronine (FT3) 7.27 pg/mL presence of hyperthyroidism determines the need Accepted 3 September 2017 (normal 2.3–4.2 pg/mL) and free thyroxine (FT4) for a definitive therapy in multinodular goitre, and 2.02 ng/dL (normal 0.8–2.3 ng/dL).
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