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Thyroid function and incidentalomas in kidney transplant recipients.
Urszula Łebkowska1, Jacek S Małyszko, Jolanta Małyszko
1Department of Radiology, Medical University in Białystok, Poland. wleb@amb.bialystok.pl
Summary
Thyroid nodules are common in kidney transplant recipients. Ultrasound and fine-needle aspiration biopsy detected malignancies in 5 of 44 patients, highlighting the need for regular screening in this high-risk group.
Area of Science:
- Endocrinology
- Nephrology
- Oncology
Background:
- Thyroid nodules are frequently detected by ultrasound, particularly small ones (incidentalomas).
- Fine-needle aspiration biopsy (FNAB), especially sonographically guided (S-FNAB), is crucial for diagnosing non-palpable thyroid masses.
- Increasing thyroid nodule prevalence necessitates risk assessment for FNAB/S-FNAB, especially in high-risk populations like transplant recipients on immunosuppression.
Purpose of the Study:
- To evaluate thyroid abnormalities in kidney allograft recipients.
- To assess the prevalence and characteristics of thyroid nodules in this patient cohort.
- To determine the diagnostic yield of ultrasound and FNAB for thyroid malignancies in transplant patients.
Main Methods:
- Prospective study involving 44 kidney allograft recipients undergoing thyroid ultrasound, color Doppler, and power Doppler.
- Assessment of TSH and urine iodide levels in all participants.
- Comparison with a control group of 35 healthy volunteers.
Main Results:
- All transplant recipients exhibited goiter (enlarged thyroid).
- Thyroid nodules were found in 19 patients (43%), with 31 nodules <1 cm and 20 nodules 1-2 cm.
- Fine-needle aspiration biopsy revealed malignancies in 5 cases (11.4%), primarily in nodules with detectable blood flow.
Conclusions:
- Kidney transplant recipients commonly develop goiter.
- Malignancies were detected in 5 out of 44 transplant patients.
- Regular ultrasound screening, alongside TSH and iodide level monitoring, is recommended for post-transplant patients.