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Related Concept Videos

Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

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Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...
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Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
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Graves' Disease I: Introduction01:28

Graves' Disease I: Introduction

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Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence...
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Goiter01:27

Goiter

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Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...
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The Thyroid Gland01:23

The Thyroid Gland

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
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Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

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Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Rheumatoid nodules in the thyroid bed following total thyroidectomy: a case report.

Amit Bhargava1, Poornima Upendra Hegde, Sameera Tallapureddy

  • 1Division of Endocrinology and Metabolism, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA. abhargava99@yahoo.com.

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Summary

Rheumatoid nodules, typically found elsewhere, were identified in the thyroid bed of a patient with rheumatoid arthritis. This case highlights the importance of considering rheumatoid nodules in the differential diagnosis of thyroid enlargement.

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Area of Science:

  • Rheumatology
  • Endocrinology
  • Pathology

Background:

  • Rheumatoid nodules are common in rheumatoid arthritis, usually affecting the skin or extensor surfaces.
  • The thyroid bed is an unusual location for rheumatoid nodules, with no prior documented cases.
  • This case involves a patient with active rheumatoid arthritis and Hashimoto's thyroiditis.

Purpose of the Study:

  • To report a rare case of rheumatoid nodules in the thyroid bed.
  • To discuss the potential pathogenesis and diagnostic considerations for rheumatoid nodules in this location.

Main Methods:

  • Case presentation of a 46-year-old woman with compressive neck symptoms.
  • Diagnostic workup included ultrasound and histopathological examination after thyroidectomy.
  • Postoperative follow-up and repeat surgery for recurrent nodules.

Main Results:

  • Initial thyroidectomy revealed neoplasms and Hashimoto's thyroiditis.
  • Recurrent nodules in the neck were diagnosed as rheumatoid nodules on repeat surgery.
  • No evidence of malignancy was found in the recurrent nodules.

Conclusions:

  • Rheumatoid nodules should be included in the differential diagnosis of thyroid enlargement in patients with rheumatoid arthritis.
  • Fine-needle aspiration biopsy can be a cost-effective initial diagnostic step.
  • Prompt identification can prevent unnecessary interventions and guide appropriate treatment.