单侧甲状腺叶片 参与格雷夫斯病
Yazan Alzedaneen1, Meaghan Chelsea Moxley2, Rashmi Reddy3
1Internal Medicine Department, University of Maryland Medical Center, Baltimore, MD 21201, USA.
JCEM case reports
|November 1, 2023
概括
格雷夫斯病很少影响单一的甲状腺叶,这带来了独特的诊断和治疗挑战. 这一案例突显了格雷夫斯病中单边甲状腺扩大和甲状腺功能过高的管理.
科学领域:
- 内分泌学 在内分泌学.
- 核医学就是核医学.
- 甲状腺学 甲状腺学
背景情况:
- 格雷夫斯病是一种自身免疫性疾病,通常会影响甲状腺两叶.
- 格雷夫斯病的单边呈现非常罕见,造成诊断困难.
- 管理格雷夫斯病需要仔细考虑治疗选择,特别是关于潜在的轨道病变恶化.
研究的目的:
- 报告一个罕见的格雷夫斯病病例,表现为单边甲状腺干扰.
- 讨论单方面格雷夫斯病的诊断方法和管理.
- 突出类似罕见病例对治疗策略的影响.
主要方法:
- 一个30岁的男性病例报告,有3年的格雷夫斯病史.
- 临床评估包括生物化学分析 (TSH,自由T4,T3,TSI,Trab).
- 诊断成像:甲状腺超声波和核医学吸收扫描.
- 手术干预:右侧甲状腺切除. 右侧甲状腺切除.
主要成果:
- 患者呈现出单侧亡,右侧甲状腺壮大和消化不良.
- 生物化学测试显示,TSH受抑制,T4/T3正常,TSI升高,最初TRAb正常.
- 超声波显示左侧结节和右叶扩大;吸收扫描显示右叶活动增加.
- 经过甲状腺切除术后,患者在甲基马中实现了甲状腺功能减退,持续升高的TSI和新的TRAb升高.
结论:
- 格雷夫斯病可能不常见地表现为单边甲状腺叶参与.
- 手术管理,如甲状腺切除术,可以在单边格雷夫斯病的选择性病例中有效.
- 需要进一步的研究,以了解这种罕见的格雷夫斯病变体的自然史和最佳管理.
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