Presentation
This report presents the first case in which the clinical features of DICER1 syndrome appear in combination with well-differentiated fetal adenocarcinoma of the lung. [ncbi.nlm.nih.gov]
Our patient presented with back pain which is the typical, though non-specific symptom, of ISCM. [unboundmedicine.com]
Presentation Lymphocytic thyroiditis may present with hyperthyroidism (early phase) or hypothyroidism (late phase), or it may present with a nodular or diffuse goitre. [surgwiki.com]
Nodules are clonal or polyclonal and are due to heterogeneous responses of follicular epithelium to TSH Exophthalmos of Graves disease is not present Also called nodular hyperplasia Nontoxic goiter: no hyperthyroidism present Epidemiology 90% of those [pathologyoutlines.com]
Entire Body System
- Euthyroid
Therefore, we investigated a proposita with a relapsing euthyroid goiter and her family, in which several members underwent thyroidectomy for euthyroid goiter. [edoc.mdc-berlin.de]
A patient with a euthyroid goiter; an opportunity to do no harm John P. [mdedge.com]
R. 2009 5 [Triiodothyroacetic acid in euthyroid goiter. [malacards.org]
- Asymptomatic
Thyrothymic thyroid remnants usually remain asymptomatic unless other pathology, e.g. nodular change, develops - in which case they may present as an intrathoracic goitre. [surgwiki.com]
Ann 2006;14:416), esophagus or blood vessels and may grow behind sternum or clavicle (plunging goiter) 3 - 5% risk of thyroid cancer, predominantly follicular variant of papillary thyroid carcinoma (S Afr J Surg 2014;52:5) Essential features Majority asymptomatic [pathologyoutlines.com]
In patients who are asymptomatic diagnostic work up can be started in the outpatient setting after the patient has been discharged. [clinicaladvisor.com]
As expected, US features surpassed clinical risk factors with high ORs, suggesting that asymptomatic thyroid nodules should be managed based primarily on US features. [kjronline.org]
[…] of malignancy They are much more common in women than men and become more prevalent with age Palpable nodules occur in 4–7% of all adults in the United States Thyroid nodules are more common in iodine-deficient regions Small thyroid nodules usually asymptomatic [accessmedicine.mhmedical.com]
- Cold Intolerance
Some of the symptoms of hypothyroidism include low energy, depression, cold intolerance and constipation. Thyroid nodules Thyroid nodules are lumps that grow on the gland. [betterhealth.vic.gov.au]
intolerance, constipation and lethargy. [en.wikipedia.org]
trembling hands, palpitations, insomnia, anxiety, increased bowel movement frequency - especially if the symptoms are new or persistent Hypothyroid Symptoms Weight gain, cold intolerance, constipation, very dry skin, slowed thinking, depressed mood, [endocrinesurgery.ucsf.edu]
Mental and physical fatigue are among the first symptoms of most patients with hypothyroidism; this may go unnoticed for some time or may be attributed to other reasons, such as aging. 15 With progression of hypothyroid disease, cold intolerance, slow [glowm.com]
- Tall Stature
(E05.8) E22.0 말단거대증 및 뇌하수체 거인증(Acromegaly and pituitary gigantism) 말단거대증과 관련된 관절병증(Arthropathy associated with acromegaly+)(M14.5*) 성장호르몬의 과잉생산(Overproduction of growth hormone) 제외 : 체질성 거인증(constitutional gigantism)(E34.4) 체질성 장신(長身)(constitutional tall [dic.impact.pe.kr]
- Precocious Puberty
puberty) E22.9 상세불명의 뇌하수체기능항진증(Hyperfunction of pituitary gland, unspecified) E35* 달리 분류된 질환에서의 내분비선 장애(Disorders of endocrine glands in diseases classified elsewhere) - E35.0*달리 분류된 질환에서의 갑상선의 장애 (Disorders of thyroid gland in diseases classified elsewhere [dic.impact.pe.kr]
Skin
- Erythema
[…] cause ipsilateral recurrent laryngeal nerve palsy are more likely to be malignant Retrosternal large multinodular goiters can cause dyspnea due to tracheal compression Large substernal goiters may cause superior vena cava syndrome, manifested by facial erythema [accessmedicine.mhmedical.com]
In addition, he has distension of his left external jugular vein, facial erythema (when compared with his shoulder), and cutaneous varicosities of venous blood draining from his head into his chest because of jugular obstruction from his goiter. [emedicine.medscape.com]
(L51.-+) 결절성 홍반에서의 관절병증(Arthropathy in (nodosum erythema)(L52+) 사르코이드증에서의 관절병증(Arthropathy in (sarcoidosis)(D86.8+) 휘플병에서의 관절병증(Arthropathy in (Whipple's disease)(K90.8+) O90 달리 분류되지 않은 산욕기의 합병증(Complications of the puerperium, NEC) - O90.0 제왕절개 부분 상처의 [dic.impact.pe.kr]
Neurologic
- Stroke
It usually occurs in the elderly when the thyroid has been compromised somehow, such as with a stroke or other life threatening medical event. Mentation may be decreased, and electrolytes can be off balance with severe hyponatremia. [thediabetescouncil.com]
Hyperlipidemia) / 골다공증(Osteoporosis) / 뇌경색(Cerebral infarction) 과민성대장증후군(Irritable bowel syndrome) / 관절염(Arthritis) / 광견병(Rabies) / 난시(Astigmatism) 궤양(Ulcer) / 남용(Abuse) / 노안(Presbyopia) / 노출증(Exhibitionism) / 뇌성마비(Cerebral palsy) 뇌염(Encephalitis) / 뇌졸중(Stroke [dic.impact.pe.kr]
Workup
Otherwise incidental finding of thyroid nodules found on the inpatient service can be deferred to outpatient workup and management. [clinicaladvisor.com]
If any changes occur, then further workup is indicated. Evidence-based answers from the Family Physicians Inquiries Network [mdedge.com]
Although the risk of cancer is small, it is the main reason for workup of these lesions. Measurement of thyroid-stimulating hormone can identify conditions that may cause hyperfunctioning of the thyroid. [aafp.org]
[…] in a young individual (often diagnosed due to routine screening of newborns for congenital hypothyroidism) Radiologic evaluation includes thyroid ultrasound and scintiscan Correlation of clinical signs with laboratory and ancillary tests Laboratory workup [pathologyoutlines.com]
Treatment
If repeat aspirations fail to provide an adequate specimen, close follow-up or surgery (particularly if the nodule is solid) should be considered.9 Treatment Options for Patients with Multinodular Goiters Several treatment modalities are available for [touchendocrinology.com]
Treatment of toxic multinodular goiter: Comparison of radioiodine and long-term methimazole treatment. (Abstract) Treatment of toxic multinodular goiter: Comparison of radioiodine and long-term methimazole treatment. [tripdatabase.com]
This can be done with: Ultrasound Thyroid scan Barium swallow X-ray Treatment Nontoxic goiters usually grow very slowly. They may not cause any symptoms. In this case, they do not need treatment. [winchesterhospital.org]
There is no standard treatment and choice of treatment depends on local practice patterns, the activity of the goitre, and the results of FNA of any suspicious nodules. surgery: partial or complete resection radioiodine: occasionally used dose = (thyroid [radiopaedia.org]
Prognosis
[…] but may be seen incidentally CT may be useful for fully characterising the extent of substernal (retrosternal) goitre an enlarged and heterogeneous thyroid gland suggests the diagnosis, which is confirmed by ultrasound or scintigraphy Treatment and prognosis [radiopaedia.org]
Support Groups: Expectations (prognosis): A goiter is a benign (harmless) process. A simple goiter may disappear on its own, or may become large. [uclahealth.org]
It has the same good outlook (prognosis) as the standard type of papillary cancer when found early, and they are treated the same way. [cancer.org]
Etiology
Pathophysiology The histopathology varies with the etiology and duration of the goiter. [ocw.tufts.edu]
Etiology Multinodular goiter (MNG) loci have been identified on chromosome 14q and on chromosome Xp22 and 3q26. Germline mutations in DICER1 (chromosome 14q31) have been found in familial MNG-1, with and without ovarian Sertoli-Leydig cell tumors. [unboundmedicine.com]
Abstract: Iodine deficiency is the most important etiological factor for euthyroid endemic goiter. However, family and twin pair studies also indicate a genetic predisposition for euthyroid simple goiter. [edoc.mdc-berlin.de]
Goiter is an etiologically and pathogenetically complex disease. The specific role of TSH in its pathogenesis has not been unraveled. [intechopen.com]
Na+/I- symporter. 54 56 Neumann S...Paschke R 10523025 1999 7 DICER1-Related Disorders 6 Doros L...Hill DA 24761742 2014 8 Germline DICER1 mutations and familial cystic nephroma. 6 Bahubeshi A...Foulkes WD 21036787 2010 9 Major role of genes in the etiology [malacards.org]
Epidemiology
Epidemiology The most common cause of pediatric goiter in the United States is chronic lymphocytic thyroiditis. The prevalence of goiter in the United States is 3–7%, although the incidence is much higher in regions of iodine deficiency. [unboundmedicine.com]
[…] atrophy type 4 Pseudohypoaldosteronism type 2E Synonym(s): - FMNG - Familial MNG Classification (Orphanet): - Rare endocrine disease - Rare genetic disease - Rare oncologic disease Classification (ICD10): - Endocrine, nutritional and metabolic diseases - Epidemiological [csbg.cnb.csic.es]
Epidemiologically ascertained risk factors are ionizing radiation, the presence of thyroid adenoma, multinodular goiter (MNG) and family history of thyroid cancer, and personal history of goiter or thyroid nodule. [iasj.net]
Epidemiology of head and neck cancer in the United States. Otolaryngol Head Neck Surg. 2006;135(3):451-457. Bonora E, Tallini G, Romeo G. Genetic predisposition to familial nonmedullary thyroid cancer J Oncol. 2010;2010:385206. [journals.sfu.ca]
EPIDEMIOLOGY A Japanese study showed that patients on treatment for hyperthyroid Graves’ disease are almost twice as likely to develop type 2 diabetes than members of the general population, are less likely to have been overweight, and are less likely [diapedia.org]
Pathophysiology
Pathophysiology The histopathology varies with the etiology and duration of the goiter. [ocw.tufts.edu]
Role of emotional stress in the pathophysiology of Graves' disease”. 《Eur. J. Endocrinol.》 168 (1): R13–18. doi:10.1530/EJE-12-0539. PMID 23027804. ↑ Stathopoulos, P.; Gangidi, S.; Kotrotsos, G.; Cunliffe, D. [ko.wikipedia.org]
Essentials of pathophysiology: Concepts of altered health states (3rd ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins. ^ Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson (2007). [en.wikipedia.org]
[Review] Endocrine. 2020 Apr 17 [Online ahead of print]Führer DE Since its cloning more than 30 years ago, the thyrotropin receptor (TSHR) has emerged as a pivotal player in thyroid physiology and pathophysiology. [unboundmedicine.com]
Prevention
Prevention: The use of iodized table salt prevents endemic goiter. [uclahealth.org]
This thoroughly updated edition includes an introduction to risk assessment and screening and results of recent clinical trials and their implications for treatment and prevention. [books.google.com]
The use of iodized salt in the United States prevents a lack of iodine in the diet. [medlineplus.gov]
The efficacy of levothyroxine suppressive therapy in preventing recurrence of goiter growth after partial thyroidectomy is less clear. [touchendocrinology.com]
Prevention To help reduce your chances of a nontoxic goiter, be sure that your diet contains enough iodine. [winchesterhospital.org]