ECE2013 Poster Presentations Clinical case reports - Thyroid / Others (62 abstracts)
A case with thyroid acropachy as the initial manifestation of thyrotoxicosis
Serpil Bal 1 , Pelin Tütüncüoglu 2 , Emel Atar 1 , Nese Olmez Sarikaya 1 , Ozlem Yoleri 1 , Bengi Oz 1 , Hikmet Kocyigit 1 & Ece Harman 2
Department of Physical Medicine and Rehabilitation, Atatürk Training and Research Hospital, Izmir, Turkey; 2Department of Endocrinology, Atatürk Training and Research Hospital, Izmir, Turkey.
Thyroid acropachy is an uncommon and usually late complication of thyroid disease. The typical clinical presentation of thyroid acropachy includes clubbing, distal soft tissue swelling and periosteal reaction involving the tubular bones of the hands and feet. It is usually associated with exophthalmos and thyroid dermopathy. We present a case with thyroid acropachy as an initial manifestation of toxic adenoma.
A 69-year-old man was admitted to our out-patient clinic with complaints of pain and swelling in his hands and wrists. These symptoms had been present for 3 years. His physical examination revealed clubbing of the fingers of both hands and exophthalmos. Dermopathy was not observed in our patient. Radiographs of both hands revealed periosteal reaction that was bilateral and symmetrical involving all proximal phalanxes. Laboratory investigation showed elevated serum T3, depressed TSH levels. Serum T3 and alkaline phosphotase levels were in normal range. Thyroid scintigraphy demonstrated a toxic adenoma in the right lobe of thyroid gland. The patient was diagnosed as thyrotoxicosis with thyroid acropachy and medical treatment was initiated involving antithyroid drugs and low dose steroid.
We present this case with thyroid acropachy as an unusual initial presentation of thyrotoxicosis.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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