ETA2022 Poster Presentations Case Reports (9 abstracts)
Do not rush to overdiagnose when a newly formed node is detected
Anna Chivchyan 1 , Lilit Kambulyan 2 , Armine Khroyan 3 , Elena Aghajanova 4 & Artashes Tadevosyan 5
1Yerevan State Medical University, Pediatric Endocrinology, Yerevan, Armenia; 2Yerevan State Medical University, Yerevan State Medical University, Endocrinology, Yerevan, Armenia; 3Yerevan State Medical University, Koryun 2, Endocrinology, Yerevan, Armenia; 4Yerevan State Medical University; 5Yerevan State Medical University, Yerevan State Medical University, Armenia
28 years old woman has presented to the Armenian-American Wellness Center complaining of muscular weakness, fatigue, palpitation, dysphagia, dry skin and hair fall. The patient was visited by the endocrinologist and referred to the following tests: ultrasound of the thyroid gland, blood test for TSH, FT4 and anti-TPO.
Results: Diffusely enlarged thyroid gland with diffuse heterogeneous echotexture and the presence of hypoechoic micronodules. In the left lobe a large nodule 7x8 mm is detected, hypoechoic with uneven outline and prominent hypervascularisation. (TIRAD-S- 4a)
| Test | Results | Result after 3 months | Normal range |
| TSH | 5,87 uIU/ml | 1,2 uIU/ml | 0,27-4,2 uIU/ml |
| FT4 | 0,83 ng/dl | 1,3 ng/dl | 0,93-1,7 ng/dl Anti-TPO |
| 208,21 IU/ml | <34 IU/ml Diagnosis |
Autoimmune thyroiditis, hypothyroidism The presence of Tr-4 a is a direct indication for FNA but conservative treatment has been taken as a start with Levothyroxine 50 mg/kg/day The next follow up was in 3 months Ultrasound of the thyroid gland - in the left lobe 4x5 mm. TIRAD-S-2 Conclusion:
In case the node of the thyroid gland is based on hypothyroidism and has rather no big dimensions, it is preferable not to rush to perform FNA and consider a treatment with Levothyroxine for 3-6 months and repeat the tests. In case of no changes in the size of the node perform FNA.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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