A Case of Graves Disease with Multinodular Goitre

This week Dr. Ashutosh is sharing a case of Graves Disease with Multinodular Goitre managed with great expertise by him. Share your views on the case & learn new things Follow us for more such updates!

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Nice case presentation Well discussed bet Graves disease and multinodular goitre Graves disease is a malignant condition and with conservative control better to subject to surgery following hypothyroidism mx Multiple goitre is benign condition doesn't need any attention unless it develops compression symptoms of dyspnea and dysphagia or cosmetic repair

Thanx dr Md Altaf Hussain
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Good clinical case presentation Toxic multinodular goitre nodules can sometimes produce too much thyroid hormone causing hyperthyroidism. This is most often found in patients over 50 years old. In many cases, a person may have had a multinodular goiter for several years before it starts to produce excess amounts of thyroid hormone. Primary Grave's disease is more common in women

.Congratulations to Dr Ashutosh Chandan Dubey for presenting a case of Graves Disease with multinodular Goitre is Curofy- Expert ,s clinical case presentation CECT orbit shows findings of thyroid related orbitopathy Patient will need life long follow up and treatment In many cases, as in this case a person may have had a multinodular goiter for several years before it starts to produce excess amounts of thyroid hormone.

Enlarged thyroid gland with multi nodular goiter Majority is benign more in women and with increasing age . Is an immune disease resulting in hyper metabolic state due to over production of thyroid hormone Symptoms anxiety , irritability fine tremor of hands and fingers , palpitation, heat sensitivity, wt loss despite normal diet,frequent bowel movements Graves ophthalmopathy and dermopathy This 36 yr patient came with proptosis , palpitation diaphoresis and wt loss Physical finding pulse 116/ Mt proptosis both eyes , mild thickening of extraocular muscle , Bilateral lobes of thyroid enlarged with multiple hypeeechoic to spongiform suggestive multi nodular goitre. Treated with Neo- Merczole 5 mg BD propranolol 40 mg of lubricant drops After two weeks palpitation and sinus tachycardia improved other symptoms also improved Dr Asutoush Chandon Dubey congratulations for nicely tacking the case

Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Nice sum up. However.. Clinically.. mentioned as NO NECK SWELLING. CECT.. says.. both lobes of thyroid enlarged. Are these not contradictory? It is unlikely to diagnose.. MNG.. without visibly enlarged thyroid. Bilateral proptosis and biochemical evidence of hyperthyroidism are evident. But in absence of.. dermopathy.. the classic triad of Graves is incomplete. It is prudent to coin a diagnosis of Toxic MNG. Please post a clinical image of neck.. anterior and lateral.. of this patient.

POSITIVE LID LAGGING SIGN PROPTOSIS AND POSITION THYROID PROFILE WITH TACHYCARDIA AND TRAMERS ARE THE DIAGNOSIS TIC HOW OFTEN YOU REFERED A CASE OF THYROID SCAN..IOD 131 SIR? INDICATIONS FOR SCAN? COLD NODULE ? INDICATIONS FOR TOTAL AND SUBTOTAL THYROIDECTOMY? PREPARATION OF PATIENT FOR SURGERY BEFORE AS RELATED TO AVVOID THYROID STORM ? CONGRATULATIONS FOR DIAGNOSIS AND MANAGEMENT IN THE CASE LAST QUESTION SIR..HOW LONG THE PERIORBITAL PAD OF FAT REMAINS AFTER THE TREATMENT OF HYPERTHYROIDISM IN ALLOPATHY? ANY CHANCE OF OPTIC NERVE DAMAGE IN VISION?

ONE THING MISSED IS HYPERREFLEXIA AND PATELLAR TAP REFLEX IF YOU PARDONED ME SO
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Very nice and useful presentation about Grave's disease with Multinodular Goiter. It's Introduction, Case Profile & History, Physical Examination, Investigations, Diagnosis, Treatment, Follow - up and Discussion & Key Learnings are Knowledge booster. Thanks Dr. Ashutosh Chandan Dubey for sharing useful presentation.

Thanks Dr Rakesh Kayasth (pt)
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Nice information uploaded.. Nice illustration.. Nice presentation.. Endocrinology clinical case.. Thanks doctor..

Thanks doctor Narendra Kumar
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SUGGESTIVE. OF GRAVES. .DISEASE WITH. . MULTINODULAR. GOITRE WELL DIAGNOSED NICELY. MANAGED. DR. ASHUTOSH. JI THANKS. FOR SHARING. SIR

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