Young boy having thyrotoxic goiter.he is on neomerkazole 10 tds since 3 asymtomatic wt gained but uniform swelling of throid still persist Kindly advise further line of treatment


The first report clearly says the boy is hyperthyroid, Second report TSH has become normal. Continue the same dose. Adv him FNAC Thyroid HR USG Thyroid. Then only we can discuss. You have not mentioned the initial weight and the present weight. Next time order T3, T4, TSH.

don't you think if the goiter persists, then surgery would be required at some stage

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Pt became clinically improved but not pathologically.Please advice FT3,FT4 and TSH , U/S Neck and FNAC.Along with Neomercazole better start Propranolol.

When asymptomatic why propranolol ???

how young is the boy. can you please mention the age?

Advised hemithyroidectomy.

First report shows only TSH levels.That to it is very near to lower limit.Second report clearly shows Hyperthyroid state.

It may take about 1 year for thyromegaly to respond.Continue Neomerxazole adjusted to TFT. No need for face at present.

First get USG and FNAC of thyroid swelling done. Continue neomercazole till thyroid profile normalizes. Then consider for Surgery.

hyperthyroidism an thyrotoxicosis are diff entities...if the pt is free from symptoms go for hemi male thyroids not to be neglected

Pl wait and watch for 2 months then repeat T3,T4 and TSH.

Neomercazole has to be continued with T3,T4 and T4 estimations time to time and dose adjusted.

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