Thursday, January 24, 2013
1:27 PM | Posted by Shams Burki | Edit Post
Clinical Vignette: A 40-year-old female with no prior history of thyroid disease, presents with a 5 day history of an acutely painful, left-sided goitre. Clinically she appeared euthyroid, and was apyrexial.
Investigations revealed the following:
- Haemoglobin 13.0 g/dL
- White cell count 7.0 x 109/l
- Platelets count 200,000/mm3
- De Quervain's thyroiditis
- Haemorrhage into a cyst
- Hashimoto's thyroiditis
- Staphylococcal abscess
- Thyroid carcinoma
Answer to clinical vignette|case: (2)
The left side of this patient's goitre becomes acutely swollen with no other signs and FBC is normal which suggests acute haemorrhage into a cyst.
Thyroid cancer is usually painless.
De Quervain's thyroiditis is a diffusely tender goitre typically with systemic features such as weight loss, pyrexia and a raised ESR.