Case Study: Hashimoto\'s Thyroiditis A 39-year-old woman presented with a large,

Question

Case Study: Hashimoto's Thyroiditis

A 39-year-old woman presented with a large, painless swelling in her neck. The enlargement had been a gradual process over 2 years. She had no other symptoms and felt generally well. On examination, her thyroid was diffusively enlarged and had a rubbery consistency. There were no signs of thyrotoxicosis or of thyroid failure.

Thyroid function tests showed that she was euthyroid; T3 was 1.2nmol/l (NR 0.8-2.4), T4 was 12nmol/l (NR 9-23) and TSH was 4.3mU/l (NR 0.4-5mU/l). However, her serum contained high titre antibodies to thyroid peroxidase (1/64000; 4000iu/ml).

This patient had Hashimoto's thyroiditis. The goitre was huge, and she was treated by partial thyroidectomy; the goitre did not recur, and the patient has remained euthyroid for 12 years.

What is the patient’s chief complaint (3 points)

What is the large painless swelling in the neck called?(2 points)

How long did she experience the swelling before she was examined?(2 points)

Are there any other subjective complaints(2 points)

How was this swelling treated?(2 points)

List all objective findings(physical examination and lab tests)(14 points) AND indicate whether the exam findings were normal, increased or decreased (3 points)

Define euthyroid. (2)

Is Hashimoto’s Thyroiditis a hypo or hyper thyroid condition?(2 points)

What is the etiology of Hashimoto’s thyroiditis? (2 points)

What does thyroid peroxidase do in the body? (2 points)

Explanation / Answer

Patients chief complaint is large, painless diffuse swelling on neck.

Large painless swelling on neck called neck mass or lump. It may be thyroid disorder.

Enlargement seen since 2 years. It is gradually increasing.

There are no subjective complaints.

Hashimotos disease can be treated by hormone replacement.

Partial thyroidectomy done because tumor is very large in size.  

Objective findings:

Diffuses enlarged rubbery swelling

High titre antibodies to thyroid peroxidase.

Euthyroid state means where thyroid functioning is normal.

Hashimotos thyroiditis is hypothyroidism

Hashimotos thyroiditis is autoimmune disease.

Thyroid peroxidase plays important role in production of thyroid hormone.

Related Questions

Navigate

• Browse (All)
• Browse C
• Subjects

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.