A study of incidence and presentation of thyroiditis in a goitrous patient at Government Rajaji Hospital, Madurai

Vijayakumar, P (2010) A study of incidence and presentation of thyroiditis in a goitrous patient at Government Rajaji Hospital, Madurai. Masters thesis, Madurai Medical College, Madurai.

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Abstract

INTRODUCTION: Thyroiditis is one of the commonest thyroid diseases, being particularly very common in south India (when compared to North India). However, in view of the diagnostic limitations in thyroid swelling, the this condition is often missed and thyroidectomy is performed on which is not only unnecessary, but also harmful to the patients, which is not only unnecessary, but also harmful to the patients, as it will lead to early and inevitable hypothyroidism. The patients are also at risk of early and late complications of thyroidectomy e.g. recurrent laryngeal nerve injury, hypoparathyroidism, neck scar, etc. Hence, the study is undertaken to elicit some of the diagnostic feature of the disease and thus to avoid surgery in these patients wherever possible. AIM OF THE STUDY: 1. To study incidence and epidemiological aspects (age, sex) of thyroiditis in a goitrous patients. 2. To find out the clinical features and presentation of thyroiditis in a goitrous patients. 3. To find out the status of investigations (hematologic, biochemistry, immunology, histopathology and imaging studies). STUDY METHOD: Setting: Patients were selected from Medical Endocrinology Department and Surgical Endocrinology Department. Study Design: prospective observational study. Period: 2007 – 2009. Inclusion Criteria: 1. Clinical findings suggestive of thyroiditis, supported by investigations. 2. Final diagnosis affirmed by head of the department of Medical Endocrinology. 3. Only newly diagnosed patients were included in the study. Diagnostic Criteria: Since a histological evidence of Hashimoto’s thyroiditis cannot be obstrainted practically routinely, the minimum requirement to diagnose a case as Hashimoto’s thyroiditis was taken as ‘positive AMA’ (most of the books quote that AMA antibodies are present in 100% of the cases). Case Selection Criteria: When history and clinical examination are suggestive of thyroiditis and it is supported by one or more of the three investigations (Thyroid function tests, Antimicrosomal antibody titer, FNAC). Number of Patients: Though the study started with- more than 300 patients, not all patients turned out for follow-up for complete investigations. 1. Only those patients who underwent all investigations were included in the study. For ease of calculation, 234 number of patients were selected. 2. The final diagnosis of all these 234 patients were confirmed by the head of the department of medical endocrinology & surgical endocrinology. CONCLUSION: Hashimoto’s thyroiditis is a most common type of thyroidits in goitrous patient. • Female are more prone to develop. • Maximum incidence age group of about 30 to 40 years. • Thyroiditis has a varied presentation as diffuse goitre, multinodular goitre or a Solitary nodular goitre. • Thyroiditis could present as in hypothyroid, euthyroid and hyperthyroid state. • Diagnosis of thyroiditis could be done by FNAC, Antibody titre, ESR, histopathology report. • Treatment is primarily medical with thyroxine replacement and surgery is required with patient having pain, difficulty in swallowing and not regressing with eltroxin.

Item Type: Thesis (Masters)
Uncontrolled Keywords: incidence ; presentation ; thyroiditis ; goitrous patient ; Government Rajaji Hospital ; Madurai.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 02 Jun 2018 16:05
Last Modified: 02 Jun 2018 16:05
URI: http://repository-tnmgrmu.ac.in/id/eprint/8102

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