1/28. Disseminated tuberculosis: still a diagnostic challenge.Disseminated tuberculosis is notoriously difficult to diagnose and, with the decrease in tuberculosis incidence in australia, familiarity with its manifestations has dwindled. We describe four bacteriologically proven cases which illustrate the range of presentations and diagnostic difficulties. Surprisingly, immunosuppressive therapy need not cause rapid deterioration. Disseminated tuberculosis should be considered in any patient with multisystem illness who is at risk of tuberculosis, particularly if born overseas. In the absence of confirmatory results, a prompt therapeutic trial may be life-saving.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
2/28. Multicystic autoimmune thyroiditis-like disease associated with hiv infection. A case report.BACKGROUND: Human immunodeficiency virus (hiv) infection and resulting acquired immunodeficiency syndrome (AIDS) may involve virtually every organ system, including the endocrine glands. Thyroid dysfunction most commonly reflects advanced disease and generally resembles euthyroid sick syndrome. Rarely do opportunistic infections, hemorrhage, neoplasms and drugs account for alterations in thyroid tissue. Multiple lymphoepithelial cysts of parotid gland and thymus have been identified, but similar findings in thyroid gland have not been reported. CASE: A 41-year-old, hiv-seropositive woman, asymptomatic for seven years, developed a squamous cell carcinoma of the cervix with local-regional extension. At the same time, bilateral complex thyroid cysts and high titers of antimicrosomal antibodies (1/6,400) were detected. Ultrasound-guided fine needle aspiration biopsy of the thyroid showed a heterogeneous lymphocytic population with a reactive appearance and occasional groups of epithelial cells with an immature squamous pattern, along with cytologic features of autoimmune thyroiditis. Immunocytochemistry was positive for CD20, CD3 and CD5. Immunoglobulin heavy chain gene rearrangement by polymerase chain reaction from cytologic material showed a polyclonal lymphoid population. External radiotherapy resulted in a significant reduction in the pelvic lesion. Four months after diagnosis, abdominal ultrasound displayed multiple hepatic metastasis, the patient's condition rapidly deteriorated, and she died about a month later. CONCLUSION: This case had unique features and probably represented an AIDS-related lesion and distinct entity.- - - - - - - - - - ranking = 0.029559485981169keywords = endocrine (Clic here for more details about this article) |
3/28. Increased levothyroxine requirements presenting as "inappropriate" TSH secretion syndrome in a patient with nephrotic syndrome.patients with primary thyroid failure on levothyroxine (LT4) replacement who develop nephrotic syndrome (NS) may rarely present with an increase in LT4 requirements. In this report, we describe a patient with thyroid failure following radioactive iodine ablation for Graves' disease who required an escalation of LT4 doses following the onset of NS. The case presented with disproportionately elevated TSH levels in the presence of normal (or slightly subnormal) thyroid hormone levels, thus, masquerading as a state of "inappropriate" TSH secretion. This pattern of extreme dysregulation in thyroid function indices due to urinary loss of thyroid hormones has not been previously described in NS, and, therefore, extends the spectrum of endocrine manifestations of NS.- - - - - - - - - - ranking = 0.029559485981169keywords = endocrine (Clic here for more details about this article) |
4/28. Unusual presentation of tuberculosis reactivation in childhood: an anterior neck mass.Although extrapulmonary tuberculosis has a broad spectrum of clinical manifestations, involvement of the thyroid gland in children has been reported very rarely. The authors report a case of an 11-year-old girl with a nontender nodular swelling of the thyroid, whose symptoms, tomographic and scintigraphic features, mimicked a nodule with a cystic component. Although seldom observed, tuberculosis should be considered in the differential diagnosis of nodular lesions of the thyroid in children, especially in the patient with known history of exposure to tuberculosis.- - - - - - - - - - ranking = 0.875keywords = tuberculosis (Clic here for more details about this article) |
5/28. Tubercular involvement of the thyroid gland: a report of two cases.Thyroid tuberculosis is rare. In the last decade, however, the incidence of extrapulmonary forms of tuberculosis has increased. We report on 2 cases of thyroid tuberculosis. In case 1, a tubercular abscess mimicking acute thyroiditis was found which was correctly diagnosed by fine-needle aspiration biopsy (FNAb). No evidence of active disease was noticed. Pleural thickening on chest X-ray was the only sign compatible with a previous infection. In case 2, tubercular thyroiditis with lymph node enlargement was also diagnosed by FNAb in a reevaluation setting. In both cases treatment with antitubercular drugs resulted in complete recovery. Thyroid tuberculosis should be kept in mind in the differential diagnosis of thyroid nodules, notably in patients with a history of tuberculous disease. FNAb represents the main approach to making the diagnosis.- - - - - - - - - - ranking = 0.5keywords = tuberculosis (Clic here for more details about this article) |
6/28. Occult thyroid pathology in a child with acquired immunodeficiency syndrome. Case report and review of the drug-related pathology in pediatric acquired immunodeficiency syndrome.A 11-year-old boy with acquired immunodeficiency syndrome (AaS), Varicella-zoster virus (VZV) infection and long-term antiviral treatment suffered from a disorder of contractility of the left ventricle of the heart. Following severe unmanageable vomiting, the patient died and the postmortem examination showed marked involution of the lymphatic system, multiple foci of fibrosis of both ventricles of the heart, and regressive changes of the thyroid gland. Biochemical values of the thyroid gland function were, however, not altered. Neither human immunodeficiency virus-related p24 antigen, nor VZV dna sequences were found in the thyroid gland. Regressive changes of the thyroid gland can probably occur before its function fails. By analyzing the possible etiologies, the endocrine toxicity of a long-term antiviral treatment should be taken into account.- - - - - - - - - - ranking = 0.029559485981169keywords = endocrine (Clic here for more details about this article) |
7/28. US and CT findings of tuberculosis of the thyroid: three case reports.With two ultrasonographic and two CT films of three cases of thyroid tuberculosis, we evaluate the ultrasonographic and CT findings and correlate them with the pathologic findings. They are demonstrated as heterogeneous hypoechoic mass on ultrasonogram and peripheral-enhancing low-density abscess on CT scan with regional lymphadenopathy. ultrasonography (US) and CT can help the diagnosis of thyroid tuberculosis.- - - - - - - - - - ranking = 0.75keywords = tuberculosis (Clic here for more details about this article) |
8/28. tuberculosis of the thyroid: two case reports.tuberculosis of the thyroid gland occurs only rarely. Since extrapulmonary tuberculosis is now seen relatively more frequently the existence of this condition should be recognized. The cases of two patients with tuberculosis involving the thyroid are presented. The first, an Asian immigrant, presented with a painless goitre with no evidence of tuberculosis elsewhere. The second was an English woman who presented with hypothyroidism due to destruction of the thyroid by tuberculosis, and who subsequently died with disseminated tuberculosis; this is the only case to report the association between myxoedema and tuberculous thyroiditis. Other manifestations of thyroid tuberculosis and the pathological types are discussed.- - - - - - - - - - ranking = 0.75keywords = tuberculosis (Clic here for more details about this article) |
9/28. Primary tuberculosis of the thyroid gland: report of three cases.We report on three cases with rapidly increasing thyroid masses who were referred with the provisional diagnosis of thyroid carcinoma. In the two cases, the diagnosis of tuberculosis was established after thyroidectomy, but in the third case diagnosis was made pre-operatively with acid fast bacilli (AFB) staining and culture from fine needle aspiration (FNA) material. Although rare, tuberculosis of the thyroid gland should be included in the differential diagnosis of thyroid masses. FNA, AFB staining and culture of the aspirate are important diagnostic tools in these cases.- - - - - - - - - - ranking = 0.75keywords = tuberculosis (Clic here for more details about this article) |
10/28. Concomitant tuberculous and cryptococcal thyroid abscess in a human immunodeficiency virus-infected patient.Suppurative thyroiditis is a rare condition caused mostly by staphylococcus aureus and streptococci. Both tuberculous and cryptococcal thyroid abscess are even rarer. The incidence of extrapulmonary forms of tuberculosis and cryptococcosis has increased in areas with a high prevalence of human immunodeficiency virus (hiv) infection. A case is reported of dual infection by M. tuberculosis and cryptococcus neoformans presenting as a thyroid abscess in a 32-y-old woman with symptomatic hiv infection. Atypical presentations of both tuberculosis and cryptococcosis should be considered in areas with a high incidence of these diseases.- - - - - - - - - - ranking = 0.375keywords = tuberculosis (Clic here for more details about this article) |
| | Next -> |