COURSE on THYROID ULTRASOUND
Section 6 Advanced courses
Part 4 The relation between a discrete lesion and a pathological nodule
Videolibrary
Lesions vc. nodule - case 195
Clinical data: A 37-year-old woman requested a second opinion. She suffered from fluctuating periods of hypothyroidism and hyperthyroidism for more than 2 years. Despite great efforts including steroid therapy, combination of replacement and thyrostatic therapy and unusually frequent follow-up examinations (checking hormone-levels every 2 to 4 weeks) to maintain euthyroid state, the patient presented alternating severe hypothyroidism and hyperthyroidism within several weeks. The patient lost her patience because she wanted to be pregnant. It is worth noting that TSAb levels were repeatedly undetectable, while aTPO was in the range of 150 to more than 1,000 U/mL.
Palpation: no abnormality.
Laboratory data: euthyroidism on daily 50 microgram levothyroxine (TSH 3.09 mIU/L, FT4 20.2 pM/L, aTPO 243 U/mL).
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