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Toxic multinodular goitre: a surprising finding
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  1. Marlene Rodrigues1,
  2. Helena Ferreira2,
  3. Ana Antunes1,3,
  4. Olinda Marques3,4
  1. 1Department of Pediatrics, Hospital de Braga, Braga, Portugal
  2. 2Department of Pediatrics, Hospital da Senhora da Oliveira Guimaraes EPE, Guimaraes, Portugal
  3. 3Pediatric Endocrinology Unit, Hospital de Braga, Braga, Portugal
  4. 4Department of Endocrinology, Hospital de Braga, Braga, Portugal
  1. Correspondence to Dr Marlene Rodrigues, rodrigues.f.marlene{at}gmail.com

https://doi.org/10.1136/bcr-2017-221913

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    Description

    A 16-year-old healthy adolescent boy was referred to the paediatric endocrinology clinic because of multiple thyroid nodules detected by cervical ultrasound, in the context of cervical lymphadenopathies. There was no family history of thyroid disease. He denied recent infections, asthenia, weight loss, sweating, palpitations, mood or sleep disturbances, dysphagia or dysphonia. At physical examination, an enlarged, irregular and fibroelastic thyroid, with a predominant right lobe, was identified. The remaining examination was normal.

    The analytical profile was thyroid stimulating hormone (TSH) <0.01 uUI/mL (normal 0.5–4.8 uUI/mL), free triiodothyronine (FT3) 7.27 pg/mL (normal 2.3–4.2 pg/mL) and free thyroxine (FT4) 2.02 ng/dL (normal 0.8–2.3 ng/dL). Thyroid antibodies were negative. Cervical ultrasound revealed an enlarged right thyroid lobe due to the presence of multiple mixed nodules with similar characteristics: the biggest one, …

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    Footnotes

    • Contributors MR and HF were involved in the planning, conduct and conception of the work; acquisition, analysis and interpretation of data; manuscript writing; revision and final approval of the version. AA was involved in conception and design of the work; analysis and interpretation of data; critical review and final approval of the manuscript. OM was involved in conception, design and conduct the work; acquisition and interpretation of data; critical review and final approval of the manuscript. All authors contributed in the clinical orientation of the patient as well as article preparation.

    • Competing interests None declared.

    • Patient consent Guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.