Endocrine: Thyroidectomy

In this chapter the essential aspects of anesthesia for thyroid surgery are reviewed. An emphasis is placed on airway management of the thyroid patient as well as on drug therapy prior to anesthetizing thyroid patients. Myxedema coma and thyroid storm are reviewed in detail. The patient discussed is to undergo resection of a goiter. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative topics discussed are patient hemodynamics, use of beta blockers, airway assessment, and antithyroid therapy, including iodine. Intraoperative issues covered include monitoring, awake fiber-optic intubation, and management of bleeding. Postoperative issues addressed include extubation and treatment of postoperative stridor.

Agranulocytosis in General Practice: Diagnosis, Treatment, Prevention and Clinical Case

The article presents literature about classification, pathogenesis, clinical manifestations, diagnosis, treatment and prevention of agranulocytosis. The clinical case of agranulocytosis in practice of family doctor is presented, it developed in patient, who was taking antithyroid therapy. The attention of physicians to monitoring indicators of general and biochemical blood tests while taking antithyroid drugs has made.

Graves Disease And Down Sindrome : Clinical Case

ABSTRACT Introduction: Pacients with Down’s syndrome present an increase revalence of autoimune endocrine disorders. We communicate the case of 14 years and 6 months old pacient known with Down syndrome admitted in Endocrinology department with suspicion of hyperthyroidism, the diagnosis being confirmed by hormonal dosage. The particularity of the case consists in: symptomatology onset during puberty, clinical evolution with mild symptoms, without ocular involvement, morphological and functional remission obtained relatively soon after the initiation of antithyroid therapy, lack of posttherapy side effects, favorabile evolution under the “block and replace” therapy

Migratory polyarthritis as an adverse effect of thiamazole use in a 13-year-old girl with Graves’ disease

Graves’ disease is the most prevalent cause of hyperthyroidism in children. The treatment commonly involves antithyroid therapy using a thionamide. We present a case of a 13-year-old girl with the antithyroid arthritis syndrome, presenting as a migratory polyarthritis, after the initiation of thionamide treatment for Graves’ disease. Antithyroid arthritis syndrome warranted immediate cessation of thionamide. Improvement of the arthritis was seen in subsequent days. As there are no other reversible treatment modalities for Graves’ disease in children, definitive treatment with radioactive iodine was needed to control the hyperthyroidism in this child. Antithyroid arthritis syndrome presenting as a migratory polyarthritis is a severe adverse effect of a common pediatric disease and should therefore be recognized by pediatricians.