of cases -Clinical Cytological- (Percentage) FNA and FNC (Percentage) Multinodular goiter 42(84%) 25(50%) Solitary nodule 5(10%) 0(0%) Colloid goiter 0(0%) 10(20%) Toxic nodular goiter
1(2%) 1(2%) Hashimoto's thyroiditis 0(0%) 6(12%) Papillary Carcinoma 2(4%) 1(2%) Follicular neoplasm(FN) 0(0%) 2(4%) Adenomatous nodule(AN) 0(0%) 2(4%) Adenomatous nodular 0(0%) 1(2%) hyperplasia(ANH) Lymphocytic thyroiditis(LT) 0(0%) 1(2%) Anaplastic carcinoma 0(0%) 1(2%) Total 50(100%) 50(100%) Table 4: Comparison between FNCC and FNAC diagnosis.
Data for patients with Graves' disease and toxic nodular goiter are presented in Tables No.
Cure rate was 77% in patients with Graves' disease group and 85% in toxic nodular goiter group (p=0.
There was no correlation between the pre-treatment RAI uptake and the development of hypothyroidism in patients with Graves' disease and those with toxic nodular goiter.
Radioactive iodine I-131 is increasingly being used as the first line therapy for treatment of hyperthyroidism both in patients with Graves' disease and toxic nodular goiter.
Patients with toxic nodular goiter are perceived to be relatively resistant to RAI and there is debate whether such patients should be treated with higher doses of RAI than those with Graves' disease.
The incidence of postablative hypothyroidism was 70% among patients with Graves' disease and 42% among patients with toxic nodular goiter.
In conclusion, we found that within our study population, post-ablative hypothyroidism tended to be more prevalent in patients with Graves' disease as compared to those with toxic nodular goiter (70% vs.
The National Academy of Clinical Biochemistry guidelines recommend use of serum thyrotropin (TSH) receptor antibody (TRAb) analysis to distinguish between Graves disease and other thyroid diseases, such as subacute or postpartum thyroiditis and toxic nodular goiter
Surgery typically is reserved for toxic nodular goiters
, large symptomatic goiters, children with hyperthyroidism, or pregnant patients.
Factors known to precipitate thyroid storm are infection, surgery, trauma, radioactive iodine treatment in patients with toxic nodular goiters
, pregnancy, anticholinergic and adrenergic drugs, thyroid hormone ingestion, and diabetic ketoacidosis (American Association of Clinical Endocrinologists [AACE], 2002).