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| Cases | Ersoy et al. [1] | Raman et al. [8] | Ouleghzal et al. [9] | Our case |
|
| Case number | 1 | 1 | 1 | 1 |
| Patient age | 40 years | 38 years | 42 years | 33 years |
| Gender | Female | Male | Female | Female |
| Clinical presentation | (i) Signs of hyperthyroidism
(ii) Lymphadenopathy + thyroid nodules | (i) Signs of hyperthyroidism + nodular goiter + high fever | (i) Hyperthyroidism
(ii) Bilateral exophthalmia
(iii) Homogeneous goiter, elastic, and very vascular | (i) Signs of hyperthyroidism
(ii) Homogeneous goiter, and a very vascular |
| Diagnostic tests | (i) TSHus: 0.0007 IU/ml (0.34–4.2)
(ii) FT3: 7 pg/ml (2.5–3.9)
(iii) FT4: 5.05 ng/dl (0.7–1.4)
(iv) Thyroid scintigraphy: grave’s disease + benign hypoactive nodule
(v) Fine needle aspiration (FNA): caseification necrosis | (i) TSH: 0.14 mIU/L
(ii) FT4: 25.1 ng/dL
(iii) CRP: 373 mg/L
(iv) ESR: 43 mm/h
(v) Ultrasound and CT scans: multinodular thyroid enlargement
(vi) Thyroid scintigraphy: no uptake in the thyroid | (i) TSH <0.005 mUI/ml
(ii) FT4: 98 pmol/l (12−22 pmol/)
(iii) FT3: 54 pmol/l (3,2–6 pmol/l)
(iv) Anti TSH receptor Ab (TRAb): 7.6 mUI/ml (<2)
(v) Cervical ultrasound: homogeneous hypo-echogenic thyroid that is highly vascularized on doppler | (i) TSH <0.05 mU/L
(ii) FT4: 43.24 pmol/L (10–28.2)
(iii) FT3: 13.4 pmol/L (4.0–8.3)
(iv) TRAb: 24 IU/L (<1.5 IU/L)
(v) Cervical ultrasound: Homogeneous thyroid, highly vascularized on doppler |
| Initial diagnostis | Grave’s disease + TB | TB thyroiditis on fine needle aspiration (FNA) | Grave’s disease resistant to treatment | Grave’s disease with multiple relapses |
| Histological diagnostic | coexistence of TB and the graves’ disease | — | coexistence of TB and the graves’ disease | coexistence of TB and the graves’ disease |
| Treatment approach | Medical treatment + thyroidectomy and TB treatment | TB treatment (6 months) | Medical treatment + thyroidectomy and TB treatment | Medical treatment + thyroidectomy and TB treatment |
| Outcome | Favorable outcome | Favorable outcome | Favorable outcome | Favorable outcome |
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