Thyrotoxicosis in a patient with Turner syndrome: radioactive iodine therapy
https://doi.org/10.14341/probl13132
Abstract
Turner syndrome (TS) is a chromosomal disorder affecting female and characterized by complete or partial monosomy of the X chromosome. These genetic changes lead to the abnormalities in growth and development and increase the risk of autoimmune diseases, including those affecting the thyroid. Thyroid pathology in TS may include autoimmune thyroiditis, hypothyroidism, thyrotoxicosis (Graves disease, AIT in the hyperthyroid state).
Thyrotoxicosis is the clinical syndrome of excess circulating thyroid hormones. One of the main causes of thyrotoxicosis is Graves’ disease (GD), an organ-specific autoimmune disease caused by the production of stimulating thyrotropin receptor antibodies. There are three treatment options for thyrotoxicosis: anti-thyroid drugs, radioactive iodine and thyroidectomy. A personalized approach to disease management is especially important in cases of genetic diseases.
We present a clinical case of a patient with TS and GD, who has been referred to a radiologist at the Department of Radionuclide Therapy of Endocrinology Research Center. The patient was diagnosed with congenital hypothyroidism at neonatal screening, but thyroid hormones therapy was initiated aged three. Based on the survey, GD was diagnosed aged twenty one. Anti-thyroid drug therapy was started, which resulted in toxic hepatitis. Taking into account intolerance to anti-thyroid drugs, radioiodine therapy has been recommended, which led to hypothyroidism.
About the Authors
R. M. GuseinovaRussian Federation
Raisat M. Guseinova
11 Dm. Ulyanova street, 117036 Moscow
Competing Interests:
None
A. A. Prosvirnina
Russian Federation
Anna A. Prosvirnina - resident
11 Dm. Ulyanova street, 117036 Moscow
Competing Interests:
None
M. O. Korchagina
Russian Federation
Maria O. Korchagina
Moscow
SPIN-код:7834-5652
Competing Interests:
None
A. A. Trukhin
Russian Federation
Alexey A. Trukhin
11 Dm. Ulyanova street, 117036 Moscow
SPIN-код: 4398-9536
Competing Interests:
None
M. S. Sheremeta
Russian Federation
Marina S. Sheremeta - PhD
11 Dm. Ulyanova street, 117036 Moscow
SPIN-код: 7845-2194
Competing Interests:
None
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Supplementary files
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1. Figure 1. Patient management algorithm: from diagnosis to treatment and observation (adapted version) [28]. | |
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2. Figure 2. Thyroid scintigraphy with 99mTc-pertechnetate after intravenous administration of radiopharmaceuticals (11/29/2021). Signs of diffuse enhancement of radiopharmaceutical capture. | |
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3. Figure 3. 131I thyroid scintigraphy 24 hours after oral administration of tracer activity (11/30/2021). | |
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4. Figure 4. Thyroid scintigraphy with 131I at 24 h after oral administration of tracer activity (04/01/2022). | |
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5. Figure 5. Algorithm for RIT and post-therapy monitoring of the patient. | |
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Review
For citations:
Guseinova R.M., Prosvirnina A.A., Korchagina M.O., Trukhin A.A., Sheremeta M.S. Thyrotoxicosis in a patient with Turner syndrome: radioactive iodine therapy. Problems of Endocrinology. 2022;68(6):49-58. (In Russ.) https://doi.org/10.14341/probl13132

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