Features of diagnostics and treatment of thyrotoxicosis in patients with severe comorbid pathology: clinical case

Abstract

Objective. To demonstrate the stages of diagnostics and successful treatment of thyrotoxicosis in a patient with severe comorbid pathology. Materials and methods. A clinical case report of a patient with toxic goiter is presented. Results. To specify the state of the thyroid gland, diagnostic and laboratory methods were applied: ultrasound examination (thyroid volume increased up to 182 cm2, isoechogenic nodule in the left lobe up to 1 cm, thyroid vascularization increased), spiral computed tomography (picture of diffuse nodular goiter with partial retrosternal location of the left thyroid lobe), hormone studies, the results of which revealed thyrotoxicosis. Thyroidectomy was subsequently carried out. Both thyroid lobes with isthmus were removed step-by-step with technical difficulties and high bleeding of tissues. The patient was discharged in 10 days in a satisfactory state. Conclusions. Thyrotoxicosis is certainly a complex surgical pathology, in which correct assessment of the diagnosis by instrumental, clinical and laboratory methods is required, as well as successful surgical intervention. Not only normalization of hormonal status of a patient has to be taken into account, but also the possibility of disease relapse, contraindications due to age, physiological status, and comorbid abnormalities.