Thyroidectomy in a patient with multinodular dyshormonogenetic goitre--a case of Pendred syndrome confirmed by mutations in the PDS/SLC26A4 gene.
We report a young woman with genetically confirmed Pendred syndrome and discuss the current therapeutic strategies of dyshormonogenetic goitre. A small diffuse thyroid enlargement developed during infancy and although substitution therapy with L-thyroxine was adequate, it progressed and underwent multinodular transformation. Cervical ultrasound at the age of 22 years demonstrated three solid nodules and fine-needle aspiration biopsy showed a finding typical of follicular adenoma. It is known that dyshormonogenetic goitres have a tendency to grow despite appropriate treatment with L-thyroxine. Management of a patient with Pendred syndrome requires careful follow-up and regular imaging of the thyroid. Although the therapeutic approach to dyshormonogenetic goitres is still controversial, in our patient we chose total thyroidectomy as the most advantageous method to prevent the development of malignancies that may arise more frequently from dyshormonogenetic goitres than from goitres of other aetiologies.
Banghova
Karolina
K
Department ofPaediatrics, Second Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. k_banghova@yahoo.com
Cinek
Ondrej
O
Al Taji
Eva
E
Zapletalova
Jirina
J
Vidura
Radan
R
Lebl
Jan
J
D000328:Adult; D007758:Ear, Inner / Q000002:abnormalities*; D005260:Female; D006044:Goiter, Nodular / Q000188:drug therapy / Q000235:genetics* / Q000601:surgery*; D006319:Hearing Loss, Sensorineural / Q000235:genetics*; D006801:Humans; D026901:Membrane Transport Proteins / Q000235:genetics*; D009154:Mutation / Q000235:genetics*; D000076988:Sulfate Transporters; D013577:Syndrome; D013965:Thyroidectomy; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000627:therapeutic use
D026901:Membrane Transport Proteins; C085609:SLC26A4 protein, human; D000076988:Sulfate Transporters; D013972:Thyrotropin; D013974:Thyroxine