Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary amyloidosis involving the thyroid gland is rare and limited to case reports. We report the case of a previously healthy 47-year-old female presenting with a 1-month history of nausea, vomiting, and diffuse thyroid enlargement. Over the next 3 months, she simultaneously developed renal insufficiency dysphagia and hoarseness of voice. Biopsies from the gastric antrum, duodenum, bone marrow, and kidney were positive for vascular deposition of amyloid. Ultrasound of the thyroid revealed diffuse enlargement of the thyroid gland, which was 32.8 ML in volume, with diffuse hyperechogenicity. Fine needle aspiration (FNA) biopsy was positive for amyloid by Congo red staining, and cytology was negative for malignancy. The patient was treated with dexamethasone 40 mg daily on days 1-4, 9-12, and 17-20 for 3 months. On 3-month follow-up, the patient's nausea and vomiting had resolved and renal insufficiency improved. Ultrasound of the thyroid demonstrated decrease in the size of the goiter to 23.2 ML. Amyloid goiter is seen only in approximately 0.04% of patients with primary systemic amyloidosis. No data is currently available regarding treatment of primary amyloidosis and its effect on the goiter. However, we have evidence demonstrating that successful treatment of amyloidosis decreases thyroid enlargement and improves organ dysfunction.
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PMID:Amyloid goiter as a manifestation of primary systemic amyloidosis. 1727 55

Over a five-year period (September 1987 to August 1992), eight patients, one male and seven females, with a characteristics history of dysphagia due to cervical esophageal webs (Paterson-Brown Kelly syndrome) were encountered. The patients, all Arabs, comprised six Saudi females, one Yemeni female and an Eygptian male. All the patients, except two, were in middle age. The webs, single in five patients and multiple in three, and present at the levels of the 5th, 6th and 7th cervical vertebrae, were located in the anterior wall of the esophagus in four patients, circumferential-producing stenosis in three patients, while one patient with multiple webs had both types of location. Associated iron-deficiency anemia was present in all patients, three of them with evident koilonychia. One patient had associated nodular goiter and rheumatoid arthritis while another had a fatal complicating postcricoid carcinoma. The only male patient had associated ulcerative protocolitis. All seven patients without malignant complication of their webs had marked or total resolution of their dysphagia with iron therapy, pharyngoscopy/esophagoscopy, and dilatation. The Paterson-Brown Kelly syndrome of postcricoid dysphagia is discussed briefly.
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PMID:Paterson-Brown Kelly syndrome. 1737 8

Presented herein is a case of diffuse fatty infiltration of amyloid goiter in a 58-year-old woman with chronic renal failure. Bilateral total thyroidectomy was performed due to symptoms of dysphagia and hoarseness. Macroscopic and microscopic examination showed that almost all thyroid follicles were replaced by fat cells. Hyalinized stroma intervening the fatty infiltration was shown to harbor amyloid deposition.
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PMID:Diffuse fatty infiltration in amyloid goiter. 1758 45

The relationship between osteoporosis and magnesium (Mg) deficiency is still controversial. Here we report a case of an 82-year-old woman with a giant adenomatous goiter and severe osteoporosis with multiple vertebral fractures, whose clinical course indicated that her osteoporosis was probably due to Mg deficiency. She visited our hospital for treatments of tetany. Laboratory data showed the existence of hypomagnesemia, hypocalcemia, hypokalemia, vitamin D deficiency, and slightly elevated intact PTH. Intravenous administration of Mg not only improved these electrolyte abnormalities but also increased serum levels of intact PTH, bone formation markers, 1,25-dihydroxyvitamin D, as well as bone resorption markers in the urine, and lowered urinary phosphate reabsorption. Hypomagnesemia on admission seemed to arise from long-lasting poor food intake and malnutrition, because it improved after the disappearance of dysphagia with a goiter resection. After the operation, BMD values at the lumbar spine and femoral neck obviously increased during 6 months of Mg supplementation without any specific therapies for osteoporosis. Mg deficiency in this case seemed to cause impaired secretion of PTH from the parathyroid and the refractoriness of bone and kidney to the hormone, which led to the suppression of both bone remodeling and renal vitamin D production. These processes were probably linked to her severe osteoporosis, which was reversed by Mg supplementation.
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PMID:A case of magnesium deficiency associated with insufficient parathyroid hormone action and severe osteoporosis. 1804 93

An 82-year-old female patient with hypothyroidism and Hashimoto's thyroiditis noted three years ago to have a small asymmetric goiter (left > right). Nevertheless, a rapid growth of the thyroid over 3-6 months caused dysphagia and shortness of breath. Ultrasound and a thyroid gammagram showed an image consistent with multinodular goiter with a hyperfunctioning nodule in the right lobe. Due to the history of Hashimoto's thyroiditis and a rapid increase in size of the thyroid gland, diagnoses of thyroid lymphoma and anaplastic thyroid cancer were considered. Thyroidectomy was attempted at an outside facility to relieve compressive symptoms. Fine needle aspiration was insufficient for diagnosis, and the product of thyroidectomy confirmed the diagnosis of diffuse large B-cell lymphoma. A positron emission tomography/computed tomography scan was performed in our institution for staging, revealing nodal and extranodal metastasis. Chemotherapy using cyclophosphamide, vincristine and dexamethasone (COP modified) led to a dramatic response of the tumor and a complete resolution of compressive symptoms.
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PMID:Whole-body (18)F-FDG PET/CT in primary non-Hodgkin's lymphoma of the thyroid associated with Hashimoto's thyroiditis and bilateral kidney infiltration. 1820 80

Parathyroid cysts are rare lesions that can present clinically as low neck masses. The clinical diagnosis of parathyroid cyst can be challenging and requires a high level of suspicion as it often mimics a thyroid nodule. The cyst occasionally can cause compressive symptoms such as dysphagia or dyspnea. When it occurs in the mediastinum, it can cause recurrent laryngeal nerve paralysis. In this report, we present a patient with a hyperfunctional parathyroid cyst in association with a papillary thyroid carcinoma. In addition, we briefly discuss the current literature on parathyroid cyst. This case is unusual in its clinical presentation in that the parathyroid cyst mimicked a thyroid goiter.
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PMID:Cystic parathyroid presenting as an apparent thyroid goiter. 1829 71

We report a 64 year-old male, living in a rural area, with a history of a thyroid nodule subjected to a fine needle aspiration 18 years ago. He consulted this time for a goiter associated to dyspnoea and dysphagia. A chest X-ray and a neck CAT scan showed a calcified nodule in the superior mediastinum of thyroidal origin, that displaced airways and blood vessels and a small thyroid nodule of uncertain origin. A thyroid scintigram showed a cold right thyroid nodule. The patient was operated, performing a subtotal thyroidectomy A calcified nodule measuring 8 x 6 x 6 cm and another nodule measuring 10 mm were found during the surgical exploration. The pathological examination of the surgical piece disclosed a calcified hydatic cyst and a focal nodular hyperplasia. The patient remains asymptomatic seven months after surgery.
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PMID:[Thyroid hydatid cyst: report of one case]. 1894 67

Retrosternal goiters are commonly situated in the anterior mediastinum, but according to the literature, 10-15% are located in the posterior mediastinum. The authors report two cases of enormous goiter in the posterior mediastinum. Case 1 was a 60-year-old man. His mass measured 12 x 9 x 8 cm and was combined with trachea compression and superior vena cava syndrome. Case 2 was a 59-year-old woman. Her mass measured 9 x 6 x 6 cm and she was admitted with the complaint of dysphagia. Both patients were discharged from hospital after successful operations. They reported normal activities in the follow-up.
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PMID:Enormous goiter in posterior mediastinum: report of 2 cases and literature review. 1936 82

Most mediastinal goiters are extensions of cervical goiters. Patients are generally female and only occasionally have symptoms. Patients most commonly complain of a mass-like sensation, dyspnoea, dysphagia and cough. The authors describe the case of a 67 year-old female who presented at the emergency room with dyspnoea, anterior cervical discomfort and tightness which had onset a few months prior but which had worsened in the last week. The patient cited a history of bronchial asthma, for which she was under medication, but the true diagnosis was mediastinal goiter.
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PMID:[Asthma mimic - a clinical case report]. 1985 37

Graves' disease is less common in prepubertal than pubertal children, and initial presentation with thyroid storm is rare. We report an 11-year-old prepubertal Hispanic girl who presented with a one-day history of respiratory distress, fever, and dysphagia. She had exophthalmos, a diffuse bilateral goiter and was agitated, tachycardic, and hypertensive. Nasal swab was positive for respiratory syncytial virus (RSV). She was diagnosed with thyroid storm and admitted to the pediatric intensive care unit. While infection is a known precipitant of thyroid storm and RSV is a common pediatric infection, to the best of our knowledge, this is the first reported case of RSV infection apparently precipitating thyroid storm in a prepubertal child.
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PMID:Respiratory syncytial virus infection as a precipitant of thyroid storm in a previously undiagnosed case of graves' disease in a prepubertal girl. 2160 50


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