Erschienen in:
06.03.2019 | Clinical Quiz
Proteinuria in a patient with Graves’ disease: Questions
verfasst von:
Aydilek Dagdeviren Cakir, Nur Canpolat, Seha Saygili, Isin Kilicaslan, Hande Turan, Oya Ercan, Olcay Evliyaoglu
Erschienen in:
Pediatric Nephrology
|
Ausgabe 8/2019
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Excerpt
A 15-year-old female presented with complaints of palpitation and tremor. On initial physical examination, her height, weight, and body mass index (BMI) were 159 cm (− 0.47 SD), 91 kg (3.95 SD), and 35.9 kg/m2 (3.47 SD), respectively. She had a diffuse goiter (grade 2) without proptosis, lid lag or lid retraction. There was a fine hand tremor. Her heart rate was 100 beats per minute and blood pressure was 130/90 mmHg (> 95th percentile). Other physical examination was unremarkable. Laboratory results showed an elevated free T4 (4.61 [0.82–1.75] ng/dL) and free T3 (17.2 [2.27–4.48] pg/mL) and a suppressed thyroid-stimulating hormone (TSH) (0.006 [0.5–4.33] μIU/mL). Immunological evaluation demonstrated the presence of thyroid antibodies against TSH receptor (TRAB) (17.7 [N 0–1.1] IU/mL), thyroid peroxidase (85 [N < 34] IU/mL), and thyroglobulin (340 [N < 115] IU/mL). Thyroid ultrasonography was compatible with thyroiditis. Hyperthyroidism associated with TRAB positivity suggested Graves’ disease and anti-thyroid treatment with methimazole was started. …
