FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4387250649> ?p ?o ?g. }

• W4387250649 endingPage "A5760" @default.
• W4387250649 startingPage "A5760" @default.
• W4387250649 abstract "SESSION TITLE: Pulmonary Manifestations of Systemic Disease Case Report Posters 16 SESSION TYPE: Case Report Posters PRESENTED ON: 10/10/2023 09:40 am - 10:25 am INTRODUCTION: Shortness of breath is a common complaint yielding broad differentials. A thorough history and physical examination can aid in targeted evaluation. Herein is described a case in which a patient with multiple non-specific symptoms was found to have a new diagnosis of Graves' disease with an initially normal screening test. CASE PRESENTATION: A 79-year-old obese female with a past medical history significant for chronic anemia, colon cancer in remission, obstructive sleep apnea, and chronic non-toxic multinodular goiter (MNG) was evaluated for 6 weeks of progressive shortness of breath, muscle weakness, and weight loss. Thyroid testing revealed a normal TSH and recent MNG biopsies were non-diagnostic. Age appropriate cancer screenings were up to date including recent colonoscopy. CT imaging showed stable MNG, mild bronchiectasis with emphysema, and no evidence of malignancy or pulmonary embolism. Spirometry suggested restrictive disease. Echocardiogram did not reveal an etiology of her symptoms. Neurologic exam was suggestive of a neuromuscular pathology and EMG with repetitive stimulation testing revealed low amplitude motor potentials and early recruitment with myopathic units noted in multiple muscles. A complete myopathic workup was planned, including repeat thyroid function testing, which revealed a newly undetectable TSH with elevated free T4, T3, and free thyroxine index. She was diagnosed with acute thyrotoxicosis with positive thyroid peroxidase antibodies and thyroid stimulating immunoglobulins, consistent with Graves' disease. Methimazole and propranolol were initiated with improvement in symptoms and thyroid function tests (TFTs). DISCUSSION: Hyperthyroidism yields an array of clinical manifestations including dyspnea, palpitations, weight loss, diarrhea, and anxiety. However, many acute, non-thyroidal conditions may manifest with overlapping symptoms. A TSH level is commonly used as an initial screening test, however in this patient with a non-toxic MNG, TSH testing was historically unremarkable and at least three times during initial evaluation. Therefore, other etiologies of her symptoms were considered. As the patient underwent extensive testing without conclusive results, ultimately a protocolized workup for myopathy revealed a transition to an overt hyperthyroid state. CONCLUSIONS: In the presence of persuasive clinical findings, targeted investigations should be pursued. In the setting of a multinodular goiter and symptoms consistent with acute thyrotoxicosis, a TSH within normal limits should not preclude a diagnosis of hyperthyroidism and serologic evaluation should correspond to the degree of clinical suspicion. REFERENCE #1: Graves' Disease. National Institutes of Diabetes and Digestive and Kidney Diseases. Reviewed November 2021. Accessed March 27, 2022. https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease REFERENCE #2: Mier A, Brophy C, Wass JA, Besser GM, Green M. Reversible respiratory muscle weakness in hyperthyroidism. Am Rev Respir Dis. 1989;139(2):529-533. doi:10.1164/ajrccm/139.2.529 DISCLOSURES: No relevant relationships by Maryssa Miller No relevant relationships by Ivana Milojevic No relevant relationships by Sowmya Swamy No relevant relationships by Christopher Walker" @default.
• W4387250649 created "2023-10-03" @default.
• W4387250649 creator A5071182322 @default.
• W4387250649 creator A5084513743 @default.
• W4387250649 creator A5087022220 @default.
• W4387250649 creator A5061634548 @default.
• W4387250649 date "2023-10-01" @default.
• W4387250649 modified "2023-10-03" @default.
• W4387250649 title "TSH DOES NOT TELL ALL: ACUTE THYROTOXICOSIS WITH NORMAL TSH" @default.
• W4387250649 doi "https://doi.org/10.1016/j.chest.2023.07.3713" @default.
• W4387250649 hasPublicationYear "2023" @default.
• W4387250649 type Work @default.
• W4387250649 citedByCount "0" @default.
• W4387250649 crossrefType "journal-article" @default.
• W4387250649 hasAuthorship W4387250649A5061634548 @default.
• W4387250649 hasAuthorship W4387250649A5071182322 @default.
• W4387250649 hasAuthorship W4387250649A5084513743 @default.
• W4387250649 hasAuthorship W4387250649A5087022220 @default.
• W4387250649 hasBestOaLocation W43872506491 @default.
• W4387250649 hasConcept C126322002 @default.
• W4387250649 hasConcept C164705383 @default.
• W4387250649 hasConcept C187212893 @default.
• W4387250649 hasConcept C206179267 @default.
• W4387250649 hasConcept C2778840127 @default.
• W4387250649 hasConcept C2779399171 @default.
• W4387250649 hasConcept C2780176905 @default.
• W4387250649 hasConcept C526584372 @default.
• W4387250649 hasConcept C527108885 @default.
• W4387250649 hasConcept C71924100 @default.
• W4387250649 hasConcept C90924648 @default.
• W4387250649 hasConceptScore W4387250649C126322002 @default.
• W4387250649 hasConceptScore W4387250649C164705383 @default.
• W4387250649 hasConceptScore W4387250649C187212893 @default.
• W4387250649 hasConceptScore W4387250649C206179267 @default.
• W4387250649 hasConceptScore W4387250649C2778840127 @default.
• W4387250649 hasConceptScore W4387250649C2779399171 @default.
• W4387250649 hasConceptScore W4387250649C2780176905 @default.
• W4387250649 hasConceptScore W4387250649C526584372 @default.
• W4387250649 hasConceptScore W4387250649C527108885 @default.
• W4387250649 hasConceptScore W4387250649C71924100 @default.
• W4387250649 hasConceptScore W4387250649C90924648 @default.
• W4387250649 hasIssue "4" @default.
• W4387250649 hasLocation W43872506491 @default.
• W4387250649 hasOpenAccess W4387250649 @default.
• W4387250649 hasPrimaryLocation W43872506491 @default.
• W4387250649 hasRelatedWork W1988109326 @default.
• W4387250649 hasRelatedWork W2053394181 @default.
• W4387250649 hasRelatedWork W2099476331 @default.
• W4387250649 hasRelatedWork W2157743352 @default.
• W4387250649 hasRelatedWork W2412135825 @default.
• W4387250649 hasRelatedWork W2748952813 @default.
• W4387250649 hasRelatedWork W2804469690 @default.
• W4387250649 hasRelatedWork W309369676 @default.
• W4387250649 hasRelatedWork W4205696617 @default.
• W4387250649 hasRelatedWork W4327511552 @default.
• W4387250649 hasVolume "164" @default.
• W4387250649 isParatext "false" @default.
• W4387250649 isRetracted "false" @default.
• W4387250649 workType "article" @default.