El hipertiroidismo primario es una condición que requiere manejo idealmente definitivo, los medicamentos antitiroideos son una opción viable y no invasiva, pero con la desventaja de ser curativa solo en el 30% de los casos y en casos de intolerancia, ausencia de respuesta o efectos secundarios se requiere manejo definitivo con yodo radioactivo o cirugía.
Con frecuencia los pacientes son llevados a estas terapias definitivas, sin embargo, hay evidencia divergente sobre las pautas de seguimiento posterior al manejo quirúrgico o post-yodo, sin protocolos establecidos en muchas instituciones. Por lo anterior, se realizó una revisión del tema y un protocolo con el fin de homogenizar el conocimiento y ser una guía para el manejo post terapia de los pacientes hipertiroideos llevados a tratamiento definitivo.
Case:
A 40-year-old Colombian woman presented with a 7-year history of progressive lower-limb pain. Sclerosis of the diaphyseal tibia and femur was observed in her latest x-ray images. A narrowing of the medullary canal is observed in Camurati-Engelmann disease (CED), a rare and progressive diaphyseal dysplasia that was confirmed in this patient by genetic testing. Medical treatment was unsuccessful; thus, surgical treatment consisted of decompression by drilling of the medullary canal was performed, achieving successful pain release.
Conclusion:
Surgical treatment should be considered for patients with CED when the medical treatment is unsuccessful because doing so reduces bone overgrowth, leading to pain relief.
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