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subhalekshmi,67yrs/F 21/04/11

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Provisional Diagnosis - Iatrogenic thyrotoxicosis IGT Spondyloarthritis/Osteopenia
Final Diagnosis - Granulomatous Cervical L.adenitis On ATT wef 16/11/11 Iatrogenic thyrotoxicosis Spondyloarthritis/Osteopenia IGT
History and Findings - Hypothyroidism on Rx LT4 150mcg od last 3yrs.wt loss 72 -62kg,tiredness,body aches,bone pains since 3yrs O/e BP-130/80,Bipedal edema,tachycardia,C.L nodes + non tender,Gr 1/6 ESM at LBA,varicose veins ++,Joints-OA knees shoulders
Investigation - Hb-11.3,CRP-1.06,ESR-60,HBA1c-6.7%,FBS-122.7,TSH-0.01,FT3-1.69,TPO-58.96,Blood urea-25.2,creat-0.8,uric-5.3,ca-9.3,P-3.5,A/g-3.59/3.7g,RA-neg,25(OH)vit D-14.73,BMD-Osteopenia,P.Smear-Normocytic normochromic,Skeletal scintigraphy-Hot spots dorsal & lumbar vertebrae-degenerative,L node biopsy AC-2451/11-Granulomatous L.adenitis
Treatment - Cap.Rcinex 600 1-0-0,Ethambutol 1000mg 1-0-0,Tab.Benadon 40mg 1/2-0-0,Tab.Risophos 35mg wkly once,Calcirol sachets 1gm in milk wkly once,Tab.Shelcal 0.5g 1-0-1,Tab.Razo 20mg od cm ,Tab.Durajoint GM 0-0-1,Cap.Fefol 0-0-1 x 2months
Follow Up - R/a 2 months with LFT/GGT/uric acid/TSH
Last modified on Saturday, 05 April 2014 08:50
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