ELEVATED THYROGLOBULIN ANTIBODIES AND PARATHYROID MALIGNANCY IN 55 YEAR OLD WOMAN WITH HASHIMOTO’S
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1
Carrick Institute, United States
Background:
A 55 year old woman presented with chief complaints of difficulty with memory and trouble with verbal communication. Eight years prior to presentation she was diagnosed with Hashimoto’s hypothyroidism. Three years prior to presentation she was diagnosed as prediabetic with an Hemoglobin A1c of 6.3 %
Methods:
Blood chemistry revealed elevated fasting glucose (120 mg/dL ), calcium (10.6 mg/dL ), ALT (51 U/L), ferritin (152 ng/mL), TPO antibodies (216.8 IU/mL), and markedly elevated anti-thyroglobulin antibodies (2049.1 IU/mL). The patient noted that her anti-thyroglobulin antibodies had been elevated to that degree for eight years.
She was referred to an endrocrinologist due to suspicion of thyroid malignancy. The endocrinologist did not think malignancy was a concern. Therefore, she was placed on an anti-inflammatory diet and supplement protocol.
Results:
After 60 days of treatment she reported 40% improvement in terms of ability to recall information and complete resolution of her difficulties with verbal expression.
Retest of blood chemistry revealed elevated calcium (10.6 mg/dL), ALT (48 U/L), TPO antibodies (220 IU/mL), anti-thyroglobulin antibodies (2100.7 IU/mL) and alkaline phosphatase (147 U/L).
Subsequent alkaline phosphatase isoenzyme testing showed elevated bone fraction (93%). Two months later, since the alkaline phosphatase had remained elevated, additional testing revealed elevated bone fraction (66 %), normal intact parathyroid hormone (28 pg/mL) and elevated ionized calcium (1.41 mmol/L)—indicating possible hypercalcemia of malignancy.
One month later she underwent surgery and two parathyroid adenomas were identified and removed.
Conclusion:
The author suggests exercising caution in patients with markedly elevated anti-thyroglobulin antibodies, even if the patient demonstrates subjective improvement.
Keywords:
Parathyroid Hormone,
Ionized calcium,
Parathyroid adenoma,
hashimoto's hypothyroidism,
Alkaline Phosphatase
Conference:
International Symposium on Clinical Neuroscience 2018, Orlando, Florida, United States, 24 May - 26 May, 2018.
Presentation Type:
Poster
Topic:
Clinical Applications in health, disease, and injury to the nervous system
Citation:
Clark
DJ
(2018). ELEVATED THYROGLOBULIN ANTIBODIES AND PARATHYROID MALIGNANCY IN 55 YEAR OLD WOMAN WITH HASHIMOTO’S.
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience 2018.
doi: 10.3389/conf.fneur.2018.60.00019
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Received:
26 Mar 2018;
Published Online:
14 Dec 2018.
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Correspondence:
Dr. David J Clark, Carrick Institute, Cape Canaveral, United States, mail@doctordavidclark.com