The qualified advice or council is necessary

[shcnik]

Hello. Would like to ask to you a question on diseases of a thyroid gland.

I am ill or sick more 7, two times laid in hospital, doctors have put DTZ II degrees. First time has made US 27.10.1998 results: the right share 5,52,52,3; left - 52,32,1, structure or frame non-uniform. Constantly I accept Mercazolilum not less than 2 tab. In day if I reduce a dose increases or is enlarged 4 (free). Last 4 months I accept Mercazolilum 2,5 tab., analysis 4. 16,3 (24), TTG less than 0,1, results of US from 14.02.2005 the right share 2,32,24,8=12,1, left - 2,62,45=15,6, ehostruktura non-uniform, in both shares gipoobrazovanija, diamentr educations in right up to 0,5, in left up to 1,1. US I do or make 2 times a year.

How you consider or count, whether there is a necessity of an operational intervention, or it is possible to continue medicamental lechanie?

Yours faithfully shcnik!

[Melnichenko]

Diffusive or Diffuse toxic struma - disease, absolutely curable on a syndrome tirotoksikoza. Combination DTZ to the site gives the basis for a puncture biopsy of the site, it is necessary to exclude also a functional autonomy of a gland (see tironet for patients).

If two-year-old conservative therapy does not give proof effect, its or her continuation will not raise or increase verotjanost treatment. In this case alternative vraianty - operative treatment or treatment by a radioactive iodine.

[shcnik]

Many thanks for the operative answer

1. Whether if somochustvie horoshoe expediently to do or make punktsionnuju biopsies of the site. Can costs or stands while it will be limited to research of US (2 times a year), with the purpose of observation over nodal educations

Whether the puncture biopsy of the site will cause or call it oslazhneny and where it or her can make is qualified?

2. After operation also it will be necessary to accept tablets constantly

[Melnichenko]

Sense of a puncture biopsy - structure or frame of the site (t.e he consists of what cells) .dlitelnost existence of the site and otsustvie body height do not answer this question. If you plan operation, and it or she will be spent by the reasonable person, the puncture biopsy is desirable, but not critical.

If you plan to continue treatment conservative (I shall remind once again - prospects of a permanent cure do not increase or are not enlarged at absence of proof effect after 2th years of treatment) or plan treatment by a radioactive iodine, and site is (instead of fantatsii US - hundred), this obligatory research.

Once again I shall express hope, that your doctors have spent differential diagnostics between a functional autonomy of a gland and DTZ.

[shcnik]

Once again many thanks for the operative answer.

I wish to set some more questions

1. What would you advise, treatment by a radioiodine or all taki operation? There Is an opinion of our doctors, that treatment by a radioiodine can be insufficiently effective and *quot; all remained ????y*quot; it is necessary to accept tablets in the same quantities or amounts, as now?

2. After treatment as a radioiodine, and after operation it is necessary to accept tablets (*quot; all ????y*quot;)?

3. Where you would advise to spend treatment by a radioiodine most professionally

[shcnik]

Once again many thanks for the operative answer.

I wish to set some more questions

1. What would you advise, treatment by a radioiodine or all taki operation? There Is an opinion of our doctors, that treatment by a radioiodine can be insufficiently effective and *quot; all remained ????y*quot; it is necessary to accept tablets in the same quantities or amounts, as now?

2. After treatment as a radioiodine, and after operation it is necessary to accept tablets (*quot; all ????y*quot;)?

3. Where you would advise to spend treatment by a radioiodine most professionally

[Melnichenko]

1\ there Is an opinion... On what it is based or founded;established? prochtite Tironet for patients. A subject for discussion I do not see

2\ a radioactive iodine vs operation - SITE from what cells?