After raising a cat, the goddess doctor became popular in the interstellar

Chapter 285 Hypothyroidism
As soon as the patient came in, Tao Le could see the difference in her.

This is a girl who is only six or seven years old in terms of height and appearance, and her mental health is fair. There is only a lump with a diameter of about 2 cm on her chin.

There may be anything in the lump growing in this position.

Thyroglossal duct cyst, submental chronic lymphadenitis and lymphatic tuberculosis, thyroid adenoma, parotid cyst, thyroid cone, cystic hydroma, lipoma, sebaceous cyst, sublingual cyst, parathyroid cyst, etc.

What is specific, but also based on clinical examination to make identification.

Accompanying the girl was a woman in her 60s who claimed to be her grandmother.

"The lump on Xiao Meixin's chin appeared more than two months ago. It was as big as a date pit at the beginning. It didn't hurt or itch. It didn't affect anything. We didn't take it seriously."

"Then it grew bigger and bigger, and my husband was a little worried, so I asked her to take a look."

"We went to the Children's Hospital. When they saw it, they asked us to have a checkup. They said it was because of the low T4, and they didn't prescribe any medicine. They told us to eat more iodine-containing food when we came back."

"As a result, after eating, the thing didn't get smaller at all, but it got bigger than before."

While talking with a sad face, grandma took out the examination papers from the children's hospital.

Nie Yuan looked at them one by one, and handed them to Tao Le.

Tao Le took over the checklist of the five items of Jia Gong, and glanced over it. T4 was low, only 3.20ug/dl, and TSH was high, 7.0mu/L.

T4, also known as total thyroxine, refers to the hormone secreted by the thyroid gland, and TSH is a hormone that specifically regulates the synthesis and secretion of thyroid hormone.

The former is low and the latter is high, indicating hypothyroidism in children, which is commonly known as "hypothyroidism".

In addition to indicators, there is another thing that caught Tao Le's attention.

On the top of the checklist, the child's age is clearly written: nine years old.

Tao Le had worked in the Children's Health Department and knew exactly the developmental standards of a nine-year-old girl.

The girl in front of me is only 1.1 meters tall, which is not tall among six or seven-year-old girls. She doesn't look like she is nine years old.

She just glanced at the registration information registered on the system, well, this child is really over nine years old.

This is clearly a developmental delay.Short-term hypothyroidism due to insufficient iodine intake should not cause such severe developmental delay.unless. ． ． ． ． ．

Nie Yuan naturally thought of the question she thought of.He signaled Tao Le to do a physical examination for the child.

The child's body temperature was normal, his mind was clear, and his breathing was steady.The heart rate was 80 beats/min, the blood pressure was 89/54mmHG, and there were no rashes and bleeding spots all over the body.

She lightly touched the lump under her neck with her hands. It was hard and smooth, and she couldn't push it.

"Make a swallowing motion." Tao Le said gently.

The girl was very obedient and immediately followed suit, and the lump moved up and down as she swallowed.

In addition, the child's lung sounds were clear without rales, the heart rhythm was regular and strong, and there was no precordial murmur.The abdomen is flat and soft, the whole abdomen has no tenderness, the limbs can move freely, the limbs are slightly warm, and the muscle strength is normal.

When she was doing the examination, the grandmother of the child was always very nervous. Seeing her stop now, she couldn't help asking:

"Doctor, look at this thing, it can't be a tumor, right?"

For a while now, the couple have been very worried about their granddaughter's health, and all kinds of worries are the worst kind.

Tao Le didn't respond.There was Deputy Director Nie, and it was not her turn to speak.

"Family, don't worry." Nie Yuan's voice was low and steady, which made people feel at ease.

Tao Le was a little envious.The deep and magnetic voice is the exclusive property of male doctors, even if she lowers her voice, she still can't achieve this effect.

I only heard Nie Yuan continue to say: "What kind of disease is it? We still need to do a comprehensive examination to rule out some other diseases, and then study it."

Having said that, he looked up at his grandmother, with a smile on his face: "However, the possibility of developing a tumor in this part is very small."

As soon as this sentence was said, the grandmother immediately relaxed a lot, and the girl also had a smile on her face.

A nine-year-old girl is already very sensible, and this lump seems to have caused her a lot of trouble.

Tao Le's heart softened.That's why, Deputy Director Nie has been displeased with her all the time, and she sticks to her with full enthusiasm.

Because from the observations in the past few days, she has already discovered that although Deputy Director Nie is harsh on her and stern, he does not hesitate to smile and speak comforting words to patients and their families.

It's just that this kind of warmth is usually wrapped in a cold shell, so I can't see it easily.

Tao Le already had some guesses in his mind.This girl is probably congenital hypothyroidism.

There are many reasons for congenital hypothyroidism, such as underdeveloped or underdeveloped thyroid in children, insufficient iodine intake of mothers during pregnancy, and the presence of immunoglobulins that inhibit the growth of thyroid cells in the body.

In addition, insufficient secretion of pituitary hormones, thyroid hormone synthesis disorders, etc., may cause the symptoms of the children in front of them.

But if you add that lump. ． ． ． ．There are very few possibilities left.

Tao Le waited for Nie Yuan to issue the checklist to make exclusions and judgments, but he sat still and chatted with the grandmother:

"How does your child sleep and eat?"

"This child is easy to feed. He hasn't been picky about food since he was a child. He can eat anything and eat a lot." Grandma said, "It's the same with sleeping. Once it's dawn, it never gets up at night."

"I'm nine years old, and I'm in the third grade, can I keep up with my studies?"

Mentioning this, grandma immediately cheered up: "It's the third grade."

"Her parents have gone out of town since they gave birth to her, and left the child to our old couple." She gushed:

"But she is sensible, and never let us worry about it. She can finish her homework at school, and she can help with housework, self-study, and reading at home. The old Wang's next door is so envious of us! That brat in his family, one day If you don't fight, you will go to the house to uncover the tiles..."

Seeing that her topic was off topic, Tao Le hurriedly pulled it back: "How's the grade?"

She roughly understood what Nie Yuan meant.Delayed physical development is often accompanied by mental retardation.

No matter how hard you try to be sensible, it will also fall on the grades.

"The grades are pretty good! The class doesn't pay much attention to grades now, but the major and minor exams are all 97 and [-] points. The teachers like her!"

That is, there is no problem with intelligence.

After getting the answer he wanted, Nie Yuan issued a series of checklists.

Tao Le noticed that in addition to the regular five-item thyroid function and color Doppler ultrasound for superficial tumors, static ECT imaging of the thyroid gland and MRI of the pituitary gland were prescribed.

The grandmother took the girl out to pay for the examination.But within a few minutes, they were back again.

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(End of this chapter)