{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T12:31:45Z","timestamp":1748435505197,"version":"3.33.0"},"reference-count":9,"publisher":"Grigore T. Popa University of Medicine and Pharmacy","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Clin Cases"],"published-print":{"date-parts":[[2024,12,31]]},"abstract":"<jats:p>A 38-year-old male patient was admitted to the Medical Intensive Care Unit during the second wave of the coronavirus disease (COVID-19) pandemic presenting with fever, headache, muscle pain, and cough. The low-dose chest computed tomography (CT) result was normal, but an increased serum level of procalcitonin (PCT) was detected. Due to COVID-19, pronounced symptoms, and increased inflammatory markers, empiric antibiotic therapy was started. PCT level remained elevated despite 7 days of antimicrobial treatment. Hence, the diagnostic evaluation of the patient was expanded, and we identified medullary thyroid microcarcinoma. After diagnosis, a total thyroidectomy with cervical lymph node resection was performed, and the patient was discharged with oral levothyroxine. Control measurements of serum calcitonin and 18F-fluorodihydroxyphenylalanine positron emission tomography (18F-PET\/CT) showed cervical and mediastinal lymph node metastases. Beside surgical treatment, the patient was not motivated for any adjuvant therapy and no new lesions were detected on control PET\/CT two years after. In conclusion, clinicians should also consider malignancies such as medullary thyroid carcinoma as a potential cause of increased PCT levels, and as a next step should measure serum calcitonin level and perform neck ultrasound.<\/jats:p>","DOI":"10.22551\/2024.45.1104.10297","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T07:39:23Z","timestamp":1737445163000},"page":"98-101","source":"Crossref","is-referenced-by-count":2,"title":["Incidental diagnosis of medullary thyroid microcarcinoma in COVID-19 patient with elevated procalcitonin levels"],"prefix":"10.22551","volume":"11","author":[{"name":"Medical Intensive Care Unit, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3814-4635","authenticated-orcid":false,"given":"Milka","family":"Jandric","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biljana","family":"Zlojutro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Medical Intensive Care Unit, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Drago\u0219","family":"Cre\u021boiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Medical Intensive Care Unit, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"9837","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"doi-asserted-by":"publisher","unstructured":"\"[1] Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet. 1993 Feb 27;341(8844):515-8. doi: 10.1016\/0140-6736(93)90277-n. PMID: 8094770; PMCID: PMC7141580.","key":"ref0","DOI":"10.1016\/0140-6736(93)90277-N"},{"doi-asserted-by":"publisher","unstructured":"[2] Vijayan AL, Vanimaya, Ravindran S, et al. Procalcitonin: a promising diagnostic marker for sepsis and antibiotic therapy. J Intensive Care. 2017 Aug 3;5:51. doi: 10.1186\/s40560-017-0246-8. PMID: 28794881; PMCID: PMC5543591.","key":"ref1","DOI":"10.1186\/s40560-017-0246-8"},{"doi-asserted-by":"publisher","unstructured":"[3] Durna\u015b B, W\u0105tek M, Wollny T, et al. Utility of blood procalcitonin concentration in the management of cancer patients with infections. Onco Targets Ther. 2016 Jan 22;9:469-75. doi: 10.2147\/OTT.S95600. PMID: 26858528; PMCID: PMC4731001.","key":"ref2","DOI":"10.2147\/OTT.S95600"},{"doi-asserted-by":"publisher","unstructured":"[4] Reinhart K, Karzai W, Meisner M. Procalcitonin as a marker of the systemic inflammatory response to infection. Intensive Care Med. 2000 Sep;26(9):1193-200. doi: 10.1007\/s001340000624. PMID: 11089742; PMCID: PMC7095266.","key":"ref3","DOI":"10.1007\/s001340000624"},{"doi-asserted-by":"publisher","unstructured":"[5] Kim M, Kim BH. Current Guidelines for Management of Medullary Thyroid Carcinoma. Endocrinol Metab (Seoul). 2021 Jun;36(3):514-524. doi: 10.3803\/EnM.2021.1082. PMID: 34154310; PMCID: PMC8258323.","key":"ref4","DOI":"10.3803\/EnM.2021.1082"},{"doi-asserted-by":"publisher","unstructured":"[6] Bae YJ, Schaab M, Kratzsch J. Calcitonin as Biomarker for the Medullary Thyroid Carcinoma. Recent Results Cancer Res. 2015;204:117-37. doi: 10.1007\/978-3-319-22542-5_5. PMID: 26494386.","key":"ref5","DOI":"10.1007\/978-3-319-22542-5_5"},{"doi-asserted-by":"publisher","unstructured":"[7] Kushchayev SV, Kushchayeva YS, Tella SH, Glushko T, Pacak K, Teytelboym OM. Medullary Thyroid Carcinoma: An Update on Imaging. J Thyroid Res. 2019 Jul 7;2019:1893047. doi: 10.1155\/2019\/1893047. PMID: 31360432; PMCID: PMC6642782.","key":"ref6","DOI":"10.1155\/2019\/1893047"},{"doi-asserted-by":"publisher","unstructured":"[8] Thomas CM, Asa SL, Ezzat S, Sawka AM, Goldstein D. Diagnosis and pathologic characteristics of medullary thyroid carcinoma-review of current guidelines. Curr Oncol. 2019 Oct;26(5):338-344. doi: 10.3747\/co.26.5539. PMID: 31708652; PMCID: PMC6821118.","key":"ref7","DOI":"10.3747\/co.26.5539"},{"doi-asserted-by":"publisher","unstructured":"[9] Jayasinghe R, Basnayake O, Jayarajah U, Seneviratne S. Management of medullary carcinoma of the thyroid: a review. J Int Med Res. 2022 Jul;50(7):3000605221110698. doi: 10.1177\/03000605221110698. PMID: 35822284; PMCID: PMC9284230.\"","key":"ref8","DOI":"10.1177\/03000605221110698"}],"container-title":["Archive of Clinical Cases"],"original-title":[],"deposited":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T06:55:30Z","timestamp":1737615330000},"score":1,"resource":{"primary":{"URL":"https:\/\/clinicalcases.eu\/index.php\/acc\/article\/view\/1092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,31]]},"references-count":9,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,12,15]]}},"URL":"https:\/\/doi.org\/10.22551\/2024.45.1104.10297","relation":{},"ISSN":["2360-6975","2360-6975"],"issn-type":[{"type":"print","value":"2360-6975"},{"type":"electronic","value":"2360-6975"}],"subject":[],"published":{"date-parts":[[2024,12,31]]}}}