scholarly journals SAT-478 A Case of Congenital Thyroid Hemi-Agenesis- Caution for Complications!

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Sabah Patel ◽  
Petra Krutilova ◽  
Janice L Gilden
Keyword(s):  
Thyroid Gland ◽  
Hashimoto’S Thyroiditis ◽  
Case Series ◽  
Cervical Lymphadenopathy ◽  
Left Lobe ◽  
Compensatory Hypertrophy ◽  
Hashimoto's Thyroiditis ◽  
Fetal Life ◽  
Free T4 ◽  
Risk Of Malignancy

Abstract Introduction: Congenital Thyroid hemi-agenesis is an uncommon clinical entity. We present a case highlighting the importance of awareness of this condition and the need to evaluate and manage co-existing hypothyroidism and risk of malignancy. Case: A 20 year old female known to have Hashimoto’s thyroiditis (non-adherent to levothyroxine), and hemi-agenesis of left lobe of thyroid gland, presented with right-sided thyroid enlargement. She was clinically euthyroid. Physical exam: enlarged right sided thyroid gland with palpable anterior cervical lymphadenopathy. Left lobe could not be palpated. TFTs were notable for TSH 4.98 uIU/ml (0.358-3.74) and Free T4 0.79 ng/dl (0.76-1.46) consistent with sub-clinical hypothyroidism while Anti TPO antibody was positive at 8332.8 U/mL (0 - 60). CBC negative for leukocytosis. US thyroid: left-sided thyroid agenesis with intact isthmus and enlargement of right lobe of the thyroid 7.7 cm x 1.6 cm x 2.6 cm with 2 sub-centimeter hypoechoic solid nodules and 2 enlarged lymph nodes 1.5 cm and 2.3 cm (not found in US thyroid 2 years ago) Levothyroxine was re-started. ENT evaluation determined that her lymphadenopathy was benign and consistent with Hashimoto’s thyroiditis. Subsequent TFTs improved. Discussion: Thyroid Gland embryogenesis occurs in the 4th week of fetal life. Subsequent abnormal bilobal differentiation of the thyroid gland is presumed to be the etiology of congenital hemi-agenesis. Its prevalence in several studies is estimated to be between 0.05-0.25%. It is symptomatic pre-dominantly in females and may have familial origin with vast majority of cases having left hemi-agenesis with intact isthmus. It is helpful to know that most symptomatic patients have compensatory hypertrophy of the remnant lobe. It is important to remember that compensatory enlargement of the remnant lobe in the setting of hypothyroidism may be a sign of insufficient endogenous thyroxine production and/or replacement. Although rarely symptomatic, hemi-thyroid remnant may need to be evaluated for co-existing hyperthyroidism, hypothyroidism, carcinoma and multinodular goiter among others, with hypothyroidism thought to be the most common. US thyroid is a useful modality to help guide the evaluation of patients with hemi-agenesis. Awareness of this congenital condition is key in preventing unnecessary evaluations and interventions. Non-resolving lymphadenopathy in Hashimoto’s thyroiditis must be evaluated for lymphoma, however, based on studies, no additional risk of malignancy was identified in patients with underlying thyroid hemi-agenesis. References: Y.H. Wu, R.O. Wein, B. Carter Thyroid hemiagenesis: a case series and review of the literature Am J Otolaryngol, 33 (3) (2012), pp. 299-302

Diffuse Large B-cell Lymphoma of thyroid gland in an Adolescent girl with Hashimoto’s thyroiditis

2020 ◽  
Author(s):  
Mara Xatzipsalti ◽  
Evangelos Bourousis ◽  
Maria Nikita ◽  
Myrsini Gkeli ◽  
Evgenia Magkou ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
B Cell ◽  
Hashimoto’S Thyroiditis ◽  
Adolescent Girl ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Hashimoto's Thyroiditis ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals TSH neurosecretory dysfunction (TSH-nd) in Down syndrome (DS): low risk of progression to Hashimoto's thyroiditis

2011 ◽  
Vol 55 (8) ◽  
pp. 628-631 ◽  
Author(s):  
Claudia Dutra Costantin Faria ◽  
Simone Ribeiro ◽  
Cristiane Kochi ◽  
Aryane Pereira Neves da Silva ◽  
Bruna Natalia Freire Ribeiro ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Hashimoto’S Thyroiditis ◽  
Low Risk ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Antibodies ◽  
Free T4 ◽  
Risk Of Progression ◽  
Slight Elevation

INTRODUCTION: Patients with Down syndrome (DS) often have elevated TSH (hypothalamic origin), which is called TSH neurosecretory dysfunction (TSH-nd). In these cases, there is slight elevation in TSH (5-15 µUI/mL), with normal free T4 and negative thyroid antibodies (AB). OBJECTIVE: To recognize the risk of progression to Hashimoto's thyroiditis (HT). SUBJECTS AND METHODS: We retrospectively analyzed 40 DS patients (mean age = 4.5 years), followed up for 6.8 years. RESULTS: HT was diagnosed in 9/40 patients, three early in monitoring, and six during evolution. In 31/40 patients, TSH-nd diagnosis remained unchanged over the years, with maximum TSH values ranging from 5 to 15 µUI/mL. In this group, free T4 also remained normal and AB were negative. There was a significant TSH reduction (p = 0.017), and normal TSH concentrations (< 5.0 µUI/mL) were observed in 29/31 patients, in at least one moment. No patient had TSH > 15 µUI/mL. CONCLUSION: DS patients with TSH-nd present low risk of progression to HT (10% for females and 6% for males).

scholarly journals Papillary Thyroid Carcinoma Arising in Children and Adolescent Hashimoto’s Thyroiditis: Ultrasonographic and Pathologic Findings

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sun Hye Jeong ◽  
Hyun Sook Hong ◽  
Eun Hye Lee ◽  
Jeong Ja Kwak
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Lymph Node Metastases ◽  
Hashimoto’S Thyroiditis ◽  
Extrathyroidal Extension ◽  
Hashimoto's Thyroiditis ◽  
Papillary Thyroid ◽  
Node Metastases

Objectives. We compared the ultrasonography and pathology features of papillary thyroid carcinoma (PTC) in pediatric and adolescents with Hashimoto’s thyroiditis (HT) with those of non-HT patients.Materials and Methods. Eleven patients who were surgically confirmed to have pediatric or adolescent PTC from 2006 to 2014 were included in this study. We retrospectively analyzed the preoperative ultrasonography and pathology features of PTC arising in HT and non-HT patients.Results. On ultrasonography, thyroid gland was lobulated and enlarged, with many scattered microcalcifications in four of five HT patients. Four of six non-HT patients had suspicious masses with calcifications. The diffuse sclerosing variant of PTC (DSVPTC) was found in three of five HT patients, but none in non-HT patients. Macroscopic or microscopic extrathyroidal extension was evident in all of the HT patients and four of the non-HT patients. Neck lymph node metastases were in all HT patients and five of non-HT patients.Conclusions. Three of five PTCs in pediatric and adolescent HT patients were DSVPTC, whereas all PTCs of the non-HT patients were classic type. On ultrasonography, thyroid gland was diffusely enlarged with scattered microcalcifications in four of five HT patients. All five HT cases had aggressive disease, including extrathyroidal extension and cervical lymph node metastases.

scholarly journals THE HISTOLOGICAL CHANGES IN THE THYROID GLAND OF THE RABBIT FOLLOWING LOBECTOMY

1925 ◽  
Vol 42 (2) ◽  
pp. 193-200 ◽  
Author(s):  
J. Hamilton Crawford ◽  
J. N. J. Hartley
Keyword(s):  
Thyroid Gland ◽  
Epithelial Cells ◽  
Left Lobe ◽  
Compensatory Hypertrophy ◽  
The Other ◽  
Histological Changes ◽  
Right Lobe ◽  
Cervical Sympathetic ◽  
The Right

1. In a series of rabbits the changes which took place in the histology of the left lobe of the thyroid gland after excision of the right lobe have been studied at varied intervals of time. 2 days after the removal of one lobe the other lobe showed a slightly increased colloid content, an increased vacuolation of the colloid, and a slight increase in the size of the epithelial cells. At the end of a week the vesicles were greatly increased in size, distended with colloid, and the epithelial cells were flattened, while after 3 to 4 months signs of compensatory hypertrophy were present. 2. The changes observed were uninfluenced by division of the vagus or cervical sympathetic.

scholarly journals Subacute Thyroiditis Associated With Liraglutide

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A957-A957
Author(s):  
Banu Erturk ◽  
Selcuk Dagdelen
Keyword(s):  
Thyroid Gland ◽  
Thyroid Tissue ◽  
Receptor Activation ◽  
Left Lobe ◽  
Subacute Thyroiditis ◽  
Thyroid Function Tests ◽  
Free T4 ◽  
Reactive Protein ◽  
Normal Limits ◽  
The Right

Abstract Objective: Incretins are expressed in thyroid tissue but without clearly-known clinical significance in human. The long-term effect of GLP-1 receptor activation on the thyroid is unknown. In the literature, liragludite-related thyroiditis has not been reported yet and here we wanted to draw attention to this association. Case Summary: A 52-year-old woman with type 2 diabetes mellitus presented with thyroid tenderness, tremor and fever. Her lab results were as follows: undetectable TSH, free T4 (FT4) = 2,4 ng/dl (0.93-1.7), free T3 (FT3) = 4.4 pg/mL (2-4.4). Erythrocyte sedimentation rate (ESR) was 60 mm/hour, C-reactive protein (CRP) was 80 mg/L. Thyroid autoantibodies were negative. USG revealed that thyroid gland was in normal localization and the right lobe was 24x22x46 mm and the left lobe was 20x21x45 mm, isthmus thickness was 5 mm. The parenchyma was heterogeneous, coarsely granular, with bilateral patchy hypoechoic areas. All these findings suggested that the patient had subacute thyroiditis. When we examine the etiological factors of subacute thyroiditis in the patient, there was no history of trauma, no previous viral or bacterial illness, contrast agent exposure. But, she had only been using liraglutide for a week. Firstly liraglutide therapy was ceased and than 20 mg prednisolone and 40 mg beta-blocker therapy was initiated. At the 8 weeks’ of cessation, patient had no symptoms. Also thyroid function tests and other laboratory values were all in normal limits. Conclusions: It has been proven by previous studies that liraglutide has several effects on the thyroid gland. Liraglutide therapy might be related to subacute thyroiditis, as well.

scholarly journals The effects of vitamins and trace minerals on chronic autoimmune thyroiditis

2014 ◽  
Vol 83 (2) ◽  
pp. 167-172
Author(s):  
Małgorzata Włochal ◽  
Marcin A. Kucharski ◽  
Marian Grzymisławski
Keyword(s):  
Thyroid Gland ◽  
Hashimoto’S Thyroiditis ◽  
Essential Element ◽  
Hashimoto Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Chronic Lymphocytic Thyroiditis ◽  
Thyroid Cells ◽  
Thyroglobulin Antibodies ◽  
Chronic Autoimmune Thyroiditis

Hashimoto’s thyroiditis (HT), also known as chronic lymphocytic thyroiditis is one of the most frequent types of inflammation of the thyroid gland. The prevalence of the overt HT is about 2% but it is believed that Hashimoto thyroiditis is more frequent than expected. Hashimoto’s thyroiditis is characterized by dysfunction of the immune system, which leads to impaired tolerance of own tissues and increased production of autoantibodies against the thyroid cells. Thyroid peroxidase antibodies (anti-TPO), thyroglobulin antibodies (anti-Tg) and/or TSH receptors antibodies are the principal markers of the disease. The essential element of the treatment of HT is the supplementation of L-thyroxine. In Hashimoto’s disease, like in many other autoimmune diseases, researchers attempted to support pharmacological treatment by adequate nutrition. The aim of this paper was to review the existing literature on the levels of antioxidants (vitamin A, C, E, selenium, zinc) and vitamin D in patients with HT, as well as the influence of the nutritional supplementation of the above mentioned elements on the metabolism of the thyroid gland hormones and the level of anti-thyroid peroxidase (anti-TPO) antibodies.

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