A Case of Painful Hashimoto Thyroiditis that Mimicked Subacute Thyroiditis.

Chonnam Medical Journal
Hye Mi SeoDae Ho Lee

Abstract

Hashimoto thyroiditis (HT) is an autoimmune thyroid disorder that usually presents as a diffuse, nontender goiter, whereas subacute thyroiditis (SAT) is an uncommon disease that is characterized by tender thyroid enlargement, transient thyrotoxicosis, and an elevated erythrocyte sedimentation rate (ESR). Very rarely, patients with HT can present with painful, tender goiter or fever, a mimic of SAT. We report a case of painful HT in a 68-year-old woman who presented with pain and tenderness in a chronic goiter. Her ESR was definitely elevated and her thyroid laboratory tests suggested subclinical hypothyroidism of autoimmune origin. (99m)Tc pertechnetate uptake was markedly decreased. Fine needle aspiration biopsy revealed reactive and polymorphous lymphoid cells and occasional epithelial cells with Hürthle cell changes. Her clinical symptoms showed a dramatic response to glucocorticoid treatment. She became hypothyroid finally and is now on levothyroxine therapy.

References

Feb 1, 1990·The Journal of Clinical Endocrinology and Metabolism·C ShigemasaH Mashiba
Jun 6, 2003·The Journal of Clinical Endocrinology and Metabolism·Yin C Kon, Leslie J DeGroot
Apr 18, 2006·Internal Medicine·Kanji Kasagi
Sep 12, 2006·Cytopathology : Official Journal of the British Society for Clinical Cytology·G KocjanA Herbert
Dec 17, 2008·Thyroid : Official Journal of the American Thyroid Association·Paola L MinciulloSebastiano Gangemi
Dec 3, 2010·Current Opinion in Rheumatology·Yaqiong LiKennichi Kakudo

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Citations

Apr 13, 2020·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Daniel E Myers
Feb 13, 2020·Journal of the Endocrine Society·Carol Chiung-Hui PengKashif M Munir
Sep 29, 2020·AACE Clinical Case Reports·Carol Chiung-Hui PengMajorie A Pennant

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Methods Mentioned

BETA
biopsy
ESR

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