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Hashimoto's thyroiditis presenting as single hot nodule and hypothyroidism
Z Mousavi1, S R Zakavi, N R Farid
1Department of Endocrinology, Ghaem Medical Center, Mashad University of Medical Sciences, Iran.
Journal of Endocrinological Investigation
|August 2, 2002
Summary
Hashimoto's thyroiditis (HT) can present with single hot thyroid nodules, mimicking other conditions. These nodules may regress with thyroid hormone replacement therapy.
Area of Science:
- Endocrinology
- Nuclear Medicine
- Oncology
Background:
- Hashimoto's thyroiditis (HT) is an autoimmune thyroid disease.
- Radionuclide thyroid scans in HT typically show heterogeneous uptake, mimicking various thyroid pathologies.
- Single hot nodules are uncommon in HT, especially in the context of primary hypothyroidism.
Observation:
- Six female patients with HT presented with thyroid failure or neck lumps.
- All patients had single, firm thyroid nodules that were "hot" on both 99mTc pertechnetate and radioiodine scans.
- This presentation is unusual, as patients with thyroid failure and single nodules are typically not scanned.
Findings:
- The association of single hot nodules in patients with HT and primary hypothyroidism was observed.
- In three patients on thyroid replacement therapy for over six months, nodules regressed by up to 60%.
- This suggests a potential therapeutic response to thyroid hormone replacement.
Implications:
- This finding challenges current diagnostic paradigms for thyroid nodules in HT.
- It highlights the importance of considering radionuclide scanning in specific HT presentations.
- Early detection and management may prevent misdiagnosis and improve patient outcomes.