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Concomitant association of thyroid sarcoidosis and Graves' disease
S Yarman1, H Kahraman, R Tanakol
1Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Turkey. esyarman@hotmail.com
Objective:
Graves' disease (GD) with sarcoid involvement of the thyroid gland has rarely been reported.
Method:
We report a case of GD with thyroid sarcoidosis in a 28-year-old woman. Thyroid function was assessed by triiodothyronine (T(3)), thyroxine (T(4)), thyroid-stimulating hormone (TSH) and TSH receptor antibodies (TSH-R Ab). Thyroid scintigraphy, ultrasound and fine-needle aspiration biopsy were performed. The patient underwent surgery.
Result:
The patient had a nodular goiter. Serum T(3), T(4) and TSH-R Ab levels were elevated with suppressed TSH level. Scintigraphy showed diffuse activity as seen in GD, and ultrasound revealed that parenchyma was heterogenous. Sarcoidosis was discovered on routine chest X-ray. Although no sarcoid involvement was found on specimen, the thyroid gland showed non-caseating granulomas on histology.
Conclusion:
Since sarcoid involvement of the thyroid gland can cause hypofunction, we report the uncommon infiltration of sarcoidosis with hyperthyroidism.