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Reversible hypothyroidism and Whipple's disease
1Hunter Area Pathology Service, John Hunter Hospital, Locked Bag Number 1, Hunter Mail Region Centre, New South Wales, 2310, Australia. huy.tran@hnehealth.nsw.gov.au
BMC Endocrine Disorders
|May 11, 2006
Summary
This case report details a rare instance of reversible hypothyroidism caused by Whipple disease, an infection affecting the thyroid gland. Treatment with antibiotics resolved the hypothyroidism, though thyroid reserve remains diminished.
Area of Science:
- Endocrinology
- Infectious Diseases
- Gastroenterology
Background:
- Autoimmune disorders are the primary cause of hypothyroidism, necessitating lifelong thyroid hormone replacement.
- Reversible hypothyroidism is uncommon, making this case of infection-induced thyroid dysfunction noteworthy.
Purpose of the Study:
- To report the first ante-mortem case of Whipple disease involving the thyroid gland.
- To highlight a rare cause of reversible primary hypothyroidism.
Main Methods:
- A 45-year-old female presented with primary hypothyroidism, unresponsive to standard thyroxine doses.
- Investigations revealed Whipple disease affecting the gastrointestinal tract and potentially the thyroid.
- Thyroid function was monitored during and after antimicrobial therapy for Whipple disease.
Main Results:
- Thyroxine requirements decreased significantly, and hormone levels normalized after antibiotic treatment for Whipple disease.
- Thyrotropin-releasing hormone testing indicated a diminished thyroid reserve despite normalized thyroid function tests.
- This suggests Whipple disease can impact thyroid function and reserve.
Conclusions:
- Whipple disease can cause reversible hypothyroidism, a rare but significant finding.
- Close monitoring of thyroid function is essential even after successful treatment due to potential long-term effects on thyroid reserve.