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Hashimoto's thyroiditis: an accidental discovery of a lingual thyroid in a 7-year-old child

Michela Mariani1, Alessandra Palpacelli, Annalisa Mussoni

  • 1Department of Paediatrics, Catholic University, Rome, Italy.

BMJ Case Reports
|August 23, 2013
PubMed

Insights

A rare lingual thyroid in a child with Hashimoto's thyroiditis was successfully treated with L-thyroxine, resolving subclinical hypothyroidism and cough. Treatment also led to a significant reduction in the size of the ectopic thyroid tissue.

Area of Science:

  • Endocrinology
  • Developmental Biology
  • Pediatrics

Background:

  • Ectopic thyroid, specifically lingual thyroid, arises from developmental defects during thyroid gland embryogenesis.
  • It is a primary cause of congenital hypothyroidism, though symptoms may manifest later in childhood.
  • Lingual thyroid can present with respiratory obstruction or feeding difficulties.

Observation:

  • A 7-year-old girl presented with subclinical hypothyroidism and Hashimoto's thyroiditis within a lingual thyroid.
  • Her primary symptom was a 3-month history of cough, without prior upper airway obstruction.
  • She had never experienced respiratory distress or feeding issues related to the lingual thyroid.

Findings:

  • L-thyroxine treatment rapidly normalized thyroid-stimulating hormone levels.
  • The patient's cough resolved shortly after initiating L-thyroxine therapy.
  • A significant reduction in lingual thyroid size was observed after 6 months of treatment.

Implications:

  • This case highlights the importance of considering ectopic thyroid in pediatric hypothyroidism, even with atypical presentations like cough.
  • Early diagnosis and L-thyroxine treatment are effective in managing lingual thyroid associated hypothyroidism and associated symptoms.
  • Therapeutic interventions can lead to both biochemical normalization and significant reduction in ectopic thyroid tissue size.

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