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Granulomatous Thyroiditis: A Case Report and Literature Review
Darshan P Trivedi1, Ramesh Bhagat2, Yukihiro Nakanishi3
1Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, USA dtrivedi@tulane.edu.
Annals of Clinical and Laboratory Science
|October 26, 2017
Summary
A rare case of Nocardia infection caused granulomatous thyroiditis in a kidney transplant recipient. This highlights the importance of considering infectious causes in immunocompromised patients with thyroid nodules.
Area of Science:
- Endocrinology
- Infectious Diseases
- Transplant Surgery
Background:
- Granulomatous thyroiditis can stem from viral, bacterial, or autoimmune origins.
- Subacute granulomatous thyroiditis, often post-viral, is the most common form.
- Bacterial causes like tuberculosis, actinomycosis, and nocardiosis are rare but documented.
Observation:
- A 45-year-old male kidney transplant recipient presented with neck nodules and muscle pain.
- Thyroid evaluation revealed bilateral nodularity and suppurative granulomatous thyroiditis on fine needle aspiration.
- Histopathology of thyroid lobectomy showed granulomatous inflammation with filamentous microorganisms.
Findings:
- The patient's presentation was consistent with infectious granulomatous thyroiditis.
- Microorganisms resembled Nocardia or Actinomyces, suggesting an infectious etiology.
- The patient had undergone a recent kidney transplant, increasing susceptibility.
Implications:
- Disseminated granulomatous disease in the thyroid is uncommon, particularly in non-immunocompromised individuals.
- This case underscores the potential for Nocardia infection in organ transplant recipients.
- Prompt diagnosis and treatment of Nocardia are crucial in immunocompromised patients presenting with thyroid abnormalities.
