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Thyroid amyloidosis with recurrent subacute thyroiditis-like syndrome.

H Ikenoue1, K Okamura, T Kuroda

  • 1Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

The Journal of Clinical Endocrinology and Metabolism
|July 1, 1988
PubMed
Summary

Systemic amyloidosis can mimic subacute thyroiditis-like syndrome (STLS). Early consideration of thyroid amyloidosis is crucial for patients with atypical STLS presentations, guiding appropriate diagnosis and management.

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Area of Science:

  • Endocrinology
  • Pathology

Background:

  • Subacute thyroiditis-like syndrome (STLS) is a clinical presentation often associated with viral infections.
  • Systemic amyloidosis is a rare condition characterized by the deposition of amyloid proteins in various organs.

Observation:

  • Two male patients presented with STLS symptoms, including tender goiters, low radioactive iodine uptake, and elevated erythrocyte sedimentation rates.
  • These patients exhibited persistent goiters, recurrent STLS exacerbations, localized pain, and systemic abnormalities (gastrointestinal, renal, cardiac).

Findings:

  • Histological examination revealed amyloid deposition in the thyroid glands, not subacute thyroiditis.
  • One patient showed low T3 thyrotoxicosis with impaired peripheral T4 to T3 conversion and Hashimoto's thyroiditis markers.
  • Glucocorticoid therapy provided significant symptom relief.

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Implications:

  • Thyroid amyloidosis should be considered in patients with STLS exhibiting unusual or persistent symptoms.
  • This association highlights the importance of thorough investigation for underlying systemic diseases in thyroid disorders.
  • Recognizing this link can lead to earlier diagnosis and improved patient outcomes for thyroid amyloidosis.