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Acute pericarditis, Graves' disease, and thymic hyperplasia: a case report
Mauro Acquaro1, Federico Breviario1, Alessandra Greco1
1Divisione di Cardiologia, Fondazione IRCCS San Matteo Hospital, Viale Golgi 19, 27100 Pavia, Italy.
Acute pericarditis can signal a mediastinal mass. Cardiac MRI is crucial for diagnosing thymic hyperplasia, especially with Graves' disease, even if initial CT scans are inconclusive.
Area of Science:
- Cardiology
- Endocrinology
- Thoracic Surgery
Background:
- Acute pericarditis is rarely a symptom of a mediastinal mass, making etiological diagnosis difficult without advanced imaging.
- Graves' disease, an autoimmune thyroid condition, can present with atypical symptoms.
Observation:
- An 18-year-old woman with Graves' disease presented with acute pericarditis symptoms.
- Initial workup, including echocardiography and chest CT, was inconclusive for a mediastinal mass.
- Thyroid function tests revealed suppressed thyroid-stimulating hormone, indicating thyrotoxicosis.
Findings:
- Cardiac magnetic resonance (MR) imaging identified an upper mediastinal mass.
- Histological analysis after surgical biopsy confirmed thymic hyperplasia.
Implications:
- This case highlights the importance of suspecting thymic hyperplasia in patients with acute pericarditis and Graves' disease.
- Cardiac MR imaging is essential for diagnosis when chest CT findings are equivocal.
- Prompt diagnosis and management of thymic hyperplasia are critical in such cases.
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