Case Report
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AĞRILI HASHİMOTO TİROİDİTİ: NADİR BİR OLGU SUNUMU Painful Hashimoto’s Thyroiditis: A Rare Case Report

Year 2016, Volume: 6 Issue: 2, 53 - 57, 19.12.2016

Abstract

Kronik lenfositik tiroidit veya Hashimoto tiroiditi (HT) iyot eksikliğinin olmadığı bölgelerde guatr

ve edinilmiş hipotiroidinin en sık nedeni olan, patogenezinde otoimmünite, genetik yatkınlık ve

çevresel faktörlerin rol oynadığı inflamatuvar bir tiroid hastalığıdır. HT’de boyunda nadiren subakut

granulamatöz tiroiditi (SAT) taklit eder şekilde ağrı ve hassasiyet olabilir. SAT genellikle kendi

kendini sınırlayan bir durum olmasına rağmen semptomların şiddetli olduğu olgular streroid kullanımını

gerektirebilir. SAT’da steroid kullanımı ile birlikte semptomlar kısa sürede azalır. Steroid

tedavisi kesildikten sonra daha yüksek dozlarda tekrarlarlayan steroid tedavisi bazı olgularda nadiren

gerekebilir. Ağrılı HT’de SAT’ın aksine, medikal tedaviye cevap ya geçicidir ya da yoktur ve/

veya tekrarlayan relapslar görülür. Ağrılı HT olgularında medikal tedaviye yanıt alınamadığı durumlarda

tiroidektomi bir seçenek olabilir Bu yazımızda, klinik ve laboratuvar özellikler nedeniyle ilk

olarak SAT tanısıyla takip ettiğimiz, ancak daha sonra medikal tedaviye yanıtsızlık nedeniyle ağrılı

HT olabileceğini düşündüğümüz ve cerrahi önerdiğimiz, patoloji sonucu HT ve mikropapiller tiroid

karsinomu ile uyumlu olan nadir bir olguyu sunmayı amaçladık.



ABSTRACT

Chronic lymphocytic thyroiditis, or Hashimoto’s thyroiditis (HT) is an inflammatory thyroid disease

which is the most common cause of goiter and acquired hypothyroidism in iodine sufficient areas

that autoimmunity, genetic predisposition and environmental factors play role in pathogenesis.

Thyroid pain and tenderness may rarely be present in HT mimicking subacute granulamatous

thyroiditis (SAT). Although SAT is a selflimiting condition, cases with severe symptoms may

necessitate use of steroids. Symptoms reduce in a short time with use of steroids in SAT. Higher

and repeated doses of steroids may be rarely necessary in some cases after stopping steroids. In

contrary to SAT, patients with painful HT have only temporary or no response to medical treatment

and/or show repeated relapses. Thyroidectomy may be an option in painful HT cases that do not

response to treatment.

In this article, we aimed to present a rare case of micropapillary thyroid cancer with coexistence

of HT who was suggested surgery after compatible pathology findings which was first followed for

the diagnosis of SAT after clinical and laboratory findings, while it was assumed to be a case with

painful HT because of the unresponsiveness to medical therapy.

References

  • 1. Zimmerman RS, Brennan MD, McConahey WM, Goellner JR, Gharib H. Hashimoto’s thyroiditis. An uncommon cause of painful thyroid unresponsive to corticosteroid therap. Annals of Internal Medicine. 1986;104(3):355–57.
  • 2. Ohye H, Fukata S, Kubota S, Sasaki I, Takamura Y, Matsuzuka F, et al. Successful treatment for recurrent painful Hashimoto’s thyroiditis by total thyroidectomy. Thyroid. 2005;15(4):340–45.
  • 3. Kon YC, DeGroot LJ. Painful Hashimoto’s thyroiditi as an indication for thyroidectomy: clinical characteristics and outcome in seven patients. Journal of Clinical Endocrinology and Metabolism. 2003;88(6): 2667–72.
  • 4. Choia YS, Kim BK, Kwon HJ, Lee JS, Heo JJ, Jung SB, et al. Subacute thyroiditis with coexisting papillary carcinoma diagnosed by immediately repeat fine needle aspiration: a case report. J Med Cases. 2012;3(5):308-11.
  • 5. Ucan B, Delibasi T, Arslan MS, Bozkurt NC, Demirci T, Ozbek M, et al. Papillary thyroid cancer case masked by subacute thyroiditis. Arq Bras Endocrinol Metabol. 2014;58(8):851-4.
  • 6. Valentini RB, Macedo BM, Izquierdo RF, Meyer EL. Painless thyroiditis associated to thyroid carcinoma: role of initial ultrasonography evaluation. Arch Endocrinol Metab. 2015;1(1):1-6.
  • 7. Shigemasa C, Ueta Y, Mitani Y, Taniguchi S, Urabe K, Tanaka T, et al. Chronic thyroiditis with painful tender thyroid enlargement and transient thyrotoxicosis. Journal of Clinical Endocrinology and Metabolism. 1990;70(2):385–90.
  • 8. Mazza E, Quaglino F, Suriani A, Palestini N, Gottero C, Leli R, et al. Thyroidectomy for Painful Thyroiditis Resistant to Steroid Treatment: Three New Cases with Review of the Literature. Case Rep Endocrinol. 2015;2015. http://dx.doi.org/10.1155/2015/138327.
  • 9. Seo HM, Kim M, Bae J, Kim JH, Lee JW, Lee SA, et al. A Case of Painful Hashimoto Thyroiditis that Mimicked Subacute Thyroiditis. Chonnam Med J. 2012;48(1):69-72.
  • 10. Kim HK, Shin HJ, Kang HC. A case of painful hashimoto’s thyroiditis successfully treated with total thyroidectomy. J Korean Endocr Soc. 2008;23(6):438-43.
Year 2016, Volume: 6 Issue: 2, 53 - 57, 19.12.2016

Abstract

References

  • 1. Zimmerman RS, Brennan MD, McConahey WM, Goellner JR, Gharib H. Hashimoto’s thyroiditis. An uncommon cause of painful thyroid unresponsive to corticosteroid therap. Annals of Internal Medicine. 1986;104(3):355–57.
  • 2. Ohye H, Fukata S, Kubota S, Sasaki I, Takamura Y, Matsuzuka F, et al. Successful treatment for recurrent painful Hashimoto’s thyroiditis by total thyroidectomy. Thyroid. 2005;15(4):340–45.
  • 3. Kon YC, DeGroot LJ. Painful Hashimoto’s thyroiditi as an indication for thyroidectomy: clinical characteristics and outcome in seven patients. Journal of Clinical Endocrinology and Metabolism. 2003;88(6): 2667–72.
  • 4. Choia YS, Kim BK, Kwon HJ, Lee JS, Heo JJ, Jung SB, et al. Subacute thyroiditis with coexisting papillary carcinoma diagnosed by immediately repeat fine needle aspiration: a case report. J Med Cases. 2012;3(5):308-11.
  • 5. Ucan B, Delibasi T, Arslan MS, Bozkurt NC, Demirci T, Ozbek M, et al. Papillary thyroid cancer case masked by subacute thyroiditis. Arq Bras Endocrinol Metabol. 2014;58(8):851-4.
  • 6. Valentini RB, Macedo BM, Izquierdo RF, Meyer EL. Painless thyroiditis associated to thyroid carcinoma: role of initial ultrasonography evaluation. Arch Endocrinol Metab. 2015;1(1):1-6.
  • 7. Shigemasa C, Ueta Y, Mitani Y, Taniguchi S, Urabe K, Tanaka T, et al. Chronic thyroiditis with painful tender thyroid enlargement and transient thyrotoxicosis. Journal of Clinical Endocrinology and Metabolism. 1990;70(2):385–90.
  • 8. Mazza E, Quaglino F, Suriani A, Palestini N, Gottero C, Leli R, et al. Thyroidectomy for Painful Thyroiditis Resistant to Steroid Treatment: Three New Cases with Review of the Literature. Case Rep Endocrinol. 2015;2015. http://dx.doi.org/10.1155/2015/138327.
  • 9. Seo HM, Kim M, Bae J, Kim JH, Lee JW, Lee SA, et al. A Case of Painful Hashimoto Thyroiditis that Mimicked Subacute Thyroiditis. Chonnam Med J. 2012;48(1):69-72.
  • 10. Kim HK, Shin HJ, Kang HC. A case of painful hashimoto’s thyroiditis successfully treated with total thyroidectomy. J Korean Endocr Soc. 2008;23(6):438-43.
There are 10 citations in total.

Details

Subjects Health Care Administration
Journal Section Case Report
Authors

Ziynet Alphan Üç This is me

Esra Ademoğlu This is me

Publication Date December 19, 2016
Published in Issue Year 2016 Volume: 6 Issue: 2

Cite

APA Alphan Üç, Z., & Ademoğlu, E. (2016). AĞRILI HASHİMOTO TİROİDİTİ: NADİR BİR OLGU SUNUMU Painful Hashimoto’s Thyroiditis: A Rare Case Report. Bozok Tıp Dergisi, 6(2), 53-57.
AMA Alphan Üç Z, Ademoğlu E. AĞRILI HASHİMOTO TİROİDİTİ: NADİR BİR OLGU SUNUMU Painful Hashimoto’s Thyroiditis: A Rare Case Report. Bozok Tıp Dergisi. December 2016;6(2):53-57.
Chicago Alphan Üç, Ziynet, and Esra Ademoğlu. “AĞRILI HASHİMOTO TİROİDİTİ: NADİR BİR OLGU SUNUMU Painful Hashimoto’s Thyroiditis: A Rare Case Report”. Bozok Tıp Dergisi 6, no. 2 (December 2016): 53-57.
EndNote Alphan Üç Z, Ademoğlu E (December 1, 2016) AĞRILI HASHİMOTO TİROİDİTİ: NADİR BİR OLGU SUNUMU Painful Hashimoto’s Thyroiditis: A Rare Case Report. Bozok Tıp Dergisi 6 2 53–57.
IEEE Z. Alphan Üç and E. Ademoğlu, “AĞRILI HASHİMOTO TİROİDİTİ: NADİR BİR OLGU SUNUMU Painful Hashimoto’s Thyroiditis: A Rare Case Report”, Bozok Tıp Dergisi, vol. 6, no. 2, pp. 53–57, 2016.
ISNAD Alphan Üç, Ziynet - Ademoğlu, Esra. “AĞRILI HASHİMOTO TİROİDİTİ: NADİR BİR OLGU SUNUMU Painful Hashimoto’s Thyroiditis: A Rare Case Report”. Bozok Tıp Dergisi 6/2 (December 2016), 53-57.
JAMA Alphan Üç Z, Ademoğlu E. AĞRILI HASHİMOTO TİROİDİTİ: NADİR BİR OLGU SUNUMU Painful Hashimoto’s Thyroiditis: A Rare Case Report. Bozok Tıp Dergisi. 2016;6:53–57.
MLA Alphan Üç, Ziynet and Esra Ademoğlu. “AĞRILI HASHİMOTO TİROİDİTİ: NADİR BİR OLGU SUNUMU Painful Hashimoto’s Thyroiditis: A Rare Case Report”. Bozok Tıp Dergisi, vol. 6, no. 2, 2016, pp. 53-57.
Vancouver Alphan Üç Z, Ademoğlu E. AĞRILI HASHİMOTO TİROİDİTİ: NADİR BİR OLGU SUNUMU Painful Hashimoto’s Thyroiditis: A Rare Case Report. Bozok Tıp Dergisi. 2016;6(2):53-7.
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