Nakae T, Kawanaka M, Suehiro M, Sugita M, Fukuchi M
Department of Nuclear Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Ann Nucl Med. 1999 Dec;13(6):433-5. doi: 10.1007/BF03164940.
A case of Plummer's disease that spontaneously progressed to hypothyroidism is presented. A 49-year-old female visited our hospital because of a 3 kg decrease in body weight during the previous month and a painless nodule in the right anterior area of her neck. A diagnosis of Plummer's disease was made based on the results of thyroid function tests, thyroid scintigrams, and an ultrasonogram, but the patient's disease followed an usual clinical course. About two months later, she gradually developed manifestations of permanent hypothyroidism, and anti-thyroid autoantibodies became positive. In spite of continuous administration of levothyroxine sodium, uptake of 99mTcO4- to the nodule was unchanged or rather increased according to the consecutive thyroid scintigraphies. These results suggested that this case represented an autonomously functioning nodule with underlying silent thyroiditis and Hashimoto's disease.
本文报告一例自发性进展为甲状腺功能减退症的普卢默病病例。一名49岁女性因前一个月体重减轻3kg以及颈部右前区出现无痛性结节前来我院就诊。根据甲状腺功能检查、甲状腺闪烁扫描和超声检查结果诊断为普卢默病，但该患者的病情遵循了不寻常的临床病程。大约两个月后，她逐渐出现永久性甲状腺功能减退的表现，抗甲状腺自身抗体呈阳性。尽管持续服用左甲状腺素钠，但根据连续的甲状腺闪烁扫描，结节对99mTcO4-的摄取未发生变化，甚至有所增加。这些结果提示该病例代表一个自主功能性结节，同时伴有潜在的寂静性甲状腺炎和桥本氏病。
