结节病合并格雷夫斯病。
Concomitant association of thyroid sarcoidosis and Graves' disease.
作者信息
Yarman S, Kahraman H, Tanakol R, Kapran Y
机构信息
Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Turkey.
出版信息
Horm Res. 2003;59(1):43-6. doi: 10.1159/000067937.
OBJECTIVE
Graves' disease (GD) with sarcoid involvement of the thyroid gland has rarely been reported.
METHOD
We report a case of GD with thyroid sarcoidosis in a 28-year-old woman. Thyroid function was assessed by triiodothyronine (T(3)), thyroxine (T(4)), thyroid-stimulating hormone (TSH) and TSH receptor antibodies (TSH-R Ab). Thyroid scintigraphy, ultrasound and fine-needle aspiration biopsy were performed. The patient underwent surgery.
RESULT
The patient had a nodular goiter. Serum T(3), T(4) and TSH-R Ab levels were elevated with suppressed TSH level. Scintigraphy showed diffuse activity as seen in GD, and ultrasound revealed that parenchyma was heterogenous. Sarcoidosis was discovered on routine chest X-ray. Although no sarcoid involvement was found on specimen, the thyroid gland showed non-caseating granulomas on histology.
CONCLUSION
Since sarcoid involvement of the thyroid gland can cause hypofunction, we report the uncommon infiltration of sarcoidosis with hyperthyroidism.
目的
甲状腺结节病合并格雷夫斯病（GD）的病例鲜有报道。
方法
我们报告一例28岁女性甲状腺结节病合并GD的病例。通过三碘甲状腺原氨酸（T(3)）、甲状腺素（T(4)）、促甲状腺激素（TSH）和促甲状腺激素受体抗体（TSH-R Ab）评估甲状腺功能。进行了甲状腺闪烁扫描、超声检查和细针穿刺活检。患者接受了手术。
结果
患者患有结节性甲状腺肿。血清T(3)、T(4)和TSH-R Ab水平升高，TSH水平降低。闪烁扫描显示出与GD中所见的弥漫性活性，超声显示实质不均匀。在常规胸部X线检查中发现结节病。尽管在标本上未发现结节病累及，但甲状腺在组织学上显示为非干酪样肉芽肿。
结论
由于甲状腺结节病可导致功能减退，我们报告了结节病合并甲状腺功能亢进这种罕见的浸润情况。
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