格雷夫斯甲状腺毒症合并结节病的不寻常临床病程：病例报告及文献复习
Unusual clinical course of Graves' thyrotoxicosis and concomitant sarcoidosis: case report and review of literature.
作者信息
Rodriguez Monica C, Rani Dolly, Faas Fred H
机构信息
Department of Medicine, Division of Endocrinology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
出版信息
Endocr Pract. 2007 Mar-Apr;13(2):159-63. doi: 10.4158/EP.13.2.159.
OBJECTIVE
To report a case of Graves' disease with concomitant sarcoidosis involving the thyroid gland.
METHODS
We present the clinical, laboratory, imaging, and pathologic findings and describe the clinical course of a patient with Graves' disease and sarcoidosis, who was unresponsive to propylthiouracil and radioiodine treatment.
RESULTS
A 23-year-old woman presented with thyrotoxicosis and a large goiter. Laboratory studies and findings on thyroid uptake and scan were consistent with Graves' disease. She was also found to have hilar lymphadenopathy and hepatosplenomegaly. Despite treatment with antithyroid drugs and radioiodine therapy, her hyperthyroidism persisted. Surgical resection of the thyroid gland and 2 lymph nodes disclosed noncaseating granulomas, consistent with sarcoid.
CONCLUSION
Autoimmune endocrinopathies and, less commonly, thyroid autoimmune disease have been reported in patients with sarcoidosis. Similarities exist in the pathogenesis of these two conditions. Concomitant sarcoidosis in the thyroid gland in patients with Graves' disease may contribute to the resistance to antithyroid drugs and radioiodine therapy.
目的
报告1例伴有结节病累及甲状腺的格雷夫斯病病例。
方法
我们展示了1例格雷夫斯病合并结节病患者的临床、实验室、影像学及病理检查结果，并描述了其临床病程，该患者对丙硫氧嘧啶和放射性碘治疗无效。
结果
一名23岁女性出现甲状腺毒症和巨大甲状腺肿。实验室检查以及甲状腺摄取和扫描结果符合格雷夫斯病。她还被发现有肺门淋巴结病和肝脾肿大。尽管接受了抗甲状腺药物和放射性碘治疗，其甲状腺功能亢进仍持续存在。甲状腺及2个淋巴结的手术切除显示非干酪样肉芽肿，符合结节病表现。
结论
结节病患者中曾有自身免疫性内分泌病的报道，甲状腺自身免疫性疾病则较少见。这两种疾病在发病机制上存在相似之处。格雷夫斯病患者甲状腺合并结节病可能导致对抗甲状腺药物和放射性碘治疗产生抵抗。
Zotero 插件