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[小儿急性化脓性甲状腺炎的非典型形式:病例报告]

[Atypical form of acute suppurative thyroiditis in pediatric patient: case report].

作者信息

Torres Maria Rosineide Dos S, Medeiros Carla C M, Nóbrega Neto Sebastião Horácio, Souza Lincoln S, Rodrigues Mônica L C, Silva Maria Nelice M, Maior Lyzandra de H C S, Avelino Márcia C, Mourão Germana T F

机构信息

Departamento de Endocrinologia, Faculdade de Ciências Médicas, Universidade Federal de Campina Grande, PB, Brasil.

出版信息

Arq Bras Endocrinol Metabol. 2008 Jun;52(4):701-6. doi: 10.1590/s0004-27302008000400018.

Abstract

Acute thyroiditis is an unusual disease. In pediatric patients it is usually associated with congenital abnormalities towards the unilateral envelopment of the left thyroid lobe. In general, in the absence of preexisting thyroid disease, the thyroid function is most often normal. It is here described a case of a six-year-old girl who had presented a mass with flogistic signs in the anterior neck region for fifteen days, together with leukocytosis and increased levels of VSH and TSH. There was no evidence of previous thyroid disease and the cervical ultrasonography suggested thyroid abscess. Intravenous antibiotic and surgical drainage were done with a good response, however, the patient developed clinical hypothyroidism afterwards. Barium swallow did not demonstrate pyriform sinus fistula and the follow-up ultrasonography revealed heterogeneous internal texture suggesting Hashimoto's thyroiditis. The relevance of this case is due to its unusual findings: the absence of congenital abnormalities, bilateral envelopment of thyroid lobes, hypothyroidism and a probable Hashimoto's thyroiditis as a predisposing factor for acute thyroiditis.

摘要

急性甲状腺炎是一种罕见疾病。在儿科患者中,它通常与左侧甲状腺叶单侧包绕的先天性异常有关。一般来说,在没有既往甲状腺疾病的情况下,甲状腺功能大多正常。本文描述了一例6岁女孩的病例,该女孩在前颈部区域出现伴有炎症体征的肿块15天,同时伴有白细胞增多以及VSH和TSH水平升高。没有既往甲状腺疾病的证据,颈部超声检查提示甲状腺脓肿。进行了静脉抗生素治疗和手术引流,反应良好,然而,患者随后出现了临床甲状腺功能减退。吞钡检查未显示梨状窦瘘,随访超声检查显示内部质地不均匀,提示桥本甲状腺炎。该病例的相关性在于其不寻常的发现:无先天性异常、甲状腺叶双侧包绕、甲状腺功能减退以及可能存在的桥本甲状腺炎作为急性甲状腺炎的易感因素。

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