Builes Barrera Carlos Alfonso, Castaño Pablo Alberto, Herrera Revollo Paula, Pérez Paternina Marcel Eduardo, Rodriguez Arrieta Luis Antonio
Internal Medicine and Endocrinology, University of Antioquia, San Vicente Fundación Hospital, Medellín, COL.
Endocrinology, Military University of Nueva Granada, Medellín, COL.
Cureus. 2021 Dec 21;13(12):e20558. doi: 10.7759/cureus.20558. eCollection 2021 Dec.
Marine-Lenhart syndrome (MLS) is an uncommon cause of primary hyperthyroidism, which can occur in the context of diffuse goiter due to Graves disease (GD) or autonomic nodular disease (Plummer disease (PD)). The coexistence of these two conditions is the hallmark of the MLS. Patients with MLS have a lower remission rate with oral antithyroid drugs, requiring definitive management therapies with radioactive iodine or surgery. We present the case of a 48-year-old female with a history of primary autoimmune hyperthyroidism (GD) since 2016, with biochemical control of hyperthyroidism with methimazole but without the possibility of stopping treatment. The scintigraphic uptake pattern showed heterogeneous uptake of the thyroid parenchyma with three hyper-uptake nodules without inhibition of the rest of the thyroid tissue, findings of an MLS condition with the indication for definitive therapy, for which he was referred to nuclear medicine for the administration of radioactive iodine.
马林-伦哈特综合征（MLS）是原发性甲状腺功能亢进症的一种罕见病因，可发生于弥漫性甲状腺肿背景下的格雷夫斯病（GD）或自主性结节性疾病（普卢默病（PD））。这两种情况并存是MLS的标志。MLS患者口服抗甲状腺药物的缓解率较低，需要采用放射性碘或手术等确定性治疗方法。我们报告了一例48岁女性病例，该患者自2016年起患有原发性自身免疫性甲状腺功能亢进症（GD），使用甲巯咪唑对甲状腺功能亢进症进行生化控制，但无法停药。闪烁扫描摄取模式显示甲状腺实质摄取不均匀，有三个摄取增强结节，其余甲状腺组织无抑制，符合MLS病情且有进行确定性治疗的指征，因此她被转诊至核医学科接受放射性碘治疗。
