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Coexistence of an autonomously functioning thyroid nodule in a patient with Graves' disease: an unusual presentation of Marine-Lenhart syndrome.
Endocr J. 1997 Aug; 44(4):571-4.EJ

Abstract

A 44-year-old woman developed hyperthyroidism due to the coexistence of Graves' disease and an autonomously functioning thyroid nodule (AFTN). Anti-thyrotropin receptor antibody (TRAb) was strongly positive (83.2%), and a thyroid scan initially showed diffuse uptake of Tc-99m pertechnatate in both lobes and further increased uptake in accordance with the right lobe nodule. The nodule in the right lobe was histologically diagnosed as thyroid follicular adenoma. After she was maintained in a euthyroid state by treatment with Methymazole (MMI), thyroid uptake of Tc-99m in the nodule became lower and was slightly suppressed by T3 administrations probably due to its dependence on TSH. Subtotal thyroidectomy was performed and she subsequently became euthyroid with negative TBII activity. It is concluded that she had a coexisting functioning nodule with Graves' disease (Marine-Lenhart syndrome) and that the nodule changed from hot to cool along with the anti-thyroid treatment, unlike usual cases of this syndrome showing a cold nodule on the initial imaging under the hyperthyroid state. Repeated Tc-99m pertechnatate thyroid scans were helpful in evaluating the reaction of MMI and TSH in both lesions separately in the present case.

Authors+Show Affiliations

Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

9447292

Citation

Nishikawa, M, et al. "Coexistence of an Autonomously Functioning Thyroid Nodule in a Patient With Graves' Disease: an Unusual Presentation of Marine-Lenhart Syndrome." Endocrine Journal, vol. 44, no. 4, 1997, pp. 571-4.
Nishikawa M, Yoshimura M, Yoshikawa N, et al. Coexistence of an autonomously functioning thyroid nodule in a patient with Graves' disease: an unusual presentation of Marine-Lenhart syndrome. Endocr J. 1997;44(4):571-4.
Nishikawa, M., Yoshimura, M., Yoshikawa, N., Toyoda, N., Yonemoto, T., Ogawa, Y., Mori, S., Tabata, S., Tokoro, T., Sakaguchi, N., & Inada, M. (1997). Coexistence of an autonomously functioning thyroid nodule in a patient with Graves' disease: an unusual presentation of Marine-Lenhart syndrome. Endocrine Journal, 44(4), 571-4.
Nishikawa M, et al. Coexistence of an Autonomously Functioning Thyroid Nodule in a Patient With Graves' Disease: an Unusual Presentation of Marine-Lenhart Syndrome. Endocr J. 1997;44(4):571-4. PubMed PMID: 9447292.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coexistence of an autonomously functioning thyroid nodule in a patient with Graves' disease: an unusual presentation of Marine-Lenhart syndrome. AU - Nishikawa,M, AU - Yoshimura,M, AU - Yoshikawa,N, AU - Toyoda,N, AU - Yonemoto,T, AU - Ogawa,Y, AU - Mori,S, AU - Tabata,S, AU - Tokoro,T, AU - Sakaguchi,N, AU - Inada,M, PY - 1997/8/1/pubmed PY - 1998/2/3/medline PY - 1997/8/1/entrez SP - 571 EP - 4 JF - Endocrine journal JO - Endocr. J. VL - 44 IS - 4 N2 - A 44-year-old woman developed hyperthyroidism due to the coexistence of Graves' disease and an autonomously functioning thyroid nodule (AFTN). Anti-thyrotropin receptor antibody (TRAb) was strongly positive (83.2%), and a thyroid scan initially showed diffuse uptake of Tc-99m pertechnatate in both lobes and further increased uptake in accordance with the right lobe nodule. The nodule in the right lobe was histologically diagnosed as thyroid follicular adenoma. After she was maintained in a euthyroid state by treatment with Methymazole (MMI), thyroid uptake of Tc-99m in the nodule became lower and was slightly suppressed by T3 administrations probably due to its dependence on TSH. Subtotal thyroidectomy was performed and she subsequently became euthyroid with negative TBII activity. It is concluded that she had a coexisting functioning nodule with Graves' disease (Marine-Lenhart syndrome) and that the nodule changed from hot to cool along with the anti-thyroid treatment, unlike usual cases of this syndrome showing a cold nodule on the initial imaging under the hyperthyroid state. Repeated Tc-99m pertechnatate thyroid scans were helpful in evaluating the reaction of MMI and TSH in both lesions separately in the present case. SN - 0918-8959 UR - https://www.unboundmedicine.com/medline/citation/9447292/Coexistence_of_an_autonomously_functioning_thyroid_nodule_in_a_patient_with_Graves'_disease:_an_unusual_presentation_of_Marine_Lenhart_syndrome_ L2 - https://joi.jlc.jst.go.jp/JST.Journalarchive/endocrj1993/44.571?from=PubMed DB - PRIME DP - Unbound Medicine ER -