Painful Hashimoto Thyroiditis in a 7-Year-Old Girl: Differential Diagnosis and Medical Treatment
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Painful Hashimoto thyroiditis (HT) is a rare pediatric condition. Because of the rarity of painful HT, it can bemisdiagnosed as other thyroid diseases, and there is limited evidence regarding its clinical course and treatment. A 7-year-old girl presented to the emergency room with neck pain. A physical examination revealed diffuselyenlarged thyroid gland with firm consistency and without tenderness. Her serum free thyroxine level was decreasedand levels of thyroid-stimulating hormone, thyroglobulin antibody, and thyroid-stimulating antibody were elevated. The ultrasonography revealed a diffusely enlarged thyroid gland with homogeneously hypoechoic parenchyma andlobulated contours. She was diagnosed with painful HT based on the clinical presentations, laboratory tests, andultrasonography findings, and was treated with a steroid, levothyroxine, and nonsteroidal anti-inflammatory drugs,after which her clinical symptoms improved dramatically. We should consider the possibility of painful HT inchildren with neck pain; HT could be treated with medical treatment.
Abstract
Painful Hashimoto thyroiditis (HT) is a rare pediatric condition. Because of the rarity of painful HT, it can bemisdiagnosed as other thyroid diseases, and there is limited evidence regarding its clinical course and treatment. A 7-year-old girl presented to the emergency room with neck pain. A physical examination revealed diffuselyenlarged thyroid gland with firm consistency and without tenderness. Her serum free thyroxine level was decreasedand levels of thyroid-stimulating hormone, thyroglobulin antibody, and thyroid-stimulating antibody were elevated. The ultrasonography revealed a diffusely enlarged thyroid gland with homogeneously hypoechoic parenchyma andlobulated contours. She was diagnosed with painful HT based on the clinical presentations, laboratory tests, andultrasonography findings, and was treated with a steroid, levothyroxine, and nonsteroidal anti-inflammatory drugs,after which her clinical symptoms improved dramatically. We should consider the possibility of painful HT inchildren with neck pain; HT could be treated with medical treatment.
참고문헌 (11)
- Vukovic R, "Hashimoto thyroiditis and dyslipidemia in childhood: a review", Front Endocrinol(Lausanne), 10, pp.868~ (2019)
- Hye Mi Seo, "A Case of Painful Hashimoto Thyroiditis that Mimicked Subacute Thyroiditis", 전남의대학술지, 48(1), pp.69~72 (2012), 의과학연구소[DOI]
- Krakovitz P, "Surgical management of neck pain and headache associated with pediatric hashimoto's thyroiditis", Laryngoscope, 128(9), pp.2213~2217 (2018)
- Anderson L, "Hashimoto thyroiditis : Part 1, sonographic analysis of the nodular form of Hashimoto thyroiditis", AJR Am J Roentgenol, 195(1), pp.208~215 (2010)
- Kahaly GJ, "Thyroid stimulating antibodies are highly prevalent in Hashimoto's thyroiditis and associated orbitopathy", J Clin Endocrinol Metab, 101(5), pp.1998~2004 (2016)
- Takasu N, "TSBAb(TSH-stimulation blocking antibody)and TSAb(thyroid stimulating antibody)in TSBAb-positive patients with hypothyroidism and Graves' patients with hyperthyroidism", Horm Metab Res, 33(4), pp.232~237 (2001)
- Zdraveska N, "Hashimoto thyroiditis in childhood–review of the epidemiology, genetic susceptibility and clinical aspects of the disease", Maced J Med Sci, 5(3), pp.336~345 (2012)
- Peng CC, "A literature review of painful Hashimoto thyroiditis:70 published cases in the past 70 years", J Endocr Soc, 4(2), pp.bvz008~ (2020)
- Lee MY, "Subacute thyroiditis-an often overlooked sonographic diagnosis : report of 3 cases", J Ultrasound Med, 35(5), pp.1095~1100 (2016)
- Sun Young Park, "Ultrasonographic Characteristics of Subacute Granulomatous Thyroiditis", Korean Journal of Radiology, 7(4), pp.229~234 (2006), 대한영상의학회
- Admoni O, "Long-term follow-up and outcomes of autoimmune thyroiditis in childhood", Front Endocrinol(Lausanne), 11, pp.309~ (2020)