Acute infectious thyroiditis in ectopic lingual thyroid causing dysphagia and dyspnoea: a case report and discussion

Abstract

Acute infectious thyroiditis in patients with ectopic lingual thyroid gland is extremely rare, and in most cases, this condition, if symptomatic, manifests as dysphagia and dyspnoea. This case report shows that, in addition to the previously mentioned typical symptoms, our patient also suffered from febrile temperature, progressive fullness in the throat and pain during swallowing. Diagnosis of acute infectious thyroiditis associated with lingual thyroid gland is complex and requires evaluation of results of clinical findings and laboratory tests, and also evaluation by radiological diagnostic methods. Treatment was performed by administering antibacterial and anti-inflammatory therapy, resulting in the disappearance of complaints. Clinical appearance, diagnostic methods and treatment options are discussed in the discussion section.

Lingual thyroiditis – an unusual cause for sore throat

“…Literature suggests that the reported incidence of this condition has been 1 in 100,000 cases with a peak incidence of occurrence in the third decade of life having a male to female ratio of 1:7 in documented cases³. Lingual thyroiditis however is extremely rare 9 and in the reported cases present with relatively common symptoms as dysphagia and dyspnoea. A high degree of suspicion is required to detect them.…”

“…A few differential diagnoses for the rare clinical entity of lingual thyroid includes vascular tumours, benign or malignancy at the base of the tongue. Though radio nucleotide Tc⁹⁹ᵐ (technetium-99) scintigraphy is an investigation of choice in confirming an ectopic thyroid although it can also have false positive results 9 .…”

“…In reported cases of lingual thyroiditis however, the patients were managed with antibiotics and anti-inflammatory medication. And surgical excision was not considered 9 . In these instances, the patient responded dramatically to treatment with reduction in symptoms within and average of 4 days.…”

Lingual thyroid with severe hypothyroidism

“…[ 1 , 2 ] Enlargement of lingual thyroid tissue can be seen while experiencing upper respiratory tract infections associated with lymphoid tissue. [ 16 ] Moreover, the size of lingual thyroid tissue may be enlarged by the stimulation of elevated TSH during puberty, pregnancy, or menstruation, when the demand for thyroid hormones increases that leads hypothyroidism to develop. This explains the reason why the reported lingual thyroid is more common in females.…”

Ectopic Thyroid in Childhood

“…©Ëitnica lahko deluje normalno (23,50); lahko nastopi hipofunkcija, ki se odraža v hipotiroidizmu in golšavosti (8,44) ali redkeje hiperfunkcija, torej hipertiroza (10,32,47,48). Pride lahko do akutnega infekcijska vnetja šËitniËnega tkiva (51) in Hashimotovega tiroiditisa (52).…”