Calm Before the Storm: Marine-Lenhart Syndrome After Hashimoto Thyroiditis

Chen, Xintong; Cai, Hai Yun; Ong, Sophie Sihui; Kiew, Jolene Jiayu; Teo, Desmond B.

doi:10.1016/j.amjmed.2021.05.030

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…On the other hand, the great significance of radionuclide imaging in recurrent hyperthyroidism with the coexistence of nodules, especially recently developed and rapidly growing ones, should be noticed. Previously, there were only two similar reports [ 7 , 8 ]. One case was Marine Lenhart syndrome, which developed after thyroxine replacement therapy in a patient with Hashimoto's thyroiditis and hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

A case of Marine Lenhart syndrome with Hashimoto’s thyroiditis that mimicked thyroid carcinoma

Ye,

Li,

Wei

et al. 2023

BMC Endocr Disord

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Background Marine Lenhart syndrome is a rare disease and causes refractory hyperthyroidism. So far, little evidence on the combination of both Marine Lenhart syndrome and Hashimoto's thyroiditis is available. We suspect that Marine Lenhart syndrome when combined with Hashimoto's thyroiditis might have its particular features, which are not exactly the same as those of the isolated Marine Lenhart syndrome. Case presentation A 56-year-old middle-aged man presented with recurrent hyperthyroidism, and Graves' disease combined with Hashimoto's thyroiditis was considered. Radionuclide imaging showed a hot nodule, but ultrasonography suggested the possibility of malignancy with a category of 4B according to the Chinese-Thyroid Imaging-Reporting and Data System (C-TIRADS) model. Fine needle aspiration cytology (FNAC) revealed eosinophilic follicular lesions with papillary features, and prompted that papillary thyroid carcinoma could not be excluded. Partial thyroidectomy was performed and the nodule was proven to be benign by histopathology. The final diagnosis was atypical Marine Lenhart syndrome with Hashimoto's thyroiditis. Conclusions Marine Lenhart syndrome combined with Hashimoto's thyroiditis has its particular characteristics, showing some signs mimicking malignancy. Limitations of ultrasonography and FNAC in diagnosis should be noted in these scenarios.

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Section: Discussionmentioning

confidence: 99%

A case of Marine Lenhart syndrome with Hashimoto’s thyroiditis that mimicked thyroid carcinoma

Ye,

Li,

Wei

et al. 2023

BMC Endocr Disord

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“…Additionally, prolonged use of methimazole and propylthiouracil can cause rare serious adverse effects such as agranulocytosis, vasculitis, and liver dysfunction. As a consequence of the above, the hyperthyroidism management guidelines and the nuclear medicine guidelines consider patients with MLS as candidates for iodotherapy, in the absence of contraindications for its use [15,16].…”

Section: Source: Authorsmentioning

confidence: 99%

“…In line with what has been discussed, it is important to elucidate the question: Is having a Marine-Lenhart syndrome the same as Graves disease? It is precisely this case that guides us to establish differences, and despite having similar clinical manifestations, it is important to specify that MLS is a condition that marks prognosis and that, unlike cases with GD that can achieve remission with the use of antithyroid drugs for 18-24 months, in patients with MLS, the option of definitive therapy should be motivated, such as how the patient of the case was proceeded [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]18].…”

Section: Source: Authorsmentioning

confidence: 99%

Type 2 Marine-Lenhart Syndrome: An Uncommon Cause of Thyrotoxicosis

Barrera¹,

Castaño²,

Revollo³

et al. 2021

Cureus

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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.

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Levothyroxine-sodium

2022

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Calm Before the Storm: Marine-Lenhart Syndrome After Hashimoto Thyroiditis

Cited by 3 publications

References 2 publications

A case of Marine Lenhart syndrome with Hashimoto’s thyroiditis that mimicked thyroid carcinoma

A case of Marine Lenhart syndrome with Hashimoto’s thyroiditis that mimicked thyroid carcinoma

Type 2 Marine-Lenhart Syndrome: An Uncommon Cause of Thyrotoxicosis

Levothyroxine-sodium

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