Coexistence of an Autonomously Functioning Thyroid Nodule in a Patient with Graves' Disease: An Unusual Presentation of Marine-Lenhart Syndrome.

Nishikawa, Mitsushige; Yoshimura, Manabu; Yoshikawa, Norio; Toyoda, Nagaoki; Yonemoto, Toshinaga; Ogawa, Yoshifumi; Mori, Shigeki; Tabata, Satoshi; Tokoro, Toshiko; Sakaguchi, Noriko; Inada, Mitsuo

doi:10.1507/endocrj.44.571

Cited by 24 publications

(15 citation statements)

References 18 publications

(13 reference statements)

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“…While early studies primarily reported on low-functioning thyroid nodules, there have recently been increasing numbers of reports of GD patients with 'increased' nodular functionality [6][7][8][9][10][11], similar to the patients examined in this case series. This phenomenon led to the hypothesis that this association could comprise either a different clinical entity from, or more likely, an extension of Marine-Lenhart syndrome.…”

Section: Discussion and Reviewmentioning

confidence: 62%

“…This phenomenon led to the hypothesis that this association could comprise either a different clinical entity from, or more likely, an extension of Marine-Lenhart syndrome. Indeed, in 1997, Nishikawa et al [10] provided the first report of a patient with a hot nodule and coexisting GD. The 44-year-old female patient was made euthyroid via administration of methimazole, which resulted in the recovery of endogenous TSH activity.…”

Section: Discussion and Reviewmentioning

confidence: 99%

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Marine-Lenhart syndrome in two adolescents, including one with thyroid cancer: a case series and review of the literature

Sharma

2017

Journal of Pediatric Endocrinology and Metabolism

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Background: The coexistence of functional thyroid nodules and Graves' disease (GD) is a rare condition known as Marine-Lenhart syndrome. Thyroid cancer has been described in several adults, but never in children, with Marine-Lenhart syndrome. This paper discusses the challenges in diagnosis and the unique management of this condition in children, in the context of extant literature. Content: In this case report, two adolescent female patients with Marine-Lenhart syndrome, aged 15 and 16 years, exhibited biochemical evidence of hyperthyroidism, and were found to have unilateral hyperfunctioning thyroid nodules via thyroid scintigraphy. Additionally, both patients showed elevated thyroid-stimulating immunoglobulins (TSI) and increased glandular activity, confirming background GD. Notably, one patient was also diagnosed with intranodular thyroid cancer upon preoperative examination. Both patients were treated via surgical resection. Summary and outlook: Diagnosis of Marine-Lenhart syndrome can be made in patients with functional thyroid nodules and increased glandular activity on thyroid scintigraphy. Standard doses of radioiodine ablation are not effective in the majority of patients and should be avoided due to the increased risk for thyroid cancer, making thyroidectomy the preferred treatment.

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Section: Discussion and Reviewmentioning

confidence: 62%

Section: Discussion and Reviewmentioning

confidence: 99%

Marine-Lenhart syndrome in two adolescents, including one with thyroid cancer: a case series and review of the literature

Sharma

2017

Journal of Pediatric Endocrinology and Metabolism

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“…Bu iki hastalığın patofizyolojisi birbirinden farklıdır. Otoimmün bir proçesle yakın ilişkili olan Graves hastalığında; TSH otoantikorunun TSH reseptörüne sitümülan olarak bağlanması sonucu tüm bezde aktivite artışı saptanır (3). Oysaki toksik nodül, klonal orjinden köken alır (4).…”

Section: Discussionunclassified

Olgu Sunumu: Marine-Lenhart Sendromu Olan Bir Erkek Hasta

2015

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Graves hastalığı ve fonksiyonel nodül veya nodüllerin birlikteliği Marine-Lenhart sendromu olarak adlandırılır. Oldukça nadir görülen bu sendromda bahsedilen iki ayrı durum aynı zamanda olabileceği gibi toksik adenom yıllar içerisinde tabloya eklenebilir. Hastalar genelde bayandır ve yapılan biyopsi sonuçlarına göre nodüller büyük çoğunlukla benign karakterdedir. Bu yazıda, egzoftalmus ve kilo kaybı şikayetleri nedeni ile Graves Hastalığı düşünülen ve yapılan tetkikler sonucunda aynı zamanda toksik adenom saptanan 28 yaşında bir erkek hasta sunulmuştur.

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“…Additional reports followed, and most of these articles describe only one or few patients (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The overall prevalence of such association was reported between 2.7% to 4.1% (4).…”

Section: Discussionmentioning

confidence: 99%

“…The coexistence of both diseases has been termed "Marine-Lenhart syndrome". Since the first description in 1911 by Marine and Lenhart (3), the presence of focal autonomy in patients with Graves' disease has been reported by numerous authors, and with different presentations (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), with an overall prevalence of such association ranging from 2.7% to 4.1% (4). Moreover, during the last years, several papers have been published on the development of Graves' disease shortly after radioiodine therapy for AFTNs (15)(16)(17)(18).…”

Section: Sumáriomentioning

confidence: 99%

An uncommon case of Marine-Lenhart syndrome

Giuffrida

Giovinazzo

Certo

et al. 2014

Arq Bras Endocrinol Metab

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SUMMARYThe term Marine-Lenhart syndrome describes the association between Graves' disease and autonomously functioning thyroid nodules (AFTN), such as toxic adenoma or toxic multinodular goiter. The two diseases may coexist or may be present at different moments in the same patient. In the literature, there are many reports on the development of Graves' disease after radioiodine treatment for AFTN, but very little information may be found on the occurrence of AFTN after radioiodine therapy for Graves' disease. We describe here the case of a female patient with Graves' disease who was successfully treated with radioiodine for Graves' disease, returning to normal thyroid function. Three years later, biochemical analysis and ultrasound examination identified a thyroid nodule that progressively increased in size. The SUMÁRIOO termo "síndrome de Marine-Lenhart" descreve a associação da doença de Graves e nódulos tireoidianos de funcionamento autônomo (AFTN), como no adenoma tóxico ou bócio multinodular tóxico. As duas doenças podem coexistir ou podem estar presentes em diferentes momentos no mesmo paciente. Na literatura, existem muitos relatos sobre o desenvolvimento da doença de Graves após radioiodoterapia para AFTN, mas muito poucos dados podem ser encontrados em relação ao aparecimento de AFTN após radioiodoterapia para doença de Graves. Descrevemos o caso de uma paciente do sexo feminino com doença de Graves que realizou com sucesso o tratamento com iodo radioativo, com a normalização da função da tireoide. Três anos depois, uma análise bioquímica e um exame de ultrassonografia identificaram o aparecimento de um nódulo na tireoide que progressivamente aumentou de tamanho. A cintilografia com 99m Tc-pertecnetato revelou uma captação ávida no lóbulo direito, correspondente à lesão nodular, consistente com uma AFTN. Arq Bras Endocrinol Metab. 2014;58(4):398-401

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Coexistence of an Autonomously Functioning Thyroid Nodule in a Patient with Graves' Disease: An Unusual Presentation of Marine-Lenhart Syndrome.

Cited by 24 publications

References 18 publications

Marine-Lenhart syndrome in two adolescents, including one with thyroid cancer: a case series and review of the literature

Marine-Lenhart syndrome in two adolescents, including one with thyroid cancer: a case series and review of the literature

Olgu Sunumu: Marine-Lenhart Sendromu Olan Bir Erkek Hasta

An uncommon case of Marine-Lenhart syndrome

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