Evaluation of infectious etiology in subacute thyroiditis – lack of association with coxsackievirus infection

Luotola, Kari; Hyöty, Heikki; Salmi, Jorma; Miettinen, A; Helin, H; Pasternack, Amos

doi:10.1111/j.1699-0463.1998.tb01378.x

Cited by 18 publications

(10 citation statements)

References 22 publications

(10 reference statements)

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“…The etiology of subacute thyroiditis is obscure, although it is postulated to be associated with viral infections and genetic factors [1][2][3]. In our patient, there was no evidence of viral infection by serologic tests or in situ hybridization.…”

Section: Endocrine Pathologymentioning

confidence: 54%

Papillary carcinoma with subacute thyroiditis

Lam

2002

Endocr Pathol

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Section: Endocrine Pathologymentioning

confidence: 54%

Papillary carcinoma with subacute thyroiditis

Lam

2002

Endocr Pathol

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“…Subacute thyroiditis is a painful, inflammatory disease postulated to be associated with viral infections. 10,11 To study the possible viral etiology of the subacute thyroiditis in our patient, we measured serum virus-specific antibodies, but failed to demonstrate a significant viral contribution. Previously, Jones et al 12 reported subacute thyroiditis after bone marrow transplantation for chronic myeloid leukemia, but did not identify a viral component in the disease.…”

Section: Discussionmentioning

confidence: 97%

Cytomegalovirus pneumonitis, activated prothrombin time prolongation and subacute thyroiditis after unrelated allogeneic bone marrow transplantation

Kawano

Muroi

Akioka

et al. 2000

Bone Marrow Transplant

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Summary:A 22-year-old female with acute myeloid leukemia (AML) in complete remission received a conditioning regimen containing antithymocyte globulin for an unrelated bone marrow transplant (BMT). After BMT, the patient suffered from cytomegalovirus (CMV) pneumonitis with markedly high levels of CMV antigenemia, activated prothrombin time (APTT) prolongation, and subacute thyroiditis. Recovery of CD4؉ cells was delayed as long as 1 year after BMT. An association between these three episodes and viral infection due to the delayed recovery of CD4 ؉ cells is suggested. Bone Marrow Transplantation (2000) 26, 1347-1349. Keywords: bone marrow transplantation; antithymocyte globulin; viral infection; CD4 ϩ cells Viral infections are major causes of mortality and morbidity in patients who receive an allogeneic BMT. During the early and late post-transplant periods, herpes and other viruses cause localized and systemic disease. Of these viruses, CMV infection is the most common, and patients may present with pneumonitis, enteritis or myelosuppression. 1-4 CMV reactivation can be measured by detecting the CMV pp65 antigen (CMV antigenemia). 5,6We describe a patient with AML who received an unrelated allogeneic BMT and developed CMV pneumonitis, APTT prolongation and subacute thyroiditis. CMV pneumonitis and subacute thyroiditis were successfully treated with ganciclovir and prednisolone, respectively. Case reportA 22-year-old female with AML (FAB M6) in first complete remission underwent an allogeneic BMT. The patient was seropositive for CMV and Epstein-Barr (EB) viruses and had normal coagulation parameters. On 5 June 1997, she received an allogeneic BMT from an unrelated HLAidentical male donor (A2, A24, B7, B54, Cw1, Cw7, DR1 and DR4). Conditioning was with total body irradiation at 1200 cGy in six fractions from days Ϫ9 to Ϫ7; cytarabine, 1000 mg/m 2 twice a day from days Ϫ6 to Ϫ4; and cyclophosphamide, 60 mg/kg on days Ϫ3 and Ϫ2. In addition, 2.5 mg/kg of antithymocyte globulin (ATG) was administered from days Ϫ5 to Ϫ2. On day 0, 4.1 ϫ 10 8 /kg of untreated nucleated bone marrow cells was infused. Graftversus-host disease (GVHD) prophylaxis was short-term methotrexate and cyclosporine. CMV hyperimmuneglobulin was given at a dose of 12.5 g every 2 weeks to prevent CMV infection, between days ϩ7 and ϩ120. Granulocyte colony-stimulating factor was given from day ϩ1.Regimen-related toxicities were mild; the patient complained of slight nausea and diarrhea. Bone marrow engraftment was confirmed on day ϩ15 using karyotypic and fluorescence in situ hybridization analyses. On day ϩ54, the patient developed a dry cough and low-grade fever. Computed tomography of the chest showed pneumonitis in both lungs. At this time, markedly high levels of CMV antigenemia were noticed (Figure 1). CMV pneumonitis was diagnosed and 5 mg/kg of ganciclovir twice a day was initiated. Following the therapy, CMV antigenemia levels dropped and the interstitial infiltrates in both lungs resolved. No acute GVHD occurred. On day ϩ118, she complaine...

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“…Although the etiology of subacute thyroiditis is not completely known, it is assumed to be related to viral infections and genetic factors. Infectious etiology is not clearly proven that no proliferation was found in viral cultures, however viral antibodies were found to be high (7).…”

Section: Discussionmentioning

confidence: 98%

Papillary thyroid cancer case masked by subacute thyroiditis

Uçan

Delibaşı

Çakal

et al. 2014

Arq Bras Endocrinol Metab

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Subacute thyroiditis (SAT) association with thyroid carcinoma has been rarely reported in the literature. We present a patient with SAT and papillary thyroid cancer that was suspected by ultrasonographic evaluation (US) following SAT treatment. A fifty-four-year old female patient referred to our department due to tachycardia, jitteriness and pain in cervical region for the past one month. SAT diagnosis was established by physical examination, laboratory and ultrasonographic findings. After treatment, control thyroid US revealed regression of the hypoechogenic regions seen in both lobes, and a previously unreported hypoechogenic lesion with microcalcification focus that had irregular borders and was not clearly separated from the surrounding parenchyma located in the posterior aspect of the lobe (Elasto score: 4, Strain index: 7.08). Fine needle aspiration biopsy was taken from this nodule; cytology was assessed to be compatible with papillary thyroid carcinoma. Postsurgical pathology evaluation showed a papillary microcarcinoma. SAT may produce ultrasound changes that obscure the coexistence of papillary carcinoma. We recommend that patients with SAT have ultrasonography after they recover. Hypoechogenic regions bigger than 1 cm that are present in the follow-up post-therapy US should be assessed by biopsy.

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Evaluation of infectious etiology in subacute thyroiditis – lack of association with coxsackievirus infection

Cited by 18 publications

References 22 publications

Papillary carcinoma with subacute thyroiditis

Papillary carcinoma with subacute thyroiditis

Cytomegalovirus pneumonitis, activated prothrombin time prolongation and subacute thyroiditis after unrelated allogeneic bone marrow transplantation

Papillary thyroid cancer case masked by subacute thyroiditis

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