Identifying Marine-Lenhart syndrome on a <sup>99m</sup> Tc-pertechnetate thyroid scan

Damle, Nishikant; Mishra, Rohini

doi:10.4103/2230-8210.109698

Cited by 6 publications

(7 citation statements)

References 3 publications

(3 reference statements)

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“…6 In Graves' disease, more than 95% of nodules on thyroid scan are hypoactive, with a small percentage hyperactive nodules, and therefore patients with Marine-Lenhart syndrome can have hyperthyroidism due to both Graves disease and toxic nodular goiter. 7 Although the few articles that address this syndrome perform mainly iodine scintigraphy for diagnosis, in our clinical case it was only performed scintigraphy with Tc-99m. In these situations nodules may be discordant, that is, hypoactive in Tc-99m scintigraphy but hyperactive in iodine, and this could be pointed as a limitation of our clinical case.…”

Section: Discussionmentioning

confidence: 92%

Marine-Lenhart Syndrome - A Rare Cause of Hyperthyroidism

Maurício¹,

Rocha²,

Heitor³

2020

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo

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A síndrome de Marine-Lenhart é uma causa rara de hipertiroidismo, caracterizada pela coexistência da doença de Graves e um nódulo funcionante ou bócio multinodular tóxico. Mulher de 88 anos com queixas de dispneia, edema dos membros inferiores, diarreia, disfonia e intolerância ao calor. Ao exame físico com bócio multinodular. Analiticamente com NT-proBNP elevado, TSH suprimida, T4 e T3 livre elevadas e anticorpos anti-receptor TSH positivos. Eletrocardiograma com fi brilhação auricular inaugural. Assumido o diagnóstico de insufi ciência cardíaca aguda em contexto de fi brilhação auricular de novo e hipertiroidismo, tendo sido iniciada terapêutica. Ecografi a com glândula tiroideia multinodular e cintigrafi a com tecnésio-99m (Tc-99m) com a presença de nódulos hiper e hipofuncionantes, sugerindo o diagnóstico de síndrome de Marine-Lenhart. Embora a autoimunidade positiva e o padrão ecográfi co confi rmem a etiologia da maioria dos casos de doença de Graves, a cintigrafi a pode ser útil em casos de bócio multinodular, pois altera a abordagem terapêutica.

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Section: Discussionmentioning

confidence: 92%

Marine-Lenhart Syndrome - A Rare Cause of Hyperthyroidism

Maurício¹,

Rocha²,

Heitor³

2020

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo

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“…A PubMed search using the term “Marine-Lenhart” at the time of writing this report returned 33 articles and the most relevant are reported in Table 1. Both “cool,” although it is unclear if hyper-functioning, and “hot” nodules are described in patients with Graves' disease [9, 10, 12, 13, 15–21]. Cases of Marine-Lenhart with papillary thyroid carcinomas are also described [6–8, 14].…”

Section: Discussionmentioning

confidence: 99%

Marine-Lenhart Syndrome: Case Report, Diagnosis, and Management

Neuman

Kuker

Vendrame

2018

Case Reports in Endocrinology

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The coexistence of thyroid functioning nodules and Graves' disease is called Marine-Lenhart syndrome. This condition is estimated to occur in 0.8-2.7% of patients with Graves' disease with few cases reported in the literature. Criteria for the diagnosis are not well defined. Here, we present a case of hyperthyroidism characterized by the presence of stimulating TSH receptor antibodies and severe bilateral exophthalmos. A thyroid uptake and scan revealed an elevated 24-hour iodine-131 uptake and a discrete hot nodule in the upper pole of the right lobe which was also observed with a thyroid ultrasound. The patient was diagnosed with Marine-Lenhart syndrome complicated by thyroid eye disease and was treated with methimazole followed by thyroidectomy and orbital decompression. We review the existing literature and propose criteria for the diagnosis and treatment of this condition.

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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%

“…Moreover, although there is ultrasound detection, it is necessary to determine nodule uptake in a thyroid scan. In most cases, a 99m Tc-pertechnetate thyroid scan enables the identification of focal abnormal uptake of the tracer, corresponding to the AFTN, even in the context of a diffuse, intense uptake by the gland (7)(8)(9)(10)(11)(12)(13)(14).…”

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%

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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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Identifying Marine-Lenhart syndrome on a ^99m Tc-pertechnetate thyroid scan

Cited by 6 publications

References 3 publications

Marine-Lenhart Syndrome - A Rare Cause of Hyperthyroidism

Marine-Lenhart Syndrome - A Rare Cause of Hyperthyroidism

Marine-Lenhart Syndrome: Case Report, Diagnosis, and Management

An uncommon case of Marine-Lenhart syndrome

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Identifying Marine-Lenhart syndrome on a 99m Tc-pertechnetate thyroid scan

Cited by 6 publications

References 3 publications

Marine-Lenhart Syndrome - A Rare Cause of Hyperthyroidism

Marine-Lenhart Syndrome - A Rare Cause of Hyperthyroidism

Marine-Lenhart Syndrome: Case Report, Diagnosis, and Management

An uncommon case of Marine-Lenhart syndrome

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Identifying Marine-Lenhart syndrome on a ^99m Tc-pertechnetate thyroid scan