Surgical management of neck pain and headache associated with pediatric hashimoto's thyroiditis

Krakovitz, Paul; Cairns, Christine; Schweiger, Bahareh; Burkey, Brian B.

doi:10.1002/lary.27099

Cited by 3 publications

(7 citation statements)

References 16 publications

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“…Although HT is the most common cause of acquired hypothyroidism in children, there are a very limited number of published reports regarding the clinical course and medical treatment of painful HT in children. 1,3) HT is an autoimmune thyroid disorder induced by inflammation resulting from the infiltration of the thyroid gland by B and T cells that are reactive to thyroid antigens. 4) Patients with HT usually exhibit fatigue, weight gain, and myxoedema with a painless firm diffuse goiter.…”

Section: Discussionmentioning

confidence: 99%

“…5,6) US usually reveals Among the causes of thyroid pain, SAT and infection are more common than HT. 3) SAT is the most common reason for painful thyroiditis and is thought to be caused by viral infection. 9) Patients often develop SAT after acquiring an upper respiratory infection with fever.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, there is limited evidence regarding the clinical course and appropriate treatment of this condition. 3) Therefore, here, we report a case involving a child with painful HT. A 7-year-old girl presented with a painful goiter and consequent neck swelling, which were present for 1 year, and the laboratory findings suggested a diagnosis of HT.…”

Section: Introductionmentioning

confidence: 94%

“…1) It predominantly affects individuals during the early to mid-puberty stages, and the patients with this disease usually develop a diffuse goiter without pain or tenderness. 2,3) Patients with HT exhibit various types of thyroid function-related manifestations, such as subclinical hypothyroidism, hypothyroidism, euthyroidism, or hyperthyroidism with elevated autoantibody levels. 1,2) Patients can present with symptoms, such as neck pain and tenderness, in very rare cases.…”

Section: Introductionmentioning

confidence: 99%

“…1,2) Patients can present with symptoms, such as neck pain and tenderness, in very rare cases. 3) Due to the rarity of painful HT, it can be misdiagnosed as other thyroid diseases, such as subacute thyroiditis (SAT) or infection. Furthermore, there is limited evidence regarding the clinical course and appropriate treatment of this condition.…”

Section: Introductionmentioning

confidence: 99%

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Painful Hashimoto Thyroiditis in a 7-Year-Old Girl: Differential Diagnosis and Medical Treatment

et al. 2021

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Painful Hashimoto thyroiditis (HT) is a rare pediatric condition. Because of the rarity of painful HT, it can be misdiagnosed as other thyroid diseases, and there is limited evidence regarding its clinical course and treatment. A 7-year-old girl presented to the emergency room with neck pain. A physical examination revealed diffusely enlarged thyroid gland with firm consistency and without tenderness. Her serum free thyroxine level was decreased and levels of thyroid-stimulating hormone, thyroglobulin antibody, and thyroid-stimulating antibody were elevated. The ultrasonography revealed a diffusely enlarged thyroid gland with homogeneously hypoechoic parenchyma and lobulated contours. She was diagnosed with painful HT based on the clinical presentations, laboratory tests, and ultrasonography findings, and was treated with a steroid, levothyroxine, and nonsteroidal anti-inflammatory drugs, after which her clinical symptoms improved dramatically. We should consider the possibility of painful HT in children with neck pain; HT could be treated with medical treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Painful Hashimoto Thyroiditis in a 7-Year-Old Girl: Differential Diagnosis and Medical Treatment

et al. 2021

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A Literature Review of Painful Hashimoto Thyroiditis: 70 Published Cases in the Past 70 Years

Peng

Chang

Pennant

et al. 2019

Journal of the Endocrine Society

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Painful Hashimoto thyroiditis (pHT) is a rare diagnosis, and optimal treatment remains unclear. To better characterize pHT, PubMed, Embase, Scopus, and Web of Science indexes were searched for case reports or case series reporting pHT, published between 1951 and February 2019. Seventy cases reported in 24 publications were identified. Female predominance (91.4%) and a median age of 39.00 years (interquartile range, 32.50-49.75 years) were observed. Among reported cases, 50.8% had known thyroid disease (including Hashimoto thyroiditis, Graves disease, and seronegative goiters), 83.3% had positive antithyroid peroxidase antibodies, and 71.2% had antithyroglobulin antibodies. Most cases did not have preceding upper respiratory tract symptoms or leukocytosis. Ultrasound features were consistent with Hashimoto thyroiditis. Thyroid function at initial presentation was hypothyroid (35.9%), euthyroid (28.1%), or thyrotoxic (35.9%). Cases evolved into hypothyroidism (55.3%) and euthyroidism (44.7%), whereas none became hyperthyroid after medical treatment. Thyroid size usually decreased after medical treatment. Most cases were empirically treated as subacute thyroiditis with corticosteroids, levothyroxine, or nonsteroidal anti-inflammatory drugs. However, no therapy provided sustained pain resolution. In subgroup analysis, low-dose oral prednisone (<25 mg/d) and intrathyroidal corticosteroid injection showed more favorable outcomes. Total thyroidectomy yielded 100% sustained pain resolution. Diagnosis of pHT is based on clinical evidence of Hashimoto thyroiditis and recurrent thyroid pain after medical treatment. The reference standard of diagnosis is pathology. Total thyroidectomy or intrathyroidal glucocorticoid injection should be considered if low-dose oral prednisone fails to achieve pain control.

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Local symptoms of Hashimoto’s thyroiditis: A systematic review

Yuan

Qi²,

Zhang³

et al. 2023

Front. Endocrinol.

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ObjectiveHashimoto’s thyroiditis (HT) is the most common type of thyroid disease and can cause many different manifestations. The local symptoms of HT are an under-studied area of research. Therefore, the purpose of this study was to investigate the local symptoms of HT and their prevalence.MethodsA systematic review was performed to find articles in PubMed that discuss the local symptoms of HT. Relevant vocabulary terms and key terms included: autoimmune thyroid disease (AITD), hyperthyroidism, hypothyroidism, neck, throat, pharynx, airway, esophagus, breathe, swallow, globus, sleep apnea, symptoms, and quality of life. Two investigators independently screened the eligible studies.ResultsA total of 54 articles fulfilled the inclusion criteria. Of these, 25 were clinical studies, 24 were case reports, and five were reviews. These clinical studies and case reports included a total of 2660 HT patients. There were eight local symptoms related to HT: neck pain (0.02%~16%), voice changes (7%~30%), throat discomfort (20%~43.7%), shortness of breath (28%~50%), dysphagia (29%), goiter-related symptoms (69.44%), sleep apnea, and generally defined compressive symptoms. Due to the use of different outcome measures among all the studies, a meta-analysis of the data could not be performed.ConclusionGoiter symptoms, which are an item on the ThyPRO scales, are the most frequent local symptoms in HT patients, and include neck pain, voice changes, throat discomfort, and dysphagia. These local symptoms should be identified in the clinic and included in the early diagnosis and management of HT, as well as evaluated further to understand their relevance in the pathogenesis of HT.

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Surgical management of neck pain and headache associated with pediatric hashimoto's thyroiditis

Abstract: 4. Laryngoscope, 128:2213-2217, 2018.

Cited by 3 publications

References 16 publications

Painful Hashimoto Thyroiditis in a 7-Year-Old Girl: Differential Diagnosis and Medical Treatment

Painful Hashimoto Thyroiditis in a 7-Year-Old Girl: Differential Diagnosis and Medical Treatment

A Literature Review of Painful Hashimoto Thyroiditis: 70 Published Cases in the Past 70 Years

Local symptoms of Hashimoto’s thyroiditis: A systematic review

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