Systemic Sarcoidosis with Thyroid Involvement

Okuma, Hideyuki; Hashimoto, Kazuhito; Wang, Xin; Ohkiba, Noriaki; Murooka, Nozomi; Akizuki, Norikazu; Inazawa, Takeshi; Ogawa, Yoshihiro

doi:10.2169/internalmedicine.8324-16

Cited by 13 publications

(8 citation statements)

References 10 publications

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“…With fewer than 70 cases reported in the medical literature, thyroid sarcoidosis is most commonly identified during postmortem, with a prevalence of only 1%–4% of those with systemic disease 14 15. Thyroid sarcoidosis has been associated with solitary hypoechoic nodules, Hashimoto’s, Graves’ disease with resistance to radioiodine, hypothalamic–pituitary involvement with secondary hypothyroidism or diffuse infiltration, with or without deranged hormonal status, as in this case 16–20…”

Section: Discussionmentioning

confidence: 91%

Rare case of multisystem sarcoidosis

et al. 2021

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Sarcoidosis is a multisystem disorder of unknown cause, characterised pathologically by granulomas and primarily affecting the lung and lymphatic system of the body. It has been termed the ‘great pretender’ due to its ability to mimic other diseases. In this article we describe a case of sarcoidosis with simultaneous rare manifestations of extrathoracic disease (thyroid, osseous and renal). It highlights the enigmatic nature of sarcoidosis and the diagnostic challenge it can pose to clinicians. A multidisciplinary approach to both diagnosis and management between endocrinology, nephrology, neurosurgical, rheumatological and respiratory teams was paramount for effective clinical improvement.

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Section: Discussionmentioning

confidence: 91%

Rare case of multisystem sarcoidosis

et al. 2021

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“…Another possible mechanism of hypothyroidism in sarcoidosis is direct granulomatous thyroid infiltration which is reported in around 4% in autopsy studies of systemic sarcoidosis patients [5,28]. Various treatments for sarcoidosis, including systemic use of steroids or other immunosuppression treatments can alter thyroid function tests [29].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and characteristics of self-reported hypothyroidism and its association with nonorgan-specific manifestations in US sarcoidosis patients: a nationwide registry study

et al. 2021

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Little is known about the prevalence, clinical characteristics and impact of hypothyroidism in patients with sarcoidosis. We aimed to determine the prevalence and clinical features of hypothyroidism and its relation to organ involvement and other clinical manifestations in patients with sarcoidosis.We conducted a national registry-based study investigating 3835 respondents to the Sarcoidosis Advanced Registry for Cures Questionnaire between June 2014 and August 2019. This registry is based on a self-reported, web-based questionnaire that provides data related to demographics, diagnostics, sarcoidosis manifestations and treatment. We compared sarcoidosis patients with and without self-reported hypothyroidism. We used multivariable logistic regression and adjusted for potential confounders to determine the association of hypothyroidism with non-organ specific manifestations.Fourteen-percent of the sarcoidosis patients self-reported hypothyroidism and were generally middle-aged white women. Hypothyroid patients had more comorbid conditions and were more likely to have multi-organ sarcoidosis involvement, especially with cutaneous, ocular, joints, liver and lacrimal glands involvement. Self-reported hypothyroidism was associated with depression (adjusted odds ratio (aOR)=1.3; 95% confidence interval (CI): 1.01–1.6), anti-depressants use (aOR=1.3; CI: 1.1–1.7), obesity (aOR=1.7; CI:1.4–2.1), sleep apnea (aOR=1.7; CI:1.3–2.2), chronic fatigue syndrome (aOR=1.5; CI:1.2–2) and was borderline associated with fibromyalgia (aOR=1.3; CI:1–1.8). Physical impairment was more common in patients with hypothyroidism.Hypothyroidism is a frequent comorbidity in sarcoidosis patients that might be a potentially reversible contributor to fatigue, depression and physical impairment in this population. We recommend considering routine screening for hypothyroidism in sarcoidosis patients especially in those with multi-organ sarcoidosis, fatigue and depression.

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“…Lastly, condensated colloid in the papillary structures can be errooneously interpreted as psammoma bodies. Core needle biopsy (CNB), on the other hand, has been reported to detect non-caseating granulomas of the thyroid, when used as an alternative method to transbrochial biopsy in patients with thyroid and pulmonary sarcoidosis ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

Thyroid sarcoidosis: a rare entity in the differential diagnosis of thyroid cancer

Katsamakas¹,

Tzitzili²,

Boudina³

et al. 2021

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary We present two cases of thyroid sarcoidosis that were misdiagnosed as thyroid cancer. In the first patient, fine needle aspiration cytology (FNAc) of a suspicious thyroid nodule indicated the presence of papillary thyroid cancer, and the patient underwent thyroid surgery. However, histopathology identified a sarcoid granuloma, without any sign of malignancy. The second patient had a history of papillary microcarcinoma with suspicious lymph nodes diagnosed years after the initial diagnosis and was referred for assessment of cervical lymphadenopathy. Fine needle aspiration cytology (FNAc) of the suspicious lymph nodes erroneously indicated metastasis from thyroid cancer, and lateral modified lymph node dissection was performed, based on FNAc and ultrasonographic features. Histopathology excluded malignancy and identified non-caseating granulomas. Sarcoidosis of the thyroid may have a clinical presentation similar to well-differentiated thyroid carcinoma and, although rare, should be considered in the differential diagnosis, especially when other signs of the disease are already present. In these cases, FNAc provided a false diagnosis of papillary thyroid carcinoma and lymph node metastases that led to unnecessary surgery. Learning points Sarcoidosis may share clinical and ultrasonographic features with papillary thyroid carcinoma. Fine needle aspiration cytology is helpful in the diagnosis of both conditions; however, the overlapping cytological characteristics may lead to erroneous diagnosis. The present cases illustrate the importance of cytological identification of these difficult cases. Every piece of information provided by the clinician is essential to the cytologist.

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Systemic Sarcoidosis with Thyroid Involvement

Cited by 13 publications

References 10 publications

Rare case of multisystem sarcoidosis

Rare case of multisystem sarcoidosis

Prevalence and characteristics of self-reported hypothyroidism and its association with nonorgan-specific manifestations in US sarcoidosis patients: a nationwide registry study

Thyroid sarcoidosis: a rare entity in the differential diagnosis of thyroid cancer

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