Uncommon Causes of Thyrotoxicosis

Mittra, Erik; Niederkohr, Ryan D.; Rodríguez, César Alonso; El-Maghraby, Tarek; McDougall, I. Ross

doi:10.2967/jnumed.107.041202

Cited by 28 publications

(11 citation statements)

References 162 publications

(155 reference statements)

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“…Thyroid scintigraphy usually shows a low uptake pattern 1. Furthermore, in clinical practice, sometimes a patient's symptoms are not associated with the laboratory findings, as it happened in our case.…”

Section: Differential Diagnosismentioning

confidence: 49%

Intermittent and recurrent episodes of subclinical hypothyroidism, central hypothyroidism and T3-toxicosis in an elderly woman

Megías¹,

Iglesias

Villanueva

et al. 2012

BMJ Case Reports

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Exogenous thyrotoxicosis is usually caused by ingestion of excessive amounts of thyroid hormone, which could be intentional or surreptitious (known as factitious thyrotoxicosis). Non-pharmacological exogenous thyrotoxicosis is an exceptional event. One example is alimentary thyrotoxicosis, which is caused by the ingestion of meat or sausage containing thyroid tissue, inadvertently mixed with traces of muscles and other tissues of the animal's neck (hamburger thyrotoxicosis). We report for the first time a patient who had recurrent episodes of triiodothyronine (T3) toxicosis for several years due to inadvertent chronic consumption of contaminated traditional Spanish cold meat with porcine thyroid.

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Section: Differential Diagnosismentioning

confidence: 49%

Intermittent and recurrent episodes of subclinical hypothyroidism, central hypothyroidism and T3-toxicosis in an elderly woman

Megías¹,

Iglesias

Villanueva

et al. 2012

BMJ Case Reports

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“…Other differential diagnoses in such patients include thyroiditis (painless, acute, subacute, or drug-induced), iatrogenic thyrotoxicosis, thyrotoxicosis factitia, struma ovarii, and metastases from thyroid cancer (mostly from the follicular cell type). [ 2 3 ] A radioiodine TBS can help to diagnose struma ovarii and metastatic thyroid cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Calculation of the I-131 dose using radiation dosimetry is recommended, and the antithyroid drug should be given before I-131 treatment to decrease the chance of a thyroid storm. [ 2 ]…”

Section: Discussionmentioning

confidence: 99%

A case report of hyperfunctioning metastatic thyroid cancer and rare I-131 avid liver metastasis

2016

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Thyroid cancer is usually, relatively hypofunctional; most patients with thyroid cancer are clinically euthyroid. The combination of thyroid cancer and thyrotoxicosis is not common. We herein, report a case of follicular thyroid cancer with hyperfunctioning metastasis in a 43-year-old woman who presented with thyrotoxicosis, a cold right thyroid nodule, and low I-131 uptake at the thyroid bed. An additional total body scan with I-131 revealed a large radioiodine avid osteolytic bone metastasis with soft tissue masses and liver metastasis. The patient received treatment with total thyroidectomy, methimazole, and I-131 at a cumulative dose of 600 mCi along with recombinant human thyroid-stimulating hormone before the first I-131 treatment and palliative radiation. The patient had normal liver function test and experienced a mild degree of bone marrow suppression after I-131. At the 2-year follow-up, the patient was still alive with the progression of bone metastases but was doing well with less severe thyrotoxicosis, good ambulation, and an Eastern Cooperative Oncology Group performance status of 2. Clinicians should be aware of the unusual concurrent presentation of thyrotoxicosis and thyroid cancer, a differential diagnosis in patients with thyrotoxicosis and low or normal radioiodine uptake over the neck and also potential pitfalls during radionuclide treatment.

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“…Thyrotoxicosis is a syndrome caused by an excess of free thyroid hormones, with multiple etiologies and manifestations, which can affect all body systems. 11 The causes of illnesses include hyperthyroidism and thyrotoxicosis with low levels of radioactive uptake. The most common causes of hyperthyroidism are Basedow-Graves disease, toxic multinodular goitre and toxic adenoma.…”

Section: Discussionmentioning

confidence: 99%

Oestrogen Receptor Alpha and Progesterone Receptor in Uterus and Ovaries on Different Days of The Oestrus Cycle in Hyperthyroid Rats

Karaca

2014

Asian J Med Sci

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Background:The present study evaluated, in different oestrus cycle phases, the oestrogen receptor alpha (ERα) and progesterone receptor (PgR) in rates with hyperthyroid ovaries and uterus. Materials and Methods: Sixty-four adult female wistar albino rats were used. Animals were randomly separated into eight different groups, four of which constituted the control group and the other four of which were the actual experimental group. Hyperthyroidism was induced by daily s.c. injection of L-thyroxine (L-T4, 250 µg/kg) for 21 days. Results: Hyperthyroidism induced decreased plasma TSH levels and increased plasma free T4 levels (P < 0.001). In addition, it increased plasma oestrogen levels in all cycle phases, and plasma progesterone levels increased in different cycle phases, excluding the oestrus phase, in rats (P < 0.01). By the end of the experiment, ERα percentages were decreased in oestrus days in uterine luminal epithelium; however, ERα percentages were increased in metoestrus phases in hyperthyroid rats. ERα was elevated in proestrus, metoestrus and dioestrus phases in the corpus luteum, and hyperthyroidism also increased ERα percentages in theca folliculi. In uterine luminal epithelium, the hyperthyroidism group showed higher expressions of PgR (P < 0.05) in oestrus and metoestrus phases and decreased oestrus phase compared to control rats. Conclusions: As a result, we conclude that both the levels of plasma estrogen and progesterone as well as the differences in the distributions of relevant receptors in ovarian and uterus tissues have an impact on female infertility due to hyperthyroidism.

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Uncommon Causes of Thyrotoxicosis

Cited by 28 publications

References 162 publications

Intermittent and recurrent episodes of subclinical hypothyroidism, central hypothyroidism and T3-toxicosis in an elderly woman

Intermittent and recurrent episodes of subclinical hypothyroidism, central hypothyroidism and T3-toxicosis in an elderly woman

A case report of hyperfunctioning metastatic thyroid cancer and rare I-131 avid liver metastasis

Oestrogen Receptor Alpha and Progesterone Receptor in Uterus and Ovaries on Different Days of The Oestrus Cycle in Hyperthyroid Rats

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