Painless Thyroiditis Associated with Severe Inflammatory Reactions in Amyloid Goiter: A Case Report

We report the case of a 64-year-old woman with rheumatoid arthritis (RA) associated with high grade fever, malaise, and painless swelling of thyroid gland. Laboratory findings showed severe systemic inflammatory reactions, including increases in various cytokines such as IL-6. Gallium-67 citrate ima...

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Bibliographic Details
Published in:Endocrine Journal 2001, Vol.48(3), pp.323-329
Main Authors: BANDO, YUKIHIRO, USHIOGI, YASUYUKI, TOYA, DAISYU, TANAKA, NOBUYOSHI, FUJISAWA, MASAKIYO
Format: Article
Language:English
Subjects:
Amyloid - analysis
Amyloid goiter
Amyloidosis - complications
Amyloidosis - metabolism
Amyloidosis - pathology
Arthritis, Rheumatoid - complications
Biopsy
Female
Gallium Radioisotopes
Goiter - complications
Goiter - metabolism
Goiter - pathology
Humans
Inflammation - complications
Interleukin-6 (IL-6)
Interleukin-6 - metabolism
Methylprednisolone - administration & dosage
Methylprednisolone - therapeutic use
Middle Aged
Painless thyroiditis
Prednisolone - administration & dosage
Prednisolone - therapeutic use
Rectum - chemistry
Rectum - pathology
Rheumatoid arthritis
Stomach - chemistry
Stomach - pathology
Subacute thyroiditis-like syndrome
Thyroid Gland - pathology
Thyroiditis - complications
Thyroiditis - diagnosis
Thyroiditis - pathology
Tomography, X-Ray Computed
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Summary:We report the case of a 64-year-old woman with rheumatoid arthritis (RA) associated with high grade fever, malaise, and painless swelling of thyroid gland. Laboratory findings showed severe systemic inflammatory reactions, including increases in various cytokines such as IL-6. Gallium-67 citrate imaging revealed intense uptake in the painlessly enlarged thyroid gland. Histologically, biopsied specimens of thyroid showed diffuse amyloid infiltrations, which included amyloid A (AA) protein. Biopsies of rectum and stomach revealed similar amyloid depositions, indicating that the amyloid had a secondary origin, potentially due to RA. All clinical symptoms were relieved by intravenous pulsatile administration of methylprednisolone followed by oral prednisone, resulting in prolonged hypothyroid status. To our knowledge, this is the first case report in Japan describing painless thyroiditis with severe inflammatory reactions in amyloid goiter.
ISSN:0918-8959
1348-4540
DOI:10.1507/endocrj.48.323