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Graves’ Disease and Marine Lenhart Syndrome: A Rare Clinical Presentation
IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
Internal Medicine, Malteser Krankenhaus Franziskus Hospital, Flensburg, Germany
Department of Pediatrics, University of São Paulo (USP) Medical School, São Paulo, Brazil
IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
Medical Clinic in Endocrinology and Diabetology, Schleswig-Flensburg, Germany
- 1 IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
- 2 IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
- 3 IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
- 4 IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
- 5 IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
- 6 Internal Medicine, Malteser Krankenhaus Franziskus Hospital, Flensburg, Germany
- 7 Department of Pediatrics, University of São Paulo (USP) Medical School, São Paulo, Brazil
- 8 IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
- 9 IPEMED Medical School/AFYA Educational, Postgraduation in Endocrinology, Rio de Janeiro, Brazil
- 10 Medical Clinic in Endocrinology and Diabetology, Schleswig-Flensburg, Germany
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Abstract
The aim of this study is to review and discuss the clinical features and treatment options for the Marine-Lenhart syndrome, an uncommon thyroid disturb. The methodology adopted was a bibliographic research. The results of this study show that different mechanisms are implicated in the pathogenesis of Graves’ disease and in the nodular formation of thyroid tissue with functional autonomy. Graves’ disease is caused by an autoimmune process that involves the entire thyroid gland and is characterized by the presence of TSH receptor stimulating antibodies. The present study concludes that caution should be exercised in interpreting thyroid disease in Graves’ disease. The treatment of thyrotoxicosis requires high doses of oral drugs. Relapsing antithyroid therapy occurs soon after oral antithyroid therapy is discontinued. This presentation should alert the physician about the existence of toxic nodules, and about the possibility of a Marine-Lenhart Syndrome.
KeywordsGraves’ DiseaseMarine-Lenhart SyndromeThyroid GlandThyroid Nodules
- Giuffrida, G., et al. (2014) An Uncommon Case of Marine-Lenhart Syndrome. Arquivos Brasileiros de Endocrinologia & Metabologia, Sao Paulo, 58, 398-401. https://doi.org/10.1590/0004-2730000003173
- Biersack, H.J. and Biermann, K. (2011) The Marine-Lenhart Syndrome Revisited. Wiener Klinische Wochenschrift, 123, 459-462. https://doi.org/10.1007/s00508-011-0029-5
- Franklyn, J.A. and Boelaert, K. (2012) Thyrotoxicosis. The Lancet, 379, 1155-1166. https://doi.org/10.1016/S0140-6736(11)60782-4
- Mohan, J.R., et al. (2013) Pertechnetate Thyroid Scan in Marine-Lenhart Syndrome. Indian Journal of Nuclear Medicine, 28, 125-126. https://doi.org/10.4103/0972-3919.118261
- Shen, G., et al. (2017) Serious Disease Following Radioiodine Therapy for Toxic Adenoma. Medicine (Baltimore), 96, e8550. https://doi.org/10.1097/MD.0000000000008550
- Scherer, T., et al. (2013) A Case of Simultaneous Occurrence of Marine-Lenhart Syndrome and a Papillary Thyroid Microcarcinoma. BMC Endocrine Disorders, 13, Article No. 16. https://doi.org/10.1186/1472-6823-13-16
- Nishikawa, M., et al. (1997) Coexistence of an Autonomously Functioning Thyroid Nodule in a Patient with Graves’ Disease: An Unusual Presentation of Marine-Lenhart Syndrome. Endocrine Journal, 44, 571-574. https://doi.org/10.1507/endocrj.44.571
- Wanderley, B.R., et al. (2015) Traps in the Papuliferous Carcinoma Diagnoses Associated with the Graves’ Disease. Re vista da Sociedade Brasileira de Clinica Medica, 13, 194-197.
- Cakir, M. (2005) Marine-Lenhart Syndrome. Journal of the National Medical Association, 97, 1036-1038. https://doi.org/10.1089/1050725041516995
- Harisankar, C.N., et al. (2013) Hybrid SPECT/CT Evaluation of Marine-Lenhart Syndrome. Clinical Nuclear Medicine, 38, e89-e90.
- Marine, D. and Lenhart, C.H. (1911) Pathological Anatomy of Exopthalmic Goiter. Archives of Internal Medicine, 3, 265-316. https://doi.org/10.1001/archinte.1911.00060090002001
- Charkes, N.D. (1972) Serious Disease with Functioning Nodules (Marine-Lenhart Syndrome). Journal of Nuclear Medicine, 13, 885-892.
- Graf, H. (2004) Nodular Thyroid Disease. Arquivos Brasileiros de Endocrinologia & Metabologia, Sao Paulo, 48, 93-104. https://doi.org/10.1590/S0004-27302004000100011
- Polyzos, S.A. and Goulis, D.G. (2011) Coincidental Thyroid Papillary Microcarcinoma in a Patient Treated for a Toxic Adenoma of the Thyroid. Archives of Iranian Medicine, 14, 149-151.