ECE2013 Poster Presentations Thyroid (non-cancer) (100 abstracts)
1Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar do Porto, Porto, Portugal; 2Faculty of Medicine, University of Porto, Porto, Portugal; 3Department of Nuclear Medicine, Centro Hospitalar do Porto, Porto, Portugal.
Introduction: The MarineLenhart syndrome is a rare cause of hyperthyroidism that is associated with the simultaneous or sequential presence of characteristics related to Graves disease and toxic nodular or multinodular goiter. Its validity as a disease is controversial and some authors believe that these are cases of hyperthyroidism where both etiologies coexist. The presence of hyperfunctioning nodules in Graves disease patients ranges between 0.8 and 4.3%.
Clinical case: We present three cases of MarineLenhart syndrome, all in female patients, aged 4057 years old at the time of diagnosis. All cases had positive titers of anti-thyroid antibodies and thyrotropin receptor antibodies (TRAbs). The thyroid scans showed diffuse uptake with one or more hyperfunctioning nodules, without attenuation of the surrounding areas. One of the cases represents the occurrence of hyperthyroidism after treatment of toxic nodular goiter with radioactive iodine.
Discussion: The described cases present criteria for the diagnosis of MarineLenhart syndrome. Graves disease is more frequent in younger individuals, while MarineLenhart syndrome occurs in older ones, as occurs in Plummers disease. As these are cases that tend to recur, total thyroidectomy is the treatment of choice.
Conclusions: MarineLenhart syndrome is a controversial cause of hyperthyroidism. The importance of its diagnosis resides in the preference for surgical treatment.