ECE2023 Poster Presentations Thyroid (163 abstracts)
Severe malnutrition associated with amyloid goiter: A case report
Carlos Jareño Martínez 1 , Ariadna Prats Custal 1 , Cristina Franco Borras 1 , Laia Martinez Guasch 1,2 , Theodora Michalopoulou Alevras 1,2 , Silvia Näf Cortés 1,2 , Manel Castellote Caixal 2,3 , Alejandro Samitier Pastor 2,4 , Antoni Raventós Estellé 2,5 & Ana Megía Colet 1,2
1Joan XXIII University Hospital, Endocrinology and Nutrition Department, Tarragona, Spain; 2Rovira i Virgili University, Tarragona, Spain; 3Joan XXIII University Hospital, General Surgery Department, Tarragona, Spain; 4Joan XXIII University Hospital, Radiology Department, Tarragona, Spain; 5Joan XXIII University Hospital, Pathology Department, Tarragona, Spain
Background: Amyloidosis is defined as the accumulation of amorphous, proteinaceous material in different parts of the body. It can be primary or secondary, having decreased the incidence of this last one due to the current therapeutic landscape of infectious and autoimmune diseases. This material can be deposited in the thyroid gland resulting in an enlargement known as Amyloid goiter. Although amyloid infiltration in thyroid is common, the occurrence of clinically enlarged thyroid owing to amyloid deposition, leading to goiter, is an extremely rare phenomenon.
Case Presentation: A 72-year-old woman with chronic pyelonephritis and hearth failure with preserved ejection fraction due to hypertrophic cardiomyopathy was referred to our outpatient clinic presenting severe malnutrition related to an enlarged thyroid gland with compressive symptoms (dysphagia). Thyroid function test results were in the normal range and serum thyroid autoantibodies were undetectable. Cervical ultrasound showed a diffusely swollen thyroid and fine-needle aspiration (FNA) cytology showed a pattern consistent with lymphocytic thyroiditis. Neck CT-scan again showed symmetrically enlarged thyroid lobes up to 107 mm at his largest diameter with retropharyngeal extension, surrounding trachea and esophagus. Abdomen CT-scan revealed a substantial dilation of calyces with lithiasis, a marked parenchymal atrophy with significant perirenal fat thickening, perirenal effusion and retroperitoneal adenopathies in his right kidney. Prior to surgery, the patient needed parenteral nutritional support. After preoperative work-up, total thyroidectomy was performed without complications. The histopathological study revealed the presence of amorphous protein aggregates that was stained with Congo-Red dye and the immunohistochemistry study was positive for Amyloid A and P proteins. The patient was later diagnosed with secondary amyloidosis due to xanthogranulomatous pyelonephritis.
Conclusion: Amyloid goiter is an extremely rare entity. Secondary amyloidosis must be considered in the differential diagnosis of thyroid enlargement, specially those with rapid onset, and particularly in patients with a history of chronic infections or inflammatory disorders predisposing to amyloid deposition. FNA biopsy should be performed to exclude malignancy and thyroidectomy is necessary for definitive diagnosis.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more