Thyroid Sarcoidosis as a Rare Explanation of Resistance to Radioactive Iodine in Graves’ Disease
David M Scott-Coombes, Michael J Stechman, Richard J Egan, Rakan Kabariti, Daniel L Hopkins
Keywords :
Case report, Graves’ disease, Sarcoidosis, Thyroidectomy.
Citation Information :
Scott-Coombes DM, Stechman MJ, Egan RJ, Kabariti R, Hopkins DL. Thyroid Sarcoidosis as a Rare Explanation of Resistance to Radioactive Iodine in Graves’ Disease. World J Endoc Surg 2018; 10 (2):142-144.
Background: Sarcoidosis is a multiorgan idiopathic inflammatory disease that involves the thyroid gland in 1 to 4.6% of the cases.
Case report: We report a case of a 36-year-old man who was diagnosed with Graves’ disease and initially treated with block and replace regimen followed by radioactive iodine (RAI), both of which were unsuccessful. The patient subsequently underwent an uncomplicated total thyroidectomy. Subsequent histological evaluation of the thyroid tissue demonstrated granulomatous inflammation consistent with a diagnosis of sarcoidosis. This was the index presentation of this diagnosis with no previous symptoms or clinical manifestations related to sarcoidosis.
Conclusion: Using this case as an example, we therefore conclude that relative resistance of Graves’ thyrotoxicosis to treatment may be due to a novel underlying presentation of sarcoidosis.
Clinical significance: Sarcoidosis of the thyroid gland should be considered as part of the clinical differential diagnosis in cases of treatment-resistant thyrotoxicosis.
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