J Korean Soc Endocrinol.  2006 Apr;21(2):142-145. 10.3803/jkes.2006.21.2.142.

A Case of Acute Perithyroiditis with Transient Thyrotoxicosis in Childhood

Affiliations
  • 1Department of Internal Medicine, Yonsei University Wonju College of Medicine, Korea.
  • 2Department of Radiology, Yonsei University Wonju College of Medicine, Korea.

Abstract

Acute thyroiditis is a rare disease because of the sufficient supply of blood vessels and lymphatics in thyroid tissue, the high concentration of iodide in the thyroid tissue and the nearly completely isolated structure of the thyroid gland from the surrounding tissue via its capsule. The most common route of infection is from a pyriform sinus fistula and then the inflammation spreads from the sinus to the perithyroidal space. Computed tomography (CT) and magnetic resonance imaging (MRI) can show a low echogenic mass encircling thyroid gland and swelling of the perithyroidal tissue in acute suppurative thyroiditis. We experienced a case of acute perithyroiditis with thyrotoxicosis that developed in a 13-year old boy and he was diagnosed by the CT findings. The patient had complained of a low graded fever and neck swelling. The laboratory diagnosis and clinical course was like that of subacute thyroiditis, but the CT finding showed a show low echogenic mass encircling the thyroid glands and swelling of the perithyroidal tissue. Therefore, we diagnosed this patient with acute perithyroiditis. After treatment with antibiotics, he displayed clinical improvement and was discharged.


MeSH Terms

Adolescent
Anti-Bacterial Agents
Blood Vessels
Clinical Laboratory Techniques
Fever
Fistula
Humans
Inflammation
Magnetic Resonance Imaging
Male
Neck
Pyriform Sinus
Rare Diseases
Thyroid Gland
Thyroiditis
Thyroiditis, Subacute
Thyroiditis, Suppurative
Thyrotoxicosis*
Anti-Bacterial Agents

Figure

  • Fig. 1 Ultrasonography of neck showed multinodular goiter on left thyroid gland (left) with adjacent vessel compression (right).

  • Fig. 2A Computed Tomography of neck showed multiloculated mass encircling left thyroid gland and suppurative lymphadenitis.

  • Fig. 2B Follow-up CT showed improvement of perithyroiditis.

  • Fig. 3 Technicium 99-pertechnate thyroid scan showed hypofunction with poor visualization of the both thyroid glands.


Reference

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