A Case of Marine-Lenhart Syndrome with Predominance of Plummer Disease

Miyazaki, Megumi; Okada, Yosuke; Torimoto, Keiichi; Tanaka, Yoshiya

doi:10.7888/juoeh.41.165

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…In line with what has been discussed, it is important to elucidate the question: Is having a Marine-Lenhart syndrome the same as Graves disease? It is precisely this case that guides us to establish differences, and despite having similar clinical manifestations, it is important to specify that MLS is a condition that marks prognosis and that, unlike cases with GD that can achieve remission with the use of antithyroid drugs for 18-24 months, in patients with MLS, the option of definitive therapy should be motivated, such as how the patient of the case was proceeded [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]18].…”

Section: Source: Authorsmentioning

confidence: 99%

Type 2 Marine-Lenhart Syndrome: An Uncommon Cause of Thyrotoxicosis

Barrera¹,

Castaño²,

Revollo³

et al. 2021

Cureus

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Marine-Lenhart syndrome (MLS) is an uncommon cause of primary hyperthyroidism, which can occur in the context of diffuse goiter due to Graves disease (GD) or autonomic nodular disease (Plummer disease (PD)). The coexistence of these two conditions is the hallmark of the MLS. Patients with MLS have a lower remission rate with oral antithyroid drugs, requiring definitive management therapies with radioactive iodine or surgery. We present the case of a 48-year-old female with a history of primary autoimmune hyperthyroidism (GD) since 2016, with biochemical control of hyperthyroidism with methimazole but without the possibility of stopping treatment. The scintigraphic uptake pattern showed heterogeneous uptake of the thyroid parenchyma with three hyper-uptake nodules without inhibition of the rest of the thyroid tissue, findings of an MLS condition with the indication for definitive therapy, for which he was referred to nuclear medicine for the administration of radioactive iodine.

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Section: Source: Authorsmentioning

confidence: 99%

Type 2 Marine-Lenhart Syndrome: An Uncommon Cause of Thyrotoxicosis

Barrera¹,

Castaño²,

Revollo³

et al. 2021

Cureus

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“…Recently documented cases of MLS include cases of coexisting Graves' disease and hyperfunctioning nodules at the time of diagnosis [7][8][9][10], cases of Graves' disease with "cold" nodules at the time of diagnosis that then later were confirmed as hyperfunctioning [11], and cases of development of toxic adenomas years after successful treatment of Graves' disease [12][13]. This highlights the need for a unified definition of MLS, which was proposed by Neuman et al [7].…”

Section: Globalize Your Researchmentioning

confidence: 99%

Does Marine Lenhart Syndrome really exist?

Francis¹,

Charles²,

Blake³

et al. 2021

AMCRCS

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Primary hyperthyroidism is the result of overproduction of thyroid hormone resulting in the classic symptoms of tachycardia, weight loss, diaphoresis, and hyperdefecation. There are multiple common causes to include Graves’ disease, toxic multinodular goiter, and solitary toxic adenomas. Marine Lenhart Syndrome (MLS) is a rare cause of hyperthyroidism, caused by a coexistence of constitutively active thyroid nodules and Graves’ disease. In the original document of Marine and Lenhart, there is no distinction made between the autoimmune phenomenon of Graves’ disease and the solitary toxic nodule of Plummer’s disease. Rather they are both considered to be the manifestation of the same disease. However, in the current era of radionuclide technology, a clear distinction of MLS can be seen with diffuse uptake in the thyroid gland and focused enhancement in the toxic nodules. Therefore what was previously described as one entity is now distinct as Graves’ disease and Plummer’s disease. It is also becoming increasingly clear within the literature that there is also a new phenomenon of post-radioiodine immunogenic hyperthyroidism in patients with toxic nodules and elevated autoantibodies. Therefore in order to properly treat and manage patients, a new definition of MLS may need to be proposed.

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