Amyloid goiter in a patient with rheumatoid arthritis and end-stage renal disease

Şeker, Ayşe; Erkinüresin, Taşkın; Demirci, Hakan

doi:10.4103/ijn.ijn_271_18

Cited by 1 publication

(3 citation statements)

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“…The amyloid involvement can result from primarily localized deposition or secondary to systemic disease [ 4 ]. 50% to 80% of individuals with medullary carcinoma of the thyroid exhibit microscopic amyloid deposition, followed by secondary amyloidosis (20%) and very rarely primary amyloidosis (15%) [ 1 , 3 , 4 ]. Most patients with amyloid goiter are euthyroid, but variations have also been reported [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…In primary amyloidosis, there is the accumulation of major fibrillar protein amyloid L derived from IgE light chains. However, in secondary amyloidosis, there is a collection of amyloid A derived from serum amyloid A protein [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…The discovery and understanding of the deposition of microscopic amyloid infiltration in the thyroid gland can be traced back to Carl von Rokitansky's work in 1855. Rudolf Eiselberg in 1904 described findings of a case of thyroid enlargement caused by unusual amyloid deposits and named this rare condition “Amyloid Goiter” [ 1 , 3 , 4 ]. This report presents a very rare case of amyloid goiter with adipose metaplasia in a patient with a history of pulmonary tuberculosis.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Co-occurrence of Amyloid Goiter and Adipose Metaplasia in a Patient With History of Pulmonary Tuberculosis: A Case Report

Khan¹,

Ahmad²,

Williams³

et al. 2023

Cureus

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Amyloid goiter is described as an accumulation of amyloid, an amorphous proteinaceous material, in the thyroid gland. The deposition of amyloid is relatively common in the thyroid gland. However, a significant clinical enlargement due to amyloid accumulation and fat deposition in the thyroid stroma resulting in diffuse goiter leading to compressive symptoms is a rare phenomenon. In this report, we describe a rare case of amyloid goiter with adipose metaplasia in a 38-year-old woman with a history of pulmonary tuberculosis who presented to the outpatient department with complaints of heartburn, abdominal discomfort, and hoarseness of voice. Incidentally patient had diffused multinodular neck swelling. Preliminary blood investigations were normal. The contrast-enhanced computed tomography neck showed multiple non-enhancing lesions and a diffusely enlarged thyroid gland, causing a mass effect on the oropharynx posteriorly and minimally on the trachea. Fine needle aspiration cytology thyroid revealed thyroiditis. The patient underwent a total thyroidectomy, and histopathological examination of the specimen showed an extracellular eosinophilic amorphous substance that was positive for Congo red and showed apple-green birefringence under polarized light, and large areas of adipose metaplasia were noted, and a diagnosis was made. The amyloid involvement can result from localized primary deposition or secondary to chronic inflammatory disease. The prevalence of amyloid goiter in developed countries is due to primary amyloidosis, and in developing countries is due to secondary amyloidosis. Patients with a history of pulmonary tuberculosis commonly present with renal amyloidosis as its complication. Patients with an enlarged thyroid gland and a history of chronic inflammatory conditions or plasma cell dyscrasias should be evaluated with extreme suspicion. The correlation of tuberculosis with the subsequent development of amyloid goiter highlights the need for research in this area.

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