Combined True Thymic Hyperplasia and Lymphoid Hyperplasia in Grave's Disease

Judd, Randy; Ramos, Claudio Rodríguez

doi:10.3109/15513819009064717

Cited by 17 publications

(8 citation statements)

References 15 publications

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“…). Human patients with hyperthyroidism experience both true thymic hyperplasia caused by increased thyroxine, and lymphoid follicular hyperplasia attributed to the autoimmune disorder underlying the syndrome (Judd and Bueso‐Ramos ). The case presented in this report developed true thymic hyperplasia based on the histopathology and history of chronic inflammation.…”

Section: Introductionmentioning

confidence: 99%

Thymic hyperplasia causing right ventricular outflow tract compression following treatment for oesophageal rupture in an Arabian colt

Smith

Underwood

Schaffer-White

et al. 2017

Equine Veterinary Education

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Summary True thymic hyperplasia has been reported sporadically in the human literature as an immunological rebound phenomenon following immunosuppressive treatment or disease. There are limited accounts in domestic species, mainly following vaccination, and thymic hyperplasia has not been a recognised condition in the horse to date. This report details a case of true thymic hyperplasia in a 10‐week‐old Arabian colt diagnosed by histopathology of core biopsy samples. The colt developed pulmonary stenosis caused by compression due to a space occupying lesion in the cranial mediastinum following a 3‐month history of hospitalisation for treatment of traumatic oesophageal rupture with perioesophageal abscess formation. Diagnostic imaging of the cranial mediastinum was indicative of a thymic mass, and histopathology confirmed the mass was normal (hyperplastic) thymic tissue. The colt was treated with a tapering dose of corticosteroids, which led to involution of the hyperplastic tissue and resolution of pulmonary artery compression. Thymic hyperplasia may be an unrecognised sequela to chronic inflammation in horses and was only identified in this case when the size was sufficient to compress right cardiac outflow.

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Section: Introductionmentioning

confidence: 99%

Thymic hyperplasia causing right ventricular outflow tract compression following treatment for oesophageal rupture in an Arabian colt

Smith

Underwood

Schaffer-White

et al. 2017

Equine Veterinary Education

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“…In contrast, true thymic hyperplasia, which is usually detected by chest X-ray or CT, is also known to complicate Graves disease [ 4 – 9 , 16 ]. Judd et al [ 17 ] reported that true and lymphoid thymic hyperplasia can be combined in Graves disease. In our study, thymic biopsy was not performed in any patient.…”

Section: Discussionmentioning

confidence: 99%

Thymic Involution after Radioiodine Therapy for Graves’ Disease: Relationships with Serum Thyroid Hormones and TRAb

Jinguji

Nakajo²,

Nakajo

et al. 2017

Journal of the Endocrine Society

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Context:The mechanisms of thymic hyperplasia in Graves disease and its involution after radioiodine (I-131) therapy remain unknown.Objective:To examine whether computed tomography (CT) findings of the thymus in patients with Graves disease change before and 6 months after I-131 therapy and to elucidate factors that affect these changes.Design, Setting:A retrospective, single-center study was conducted. Thymic and thyroid volumes and thymic density were measured on CT. The associations of thymic volume or density with the following factors before I-131 therapy were examined: age; serum triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone receptor antibody (TRAb) levels; and thyroid volume. The changes in thymic volume and density and TRAb levels before and after I-131 therapy, and the correlations of thymic volume with T3 and T4 decline rates and TRAb changing rate and age were examined.Patients:We studied 40 consecutive patients with Graves disease who underwent neck and chest CT before and 6 months after I-131 therapy.Intervention:Observational study.Results:A significant negative correlation was observed only between thymic density and age before I-131 therapy. Thymic volume and density decreased and TRAb levels increased significantly after I-131 therapy. The thymic volume decline rate significantly positively correlated with serum T3 and thyroid volume decline rates. No significant correlation was found between thymic volume decline and TRAb changing rates.Conclusions:Significant thymic involution occurs after I-131 therapy in patients with Graves disease. Serum T3, but not TRAb, may be related to thymic hyperplasia and involution following I-131 therapy.

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“…Este estudo constatou um aumento das regiões cortical e medular da glandula pré-tratamento e a regressão do tecido cortical com manutenção do aumento da região medular após tratamento prolongado com ATS 18 .…”

Section: Discussionunclassified

Doença de Graves e hiperplasia do timo: caso clínico e revisão da literatura

2015

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo

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A doença de graves (DG) é uma doença auto-imune sistémica e o atingimento de outros órgãos que não a tiróide é bem conhecido, nomeadamente sob a forma de oftalmopatia e dermopatia. A sua associação com hiperplasia do timo encontra-se estabelecida na literatura, sendo no entanto raramente notada na prática clínica já que, na maioria dos casos, o aumento de volume não atinge proporções significativas. Os autores apresentam o caso de uma doente de 34 anos enviada à consulta com quadro de emagrecimento e uma massa mediastínica anterior com 2,4×1,8 cm de etiologia a esclarecer. Após avaliação clínica e laboratorial o diagnóstico foi de doença de Graves. Relativamente à massa mediastínica, como as caracteristicas eram sugestivas de benignidade, postulou-se como hipótese mais provável tratar-se de uma doença de Graves com uma hiperplasia tímica associada. Procedeu-se ao controlo da função tiroideia com anti-tiroideus de síntese e adoptou-se uma atitude expectante relativamente à massa. Aos seis meses o diagnóstico foi confirmado pelo desaparecimento imagiológico da massa no exame de controle. Com este caso, realça-se a importância do reconhecimento da existência desta associação, de forma a evitar procedimentos invasivos desnecessários e não isentos dos riscos. A B S T R A C TGraves' disease (GD) is a systemic autoimmune disease and it's effects on other organs rather than thyroid is well known, particularly it's association to ophthalmopathy and dermopathy. It's association with thymic hyperplasia is now well established in the literature, however rarely noted in clinical practice. This is in part due to the fact that in most cases the increase in volume does not reach significant proportions. The authors present the case of a patient of 34 years sent to the department with a history of weight lost and an anterior mediastinal mass with 2.4×1,8 cm of unknown etiology. After clinical and laboratory evaluation, the diagnosis was GD. The mediastinal mass was postulated to be a thymic hyperplasia as it had imagiologic characteristics suggestive of benignity. The control of thyroid function with antithyroid drugs was the treatment of choice along with an expectant attitude with respect to the mass. After six months of treatment, the diagnosis was confirmed by the disappearance of the mass in the imagiologic controle examination. This case highlights the importance of recognizing the existence of this association, in order to avoid unnecessary invasive procedures which are not free from risks.

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Combined True Thymic Hyperplasia and Lymphoid Hyperplasia in Grave's Disease

Cited by 17 publications

References 15 publications

Thymic hyperplasia causing right ventricular outflow tract compression following treatment for oesophageal rupture in an Arabian colt

Thymic hyperplasia causing right ventricular outflow tract compression following treatment for oesophageal rupture in an Arabian colt

Thymic Involution after Radioiodine Therapy for Graves’ Disease: Relationships with Serum Thyroid Hormones and TRAb

Doença de Graves e hiperplasia do timo: caso clínico e revisão da literatura

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