Schilddrüsenhemiagenesie mit Immunthyreopathie

Unusual thyroid constellation in Down syndrome: congenital hypothyroidism, Graves' disease, and hemiagenesis in the same child

We report a girl with Down syndrome who was diagnosed with congenital hypothyroidism in the newborn period due to left thyroid hemiagenesis. Unexpectedly, her hypothyroidism resolved at the age of 3 years. After being off thyroid hormone replacement for 7 years and having normal thyroid function, she developed Graves' disease. Although Graves' disease in association with thyroid hemiagenesis has previously been reported, this represents the youngest patient in whom this scenario has been described. Issues pertaining to thyroid hemiagenesis, autoimmune hyperthyroidism, and thyroid disease in children with Down's syndrome are discussed.

A singular case of Graves' disease in congenital thyroid hemiagenesis

We report the observation of an unusual case of Graves' disease associated with thyroid hemiagenesis. A 41-year-old woman who presented with symptoms and clinical signs of hyperthyroidism was discovered to have thyroid hemiagenesia of the left lobe. Thyroid ultrasound scan showed enlargement of the right lobe with a single nodule, and absence of the left lobe; isotope scan showed homogeneous uptake in the single lobe and nodule. Ophthalmopathy, which was absent at presentation, developed after two years; after a further 2 years the patient developed decompensated hypothyroidism requiring thyroxine replacement. This is the first case of Graves' disease in thyroid hemiagenesis evolved to hypothyroidism, and a rare case of thyroid ophthalmopathy accompanying this condition.

Thyroid hemiagenesis associated with Graves' disease and Graves' ophthalmopathy: case report

Failure of embryologic development of a lobe of the thyroid gland is a rare anomaly. Usually, this condition is diagnosed when there are some other pathologic conditions in the gland and is often found when a patient presents with a thyroid nodule, which in reality is compensatory hypertrophy of the side that is present, therefore appearing as a nodule. A variety of pathological conditions occur in the remaining thyroid tissue in association with this rare anomaly such as adenoma, carcinoma, subacute thyroiditis, colloid nodule, Graves' disease, simple goiter, and Hashimoto thyroiditis. Association of Graves' disease with ophthalmopathy and thyroid hemiagenesis is quite rare and very few cases are reported in the literature. We report a 29-year-old female presented as Graves' disease and Graves' ophthalmopathy with left lobe hemiagenesis of the thyroid gland.

Hemiagenesis of the Thyroid Associated with Chronic Lymphocytic Thyroiditis

The authors report a case of hemiagenesis of the left thyroid lobe indicated on Tc-99m pertechnetate scan and later confirmed on ultrasonography. The patient was clinically hypothyroid with a right-sided goiter. The cytopathologic diagnosis was made by fine-needle aspiration cytologic analysis, which indicated chronic lymphocytic thyroiditis in the right lobe of the thyroid gland. Later the patient's condition was stabilized with thyroxine replacement therapy. The association of hemiagenesis of the thyroid with chronic lymphocytic thyroiditis has not been reported in the literature.

Thyroid hemiagenesis in an endemic goiter area diagnosed by ultrasonography: report of sixteen patients

During a period of 9 years, 71,500 patients underwent thyroid investigations at our department. Sixteen patients with thyroid hemiagenesis, 13 women and 3 men, were seen during this period. Fifteen had no left lobe and only 1 had no right lobe, the isthmus was present in 5 patients. Associated thyroid diseases of the lobe that was present could be observed in 11 patients (9 diffuse or nodular goiters, 2 thyroid autoimmune diseases). One patient was hyperthyroid and 7 were hypothyroid. Hypothyroidism associated with hemiagenesis has rarely been reported in the literature. In our survey, the high percentage of hypothyroidism may be explained by coexisting iodine deficiency, which could be verified in 4 hypothyroid patients. Ultrasonography is the key investigation to diagnose thyroid hemiagenesis. Fine-needle aspiration biopsies, laboratory tests, and scintigraphies are useful to diagnose other diseases within the remaining lobe or to visualize ectopic thyroid tissue. Review of the literature, including our cases, presented a total of 256 patients with thyroid hemiagenesis. Its prevalence can be estimated between 1:1900 and 1:2675. Left to right ratio of thyroid hemiagenesis is 3.6:1 with an isthmus present in 44%. The female-to-male ratio is 3:1; however, the larger number of females is probably based on a bias due to a female predominance of the populations investigated. On the basis of an equal distribution of both sexes, the female-to-male ratio of thyroid hemiagenesis would be only 1.3:1 in our survey.