An uncommon case of Marine-Lenhart syndrome

Arquivos Brasileiros de Endocrinologia & Metabologia (Impact Factor: 0.84). 06/2014; 58(4):398-401. DOI: 10.1590/0004-2730000003173
Source: PubMed


The term Marine-Lenhart syndrome describes the association between Graves' disease and autonomously functioning thyroid nodules (AFTN), such as toxic adenoma or toxic multinodular goiter. The two diseases may coexist or may be present at different moments in the same patient. In the literature, there are many reports on the development of Graves' disease after radioiodine treatment for AFTN, but very little information may be found on the occurrence of AFTN after radioiodine therapy for Graves' disease. We describe here the case of a female patient with Graves' disease who was successfully treated with radioiodine for Graves' disease, returning to normal thyroid function. Three years later, biochemical analysis and ultrasound examination identified a thyroid nodule that progressively increased in size. The 99mTc-pertechnetate scintigraphy showed avid uptake in the right lobule, which corresponded to a nodular lesion consistent with AFTN.

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Available from: Rosaria M Ruggeri, Aug 25, 2015
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    ABSTRACT: The coexistence of thyroid autonomy (Plummer's disease) and Graves' disease has been termed "Marine-Lenhart syndrome". During the last years, several papers have been published on the development of Graves' disease shortly after radioiodine therapy of Plummer's disease (autonomy). Especially in patients with elevated thyroid antibodies, the incidence of this event is significantly higher after radioiodine therapy of autonomy. A review of the literature dating back to 1911 is discussed in this paper. The original paper published by Marine and Lenhart comes to the conclusion that the two diseases are different expressions of one disease. Looking at the literature, we have to state now that the Marine-Lenhart syndrome has never existed: With Plummer we know now that Plummer's and Graves' disease are different diseases. They may develop in the same patient but independent from each other.
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