Horm Metab Res 1996; 28(1): 27-31
DOI: 10.1055/s-2007-979125
Originals Clinical

© Georg Thieme Verlag Stuttgart · New York

Amyloid Goiter: Radiological Study in a Case Presenting Hypothyroidism

E. Ishimura1 , T. Okamura2 , H. Masaki1 , Y. Hiura1 , T. Kawagishi1 , M. Inaba1 , Y. Nishizawa1 , H. Ochi2 , Hirotoshi Morii1
  • 1Second Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan
  • 2Division of Nuclear Medicine, Osaka City University Medical School, Osaka, Japan
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23. April 2007 (online)

We report herein a case of amyloid goiter associated with rheumatoid arthritis in which hypothyroidism was observed. A 52-year-old housewife who had suffeed from rheumatoid arthritis for 15 years was referred to our hospital because of general fatigue. On admission, a large goiter was observed. Laboratory data showed primary hypothyroidism. Renal biopsy and gastric mucosa biopsy showed amyloid deposition of AA-type. Thyroid biopsy showed massive amyloid involvement. Although the findings of iodine-123 scintigraphy, technetium-99m pertechnetate scintigraphy, computed tomography and magnetic resonance image studies were similar to those for goiter associated with chronic thyroiditis, tallium-201 chloride scintigraphy gave a differing result, demonstrating absent uptake at 3 hours in this case. Replcement therapy with levothyroxine relieved the symptoms. This case was unusual in that amyloid goiter presented clinically as hypothyroidism. Absence of tallium-201 chloride uptake at 3 hours may be a diagnostic specificity for amyloid goiter in differentiating its hypothyroidism from that caused by chronic thyroiditis.