Prevalence and Treatment Outcomes of Marine-Lenhart Syndrome in Japan

Autor:	Toshihiko Kasahara, Shuji Fukata, Takumi Kudo, Mitsushige Nishikawa, Tomohiko Nakamura, Mitsuru Ito, Eijun Nishihara, Hirosuke Danno, Kazuyoshi Kousaka, Akira Miyauchi
Rok vydání:	2020
Předmět:	endocrine system Pediatrics medicine.medical_specialty endocrine system diseases Clinical Thyroidology / Research Article business.industry Endocrinology Diabetes and Metabolism Treatment outcome Medicine chemical and pharmacologic phenomena business
Zdroj:	Eur Thyroid J
ISSN:	2235-0802 2235-0640
DOI:	10.1159/000510312
Popis:	Introduction: Marine-Lenhart syndrome (MLS) is now understood to be a combination of Graves’ disease and autonomously functioning thyroid nodule(s) (AFTNs). The prevalence of the syndrome and suitable treatments for those living in iodine-sufficient areas are uncertain. Objectives: We aimed to investigate the prevalence, treatment, and prognosis of MLS in Japan, an iodine-sufficient area. Methods: This study involved patients who visited our hospital between February 2005 and August 2019. Among patients with both thyrotoxicosis and thyroid nodule(s) larger than 10 mm, MLS and isolated AFTNs were diagnosed based on serum thyroid-stimulating hormone receptor antibody levels and scintigraphy using radioiodine or technetium-99m and thyroid uptake. Results: Twenty-two patients were found to have MLS, compared to 372 with isolated AFTNs and 8,343 with Graves’ disease, during the period. Therefore, the rate of MLS cases was 0.26% among all patients with Graves’ disease (22/8,343). Treatments and outcomes were assessed for cases of MLS (n = 18) and isolated AFTNs (n = 269). Antithyroid drugs (ATDs) were withdrawn in 27.8% of cases in the MLS group and 10.3% in the isolated AFTN group. There was no significant difference in the clinical outcome after ATD withdrawal between the 2 groups. However, the rate of hypothyroidism after radioactive iodine (RAI) administration was significantly higher in the MLS group than in the isolated AFTN group (42.9 vs. 9.0%, p = 0.005) despite similar doses of RAI. Conclusions: The prevalence of MLS among patients with Graves’ disease was 0.26% in Japan. RAI therapy induces hypothyroidism more frequently than in those with AFTNs probably because RAI is taken up in the surrounding Graves’ tissues.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::db3fd96d3e8e1e41807fd4bde1ab4efd https://doi.org/10.1159/000510312 Zobrazit plný text záznamu