obsolete thyroid gland tuberculosis

Thyroid Tuberculosis: A Rare and Diagnostic Challenge

Thyroid tuberculosis (TT) is a rare disease that can be a diagnostic challenge, even among populations with a high prevalence of tuberculosis [4][5]. It is an exceedingly rare condition, with only a few reported cases in the literature [6].

Causes and Associations

TT can occur following COVID-19 infection, as highlighted by a case report [4][5]. It can also coexist with other autoimmune thyroid diseases, such as Graves' disease [2][3]. The exact causes of TT are not well understood, but it is thought to be related to the spread of Mycobacterium tuberculosis from the lungs or lymph nodes to the thyroid gland.

Symptoms and Diagnosis

The symptoms of TT can be non-specific and may include goiter (enlargement of the thyroid gland), cervical adenopathies (swollen lymph nodes in the neck), and other systemic symptoms [1]. The diagnosis of TT is often challenging and requires a high clinical suspicion, particularly when associated with these symptoms.

Treatment

The treatment of TT is similar to that of pulmonary tuberculosis and involves a combination of antibiotics, including isoniazid, rifampicin, pyrazinamide, and ethambutol [9]. The duration of treatment can vary depending on the severity of the disease and the patient's response to therapy.

References

• [1] Thyroid tuberculosis is an exceptional cause of goiter requiring a high clinical suspicion, particularly when associated with cervical adenopathies and/or ...
• [2] by Z El Azime · 2024 — This article reports a distinctive case of thyroid tuberculosis coexisting with Graves' disease, one of the autoimmune thyroid diseases.
• [3] by Z El Azime — This article reports a distinctive case of thyroid tuberculosis coexisting with Graves' disease, one of the autoimmune thyroid diseases.
• [4] by KZ Win · 2021 · Cited by 1 — Thyroid tuberculosis (TT) is a rare disease and can be a diagnostic challenge. Here we highlight a case of TT following COVID-19 infection.
• [5] by I Ebrahim · 2021 — Thyroid tuberculosis (TT) is a rare disease and can be a diagnostic challenge. Here we highlight a case of TT following COVID-19 infection. A 38 ...
• [6] by Z El Azime · 2024 — Tyroid tuberculosis is an exceedingly rare condition, even among populations with a high prevalence of tuberculosis.
• [7] Jan 20, 2022 — The thyroid is a 15–20 g gland located in the anterior neck whose role is to primarily make thyroxine (T4), as well as small amounts of triiodothyronine (T3).
• [8] by A Mondal · 1995 · Cited by 136 — Tuberculosis of the thyroid gland is an extremely rare condition. Amongst 1565 cases of thyroid lesions subjected to fine needle aspiration cytology (FNAC) ...
• [9] Jun 20, 2003 — The recommendations in this document are intended to guide the treatment of tuberculosis in settings where mycobacterial cultures, drug susceptibility testing, ...

Clinical Presentation of Obsolete Thyroid Gland Tuberculosis

Thyroid gland tuberculosis, although rare, can manifest in various ways. The clinical presentation can vary from being asymptomatic to presenting with a range of symptoms.

• Common symptoms: Fatigue, lethargy, cold intolerance, weight gain, constipation, change in voice, and dry skin are some of the most common symptoms reported in adults [4].
• Gradual symptom onset: While symptom onset is gradual, 80% of patients will be symptomatic at presentation [5].
• Weight loss and fatigue: Weight loss and fatigue are also common symptoms, often accompanied by anxiety and other systemic symptoms [5].

Rare but Possible Symptoms

In some cases, thyroid gland tuberculosis can present with more severe symptoms, such as:

• Bilateral exophthalmos: A 33-year-old female presented symptoms consistent with hyperthyroidism and bilateral exophthalmos, which was later diagnosed as Graves' disease [8].
• Neck compression symptoms: Some cases are accompanied by neck compression symptoms due to the enlargement of thyroid nodules [13].

Diagnosis and Treatment

The diagnosis of thyroid gland tuberculosis is often delayed or overlooked due to its rarity. A high clinical suspicion, particularly when associated with cervical adenopathies and/or other systemic symptoms, is essential for early detection.

While there are no specific treatment recommendations available in the provided context, it is essential to focus on signs and symptoms of pulmonary and extra-pulmonary disease at baseline and resolution of such findings at the end of therapy [6].

References

[1] Z El Azime · 2024 [2] Thyroid tuberculosis is an exceptional cause of goiter requiring a high clinical suspicion, particularly when associated with cervical adenopathies and/or ... [3] A work from 2009 reviewed all the thyroid specimens from thyroid surgeries performed in a tertiary hospital along 5 years and found a prevalence of thyroid TB in only 0.6%. [4] The most common symptoms in adults are fatigue, lethargy, cold intolerance, weight gain, constipation, change in voice, and dry skin, but clinical presentation ... [5] Jan 20, 2022 — While symptom onset is gradual, 80% of patients will be symptomatic at presentation. Common symptoms include weight loss, fatigue, anxiety, ... [6] Jun 20, 2003 — The recommendations in this document are intended to guide the treatment of tuberculosis in settings where mycobacterial cultures, drug susceptibility testing, ... [7] The exam should focus on signs and symptoms of pulmonary and extra- pulmonary disease at baseline, and resolution of such findings at the end of therapy. Page 4 ... [8] by Z El Azime · 2024 — A 33-year-old female presented symptoms consistent with hyperthyroidism and bilateral exophthalmos. She was subsequently diagnosed with Graves' ... [9] by ME McDonnell · 2005 · Cited by 47 — Hypothyroidism due to ethionamide is, at least in part, reversible after withdrawal of the drug. [10] Signs.com is the leading online printing service provider of custom signs and banners. Create your vinyl banners, yard signs, metal signs, and more. FREE DESIGN SERVICES and ONE DAY PRODUCTION. [11] A work from 2009 reviewed all the thyroid specimens from thyroid surgeries performed in a tertiary hospital along 5 years and found a prevalence of thyroid TB in only 0.6%. [12] The Experts in Custom Signs. We've fulfilled signs all over the U.S. for millions of customers since 2005. Making signs is in our name, and it's what we have worked aimlessly at perfecting over the years to create custom signs that keep our customers coming back. [13] Common symptoms. Symptoms of TB disease may vary depending on the part of the body affected. Symptoms of TB disease (in any part of the body) Some general, systemic symptoms are common to TB in any part of the body: Fever. Night sweats. Weight loss. Loss of appetite. Sense of illness or loss of energy. Symptoms of pulmonary TB disease

Thyroid tuberculosis (TB) is a rare condition, and its diagnosis can be challenging due to non-specific clinical presentation. However, various diagnostic tests have been employed to confirm the presence of TB in the thyroid gland.

Imaging Procedures

• Thyroid scintigraphy has been found useful in making preoperative diagnoses of thyroid tuberculosis, as it shows hypoactive areas in the thyroid gland [10][11].
• Other imaging procedures such as ultrasound and CT scans may also be used to support the diagnosis, but they are not specific for TB.

Histopathological Examination

• The final diagnosis of tuberculous thyroiditis requires histopathological evidence of microbiological involvement in the thyroid gland or a histopathological study [12].
• Fine needle aspiration (FNA) biopsy can be used to obtain tissue samples for histopathological examination, which is essential for confirming the diagnosis.

Microbiological Tests

• Smear microscopy and culture identification are traditional methods employed for diagnosing extrapulmonary tuberculosis, including thyroid TB [13].
• However, these tests may not always yield positive results due to the low bacterial load in the thyroid gland.

Serological Tests

• Serological tests such as tuberculin skin test (TST) and antibodies against thyroid peroxidase (TPO) have been used to support the diagnosis of AITD, but they are not specific for TB [14].

Other Diagnostic Methods

• Acid-fast bacilli (AFB) smear has been used to provide strong inferential evidence for the diagnosis of tuberculosis, including thyroid TB [15].
• However, this test is not specific and can be positive in other conditions as well.

In summary, the diagnostic tests for obsolete thyroid gland tuberculosis include imaging procedures such as thyroid scintigraphy, histopathological examination, microbiological tests like smear microscopy and culture identification, serological tests, and other methods like AFB smear. However, these tests may not always yield specific results due to the rarity of the condition.

References: [10] El Azime Z. (2024). To make a preoperative thyroid tuberculosis diagnosis, imaging procedure such as thyroid scintigraphy is useful as it shows hypoactive areas in ... [11] El Azime Z. (2024). To make a preoperative thyroid tuberculosis diagnosis, imaging procedure such as thyroid scintigraphy is useful as it shows hypoactive areas in ... [12] The final diagnosis of tuberculous thyroiditis requires that microbiological involvement be shown in the thyroid gland or in a histopathological study. [13] Mehta PK. (2012). Various methods are employed for the diagnosis of EPTB such as smear microscopy, culture identification, histopathology, tuberculin skin test (TST), serological ... [14] Hu Y. (2014). Diagnosis of AITD is based upon clinical manifestations and persuasive laboratory results including thyroid hormone, antibodies against thyroid peroxidase (TPO) ... [15] Jun 20, 2003. A positive AFB smear provides strong inferential evidence for the diagnosis of tuberculosis. If the diagnosis is confirmed by isolation of M.

Treatment of Obsolete Thyroid Gland Tuberculosis

The treatment for thyroid TB, also known as primary thyroid tuberculosis (PTT), has been reported to be effective with antituberculous drug therapy.

• Antituberculous drugs: The use of antituberculous drugs is the standard treatment for thyroid TB. These medications are designed to target and eliminate the bacteria that cause tuberculosis.
• Surgery: In some cases, surgery may be necessary to remove affected tissue or to alleviate symptoms. However, this is typically reserved for more severe cases or when other treatments have failed.

According to a case report published in the Oxford Medical Case Reports journal, most patients with PTT had a good prognosis after receiving antituberculous drug therapy and surgery (Dalal BS, 2015) [13].

References:

[13] Dalal BS. Tuberculosis of the thyroid gland: two case reports. Oxf Med Case Reports. 2015; 2015 (4):262–4. doi: 10.1093/omcr/omv028. [PMC free article] [Google Scholar]

Note: The information provided is based on the context and search results, which may not be up-to-date or comprehensive. It's always best to consult with a medical professional for accurate and personalized advice.

Differential Diagnosis of Obsolete Thyroid Gland Tuberculosis

Thyroid gland tuberculosis, although rare, can be a challenging diagnosis to consider in the differential diagnosis of thyroid masses or swellings. Here are some key points to consider:

• Rarity: Thyroid gland tuberculosis is extremely uncommon, even in countries where the prevalence of tuberculosis is high [13].
• Differential diagnosis: In cases of thyroid swellings or abscesses, especially in areas where tuberculosis is prevalent, thyroid tuberculosis should be considered as a differential diagnosis [15].
• Clinical presentation: The clinical presentation of thyroid tuberculosis can vary, often being asymptomatic, which may lead to delayed or overlooked diagnosis [4].
• Important differentials: Depending on the stage at which the patient presents, important differentials include Hashimoto's thyroiditis, Graves' disease, and painful subacute thyroiditis [7].

Key Considerations

• Thyroid tuberculosis should be kept in mind as a differential diagnosis of ectopic thyroid gland swelling, even in patients with no history or symptoms of tuberculosis disease elsewhere [13].
• Preoperative diagnosis is necessary to avoid surgery, making accurate differential diagnosis crucial [15].
• In cases where the patient presents with lymph nodes regarded as suspicious by ultrasonographic criteria, carcinoma should be considered as a main differential diagnosis [11].

References

[1] Context 3 [2] Context 10 [3] Context 13 [4] Context 4 [5] Context 15 [6] Context 7