Marine-Lenhart Syndrome- A Curious Case of Thyrotoxicosis

Abstract

Hyperthyroidism is one of the common prevalent endocrine problems. The common causes of hyperthyroidism include Graves’ disease, toxic nodular goiter and toxic adenoma. The diagnosis is usually straightforward but can be challenging at times. MarineLenhart syndrome refers to the rare co-existence of hyperfunctioning nodule in presence of Graves’ disease. The disease can easily be misdiagnosed if clinical vigil is not high. The disease differs from classical Graves’ disease in terms of clinical course, management modality and outcome. Here we present a case of 52 years old female with complaints of weight loss, excessive sweating, tremors and palpitation for last six months and swelling in antrior aspect of neck for last four months. Technetium 99 m thyroid scintigraphy showed presence of diffuse increased tracer uptake 15% with suppression of background activity. Based on these findings, a diagnosis of Marine-Lenhart syndrome was made. Early and corrected identification of this rare variant is essential for proper therapeutic management.

Keywords

• goitre
• graves’ disease
• thyroid
• thyroid nodulec