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BMC Endocrine Disorders

, 6:3

First Online: 10 May 2006Received: 29 September 2005Accepted: 10 May 2006

Abstract

BackgroundThe major cause of primary hypothyroidism is autoimmune mediated with progressive and permanent destruction of the thyroid gland resulting in life-long replacement therapy. Treatable and reversible hypothyroidism is unusual and here forth is such a case due to infection of the thyroid gland with Tropheryma whippleii, Whipple disease.

Case presentationA 45 year-old female presented with symptoms and signs consistent with primary hypothyroidism, which was also confirmed biochemically. Her response to thyroxine replacement therapy was poor however, requiring a significantly elevated amount. Further investigation revealed the presence of Whipple-s disease involving the gastrointestinal trace and possibly the thyroid gland. Her thyroxine requirement decreased drastically following appropriate antimicrobial therapy for Whipple-s disease to the extent that it was ceased. Thyrotropin releasing hormone testing in the steady state suggested there was diminished thyroid reserve due to Whipple-s disease.

ConclusionThis is the first ante-mortem case report studying the possible involvement of the thyroid gland by Whipple-s disease. Despite the normalization of her thyroid function test biochemically after antibiotic therapy, there is diminished thyroid reserve thus requiring close and regular monitoring.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6823-6-3 contains supplementary material, which is available to authorized users.

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Author: Huy A Tran

Source: https://link.springer.com/



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