July - September 2007, Volume 3, Issue 3

Balmes E, Burcea A, Ioachim D, Strambu I, Badiu C

Sarcoidosis with pulmonary and thyroid determination coexisting with Hashimoto's disease

Acta Endo (Buc) 2007, 3 (3): 351-358
doi: 10.4183/aeb.2007.351

Sarcoidosis, a disease of an unknown etiology, is characterized by the presence of noncaseating granulomas that are most often found in the intrathoracic lymph nodes, lung and in other organs. Hashimoto' thyroiditis is one of the most common organ-specific autoimmune diseases. Although several reports describe the coincidence of sarcoidosis and Hashimoto's thyroiditis, the understanding of the relationship between these two disorders is limited. A 50 year old woman was admitted for cervico-thoracic goiter having a long history of nodular goiter for about 25 years and being suspect of pulmonary sarcoidosis. A chest radiograph and CT scan showed plunging intrathoracic goiter, lymphadenopathy with a pulmonary interstitial infiltrating process. A tracheo-bronchial lung biopsy revealed non-caseating granulomatous lesions consisting of epithelioid cells, confirming sarcoidosis. Angiotensin converting enzyme was high, therefore the patient was diagnosed as having sarcoidosis. The thyroid gland showed signs of goiter, tenderness and nodularity, without latero-cervical adenopathy. Thyroid function tests were normal and thyroid antibodies were positive. For cervico - thoracic goiter, total thyroidectomy with cervical lymph-adenomectomy was practiced. The histopathological exam demonstrated thyroid sarcoidosis, lymph nodes involvement and chronic thyroiditis.

Keywords: sarcoidosis, Hashimoto`s thyroiditis, lungs, autoimmune disorder

Correspondence: Corin Badiu, MD, Department of Thyroid-Related Disorders, Institute of Endocrinology, Bucharest, 011863, Romania, badicrin@yahoo.co.uk