Primary thyroid tuberculosis: a rare hypothyroidism etiology

Objective: To present a clinical case of primary thyroid tuberculosis associated with hypothyroidism. Case details: Primary thyroid tuberculosis with associated hypothyroidism is an unusual manifestation of tuberculous infection. We present the case of a 31-year-old female patient who reported a loss of appetite, hair loss, and the development of cervical nodules without fever or secretions. Her thyroid ultrasound revealed only an atypical cervical lymph node on the right side, with no other abnormalities. Laboratory tests indicated hypothyroidism, and she was started on levo Objective: To present a clinical case of primary thyroid tuberculosis associated with hypothyroidism. Case details: Primary thyroid tuberculosis with associated hypothyroidism is an unusual manifestation of tuberculous infection. We present the case of a 31-year-old female patient who reported a loss of appetite, hair loss, and the development of cervical nodules without fever or secretions. Her thyroid ultrasound revealed only an atypical cervical lymph node on the right side, with no other abnormalities. Laboratory tests indicated hypothyroidism, and she was started on levothyroxine sodium 25 mcg/day. Despite the treatment, the patient remained symptomatic. Fine-needle aspiration cytology of the thyroid suggested a hyperplastic follicular nodule or papillary cancer, leading to a decision for total thyroidectomy. Anatomopathological examination of the thyroidectomy specimen revealed chronic granulomatous thyroiditis with necrosis and granulomatous lymphadenitis. Given the strong response to the tuberculin test, a six-month course of antitubercular treatment was initiated. Final considerations: This case punctuates the importance of considering thyroid tuberculosis in the differential diagnosis of cervical masses and the necessity of biopsy and histopathological examination to accurately diagnose the disease and initiate timely treatment. Objective: To present a clinical case of primary thyroid tuberculosis associated with hypothyroidism. Case details: Primary thyroid tuberculosis with associated hypothyroidism is an unusual manifestation of tuberculous infection. We present the case of a 31-year-old female patient who reported a loss of appetite, hair loss, and the development of cervical nodules without fever or secretions. Her thyroid ultrasound revealed only an atypical cervical lymph node on the right side, with no other abnormalities. Laboratory tests indicated hypothyroidism, and she was started on levothyroxine sodium 25 mcg/day. Despite the treatment, the patient remained symptomatic. Fine-needle aspiration cytology of the thyroid suggested a hyperplastic follicular nodule or papillary cancer, leading to a decision for total thyroidectomy. Anatomopathological examination of the thyroidectomy specimen revealed chronic granulomatous thyroiditis with necrosis and granulomatous lymphadenitis. Given the strong response to the tuberculin test, a six-month course of antitubercular treatment was initiated. Final considerations: This case punctuates the importance of considering thyroid tuberculosis in the differential diagnosis of cervical masses and the necessity of biopsy and histopathological examination to accurately diagnose the disease and initiate timely treatment.