Citation

Dunstheimer D, Vollert K, Heidemann PH. Padiatr. Praxis 2010; 75(2): 217-224.

Copyright

(Copyright © 2010, E U Hans Marseille Verlag)

DOI

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PMID

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Abstract

Ectopic thyroid is the result of failure of the thyroid to descend from the foramen caecum to its final pretracheal position during embryonic period. An ectopic thyroid predisposes the patient to thyroid dysfunction at birth or later in life. About 50% of the cases with congenital hypothyroidism have an ectopic thyroid, i.e. the incidence is 1:7000. Beyond the neonatal period the incidence of ectopic thyroid varies widely. We report an 11 year old boy, who was in psychiatric care because of suicidal tendencies. Before initiation medical treatment routine thyroid function tests showed hypothyroidism in the patient. Examination and ultrasound of the neck revealed no thyroid tissue in the normal pretracheal position. 123-iodine thyroid scan demonstrated an abnormal uptake at the base of the tongue without any uptake in the normal thyroid position. Diagnosis of lingual thyroid was confirmed by MRI and thyroxine replacement therapy was started. Follow-up examination showed normalization of TSH and thyroid hormones and improvement of psychological symptoms. In every child with psychological signs or symptoms thyroid function tests should be determined before starting any other therapy. In any patient with newly diagnosed hypothyroidism - even though hypothyroidism is subclinical - careful diagnostic work-up including an ultrasound of the thyroid gland should be performed. Patients with a lingual thyroid and hypothyroidism require life-long thyroid hormone replacement. The goal of the therapy is to restore a euthyroid state and to minimize goitrous enlargement to avoid development of obstructive complications.

Language: de

Keywords

human; child; male; case report; suicide attempt; article; mental disease; mental health care; school child; physical examination; nuclear magnetic resonance imaging; thyrotropin; follow up; thyroid function test; hormone substitution; hypothyroidism; thyroid hormone; thyroxine; iodine 123; goiter; (Congenital) hypothyroidism; Ectopic thyroid; lingual thyroid; Lingual thyroid; ultrasound