Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2015 Sep 28;7(3):5914.
doi: 10.4081/pr.2015.5914.

A Rare Case of Painful Goiter Secondary to Pediatric Hashimoto's Thyroiditis Requiring Thyroidectomy for Pain Control

Liladhar Kashyap  1 , Abdulhameed Alsaheel  1 , Rohan Walvekar  2 , Lawrence Simon  2 , Ricardo Gomez  1
Affiliations
Case Reports

A Rare Case of Painful Goiter Secondary to Pediatric Hashimoto's Thyroiditis Requiring Thyroidectomy for Pain Control

Liladhar Kashyap et al. Pediatr Rep. .

Abstract

Hashimoto's thyroiditis (HT) usually presents as painless thyroid swelling. Painful pediatric HT is a rare condition with limited literature on pain management. We report a 15-year-old female who presented with 4 weeks history of fatigue, malaise and progressive, painful midline thyroid swelling. There was no difficulty in swallowing, no fever or recent upper respiratory infection symptoms. Exam was remarkable for diffusely enlarged, very tender, and non-nodular thyroid. Thyroid function tests, C-reactive protein, and complete blood count were normal. Ultrasound revealed diffusely enlarged non-nodular, non-cystic gland with mild increased vascularity. Diagnosis of HT was confirmed by biopsy and thyroid antibodies. Over a 6 week period, pain management with ibuprofen, levothyroxine, corticosteroid, gabapentin and amitriptyline was unsuccessful. Ultimately, total thyroidectomy resulted in complete resolution of thyroid pain. We can conclude that thyroidectomy may be considered for the rare case of painful HT in children.

Keywords: Painful goiter; pain management; pediatric Hashimoto’s thyroiditis.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: the authors declare no potential conflict of interest.

Figures

Figure 1.
Figure 1.
Thyroid ultrasound.
Figure 2.
Figure 2.
Histological finding: lymphocytic infiltration of thyroid gland.
See this image and copyright information in PMC

References

    1. Kon YC, DeGroot LJ. Painful Hashimoto’s thyroiditis as an indication for thyroidectomy: clinical characteristics and outcome in seven patients. J Clin Endocrinol Metab 2003;88:2667-72. - PubMed
    1. Zimmerman RS, Brennan MD, McConahey WM, et al. Hashimoto’s thyroiditis. An uncommon cause of painful thyroid unresponsive to corticosteroid therapy. Ann Intern Med 1986;104:355-7. - PubMed
    1. Kubota S, Nishihara E, Kudo T, et al. Initial treatment with 15 mg of prednisolone daily is sufficient for most patients with subacute thyroiditis in Japan. Thyroid 2013;23:269-72. - PubMed
    1. Levine SN. Current concepts of thyroiditis. Arch Intern Med 1983;143:1952-6. - PubMed
    1. Ohye H, Fukata S, Kubota S, et al. Successful treatment for recurrent painful Hashimoto’s thyroiditis by total thyroidectomy. Thyroid 2005;15:340-5. - PubMed

Publication types

LinkOut - more resources