Marine Lenhart syndrome: Case reports of an unusual hyperthyroidism presentation
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Graves’ disease
thyroid nodules

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Álvarez, A., Jaramillo , D. ., Valencia , A. I. ., Orozco, E., Zuluaga Gil, A., & Aristizabal, N. (2023). Marine Lenhart syndrome: Case reports of an unusual hyperthyroidism presentation. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 10(1).


Introduction: Marine Lenhart syndrome is a rare form of presentation of Graves’ disease or diffuse hypercapting goiter, which is associated with autonomously functioning thyroid nodules. It has a prevalence between 0.8-2.7% among patients with Graves’ disease. This pathology is suspected in patients who require high doses of antithyroid drugs, its diagnosis is based on the finding of an enlarged hyperfunctioning gland, associated with one or more thyrotropin (TSH) dependent and histologically benign nodules. Treatment consists of high doses of antithyroid or radioactive iodine, and in selected cases, thyroidectomy.

Objective: The objective of this case study is to determine the sociodemographic, clinical, and therapeutic profile of patients with Marine Lenhart syndrome treated at a third level center in Medellín.

Case presentation: Therefore, we present the cases of two patients who consulted due to a clinical presentation compatible with thyrotoxicosis, who underwent a scintigraphy associated with ultrasound, and whose results established the diagnosis. Management with antithyroids was performed until euthyroidism was achieved prior to definitive therapy with surgery.

Discussion and conclusion: This article discusses the definition, clinical presentation, diagnosis and treatment of Marine Lenhart syndrome. In addition, this paper presents two clinical cases of patients with the disease, diagnostic imaging, paraclinical findings and clinical approach.
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