title: Acute suppurative thyroiditis as a rare complication of aggressive chemotherapy in children with acute myelogeneous leukemia.
abstract: Acute suppurative thyroiditis (AST) is quite rare, even in immunocompromised patients. The authors describe 2 cases of AST during aggressive chemotherapy for acute myelogeneous leukemia (AML). They were treated with aggressive combination chemotherapy and achieved complete remission. After several courses of chemotherapy, they developed fever and pain in the region of the thyroid gland. Laboratory tests showed hyperthyroidism and elevated levels of thyroglobulin and C-reactive protein. Ultrasonography revealed hypoechoic areas in the thyroid gland. A diagnosis of AST was made. Bacterial infections were suspected because they were sucessfully treated with antibiotics. After a month, the patients' thyroid function and thyroglobulin levels returned to normal without a period of transient hypothyroidism. A pyriform sinus fistula was not demonstrated. The results suggest that neutropenia and preceding cellulitis around the thyroid gland, which might be subsequent to oral mucosal damage induced by anticancer drugs, may play a role in the development of AST. AST should be considered a potential complication of aggressive chemotheragy for leukemia.
authors.affiliation: Department of Homeostatic Regulation and Development, Graduate School of Medical and Dental Sciences, Niigata University, Japan. chihayaimai@yahoo.co.jp
authors.forename: Chihaya
authors.initials: C
authors.lastname: Imai
authors.forename: Toshio
authors.initials: T
authors.lastname: Kakihara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Watanabe
authors.forename: Yukie
authors.initials: Y
authors.lastname: Ikarashi
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hotta
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Makoto
authors.initials: M
authors.lastname: Uchiyama
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D013969:Thyroiditis, Suppurative / Q000139:chemically induced* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed