Hashimoto's thyroiditis presenting as acute painful thyroiditis and as a manifestation of an immune reconstitution inflammatory syndrome in a human immunodeficiency virus-seropositive patient.
BACKGROUND
An immune reconstitution inflammatory syndrome (IRIS) may complicate immune restoration following start of antiretroviral therapy (ART) in human immunodeficiency virus (HIV)-infected patients. The occurrence of Graves' disease in the setting of an IRIS is well recognized. We hereby report a case of Hashimoto's thyroiditis, presenting as an acute painful thyroiditis, and as a complication of IRIS.


CONCLUSIONS
A painful acute thyroiditis with thyrotoxicosis occurred in a 37-year-old HIV-infected woman 10 months after initiation of ART. This thyroiditis was associated with the appearance of a high titer of anti-thyroid peroxidase (anti-TPO) antibodies and was followed by persistent hypothyroidism, requiring thyroxine replacement therapy.


CONCLUSIONS
Hashimoto's thyroiditis may present as an acute thyroiditis with thyrotoxicosis in HIV-infected patients after initiation of ART. Clinicians caring for HIV-infected patients should be aware of this possible association.
Department of Internal Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Roos
R
Visser
Quirijn
Q
de Mast
Romana T
RT
Netea-Maier
Andre J A M
AJ
van der Ven
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D050031:Hashimoto Disease / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000209:etiology*; D007453:Iodide Peroxidase / Q000276:immunology; D013967:Thyroiditis, Autoimmune / Q000150:complications*; D013971:Thyrotoxicosis / Q000209:etiology*; D013974:Thyroxine / Q000627:therapeutic use
D044966:Anti-Retroviral Agents; D007453:Iodide Peroxidase; D013974:Thyroxine