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Harlequin syndrome in a case of toxic goitre: a rare association.

Pradeep PV, Benede AK, Harshita SS, Jayashree B - Case Rep Med (2011)

Bottom Line: Harlequin syndrome (HS) is known to be associated with conditions like brain stem infarcts and superior mediastinal neurinoma.Previous reports have suggested that a tortuous inferior thyroid artery can produce neurovascular compression of the sympathetic chain which was not observed in our patient.Increased sweating in hyperthyroid patients needs to be assessed properly so as to prognosticate appropriately.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrine Surgery, Narayana Medical College & Superspeciality Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524002, India.

ABSTRACT
Harlequin syndrome (HS) is known to be associated with conditions like brain stem infarcts and superior mediastinal neurinoma. However, it has not been reported in association with autoimmune hyperthyroidism. We report a case of exacerbation of unilateral sweating in a patient with HS following the onset of toxic goitre. Previous reports have suggested that a tortuous inferior thyroid artery can produce neurovascular compression of the sympathetic chain which was not observed in our patient. Autoimmune aetiology for HS needs to be explored. Increased sweating in hyperthyroid patients needs to be assessed properly so as to prognosticate appropriately.

No MeSH data available.


Related in: MedlinePlus

It depicts the postoperative status with the thyroidectomy scar.
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fig2: It depicts the postoperative status with the thyroidectomy scar.

Mentions: The patient had also felt that she is sweating more on the right side of the face which appeared six months after the thyroid swelling. There was no associated Horner's syndrome. MRI of the neck and superior mediastinum revealed no lesions. At surgery, the right lobe of thyroid measured 6.5 × 3 × 3.5 cm, left lobe 6 × 3 × 3.2 cm and contained multiple nodules. The inferior thyroid artery was visualized on both sides. The left inferior thyroid artery was longer and tortuous in course when compared to the right side. After the surgery at 1.5 years of followup, Harlequin syndrome persisted (Figure 2). She had no signs of hypocalcemia or voice changes.


Harlequin syndrome in a case of toxic goitre: a rare association.

Pradeep PV, Benede AK, Harshita SS, Jayashree B - Case Rep Med (2011)

It depicts the postoperative status with the thyroidectomy scar.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3139896&req=5

fig2: It depicts the postoperative status with the thyroidectomy scar.
Mentions: The patient had also felt that she is sweating more on the right side of the face which appeared six months after the thyroid swelling. There was no associated Horner's syndrome. MRI of the neck and superior mediastinum revealed no lesions. At surgery, the right lobe of thyroid measured 6.5 × 3 × 3.5 cm, left lobe 6 × 3 × 3.2 cm and contained multiple nodules. The inferior thyroid artery was visualized on both sides. The left inferior thyroid artery was longer and tortuous in course when compared to the right side. After the surgery at 1.5 years of followup, Harlequin syndrome persisted (Figure 2). She had no signs of hypocalcemia or voice changes.

Bottom Line: Harlequin syndrome (HS) is known to be associated with conditions like brain stem infarcts and superior mediastinal neurinoma.Previous reports have suggested that a tortuous inferior thyroid artery can produce neurovascular compression of the sympathetic chain which was not observed in our patient.Increased sweating in hyperthyroid patients needs to be assessed properly so as to prognosticate appropriately.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrine Surgery, Narayana Medical College & Superspeciality Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524002, India.

ABSTRACT
Harlequin syndrome (HS) is known to be associated with conditions like brain stem infarcts and superior mediastinal neurinoma. However, it has not been reported in association with autoimmune hyperthyroidism. We report a case of exacerbation of unilateral sweating in a patient with HS following the onset of toxic goitre. Previous reports have suggested that a tortuous inferior thyroid artery can produce neurovascular compression of the sympathetic chain which was not observed in our patient. Autoimmune aetiology for HS needs to be explored. Increased sweating in hyperthyroid patients needs to be assessed properly so as to prognosticate appropriately.

No MeSH data available.


Related in: MedlinePlus