Ayse Seker,
Dmed Dialysis Center, Turkey
Title: Amyloid goitre in a hemodialysis patient with rhematoid arthritis
Biography
Biography: Ayse Seker,
Abstract
The association between amyloidosis and collagen vascular diseases such as rheumatoid arthritis is well documented. A 55 years old man with 7 years hemodialysis was assessed for decreased appetite, dysphagia and nausea during hemodialysis session. He had been diagnosed with rheumatoid arthritis 20 years ago and had used prednisone regularly. On physical examination, the thyroid was diffusely enlarged (grade 4) with multiple nodules. He was biochemically euthyroid. Anti-thyroglobulin and anti-thyroid peroxidase autoantibodies were negative. Thyroid ultrasound showed multinodular goiter. Total thyroidectomy was performed. Histopathological examination showed dilated follicles surrounded by abundant homogenous substance which stained positive with Congo red. There was no evidence of medullary carcinoma. Complaints of dysphagia, nausea and decreased appetite of the patient improved after the operation. In literature, amyloid goitre with rheumatoid arthritis in a hemodialysis patient is very rare. Amyloidosis should be considered if there is a goiter that is rapidly growing and causes pressure symptoms in rheumatic disease patients.