The oldest case of Marine-Lenhart syndrome?

Thyroid dysfunction is relatively common, with hypothyroidism in women reported to have a prevalence of 4.1 per 1000 population, and 0.8 per 1000 having hyperthyroidism. Unlike hypothyroidism which becomes more prevalent with age, Grave’s disease – autoimmune hyperthyroidism – seems to not do this, with the incidence remaining relatively steady at 1 in 1000 per year between the ages of 35 and 60 years. Thyroid nodules are also very common, being palpable in approximately 5%, and being detectable on ultrasound in up to two thirds in the general (iodine replete) population. The prevalence has been shown to be higher with increasing age and in women. The vast majority of these nodules are non-functioning, and cause no symptoms. Thus the presence of autonomously functioning nodules within a Grave’s thyroid is rare, occurring in 0.8% to 2.7% of cases of Grave’s disease. We present such a case of Marine Lenhart syndrome – functioning nodules within an overactive thyroid gland – in a lady of advanced age.