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Clinical image - (2020)Volume 9, Issue 5
35 years man presented with foreign body sensation in mouth, difficulty in breathing and swallowing. He had noticed enlargement of his tongue, which filled the whole of his mouth. On further enquiry, he admitted of general weakness, associated with body aches, fatigue, swelling of face and constipation.
He was clinically suspected to have hypothyroidism and subjected the relevant thyroid hormone assays which confirmed primary hypothyroidism with elevated level of thyroid stimulating hormone (TSH) at 114 micro IU/mL (0.4-4.2)* combined with low levels of thyroid hormones (T3-48.6ng/dL (60-180)*, T4- 2.1mcg/dL (4.6-10.5)*. He was initiated on the standard replacement doses of levothyroxine.
At follow up, three and a half months later there was resolution of macroglossia and all the other symptoms with restoration of euthyroid state (T3-103ng/dL, t4- 10.7mcg/dL and TSH- 0.30 micro IU/mL). We report the rare presentation of primary hypothyroidism as macroglossia. Other causes of macroglossia include amyloidosis, acromegaly, Downs' syndrome and Beckwith-Wiedemann syndrome (Figure 1 & 2).
Figure 1: Macroglossia with teeth indentation on the lateral margins of the tongue.
Figure 2: Resolution of macroglossia.
Citation: Venkatanarasu A (2020) Uncommon Presentation of A Common Disease. Endocrinol Metab Syndr. 9:312. doi: 10.4172/2161-1017.20.9.312
Received: 11-Aug-2020 Accepted: 13-Aug-2020 Published: 20-Aug-2020 , DOI: 10.35248/2161-1017.20.9.312
Copyright: © 2020 Venkatanarasu A. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sources of funding : None