AMYLOID GOITER IN CYSTIC-FIBROSIS

Chronic infectious or inflammatory diseases lead to amyloid infiltrati on and dysfunction of many organs, including the kidney, liver, heart, and gastrointestinal tract, Subclinical amyloid infiltration of the t hyroid gland has been described in over 80% of such patients. However, symptomatic involvement of the thyroid gland by amyloid is rare, We d escribe a euthyroid patient with cystic fibrosis and widespread amyloi dosis who presented with a rapidly enlarging goiter and symptoms of lo cal compression that compromised his pulmonary status, Fine needle asp iration of the goiter was nondiagnostic. At surgery he proved to have replacement of the thyroid gland by amyloid. A review of the literatur e reveals only five previous cases of amyloid goiter in patients with cystic fibrosis, However, as more patients survive into adulthood, amy loid goiter may become a more common complication of cystic fibrosis, In contrast to other patients with reactive amyloidosis and goiter, pa tients with cystic fibrosis may require thyroid surgery to relieve air way compression that can compromise pulmonary function.