Melkersson-Rosenthal syndrome with Hashimoto thyroiditis in a 9-year-old girl: an autoimmune disorder

Pediatr Neurol. 2014 May;50(5):503-6. doi: 10.1016/j.pediatrneurol.2014.01.010. Epub 2014 Jan 7.

Abstract

Background: Melkersson-Rosenthal syndrome (MRS) is a rare disorder of unknown cause. The classical triad of MRS is orofacial edema, recurrent facial paralysis, and a fissured tongue.

Patient: We present a 9-year-old girl with a recurrent peripheral facial paralysis. She experienced the first episode of a peripheral facial paralysis on the same side without orofacial swelling and lingua plicata 1 year ago. She was diagnosed with Hashimoto thyroiditis 9 months earlier, as confirmed by an endocrinologic investigation.

Results: While the patient was hospitalized with recurrent facial paralysis, we found that serum levels of free thyroxine (1.3 ng/dL) and thyrotropin (0.4 uIU/mL) were within normal range, but the level of antithyroperoxidase antibodies (772.0 IU/mL) was very increased. She had been taking an oral prednisolone orally for 2 weeks. At the 1-month follow-up, the patient's symptoms had completely disappeared.

Discussion: The possible correlation between MRS and autoimmune disorders has been documented in only one report, which described an adult with autoimmune thyroiditis (Hashimoto thyroiditis) and MRS. We suggest that the co-occurrence of MRS and Hashimoto thyroiditis is not coincidental but linked to autoimmunity.

Keywords: Hashimoto disease; Melkersson–Rosenthal syndrome; child; facial paralysis.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / pathology
  • Child
  • Face / pathology
  • Female
  • Follow-Up Studies
  • Hashimoto Disease / blood
  • Hashimoto Disease / complications*
  • Hashimoto Disease / drug therapy
  • Hashimoto Disease / pathology
  • Humans
  • Melkersson-Rosenthal Syndrome / blood
  • Melkersson-Rosenthal Syndrome / complications*
  • Melkersson-Rosenthal Syndrome / drug therapy
  • Melkersson-Rosenthal Syndrome / pathology
  • Prednisolone / therapeutic use
  • Tongue / pathology
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Prednisolone