Tuberculosis has often been implicated as a cause of specific organ disease - classic example being Addison's disease which was originally identified as tuberculosis of the adrenal glands. Tuberculosis of the thyroid is also documented - but not very often in recent years, in Europe and north America. (I suspect it is more common in those countries where tuberculosis itself is more prevalent.)
BMJ Case Rep. 2014 Feb 27;2014. pii: bcr2013202792. doi: 10.1136/bcr-2013-202792.
Primary tuberculosis of the thyroid gland: an unexpected cause of thyrotoxicosis.
Raman L1, Murray J, Banka R.
Department of Respiratory, King George Hospital, London, UK.
We describe a 38-year-old Indian man who presented with a 2-week history of fever, night sweats and neck swelling who was found to be clinically thyrotoxic with a nodular goitre, tachycardia and high fever. Biochemical investigation revealed hyperthyroidism in association with deranged liver function tests and raised inflammatory markers. Ultrasound and CT scans of the neck revealed multinodular thyroid enlargement. He was considered most likely to have an acute infectious thyroiditis with a differential diagnosis of a toxic multinodular goitre and was started on carbimazole and antibiotics. He underwent fine needle aspiration of the thyroid which revealed necrotic cells and acid-fast bacilli, confirming a diagnosis of primary tuberculosis (TB) of the thyroid gland with no evidence of any other organ involvement on systemic imaging. He was started on TB therapy for 6 months and discharged with outpatient follow-up. Symptoms and biochemical markers subsequently resolved.
[PubMed - in process]
And other reports here: