A Case of Graves' Disease in a Patient with Kartagener's Syndrome (Complete Visceral Inversion, Chronic Sinusitis, and Bronchiectasis).

IF 0.7 Q4 SURGERY
Surgical Case Reports Pub Date : 2025-01-01 Epub Date: 2025-01-31 DOI:10.70352/scrj.cr.24-00437
Naoyoshi Onoda, Masashi Yamamoto, Hiroo Masuoka, Minoru Kihara, Takuya Higashiyama, Akihiro Miya, Kahoru Nishina, Akira Miyauchi
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Abstract

Introduction: Kartagener's syndrome (KS) is a rare disease characterized by a triad of situs inversus totalis, chronic sinusitis, and bronchiectasis. The disorder is caused by a hereditary genetic abnormality that impairs ciliary movement. Although aberrant pass course of the inferior laryngeal nerves due to visceral inversion should be considered during thyroid surgery in patients with KS, no report of surgical treatment for Graves' disease (GD) in patients with KS has been found to date.

Case presentation: A Japanese male in his 40s was referred to our hospital for surgical treatment for drug-refractory GD. He was diagnosed to have KS by genetic alteration of the DNAH5 gene as well as clinical triad. No abnormal branching in the mediastinal great vessels was identified in the present case, and left-sided non-recurrent inferior laryngeal nerve (NRLN) was not observed during surgery. Previous literature has demonstrated that the presence of a right-sided aortic arch and an anomalous branch of the left subclavian artery, as well as the absence of a left ductus arteriosus demonstrable on preoperative imaging studies, are prerequisites for the development of the extremely rare left-sided NRLN.

Conclusion: We reported the first case of surgical treatment for GD in a patient with KS and discussed the preoperative diagnosis of NRLN.

Graves病合并Kartagener综合征(完全性内脏倒置、慢性鼻窦炎和支气管扩张)1例。
简介:卡塔赫纳综合征(KS)是一种罕见的疾病,其特征是全身性倒位,慢性鼻窦炎和支气管扩张。这种疾病是由损害纤毛运动的遗传基因异常引起的。虽然在KS患者的甲状腺手术中应考虑由于内脏内翻导致的喉下神经异常通过,但迄今为止尚未发现KS患者Graves病(GD)的手术治疗报告。病例介绍:一名40多岁的日本男性因药物难治性GD转诊至我院接受手术治疗。经DNAH5基因改变及临床三联征诊断为KS。本病例未发现纵隔大血管分支异常,术中未发现左侧非复发喉下神经(NRLN)。先前的文献表明,右侧主动脉弓和左侧锁骨下动脉异常分支的存在,以及术前影像学检查显示左侧动脉导管的缺失,是发生极其罕见的左侧NRLN的先决条件。结论:我们报道了首例手术治疗GD的KS患者,并讨论了NRLN的术前诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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