SAT-598 Traumatic Thyroiditis by Hanging in a Judoka Teen

Background: Traumatic thyroiditis cases has been previously reported related to multiple causes; however, no case of strangulation thyroiditis have been reported in martial arts practitioners. Clinical case: 15 years old male, reports 8 weeks of typical thyrotoxicosis symptoms (palpitations, loss of 12 kg of weight, asthenia, fatigue, diaphoresis and tremor). At anamnesis relates an episode of hanging during an official judo competition. The initial labs revealed suppression of TSH (0.01) and high free T4 confirming thyroiditis. Autoinmunity studies were negatives (anti-peroxidase and anti-thyroglobulin antibodies). Taking into account the duration of the symptoms, the absent goiter and exofthalmos an Tc 99 thyroid scintigraphy was done, revealing blockage in the capture of the radiopharmaceutical and a low thyroid uptake (0.1%), confirming the traumatic etiology of thyroiditis in this patient. Symptomatic management with propranolol 40mg twice a day was initiated. At follow up, three months later the patient was asymptomatic, and euthyroid (TSH ⋯. And FreeT4⋯.), reflecting thyroiditis resolution. Pocecco E et al., in his systematic literature review published in 2013 in The British Journal of Sports Medicine, reviewed all the injuries suffered by judokas in the olympic games from 2008-2012, no cases of thyroiditis were found.( 1). Another published article in 2015, by Keun-Suh Kim et al, neither reported cases of thyroiditis related to trauma in olympic martial arts. The case reported in the New England Journal of Medicine in 1984, corresponded to a painful thyroiditis in an aikido participant, with no altered thyroid function.( 3)Conclusion: We report the first case of subacute thyroiditis with tirotoxicosis and spontaneous resolution in a patient with strangulation during judo practice. References: 1. Poecco E et al. Injuries in judo: a systematic literature review including suggestions for prevention. Br J Sports Med. 2013 Dec;47(18):1139-43.2. Keun-Suh Kim et al. Injuries in national Olympic level judo athletes: an epidemiological study. Br J Sports Med. 2015 Sep;49(17):1144-503. Blum M, Schloss MF. Martial-arts thyroiditis. N Engl J Med. 1984;311(3):199-200.