{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T02:27:02Z","timestamp":1784255222009,"version":"3.55.0"},"reference-count":40,"publisher":"Bioscientifica","issue":"6","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":1965,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Introduction: Marine-Lenhart syndrome (MLS) is now understood to be a combination of Graves\u2019 disease and autonomously functioning thyroid nodule(s) (AFTNs). The prevalence of the syndrome and suitable treatments for those living in iodine-sufficient areas are uncertain. Objectives: We aimed to investigate the prevalence, treatment, and prognosis of MLS in Japan, an iodine-sufficient area. Methods: This study involved patients who visited our hospital between February 2005 and August 2019. Among patients with both thyrotoxicosis and thyroid nodule(s) larger than 10 mm, MLS and isolated AFTNs were diagnosed based on serum thyroid-stimulating hormone receptor antibody levels and scintigraphy using radioiodine or technetium-99m and thyroid uptake. Results: Twenty-two patients were found to have MLS, compared to 372 with isolated AFTNs and 8,343 with Graves\u2019 disease, during the period. Therefore, the rate of MLS cases was 0.26% among all patients with Graves\u2019 disease (22\/8,343). Treatments and outcomes were assessed for cases of MLS (n = 18) and isolated AFTNs (n = 269). Antithyroid drugs (ATDs) were withdrawn in 27.8% of cases in the MLS group and 10.3% in the isolated AFTN group. There was no significant difference in the clinical outcome after ATD withdrawal between the 2 groups. However, the rate of hypothyroidism after radioactive iodine (RAI) administration was significantly higher in the MLS group than in the isolated AFTN group (42.9 vs. 9.0%, p = 0.005) despite similar doses of RAI. Conclusions: The prevalence of MLS among patients with Graves\u2019 disease was 0.26% in Japan. RAI therapy induces hypothyroidism more frequently than in those with AFTNs probably because RAI is taken up in the surrounding Graves\u2019 tissues.<\/jats:p>","DOI":"10.1159\/000510312","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T17:00:33Z","timestamp":1601485233000},"page":"461-467","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-17","source":"Crossref","is-referenced-by-count":16,"title":["Prevalence and Treatment Outcomes of Marine-Lenhart Syndrome in Japan"],"prefix":"10.1530","volume":"10","author":[{"given":"Hirosuke","family":"Danno","sequence":"first","affiliation":[{"name":"1Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eijun","family":"Nishihara","sequence":"additional","affiliation":[{"name":"1Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyoshi","family":"Kousaka","sequence":"additional","affiliation":[{"name":"1Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Nakamura","sequence":"additional","affiliation":[{"name":"1Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Kasahara","sequence":"additional","affiliation":[{"name":"1Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Kudo","sequence":"additional","affiliation":[{"name":"1Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Ito","sequence":"additional","affiliation":[{"name":"1Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Fukata","sequence":"additional","affiliation":[{"name":"1Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsushige","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"1Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"2Division of Surgery and Director, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, 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