This systematic review–meta-analysis appraises and summarizes all the available research (128 papers) on the zoonotic potential of Mycobacterium avium ssp. paratuberculosis. The latter has been debated for a century due to pathogenic and clinical similarities between Johne's disease in ruminants and Crohn's disease (108 studies) in humans and recently for involvement in other human diseases; human immunodeficiency virus (HIV) infection (2), sarcoidosis (3), diabetes mellitus type 1 (T1DM) (7) and type 2 (3), multiple sclerosis (5) and Hashimoto's thyroiditis (2). Meta-analytical results indicated a significant positive association, consistently across different laboratory methods for Crohn's disease [odds ratio (OR) range 4·26–8·44], T1DM (OR range 2·91–9·95) and multiple sclerosis (OR range 6·5–7·99). The latter two and the thyroiditis hypothesis require further investigation to confirm the association. Meta-regression of Crohn's disease studies using DNA detection methods indicated that choice of primers and sampling frame (e.g. general population vs. hospital-based sample) explained a significant proportion of heterogeneity. Other epidemiological studies demonstrated a lack of association between high-risk occupations and development of Crohn's disease. Due to knowledge gaps in understanding the role of M. paratuberculosis in the development or progression of human disease, the evidence at present is not strong enough to inform the potential public health impact of M. paratuberculosis exposure.

We describe a case of quick recovery of myocardium damage in a 15-year-old adolescent with subacute thyroiditis. After 1 week of admission, his cardiovascular status began to show signs of improvement accompanied by the recovery of electrocardiogram and indicators of myocardial damage. We speculate that myocardium damage associated with subacute thyroiditis is a complication of common virus, although we did not detect any abnormal virus antibody and deoxyribonucleic acid in the patient's serum.

Introduction: The globus sensation is a constant feeling of a lump in the throat and may be associated with thyroid enlargement. A two year prospective study was set up to ascertain the relationship between thyroid pathology and globus symptoms.

Materials and methods: All patients undergoing thyroid surgery over a two year period were included. Patients were questioned pre- and post-operatively. Globus symptom scores were recorded using a visual analogue scale. The size, weight and histological features of the removed specimens were correlated and statistical analysis performed.

Results: Two hundred patients were included in the study; 58 were symptomatic for globus pharyngeus pre-operatively, and 80 per cent of these patients' symptoms resolved post-operatively (p≤0.0001). Patients with histological features of inflammation showed the greatest improvement (p≤0.0001).

Conclusion: As many as one-third of patients with a thyroid mass will complain of a globus-like symptom. Patients undergoing thyroid surgery, who are symptomatic for globus pharyngeus, can expect that their symptoms will improve following surgery.

A 77-year-old euthyroid man developed atrial fibrillation on the fourth post-operative day following a total laryngectomy and right radical neck dissection including a hemi-thyroidectomy for a squamous cell carcinoma of the larynx with nodal metastases. The episode of atrial fibrillation coincided with an elevated serum free thyroxine of 3.36 ng/dl (43.3 pmol/L) (reference values: 0.71–1.85 ng/dl or 9.1–23.8 pmol/L), normal total triiodothyronine of 104 ng/dl (1.6 nmol/L) (reference values: 46–137 ng/dl or 0.7–2.1 nmol/L) and a suppressed thyroid-stimulating hormone (TSH) of 0.05 mIU/L (reference values: 0.35–5.0 mIU/L). These values, in relation to those prior and subsequent, suggested a surgery-induced thyroiditis. The limited literature about this controversial entity is reviewed.

A previously undescribed association of Reidel’s thyroiditis with Tolosa-Hunt syndrome is reported. A 33 year-old Caucasian female presented with a two-year historyof painful progressive goitre, histologically a Reidel’s thyroiditis. She underwent left partial thyroidectomy. Post-operatively she developed severe right retro-orbital pain, right temporal headache and a partial right occulomotor nerve palsy. A diagnosis of Tolosa-Hunt syndrome was made. Some important aspects of this case are discussed.

Both thyroglossal cysts and aberrant thyroid tissue may present as a mid-line neck swelling. We report a case of autoimmune thyroiditis presenting as a thyroglossal swelling in a middle-aged woman. This very rare finding is discussed with reference to the optimal management of thyroglossal tract swellings.

A potentially life-threatening case of recurrent left-sided thyroid abscess formation secondary to a fourth branchial arch sinus fistula is presented. The patient developed a reversible left vocal fold palsy during an acute episode of suppurative thyroiditis requiring a temporary tracheostomy due to a compromised airway. Investigations commonly used to demonstrate this anomaly may fail to confirm the diagnosis as in the case presented and exploratory surgery with excision of the fistulous tract should still be considered. We describe a method of repairing the pharyngeal opening to reduce the risk of recurrence or pharyngeal leak.

An unusual case of acute purulent thyroiditis in a 45-year-old man forming a large abscess in the left lobe of the thyroid gland is described. It perforated the capsule at the posterior wall of the thyroid, causing extensive retropharyngeal and retrotracheal abscesses. The patient was treated with broad-spectrum antibiotics and surgical excision of the infected tissues. He has remained well one year after the operation.