Spontaneous conversion from Graves’ disease to Hashimoto’s thyroiditis: a case report

Year 2018, Volume: 10 Issue: 1, 81 - 84, 05.04.2018

Muharrem Bayrak , Kenan Çadırcı , Emine Kartal Baykan , Unsal Aydın Ayşe Çarlıoğlu

https://doi.org/10.21601/ortadogutipdergisi.284911

Abstract

Graves’ disease and autoimmune thyroiditis are part of the spectrum of
thyroid diseases known to develop with an autoimmune etiology. The presence of
anti-thyroid autoantibodies is known, and the thyroid is the organ where
autoimmune diseases are most commonly seen in the all body. A 29-year-old woman
who admitted our clinic with tremor in the hands, sweating and palpitation was
diagnosed with Graves’ disease with accompanying laboratory findings and was
started on anti-thyroid therapy. The patient entered into remission at the end
of 2 years. She was then regarded as euthyroid and followed-up for another 18
months without using anti-thyroid drugs. At the end of 18 months,
Hashimoto’s thyroiditis was determined to have developed at routine polyclinic
follow-up.

Keywords

Graves’ disease, Hashimoto’s disease, autoantibodies

Graves hastalığından Hashimoto tiroiditine spontan dönüşüm: olgu sunumu

Abstract

Graves
hastalığı ve otoimmün tiroiditler, otoimmün etiyoloji ile oluştuğu gösterilmiş
tiroid hastalıkları spektrumunun içinde yer alır. Tiroide karşı otoantikorların
varlığı bilinmektedir ve tiroid tüm vücutda otoimmün hastalıkların en sık
görüldüğü organdır.  Ellerinde
titreme,  terleme ve çarpıntı şikayetleri
ile başvuran 29 yaşında bayan hastaya laboratuar bulgular eşliğinde Graves
hastalığı tanısı konularak anti-tiroid tedavi başlanıldı. Hasta iki yılın
sonunda remisyona girdi. Remisyona giren hasta 18 ay anti-tiroid ilaç kullanımı olmadan ötiroid
olarak takip edildi. 18. ayın sonunda rutin poliklinik kontrolünde Hashimoto
tiroiditi geliştiği tespit edildi.

Keywords

Graves hastalığı, Hashimoto Hastalığı, otoantikorlar

References

• 1-Sgarbi JA, Maciel RM. Pathogenesis of autoimmune thyroid disease. Arg Bras Endocrinol Metabol. 2009 Feb; 53(1): 5-14
• 2-Lee HJ, Li CW, Hammerstad SS, Stefan M, Tomer Y. Immunogenetics of autoimmune thyroid disease: A comprehensive review. J Autoimmun. 2015 Nov;64: 82-90
• 3-Antonelli A, Ferrari SM, Corrado A, Di Domenicantonio A, Fallahi P. Autoimmune thyroid disorders. Autoimmun Rev. 2015 Feb; 14(2): 174-80
• 4-Tomer Y, Huber A. The etiology of autoimmune thyroid disease: A story of genes and environment. J Autoimmun. 2009; 32(3-4): 231-239
• 5-Wiersinga WM. Clinical relevance of environmental factors in the pathogenesis of autoimmune thyroid disease. Endocrinol Metab (Seoul) 2016 May 13:1-10
• 6-Hasham A, Tomer Y. Genetic and epigenetic mechanism in thyroid autoimmunity. Immunol Res.2012 Dec; 54(1-3): 204-13
• 7-Majumder A, Sanyal D. A case of simultaneous occurence of Graves’ disease and Hashimoto’s thyroiditis. Indian J Endocrinol Metab. 2012 Dec; 16 ( Suppl 2): 338-339
• 8-Umar H, Muallima N, Adam JM, Sanusi H. Hashimoto’ s thyroiditis following Graves’ disease. Acta Med Indones 2010;42:31-5
• 9-Shigemasa C, Mitani Y, Taniguchi S, et al. Three patients who spontaneously developed persistent hypothyroidism during or following treatment with antithyroid drugs for Graves’ hyperthyroidism. Arch Intern Med. 1990 May;150( 5):1105-9
• 10-Ohye H, Nishihara E, Sasaki I, et al. Four cases of Graves' disease which developed after painful Hashimoto's thyroiditis. Intern Med 2006;45: 385-9.
• 11-Ouleghzal H, Imane Z, Boufares F. Exceptional Evolution of Autoimmune Hypothyroidism to Graves’ Disease. Turk Jem 2014; 18: 95-96
• 12-Tamai H, Hirota Y, Kasagi K, et al. The mechanism of spontaneous hypothyroidism in patients with Graves’ disease after antithyroid drug treatment. J Clin Endocrinol Metab. 1987 Apr; 64(4): 718-22