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Graves' disease presented as painful goiter
Chen-Shun Chao1, Shih-Yi Lin, Wayne Huey-Herng Sheu
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
Hormone Research
|May 15, 2002
Summary
This case study highlights a rare instance of painful goiter as the initial symptom of Graves' disease. Prompt treatment with anti-thyroid medication and corticosteroids effectively managed the thyroid pain and inflammation.
Area of Science:
- Endocrinology
- Immunology
Background:
- Graves' disease is an autoimmune disorder typically causing hyperthyroidism.
- Thyroid gland pain (goiter tenderness) is an uncommon initial presentation of Graves' disease.
Observation:
- A 32-year-old female presented with a painful, enlarged thyroid gland, elevated thyroid hormones, suppressed TSH, and increased inflammatory markers.
- Initial investigations suggested an acute inflammatory thyroid process, but subsequent tests confirmed Graves' disease.
Findings:
- The patient was treated with propylthiouracil for hyperthyroidism and prednisolone for pain.
- Rapid improvement in thyroid tenderness and normalization of inflammatory markers were observed.
- Despite symptom resolution, persistent hyperthyroidism required ongoing management.
Implications:
- This case underscores the importance of considering Graves' disease even with atypical presentations like painful goiter.
- The findings suggest that inflammatory processes can contribute to thyroid pain in Graves' disease.
- Early diagnosis and multimodal treatment are crucial for managing painful thyroid conditions associated with Graves' disease.