[Dysthyroid ophthalmopathy associated with hypothyroidism]

Graves' ophthalmopathy (exophthalmos, muscular and eyelid infiltration) is associated almost systematically to hyperthyroidism. A female patient was diagnosed with subclinical hypothyroidism and treated with oral thyroxine. Months later she developed bilateral exophthalmos and was serum-positive for thyrotropin receptor antibodies. Thyroxine treatment was suspended, and it was verified that her condition had developed into primary hypothyroidism. A diagnosis of Graves' disease with hypothyroidism was made.

The diagnosis was based on the existence of ophthalmopathy and positive serum antibodies, both specific indicators of Graves' disease. The coexistence of hypothyroidism with Graves' disease is exceptional, but possible.