[An operative case of ulcerative colitis associated with hyperthyroidism]

Area of Science:

• Endocrinology
• Gastroenterology
• Immunology

Background:

• Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
• Hyperthyroidism, a condition of overactive thyroid, can present with various symptoms.
• A potential association between autoimmune thyroid diseases and UC has been noted in previous studies.

Observation:

• A 26-year-old male presented with symptoms suggestive of adrenal insufficiency, including weight loss, fever, and palpitations.
• Diagnostic workup revealed hyperthyroidism, characterized by elevated serum free T3 and T4 levels and suppressed TSH.
• The patient's hyperthyroidism symptoms and thyroid function were managed with thiamazole prior to surgery.

Findings:

• The patient underwent total proctocolectomy for ulcerative colitis.
• This case represents one of only nine reported instances of hyperthyroidism coexisting with UC in Japan.
• The co-occurrence suggests a possible shared autoimmune or immunological pathway in the pathogenesis of both conditions.

Implications:

• The findings underscore the importance of recognizing and managing hyperthyroidism in patients with UC, especially when surgery is indicated.
• Further research is needed to elucidate the precise immunological mechanisms underlying the association between hyperthyroidism and UC.
• Understanding this link may lead to improved diagnostic and therapeutic strategies for patients with these coexisting conditions.