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Hashimoto's thyroiditis following Graves' disease
Husaini Umar1, Nur Muallima, John M F Adam
1Department of Internal Medicine, Faculty of Medicine, University of Hasanuddin-Wahidin Sudirohusodo Hospital, Makassar 90245, Sulawesi Selatan, Indonesia. husani_umar65@yahoo.co.id
Acta Medica Indonesiana
|March 23, 2010
Summary
Graves' disease can lead to Hashimoto's thyroiditis, an autoimmune condition. This study reports four cases where Hashimoto's developed after Graves' disease treatment, successfully managed with levothyroxine.
Area of Science:
- Endocrinology
- Immunology
- Pathology
Background:
- Graves' disease involves TSH receptor antibodies (TRAb) causing thyroid hyperplasia and hyperfunction.
- Hashimoto's thyroiditis is linked to TSH stimulation-blocking antibodies (TSBAb), leading to thyroid damage and atrophy.
- Approximately 15-20% of Graves' disease patients develop spontaneous hypothyroidism due to chronic thyroiditis.
Observation:
- This study presents four cases of chronic thyroiditis (Hashimoto's disease) in patients previously diagnosed with Graves' hyperthyroidism.
- In three cases, Hashimoto's thyroiditis emerged 7 to 25 years post-Graves' disease treatment.
- One case developed Hashimoto's thyroiditis within months of Graves' disease treatment.
Findings:
- Diagnosis of Hashimoto's disease was confirmed by clinical signs, elevated TSH, positive thyroid peroxidase and thyroglobulin antibodies, and fine needle aspiration biopsy.
- Histopathological tests further supported the diagnosis in two cases.
- All reported cases showed successful treatment outcomes with levothyroxine.
Implications:
- The development of Hashimoto's thyroiditis post-Graves' disease may stem from an extended immune response targeting endogenous thyroid antigens.
- Understanding this progression is crucial for managing autoimmune thyroid disorders.
- Levothyroxine is an effective treatment for Hashimoto's thyroiditis following Graves' disease.
Related Concept Videos
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Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...