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Hyperthyroidism from autoimmune thyroiditis in a man with type 1 diabetes mellitus: a case report
1Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA. jamory@u.washington.edu.
Journal of Medical Case Reports
|July 5, 2011
Summary
This case study highlights autoimmune thyroiditis presenting as hyperthyroidism in a man with type 1 diabetes mellitus. This condition can rapidly progress to hypothyroidism, necessitating thyroid hormone replacement.
Area of Science:
- Endocrinology
- Autoimmune Diseases
- Metabolic Disorders
Background:
- Type 1 diabetes mellitus (T1DM) is an autoimmune condition.
- Autoimmune thyroiditis (AIT) is a common comorbidity of T1DM.
- Hyperthyroidism secondary to AIT in men with T1DM is rarely described.
Purpose of the Study:
- To describe the presentation, diagnosis, clinical course, and treatment of a male patient with T1DM and hyperthyroidism due to AIT.
- To emphasize the importance of considering AIT in T1DM patients presenting with hyperthyroidism.
Main Methods:
- Case report of a 32-year-old male with an 8-year history of T1DM.
- Evaluation included physical examination, thyroid function tests, thyroid autoantibody assays, and radioactive iodine uptake scan.
- Clinical and biochemical monitoring for thyroid status changes.
Main Results:
- Patient presented with unintentional weight loss and biochemical hyperthyroidism (suppressed TSH, elevated T4).
- Positive anti-thyroid peroxidase antibodies and negative thyroid-stimulating immunoglobulin confirmed AIT.
- Radioactive iodine uptake was markedly low (0.5% at 24 hours).
- Patient subsequently developed hypothyroidism and was treated with thyroxine.
Conclusions:
- Autoimmune thyroiditis can manifest as hyperthyroidism in men with type 1 diabetes mellitus.
- AIT in this context may be isolated or part of a polyglandular syndrome.
- Graves' disease and other hyperthyroid causes must be excluded; AIT can rapidly progress to hypothyroidism requiring treatment.
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