Typical graves' ophthalmopathy in primary hypothyroidism

Area of Science:

• Endocrinology
• Ophthalmology
• Autoimmune Diseases

Background:

• Graves ophthalmopathy (GO) typically co-occurs with hyperthyroidism.
• GO in euthyroid or hypothyroid patients is uncommon.
• This study focuses on a rare presentation of GO in a hypothyroid patient.

Observation:

• A 52-year-old man with recently diagnosed primary hypothyroidism presented with bilateral proptosis and chemosis.
• Ophthalmological examination and orbital MRI confirmed Graves ophthalmopathy.
• This marks the first reported case of GO in a hypothyroid patient from Pakistan.

Findings:

• The patient exhibited classic signs of Graves ophthalmopathy despite having primary hypothyroidism.
• Magnetic resonance imaging confirmed the diagnosis of GO.
• The case highlights the unusual association of GO with hypothyroidism.

Implications:

• Graves ophthalmopathy can occur in patients with primary hypothyroidism.
• Steroid therapy is effective for GO in hypothyroid patients, similar to hyperthyroid cases.
• This case expands the understanding of GO presentation and management in autoimmune thyroid disease spectrum.