Graves' disease with only unilateral involvement; a case report

Area of Science:

• Endocrinology
• Immunology
• Nuclear Medicine

Background:

• Graves' disease is an autoimmune disorder causing diffuse goiter due to antibodies targeting thyrotropin receptors.
• Unilateral Graves' disease, affecting only one thyroid lobe, is a rare presentation with uncertain etiology.
• This report details a case of unilateral Graves' disease, contributing to understanding this uncommon manifestation.

Observation:

• A 43-year-old female presented with symptoms of thyrotoxicosis and unilateral neck swelling.
• Clinical examination revealed an enlarged right thyroid lobe with normal left lobe and isthmus.
• Laboratory tests confirmed thyrotoxicosis with positive anti-TSH receptor and anti-thyroperoxidase antibodies.

Findings:

• Neck ultrasound demonstrated an enlarged, hypervascular right thyroid lobe.
• Thyroid scintigraphy showed intense, unilateral uptake in the right lobe with suppression of the left.
• Diagnosis of unilateral Graves' disease was established based on clinical and imaging findings.

Implications:

• Unilateral Graves' disease shares the autoimmune basis and thyrotoxic symptoms of classical Graves' disease.
• Distinctive diagnostic features include unilateral lobar enlargement and scintigraphic uptake.
• Management and treatment outcomes for unilateral Graves' disease are comparable to the bilateral form, despite its rarity.