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Primary hypothyroidism followed by hyperthyroidism. Five case reports.

S Skare, H M Frey, R Konow-Thorsen

    Acta Endocrinologica
    |February 1, 1984
    PubMed
    Summary
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    Patients treated for primary hypothyroidism later developed Graves' disease, suggesting a potential link between these autoimmune thyroid conditions. Further research is needed to understand the underlying pathogenesis of this association.

    Area of Science:

    • Endocrinology
    • Immunology
    • Thyroidology

    Background:

    • Primary hypothyroidism and Graves' disease are common autoimmune thyroid disorders.
    • The sequential development of these conditions in the same patient is unusual.
    • Understanding the relationship between hypothyroidism and Graves' disease is crucial for patient management.

    Observation:

    • Five adult patients developed primary hypothyroidism and were treated with L-thyroxine.
    • These patients later developed Graves' disease between six months and 34 years after their initial hypothyroidism diagnosis.
    • Two patients had detectable TSH binding inhibiting immunoglobulin (TBII) when Graves' disease manifested.

    Findings:

    • The study describes a series of patients with a history of hypothyroidism who subsequently developed Graves' disease.

    Related Experiment Videos

  • Treatment with carbimazole was initiated for Graves' disease, with three patients experiencing relapse after discontinuation.
  • The presence of TSH binding inhibiting immunoglobulin (TBII) in some patients suggests ongoing autoimmune activity.

    • Implications:

    • The findings suggest a potential, yet unexplained, association between primary hypothyroidism and the subsequent development of Graves' disease.
    • The pathogenesis of developing Graves' disease after hypothyroidism requires further investigation.
    • This observation may inform clinical surveillance and diagnostic approaches in patients with autoimmune thyroid disease.