Cardiomyopathy associated with Graves' disease

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H Koshiyama1, D F Sellitti, T Akamizu

  • 1Department of Internal Medicine, Hyogo Prefectural Amagasaki Hospital, Japan.

Clinical Endocrinology
|July 1, 1996
PubMed

Insights

Graves' disease can cause heart failure through cardiomyopathy. Autoimmunity against the TSH receptor (TSH-R) may link heart and eye conditions in Graves' disease patients.

Area of Science:

  • Endocrinology and Cardiology
  • Molecular Biology and Immunology

Background:

  • Cardiovascular manifestations in Graves' disease are typically attributed to elevated thyroid hormone levels.
  • This case explores a potential autoimmune mechanism beyond hormonal effects in Graves' disease.

Observation:

  • A 25-year-old male with Graves' disease presented with severe cardiomyopathy and heart failure.
  • Myocardial biopsies revealed fibroblast infiltration and degenerative changes.
  • The patient later developed goiter, hyperthyroidism, and Graves' ophthalmopathy, suggesting a unified pathological process.

Findings:

  • Thyroid stimulating hormone receptor (TSH-R) mRNA was detected in human heart tissue via RT-PCR and DNA sequencing.
  • These findings indicate the presence of TSH-R in the heart, a potential target for autoimmunity.

Implications:

  • Autoimmunity directed against the TSH receptor may be a contributing factor to both cardiomyopathy and ophthalmopathy in certain Graves' disease cases.
  • This suggests TSH-R as a potential common target in the pathogenesis of Graves' disease complications.
  • Further research into TSH-R autoimmunity could lead to novel therapeutic strategies for cardiovascular and ocular manifestations.

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