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Article Synopsis
- - A 32-year-old male with a 7-year history of Graves disease experienced multiple recurrences requiring anti-thyroid medication, leading to fluctuating thyroid hormone levels and a period of remission before developing hyperthyroid symptoms again.
- - Diagnostic tests revealed elevated TRAb levels and a new thyroid nodule on ultrasound, classified as EU-TIRADS score 4, which led to surgery.
- - Post-surgery histopathology confirmed the nodule was a papillary microcarcinoma of 1 mm, associated with Hashimoto thyroiditis, and the patient's recovery was complicated by parathyreoprive tetany.
Acute adrenal crisis precipitated by thyroid storm in a patient with undiagnosed autoimmune polyglandular syndrome type 2.
Endocrinol Diabetes Metab Case Rep
April 2023
Endocrinology Department, Taher Sfar University Hospital, Mahdia, Tunisia.
Article Synopsis
- Autoimmune polyglandular syndrome type 2 is marked by Addison's disease, autoimmune thyroid disease, and/or type 1 diabetes, with specific cases known as Schmidt's syndrome involving adrenal insufficiency and thyroiditis.
- A rare case of a 28-year-old female presented a thyroid storm with an acute adrenal crisis, which was treated effectively with antithyroid drugs and intravenous glucocorticoids, although she later developed hypothyroidism likely due to Hashimoto's thyroiditis.
- The case highlights the need for clinicians to be alert to overlapping autoimmune conditions to prevent misdiagnosis and manage potentially life-threatening situations like adrenal insufficiency and thyroid storm, which require careful treatment strategies including glucocorticoids.
Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment.
Pol Arch Intern Med
March 2022
Georgetown University School of Medicine, Washington, United States
Hashimoto thyroiditis (HT) is a common autoimmune disorder, affecting women 7-10 times more often than men, that develops because of genetic susceptibility, Xchromosome inactivation patterns modulated by environmental factors as well as microbiome composition, and leads to an imbalance in self‑tolerance mechanisms. The consequential thyroid infiltration by lymphocytes, potentiated by antibody‑mediated autoimmune response through the antibodies against thyroid peroxidase (TPOAbs), leads to a destruction of thyrocytes. The presence of TPOAbs is associated with a 2 to 4‑fold increase in the risk of recurrent miscarriages and preterm birth in pregnant women.
View Article and Find Full Text PDFTransient T3 toxicosis associated with Hashimoto's disease.
Proc (Bayl Univ Med Cent)
January 2019
Texas Tech University Health Sciences Center, Clinical Research Institute and Department of Internal MedicineLubbockTexas.
In its early course, Hashimoto's disease may present as thyrotoxicosis (Hashitoxicosis). This usually manifests as elevated free T4 and suppressed thyroid-stimulating hormone (TSH). We report the unusual occurrence of an elevated T3 level in a patient with Hashimoto's disease.
View Article and Find Full Text PDFRare Co-occurrence of Ocular Myasthenia Gravis and Thyroid-Associated Orbitopathy (Ophthalmopathy) in an Individual With Hypothyroidism.
Front Endocrinol (Lausanne)
February 2019
Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Ocular myasthenia gravis (Ocular MG, OMG) shares many clinical features with thyroid-associated orbitopathy or thyroid-associated ophthalmopathy (TAO). In the rare instance of their coexistence, clinicians may fail to diagnose ocular MG when TAO is also present. Here we report the case of a patient with both TAO and ocular MG, whose "hyperthyroidism"-most likely the hashitoxicosis variant of Hashimoto's thyroiditis-rapidly transformed to hypothyroidism after radioactive iodine therapy.
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