title: Primary hypothyroidism followed by hyperthyroidism. Five case reports.
abstract: Five patients are described, who developed primary hypothyroidism between 25 and 57 years of age. They were all adequately treated with L-thyroxine. Graves' disease developed six months to 34 years later. Two had TSH binding inhibiting immunoglobulin (TBII) in their serum at this stage. All were treated with carbimazole, and 3 have experienced relapse upon withdrawal. Our patients are discussed in relation to the 16 cases previously reported. The pathogenesis of this condition is open to speculation.
mesh_terms: D000328:Adult; D000368:Aged; D002231:Carbimazole / Q000627:therapeutic use; D005260:Female; D006111:Graves Disease / Q000209:etiology*; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D013974:Thyroxine / Q000627:therapeutic use; D013975:Thyroxine-Binding Proteins / Q000032:analysis
chemical_list: D013975:Thyroxine-Binding Proteins; D002231:Carbimazole; D013974:Thyroxine