title: Recurrence of thyrotoxicosis after attack of allergic rhinitis in patients with Graves' disease.
abstract: Graves' disease is frequently aggravated during antithyroid drug therapy; however, little is known of its aggravating factors. We studied 83 patients with Graves' disease who were euthyroid for at least 6 months under antithyroid maintenance therapy, and we examined the relationship between thyrotoxicosis relapse, attack of allergic rhinitis, and peripheral eosinophil increase. Forty-one patients showed thyrotoxicosis relapse; of these, 22 (54%) showed peripheral eosinophil increase, and 14 (34%) had attacks of allergic rhinitis. In the remaining 42 patients without thyrotoxicosis relapse, only 4 (10%, P < 0.001) showed an increase in peripheral eosinophils, and only 3 (7%, P < 0.01) had allergic rhinitis. Recurrence of thyrotoxicosis was observed with the increase in serum levels of TSH-receptor antibodies and increase in eosinophils 2 months after the attack of allergic rhinitis. Three patients with seasonal allergic rhinitis showed thyrotoxicosis relapse at the same time of year within 2 consecutive years. Our findings indicate that allergic rhinitis can be an aggravating factor of Graves' disease and suggest that the preceding increase in peripheral eosinophils can be a predictive indicator of recurrence of thyrotoxicosis during antithyroid drug therapy.
authors.affiliation: Department of Laboratory Medicine, Osaka University Medical School, Suita, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hidaka
authors.forename: N
authors.initials: N
authors.lastname: Amino
authors.forename: Y
authors.initials: Y
authors.lastname: Iwatani
authors.forename: E
authors.initials: E
authors.lastname: Itoh
authors.forename: M
authors.initials: M
authors.lastname: Matsunaga
authors.forename: H
authors.initials: H
authors.lastname: Tamaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000097:blood; D004804:Eosinophils; D005260:Female; D006111:Graves Disease / Q000150:complications*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011989:Receptors, Thyrotropin / Q000276:immunology; D012008:Recurrence; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications*; D013971:Thyrotoxicosis / Q000209:etiology*; D013974:Thyroxine / Q000097:blood
chemical_list: D000906:Antibodies; D011989:Receptors, Thyrotropin; D013974:Thyroxine