Development of Graves' hyperthyroidism from primary hypothyroidism in a case of thyroid hemiagenesis.
We report a 42-year-old female with right thyroid hemiagenesis who initially presented with hypothyroidism and then developed hyperthyroidism. The serum titer of thyroid-stimulating antibody was weakly positive in the initial hypothyroid state, and then markedly increased along with the development of hyperthyroidism, while thyroid stimulation-blocking antibody was continuously negative throughout the observation period. Thyroid histology of biopsied specimens during the hypothyroid state demonstrated diffuse thyroiditis with mononuclear cell infiltrations; however, the histology during the hyperthyroid state showed hyperplasia in follicular epithelial cells accompanied by partial lymphocyte infiltration. This is the first case of thyroid hemiagenesis associated with a conversion from primary hypothyroidism due to Hashimoto's thyroiditis to hyperthyroidism due to Graves' disease.
Bando
Y
Y
Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan.
Nagai
Y
Y
Ushiogi
Y
Y
Toya
D
D
Tanaka
N
N
Fujisawa
M
M
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001707:Biopsy, Needle; D005260:Female; D006111:Graves Disease / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D006801:Humans; D007037:Hypothyroidism / Q000150:complications*; D018828:Immunoglobulins, Thyroid-Stimulating / Q000097:blood; D011989:Receptors, Thyrotropin / Q000097:blood; D013667:Technetium; D013961:Thyroid Gland / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D014463:Ultrasonography
D001323:Autoantibodies; D018828:Immunoglobulins, Thyroid-Stimulating; D011989:Receptors, Thyrotropin; C094372:thyrotropin-binding inhibitory immunoglobulin; D014284:Triiodothyronine; D013667:Technetium; D013972:Thyrotropin; D013974:Thyroxine