title: [A rare case of Graves' disease in a patient on regular haemodialysis].
abstract: OBJECTIVE
  Abnormal thyroid hormone production and metabolism are relatively common in chronic renal failure and in regular haemodialysis. Graves' disease is a very unusual condition and is difficult to identify. We report a case of Graves' disease in a patient on regular hemodialysis.
  
  
  METHODS
  A 26-year-old man undergoing regular hemodialysis from unknown chronic nephropathy since four years. The patient suffered from unexplained slimming and aggressiveness. On admission, he had an irritability, tremor of the extremities, arterial hypertension not controlled by the medical treatment, discrete asynergy oculo-palpebral, glare of the glance and protrusion of the ocular spheres. The thyroid was non palpable. Biological tests demonstrated hyperthyroidism. Thyroid-stimulating hormone receptor antibodies were positive. Thyroid echography and scintiscanning showed vascular and hyperfonctionnel character of the thyroid. The patient was treated radically by radioactive iodine 131 therapy after medical preparation by antithyroid agent. He developed hypothyroidism treated by substitutive treatment.
  
  
  CONCLUSIONS
  The diagnosis of Graves' disease must be evoked even in the absence of specific symptoms in haemodialysis patients. In front of clinical symptoms, since the conventional treatment is effective and inoffensive.
authors.affiliation: Service de médecine A, hôpital Charles-Nicolle, boulevard 9-Avril, Bab Souika, 1006 Tunis, Tunisie. ranou04@yahoo.fr
authors.forename: Karima
authors.initials: K
authors.lastname: Boubaker
authors.forename: Mondher
authors.initials: M
authors.lastname: Ounissi
authors.forename: Karima
authors.initials: K
authors.lastname: Khiari
authors.forename: Amel
authors.initials: A
authors.lastname: Harzallah
authors.forename: Monia
authors.initials: M
authors.lastname: Abbes
authors.forename: Fethi
authors.initials: F
authors.lastname: El Younsi
authors.forename: Taieb
authors.initials: T
authors.lastname: Ben Abdellah
authors.forename: Hedi
authors.initials: H
authors.lastname: Ben Maïz
authors.forename: Hayet
authors.initials: H
authors.lastname: Kaaroud
authors.forename: Adel
authors.initials: A
authors.lastname: Kheder
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D006111:Graves Disease / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy / Q000209:etiology*; D018828:Immunoglobulins, Thyroid-Stimulating / Q000097:blood; D007457:Iodine Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D006435:Renal Dialysis; D013974:Thyroxine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D018828:Immunoglobulins, Thyroid-Stimulating; D007457:Iodine Radioisotopes; D013974:Thyroxine