[A rare case of Graves' disease in a patient on regular haemodialysis].
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.
Boubaker
Karima
K
Service de médecine A, hôpital Charles-Nicolle, boulevard 9-Avril, Bab Souika, 1006 Tunis, Tunisie. ranou04@yahoo.fr
Ounissi
Mondher
M
Khiari
Karima
K
Harzallah
Amel
A
Abbes
Monia
M
El Younsi
Fethi
F
Ben Abdellah
Taieb
T
Ben Maïz
Hedi
H
Kaaroud
Hayet
H
Kheder
Adel
A
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
D015415:Biomarkers; D018828:Immunoglobulins, Thyroid-Stimulating; D007457:Iodine Radioisotopes; D013974:Thyroxine