title: Presence of Thyroid-Stimulating Hormone Receptor Antibodies in a Patient with Subacute Thyroiditis followed by Hypothyroidism and Later Graves' Disease with Ophthalmopathy: A Case Report.
abstract: BACKGROUND
  The development of Graves' disease (GD) after subacute thyroiditis (SAT) is very rare and only a limited number of cases have been reported.
  
  
  OBJECTIVE
  Here, we report a patient with SAT followed by hypothyroidism and later GD, with ophthalmopathy, occurring 11 years after SAT.
  
  
  CONCLUSIONS
  This case illustrates the appearance of thyroid-stimulating hormone (TSH) receptor antibodies in a female 1 year after SAT, the development of hypothyroidism requiring thyroxine, and later the occurrence of GD with severe ophthalmopathy, 11 years after SAT. The occurrence of SAT and GD may be coincidental but SAT may have induced the appearance of TSH-receptor antibodies, with the bioactivity changing from blocking, leading to hypothyroidism, and later to a stimulating activity that led to GD in a genetically susceptible patient.
authors.affiliation: Department of Endocrinology, Skåne University Hospital, Malmö, Sweden ; Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Hallengren
authors.affiliation: Department of Endocrinology, Skåne University Hospital, Malmö, Sweden ; Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Tereza
authors.initials: T
authors.lastname: Planck
authors.affiliation: Department of Ophthalmology, Skåne University Hospital, Malmö, Sweden ; Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Åsman
authors.affiliation: Department of Endocrinology, Skåne University Hospital, Malmö, Sweden ; Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Lantz
keywords: Endocrine ophthalmopathy; Graves’ disease; Subacute thyroiditis; Thyroid-stimulating hormone receptor antibody