Four patients with hypothyroid Graves' disease

• Published in: Netherlands journal of medicine Vol. 68; no. 4; pp. 178 - 180
• Main Authors: STARRENBURG-RAZENBERG, A. J, CASTRO CABEZAS, M, GAN, I. M, NJO, T. L, RIETVELD, A. P, ELTE, J. W. F
• Format: Journal Article
• Language: English
• Published: Alphen aan den Rijn Van zuiden 01.04.2010
• Subjects: Adult; Aged; Biological and medical sciences; Diagnosis, Differential; Endocrinopathies; Female; General aspects; Graves Ophthalmopathy - blood; Graves Ophthalmopathy - diagnosis; Hashimoto Disease - blood; Hashimoto Disease - diagnosis; Humans; Male; Medical sciences; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Thyroid. Thyroid axis (diseases); Endocrinopathy; Human; Medicine; Immunopathology; Hyperthyroidism; Thyroid diseases; Graves disease; Autoimmune disease; Patient; Hypothyroidism
• ISSN: 0300-2977; 1872-9061

In autoimmune hypothyroidism (Hashimoto's disease), TPO (thyroid peroxidase) antibodies may be detected, while in autoimmune hyperthyroidism (Graves' disease) thyroid-stimulating hormone (TSH ) receptor antibodies (TSH -R-AB s) are frequently present. Less well known is the fact that autoimmune hypothyroidism can present with TSH-R-ABs and ophthalmic Graves' disease (OGD). This condition is also known as hypothyroid Graves' disease. In this report we describe four patients with this uncommon phenomenon. These four cases demonstrate that differences between Hashimoto and Graves' disease are less clear than expected. Hypothetically the thyroid cell might be 'attacked' by blocking and stimulating antibodies. Dependent on the relative concentrations, hypothyroidism or hyperthyroidism may occur. So the differences between Hashimoto's disease and Graves' disease, at least in these cases, may be gradual and small.