Four Cases of Graves' Disease which Developed after Painful Hashimoto's Thyroiditis

Ohye, Hidemi; Nishihara, Eijun; Sasaki, Ichiro; Kubota, Sumihisa; Fukata, Shuji; Amino, Nobuyuki; Kuma, Kanji; Miyauchi, Akira

doi:10.2169/internalmedicine.45.1506

Cited by 33 publications

(27 citation statements)

References 34 publications

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“…In fact, the literature of the last years has included only sporadic case reports [8,11,12], but no epidemiological investigations. According to our data, the relative frequency of this sequence of events in a pediatric population is not exceptionally low: at least 3.7%.…”

Section: Discussionmentioning

confidence: 99%

Frequency of Hashimoto’s Thyroiditis Antecedents in the History of Children and Adolescents with Graves’ Disease

et al. 2010

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Background: The development of Graves’ disease (GD) from Hashimoto’s thyroiditis (HT) has sporadically been reported, but no data are available concerning the prevalence of this sequence of events in GD patients. Our aim was to ascertain HT antecedents in the history of GD children in order to assess for the first time the relative frequency of the event sequence leading from HT to GD in a pediatric population. Study Population and Results: In 105/109 patients, no HT antecedents were documented at GD presentation. The remaining 4 patients had previously exhibited a picture of HT with either hypothyroidism or euthyroidism. The interval between HT diagnosis and GD presentation ranged from 1.5 to 2.8 years. Serum thyrotropin receptor antibodies were higher in the patients with no HT antecedents. Conclusions: In at least 3.7% of the children with GD, hyperthyroidism may be preceded by HT presentation with either hypothyroidism or euthyroidism. The clinical course of GD in these patients is not different from the one observed in those with no HT antecedents. Our report confirms the existence of a continuum between HT and GD within the spectrum of autoimmune thyroid diseases.

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Section: Discussionmentioning

confidence: 99%

Frequency of Hashimoto’s Thyroiditis Antecedents in the History of Children and Adolescents with Graves’ Disease

et al. 2010

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“…Finally, another possible even though unusual outcome of HT is the conversion to GD [7,34,35]. In fact, according to a recent retrospective epidemiological study, in at least 3,7% of children and adolescents with GD, the onset of hyperthyroidism may be preceded by an HT diagnosis, with either hypothyroidism or euthyroidism [9].…”

Section: Introductionmentioning

confidence: 99%

Hashimoto's thyroiditis in childhood: presentation modes and evolution over time

et al. 2013

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Aim of this survey is to report the most recent views about Hashimoto’s thyroiditis (HT) natural history according to the different presentations. In children presenting with either euthyroidism or subclinical hypothyroidism HT spontaneous course is frequently characterized by a trend towards deterioration of thyroid function, whereas in those presenting with overt hyperthyroidism a definitive resolution of hyperthyroid phase is to be expected. Another possible even though unusual outcome of HT is the conversion to Graves’ disease.

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“…In 2 of them “occasional giant cells” were reported, while granulomatous inflammation or giant cells were not reported in the final histological report of the surgical specimen. Ohye et al [27] reported 2 patients: one of them showed both lymphocytic infiltration and granulomatous inflammation, while the other had only chronic lymphocytic thyroiditis. These observations (though only in 1/16 cases, with other 2 doubtful cases) may indicate that granulomatous changes may be present in PHT and are not specific for SAT.…”

Section: Discussionmentioning

confidence: 99%

Thyroidectomy for Painful Thyroiditis Resistant to Steroid Treatment: Three New Cases with Review of the Literature

Mazza

Quaglino

Suriani

et al. 2015

Case Reports in Endocrinology

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Thyroidal pain is usually due to subacute thyroiditis (SAT). In more severe forms prednisone doses up to 40 mg daily for 2-3 weeks are recommended. Recurrences occur rarely and restoration of steroid treatment cures the disease. Rarely, patients with Hashimoto's thyroiditis (HT) have thyroidal pain (painful HT, PHT). Differently from SAT, occasional PHT patients showed no benefit from medical treatment so that thyroidectomy was necessary. We report three patients who did not show clinical response to prolonged high dose prednisone treatment: a 50-year-old man, a 35-year-old woman, and a 33-year-old woman. Thyroidectomy was necessary, respectively, after nine-month treatment with 50 mg daily, two-month treatment with 75 mg daily, and one-month treatment with 50 mg daily. The two women were typical cases of PHT. Conversely, in the first patient, thyroid histology showed features of granulomatous thyroiditis, typical of SAT, without fibrosis or lymphocytic infiltration, typical of HT/PHT, coupled to undetectable serum anti-thyroid antibodies. Our data (1) suggest that not only PHT but also SAT may show resistance to steroid treatment and (2) confirm a previous observation in a single PHT patient that increasing prednisone doses above conventional maximal dosages may not be useful in these patients.

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Four Cases of Graves' Disease which Developed after Painful Hashimoto's Thyroiditis

Abstract: We report four cases of Graves

Cited by 33 publications

References 34 publications

Frequency of Hashimoto’s Thyroiditis Antecedents in the History of Children and Adolescents with Graves’ Disease

Frequency of Hashimoto’s Thyroiditis Antecedents in the History of Children and Adolescents with Graves’ Disease

Hashimoto's thyroiditis in childhood: presentation modes and evolution over time

Thyroidectomy for Painful Thyroiditis Resistant to Steroid Treatment: Three New Cases with Review of the Literature

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