Hyperthyroid Graves' Disease and Primary Hypothyroidism Caused by TSH Receptor Antibodies in Monozygotic Twins: Case Reports.

Tani, Junichi; Yoshida, Katsumi; Fukazawa, Hiroshi; Kiso, Yoshinori; Sayama, Noriyo; Mori, Keiichiro; Aizawa, Yoshihiko; Hori, Hirunobu; Nakasato, Naoki; Abe, Keishi

doi:10.1507/endocrj.45.117

Cited by 14 publications

(7 citation statements)

References 28 publications

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“…Although GD and HT have different phenotypes and the mechanisms leading to their dichotomy are unknown, they are generally believed to share a number of common etiological factors. In fact, there have been reports on monozygotic twins in whom one twin had GD and the other one had HT [1,2,3]. Moreover, both conditions may aggregate in the same families [4] or may even coexist in the same thyroid gland [5], and some individuals may progress from one form to the other.…”

Section: Introductionmentioning

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: Introductionmentioning

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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“…Apart from the present case and the recent case reports with Graves’ disease in twins [5-7], the combination of Graves’ disease and primary hypothyroidism in female twins has also been reported [19,20]. Aust et al described twins where simultaneously Graves’ disease and Hashimoto’s thyroiditis occurred in monozygotic twins [19].…”

Section: Discussionmentioning

confidence: 46%

Graves’ disease in monozygotic twins – a case report

2013

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BackgroundAutoimmune thyroid diseases including Graves’ disease and Hashimoto’s thyroiditis are caused by immune response to self-thyroid antigens. The rare situation of hyperthyroidism with Graves’ disease in twins has been reported in a very few case reports in literature.Case presentationWe present monozygotic female twins developing consecutively Graves’ disease within five years. One year before the diagnosis of Graves’ disease was established in the first twin, the mother developed a toxic thyroid nodule with hyperthyroidism leading to hemi thyroidectomy. Both the mother and the twins were cigarette smokers. The twins were treated with carbamizole and this therapy led to normalization of thyroid stimulating hormone and thyroxine.ConclusionThis case report supports the hypothesis that a genetic factor as well as an environmental factor (cigarette smoking) might be of great importance in the aetiology of Graves’ disease.

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“…The diagnosis of GD in two of the studies was confirmed by the presence of LATS (long-acting thyroid stimulator). In two pairs of twins, the GD patient was TSAb-positive, while TBAbs were detected in the patient with hypothyroidism (5,6). In the case presented here, TBII was only detected in the GD patient, who showed TSAb but not TBAb activity.…”

Section: Discussionmentioning

confidence: 52%

Graves’ disease and Hashimoto’s thyroiditis in monozygotic twins: case study as well as transcriptomic and immunohistological analysis of thyroid tissues

Aust

Krohn²,

Morgenthaler³

et al. 2006

eur j endocrinol

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Objective: To report on the rare simultaneous occurrence of Graves' disease (GD) and Hashimoto's thyroiditis (HT) in monozygotic twins. Design: We compared the pattern of thyroid tissue-derived cDNAs to gain insight into previous and ongoing immune destruction and reconstruction processes using microarrays. The results were confirmed by immunohistology and real-time PCR. Results: Destruction of thyroid tissue in HT reduced levels of thyrocyte-related cDNAs and cDNAs encoding extracellular matrix components, but increased levels of proteases involved in extracellular matrix degradation compared with GD. Lymphocytic infiltrates forming ectopic follicles replaced the thyroid tissue almost completely in HT. Thus, lymphocyte-related cDNA levels were higher in HT than in GD. The same was true for many chemokines and their receptors, which not only enable migration towards the thyroid but also maintain the lymphocytic infiltrate. HT also showed increased levels of cDNAs encoding molecules related to apoptosis than did GD. Surprisingly, the Th1-and Th2-specific cytokine profiles suggested for HT and GD respectively could not be confirmed. cDNAs encoding factors and receptors involved in angiogenesis were increased in GD compared with HT. Conclusions: Comparison of gene expression reflects the cellular differences between the two types of autoimmune thyroid disease in twins with identical genetic and similar environmental background.European Journal of Endocrinology 154 13-20

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Hyperthyroid Graves' Disease and Primary Hypothyroidism Caused by TSH Receptor Antibodies in Monozygotic Twins: Case Reports.

Abstract: Abstract.A

Cited by 14 publications

References 28 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

Graves’ disease in monozygotic twins – a case report

Graves’ disease and Hashimoto’s thyroiditis in monozygotic twins: case study as well as transcriptomic and immunohistological analysis of thyroid tissues

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