Transient Graves Disease Developing after Surgery for Cushing Disease

Thyrotoxicosis in a 13‐year‐old girl following pituitary adenectomy for Cushing′s disease

“…They speculate that exposure to a large amount of endogenous and supplementary glucocorticoid protected the patient from thyroid antigens and that tapering of the prednisolone caused exacerbation of immune responses resulting in thyroid dysfunction. Another case report tells of an adult developing transient Grave′s disease after surgery for Cushing′s disease and the authors presume that a latent autoimmune process in the thyroid, suppressed by hypercortisolism, developed into overt Grave′s disease after abrupt reduction of plasma glucocorticoid levels after surgery 12. Unlike our case, both of these cases postulate an antibody‐positive thyroid dysfunction, and therefore, this pediatric case is unique.…”

Development of Graves' Hyperthyroidism Caused an Adrenal Crisis in a Patient with Previously Unrecognized Non-classical 21-hydroxylase Deficiency

“…Such conditions usually include acute infections or cardiovascular events. It is, however, also well recognized that thyroid hormones accelerate glucocorticoid turnover, so that hyperthyroidism may increase glucocorticoid requirements in subjects on hydrocortisone replacement (11). We have seen a patient with unrecognized adrenocortical disease, in whom the development of Graves' hyperthyroidism caused an adrenal crisis.…”

Role of Glucocorticoids in Regulation of Iodine Metabolism in Thyroid Gland: Effects of Hyper-And Hypocorticism

“…These patients had an attenuated pituitary response to TRH administration and there was a negative correlation between plasma levels of TSH and cortisol (but not T3); after convalescence the reaction to TRH normalized [64]. There was a single case report on the development of Graves's disease characterized by pronounced hyperthyroidism after a successful surgical operation in a patient with Cushing's syndrome [65]. Authors suggest that suppression of hypercorticism activated latent autoimmune processes in the thyroid gland.…”