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Unilateral Graves’ Disease in a Bilobar Thyroid Gland: A Very Unusual Cause of Hyperthyroidism

Graves’ disease (GD) is an autoimmune condition that affects both thyroid gland lobes. Patients with GD with unilateral thyroid scan uptake are rare. These patients present with classic Graves’ symptoms, occasionally with Graves’ ophthalmopathy characteristics and increased thyroid hormones, and sci...

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Detalles Bibliográficos
Autores principales: Alaybaa, Khaled, Alhuzaim, Omar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580439/
https://www.ncbi.nlm.nih.gov/pubmed/37908571
http://dx.doi.org/10.1210/jcemcr/luad048
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author Alaybaa, Khaled
Alhuzaim, Omar
author_facet Alaybaa, Khaled
Alhuzaim, Omar
author_sort Alaybaa, Khaled
collection PubMed
description Graves’ disease (GD) is an autoimmune condition that affects both thyroid gland lobes. Patients with GD with unilateral thyroid scan uptake are rare. These patients present with classic Graves’ symptoms, occasionally with Graves’ ophthalmopathy characteristics and increased thyroid hormones, and scintigraphic assessment reveals radiotracer uptake in only 1 lobe of the thyroid gland. In this case, a 48-year-old female presented with symptoms and signs indicative of thyrotoxicosis. Laboratory results revealed that TSH was undetectable, whereas free thyroxine and free triiodothyronine were in the high-normal range. Positive results were observed for both thyroid-stimulating Ig and TSH receptor antibodies. Ultrasonography of the thyroid gland revealed an enlarged left lobe with heterogeneous echotexture and a hyperemic gland without any focal lesions, distinct nodules, or cysts. Thyroid scintigraphy revealed enlarged and increased radioisotope uptake in the left lobe and decreased uptake in the right lobe, with no hot or cold nodules. The most likely diagnosis was unilateral GD. The patient was administered carbimazole and within 8 weeks had improved clinically and biochemically.
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spelling pubmed-105804392023-10-31 Unilateral Graves’ Disease in a Bilobar Thyroid Gland: A Very Unusual Cause of Hyperthyroidism Alaybaa, Khaled Alhuzaim, Omar JCEM Case Rep Case Report Graves’ disease (GD) is an autoimmune condition that affects both thyroid gland lobes. Patients with GD with unilateral thyroid scan uptake are rare. These patients present with classic Graves’ symptoms, occasionally with Graves’ ophthalmopathy characteristics and increased thyroid hormones, and scintigraphic assessment reveals radiotracer uptake in only 1 lobe of the thyroid gland. In this case, a 48-year-old female presented with symptoms and signs indicative of thyrotoxicosis. Laboratory results revealed that TSH was undetectable, whereas free thyroxine and free triiodothyronine were in the high-normal range. Positive results were observed for both thyroid-stimulating Ig and TSH receptor antibodies. Ultrasonography of the thyroid gland revealed an enlarged left lobe with heterogeneous echotexture and a hyperemic gland without any focal lesions, distinct nodules, or cysts. Thyroid scintigraphy revealed enlarged and increased radioisotope uptake in the left lobe and decreased uptake in the right lobe, with no hot or cold nodules. The most likely diagnosis was unilateral GD. The patient was administered carbimazole and within 8 weeks had improved clinically and biochemically. Oxford University Press 2023-05-17 /pmc/articles/PMC10580439/ /pubmed/37908571 http://dx.doi.org/10.1210/jcemcr/luad048 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Alaybaa, Khaled
Alhuzaim, Omar
Unilateral Graves’ Disease in a Bilobar Thyroid Gland: A Very Unusual Cause of Hyperthyroidism
title Unilateral Graves’ Disease in a Bilobar Thyroid Gland: A Very Unusual Cause of Hyperthyroidism
title_full Unilateral Graves’ Disease in a Bilobar Thyroid Gland: A Very Unusual Cause of Hyperthyroidism
title_fullStr Unilateral Graves’ Disease in a Bilobar Thyroid Gland: A Very Unusual Cause of Hyperthyroidism
title_full_unstemmed Unilateral Graves’ Disease in a Bilobar Thyroid Gland: A Very Unusual Cause of Hyperthyroidism
title_short Unilateral Graves’ Disease in a Bilobar Thyroid Gland: A Very Unusual Cause of Hyperthyroidism
title_sort unilateral graves’ disease in a bilobar thyroid gland: a very unusual cause of hyperthyroidism
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580439/
https://www.ncbi.nlm.nih.gov/pubmed/37908571
http://dx.doi.org/10.1210/jcemcr/luad048
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