Alternating Hyperthyroidism and Hypothyroidism in Graves’ Disease: A Case Report and Literature Review  

作　　者：Alya Hassan Alhajjaj Maryam M. Al-Said Aqeelah H. Alkhatam Alya Hassan Alhajjaj;Maryam M. Al-Said;Aqeelah H. Alkhatam(Internal Medicine Department, Qatif Central Hospital, Qatif, KSA)

机构地区：[1]Internal Medicine Department, Qatif Central Hospital, Qatif, KSA

出　　处：《Case Reports in Clinical Medicine》2020年第12期361-367,共7页临床医学病理报告（英文）

摘　　要：<strong>Background:</strong> Alternating thyroid function between hypo- and hyperthyroidism is a very rare phenomenon attributed to the switch between the types of thyroid stimulating hormone receptor autoantibodies;thyroid stimulating antibody and thyroid stimulating hormone blocking antibody. <strong>Case Presentation:</strong> We report an 18 years old male who presented with hyperthyroidism attributed to Graves’ disease. He was treated with antithyroid medication. During follow up, his thyroid function was switching between hyper- and hypothyroidism which was difficult to treat with antithyroid medication. His laboratory investigations revealed high thyroid stimulating immunoglobulin and TSH binding inhibitory immunoglobulin. Due to the difficultly of managing him with antithyroid medication, he was offered a definitive management for his Graves’ disease. <strong>Conclusion:</strong> This case demonstrates a rare challenging presentation of Graves’ disease. Patients presenting with fluctuation in thyroid function between hyper-and hypothyroidism need a definitive management for Graves’ disease.<strong>Background:</strong> Alternating thyroid function between hypo- and hyperthyroidism is a very rare phenomenon attributed to the switch between the types of thyroid stimulating hormone receptor autoantibodies;thyroid stimulating antibody and thyroid stimulating hormone blocking antibody. <strong>Case Presentation:</strong> We report an 18 years old male who presented with hyperthyroidism attributed to Graves’ disease. He was treated with antithyroid medication. During follow up, his thyroid function was switching between hyper- and hypothyroidism which was difficult to treat with antithyroid medication. His laboratory investigations revealed high thyroid stimulating immunoglobulin and TSH binding inhibitory immunoglobulin. Due to the difficultly of managing him with antithyroid medication, he was offered a definitive management for his Graves’ disease. <strong>Conclusion:</strong> This case demonstrates a rare challenging presentation of Graves’ disease. Patients presenting with fluctuation in thyroid function between hyper-and hypothyroidism need a definitive management for Graves’ disease.

关 键 词：ALTERNATING HYPOTHYROIDISM HYPERTHYROIDISM GRAVES TSHR Stimulating BLOCKING 

分 类 号：R58[医药卫生—内分泌]